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Lagura JA, Dordunoo D, Mallidou A, Carey J, Borycki EM, Kushniruk A. Patient Journey Map: Metal Hypersensitivity. J Patient Exp 2023; 10:23743735231183576. [PMID: 37362250 PMCID: PMC10286172 DOI: 10.1177/23743735231183576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
In this study, we highlight patients' experiences with metal hypersensitivity (MH) after receiving implantable medical devices (IMDs). We aim to identify gaps in clinical care and improve outcomes for individuals who have or may be sensitive to metals. Secondary data analysis from a previous interpretative phenomenological qualitative study was utilized. Using patient journey maps, we explored the experiences of 8 individuals from outpatient settings who received IMD and have first-hand experience with MH. We documented their journey from MH symptom recognition to diagnosis and subsequent IMD management. The results reveal that the time frames from device implantation to the treatment of MH varied from 17 to 228 months. The longest phase on the patient journey maps was the symptom recognition phase, which refers to the time between symptom emergence and MH diagnosis. Participants also required extensive healthcare utilization following their initial surgery. These findings emphasize that MH should be considered in differential diagnoses for patients with IMD. Early screening and detection of MH can enhance patient safety, alleviate distress, and reduce unnecessary healthcare utilization.
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Affiliation(s)
| | - Dzifa Dordunoo
- School of Nursing, University of Victoria, Victoria, Canada
| | | | - Jett Carey
- School of Nursing, University of Victoria, Victoria, Canada
| | - Elizabeth M. Borycki
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
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Petrovic B, Bender JL, Liddy C, Afkham A, McGee SF, Morgan SC, Segal R, O’Brien MA, Julian JA, Sussman J, Urquhart R, Fitch M, Schneider ND, Grunfeld E. Implementation of a Web-Based Communication System for Primary Care Providers and Cancer Specialists. Curr Oncol 2023; 30:3537-3548. [PMID: 36975482 PMCID: PMC10047665 DOI: 10.3390/curroncol30030269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/03/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Healthcare providers have reported challenges with coordinating care for patients with cancer. Digital technology tools have brought new possibilities for improving care coordination. A web- and text-based asynchronous system (eOncoNote) was implemented in Ottawa, Canada for cancer specialists and primary care providers (PCPs). This study aimed to examine PCPs' experiences of implementing eOncoNote and how access to the system influenced communication between PCPs and cancer specialists. As part of a larger study, we collected and analyzed system usage data and administered an end-of-discussion survey to understand the perceived value of using eOncoNote. eOncoNote data were analyzed for 76 shared patients (33 patients receiving treatment and 43 patients in the survivorship phase). Thirty-nine percent of the PCPs responded to the cancer specialist's initial eOncoNote message and nearly all of those sent only one message. Forty-five percent of the PCPs completed the survey. Most PCPs reported no additional benefits of using eOncoNote and emphasized the need for electronic medical record (EMR) integration. Over half of the PCPs indicated that eOncoNote could be a helpful service if they had questions about a patient. Future research should examine opportunities for EMR integration and whether additional interventions could support communication between PCPs and cancer specialists.
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Affiliation(s)
- Bojana Petrovic
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Jacqueline L. Bender
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Clare Liddy
- Bruyère Research Institute, Ottawa, ON K1N 5C8, Canada
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Amir Afkham
- Ontario Health East, Ottawa, ON K1J 1J8, Canada
| | - Sharon F. McGee
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada
| | - Scott C. Morgan
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada
- Department of Radiology, Radiation Oncology and Medical Physics, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Roanne Segal
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada
| | - Mary Ann O’Brien
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Jim A. Julian
- Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, ON L8V 5C2, Canada
| | - Jonathan Sussman
- Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, ON L8V 5C2, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
- Department of Surgery, Nova Scotia Health, Halifax, NS B3H 2Y9, Canada
| | - Margaret Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
- CanIMPACT Patient Advisory Committee, Toronto, ON M5G 1V7, Canada
| | | | - Eva Grunfeld
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M7, Canada
- Ontario Institute for Cancer Research, Toronto, ON M5G 1N8, Canada
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3
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Patient Engagement in Health Research: Perspectives from Patient Participants. Curr Oncol 2023; 30:2770-2780. [PMID: 36975423 PMCID: PMC10047022 DOI: 10.3390/curroncol30030210] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/10/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Background and purpose: Over the past decade, patient engagement (PE) has emerged as an important way to help improve the relevance, quality, and impact of health research. However, there is limited consensus on how best to meaningfully engage patients in the research process. The goal of this article is to share our experiences and insights as members of a Patient Advisory Committee (PAC) on a large, multidisciplinary cancer research study that has spanned six years. We hope by sharing our reflections of the PAC experiences, we can highlight successes, challenges, and lessons learned to help guide PE in future health research. To the best of our knowledge, few publications describing PE experiences in health research teams have been written by patients, survivors, or family caregivers themselves. Methods: A qualitative approach was used to gather reflections from members of the Patient Advisory Committee regarding their experiences in participating in a research study over six years. Each member completed an online survey and engaged in a group discussion based on the emergent themes from the survey responses. Results: Our reflections about experiences as a PAC on a large, pan-Canadian research study include three overarching topics (1) what worked well; (2) areas for improvement; and (3) reflections on our overall contribution and impact. Overall, we found the experience positive and experienced personal satisfaction but there were areas where future improvements could be made. These areas include earlier engagement and training in the research process, more frequent communication between the patient committee and the research team, and on-going monitoring regarding the nature of the patient engagement. Conclusions: Engaging individuals who have experienced the types of events which are the focus of a research study can contribute to the overall relevance of the project. However, intentional efforts are necessary to ensure satisfactory involvement.
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Kukafka R, Julian JA, Liddy C, Afkham A, McGee SF, Morgan SC, Segal R, Sussman J, Pond GR, O'Brien MA, Bender JL, Grunfeld E. Web-Based Asynchronous Tool to Facilitate Communication Between Primary Care Providers and Cancer Specialists: Pragmatic Randomized Controlled Trial. J Med Internet Res 2023; 25:e40725. [PMID: 36652284 PMCID: PMC9892983 DOI: 10.2196/40725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/28/2022] [Accepted: 11/13/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer poses a significant global health burden. With advances in screening and treatment, there are now a growing number of cancer survivors with complex needs, requiring the involvement of multiple health care providers. Previous studies have identified problems related to communication and care coordination between primary care providers (PCPs) and cancer specialists. OBJECTIVE This study aimed to examine whether a web- and text-based asynchronous system (eOncoNote) could facilitate communication between PCPs and cancer specialists (oncologists and oncology nurses) to improve patient-reported continuity of care among patients receiving treatment or posttreatment survivorship care. METHODS In this pragmatic randomized controlled trial, a total of 173 patients were randomly assigned to either the intervention group (eOncoNote plus usual methods of communication between PCPs and cancer specialists) or a control group (usual communication only), including 104 (60.1%) patients in the survivorship phase (breast and colorectal cancer) and 69 (39.9%) patients in the treatment phase (breast and prostate cancer). The primary outcome was patient-reported team and cross-boundary continuity (Nijmegen Continuity Questionnaire). Secondary outcome measures included the Generalized Anxiety Disorder Screener (GAD-7), Patient Health Questionnaire on Major Depression, and Picker Patient Experience Questionnaire. Patients completed the questionnaires at baseline and at 2 points following randomization. Patients in the treatment phase completed follow-up questionnaires at 1 month and at either 4 months (patients with prostate cancer) or 6 months following randomization (patients with breast cancer). Patients in the survivorship phase completed follow-up questionnaires at 6 months and at 12 months following randomization. RESULTS The results did not show an intervention effect on the primary outcome of team and cross-boundary continuity of care or on the secondary outcomes of depression and patient experience with their health care. However, there was an intervention effect on anxiety. In the treatment phase, there was a statistically significant difference in the change score from baseline to the 1-month follow-up for GAD-7 (mean difference -2.3; P=.03). In the survivorship phase, there was a statistically significant difference in the change score for GAD-7 between baseline and the 6-month follow-up (mean difference -1.7; P=.03) and between baseline and the 12-month follow-up (mean difference -2.4; P=.004). CONCLUSIONS PCPs' and cancer specialists' access to eOncoNote is not significantly associated with patient-reported continuity of care. However, PCPs' and cancer specialists' access to the eOncoNote intervention may be a factor in reducing patient anxiety. TRIAL REGISTRATION ClinicalTrials.gov NCT03333785; https://clinicaltrials.gov/ct2/show/NCT03333785.
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Affiliation(s)
| | - Jim A Julian
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Clare Liddy
- Bruyère Research Institute, Ottawa, ON, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | | | - Scott C Morgan
- The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada.,Department of Radiology, Radiation Oncology and Medical Physics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Roanne Segal
- The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada
| | - Jonathan Sussman
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Gregory R Pond
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Mary Ann O'Brien
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Jacqueline L Bender
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Eva Grunfeld
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Ontario Institute for Cancer Research, Toronto, ON, Canada
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5
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Casanova NL, LeClair AM, Xiao V, Mullikin KR, Lemon SC, Freund KM, Haas JS, Freedman RA, Battaglia TA. Development of a workflow process mapping protocol to inform the implementation of regional patient navigation programs in breast oncology. Cancer 2022; 128 Suppl 13:2649-2658. [PMID: 35699611 PMCID: PMC9201987 DOI: 10.1002/cncr.33944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/06/2021] [Accepted: 08/20/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Implementing city-wide patient navigation processes that support patients across the continuum of cancer care is impeded by a lack of standardized tools to integrate workflows and reduce gaps in care. The authors present an actionable workflow process mapping protocol for navigation process planning and improvement based on methods developed for the Translating Research Into Practice study. METHODS Key stakeholders at each study site were identified through existing community partnerships, and data on each site's navigation processes were collected using mixed methods through a series of team meetings. The authors used Health Quality Ontario's Quality Improvement Guide, service design principles, and key stakeholder input to map the collected data onto a template structured according to the case-management model. RESULTS Data collection and process mapping exercises resulted in a 10-step protocol that includes: 1) workflow mapping procedures to guide data collection on the series of activities performed by health care personnel that comprise a patient's navigation experience, 2) a site survey to assess program characteristics, 3) a semistructured interview guide to assess care coordination workflows, 4) a site-level swim lane workflow process mapping template, and 5) a regional high-level process mapping template to aggregate data from multiple site-level process maps. CONCLUSIONS This iterative, participatory approach to data collection and process mapping can be used by improvement teams to streamline care coordination, ultimately improving the design and delivery of an evidence-based navigation model that spans multiple treatment modalities and multiple health systems in a metropolitan area. This protocol is presented as an actionable toolkit so the work may be replicated to support other quality-improvement initiatives and efforts to design truly patient-centered breast cancer treatment experiences. LAY SUMMARY Evidence-based patient navigation in breast cancer care requires the integration of services through each phase of cancer treatment. The Translating Research Into Practice study aims to implement patient navigation for patients with breast cancer who are at risk for delays and are seeking care across 6 health systems in Boston, Massachusetts. The authors designed a 10-step protocol outlining procedures and tools that support a systematic assessment for health systems that want to implement breast cancer patient navigation services for patients who are at risk for treatment delays.
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Affiliation(s)
- Nicole L Casanova
- University of Washington School of Public Health, 1959 NE Pacific St., Seattle, WA, United States of America
| | - Amy M LeClair
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center,800 Washington Street., Boston, MA, United States of America
| | - Victoria Xiao
- Boston Medical Center, 801 Massachusetts Ave., Boston, MA, United States of America
| | - Katelyn R Mullikin
- Boston Medical Center, 801 Massachusetts Ave., Boston, MA, United States of America
| | - Stephenie C Lemon
- University of Massachusetts Medical School, 368 Plantation St., Worcester MA, United States of America
| | - Karen M Freund
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center,800 Washington Street., Boston, MA, United States of America
| | - Jennifer S Haas
- Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, United States of America
| | - Rachel A Freedman
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, United States of America
| | - Tracy A Battaglia
- Boston Medical Center, 801 Massachusetts Ave., Boston, MA, United States of America,Boston University School of Medicine, 801 Massachusetts Ave., Boston, MA, United States of America
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Schoepen M, Vansteenkiste E, De Gersem W, Detand J. Systems thinking and designerly tools for medical device design in engineering curricula. Health Syst (Basingstoke) 2022; 12:461-471. [PMID: 38235301 PMCID: PMC10791094 DOI: 10.1080/20476965.2022.2072778] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/21/2022] [Indexed: 10/18/2022] Open
Abstract
Background In this paper we focus on medical device development (MDD) in Industrial Design Engineering (IDE) academia. We want to find which methods our MDD-students currently use, where our guidance has shortcomings and where it brings added value. Methods We have analysed 19 master and 3 doctoral MDD-theses in our IDE curriculum. The evaluation focusses around four main themes: 1) regulatory 2) testing 3) patient-centricity and 4) systemic design. Results Regulatory aspects and medical testing procedures seem to be disregarded frequently. We assume this is because of a lack of MDD experience and the small thesis timeframe. Furthermore, many students applied medical-oriented systemic tools, which enhances multiperspectivism. However, we found an important lack in the translation to the List of Specifications and to business models of these medical devices. Finally, students introduced various participatory techniques, but seem to struggle with implementing this in the setting of evidence-based medicine.
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Affiliation(s)
- Max Schoepen
- Department of Industrial Systems Engineering and Product Design, Ghent University, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | | | - Werner De Gersem
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Jan Detand
- Department of Industrial Systems Engineering and Product Design, Ghent University, Ghent, Belgium
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Scherer LD, Matlock DD, Allen LA, Knoepke CE, McIlvennan CK, Fitzgerald MD, Kini V, Tate CE, Lin G, Lum HD. Patient Roadmaps for Chronic Illness: Introducing a New Approach for Fostering Patient-Centered Care. MDM Policy Pract 2021; 6:23814683211019947. [PMID: 34277949 PMCID: PMC8255605 DOI: 10.1177/23814683211019947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/30/2021] [Indexed: 12/25/2022] Open
Abstract
Background. Too frequently, patients with chronic illnesses are surprised by disease-related changes and are unprepared to make decisions based on their values. Many patients are not activated and do not see a role for themselves in decision making, which is a key barrier to shared decision making and patient-centered care. Patient decision aids can educate and activate patients at the time of key decisions, and yet, for patients diagnosed with chronic illness, it would be advantageous to activate patients in advance of critical decisions. In this article, we describe and formalize the concept of the Patient Roadmap, a novel approach for promoting patient-centered care that aims to activate patients earlier in the care trajectory and provide them with anticipatory guidance. Methods. We first identify the gap that the Patient Roadmap fills, and describe theory underlying its approach. Then we describe what information a Patient Roadmap might include. Examples are provided, as well as a review comparing the Patient Roadmap concept to existing tools that aim to promote patient-centered care (e.g., patient decision aids). Results and Conclusions. New approaches for promoting patient-centered care are needed. This article provides an introduction and overview of the Patient Roadmap concept for promoting patient-centered care in the context of chronic illness.
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Affiliation(s)
- Laura D. Scherer
- Laura D. Scherer, Division of Cardiology, University of Colorado Anschutz Medical Campus, Fitzsimons Building, 13001 East 17th Place, Aurora, CO 80045, USA ()
| | - Daniel D. Matlock
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,VA Eastern Colorado, Aurora, Colorado
| | - Larry A. Allen
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Chris E. Knoepke
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Colleen K. McIlvennan
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Monica D. Fitzgerald
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Vinay Kini
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Channing E. Tate
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Grace Lin
- Department of General Internal Medicine, University of California San Francisco, San Francisco, California
| | - Hillary D. Lum
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,VA Eastern Colorado, Aurora, Colorado
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8
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Holden RJ, Abebe E. Medication transitions: Vulnerable periods of change in need of human factors and ergonomics. APPLIED ERGONOMICS 2021; 90:103279. [PMID: 33049545 PMCID: PMC7606579 DOI: 10.1016/j.apergo.2020.103279] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 06/06/2023]
Abstract
We present a novel view of transitions from the lens of patient ergonomics (the "science of patient work"), which posits that patients and other non-professionals perform effortful work towards health-related goals. In patient work transitions, patients experience changes in, for example, health, task demands, work capacity, roles and responsibilities, knowledge and skills, routines, needs and technologies. Medication transitions are a particularly vulnerable type of patient work transitions. We describe two cases of medication transitions-new medications and medication deprescribing-in which the patient work lens reveals many accompanying changes, vulnerabilities, and opportunities for human factors and ergonomics.
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Affiliation(s)
- Richard J Holden
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA; Center for Health Innovation and Implementation Science, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Ephrem Abebe
- Purdue University College of Pharmacy, West Lafayette, IN, USA
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Visual Elicitation: Methods for Enhancing the Quality and Depth of Interview Data in Applied Qualitative Health Research. ANS Adv Nurs Sci 2020; 43:202-213. [PMID: 32732605 DOI: 10.1097/ans.0000000000000321] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Generating rich data from interviews for a qualitative study can be difficult to operationalize; especially when difficulties establishing rapport, power imbalances, and participant factors threaten the interview process and quality of data. The aim of this methods article is to (a) discuss the value of incorporating visual elicitation tools or tasks within semistructured or in-depth qualitative interviews to enhance the depth of data generated and (b) provide a specific example of how this is planned and executed within the context of an applied qualitative health research study.
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10
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Affiliation(s)
- Eva Grunfeld
- University of Toronto, Toronto, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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11
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Grunfeld E. The two solitudes of primary care and cancer specialist care: is there a bridge? ACTA ACUST UNITED AC 2017; 24:69-70. [PMID: 28490918 DOI: 10.3747/co.24.3488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
In Canadian Cancer Statistics, the Canadian Cancer Society recently reported a projected increase in cancer incidence of 40% by 2030. [...]
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Affiliation(s)
- E Grunfeld
- Ontario Institute for Cancer Research, Toronto, and.,Department of Family and Community Medicine, University of Toronto, Toronto, ON
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