1
|
Hastings C. Is the Calgary-Cambridge Model of consultation a suitable communication tool for students and newly qualified paramedics? A qualitative study. Br Paramed J 2024; 9:23-33. [PMID: 38946736 PMCID: PMC11210582 DOI: 10.29045/14784726.2024.6.9.1.23] [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: 07/02/2024] Open
Abstract
Introduction The Calgary-Cambridge Model (C-CM), developed by Kurtz and Silverman in 1996, is a communication tool developed for doctors. Since its publication, it has been adopted by various healthcare professionals; however, no previous research has been identified that evaluates its use in paramedic practice. This study aims to explore the experience of students and newly qualified paramedics (NQPs) applying the C-CM in practice, and establish their experiences and perceptions of its suitability as a communication tool in the pre-hospital environment. Methods This MSc research project, conducted in April-May 2021, applied qualitative methods with thematic analysis to written reflections and semi-structured interview transcripts discussing the implementation of C-CM in paramedic practice. A convenience-quota sample of 11 participants, consisting of third-year paramedic students and recent NQPs, were recruited. This research is reported using Consolidated Criteria for Reporting Qualitative Research (COREQ) reporting guidelines. Results Eleven participants were recruited in total; nine consented to reflective writing analysis and interviews, two consented to writing analysis only. Analysis of the writing samples allowed for a deductive approach to the interview plan. Participants consisted of seven males and four females. All eleven participants (ten British and one Indian) spoke English as a first language. Ages ranged from 18 to 59 years. Career status was 46.2% third-year students and 53.8% NQPs. Four major themes were identified: barriers to implementation of the C-CM in practice; impact of C-CM on paramedic practice; C-CM as a teaching and learning tool in paramedic practice; and adaptation of C-CM for paramedic practice. Conclusions Participants suggested that implementation of C-CM leads to improved structure and shared decision-making; however, adaptions to make it more paramedic-focused would be welcomed. The diversity of patients and their preferences can make its implementation challenging, and the negative feedback received from experienced ambulance staff was a significant concern to participants.
Collapse
Affiliation(s)
- Claire Hastings
- Sheffield Hallam University ORCID iD: https://orcid.org/0009-0003-4139-0981
| |
Collapse
|
2
|
Noack EM, Bramesfeld A, Schmid S, Schröder D, Müller F. [Rescue Missions with Patients with Psychiatric and Psychosocial Symptoms: An Analysis from Eastern Lower Saxony]. PSYCHIATRISCHE PRAXIS 2024. [PMID: 38810903 DOI: 10.1055/a-2310-5534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
OBJECTIVE Characterization of medical emergencies of patients with psychiatric symptoms or in psychosocial crisis. METHODS Analysis of emergency medical services (EMS) mission logs from four German EMS stations of patients aged 12-65 from 2019 to 2020. RESULTS 23.4% of missions involved patients with psychiatric or psychosocial symptoms (1.6% psychotic, 3.0% suicidal, 7.1% psychosocial crisis, 15.7% intoxicated). On average, these patients were younger than those with other symptoms. 48.9% exhibited additional somatic complaints. The COVID-19 pandemic showed only little impact on the frequency of such emergencies. CONCLUSION Psychiatric and psychosocial symptoms account for a significant proportion of rescue missions in our sample. Managing psychiatric and psychosocial emergencies should be an integral part of the training of medical and paramedical staff.
Collapse
Affiliation(s)
- Eva Maria Noack
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen
| | - Anke Bramesfeld
- Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover
| | | | | | - Frank Müller
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen
| |
Collapse
|
3
|
Kiblinger T, Daniels K, Calamaro C. Point-of-care communication for patients with limited language proficiency: A scoping review of healthcare interpretation applications. PATIENT EDUCATION AND COUNSELING 2024; 119:108060. [PMID: 37976669 DOI: 10.1016/j.pec.2023.108060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 10/17/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Linguistic diversity has the potential to create barriers for limited language proficiency (LLP) patients when navigating the healthcare system. When a verified interpretation method is utilized, there are improvements in LLP patient outcomes. The purpose of this scoping review is to identify articles that outline applications used for point-of-care tasks between LLP patients and providers. METHODS The Arksey and O'Malley methodologic framework was utilized for study selection, data charting and analysis. Each application was evaluated on patient and provider satisfaction, overall feasibility, and time associated with interpretation. RESULTS Eight peer-reviewed journals are included (four pilot studies, one prospective study, two participatory studies, and one mixed methods design). Applications ranged in number of unique phrases (32-1800 phrases) and number of languages supported (1-39 languages). Overall, the applications were feasible to use and assisted with basic communication between providers and patients. CONCLUSIONS As patients and families become more comfortable with using technology, interpretation applications provide an innovative approach to streamline the interpretation process for point-of-care healthcare encounters. PRACTICE IMPLICATIONS Interpretation applications may increase an LLP patient's access to interpretation tools which can improve outcomes. Further studies should focus on implementing robust evaluation methods to assess these tools and evaluate the LLP patient's perspectives of interpretation applications.
Collapse
Affiliation(s)
- Theresa Kiblinger
- Children's Healthcare of Atlanta, Atlanta, USA; Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, USA.
| | | | - Christina Calamaro
- Children's Healthcare of Atlanta, Atlanta, USA; Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, USA
| |
Collapse
|
4
|
Müller F, Schröder D, Schäning J, Schmid S, Noack EM. Lost in translation? Information quality in pediatric pre-hospital medical emergencies with a language barrier in Germany. BMC Pediatr 2023; 23:312. [PMID: 37344777 DOI: 10.1186/s12887-023-04121-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND In pediatric medical emergencies, paramedics and emergency physicians must often rely on the information of third parties, often caregivers, to gather information. Failing to obtain relevant information may lead to misinterpretation of symptoms and subsequent errors in decision making and clinical treatment. Thus, children and/or caregivers with limited proficiency of the locally spoken language may be at risk for medical errors. This study analyzes logs of rescue missions to determine whether paramedics could obtain essential information from German-speaking and foreign-language children and their caregivers. METHODS We conducted a secondary data analysis based on retrospective data on pediatric patients of four emergency medical services (EMS) stations in Northern Germany. We defined language discordance with communication difficulties as main exposure. We used documentation quality as outcome defined as existing information on (a) pre-existing conditions, (b) current medication, and (c) events prior to the medical emergency. Statistical analyses include descriptive statistics, simple regression and multivariable regression. As multivariable regression model, a logistic regression was applied with documentation quality as dependent variable and language discordance with communication difficulties as independent variable adjusted for age, sex and Glasgow Coma Scale (GCS). RESULTS Data from 1,430 pediatric rescue missions were analyzed with 3.1% (n = 45) having a language discordance with communication difficulties. Patients in the pediatric foreign-language group were younger compared to German-speaking patients. Thorough documentation was more frequent in German-speaking patients than in patients in the foreign-language group. Pre-existing conditions and events prior to the medical emergency were considerably more often documented in German-speaking than for foreign-language patients. Documentation of medication did not differ between these groups. The adjustment of sex, age and GCS in the multivariable analysis did not change the results. CONCLUSION Language barriers are hindering paramedics to obtain relevant information in pediatric pre-hospital emergencies. This jeopardizes the safe provision of paramedic care to children who themselves or their caregivers are not fluent in German language. Further research should focus on feasible ways to overcome language barriers in pre-hospital emergencies. TRIAL REGISTRATION This is a retrospective secondary data analysis of a study that was registered at the German Clinical Trials Register (No. DRKS00016719), 08/02/2019.
Collapse
Affiliation(s)
- Frank Müller
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, DE, Germany.
| | - Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, DE, Germany
| | - Jennifer Schäning
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, DE, Germany
| | - Sybille Schmid
- Fire Department, City of Braunschweig, Brunswick, DE, Germany
| | - Eva Maria Noack
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, DE, Germany
| |
Collapse
|
5
|
Fernández C, Vicente MA, Guilabert M, Carrillo I, Mira JJ. Developing a mobile health app for chronic illness management: Insights from focus groups. Digit Health 2023; 9:20552076231210662. [PMID: 37928329 PMCID: PMC10621305 DOI: 10.1177/20552076231210662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Background Mobile applications have the potential to assist patients and caregivers in managing chronic diseases, but current offerings are typically limited to a single disease or only focused on patients. A multifaceted app could expand the user base and provide more comprehensive support for patients who usually suffer from diverse chronic conditions at the same time and their caregivers. Objectives This study aimed to design, develop, and evaluate a mobile application that could aid chronic patients and their caregivers in managing the range of chronic conditions. Methods Focus group meetings were conducted with patients and caregivers to identify their needs, which were translated into app functionalities. The final version of the app was evaluated through a survey and analysis of the most used features. Results Five focus group (FG) meetings were held, involving 39 patients and 22 caregivers. The app included medication aids, self-monitoring aids, activation reminders, messages for caregiver shifts, remote monitoring, medicine management, and informative videos. Testing by 65 patients revealed that medication reminders (96.8% positive responses), medicine information (96.8%), messages for caregiver shifts (90.3%), and ease of use (80.6%) were the most valued aspects. The most frequently used feature was the health data record check. Conclusions A multifaceted mobile application can address the needs of a variety of chronic patients and their caregivers, while still being easy to use. The app's most used functionalities were aligned with the needs expressed in the FG, which reflects the success of this study and suggests that future research could benefit from incorporating similar user-centered design methodologies.
Collapse
Affiliation(s)
- César Fernández
- Telematics Engineering, Miguel Hernandez University, Elche, Spain
| | | | | | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - José Joaquín Mira
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| |
Collapse
|
6
|
Mohammadi F, Jeihooni AK, Sabetsarvestani P, Abadi F, Bijani M. Exploring the challenges to telephone triage in pre-hospital emergency care: a qualitative content analysis. BMC Health Serv Res 2022; 22:1195. [PMID: 36151507 PMCID: PMC9502955 DOI: 10.1186/s12913-022-08585-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 09/19/2022] [Indexed: 12/04/2022] Open
Abstract
Background One of the important indices for the efficacy of pre-hospital emergency services is telephone triage. The dispatching team members are faced with many challenges in telephone triage which can adversely affect their performance. This study was conducted in the south of Iran to determine the challenges to telephone triage in pre-hospital emergency services. Method The present study is qualitative-descriptive where the sample was selected purposefully. Data were collected through 18 semi-structured, in-depth interviews with 18 dispatching team members in pre-hospital emergency care. The collected qualitative data were analyzed using the content analysis approach recommended by Graneheim and Lundman. Results Analysis of the data resulted in the emergence of three themes and ten sub-themes. The three main themes extracted from the data included inefficient interaction, insufficient and unreal information, and professional challenges. Conclusion The dispatching unit personnel in pre-hospital emergency care are confronted with various interactional, organizational, and professional issues. Accordingly, the senior managers in emergency departments should take effective measures to remove the existing barriers toward improving the efficacy of telephone triage and, by extension, the quality of pre-hospital emergency care services. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08585-z.
Collapse
Affiliation(s)
- Fateme Mohammadi
- Department of Nursing, Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Khani Jeihooni
- Department of General Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Fozieh Abadi
- School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- School of Nursing, Fasa University of Medical Sciences, Fasa, Iran. .,Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran.
| |
Collapse
|
7
|
Dinari F, Bahaadinbeigy K, Moulaei K. Analysis of requirements for developing a mobile device‐based medicines management application for people who are blind and visually impaired. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2022. [DOI: 10.1002/jppr.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Fatemeh Dinari
- Medical Informatics Research Centre Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Centre Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Khadijeh Moulaei
- Medical Informatics Research Centre Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| |
Collapse
|
8
|
Noack EM, Schäning J, Müller F. A Multilingual App for Providing Information to SARS-CoV-2 Vaccination Candidates with Limited Language Proficiency: Development and Pilot. Vaccines (Basel) 2022; 10:360. [PMID: 35334992 PMCID: PMC8955787 DOI: 10.3390/vaccines10030360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/24/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
Language barriers are obstacles in receiving vaccinations against COVID-19. They jeopardize informed consent, vaccination safety, and a positive immunization experience. We have developed a multilingual app to overcome language barriers when dealing with vaccination candidates with a limited proficiency in the locally spoken language. We applied the Spiral Technology Action Research (STAR) model to create the app within a discursive process involving healthcare professionals (HCPs) from vaccination sites, literature searches and guidelines, and field trials at vaccination centers. In a real-world pilot test, we assessed the usability and feedback for further improvement. Our efforts resulted in an app that facilitates communication with vaccination candidates in 40 languages, each with over 500 phrases that can be played back or displayed as text. In the pilot test, the app demonstrated its usability, and was well accepted by the vaccination candidates (n = 20). The app was mainly used to inform about the risks and benefits of the SARS-CoV-2 vaccination. Some HCPs struggled to navigate the comprehensive content and the pilot test exposed the need for additional phrases. The STAR model proved to be flexible in adapting to dynamic pandemic conditions and changing recommendations. This multilingual app overcomes language barriers in healthcare settings, promoting vaccines to migrants with limited language proficiency.
Collapse
Affiliation(s)
- Eva Maria Noack
- Department of General Practice, University Medical Center Göttingen, 37073 Göttingen, Germany; (J.S.); (F.M.)
| | | | | |
Collapse
|
9
|
Müller F, Hummers E, Schulze J, Noack EM. [Usability of an app to overcome language barriers in paramedic care]. Notf Rett Med 2021; 25:570-577. [PMID: 34230808 PMCID: PMC8251687 DOI: 10.1007/s10049-021-00913-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 11/30/2022]
Abstract
Hintergrund Im Rettungsdienst können, im Gegensatz zum stationären Setting, adäquate Dolmetscher häufig nicht ohne Weiteres hinzugezogen werden. Gleichzeitig erfordern Notfallsituationen aber eine rasche Anamnese und ein Assessment als Basis für jedes therapeutische Handeln. Material und Methoden Eine Smartphone-App, die auf 18 Sprachen eine basale Kommunikation mittels 600 fest eingesprochener unterschiedlicher Phrasen auf 20 Sprachen ermöglicht, wurde über 6 Monate in vier Rettungswachen pilotiert. Abschließend wurde die Nutzbarkeit der App durch das gesamte Rettungsdienstpersonal in einer Fragebogenstudie unter Verwendung des System Usability Scores und des AttrakDiff-Fragebogens bewertet. Ergebnisse Die Rücklaufquote betrug 48,5 % und n = 48 Fragebögen wurden ausgewertet. Das Durchschnittsalter der Befragten betrug 36 Jahre und fast zwei Drittel waren männlichen Geschlechts. Der System Usability Score zeigte im Median 67,5 Punkte, was eine grenzwertig gute Nutzbarkeit zeigte. Im AttrakDiff-Fragebogen zeigte sich die pragmatische Qualität mit durchschnittlich 0,69 (SD 0,86), die hedonische Qualität mit 0,59 (SD 0,58) und die Attraktivität (ATT) mit 0,64 Punkten (SD 0,83). Die Durchschnittswerte zeigen zufriedenstellende Werte jeweils oberhalb der neutral markierenden Grenze von 0. Auffällig zeigte sich, dass in wesentlichen Bewertungskriterien diejenigen Rettungsdienstkräfte, die angaben, die App bereits aktiv im Einsatz mit Patienten genutzt zu haben, die App signifikant besser einschätzten. Diskussion Vor dem Hintergrund, dass es sich bei der untersuchten App um ein komplexes Arbeitswerkzeug handelt, werden die Nutzbarkeit und Attraktivität als insgesamt gut eingeschätzt, wobei in der Nutzung erfahrene Rettungskräfte diese noch positiver einschätzten. Dies könnte auf eine Art Schwellenangst hindeuten, einer bereits durch Sprach- und kulturelle Barrieren geprägten Rettungssituation mit einer ebenfalls recht komplexen Intervention zu begegnen.
Collapse
Affiliation(s)
- Frank Müller
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073 Göttingen, Deutschland
| | - Eva Hummers
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073 Göttingen, Deutschland
| | - Jennifer Schulze
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073 Göttingen, Deutschland
| | - Eva Maria Noack
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073 Göttingen, Deutschland
| |
Collapse
|