1
|
Cruz M, Durães MI, Azevedo P, Carvalhal C, Pinho S, Sampaio R. Perspectives on Creating a Chronic Pain Support Line in Portugal: Results of a Focus Group Study among Patients and Healthcare Professionals. J Clin Med 2024; 13:5207. [PMID: 39274420 PMCID: PMC11396648 DOI: 10.3390/jcm13175207] [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: 08/01/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 09/16/2024] Open
Abstract
Background: Chronic pain (CP) patients frequently feel misunderstood and experience a lack of support. This led to the creation of support telephone lines in some countries. However, there is no scientific data grounding their development or evaluating their performance. Almost 37% of the Portuguese adult population suffers from CP, with great costs for patients and the healthcare system. Methods: To determine the viability of a support line for CP in Portugal, a qualitative study was designed, and online focus group meetings, with patients and healthcare professionals, were conducted. Their perspectives, beliefs, and expectations were evaluated and described. Results: This study revealed that a CP support line is a feasible project from the participants' perspective if its interventions are limited to active listening, emotional support, and tailored suggestions. Conclusions: It has the potential to generate a positive impact on healthcare services, while also contributing to greater equity of access to support.
Collapse
Affiliation(s)
- Mariana Cruz
- Department of Biomedicine, Faculty of Medicine of University of Porto, Portugal Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Centro Hospitalar Universitário de Coimbra, Praceta Prof. Mota Pinto, 3004-561 Coimbra, Portugal
| | - Maria Inês Durães
- Administração Regional de Saúde do Norte, R. de Santa Catarina 1288, 4000-477 Porto, Portugal
| | - Patrícia Azevedo
- Administração Regional de Saúde do Norte, R. de Santa Catarina 1288, 4000-477 Porto, Portugal
| | - Célia Carvalhal
- Administração Regional de Saúde do Norte, R. de Santa Catarina 1288, 4000-477 Porto, Portugal
| | - Simão Pinho
- Department of Biomedicine, Faculty of Medicine of University of Porto, Portugal Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Centro Hospitalar Tondela Viseu, Av. Rei Dom Duarte, 3504-509 Viseu, Portugal
| | - Rute Sampaio
- Department of Biomedicine, Faculty of Medicine of University of Porto, Portugal Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- CINTESIS@RISE, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| |
Collapse
|
2
|
Rashid NSA, Mohamad Marzuki MF, Abdullah NN, Mohamad M, Takshe AA, Mohd Yunus R, Chen XW. Supporting caregivers of people with dementia: insights from Demensia KITA mobile application online content development. Sci Rep 2024; 14:19302. [PMID: 39164373 PMCID: PMC11336210 DOI: 10.1038/s41598-024-69947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 08/12/2024] [Indexed: 08/22/2024] Open
Abstract
Dementia significantly impacts caregivers, particularly in low and middle-income countries where support is often inadequate. Given the gap in affordable and culturally relevant digital resources for Malaysian dementia caregivers, we developed "Demensia KITA," a mobile application (app) specifically tailored to their needs. This study utilized a theoretical framework proposed from existing literature and the "Model of Carer Stress and Burden". This paper discusses our app content development, highlighting key findings and challenges. To assess caregivers' needs, the Nominal Group Technique (NGT) with five dementia caregivers was conducted, followed by a Focus Group Discussion (FGD) with eight medical professionals. Both sessions were conducted online via Google Meet. In the NGT, ideas were generated, organized, prioritized, reviewed, and refined by medical professionals in the FGD. Content relevant to addressing the complexities of dementia caregiving was then discussed. Topics were either adapted from established modules or newly developed from credible sources. Subsequently, these were organized into modules and themes, and subsequently underwent expert validation. From the NGT, three key domains emerged: Knowledge, Services, and Support. These were further organized into two modules: 'Patient Care for Caregivers' and 'Caregiver Wellbeing'. Within these, twelve sub-modules were identified, covering a range of topics including basic knowledge on dementia, patient care, nutritional management, oral and dental care, simple exercises, daily activity and memory rehabilitation, service directories, support groups, emotional and stress management, welfare assistance, and daily motivation. This framework was developed to address the specific needs of dementia caregivers in terms of psychoeducation, psychosocial and caregiving skills, incorporating expert opinions in the field. This study corroborates the feasibility of online methods for mobile health app content development and encourages similar research. Future studies should evaluate Demensia KITA's effectiveness in alleviating caregiver burden across all regions, assess users' acceptance, and ensure it meets the evolving needs of Malaysian caregivers with regular updates.
Collapse
Affiliation(s)
- Nurul Syaireen A Rashid
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
- Training Management Division, Ministry of Health, Menara Prisma Aras 6, Persiaran Perdana, Persint 3, 62675, Wilayah Persekutuan Putrajaya, Malaysia
| | - Muhamad Fadhil Mohamad Marzuki
- Kedah State Health Department, Ministry of Health Malaysia, Simpang Kuala, Jalan Kuala Kedah, 05400, Alor Setar, Kedah, Malaysia
| | - Nik Nairan Abdullah
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Mariam Mohamad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Aseel A Takshe
- Department Public Health, Faculty of Communication, Arts and Sciences, Canadian University Dubai, Al Safa Street-Al Wasi City Walk Mall, P.O. Box 17781, Dubai, United Arab Emirates
| | - Raudah Mohd Yunus
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Xin Wee Chen
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia.
| |
Collapse
|
3
|
Gray M, Cooke A, Livingston CJ, LaForge K, Flores DP, Choo EK. "It Has Improved My Practice to Be Able to Offer Alternative Treatments": A Longitudinal Qualitative Study of Oregon Medicaid Back Pain Providers. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 38976502 DOI: 10.1089/jicm.2023.0743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Introduction: This study aimed to understand health care providers' experiences implementing the Oregon Back Pain Policy (OBPP) over time. The Medicaid OBPP expanded coverage of evidence-based nonpharmacological therapy (NPT) for back pain and restricted access to opioid therapy and interventional approaches. Methods: The study included six online, asynchronous focus groups with providers in February 2020 (Time 1) and August 2022 (Time 2). Analysis was conducted with a longitudinal, recurrent cross-sectional approach. Analysis occurred in three stages: (1) An immersion/crystallization approach was used to analyze Time 1 focus group data, (2) reflexive thematic analysis was used to analyze Time 2 data, and (3) longitudinal analysis was used to integrate the findings across time points. Results: At Time 1, 48 clinicians and 44 NPT providers participated in the study. Time 2 included 63 clinicians and 59 NPT providers. The longitudinal analysis of the focus group data resulted in four themes: (1) general awareness of the policy, (2) providers support the policy and perceive a benefit to their patients, (3) barriers to NPT accessibility, and (4) barriers to referring patients to NPT. Conclusion: The goal of the OBPP was to improve back pain care for Oregon Medicaid members by increasing access to evidence-based NPT and decreasing reliance on opioid medications. This study revealed that, although clinicians and NPT providers supported the policy, they faced persistent implementation challenges related to referrals, prior authorizations, coverage limitations, low reimbursement rates, and a reduced workforce for NPT providers. In some cases, implementation barriers were removed during the COVID-19 pandemic, but other challenges were more prominent during the pandemic.
Collapse
Affiliation(s)
| | | | | | - Kate LaForge
- Department of Social and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Esther K Choo
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, OR Health & Science University, Portland, OR, USA
| |
Collapse
|
4
|
Schøler PN, Søndergaard J, Rasmussen S, Nielsen AS. Adjusting the 15-method to Danish general practice: identification of barriers, facilitators, and user needs. BMC PRIMARY CARE 2024; 25:248. [PMID: 38971738 PMCID: PMC11227717 DOI: 10.1186/s12875-024-02508-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND The 15-method is an opportunistic screening and brief intervention tool for alcohol-related problems in primary healthcare. A Danish feasibility study of the 15-method indicated that adjustments were needed to improve its contextual fit to Danish general practice. This adjustment process was conducted in two parts. The first part focused on identifying barriers, facilitators, and user needs for addressing alcohol using the 15-method. The second part will address the identified barriers and user needs to finalize a Danish version of the method. This study reports on part one of the adjustment process. METHODS Semi-structured individual interviews and focus group interviews with healthcare professionals (n = 8) and patients (n = 5) from general practice in Denmark. Data analysis was conducted using thematic content analysis. The results were condensed into two focus areas that will form the basis for user workshops in part two of the adjustment process. RESULTS The main barriers for addressing alcohol using the 15-method were patients and healthcare professionals not having the same agenda, having difficulty opening a conversation on alcohol, and workflow in the practices. Main facilitators included high interpersonal skills, taking the patient's perspective, and good routines and interdisciplinary work. Suggested adjustments and additions to the method included digitalization, visual icebreakers, quotes and examples, and development of a quick guide. The identified focus areas for user workshops were Communication and Material, and Integration to Workflows. CONCLUSION Healthcare professionals found the opportunistic screening approach exemplified by the 15-method to be beneficial in identifying and addressing alcohol-related problems. They appreciate the method's structured framework that assists in presenting treatment options. Identified adjustment areas to the 15-method will lay the groundwork for future efforts to develop a finalized Danish version of the 15-method.
Collapse
Affiliation(s)
- Peter Næsborg Schøler
- Unit for Clinical Alcohol Research, Research Unit of Psychiatry, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
- Research Unit of General Practice Odense and Esbjerg, Department of Public Health, University of Southern Denmark, Odense, Denmark.
- Department of Psychiatry Odense, Mental Health Services Region of Southern Denmark, Odense, Denmark.
| | - Jens Søndergaard
- Research Unit of General Practice Odense and Esbjerg, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sanne Rasmussen
- Research Unit of General Practice Odense and Esbjerg, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit for Clinical Alcohol Research, Research Unit of Psychiatry, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- BRIDGE, Brain Research - Inter Disciplinary Guided Excellence, University of Southern Denmark, Odense, Denmark
- Department of Psychiatry Odense, Mental Health Services Region of Southern Denmark, Odense, Denmark
| |
Collapse
|
5
|
Andreou V, Peters S, Eggermont J, Schoenmakers B. A needs assessment for enhancing workplace-based assessment: a grounded theory study. BMC MEDICAL EDUCATION 2024; 24:659. [PMID: 38872142 DOI: 10.1186/s12909-024-05636-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Workplace-based assessment (WBA) has been vigorously criticized for not fulfilling its educational purpose by medical educators. A comprehensive exploration of stakeholders' needs regarding WBA is essential to optimize its implementation in clinical practice. METHOD Three homogeneous focus groups were conducted with three groups of stakeholders: General Practitioner (GP) trainees, GP trainers, and GP tutors. Due to COVID-19 measures, we opted for an online asynchronous form to enable participation. An constructivist grounded theory approach was used to employ this study and allow the identification of stakeholders' needs for using WBA. RESULTS Three core needs for WBA were identified in the analysis. Within GP Training, stakeholders found WBA essential, primarily, for establishing learning goals, secondarily, for assessment purposes, and, lastly, for providing or receiving feedback. CONCLUSION All stakeholders perceive WBA as valuable when it fosters learning. The identified needs were notably influenced by agency, trust, availability, and mutual understanding. These were facilitating factors influencing needs for WBA. Embracing these insights can significantly illuminate the landscape of workplace learning culture for clinical educators and guide a successful implementation of WBA.
Collapse
Affiliation(s)
- Vasiliki Andreou
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Sanne Peters
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Jan Eggermont
- Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Birgitte Schoenmakers
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| |
Collapse
|
6
|
Hollaar VRY, Naumann E, Haverkort EB, Jerković-Ćosić K, Kok WE, Schueren MAEDVD. Success factors and barriers in interprofessional collaboration between dental hygienists and dietitians in community-dwelling older people: Focus group interviews. Int J Dent Hyg 2024; 22:321-328. [PMID: 37845813 DOI: 10.1111/idh.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/17/2023] [Accepted: 09/19/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION Poor nutritional status can impair oral health while poor oral health can influence the individual's dietary intake, which may result in malnutrition. This interaction between nutritional status and oral health in older age requires attention, coordination and collaboration between healthcare professionals. This qualitative study explores dental hygienists' and dietitians' opinions about current collaboration with the aim of identifying success factors and barriers to this interprofessional collaboration. METHODS Three focus group interviews were held with Dutch dental hygienists and dietitians about nutritional and oral healthcare in community-dwelling older people. RESULTS In total, 9 dietitians and 11 dental hygienists participated in three online focus group interviews. Dental hygienists and dietitians seldom collaborated or consulted with each other. They struggled with the professional boundaries of their field of expertise and experienced limited knowledge about the scope of practice of the other profession, resulting in conflicting information to patients about nutrition and oral health. Interprofessional education was scarce during their professional training. Organizational and network obstacles to collaborate were recognized, such as limitations in time, reimbursement and their professional network that often does not include a dietitian or dental hygienist. CONCLUSION Dental hygienists and dietitians do not collaborate or consult each other about (mal)nutrition or oral health in community-dwelling older people. To establish interprofessional collaboration, they need to gain knowledge and skills about nutrition and oral health to effectively recognize problems in nutritional status and oral health. Interprofessional education for healthcare professionals is needed to stimulate interprofessional collaboration to improve care for older people.
Collapse
Affiliation(s)
- Vanessa R Y Hollaar
- Research Group Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Elke Naumann
- Research Group Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Elizabeth B Haverkort
- Research Group Innovations in Preventive Health Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Katarina Jerković-Ćosić
- Research Group Innovations in Preventive Health Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Wilhelmina E Kok
- Research Group Innovations in Preventive Health Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Marian A E de van der Schueren
- Research Group Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| |
Collapse
|
7
|
Irwin AN, Gray M, Ventricelli D, Boggis JS, Bratberg J, Floyd AS, Silcox J, Hartung DM, Green TC. "I go out of my way to give them an extra smile now:" A study of pharmacists who participated in Respond to Prevent, a community pharmacy intervention to accelerate provision of harm reduction materials. Res Social Adm Pharm 2024; 20:512-519. [PMID: 38395644 PMCID: PMC10981567 DOI: 10.1016/j.sapharm.2024.02.001] [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: 10/20/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Community pharmacies are well-positioned to improve the health of people with opioid use disorder and who use drugs by providing naloxone and other essential public health supplies. Respond to Prevent (R2P) is a clinical trial which sought to accelerate provision of harm reduction materials through a multicomponent intervention that included in-store materials, online training, and academic detailing. OBJECTIVES The objective of this study was to explore pharmacists' attitudes, knowledge, and experiences in providing naloxone, dispensing buprenorphine, and selling nonprescription syringes following participation in the R2P program. METHODS Two online asynchronous focus groups were conducted with community-based chain pharmacists across Massachusetts, New Hampshire, Oregon, and Washington who had participated in the R2P program. Participants accessed an online repository of group interview items and responded to questions over a short period. Each pharmacist participated anonymously for approximately 30 min over 2 ½ days. Pharmacists answered questions on experiences with pharmacy-based harm reduction care and R2P intervention implementation barriers and facilitators. Qualitative data analysis was conducted by a multidisciplinary team using an immersion-crystallization approach. RESULTS A total of 32 pharmacists participated in the two focus groups. Most participants were female (n = 18, 56%), non-Hispanic (n = 29, 91%), and white (n = 17, 53%). Four major themes were identified related to (1) addressing bias and stigma toward people with opioid use disorder and who use drugs, (2) familiarity and comfort with naloxone provision, (3) perspective and practice shifts in nonprescription syringe sales, (4) structural challenges to harm reduction care in the pharmacy. CONCLUSIONS Community pharmacists across the four states identified attitudes, knowledge, and experiences that create barriers to providing care to people with opioid use disorder and who use drugs. R2P approaches and tools were effective at reducing stigma and changing attitudes but were less effective at addressing structural challenges from the pharmacists' perspective.
Collapse
Affiliation(s)
- Adriane N Irwin
- Department of Pharmacy Practice, Oregon State University College of Pharmacy, Corvallis, OR, USA
| | | | - Daniel Ventricelli
- Indivior, Inc., North Chesterfield, VA, USA; Department of Clinical Pharmacy, Philadelphia College of Pharmacy at University of the Sciences, Philadelphia, PA, USA
| | - Jesse S Boggis
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA; Opioid Policy Research Collaborative, Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA
| | - Jeffrey Bratberg
- Department of Pharmacy Practice and Clinical Research, University of Rhode Island College of Pharmacy, Kingston, RI, USA
| | - Anthony S Floyd
- Department of Psychiatry and Behavioral Sciences, Addictions, Drug & Alcohol Institute, University of Washington School of Medicine, Seattle, WA, USA
| | - Joseph Silcox
- Opioid Policy Research Collaborative, Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; Department of Sociology, University of Massachusetts, Boston, MA, USA
| | - Daniel M Hartung
- Department of Pharmacy Practice, Oregon State University College of Pharmacy, Corvallis, OR, USA
| | - Traci C Green
- Opioid Policy Research Collaborative, Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; Departments of Emergency Medicine and Epidemiology, Brown Schools of Medicine and Public Health, Providence, RI, USA.
| |
Collapse
|
8
|
Baudoin F, Hogeveen H, Wauters E. Participatory identification of the causes of antimicrobial use and how they may vary according to differences in sector structure: The case of the Flemish pork and veal sectors. Prev Vet Med 2024; 224:106099. [PMID: 38241899 DOI: 10.1016/j.prevetmed.2023.106099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/13/2023] [Accepted: 12/16/2023] [Indexed: 01/21/2024]
Abstract
The increasing threat of antimicrobial resistance (AMR) to human health has prompted many countries to adopt national action plans to reduce antimicrobial use (AMU) in farm animals. To achieve this goal, it is necessary to gain a deeper understanding of the factors driving AMU in farm animals. While previous research has focused on gaining a better understanding of AMU from the perspective of farmers and veterinarians, less emphasis has been placed on examining the systemic and contextual factors that influence AMU from multiple viewpoints within the food supply chain. To this end, this paper describes a participatory approach involving multiple stakeholders from two distinct livestock sectors to identify the underlying drivers of AMU and explore their case-specificity. For each sector, we identified causes of AMU during four online focus groups, by co-creating a "problem tree", which resulted in the identification of over 50 technical, economic, regulatory, and sociocultural causes per sector and exploration of causal links. Following this, we analysed the focus group discussion through a content analysis and clustered causes of AMU that were related into 17 categories (i.e. main drivers of AMU), that we then classified as drivers of AMU at sector level or drivers of AMU at farm level. Finally, we compared the two sectors by assessing whether the generated categories (i.e. main drivers for AMU) had been discussed for both sectors and, if so, whether they involved the same causes and had the same implications. Through our analysis, we gained a better understanding of several main drivers of AMU at sector level, that result from systemic and/or contextual causes. As these cannot always be addressed by farmers and/or their veterinarian, we suggest that interventions should also target other actors related to these causes or consider them to help implement certain strategies. Furthermore, based on the results of our comparative analysis, we suggest that systemic structural differences, such as size and level of supply chain integration/fragmentation, may lead to differences in how animal health management is approached. This in turn may influence AMU's decision-making and the effectiveness of interventions, if they are generic and not tailored to the specificities of the sector.
Collapse
Affiliation(s)
- Fanny Baudoin
- Business Economics, Department of Social Sciences, Wageningen University and Research, Wageningen, the Netherlands.
| | - Henk Hogeveen
- Business Economics, Department of Social Sciences, Wageningen University and Research, Wageningen, the Netherlands.
| | - Erwin Wauters
- Social Sciences Unit, Flanders Research Institute for Agriculture, Fisheries and Food, Merelbeke, Belgium.
| |
Collapse
|
9
|
Fleischmann-Struzek C, Rose N, Ditscheid B, Draeger L, Dröge P, Freytag A, Goldhahn L, Kannengießer L, Kimmig A, Matthäus-Krämer C, Ruhnke T, Reinhart K, Schlattmann P, Schmidt K, Storch J, Ulbrich R, Ullmann S, Wedekind L, Swart E. Understanding health care pathways of patients with sepsis: protocol of a mixed-methods analysis of health care utilization, experiences, and needs of patients with and after sepsis. BMC Health Serv Res 2024; 24:40. [PMID: 38191398 PMCID: PMC10773042 DOI: 10.1186/s12913-023-10509-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Sepsis is associated with about 20% of deaths worldwide. It often presents with non-specific initial symptoms, making its emergency treatment an interdisciplinary and cross-sectoral challenge. Three in four sepsis survivors suffers from new cognitive, psychological, or physical sequelae for which specific treatment concepts are scarce. The AVENIR project aims to improve the understanding of patient pathways, and subjective care experiences and needs along the entire healthcare pathway before, with and after sepsis. Based on this, concrete recommendations for the organization of care and patient information materials will be developed with close patient participation. METHODS Mixed-methods study including (1) analysis of anonymized nationwide health claims data from Germany, (2) linkage of health claims data with patient care reports (PCR) of emergency medical services from study regions in two federal states within Germany, and (3) qualitative exploration of the patient, relative, and care provider perspective on sepsis care. In (1), we analyze inpatient and outpatient health care utilization until 30 days pre-sepsis; clinical sepsis care including intra- and inter-hospital transfers; and rehabilitation, inpatient and outpatient aftercare of sepsis survivors as well as costs for health care utilization until 24 months post-sepsis. We attempt to identify survivor classes with similar health care utilization by Latent Class Analyses. In (2), PCR are linked with health claims data to establish a comprehensive database outlining care pathways for sepsis patients from pre-hospital to follow-up. We investigate e.g., whether correct initial assessment is associated with acute (e.g., same-day lethality) and long-term (e.g., new need for care, long-term mortality) outcomes of patients. We compare the performance of sepsis-specific screening tools such as qSOFA, NEWS-2 or PRESEP in the pre-clinical setting. In (3), semi-structured interviews as well as synchronous and asynchronous online focus groups are conducted and analyzed using qualitative content analyses techniques. DISCUSSION The results of the AVENIR study will contribute to a deeper understanding of sepsis care pathways in Germany. They may serve as a base for improvements and innovations in sepsis care, that in the long-term can contribute to reduce the personal, medical, and societal burden of sepsis and its sepsis sequelae. TRIAL REGISTRATION Registered at German Clinical Trial Register (ID: DRKS00031302, date of registration: 5th May 2023).
Collapse
Affiliation(s)
- Carolin Fleischmann-Struzek
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, Stoystraße 3, 07743, Jena, Germany.
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany.
| | - Norman Rose
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, Stoystraße 3, 07743, Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - Bianka Ditscheid
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | - Lea Draeger
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | | | - Antje Freytag
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | - Ludwig Goldhahn
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto-Von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Lena Kannengießer
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto-Von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Aurelia Kimmig
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, Stoystraße 3, 07743, Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - Claudia Matthäus-Krämer
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, Stoystraße 3, 07743, Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | | | - Konrad Reinhart
- Sepsis Foundation, Berlin, Germany
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité University Medicine Berlin, Berlin, Germany
| | - Peter Schlattmann
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - Konrad Schmidt
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
- Institute of General Practice and Family Medicine, Charité University Medicine Berlin, Berlin, Germany
| | - Josephine Storch
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | - Ruben Ulbrich
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto-Von-Guericke-University Magdeburg, Magdeburg, Germany
| | | | - Lisa Wedekind
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - Enno Swart
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto-Von-Guericke-University Magdeburg, Magdeburg, Germany
| |
Collapse
|
10
|
Thornton C, Lanyi K, Wilkins G, Potter R, Hunter E, Kolehmainen N, Pearson F. Scoping the Priorities and Concerns of Parents: Infodemiology Study of Posts on Mumsnet and Reddit. J Med Internet Res 2023; 25:e47849. [PMID: 38015600 PMCID: PMC10716753 DOI: 10.2196/47849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Health technology innovation is increasingly supported by a bottom-up approach to priority setting, aiming to better reflect the concerns of its intended beneficiaries. Web-based forums provide parents with an outlet to share concerns, advice, and information related to parenting and the health and well-being of their children. They provide a rich source of data on parenting concerns and priorities that could inform future child health research and innovation. OBJECTIVE The aim of the study is to identify common concerns expressed on 2 major web-based forums and cluster these to identify potential family health concern topics as indicative priority areas for future research and innovation. METHODS We text-mined the r/Parenting subreddit (69,846 posts) and the parenting section of Mumsnet (99,848 posts) to create a large corpus of posts. A generative statistical model (latent Dirichlet allocation) was used to identify the most discussed topics in the corpus, and content analysis was applied to identify the parenting concerns found in a subset of posts. RESULTS A model with 25 topics produced the highest coherence and a wide range of meaningful parenting concern topics. The most frequently expressed parenting concerns are related to their child's sleep, self-care, eating (and food), behavior, childcare context, and the parental context including parental conflict. Topics directly associated with infants, such as potty training and bottle feeding, were more common on Mumsnet, while parental context and screen time were more common on r/Parenting. CONCLUSIONS Latent Dirichlet allocation topic modeling can be applied to gain a rapid, yet meaningful overview of parent concerns expressed on a large and diverse set of social media posts and used to complement traditional insight gathering methods. Parents framed their concerns in terms of children's everyday health concerns, generating topics that overlap significantly with established family health concern topics. We provide evidence of the range of family health concerns found at these sources and hope this can be used to generate material for use alongside traditional insight gathering methods.
Collapse
Affiliation(s)
- Christopher Thornton
- National Institute for Health and Care Research Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Kate Lanyi
- National Institute for Health and Care Research Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Georgina Wilkins
- National Institute for Health and Care Research Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Rhiannon Potter
- National Institute for Health and Care Research Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Emily Hunter
- National Institute for Health and Care Research Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Niina Kolehmainen
- National Institute for Health and Care Research Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Fiona Pearson
- National Institute for Health and Care Research Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| |
Collapse
|
11
|
Genuis SK, Luth W, Weber G, Bubela T, Johnston WS. Asynchronous online focus groups for research with people living with amyotrophic lateral sclerosis and family caregivers: usefulness, acceptability and lessons learned. BMC Med Res Methodol 2023; 23:222. [PMID: 37803257 PMCID: PMC10557269 DOI: 10.1186/s12874-023-02051-y] [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: 09/29/2022] [Accepted: 09/28/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND People with amyotrophic lateral sclerosis (ALS) face disability- and travel-related barriers to research participation. We investigate the usefulness and acceptability of asynchronous, online focus groups (AOFGs) for research involving people affected by ALS (patients and family caregivers) and outline lessons learned. METHODS The ALS Talk Project, consisting of seven AOFGs and 100 participants affected by ALS, provided context for this investigation. Hosted on the secure itracks Board™ platform, participants interacted in a threaded web forum structure. Moderators posted weekly discussion questions and facilitated discussion. Data pertaining to methodology, participant interaction and experience, and moderator technique were analyzed using itracks and NVivo 12 analytics (quantitative) and conventional content analysis and the constant-comparative approach (qualitative). RESULTS There was active engagement within groups, with post lengths averaging 111.48 words and a complex network of branching interactions between participants. One third of participant responses included individual reflections without further interaction. Participants affirmed their co-group members, offered practical advice, and discussed shared and differing perspectives. Moderators responded to all posts, indicating presence and probing answers. AOFGs facilitated qualitative and quantitative data-gathering and flexible response to unanticipated events. Although total participation fell below 50% after 10-12 weeks, participants valued interacting with peers in an inclusive, confidential forum. Participants used a variety of personal devices, browsers, and operating systems when interacting on the online platform. CONCLUSIONS This methodological examination of AOFGs for patient-centred investigations involving people affected by ALS demonstrates their usefulness and acceptability, and advances knowledge of online research methodologies. Lessons learned include: early identification of research goals and participant needs is critical to selecting an AOFG platform; although duration longer than 10-12 weeks may be burdensome in this population, participants were positive about AOFGs; AOFGs offer real world flexibility enabling response to research challenges and opportunities; and, AOGFs can effectively foster safe spaces for sharing personal perspectives and discussing sensitive topics. With moderators playing an important role in fostering engagement, AOFGs facilitated rich data gathering and promoted reciprocity by fostering the exchange of ideas and interaction between peers. Findings may have implications for research involving other neurologically impaired and/or medically vulnerable populations.
Collapse
Affiliation(s)
- Shelagh K Genuis
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, AB, T6G 2B7, Canada
| | - Westerly Luth
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, AB, T6G 2B7, Canada
| | | | - Tania Bubela
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall 11328 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Wendy S Johnston
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, AB, T6G 2B7, Canada.
| |
Collapse
|
12
|
Lawal O, Regelous P, Omiyi D. Supporting claustrophobic patients during Magnetic Resonance Imaging examination- the patient perspective. Radiography (Lond) 2023; 29:1108-1114. [PMID: 37774577 DOI: 10.1016/j.radi.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION Magnetic Resonance Imaging (MRI) is a common imaging modality used to diagnose disease and monitor treatment. However, some patients cannot complete their MRI examination as a result of claustrophobia. The recent developments in the MRI scanner design may have reduced the incidence of claustrophobia in MRI. This study aimed to explore the claustrophobic patients' experience to better understand how to support them. METHODS A qualitative descriptive approach using focus groups was deemed appropriate for the study. The research was advertised in a print newspaper and on social media platforms for eligible participants to contact the researcher. Six claustrophobic patients were recruited to the focus group meeting. The discussion was audio recorded and transcribed. Content analysis was used to analyse the data into code and categories. RESULTS Four themes emerged from the data analysis, which included examination preparation, information provision, coping mechanisms and MR scanner design. Participants reported that the confined space in the MRI scanner bore is responsible for their anxiety during MRI. However, the majority of the participants believe that they would be able to complete the examination if, in advance of their scan, they were shown the MRI scanner and what they would be required to do. CONCLUSION Several coping mechanisms were shared by the participants on how they were able to complete their MRI examination despite their claustrophobia. MRI radiographers should endeavour to use these mechanisms to support their patients in practice. Also, the findings emphasise the importance of virtual reality and clear communication with patients in preparing them for their MRI examinations. IMPLICATIONS FOR PRACTICE The findings of this study may be used to enhance claustrophobic patients' experience in MRI. It also identified those aspects of the MRI examination that matter most to patients with claustrophobia in order to provide a suitable intervention to support these patients.
Collapse
Affiliation(s)
- O Lawal
- Department of Allied Health Professions, Midwifery and Social Work, School of Health and Social Work, University of Hertfordshire, UK.
| | - P Regelous
- Department of Allied Health Professions, Midwifery and Social Work, School of Health and Social Work, University of Hertfordshire, UK
| | - D Omiyi
- School of Allied Health Professions & Midwifery, Faculty of Health Studies, University of Bradford, UK
| |
Collapse
|
13
|
Rose ID, Murray C, Hodges AM, Dyer H, Wallace S. Perceived Role of the School Nurse in Providing Pertinent COVID-19 Information to the School Community: Experiences of Public Health Graduate Students With School-Aged Children. J Sch Nurs 2023:10598405231193429. [PMID: 37559391 DOI: 10.1177/10598405231193429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
The COVID-19 pandemic has been a major disruptor to school systems across the United States since March 2020. As a result, school nurses have had to adapt to these uncertain times. Previous research has demonstrated the impact of school nurses on student health; however, less is known about their role in educating the broader school community about COVID-19 prevention. In Spring 2022, four focus groups were conducted with public health graduate students with school-aged children, to assess perceptions of COVID-19 and public health emergency preparedness communication. MAXQDA was used for thematic analysis. School nurses were viewed as a credible source of COVID-19 information, especially for those who do not have access to healthcare services. While the primary role of school nurses is to provide health services to students, they also have the capacity to provide the community with vital public health emergency preparedness information.
Collapse
Affiliation(s)
- India D Rose
- Chamberlain University, Master of Public Health Program, Chicago, IL, USA
| | - Colleen Murray
- Chamberlain University, Master of Public Health Program, Chicago, IL, USA
| | - Anne Marie Hodges
- Chamberlain University, Master of Public Health Program, Chicago, IL, USA
| | - Hedda Dyer
- Chamberlain University, Master of Public Health Program, Chicago, IL, USA
| | - Sharonda Wallace
- Chamberlain University, Master of Public Health Program, Chicago, IL, USA
| |
Collapse
|
14
|
Ko H, Gatto AJ, Jones SB, O'Brien VC, McNamara RS, Tenzer MM, Sharp HD, Kablinger AS, Cooper LD. Improving measurement-based care implementation in adult ambulatory psychiatry: a virtual focus group interview with multidisciplinary healthcare professionals. BMC Health Serv Res 2023; 23:408. [PMID: 37101134 PMCID: PMC10132409 DOI: 10.1186/s12913-023-09202-3] [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: 06/14/2022] [Accepted: 02/20/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Measurement-Based Care (MBC) is an evidence-based practice shown to enhance patient care. Despite being efficacious, MBC is not commonly used in practice. While barriers and facilitators of MBC implementation have been described in the literature, the type of clinicians and populations studied vary widely, even within the same practice setting. The current study aims to improve MBC implementation in adult ambulatory psychiatry by conducting focus group interviews while utilizing a novel virtual brainwriting premortem method. METHODS Semi-structured focus group interviews were conducted with clinicians (n = 18) and staff (n = 7) to identify their current attitudes, facilitators, and barriers of MBC implementation in their healthcare setting. Virtual video-conferencing software was used to conduct focus groups, and based on transcribed verbatin, emergent barriers/facilitators and four themes were identified. Mixed methods approach was utilized for this study. Specifically, qualitative data was aggregated and re-coded separately by three doctoral-level coders. Quantitative analyses were conducted from a follow-up questionnaire surveying clinician attitudes and satisfaction with MBC. RESULTS The clinician and staff focus groups resulted in 291 and 91 unique codes, respectively. While clinicians identified a similar number of barriers (40.9%) and facilitators (44.3%), staff identified more barriers (67%) than facilitators (24.7%) for MBC. Four themes emerged from the analysis; (1) a description of current status/neutral opinion on MBC; (2) positive themes that include benefits of MBC, facilitators, enablers, or reasons on why they conduct MBC in their practice, (3) negative themes that include barriers or issues that hinder them from incorporating MBC into their practice, and (4) requests and suggestions for future MBC implementation. Both participant groups raised more negative themes highlighting critical challenges to MBC implementation than positive themes. The follow-up questionnaire regarding MBC attitudes showed the areas that clinicians emphasized the most and the least in their clinical practice. CONCLUSION The virtual brainwriting premortem focus groups provided critical information on the shortcomings and strengths of MBC in adult ambulatory psychiatry. Our findings underscore implementation challenges in healthcare settings and provide insight for both research and clinical practice in mental health fields. The barriers and facilitators identified in this study can inform future training to increase sustainability and better integrate MBC with positive downstream outcomes in patient care.
Collapse
Affiliation(s)
- Hayoung Ko
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
| | - Alyssa J Gatto
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Sydney B Jones
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Virginia C O'Brien
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Robert S McNamara
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Martha M Tenzer
- Health Analytics Research Team, Carilion Clinic, Roanoke, Virginia, USA
| | - Hunter D Sharp
- Health Analytics Research Team, Carilion Clinic, Roanoke, Virginia, USA
| | - Anita S Kablinger
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Lee D Cooper
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| |
Collapse
|
15
|
Ejegi-Memeh S, Salway S, McGowan V, Villarroel-Williams N, Ronzi S, Egan M, Gravenhorst K, Holman D, Rinaldi C. Can White allyship contribute to tackling ethnic inequalities in health? Reflections on the experiences of diverse young adults in England. CRITICAL PUBLIC HEALTH 2023. [DOI: 10.1080/09581596.2023.2188139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
| | - Sarah Salway
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Victoria McGowan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Sara Ronzi
- Department of Health Services and Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Matt Egan
- Department of Public Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Katja Gravenhorst
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Daniel Holman
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Chiara Rinaldi
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
16
|
Slaghmuylder Y, Pype P, Van Hecke A, Lauwerier E. Development of an intervention aimed at the prevention and treatment of chronic pain in breast cancer survivors: An intervention mapping approach. PATIENT EDUCATION AND COUNSELING 2023; 108:107618. [PMID: 36586350 DOI: 10.1016/j.pec.2022.107618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Pain is prevalent among breast cancer survivors and can persist for years, impeding quality of life. Both prevention and pain treatment are important. However, this requires an interdisciplinary approach and complex models of care. We report on the design and implementation of an intervention that follows a step-wise care model, aimed at timely and adequate pain follow-up among breast cancer survivors. METHODS We used intervention mapping to guide our planning process. The intervention was developed in co-design with relevant stakeholders, such as breast cancer survivors and healthcare providers. RESULTS An e-learning training was developed aimed at changing healthcare providers' knowledge, beliefs, and interprofessional behaviour regarding pain follow-up. Second, guides were produced to empower patients in talking about pain and stimulate referral to other disciplines. CONCLUSION To achieve change in pain follow-up, multiple levels should be addressed. Additionally, the implementation and adoption of an intervention opposes challenges. Intervention mapping can serve as a theory-based and data-driven approach for decision-making during planning. PRACTICE IMPLICATIONS This study can inform others about how to prepare for the development and implementation of an intervention. The developed intervention can also be adapted according to the target population and context, and used for other cancer populations.
Collapse
Affiliation(s)
- Yaël Slaghmuylder
- InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Peter Pype
- InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Ann Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| |
Collapse
|
17
|
Tan PL, Loh TJ, Chan SY. A Pilot Study on Pharmacists' Knowledge, Attitudes and Practices towards Medication Dysphagia via Asynchronous Online Focus Group Discussion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2858. [PMID: 36833554 PMCID: PMC9956395 DOI: 10.3390/ijerph20042858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
Medication dysphagia (MD) refers to difficulty swallowing oral medications. To cope, patients may inappropriately modify or skip medications, leading to poorer outcomes. Little is known about healthcare professionals' (HCPs') perspectives in managing MD. This study investigated pharmacists' knowledge, attitudes, and practices (KAP) in caring for patients with MD. An asynchronous online focus group was pilot tested in seven pharmacists, with up to two questions posted daily on an online platform over 15 days. Thematic analysis of the transcripts revealed five interrelated themes: (1) knowledge about MD; (2) management of MD; (3) expectations of patient proactivity; (4) desire for objectivity; (5) professional roles. The findings provided insight into pharmacists' KAP and may be incorporated into a full-scale study involving various HCPs.
Collapse
Affiliation(s)
| | | | - Sui Yung Chan
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117559, Singapore
| |
Collapse
|
18
|
LaForge K, Gray M, Livingston CJ, Leichtling G, Choo EK. Clinician Perspectives on Referring Medicaid Back Pain Patients to Integrative and Complementary Medicine: A Qualitative Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:55-60. [PMID: 36154196 PMCID: PMC10623460 DOI: 10.1089/jicm.2022.0600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective: To increase understanding of referral processes from primary care to integrative and complementary medicine (ICM) under an Oregon Medicaid policy that restricted opioids and expanded access to ICM for back pain patients. Methods: Four asynchronous online focus groups with 48 medical clinicians were conducted. Themes were constructed using thematic analysis. Results: Three themes were constructed related to the clinician's experience: (1) high patient receptivity to ICM, (2) difficulty finding ICM providers who accept Medicaid beneficiaries, and (3) uncertainty of the effectiveness of ICM among clinicians. Conclusions: Findings suggest that health systems expanding access to ICM for Medicaid beneficiaries may benefit from establishing and supporting linkages between clinicians and ICM providers, especially in rural areas.
Collapse
Affiliation(s)
| | | | | | | | - Esther K. Choo
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health and Science University, Portland, OR, USA
| |
Collapse
|
19
|
Bahceli PZ, Donmez AA, Akca NK. Perceived barriers and motivators of undergraduate nursing students in end-of-life care: A qualitative study based on lived experiences. Perspect Psychiatr Care 2022; 58:2687-2696. [PMID: 35538600 DOI: 10.1111/ppc.13109] [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] [Received: 02/13/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study is to determine which barriers and motivators undergraduate nursing students perceived during their experience of providing end-of-life (EoL) care. DESIGN AND METHODS Qualitative phenomenological study leans on focus groups. The study was carried out with Zoom, a Web-based mobile video-conferencing application. Students were recruited from two universities in Turkey. Semistructured focus group interviews were conducted with 28 nursing students. The Heidegger phenomenological approach was adopted in this study. FINDINGS Three thematic categories and nine subcategories were determined. While the students stated that insufficient clinical experience, lack of knowledge, the inadequacy of communication techniques, and the insecurity of patients, relatives, and healthcare teams were barriers in EoL care, they stated they were motivated by witnessing the effect of nursing care on patients, integrating their theoretical knowledge into care, applying different communication techniques, and being positive role models of nurses in clinics. PRACTICE IMPLICATIONS As students were not adequately prepared to cope with clinical practices in EoL care, the nursing core curriculum needs revision in this regard. Providing adequate theoretical and clinical training in EoL care will help nursing students manage their emotions and provide high-quality care to patients and their families.
Collapse
Affiliation(s)
- Pinar Z Bahceli
- Nursing Department, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey
| | - Ayse A Donmez
- Internal Medicine Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Nazan K Akca
- Nursing Department, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey
| |
Collapse
|
20
|
Stimpfel AW. Work Organization Factors Associated With Nurses' Stress, Sleep, and Performance: A Pre-pandemic Analysis. JOURNAL OF NURSING REGULATION 2022; 13:4-12. [PMID: 36281346 PMCID: PMC9581500 DOI: 10.1016/s2155-8256(22)00085-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background The COVID-19 pandemic put extreme stress on an already strained healthcare workforce. Suboptimal work organization, exacerbated by the pandemic, is associated with poor worker, patient, and organizational outcomes. However, there are limited qualitative studies exploring how the interconnections of work organization factors related to shift work, sleep, and work stress influence registered nurses and their work performance in the United States. Purpose We sought to understand how nurses perceive work organization factors that impact their performance. Knowledge in this area could direct efforts to implement policies and design tailored interventions to support nurses in the post-pandemic period. Methods We used a qualitative descriptive design with the Work, Stress, and Health framework as an overarching guide to understand the interconnectedness of work organization factors, work stress, and outcomes. Participants were randomly assigned to one of two anonymous, asynchronous virtual focus groups (i.e., threaded discussion boards) in 2019. Registered nurses (N = 23) working across the United States were recruited and engaged until data saturation was achieved. Directed content analysis was used to analyze the data. Results Findings aligned with the Work, Stress, and Health framework and revealed three themes: (1) "Our Voice Should Matter" (nurses' desire to have their voices heard in staffing policies); (2) "Tired But Wired" (the harmful cycle of work stress, rumination, and poor sleep); and (3) "We're Only Human" (nurses' physical, emotional, and mental exhaustion linked to critical performance impairments). Conclusion These findings underscore that high work stress and poor sleep were present before the pandemic and impacted nurses' perceptions of their performance. As leaders look forward to recovery and work redesign efforts, these findings can guide decision-making and resource allocation for optimal nurse, patient, and organization outcomes.
Collapse
|
21
|
Slaghmuylder Y, Pype P, Van Hecke A, Lauwerier E. Exploring healthcare providers’ perceptions regarding the prevention and treatment of chronic pain in breast cancer survivors: A qualitative analysis among different disciplines. PLoS One 2022; 17:e0273576. [PMID: 36006950 PMCID: PMC9409579 DOI: 10.1371/journal.pone.0273576] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background The prevention and treatment of chronic pain problems in breast cancer follow-up care require an adequate response from healthcare providers. Generally, this involves the uptake of evidence-based principles regarding pain management in everyday practice. However, despite the extensive literature on effective pain interventions, systematic and coordinated follow-up care is lacking for breast cancer survivors with pain problems in Flanders, Belgium. Objective This study aimed to gather insight into healthcare providers’ perceptions of pain prevention and treatment in breast cancer follow-up care, particularly with attention to the multilevel influences on pain follow-up. Methods We conducted four online focus groups with twenty-two healthcare providers from different disciplines such as oncologists, pharmacists, nurses, physiotherapists, and psychologists. Data analysis was guided by the Qualitative Analysis Guide of Leuven. This guide is inspired by the constant comparison method, based on Grounded Theory. Results The identified influencing factors were thematically grouped into four levels: at the level of the individual healthcare provider, in interaction with the patient, in interaction with colleagues, and at the context level. At each level, we distinguished factors related to healthcare providers’ perceptions such as awareness, knowledge, attitudes, beliefs, experiences, and intentions. For example, because of a lack of knowledge and certain beliefs among healthcare providers, referral to other disciplines often does not happen in the context of pain. Conclusion This study points out the need to explore the prevention and treatment of chronic pain after breast cancer from a multidimensional point of view. This involves not only the characteristics of individual healthcare providers but is also inherently interactional and system-like in nature. This analysis provides opportunities for the development of interventions that target the influencing factors of prevention and treatment of chronic pain in breast cancer survivors.
Collapse
Affiliation(s)
- Yaël Slaghmuylder
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium
- * E-mail:
| | - Peter Pype
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium
- Nursing Department, Ghent University Hospital, Ghent, Flanders, Belgium
| | - Emelien Lauwerier
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Flanders, Belgium
| |
Collapse
|
22
|
Cruz M, Pinho S, Castro-Lopes JM, Sampaio R. Patients and healthcare professionals perspectives on creating a chronic pain support line in Portugal: A qualitative study protocol. PLoS One 2022; 17:e0273213. [PMID: 35976966 PMCID: PMC9384994 DOI: 10.1371/journal.pone.0273213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Chronic pain affects almost 38% of the Portuguese adult population, with high costs for both patients and society. Those who suffer with chronic pain frequently complain of feeling misunderstood and of lack of support. These complaints are the main reason why support telephone lines for chronic pain were created in some countries. However, there is no scientific data supporting their creation or evaluating their performance. This paper presents a qualitative study protocol to assess patients and healthcare professionals’ perspectives on the creation of a telephone support line for chronic pain. It constitutes the first step to attain the main goal of developing and implementing a functioning support line for chronic pain in Portugal. The methodology to assess patients and healthcare professionals’ perspectives and needs is presented. In order to gather information as close to reality as possible, focus groups interviews were chosen as data sources. Given the present context of the COVID-19 pandemic, meetings will take place online, using a digital platform. All interviews will be transcribed verbatim, coded and synthesised into categories and main themes. Thematic analysis will be conducted using NVivo® V12 software, employing an iterative and reflexive approach. Finally, comparative and relational analysis will be performed in order to identify topics where patients and professionals converge or greatly diverge. The findings will be useful for grounding the creation of a telephone support line for chronic pain patients. Results dissemination will be important for policy-makers to develop a new perspective towards chronic pain services available.
Collapse
Affiliation(s)
- Mariana Cruz
- Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, Portugal
- * E-mail:
| | - Simão Pinho
- Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, Portugal
| | - José Manuel Castro-Lopes
- Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, Portugal
- i3S Institute for Research & Innovation in Health, Porto, Portugal
| | - Rute Sampaio
- Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, Portugal
- CINTESIS—Center for Health Technology and Services Research, Porto, Portugal
| |
Collapse
|
23
|
Quinn LM, Shukla D, Greenfield SM, Barrett T, Garstang J, Boardman F, Litchfield I, Dayan C, Gardner C, Connop C, Lepley A, Narendran P. EarLy Surveillance for Autoimmune diabetes: protocol for a qualitative study of general population and stakeholder perspectives on screening for type 1 diabetes in the UK (ELSA 1). BMJ Open Diabetes Res Care 2022; 10:10/2/e002750. [PMID: 35450871 PMCID: PMC9024254 DOI: 10.1136/bmjdrc-2021-002750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/19/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Type 1 diabetes (T1D) is the most common form of diabetes in children, accounting for 96% of cases, with 29 000 children affected in the UK. Studies have recently identified immunotherapies that safely delay the development of T1D for at least 3 years, and further therapies are in development. General population screening programs in other countries can now accurately identify children with presymptomatic T1D who can be entered into prevention studies. The UK does not have such a system in place. We aim to explore whether parents and children in the UK would want to be part of such a program of testing for T1D in the general population, how they would want to be informed and participate in such a program, and how any barriers to recruitment and participation can be addressed. Additionally, the views of stakeholders who would be involved in the testing program will be collected and analyzed. RESEARCH DESIGN AND METHODS We will interview parents/guardians and children aged 3-13 years about their views on screening for T1D. We will recruit purposefully to ensure representation across ethnicities and socioeconomic groups. Interviews will be transcribed, analyzed and used to inform iterative co-design work with additional families to address any issues raised. Similar qualitative work will be undertaken with professional stakeholders who would be involved in implementing any future screening program. Where possible, all aspects of this study will be performed remotely by phone or online to minimize infection risk. CONCLUSIONS This qualitative study will provide the first insights into acceptability of testing and monitoring for T1D in the general population from the perspective of families and stakeholders in the UK. Co-design work will help establish the barriers and identify strategies to mitigate and overcome these issues, as an important step towards consideration of national testing for T1D.
Collapse
Affiliation(s)
- Lauren Marie Quinn
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - David Shukla
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Tim Barrett
- Institute of Child Health, University of Birmingham, Birmingham, UK
| | - Joanna Garstang
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
- School of Nursing, University of Birmingham, Birmingham, UK
| | | | - Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Colin Dayan
- School of Medicine, University of Cardiff, Cardiff, UK
| | | | | | | | - Parth Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
- Department of Diabetes, University Hospitals of Birmingham, Birmingham, UK
| |
Collapse
|
24
|
De Groot K, De Veer AJE, Munster AM, Francke AL, Paans W. Nursing documentation and its relationship with perceived nursing workload: a mixed-methods study among community nurses. BMC Nurs 2022; 21:34. [PMID: 35090442 PMCID: PMC8795724 DOI: 10.1186/s12912-022-00811-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background The time that nurses spent on documentation can be substantial and burdensome. To date it was unknown if documentation activities are related to the workload that nurses perceive. A distinction between clinical documentation and organizational documentation seems relevant. This study aims to gain insight into community nurses’ views on a potential relationship between their clinical and organizational documentation activities and their perceived nursing workload. Methods A convergent mixed-methods design was used. A quantitative survey was completed by 195 Dutch community nurses and a further 28 community nurses participated in qualitative focus groups. For the survey an online questionnaire was used. Descriptive statistics, Wilcoxon signed-ranked tests, Spearman’s rank correlations and Wilcoxon rank-sum tests were used to analyse the survey data. Next, four qualitative focus groups were conducted in an iterative process of data collection - data analysis - more data collection, until data saturation was reached. In the qualitative analysis, the six steps of thematic analysis were followed. Results The majority of the community nurses perceived a high workload due to documentation activities. Although survey data showed that nurses estimated that they spent twice as much time on clinical documentation as on organizational documentation, the workload they perceived from these two types of documentation was comparable. Focus-group participants found organizational documentation particularly redundant. Furthermore, the survey indicated that a perceived high workload was not related to actual time spent on clinical documentation, while actual time spent on organizational documentation was related to the perceived workload. In addition, the survey showed no associations between community nurses’ perceived workload and the user-friendliness of electronic health records. Yet focus-group participants did point towards the impact of limited user-friendliness on their perceived workload. Lastly, there was no association between the perceived workload and whether the nursing process was central in the electronic health records. Conclusions Community nurses often perceive a high workload due to clinical and organizational documentation activities. Decreasing the time nurses have to spend specifically on organizational documentation and improving the user-friendliness and intercommunicability of electronic health records appear to be important ways of reducing the workload that community nurses perceive.
Collapse
|
25
|
Walters SM, Li WP, Saifi R, Azwa I, Syed Omar SF, Collier ZK, Amir Hassan AB, Haddad MS, Altice FL, Kamarulzaman A, Earnshaw VA. Barriers and Facilitators to Implementing Project ECHO in Malaysia During the COVID-19 Pandemic. J Int Assoc Provid AIDS Care 2022; 21:23259582221128512. [PMID: 36177542 PMCID: PMC9528038 DOI: 10.1177/23259582221128512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective: In Malaysia, HIV is concentrated among key populations who experience barriers to care due to stigma and healthcare discrimination. The COVID-19 pandemic has increased barriers to healthcare. Project ECHO (Extension for Community Healthcare Outcomes) is a transformative tele-education strategy that could improve HIV prevention and treatment. Methods: Practicing physicians who were aged 18 years or older and had internet access participated in asynchronous online focus groups. Results: Barriers to Project ECHO were conflicting priorities, time constraints, and technology. Facilitators included content and format, dedicated time, asynchronized flexible programming, incentives, and ensuring technology was available. Conclusion: Project ECHO is a promising intervention that can increase physicians' knowledge and skill set in specialty medicine during the COVID-19 pandemic. Interventionists in Malaysia in particular, but also in general, should consider these barriers and facilitators when developing Project ECHO as they may aid in developing a more robust program and increase participation.
Collapse
Affiliation(s)
- Suzan M Walters
- Department of Epidemiology, 5894New York University School of Global Public Health, New York, NY, USA.,Center for Drug Use and HIV/HCV Research, New York, NY, USA
| | - Wong Pui Li
- Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Rumana Saifi
- Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Iskandar Azwa
- Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Marwan S Haddad
- Center for Key Populations, 219813Community Health Center, Inc., New Britain, CT, USA
| | - Frederick L Altice
- Centre of Excellence for Research in AIDS, 37447University of Malaya, Kuala Lumpur, Malaysia.,Department of Internal Medicine, 12228Yale School of Medicine, Yale University, New Haven, CT, USA.,Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Adeeba Kamarulzaman
- Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Valerie A Earnshaw
- Department of Human Development and Family Sciences, 5972University of Delaware, Newark, DE, USA
| |
Collapse
|
26
|
Bogart LM, Kgotlaetsile K, Phaladze N, Mosepele M. HIV self-testing may overcome stigma and other barriers to HIV testing among higher-socioeconomic status men in Botswana: A qualitative study. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2021; 20:297-306. [PMID: 34905451 PMCID: PMC8717737 DOI: 10.2989/16085906.2021.2000450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In Botswana, HIV prevalence is 20.3% among those between 15 and 49 years old, and in sub-Saharan Africa, higher income has been associated with increased HIV risk. We qualitatively explored barriers to HIV testing and acceptability of HIV self-testing (HIVST) among higher socio-economic status (SES) men in Botswana. Twenty higher SES men (10 tested, 10 not tested recently) participated in semi-structured interviews and 10 men participated in asynchronous online focus groups (FGs) about HIV testing barriers and HIVST acceptability. Results indicated that stigma, inconvenience and perceived lack of confidentiality were barriers to HIV testing, as were masculinity-related concerns (e.g. fear of losing status if they accessed testing or were found to be HIV positive). Men said that HIVST reduced barriers to testing and that test kits could be placed in public spaces for pick-up and used in private. Overall, HIVST was seen as acceptable and feasible among higher SES men in Botswana.
Collapse
Affiliation(s)
| | | | | | - Mosepele Mosepele
- Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
| |
Collapse
|
27
|
Gamarel KE, Stephenson R, Hightow-Weidman L. Technology-driven methodologies to collect qualitative data among youth to inform HIV prevention and care interventions. Mhealth 2021; 7:34. [PMID: 33898603 PMCID: PMC8063018 DOI: 10.21037/mhealth-2020-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/22/2020] [Indexed: 11/06/2022] Open
Abstract
The use of technology as a platform for delivering HIV prevention interventions provides an efficient opportunity to reach those at risk for HIV with targeted and timely prevention and treatment messages. Technology-delivered HIV interventions are becoming increasingly popular and include interventions that use mobile text messaging and mobile phone apps or deliver prevention messages through telehealth platforms. Community-centered approaches of intervention development can help address the potential gap between science and practice by ensuring that interventions are appropriate and driven by community needs and desires. Common approaches to gaining community input rely on qualitative data gathered through in-person focus group discussions (FGD), in-depth interviews (IDI) and youth advisory boards (YABs). While these proven methodologies have strengths, youth engagement can be limited by structural barriers (e.g., lack of transportation, inconvenient timing) and reluctance to participate due to stigma or discomfort with group settings. This results in a number of biases that limit the quality of face-to-face qualitative data collection, i.e., social desirability bias or selection biases created by differential likelihood of recruitment and attendance. As an increasing number of HIV prevention and care interventions are successfully delivered online, innovative approaches to youth engagement in virtual spaces can also be applied across the intervention lifespan to increase the quality and validity of formative data. In this paper, we describe a range of qualitative data collection techniques that can be used via online platforms to collect qualitative data, and we outline their relative advantages over face-to-face FGD or IDI. We use four case studies to highlight the methodologies and findings and provide recommendations for researchers moving forward.
Collapse
Affiliation(s)
- Kristi E. Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Lisa Hightow-Weidman
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA
| |
Collapse
|
28
|
Dangerfield Ii DT, Wylie C, Anderson JN. Conducting Virtual, Synchronous Focus Groups Among Black Sexual Minority Men: Qualitative Study. JMIR Public Health Surveill 2021; 7:e22980. [PMID: 33427671 PMCID: PMC7899800 DOI: 10.2196/22980] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/23/2020] [Accepted: 01/09/2021] [Indexed: 11/25/2022] Open
Abstract
Background Focus groups are useful to support HIV prevention research among US subpopulations, such as Black gay, Black bisexual, and other Black sexual minority men (BSMM). Virtual synchronous focus groups provide an electronic means to obtain qualitative data and are convenient to implement; however, the protocols and acceptability for conducting virtual synchronous focus groups in HIV prevention research among BSMM are lacking. Objective This paper describes the protocols and acceptability of conducting virtual synchronous focus groups in HIV prevention research among BSMM Methods Data for this study came from 8 virtual synchronous focus groups examined in 2 studies of HIV-negative BSMM in US cities, stratified by age (N=39): 2 groups of BSMM ages 18-24 years, 5 groups of BSMM ages 25-34 years, and 1 group of BSMM 35 years and older. Virtual synchronous focus groups were conducted via Zoom, and participants were asked to complete an electronic satisfaction survey distributed to their email via Qualtrics. Results The age of participants ranged from 18 to 44 years (mean 28.3, SD 6.0). All participants “strongly agreed” or “agreed” that they were satisfied participating in an online focus group. Only 17% (5/30) preferred providing written informed consent versus oral consent. Regarding privacy, most (30/30,100%) reported “strongly agree” or “agree” that their information was safe to share with other participants in the group. Additionally, 97% (29/30) reported being satisfied with the incentive. Conclusions Conducting virtual synchronous focus groups in HIV prevention research among BSMM is feasible. However, thorough oral informed consent with multiple opportunities for questions, culturally relevant facilitation procedures, and appropriate incentives are needed for optimal focus group participation.
Collapse
Affiliation(s)
- Derek T Dangerfield Ii
- Johns Hopkins School of Nursing, Baltimore, MD, United States.,Us Helping Us, People Into Living, Inc, Washington DC, MD, United States
| | - Charleen Wylie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Janeane N Anderson
- Department of Health Promotion and Disease Prevention, College of Nursing, University of Tennessee Health Science Center, Memphis, TN, United States
| |
Collapse
|
29
|
Gordon AR, Calzo JP, Eiduson R, Sharp K, Silverstein S, Lopez E, Thomson K, Reisner SL. Asynchronous Online Focus Groups for Health Research: Case Study and Lessons Learned. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2021; 20:10.1177/1609406921990489. [PMID: 35185443 PMCID: PMC8856649 DOI: 10.1177/1609406921990489] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Increasingly, social life-and accordingly, social research-is conducted in online environments. Asynchronous online focus groups (AOFGs) have emerged as an important tool to conduct remote research with geographically diverse populations. However, there remain few systematic accounts of AOFG methods to guide researchers' decision-making in designing and implementing studies. This paper seeks to address this gap by describing a recent study on body image and health among transgender and gender diverse (TGD) young adults. In this study, eight AOFGs were conducted in August-October 2019 with 66 TGD young adults residing in 25 U.S. states. Each AOFG lasted four consecutive days with two prompts posted by moderators per day. Overall, participant satisfaction with AOFGs was high: 98% reported their experience was excellent, very good, or good and 95% would be somewhat or very likely to sign up for another AOFG. This example is used to illustrate key methodological decision-points, acceptability of the method to participants, and lessons learned. The goal of this paper is to encourage other researchers, particularly health researchers, to consider using AOFGs and to engage with the method's strengths and limitations in order to develop new opportunities for online technologies to enrich the field of qualitative health research.
Collapse
Affiliation(s)
- Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Division of Adolescent/Young Adults Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jerel P Calzo
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, CA, USA
| | - Rose Eiduson
- Division of Adolescent/Young Adults Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Kendall Sharp
- Division of Adolescent/Young Adults Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | | | - Katharine Thomson
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Sari L Reisner
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
30
|
Huurneman KAM, Lankhorst IMF, Baars ECT, van Wijk I, van der Sluis CK. Opinions on rehabilitation care of young adults with transversal upper limb reduction deficiency in their transition to adulthood. J Pediatr Rehabil Med 2021; 14:103-112. [PMID: 33720858 DOI: 10.3233/prm-200690] [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: 11/15/2022] Open
Abstract
PURPOSE Young adults with transversal upper limb reduction deficiency experience limitations regarding education, employment and obtaining a driver's license. Contribution of rehabilitation care within these domains has been reported to be inadequate. This study evaluates the needs and suggestions of participants in rehabilitation care. METHODS Two online focus groups with young adults and parents met during 4 consecutive days. Health care professionals joined a face-to-face focus group. Data analysis was based on framework analysis. RESULTS The rehabilitation team was mainly consulted for problems with residual limb or for prostheses. Young adults and their parents were mostly unaware of resources regarding education, job selection or obtaining a driver's license. Professionals stated that these subjects were addressed during periodic appointments. Young adults didn't always attend these appointments due to limited perceived benefit. To improve rehabilitation care, participants suggested methods for providing relevant information, facilitating peer contact and offering dedicated training programs to practice work-related tasks, prepare for job interviews or enhance self-confidence. CONCLUSION Periodic appointments do not fulfil needs of young adults with transversal upper limb reduction deficiency. To improve care, rehabilitation teams should offer age-relevant information, share peer stories, and create dedicated training programs.
Collapse
Affiliation(s)
| | | | | | - Iris van Wijk
- Department of Rehabilitation Medicine, Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands
| | - Corry K van der Sluis
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| |
Collapse
|
31
|
Martin-Delgado J, Viteri E, Mula A, Serpa P, Pacheco G, Prada D, Campos de Andrade Lourenção D, Campos Pavan Baptista P, Ramirez G, Mira JJ. Availability of personal protective equipment and diagnostic and treatment facilities for healthcare workers involved in COVID-19 care: A cross-sectional study in Brazil, Colombia, and Ecuador. PLoS One 2020; 15:e0242185. [PMID: 33175877 PMCID: PMC7657544 DOI: 10.1371/journal.pone.0242185] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/28/2020] [Indexed: 12/31/2022] Open
Abstract
Many affected counties have had experienced a shortage of personal protective equipment (PPE) during the coronavirus disease (COVID-19) pandemic. We aimed to investigate the needs of healthcare professionals and the technical difficulties faced by them during the initial outbreak. A cross-sectional web-based survey was conducted among the healthcare workforce in the most populous cities from three Latin American countries in April 2020. In total, 1,082 participants were included. Of these, 534 (49.4%), 263 (24.3%), and 114 (10.5%) were physicians, nurses, and other professionals, respectively. At least 70% of participants reported a lack of PPE. The most common shortages were shortages in gown coverall suits (643, 59.4%), N95 masks (600, 55.5%), and face shields (569, 52.6%). Professionals who performed procedures that generated aerosols reported shortages more frequently (p<0.05). Professionals working in the emergency department and primary care units reported more shortages than those working in intensive care units and hospital-based wards (p<0.001). Up to 556 (51.4%) participants reported the lack of sufficient knowledge about using PPE. Professionals working in public institutions felt less prepared, received less training, and had no protocols compared with their peers in working private institutions (p<0.001). Although the study sample corresponded to different hospital centers in different cities from the participating countries, sampling was non-random. Healthcare professionals in Latin America may face more difficulties than those from other countries, with 7 out of 10 professionals reporting that they did not have the necessary resources to care for patients with COVID-19. Technical and logistical difficulties should be addressed in the event of a future outbreak, as they have a negative impact on healthcare workers. Clinical trial registration: NCT04486404.
Collapse
Affiliation(s)
- Jimmy Martin-Delgado
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Sant Joan d’Alacant, Spain
| | - Eduardo Viteri
- Santander Ophthalmologic Foundation FOSCAL, Floridablanca, Colombia
- CEMEDIP, Guayaquil, Ecuador
| | - Aurora Mula
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Sant Joan d’Alacant, Spain
| | | | | | | | | | - Patricia Campos Pavan Baptista
- Sao Paulo University, Sao Paulo, Brazil
- CNPQ research group, Studies on the health of nursing and health workers, Sao Paulo, Brazil
| | - Gustavo Ramirez
- Catholic University of Santiago of Guayaquil, Guayaquil, Ecuador
| | - Jose Joaquin Mira
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Sant Joan d’Alacant, Spain
- Alicante-Sant Joan Health Department, Alicante, Spain
- Miguel Hernandez University, Elche, Spain
| |
Collapse
|
32
|
Whiffin CJ, Smith BG, Esene IN, Karekezi C, Bashford T, Khan MM, Fontoura Solla DJ, Hutchinson PJ, Kolias A. Neurosurgeons' experiences of conducting and disseminating clinical research in low- and middle-income countries: a qualitative study protocol. BMJ Open 2020; 10:e038939. [PMID: 32792451 PMCID: PMC7430326 DOI: 10.1136/bmjopen-2020-038939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Low-income and middle-income countries (LMICs) face the greatest burden of neurotrauma. However, most of the research published in scientific journals originates from high-income countries, suggesting those in LMICs are either not engaging in research or are not publishing it. Evidence originating in high-income countries may not be generalisable to LMICs; therefore, it is important to nurture research capacity in LMICs so that a relevant evidence base can be developed. However, little is published about specific challenges or contextual issues relevant to increasing research activity of neurosurgeons in LMICs. Therefore, the aim of this study was to understand neurosurgeons' experiences of, aspirations for and ability to conduct and disseminate clinical research in LMICs. METHODS AND ANALYSIS This is a pragmatic qualitative study situated within the naturalistic paradigm using focus groups and interviews with a purposive sample of neurosurgeons from LMICs. First, we will conduct asynchronous online focus groups with 36 neurosurgeons to broadly explore issues relevant to the study aim. Second, we will select 20 participants for follow-up semistructured interviews to explore concepts in more depth and detail than could be achieved in the focus group. Interviews will be audio-recorded and transcribed verbatim. A thematic analysis will be conducted following Braun and Clarke's six stages and will be supported by NVIVO software. ETHICS AND DISSEMINATION The University of Cambridge Psychology Research Ethics Committee reviewed this study and provided a favourable opinion in January 2020 (REF PRE.2020.006). Participants will provide informed consent, be able to withdraw at any time and will have their contributions kept confidential. The findings of the study will be shared with relevant stakeholders and disseminated in conference presentations and journal publications.
Collapse
Affiliation(s)
- Charlotte J Whiffin
- College of Health and Social Care, University of Derby, Derby, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Brandon G Smith
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Ignatius N Esene
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, NW Region, Cameroon
| | - Claire Karekezi
- Department of Neurosurgery, Rwanda Military Hospital, Kigali, Kigali City, Rwanda
| | - Tom Bashford
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Muhammad Mukhtar Khan
- Neurosurgery, Northwest School of Medicine and Northwest General Hospital and Research Centre, Peshawar, Pakistan
| | - Davi J Fontoura Solla
- Department of Neurology, Division of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil
| | - Peter J Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Angelos Kolias
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| |
Collapse
|
33
|
Cummings R, Ozburn L, Payant A, Rozum B, Shelton M, Bushman R. Assessing Research Compliance for Federally Funded Projects: The Good, the Bad, and the Publicly Accessible. JOURNAL OF LIBRARY ADMINISTRATION 2020. [DOI: 10.1080/01930826.2020.1786985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Rebekah Cummings
- Digital Matters Librarian, J. Willard Marriott Library, University of Utah, Salt Lake City, UT, USA
| | - Lindsay Ozburn
- Assessment Coordinator, Merrill-Cazier Library, Utah State University, Logan, UT, USA
| | - Andrea Payant
- Metadata Librarian, Merrill-Cazier Library, Utah State University, Logan, UT, USA
| | - Betty Rozum
- Data Librarian, Merrill-Cazier Library, Utah State University, Logan, UT, USA
| | - Michael Shelton
- Research Data Library Assistant, Merrill-Cazier Library, Utah State University, Logan, UT, USA
| | - Ryan Bushman
- Data Analytics Assistant, Merrill-Cazier Library, Utah State University, Logan, UT, USA
| |
Collapse
|
34
|
Ranieri V, Kennedy E, Walmsley M, Thorburn D, McKay K. The Primary Sclerosing Cholangitis (PSC) Wellbeing Study: Understanding psychological distress in those living with PSC and those who support them. PLoS One 2020; 15:e0234624. [PMID: 32628685 PMCID: PMC7337345 DOI: 10.1371/journal.pone.0234624] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 05/31/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The impact of living with Primary Sclerosing Cholangitis (PSC) on psychological wellbeing is not well-known. A recent scoping review by the authors found that both depression and anxiety frequently featured in the accounts of those living with the illness. However, less clear were the factors that led to such psychological distress, the impact that the illness had on families and how to best support those living or supporting someone living with the illness. In light of this, the aim of this study was to explore how the illness impacted the lives of both those diagnosed with the illness and those supporting them. METHOD AND RESULTS This study adopted a phenomenological approach to understand the subjective experiences of individual participants. A total of 30 individuals took part in Asynchronous Virtual Focus Groups hosted on a Virtual Learning Environment for a four-week period. Chronological narratives of individuals' lived experiences from diagnosis to post-transplant are presented below. These narratives centred upon individuals' and families' experiences of receiving a diagnosis, and adjusting to life post-diagnosis, particularly in regard to their relationships with health professionals and other family members, and in preparing for the possibility of transplant. DISCUSSION The present article provides an in-depth look at how PSC can impact psychological wellbeing, how psychological distress arises and includes advice tailored to individuals, families and health professionals on how to best support each other.
Collapse
Affiliation(s)
- Veronica Ranieri
- Research & Development Unit, Tavistock Centre, Tavistock & Portman NHS Foundation Trust, London, United Kingdom
- Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
- * E-mail:
| | - Eilis Kennedy
- Research & Development Unit, Tavistock Centre, Tavistock & Portman NHS Foundation Trust, London, United Kingdom
- Research Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
| | | | - Douglas Thorburn
- Sheila Sherlock Liver Centre & UCL Institute of Liver and Digestive Health, Royal Free Hospital, London, United Kingdom
| | - Kathy McKay
- Research & Development Unit, Tavistock Centre, Tavistock & Portman NHS Foundation Trust, London, United Kingdom
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
35
|
Parmenter JG, Galliher RV, Maughan ADA. LGBTQ+ emerging adults perceptions of discrimination and exclusion within the LGBTQ+ community. PSYCHOLOGY & SEXUALITY 2020. [DOI: 10.1080/19419899.2020.1716056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - R. V. Galliher
- Department of Psychology, Utah State University, Logan, UT, USA
| | - A. D. A. Maughan
- Department of Psychology, University of Tennessee- Knoxville, Knoxville, TN, USA
| |
Collapse
|
36
|
|
37
|
Oosterveld-Vlug M, Onwuteaka-Philipsen B, ten Koppel M, van Hout H, Smets T, Pivodic L, Tanghe M, Van Den Noortgate N, Hockley J, Payne S, Moore DC, Kijowska V, Szczerbińska K, Kylänen M, Leppäaho S, Mercuri C, Rossi P, Mercuri M, Gambassi G, Bassal C, de Paula EM, Engels Y, Deliens L, Van den Block L, Pasman HR. Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework. Implement Sci 2019; 14:107. [PMID: 31856882 PMCID: PMC6924025 DOI: 10.1186/s13012-019-0953-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 11/08/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The PACE 'Steps to Success' programme is a complex educational and development intervention for staff to improve palliative care in long-term care facilities (LTCFs). In a cluster randomized controlled trial, this programme has been implemented in 37 LTCFs in 7 European countries. Alongside an effectiveness study, a process evaluation study was conducted. This paper reports on the results of this process evaluation, of which the aim was to provide a more detailed understanding of the implementation of the PACE Programme across and within countries. METHODS The process evaluation followed the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and involved various measures and tools, including diaries for country trainers, evaluation questionnaires for care staff, attendance lists and interviews (online and face-to-face, individual and in groups) with country trainers, managers, PACE coordinators and other staff members. Based on key elements of the PACE Programme, a priori criteria for a high, medium and low level of the RE-AIM components Reach, Adoption, Implementation and intention to Maintenance were defined. Qualitative data on factors affecting each RE-AIM component gathered in the online discussion groups and interviews were analysed according to the principles of thematic analysis. RESULTS The performance of the PACE Programme on the RE-AIM components was highly variable within and across countries, with a high or medium score for in total 28 (out of 37) LTCFs on Reach, for 26 LTCFs on Adoption, for 35 LTCFs on Implementation and for 34 LTCFs on intention to Maintenance. The factors affecting performance on the different RE-AIM components could be classified into three major categories: (1) the PACE Programme itself and its way of delivery, (2) people working with the PACE Programme and (3) contextual factors. Several country-specific challenges in implementing the PACE Programme were identified. CONCLUSIONS The implementation of the PACE Programme was feasible but leaves room for improvement. Our analysis helps to better understand the optimal levels of training and facilitation and provides recommendations to improve implementation in the LTC setting. The results of the process evaluation will be used to further adapt and improve the PACE Programme prior to its further dissemination. TRIAL REGISTRATION The PACE study was registered at www.isrctn.com-ISRCTN14741671 (FP7-HEALTH-2013-INNOVATION-1 603111) July 30, 2015.
Collapse
Affiliation(s)
- Mariska Oosterveld-Vlug
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bregje Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maud ten Koppel
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hein van Hout
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tinne Smets
- VUB-UGhent End-of-Life Care Research Group, Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lara Pivodic
- VUB-UGhent End-of-Life Care Research Group, Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Marc Tanghe
- VUB-UGhent End-of-Life Care Research Group, Department of Geriatric Medicine, Ghent University Hospital, Ghent, Belgium
| | - Nele Van Den Noortgate
- VUB-UGhent End-of-Life Care Research Group, Department of Geriatric Medicine, Ghent University Hospital, Ghent, Belgium
| | | | - Sheila Payne
- International Observatory on End-of-Life Care, Lancaster University, Lancaster, UK
| | | | - Violetta Kijowska
- Unit for Research on Ageing Society, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Szczerbińska
- Unit for Research on Ageing Society, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Marika Kylänen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Suvi Leppäaho
- National Institute for Health and Welfare, Helsinki, Finland
| | - Claudia Mercuri
- Department of Internal Medicine & Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paola Rossi
- Department of Internal Medicine & Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Mercuri
- Department of Internal Medicine & Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Gambassi
- Department of Internal Medicine & Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Catherine Bassal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Geneva, Switzerland
| | - Emilie Morgan de Paula
- HE-Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Luc Deliens
- VUB-UGhent End-of-Life Care Research Group, Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- VUB-UGhent End-of-Life Care Research Group, Department of Public Helath and Primary Care, Ghent University, Ghent, Belgium
| | - Lieve Van den Block
- VUB-UGhent End-of-Life Care Research Group, Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- VUB-UGhent End-of-Life Care Research Group, Department of Clinical Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - H. Roeline Pasman
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
38
|
Adams D, Simpson K, Keen D. Exploring Anxiety at Home, School, and in the Community Through Self-Report From Children on the Autism Spectrum. Autism Res 2019; 13:603-614. [PMID: 31793245 DOI: 10.1002/aur.2246] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/08/2019] [Accepted: 11/16/2019] [Indexed: 12/12/2022]
Abstract
Research investigating anxiety in children on the autism spectrum usually reports caregiver rather than self-report perspectives. This study aimed to document children's own descriptions of their anxiety symptomatology by combining profiles on a standardized autism-specific self-report measure of anxiety (ASC-ASD-C) with the answers from closed- and open-answer questions about anxiety across home, school, and community settings. Across the sample of 113 children on the spectrum aged 6-14 years, the two most frequently endorsed items on the ASC-ASD-C were from the Uncertainty and Performance Anxiety subscales, and the least endorsed were both from the Anxious Arousal subscale. Almost all (96.5%) of the children on the spectrum reported experiencing anxiety in at least one setting, with 40.7% reporting anxiety in all three contexts (home, school, and community). Approximately half of the sample felt their anxiety goes unrecognized by others at school and almost 60% felt it was unrecognized by others when out in the community. The proportion of children reporting having someone to help reduce their anxiety differed across home (86%), school (76%), and community (45%) settings. This highlights the importance of understanding anxiety and its impact, not only within the context of autism but also for each particular child. Autism Res 2020, 13: 603-614. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: There has been a lot of research focusing on anxiety and autism, but most of it has used parent reports, rather than asking the child themselves. This study summarizes data from 113 children on the autism spectrum, aged 6-14 years. It reports the symptoms of anxiety that these children most and least commonly experience. The results suggest only 40-50% of children feel that others are able to recognize their anxiety at school and when out in the community, suggesting that more training is needed to help adults in these settings to recognize and support anxiety.
Collapse
Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia.,Griffith Institute of Educational Research, Griffith University, Brisbane, Queensland, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Kate Simpson
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia.,Griffith Institute of Educational Research, Griffith University, Brisbane, Queensland, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Deb Keen
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia.,Griffith Institute of Educational Research, Griffith University, Brisbane, Queensland, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| |
Collapse
|
39
|
Ranieri V, Kennedy E, Walmsley M, Thorburn D, McKay K. Rare but heard: using asynchronous virtual focus groups, interviews and roundtable discussions to create a personalised psychological intervention for primary sclerosing cholangitis: a protocol. BMJ Open 2019; 9:e031417. [PMID: 31578198 PMCID: PMC6797408 DOI: 10.1136/bmjopen-2019-031417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Primary sclerosing cholangitis (PSC) is a rare and chronic disease characterised by inflammation and fibrosis of the liver's bile ducts. There is no known cause or cure for the illness, which often progresses to end-stage liver disease requiring liver transplantation. Symptoms of PSC can be very burdensome on those living with the illness, leading to restrictions in daily living, as well as a greater risk of colorectal and biliary tract cancers. Limited voices from lived experience suggest that living with PSC can cause considerable psychological distress. This study, therefore, aims to explore how the illness impacts the psychological well-being of those living with the illness, and those supporting them. It also aims to create a personalised psychological intervention to support all groups. METHODS AND ANALYSIS This project will take a layered qualitative approach to understanding the ways in which people experience living with PSC within their day-to-day lives. There will be two stages to this study, which will pilot a unique methodological process using online resources. The first stage will consist of asynchronous virtual focus groups (AVFGs) with those living with PSC and those who provide support for those diagnosed with PSC, and narrative interviews with both groups and health professionals. Both the AVFGs and the narrative interviews will be analysed using thematic narrative analysis. The second stage will comprise a roundtable discussion where the researchers and health professionals will devise a personalised psychological intervention to help to support those living with PSC and their supporters. The study duration is expected to be 18 months. ETHICS AND DISSEMINATION The proposed study has been approved by the UK Health Research Authority and London-Queen Square Research Ethics Committee as application 18/LO/1075. Results from the AVFGs and the narrative interviews will be submitted for peer-reviewed publication. The findings of the study will also be presented nationally to PSC and medical communities, and a summary of the findings will be shared with participants.
Collapse
Affiliation(s)
- Veronica Ranieri
- Research and Development, Tavistock and Portman NHS Foundation Trust, London, UK
- Science and Technology Studies, University College London, London, UK
| | - Eilis Kennedy
- Research and Development, Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - Doug Thorburn
- Department of Hepatology, Royal Free London NHS Trust, London, UK
| | - Kathy McKay
- Research and Development, Tavistock and Portman NHS Foundation Trust, London, UK
| |
Collapse
|
40
|
Petit-Steeghs V, Pittens CACM, Barnhoorn MJM, Broerse JEW. "The challenge of managing insecurities": Parents' experiences with the care for their child with congenital diaphragmatic hernia. J SPEC PEDIATR NURS 2019; 24:e12247. [PMID: 31025826 PMCID: PMC6767506 DOI: 10.1111/jspn.12247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/20/2019] [Accepted: 03/20/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE Last decennia remarkable advances have been made in decreasing the mortality rate of children with congenital diaphragmatic hernia (CDH), resulting in a relatively growing patient group with long-term complications and complex care needs. These consequences have a huge impact on the quality of life of both children and their families. To provide practical recommendations for improving the quality of care for this patient group, the present study sought to obtain insights into the experiences and needs of parents with a child with CDH. DESIGN AND METHODS A qualitative study was conducted on the experiences and needs of parents with a child with CDH living in the Netherlands. Data was obtained by means of a discourse analyses of 17 weblogs written by parents and three online focus groups with 8-12 parents per group (n = 29). The data was analysed thematically and structured by using the model of Lawoko (2007) on parental satisfaction with care. RESULTS Although parents were generally satisfied with the delivered care, they frequently encountered challenges in managing insecurities throughout the care process. Besides the unpredictable disease progress, insecurities were exacerbated by: (a) limited specialized knowledge of long-term consequences, (b) logistical problems, and (c) nontransparent communication. Providing security through, for instance, a clear care plan and by engaging parents in the decision-making process helped them feel more in control. PRACTICE IMPLICATIONS This study showed that parents' main challenge was to manage insecurities. Creating securities by providing a care plan and involving parents in the decision-making process helped parents to feel more in control. To improve quality of care for children with CDH, future measures should, therefore, focus on reducing insecurities by managing expectations, improving transparency and stimulating engagement.
Collapse
|
41
|
Stephens GC, Rees CE, Lazarus MD. How does Donor Dissection Influence Medical Students' Perceptions of Ethics? A Cross-Sectional and Longitudinal Qualitative Study. ANATOMICAL SCIENCES EDUCATION 2019; 12:332-348. [PMID: 30903742 DOI: 10.1002/ase.1877] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/07/2019] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
The contribution of donor dissection to modern anatomy pedagogy remains debated. While short-term anatomy knowledge gains from dissection are questionable, studies suggest that donor dissection may have other impacts on students including influencing medical students' professional development, though evidence for such is limited. To improve the understanding of how anatomy education influences medical student professional development, the cross-sectional and longitudinal impacts of donor dissection on medical students' perceptions of ethics were explored. A cross-sectional and longitudinal qualitative study was undertaken at an Australian university where student responses to online discussion forums and in-person interviews were analyzed. Data were collected across the 1.5 years that undergraduate medical students received anatomy instruction (three semesters during first and second years). A total of 207 students participated in the online discussion forums, yielding 51,024 words; 24 students participated in at least 1 of 11 interviews, yielding over 11 hours of interview data. Framework analysis identified five themes related to ethics in an anatomical education context: (1) Dignity, (2) Beneficence, (3) Consent, (4) Justification for versus the necessity of dissection, and (5) Dichotomy of objectification and personification. The dominant themes of students' ethical perceptions changed with time, with a shift from focusing on donors as people, toward the utility of donors in anatomy education. Additionally, themes varied by student demographics including gender, ancestry, and religiosity. Together this study suggests a strong impact of donor dissection on priming students' focus on medical ethics and provides further advocacy for formal and purposeful integration of medical ethics with anatomy education.
Collapse
Affiliation(s)
- Georgina C Stephens
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
| | - Charlotte E Rees
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michelle D Lazarus
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
42
|
Bouchard K, Tulloch H. Strengthening behavioral clinical trials with online qualitative research methods. J Health Psychol 2019; 25:256-265. [DOI: 10.1177/1359105319855120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Qualitative methods are integral to the systematic development of effective health behavioral interventions, as noted in recent translational models, such as the Obesity-Related Behavioral Intervention Trials model. To our knowledge, however, no scholarly literature describes how online qualitative research methods can be used to benefit the development and conduct of behavioral clinical trials. We emphasize the value of qualitative methodologies to behavioral clinical trial research more broadly and provide an introductory overview of online qualitative research methods. We highlight the specific affordances of these methods in maximizing the quality of behavioral clinical trials as well as note their potential limitations. Finally, we argue that online qualitative research methods ought to be incorporated in behavioral trial development and call for future research in this area.
Collapse
|
43
|
|
44
|
Koper I, Pasman HRW, Onwuteaka-Philipsen BD. Experiences of Dutch general practitioners and district nurses with involving care services and facilities in palliative care: a mixed methods study. BMC Health Serv Res 2018; 18:841. [PMID: 30409204 PMCID: PMC6225713 DOI: 10.1186/s12913-018-3644-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/23/2018] [Indexed: 01/18/2023] Open
Abstract
Background Generals practitioners (GPs) and district nurses (DNs) play a leading role in providing palliative care at home. Many services and facilities are available to support them in providing this complex care. This study aimed to examine the extent to which GPs and DNs involve these services, what their experiences are, and how involvement of these services and facilities can be improved. Methods Sequential mixed methods consisting of an online questionnaire with structured and open questions completed by 108 GPs and 258 DNs, followed by three homogenous online focus groups with 8 GPs and 19 DNs, analyzed through open coding. Results Most GPs reported that they sometimes or often involved palliative home care teams (99%), hospices (94%), and palliative care consultation services (93%). Most DNs reported sometimes or often involving volunteers (90%), hospices (88%), and spiritual caregivers (80%). The least involved services and facilities were psychologists and psychiatrists (51% and 50%) and social welfare (44% and 57%). Main reason for not involving services and facilities was ‘not needing’ them. If they had used them, most GPs and DNs (68–93%) reported solely positive experiences. Hardly anyone (0–3%) reported solely negative experiences with any of the services and the facilities. GPs and DNs suggested improvements in three areas: (1) establishment of local centers giving information on available services and facilities, (2) presentation of services and facilities in local multidisciplinary meetings, and (3) support organizations to proactively offer their facilities and services. Conclusion Psychological, social, and spiritual services are involved less often, suggesting that the classic care model, which focuses strongly on somatic issues, is still well entrenched. More familiarity with services that can provide additional care in these areas, regarding their availability and their added value, could improve the quality of life for patients and relatives at the end of life.
Collapse
Affiliation(s)
- Ian Koper
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081, BT, Amsterdam, The Netherlands.
| | - H Roeline W Pasman
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081, BT, Amsterdam, The Netherlands
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081, BT, Amsterdam, The Netherlands
| |
Collapse
|
45
|
Why Girls Choose Not to Use Barriers to Prevent Sexually Transmitted Infection During Female-to-Female Sex. J Adolesc Health 2018; 62:411-416. [PMID: 29290373 DOI: 10.1016/j.jadohealth.2017.10.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/06/2017] [Accepted: 10/10/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE Using data from a national qualitative study of lesbian, bisexual, and other sexual minority adolescent girls in the U.S., this study examined their awareness of the risk of sexually transmitted infection (STI) and opportunities for barrier use. METHODS Online asynchronous focus groups were conducted with lesbian and bisexual (LB) girls ages 14-18 years. Girls were assigned to online groups based on their self-identified sexual identity and whether they were sexually experienced or not. Two moderators posed questions and facilitated online discussions. Interpretive description analysis conducted by multiple members of the research team was used to categorize the results. RESULTS Key factors in girls' decisions not to use barriers with female partners concerned pleasure, sex of sexual partner, lack of knowledge of sexual risk or of barrier use for female-to-female sexual activities, and use of STI testing as a prevention tool. CONCLUSIONS Addressing knowledge and access gaps is an important first step for improving sexual health. Prevention priorities should focus on helping LB girls understand their risk of STI transmission in both opposite and same-sex relationships. Tailoring messaging to move beyond heteronormative scripts is critical to engaging LB girls and equipping them with the skills and knowledge to have safer sex regardless of the sex of their partner.
Collapse
|
46
|
Jamison J, Sutton S, Mant J, De Simoni A. Online stroke forum as source of data for qualitative research: insights from a comparison with patients' interviews. BMJ Open 2018; 8:e020133. [PMID: 29602848 PMCID: PMC5884329 DOI: 10.1136/bmjopen-2017-020133] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To determine the appropriateness of an online forum compared with face-to-face interviews as a source of data for qualitative research on adherence to secondary prevention medications after stroke. DESIGN A comparison of attributes of two data sources, interviews and a forum, using realistic evaluation; a comparison of themes around adherence according to the Perceptions and Practicalities Approach (PAPA) framework. SETTING Interviews were conducted in UK GP practices in 2013 and 2014; online posts were written by UK stroke survivors and family members taking part in the online forum of the Stroke Association between 2004 and 2011. PARTICIPANTS 42 interview participants: 28 stroke survivors (age range 61-92 years) and 14 caregivers (85% spouses). 84 online forum participants: 49 stroke survivors (age range 32-72 years) and 33 caregivers (60% sons/daughters). RESULTS 10 attributes were identified within the two data sources and categorised under three domains (context, mechanisms and outcomes). Participants' characteristics of forum users were often missing. Most forum participants had experienced a stroke within the previous 12 months, while interviewees had done so 1-5 years previously.All interview themes could be matched with corresponding themes from the forum. The forum yielded three additional themes: influence of bad press on taking statins, criticisms of clinicians' prescribing practices and caregiver burden in assisting with medications and being advocates for survivors with healthcare professionals. CONCLUSIONS An online forum is an appropriate source of data for qualitative research on patients' and caregivers' issues with adherence to secondary prevention stroke medications and may offer additional insights compared with interviews, which can be attributed to differences in the approach to data collection.
Collapse
Affiliation(s)
- James Jamison
- Primary Care Unit, Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Stephen Sutton
- Primary Care Unit, Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Jonathan Mant
- Primary Care Unit, Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Anna De Simoni
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
47
|
Huis In Het Veld JG, Verkaik R, van Meijel B, Verkade PJ, Werkman W, Hertogh CMPM, Francke AL. Self-Management Support and eHealth When Managing Changes in Behavior and Mood of a Relative With Dementia: An Asynchronous Online Focus Group Study of Family Caregivers' Needs. Res Gerontol Nurs 2018; 11:151-159. [PMID: 29498746 DOI: 10.3928/19404921-20180216-01] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/02/2018] [Indexed: 11/20/2022]
Abstract
The current article discusses how and by whom family caregivers want to be supported in self-management when managing changes in behavior and mood of relatives with dementia and whether family caregivers consider eHealth a useful tool for self-management support. Four asynchronous online focus groups were held with 32 family caregivers of individuals with dementia. Transcripts of the online focus groups were analyzed using qualitative thematic analysis. Family caregivers need support from professionals or peers in the form of (a) information about dementia and its symptoms, (b) tips and advice on managing changes in behavior and mood, (c) opportunities to discuss experiences and feelings, and (d) appreciation and acknowledgement of caregiving. The opinions of family caregivers about self-management support through eHealth were also reported. Findings suggest a personal approach is essential to self-management support for family caregivers managing changes in behavior and mood of relatives with dementia. In addition, self-management support can be provided to some extent through eHealth, but this medium cannot replace personal contacts entirely. [Res Gerontol Nurs. 2018; 11(3):151-159.].
Collapse
|
48
|
De Groot K, Maurits EEM, Francke AL. Attractiveness of working in home care: An online focus group study among nurses. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e94-e101. [PMID: 28730631 DOI: 10.1111/hsc.12481] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/22/2017] [Indexed: 06/07/2023]
Abstract
Many western countries are experiencing a substantial shortage of home-care nurses due to the increasing numbers of care-dependent people living at home. In-depth knowledge is needed about what home-care nurses find attractive about their work in order to make recommendations for the recruitment and retention of home-care nursing staff. The aims of this explorative, qualitative study were to gain in-depth knowledge about which aspects home-care nurses find attractive about their work and to explore whether these aspects vary for home-care nurses with different levels of education. Discussions were conducted with six online focus groups in 2016 with a total of 38 Dutch home-care nurses. The transcripts were analysed using the principles of thematic analysis. The findings showed that home-care nurses find it attractive that they are a "linchpin", in the sense of being the leading professional and with the patient as the centre of care. Home-care nurses also find having autonomy attractive: autonomy over decision-making about care, freedom in work scheduling and working in a self-directed team. Variety in patient situations and activities also makes their work attractive. Home-care nurses with a bachelor's degree did not differ much in what they found attractive aspects from those with an associate degree (a nursing qualification after completing senior secondary vocational education). It is concluded that autonomy, variety and being a "linchpin" are the attractive aspects of working in home care. To help recruit and retain home-care nursing staff, these attractive aspects should be emphasised in nursing education and practice, in recruitment programmes and in publicity material.
Collapse
Affiliation(s)
- Kim De Groot
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Thebe Wijkverpleging [Home Care Organisation], Tilburg, The Netherlands
| | - Erica E M Maurits
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Anneke L Francke
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| |
Collapse
|
49
|
Nolan S, Hendricks J, Williamson M, Ferguson S. Using narrative inquiry to listen to the voices of adolescent mothers in relation to their use of social networking sites (SNS). J Adv Nurs 2017; 74:743-751. [PMID: 28910502 DOI: 10.1111/jan.13458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 07/27/2017] [Accepted: 08/15/2017] [Indexed: 12/13/2022]
Abstract
AIM This article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers. BACKGROUND Narrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences with SNS as a means of providing social support. DESIGN Discussion paper. DATA SOURCES This paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, "social networking sites", online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995-June 2017. IMPLICATIONS FOR PRACTICE/RESEARCH Narrative research inherently values the individual "story" of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents. CONCLUSION Narrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process.
Collapse
Affiliation(s)
- Samantha Nolan
- School of Nursing, Midwifery & Social Sciences, CQ University, Brisbane, QLD, Australia
| | - Joyce Hendricks
- School of Nursing, Midwifery & Social Sciences, CQ University, Brisbane, QLD, Australia
| | - Moira Williamson
- School of Nursing, Midwifery & Social Sciences, CQ University, Brisbane, QLD, Australia
| | - Sally Ferguson
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| |
Collapse
|
50
|
Strout TD, DiFazio RL, Vessey JA. Technology-enhanced focus groups as a component of instrument development. Nurse Res 2017. [PMID: 28639521 DOI: 10.7748/nr.2017.e1458] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Bullying is a critical public health problem and a screening tool for use in healthcare is needed. Focus groups are a common tool for generating qualitative data when developing an instrument and evidence suggests that technology-enhanced focus groups can be effective in simultaneously engaging participants from diverse settings. Aim To examine the use of technology-enhanced focus groups in generating an item pool to develop a youth-bullying screening tool. Discussion The authors explore methodological and ethical issues related to conducting technology-enhanced focus groups, drawing on their experience in developing a youth-bullying measure. They conducted qualitative focus groups with professionals from the front lines of bullying response and intervention. They describe the experience of conducting technology-enhanced focus group sessions, focusing on the methodological and ethical issues that researchers engaging in similar work may encounter. Challenges associated with this methodology include establishing rapport among participants, privacy concerns and limited non-verbal communication. Conclusion The use of technology-enhanced focus groups can be valuable in obtaining rich data from a wide variety of disciplines and contexts. Organising these focus groups was inexpensive and preferred by the study's participants. Implications for practice Researchers should consider using technology-enhanced focus groups to generate data to develop health-related measurement tools.
Collapse
|