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Beresford CJ, Rahman M, Gray Y, Ramshaw S, Gelling L, Baron S, Dominey J. Embedding Public Involvement in a PhD Research Project With People Affected by Advanced Liver Disease. Health Expect 2024; 27:e14097. [PMID: 38864117 PMCID: PMC11167232 DOI: 10.1111/hex.14097] [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: 02/25/2024] [Revised: 05/06/2024] [Accepted: 05/21/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Liver disease is an increasing cause of morbidity and mortality in the United Kingdom and can be challenging to live with in the advanced stages. There has been little research exploring the healthcare experiences of UK individuals with decompensated disease when the liver cannot carry out its functions properly. A PhD research project was developed with people who have liver disease to explore care experiences in decompensated advanced liver disease. Public involvement (PI) is an essential aspect of meaningful health research, and this paper reports on the progression of our PI approach in this ongoing study. OBJECTIVE To embed PI throughout the research project to ensure that the study is meaningful to individuals with liver disease and the people who support them. METHODS The research adopts a Constructivist Grounded Theory methodology to develop a theory of care experience. Various PI approaches were considered in developing the PI strategy for this qualitative study. Initially, Embedded consultation was the preferred model, which has evolved to include aspects of collaboration and coproduction. A PI group was set up to oversee the project through the national public engagement website VOICE, and reflections on PI from three members of the group are included in this paper to illuminate the PI process. RESULTS Six individuals with liver disease and three carers from across the United Kingdom are part of an ongoing PI group. Their role includes commenting on the findings of the systematic literature review for this project and contributing to decisions about recruitment, data collection and data analysis. Additionally, they had a direct impact on changing the focus of the research. The PI group will continue involvement until the completion of the project. CONCLUSION Successfully embedding PI into doctoral research, as demonstrated in this project, requires commitment, planning and dedication to reciprocal working for the benefit of PI contributors as well as the research. This approach could be adopted by other postgraduate researchers. PATIENT OR PUBLIC CONTRIBUTION This project is overseen by the PI group, whose contribution is described throughout, including reflections from three PI group members.
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Affiliation(s)
- Cathy J. Beresford
- Department of Nursing Science, Faculty of Health & Social SciencesBournemouth UniversityBournemouthDorsetUK
| | | | | | | | - Leslie Gelling
- Department of Nursing Science, Faculty of Health & Social SciencesBournemouth UniversityBournemouthDorsetUK
| | - Sue Baron
- Department of Nursing Science, Faculty of Health & Social SciencesBournemouth UniversityBournemouthDorsetUK
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Nabil Y, Eldaw A, El-Shourbagy D, Ibrahim D, Alturkistani H, Alshahrani M, Farghaly M, AlMadhi S, Mansour R. Unmet Needs and Strategies to Promote Patient Engagement in the Arab World: Experts' Opinion. Cureus 2024; 16:e56804. [PMID: 38654792 PMCID: PMC11036113 DOI: 10.7759/cureus.56804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND The significance of patient engagement (PE) is widely acknowledged as a crucial element in fostering positive health outcomes, elevating care quality, and streamlining healthcare systems. Despite its recognized advantages, the level of patient engagement in Arab nations remains suboptimal. METHODS A high-level assembly was convened in Dubai with 11 distinguished patient advocates from diverse Arab countries. Their collective aim was to dissect the obstacles hindering patient engagement in the Arab world and propose pragmatic strategies to surmount them. First, a series of five open-ended, comprehensive questions were posed and thoroughly deliberated upon. Second, the barriers to patient engagement within the experts' respective communities were debated. A qualitative thematic analysis was conducted and two reports were generated by two independent researchers from the original meeting recordings. RESULTS This paper highlights the importance of patient engagement in advancing healthcare and categorizes barriers to patient engagement as patient-related, provider-related, or system/government-related. The experts identified the primary gaps in patient engagement and proposed strategies to promote it, with a primary focus on motivating both patients and providers toward shared decision-making. CONCLUSIONS This paper amalgamates the insights and recommendations distilled from the expert gathering, juxtaposing them within the broader context of existing literature on patient engagement. Offering a comprehensive viewpoint, this article delves into the challenges and opportunities intrinsic to bolstering patient engagement in the Arab world. Moreover, it spotlights invaluable tools often overlooked within Arab countries. The practical insights provided here can serve as a roadmap for administrators and decision-makers, providing guidance to enhance patient engagement on both a national and institutional scale.
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Affiliation(s)
- Yehia Nabil
- Medical Affairs, Gilead Sciences Inc., Dubai, ARE
| | - Anwar Eldaw
- Infectious Disease/Public Health and Preventive Medicine, Ministry of Health, Riyadh, SAU
| | | | - Dima Ibrahim
- Transplant Infectious Diseases, Burjeel Medical Center, Abu Dhabi, ARE
| | | | - Mohammed Alshahrani
- Pediatric Hematology/Oncology, Prince Sultan Military Medical City, Riyadh, SAU
| | - Mohamed Farghaly
- Family Medicine/Public Health, Dubai Medical College, Dubai, ARE
| | - Sawsan AlMadhi
- Advocacy, AlignnEficient Health Consultancies, Dubai, ARE
| | - Romy Mansour
- Ophthalmology, Lebanese American University Medical Center-Rizk Hospital, Beirut, LBN
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Gehrmann J, Eck S, Schneider A, Fischer F, Bruhn I, Teusen C. [Participation in primary care research - From the idea to the constitution of a citizens advisory board]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2024; 184:40-49. [PMID: 38220534 DOI: 10.1016/j.zefq.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 10/06/2023] [Accepted: 11/02/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Public participation in research processes is becoming increasingly important and is justified with positive effects for research. The first successful initiatives can also be found in general practice and health services research. The transparent presentation of these projects is essential to the discussion about participation. The aim of this article is to present and discuss the conception and implementation of the initiative at the Institute of General Practice and Health Services Research at the Technical University of Munich and the kick-off event for the participation of patients, citizens and patient representatives. METHODS This article reports the planning, recruitment, implementation, and evaluation of the kick-off event. Frameworks for future events are described. RESULTS In total, twelve persons were recruited through various recruitment channels to participate in the kick-off event. The participants showed a diverse structure of motives with regard to participation in research. All participants shared the essential goal of improving research and care by adding their perspectives to research processes. However, the specific opportunities for participation and the role of patients and citizens in research processes were unclear. During the event, future workshops were planned to address these challenges. The focus was on strengthening relationships and communicating the basics of primary care research in order to enable sustainable participation. DISCUSSION The participants' different motivations resulted in the need to explore the concrete possibilities of participation. One of the specific requirements was to focus on role identification and the structure of the initiative. The question of self-description and -identification as a patient and/or citizen seemed crucial. Furthermore, a concise introduction to the topic of participation in research processes, as well as patient and citizen qualifications, is considered necessary. CONCLUSION Establishing an advisory board for patients and citizens in primary care research is associated with specific requirements. In addition to fundamental necessities such as the joint clarification of the possibilities of participation, defining the role and establishing the identity of the initiative should be promoted.
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Affiliation(s)
- Jan Gehrmann
- Technische Universität München, TUM School of Medicine and Health, Department Clinical Medicine, Institut für Allgemeinmedizin und Versorgungsforschung, München, Deutschland; Technische Universität München, TUM School of Medicine and Health, Department Health and Sport Sciences, Lehrstuhl für Soziale Determinanten der Gesundheit, München, Deutschland
| | - Stefanie Eck
- Technische Universität München, TUM School of Medicine and Health, Department Clinical Medicine, Institut für Allgemeinmedizin und Versorgungsforschung, München, Deutschland.
| | - Antonius Schneider
- Technische Universität München, TUM School of Medicine and Health, Department Clinical Medicine, Institut für Allgemeinmedizin und Versorgungsforschung, München, Deutschland
| | - Florian Fischer
- Bürger*innenbeirat - Patient*innen und allgemeinmedizinische Forschung im Dialog, stellvertretend für den Bürger*innenbeirat des Instituts für Allgemeinmedizin und Versorgungsforschung der Technischen Universität München, München, Deutschland
| | - Isabella Bruhn
- Bürger*innenbeirat - Patient*innen und allgemeinmedizinische Forschung im Dialog, stellvertretend für den Bürger*innenbeirat des Instituts für Allgemeinmedizin und Versorgungsforschung der Technischen Universität München, München, Deutschland
| | - Clara Teusen
- Technische Universität München, TUM School of Medicine and Health, Department Clinical Medicine, Institut für Allgemeinmedizin und Versorgungsforschung, München, Deutschland; Graduate Program "PrädiktOren und Klinische Ergebnisse bei depressiven ErkrAnkungen in der hausärztLichen Versorgung (POKAL, DFG-GRK 2621)", München, Deutschland
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Scholz B, Kirk L, Warner T, O'Brien L, Kecskes Z, Mitchell I. From a Single Voice to Diversity: Reframing 'Representation' in Patient Engagement. QUALITATIVE HEALTH RESEARCH 2024:10497323231221674. [PMID: 38229426 DOI: 10.1177/10497323231221674] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
There has been a growing emphasis on consumer representation in the development of health policy, services, research, and education. Existing literature has critiqued how discourses of representativeness can disempower consumers working in health systems. The context of the current study is consumer engagement in the development of COVID-19 triage policy and practice in a local health service. Consumer engagement has often been an afterthought in the COVID response, with few examples of consumers in agenda-setting or decision-making roles. In the Australian Capital Territory, 26 consumer, carer, and community groups worked together with academics and clinicians to develop these principles. Interviews were conducted with stakeholders (including consumers, clinicians, and other health professionals) to evaluate the development of triage principles. A discursive psychological approach to analysis was used to explore participants' understandings about and constructions of consumers being representative (or not) and how this may reproduce power imbalances against consumers. The results explore two distinct ways in which participants talked about consumer representativeness: the first drawing on rhetoric about consumers as lay members of the public (as distinct from being professionally engaged in the health sector), and the second in terms of consumer representatives being diverse and having intersectional identities and experiences. Expectations about consumers to be representative of the general population may reproduce traditional power imbalances and silence lived experience expertise. These power imbalances may be challenged by a shift in the way representativeness is conceptualised to requiring health services to seek out diverse and intersectionally marginalised consumers.
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Affiliation(s)
- Brett Scholz
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Lucy Kirk
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Terri Warner
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Lauren O'Brien
- ACT Disability, Aged and Carer Advocacy Service, Canberra, ACT, Australia
| | - Zsuzsoka Kecskes
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Imogen Mitchell
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Canberra Health Services, Canberra, ACT, Australia
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Wang P, Li S, Wang Z, Jiao M, Zhang Y, Huang W, Ning N, Gao L, Shan L, Li Y, Wu Q. Perceptions of the benefits of the basic medical insurance system among the insured: a mixed methods research of a northern city in China. Front Public Health 2023; 11:1043153. [PMID: 37139382 PMCID: PMC10149763 DOI: 10.3389/fpubh.2023.1043153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Background The perceptions of the benefits of the basic medical insurance system among the insured not only reflect the system's performance but also the public's basic medical insurance policy literacy, valuable information for countries that have entered the stage of deepening reform. This study aims to examine the factors that affect the perceptions of the benefits of the basic medical insurance system in China, diagnose the key problems, and propose corresponding measures for improvement. Methods A mixed method design was used. Data for the quantitative study were obtained from a cross-sectional questionnaire survey (n = 1,045) of residents of Harbin who had enrolled for basic medical insurance system. A quota sampling method was further adopted. A multivariate logistic regression model was then employed to identify the factors influencing the perceptions of the benefits of the basic medical insurance system, followed by semi-structured interviews with 30 conveniently selected key informants. Interpretative phenomenological analysis was used to analyze the interview data. Results Approximately 44% of insured persons reported low perceptions of benefits. The logistic regression model showed that low perceptions of the benefits of the basic medical insurance system was positively correlated with the experience of daily drug purchases (OR = 1.967), perceptions of recognition with basic medical insurance system (OR = 1.948), perceptions of the financial burden of participation costs (OR = 1.887), perceptions of the convenience of using basic medical insurance for medical treatment (OR = 1.770), perceptions of the financial burden of daily drug purchases costs (OR = 1.721), perceptions of the financial burden of hospitalization costs (OR = 1.570), and type of basic medical insurance system (OR = 1.456). The results of the qualitative analysis showed that the key problem areas of perceptions of the benefits of the basic medical insurance system were: (I) system design of basic medical insurance; (II) intuitive cognition of the insured; (III) rational cognition of the insured; and (IV) the system environment. Conclusions Improving the perceptions of the benefits of the basic medical insurance system of the insured requires joint efforts in improving system design and implementation, exploring effective publicity methods of basic medical insurance system information, supporting public policy literacy, and promoting the health system environment.
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Affiliation(s)
- Peng Wang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
| | - Shuyi Li
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
| | - Zhizhen Wang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
| | - Mingli Jiao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Yuchao Zhang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
| | - Weiqi Huang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
| | - Ning Ning
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
| | - Lijun Gao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
| | - Linghan Shan
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
| | - Ye Li
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
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Bordarie J, Dieudonné M, Ledent M, Prignot N. A qualitative approach to experiential knowledge identified in focus groups aimed at co-designing a provocation test in the study of electrohypersensitivity. Ann Med 2022; 54:2363-2375. [PMID: 36135790 PMCID: PMC9518295 DOI: 10.1080/07853890.2022.2114605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Patients' experiential knowledge is increasingly recognised as valuable for biomedical research. Its contribution can reveal unexplored aspects of their illnesses and allows research priorities to be refined according to theirs. It can also be argued that patients' experiential knowledge can contribute to biomedical research, by extending it to the most organic aspects of diseases. A few examples of collaboration between medicine and patient associations are promising, even if there is no single, simple methodology to apply. This article provides feedback on a project involving the experiential knowledge of electrohypersensitive persons with a view to developing an experimental protocol to study their condition. It presents the participatory approach with focus groups that was implemented and reflects on ways to take advantage of experiential knowledge. It also demonstrates the complexity of the electrohypersensitivity syndrome and reflects on the difficult transition between the experiential knowledge and the experimental design of provocation studies.KEY MESSAGESExperiential knowledge is a valuable source of information for research and the design of investigation protocols.The participatory approach allows co-designing protocols by drawing on experiential knowledge.The controversial dimension of EHS reveals the complexity of translating experiential knowledge into an experimental protocol.
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Affiliation(s)
| | - Maël Dieudonné
- Pôle de Santé Publique, Hospices Civils de Lyon/Department of Public Health, University Hospital of Lyon; Centre Max Weber, Institut des Sciences de l'Homme, Lyon, France
| | - Maryse Ledent
- Sciensano, Risk and Health Impact Assessment, Bruxelles & Université Libre de Bruxelles, École de Santé Publique, Brussels, Belgique
| | - Nicolas Prignot
- Université Libre de Bruxelles, Groupe d'Études Constructivistes, Brussels, Belgique
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Lauzon-Schnittka J, Audette-Chapdelaine S, Boutin D, Wilhelmy C, Auger AM, Brodeur M. The experience of patient partners in research: a qualitative systematic review and thematic synthesis. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:55. [PMID: 36192817 PMCID: PMC9528123 DOI: 10.1186/s40900-022-00388-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 09/16/2022] [Indexed: 05/26/2023]
Abstract
CONTEXT Patient engagement in research consists in involving patients as partners across the research cycle. This practice has quickly become an international standard, with funding bodies actively encouraging it. As the increased incentive to engage patients can lead to tokenistic partnerships, it is important to consider the experiences of patient-partners. OBJECTIVE To synthesize the qualitative literature on the experience of patients as partners in research. DESIGN A systematic review of the literature with thematic synthesis was realized, guided by the framework developed by Thomas and Harden (Bmc Med Res Methodol 8: 45, 2008). DATA COLLECTION A search strategy was developed to encompass keywords relating to patient-partners in research, their experience, and the qualitative nature of the target studies. 10 databases were searched using the EBSCO-host engine, along with the Scopus engine to include EMBASE. The search results were screened for the following inclusion criteria: articles written in English; articles reporting on the experience of patient-partners in research; qualitative studies or mixed-methods studies with a distinct qualitative section. ANALYSIS Included articles were charted for general information. The CASP qualitative checklist was used for critical appraisal. The "results" section of each article was coded line by line. Codes were aggregated inductively to form descriptive themes and analytical themes, in order to synthesize the ideas found in the selection of articles. RESULTS The initial search yielded 10,222 results. After the removal of duplicates, 5534 titles and abstracts were screened, 88 full-text reports were evaluated, and 41 studies were included. Articles reporting on these studies were published between 2005 and 2020. Seven themes emerged from the analysis: "motivations to engage in research", "activities in patient engagement", "structure", "competence", "team dynamics", "impacts on broader life", and "illness". Articles reported varying degrees of perceived impact on research and satisfaction concerning the level of engagement. The importance of power differentials and team dynamics were widely stated. CONCLUSIONS Findings provide an in-depth view of the experiences of patient-partners in research. Most articles reported a generally positive experience, but challenges and pitfalls of patient engagement were identified. This will serve research teams by highlighting good practices and possible improvements.
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Affiliation(s)
| | - Sophie Audette-Chapdelaine
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Médecine Familiale et de Médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Denis Boutin
- Comité Stratégique Patient-Partenaire, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Catherine Wilhelmy
- Comité Stratégique Patient-Partenaire, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Anne-Marie Auger
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Médecine Familiale et de Médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Magaly Brodeur
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Département de Médecine Familiale et de Médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada.
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Carter B, Young R, Munro J. “Communicating Lily’s Pain”: A reflective narrative commentary about co‐creating a resource to provoke thinking and change about assessing and managing the pain of children with profound cognitive impairment. PAEDIATRIC AND NEONATAL PAIN 2022; 4:4-11. [PMID: 35546912 PMCID: PMC8975188 DOI: 10.1002/pne2.12074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 12/09/2021] [Accepted: 01/24/2022] [Indexed: 11/24/2022]
Abstract
This paper draws together about 20 years of research work and discovery and the development of a resource about pain assessment and management in children with profound cognitive impairment. The animation tells the story of an imagined child called Lily and the skills her mother uses and the challenges that her mother faces in assessing and managing Lily's pain. The animation is built on stories drawn from qualitative research findings, conversations while in clinical practice and with members of the general public, parent advisers and other sources. Most of the “evidence” came from stories shared by parents and healthcare professionals. This paper draws on some elements of socio‐narratology and is predicated on the basis that stories are important and they can act on and with us. By using an animation to tell Lily's story, the intention was to communicate research findings to a wider and more diverse audience than the typical readership of an academic journal. The intention was to act in and on people's consciousness about children's pain and to strengthen relationships and create bonds between clinicians, parents, and children in pain to make their dialog more social, connected, and meaningful. All three of us—the researcher, the writer, and the animator—have been marked and “re‐shaped” by our work related to creating Lily; we have learned more about children like Lily and their mothers, and we have learned more about ourselves and our humanity. This animation is still a story in progress, a story ‘in the wild’, a story (and a resource) we would like you to re‐tell and share. The story of Lily's pain aimed to change the lives of parents and children and professionals. Our hope is that you can be part of that change.
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Affiliation(s)
- Bernie Carter
- Faculty of Health, Social Care and Medicine Edge Hill University Ormskirk UK
| | - Rob Young
- Faculty Associate at NHS Research & Development North West Salford UK
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Koren Solvang P, Sveen U, Søberg HL. User involvement in the making: Positions and types of knowledge enacted in the interaction between service users and researchers in user panel meetings. Health Expect 2021; 24:1424-1432. [PMID: 34048617 PMCID: PMC8369089 DOI: 10.1111/hex.13281] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/18/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Numerous studies of user involvement in research have been conducted. However, there is a lack of studies applying observational methods and addressing the concrete practice of involvement. OBJECTIVE To determine what knowledge types and competences users apply when involved in the research process through user panel meetings. DESIGN User panel meetings in a qualitative project in rehabilitation were sound-recorded and transcribed verbatim. Data analysis applied an abductive approach framed by positioning theory. SETTING AND PARTICIPANTS Six rehabilitation service users and a similar number of researchers met 20 times during a six-year project period. They discussed various issues in the research process such as interview guides, analysis and dissemination of results. FINDINGS The service users combined their respective knowledge and competence into six positions enacted in the panel interactions. They engaged as co-researchers, based their contributions on their respective personal histories, represented an NGO and peers, applied their respective professional and educational backgrounds and, finally, engaged as concerned citizens. DISCUSSION AND CONCLUSION The findings add to the discussion of professionalization of user involvement by introducing a wider array of positions enacted than do the findings of previous studies. Researchers recruiting user panel members, as well as NGOs appointing candidates for user panels, are advised to consider a wide competence profile for possible candidates. A panel is also considered as a resource in confirming and elaborating on a study's findings. PATIENT AND PUBLIC CONTRIBUTION A service user panel contributed to the study.
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Affiliation(s)
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and OrthoticsOslo Metropolitan UniversityOsloNorway
- Department of Physical Medicine & RehabilitationOslo University HospitalOsloNorway
| | - Helene Lundgaard Søberg
- Department of PhysiotherapyOslo Metropolitan UniversityOsloNorway
- Department of Physical Medicine & RehabilitationOslo University HospitalOsloNorway
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Weicker NP, Whaley S, Urquhart G, Park JN, Sherman SG, Owczarzak J. "I Know It Is Going to Ruin Their Life:" Fortune-Telling, Agency, and Harm Reduction in Narratives Concerning Injection Initiation Assistance. Subst Use Misuse 2021; 56:1860-1868. [PMID: 34348070 DOI: 10.1080/10826084.2021.1958854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Considering most people who inject drugs (PWID) received help with the first injection, understanding the perspective of potential 'initiators' is a priority to inform harm reduction interventions. This paper examines how PWID narrate their experiences with injection initiation and assistance from the lens of their lived experience and perceptions of harm reduction. METHODS In-depth interviews were conducted with individuals who reported injection drug use and recent (past 30 days) opioid use in Baltimore (N = 19) and Anne Arundel County (N = 4), Maryland and analyzed using a narrative approach. RESULTS Respondents cast initiation events as meaningful transitions to a life characterized by predictable harms, including homelessness, infections, and social stigma. Respondents used examples from their personal experience to explain experiences with initiation and assistance by strategically attributing personal agency and predicting specific injection-related harms for initiates. In their narratives, respondents balanced notions of individual agency with harm reduction intentions by distinguishing between two forms of harm: perceived inevitable distal harm caused by long-term injection (e.g. socioeconomic decline) and potentially avoidable proximal harm caused by risky injection practices (e.g. overdose, HIV). CONCLUSIONS These findings highlight opportunities for interventions targeting injection initiation events and support the implementation of safer injection training in interventions. This identity of the 'responsible drug user' could be leveraged to support employing peers to help mitigate harm among inexperienced PWID either through peer outreach or formal venues, such as overdose prevention sites.
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Affiliation(s)
- Noelle P Weicker
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sara Whaley
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Glenna Urquhart
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ju Nyeong Park
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Susan G Sherman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jill Owczarzak
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Reynolds J, Ogden M, Beresford R. Conceptualising and constructing 'diversity' through experiences of public and patient involvement in health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:53. [PMID: 34294162 PMCID: PMC8295976 DOI: 10.1186/s40900-021-00296-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/05/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Increasing the accessibility of public and patient involvement (PPI) in health research for people from diverse backgrounds is important for ensuring all voices are heard and represented. Critiques of PPI being dominated by 'the usual suspects' reflect concerns over the barriers to involvement in PPI faced by people from minority groups or non-professional backgrounds. Yet, what has received less attention is how undertaking PPI work might produce diverse experiences, potentially shaping the motivation and capacity of people from different backgrounds to continue in PPI. METHODS We conducted qualitative research to explore experiences of the health research PPI field in the UK and to understand how these might shape the accessibility of PPI for people of diverse backgrounds. We conducted in-depth and follow-up interviews with five PPI contributors with experience of multiple health research projects, and a focus group with nine people in professional roles relating to PPI. Interview data were analysed using a narrative approach, and then combined with the focus group data for thematic analysis. RESULTS The structure, organisation and relationships of health research in the UK all shape PPI experiences in ways that can intersect the different backgrounds and identities of contributors, and can pose barriers to involvement and motivation for some. Navigating processes for claiming expenses can be frustrating particularly for people from lower-income backgrounds or with additional needs, and short-term research can undermine relationships of trust between contributors and professionals. Pressure on PPI coordinators to find 'more diverse' contributors can also undermine ongoing relationships with contributors, and how their inputs are valued. CONCLUSIONS To increase diversity within PPI, and to ensure that people of different backgrounds are supported and motivated to continue in PPI, changes are needed in the wider health research infrastructure in the UK. More resources are required to support relationships of trust over time between contributors and professionals, and to ensure the unique circumstances of each contributor are accommodated within and across PPI roles. Finally, critical reflection on the pressure in PPI to seek 'more diverse' contributors is needed, to understand the impacts of this on those already involved.
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Affiliation(s)
- Joanna Reynolds
- Department of Psychology, Sociology & Politics, Sheffield Hallam University, Heart of the Campus, Collegiate Crescent, Sheffield, S10 2BP, UK.
| | | | - Ruth Beresford
- Department of Psychology, Sociology & Politics, Sheffield Hallam University, Heart of the Campus, Collegiate Crescent, Sheffield, S10 2BP, UK
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