A focus group interview

BACKGROUND

As healthcare and especially health technology evolve rapidly, new challenges require healthcare professionals to take on new roles. Consequently, the demand for health informatics competencies is increasing, and achieving these competencies using frameworks, such as Technology Informatics Guiding Reform (TIGER), is crucial for future healthcare.

AIM

The study examines essential health informatics and educational competencies and health informatics challenges based on TIGER Core Competency Areas. Rather than examine each country independently, the focus is on uncovering commonalities and shared experiences across diverse contexts.

METHODS

Six focus group interviews were conducted with twenty-one respondents from three different countries (Germany (n = 7), Portugal (n = 6), and Finland (n = 8)). These interviews took place online in respondents' native languages. All interviews were transcribed and then summarized by each country. Braun and Clarke's thematic analysis framework was applied, which included familiarization with the data, generating initial subcategories, identifying, and refining themes, and conducting a final analysis to uncover patterns within the data.

RESULTS

Agreed upon by all three countries, competencies in project management, communication, application in direct patient care, digital literacy, ethics in health IT, education, and information and knowledge management were identified as challenges in healthcare. Competencies such as communication, information and communication technology, project management, and education were identified as crucial for inclusion in educational programs, emphasizing their critical role in healthcare education.

CONCLUSIONS

Despite working with digital tools daily, there is an urgent need to include health informatics competencies in the education of healthcare professionals. Competencies related to application in direct patient care, IT-background knowledge, IT-supported and IT-related management are critical in educational and professional settings are seen as challenging but critical in healthcare.

Barriers encountered by nurses in the care of walk-in international patients in an emergency department in Japan

BACKGROUND

An increasing number of international patients continue to visit emergency departments (EDs) in Japanese hospitals. However, nurses in Japan perceive challenges when caring for patients from other countries. This study explored ED nurses' perceptions of barriers when caring for walk-in international patients.

METHODS

Five semi-structured online focus group interviews involving 15 registered nurses with experience in caring for patients in an ED at a university referral hospital located in the center of Tokyo were conducted. Thematic analysis was used to identify patterns from the interviews.

RESULTS

The themes that emerged were as follows: (1) hesitation to engage with patients due to ambiguity, (2) loss of harmony in the ED, (3) difficulty with mutual goal settings, and (4) decreased professional self-efficacy.

CONCLUSION

The findings provide an understanding of the challenges faced when caring for walk-in international patients. Educational interventions for ED nurses and other strategies, such as the use of interpreters, can enhance nurses' abilities to improve patient safety and maintain equality.

Orthopaedic nurses' experiences with real-time documentation in a high-tech ward: A qualitative study

BACKGROUND

Real-time documentation is a novel process that changes nursing workflow; however, nurses' experiences of real-time documentation are unknown.

AIM

This study aimed to explore nurses' experiences with real-time documentation in an orthopaedic ward.

DESIGN

This qualitative study took a phenomenological-hermeneutic approach.

METHODS

Data were generated from three semi-structured focus group interviews with 18 nurses from an orthopaedic ward. Data analysis was based on Ricoeur's theory of narrative and interpretation and included naïve reading, structural analysis and critical interpretation, and discussion.

RESULTS

Five themes emerged from the structural analysis: 1) nurses were initially sceptical and outside of their comfort zone; 2) implementation required support from the head nurse and other colleagues; 3) increased time with patients led to better relationships, but nurses lacked time for reflection; 4) increased patient involvement could also present challenges; and 5) documentation became more integrated into orthopaedic nursing.

CONCLUSION

Real-time documentation improved orthopaedic nursing documentation and increased patient involvement. Nurses spent more time with patients, leading to better relationships, but they had decreased time with their colleagues and the opportunity to reflect. Real-time documentation leads to changes in workflow, so, nurses should be provided with training and the opportunity to reflect.

Effects of participatory workplace improvement program on stress-related biomarkers and self-reported stress among university hospital nurses: a preliminary study

Although participatory workplace improvement programs are known to provide favorable effects on high stress occupations like nursing, no studies have confirmed its effect using biomarkers. The aim of this study was to determine whether a participatory workplace improvement program would decrease stress-related symptoms as evaluated by biomarkers and self-reported stress among hospital nurses. Three actions to alleviate job stress, which were determined through focus group interviews and voting, were undertaken for two months. A total of 31 female Japanese nurses underwent measurement of inflammatory markers, autonomic nervous activity (ANA), and perceived job stress (PJS) at three-time points; before the program (T1), within a week after the completion of the program (T2), and three months after the program (T3). A series of inflammatory markers (Interferon-γ, Interleukin (IL)-6, and IL-12/23p40) decreased significantly at T2, and IL-12/23p40 and IL-15 significantly decreased at T3 compared to T1, while ANA and PJS remained unchanged. Our participatory program exerted beneficial effects in reducing inflammatory responses, but not for ANA and PJS. Further investigations with a better study design, i.e., a randomized controlled trial, and a larger sample size are warranted to determine what exerted beneficial effects on inflammatory markers and why other outcomes remained unchanged.

Importance of congruence between communicating and executing implementation programmes: a qualitative study of focus group interviews

Background

The Ostrobothnia Depression Programme (ODP) in Finland was intended to implement two evidence-based brief psychotherapy interventions, namely motivational interview and behavioural activation, in several regional psychiatric teams. A simultaneous effectiveness study was conducted. Considerable tension was encountered between these two arms, causing resistance to change. We conducted a qualitative case study to better understand this tension and to discuss how managerial and executive practices may ensure the successful running of a hybrid design programme.

Methods

We conducted focus group interviews to evaluate the phases of preparation and practical execution of the ODP from the perspectives of management and the programme executives. To gather the data, we applied the revised Socratic approach for health technology assessment and focus group interviews. We analysed the data deductively according to the Normalization Process Theory.

Results

We identified two main critical issues: (1) The ODP programme plan ignored the team leaders’ crucial role in influencing the implementation climate and mobilizing organizational strategies. The ODP had a simplistic top-down design with minimal and delayed collaboration with its target groups in the preparation phase. (2) Incongruence occurred between what the project group had explicitly communicated about being the spearhead of the ODP and what they then actually enacted. These two issues caused tension between the implementation efforts and the effectiveness study as well as resistance to change among the staff.

Conclusion

Early, open collaboration with all prospective stakeholders towards a shared understanding about the programme is the first action the programme administrators should take. Agreement on goals and the means to achieve them would lower tension between the two arms of a hybrid design programme, thereby reducing resistance to change. Congruence between the goals communicated and the actual managerial and executive actions is of paramount importance in getting the programme recipients on board.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43058-020-00090-w.

Exploring the perceptions of cancer survivors of a mindfulness intervention at a tertiary hospital in Singapore: a descriptive qualitative study

BACKGROUND

Cancer survivors often experience physical and psychological symptoms that may affect their daily activities and quality of life. A mindfulness-based psychoeducation for cancer survivors, (MindCAN) program, has been established to help cancer survivors manage their physical and psychological symptoms. This study aimed to explore perceptions of participants who attended the MindCAN program.

METHODS

A descriptive qualitative study was conducted at a tertiary hospital in Singapore. Purposive sampling was used to recruit adult cancer survivors. They attended the MindCAN program that was conducted once a week for 8 weeks, comprising education and mindfulness practice. Two focus group interviews were conducted to elicit the participants' perceptions of the program. The interviews were audio-recorded and transcribed verbatim. A thematic analysis was performed to identify essential themes and subthemes. Trustworthiness, including creditability, confirmability, dependability, and transferability were ascertained.

RESULTS

A total of 13 participants were recruited. Most of whom were Chinese, female, and single. The participants' perceptions were documented in five major themes: heightened awareness of the self, enriching body experiences through mindfulness practice, cultivating powerful minds and positive emotions, integrating mindfulness to daily life, and embracing interpersonal mindfulness.

CONCLUSION

Overall, the MindCAN program received positive comments from cancer survivors. They reported increased self-awareness, pleasant body experiences, positive thinking and emotions, and relaxation. Future research is required to test the effectiveness of the program.

Practical nursing students' discursive practices on smoking in Finland

Purpose: Based on focus groups, we analyse how practical nursing students deal with being as smokers and future healthcare workers. The way they justify their smoking is discussed within a group of peers.

Methods: The study has a qualitative design with an inductive approach using focus group interviews (FGIs) for data collection. A total of 29 students were interviewed in five groups of five and one group of four participants.

Results: In the analysis, we found four different discursive practices the students utilized for rationalizing their own smoking and coping with the moral dilemma of smoking in a context of health care where smoking is forbidden: (1) students normalized smoking with references to its prevalence within their social circles, (2) the students asserted that their smoking was under control, (3) students considered themselves responsible smokers, and (4) students identified smoking as a part of their identity.

Conclusion: Training should support the growth of professional identity and address the smoker’s identity right from the start of education. Smokers need special attention in the formulation of professional identity, however, without being stigmatized any further.

Understanding medical students' practices and perceptions towards vaccination in China: A qualitative study in a medical university

The qualitative study aims to understand and conceptualize Chinese medical students' practices and perceptions towards vaccination. Focus groups (n = 5) were conducted through convenience sampling in a medical university in October 2016 in Anhui, China. Two years later, 6 participants among them were follow-up interviewed. All the interviews were audio-recorded, then transcribed verbatim, and analyzed using constant comparative method. Opinions of 22 participants (13 females, 9 males) were collected. Results revealed that hepatitis B vaccination was discussed the most frequently, and most of participants were vaccinated against (or had documented immunity to) hepatitis B before or during their clinical internship. None of the participants reported other vaccines uptake. Three dimensions of themes were identified: (i) at individual level, the factor "feeling less infection risk" might strengthen their perceived barriers. The factors "laziness" and "fluke mind" would be used to rationalize their inactive practices about vaccination; (ii) at social level, themes involved "inactive organizational behaviors", "suggestions from people around", and "social norms". Decision-making of medical students' vaccination was more relying on themselves and influenced more by their classmates before or during their internship, rather than being influenced more by their families/universities as before. (iii) at professional level, there are two contradictions about the participants' behaviors and attitudes. One is that they may have inappropriate behaviors because of their lack of knowledge, but sometimes they seem too satisfied about their medical knowledge to vaccination. The other is that there are both vigilance response and desensitization to occupational infection risk. It is suggested that efforts should be strengthened to spread scientific knowledge of infectious diseases and immunization as long as medical students enter the university. Publicity and organizational activities should be strengthened, and related researches should be carried out by the government or scholars.

A cooperative support model for cancer therapy and employment balance: from focus-group interviews of health and business professionals

This study aimed to obtain a comprehensive collection of ideas and opinions from the perspective of various professionals and support providers for cancer treatment and employment balance. We performed a focus group interview, and a model diagram was created using categories created via classification of important items. The focus group interview revealed six strategies aligned with seven issues concerning the support needed to balance cancer treatment and employment. These strategies suggested the importance of not only the way of directly connecting among several specialists but also the presence and the role of the coordinators with their own specialties. Workers with cancer need supportive advices after their initial diagnosis, when returning to work, and after returning to work. After returning to work, a number of problems resulted from the lack of advice at the time of diagnosis or when returning to work. These results emphasized the necessity for the development of early comprehensive system for integrated collaboration between medical institutions, workplaces and other occupational health institutions. The results suggest that a multi-profession collaboration model is necessary to support cancer patients staying at work, which includes the cooperation between medical institutions and their counterparts from occupational health and the patients' employers.

Difficulties in using personal protective equipment: Training experiences with the 2015 outbreak of Middle East respiratory syndrome in Korea

This study aimed to evaluate practical barriers to personal protective equipment (PPE) use found through health care personnel (HCP) training sessions held during and after the 2015 Middle East respiratory syndrome outbreak in Korea. Difficulties observed were ill-fitting sizes, anxiety, confusion from unstandardized protocols, doubts about PPE quality and effectiveness, and complexity of using several PPE items together. Further research to generate robust evidence and repeated HCP trainings are necessary to ensure HCP and patient safety in future outbreaks.

A qualitative study on feedback provided by students in nurse education

BACKGROUND

This study aims to help nurse educators/academics understand the perspectives and expectations of students providing their feedback to educators about teaching performance and subject quality.

AIM

The aim of this study is to reveal students' voices regarding their feedback in nurse education in order to shed light on how the current student feedback practice may be modified.

DESIGN

A qualitative study using focus group inquiry.

METHODS

Convenience sampling was adopted and participants recruited from one school of nursing in Hong Kong. A total of 66 nursing students from two pre-registration programs were recruited for seven focus group interviews: one group of Year 1 students (n=21), two groups of Year 3 students (n=27), and four groups of Final Year students (n=18). The interviews were guided by a semi-structured interview guideline and the interview narratives were processed through content analysis. The trustworthiness of this study was guaranteed through peer checking, research meetings, and an audit trail. The participants' privacy was protected throughout the study.

RESULTS

Four core themes were discerned based on the narratives of the focus group interviews: (1) "timing of collecting feedback at more than one time point"; (2) "modify the questions being asked in collecting student feedback"; (3) "are electronic means of collecting feedback good enough?; and (4) "what will be next for student feedback?".

CONCLUSIONS

This study is significant in the following three domains: 1) it contributed to student feedback because it examined the issue from a student's perspective; 2) it explored the timing and channels for collecting feedback from the students' point of view; and 3) it showed the preferred uses of student feedback.

Health care as perceived by persons with inflammatory bowel disease - a focus group study

AIMS AND OBJECTIVES

The aim of this study was to explore the perceptions of health care among persons living with inflammatory bowel disease.

BACKGROUND

The quality of care plays an important role in the life of persons with a chronic disease. To define what persons with inflammatory bowel disease perceive as high-quality care, greater focus must be placed on the individual's own perspective of living with the condition.

DESIGN

A qualitative exploratory study was conducted based on focus groups.

METHODS

Five focus groups were conducted with adult persons living with inflammatory bowel disease, 14 men and 12 women aged 19-76 years. The interviews were performed between January-June 2014.

RESULTS

The perceptions of health care from the perspective of persons living with inflammatory bowel disease were summarised in two categories: 'professional attitudes of healthcare staff' and 'structure of the healthcare organisation'. Persons with inflammatory bowel disease want to be encountered with respect, experience trust and obtain information at the right time. They also expect shared decision-making, communication and to encounter competent healthcare professionals. Furthermore, the expectations on and perceptions of the structure of the healthcare organisation comprise access to care, accommodation, continuity of care, as well as the pros and cons of specialised care.

CONCLUSION

The findings show the importance of establishing a respectful and trusting relationship, facilitating healthcare staff and persons with inflammatory bowel disease to work as a team in fulfilling individual care needs - but there is room for improvement in terms of quality of care.

RELEVANCE TO CLINICAL PRACTICE

A person-centred approach, which places the individual and her/his family at the centre, considering them experts on their own health and enabling them to collaborate with healthcare staff, seems important to reach a high-quality healthcare organisation for patients with Inflammatory bowel disease.

Supporting self-management of pain by patients with advanced cancer: views of palliative care professionals

PURPOSE

The aim of the study is to ascertain the views of specialist palliative care professionals on patient self-management of cancer pain in order to inform the development of a new educational intervention to support self-management.

METHODS

This is a qualitative research study using focus group interviews.

RESULTS

Participants viewed self-management of cancer pain as desirable and achievable but also as something that could be problematic. Challenges to self-management were perceived in patient attitudes and behaviours, professionals' own beliefs and actions and the wider social system. Practitioners showed awareness of potential tension between their espoused views (the desirability that patients manage pain autonomously) and their tacit views (the undesirability of patients managing pain in ways which conflict with professionals' knowledge and identity).

CONCLUSIONS

Practitioners espoused patient-centred professional practice which inclined them towards supporting self-management. They showed awareness of factors which might inhibit them from effectively incorporating education and support for self-management into routine practice.

Dilemma of integration with Western medicine - views of Traditional Chinese Medicine practitioners in a predominant Western medical setting

OBJECTIVES

This study aimed to explore the in-depth views of the Traditional Chinese Medicine (TCM) practitioners towards Western and Chinese medicine, and the possible ways of integration under a predominant Western medical setting.

DESIGN AND SETTING

Purposive, qualitative design based on focus group interviews of TCM practitioners in Hong Kong.

PARTICIPANTS

Information-rich participants were recruited from a Western medicine training course for TCM practitioners. Two focus groups comprising 13 TCM practitioners were held before the course, and two others with 10 TCM practitioners after the course.

RESULTS

The TCM practitioners were adapted to act in a supportive role to Western doctors although they recognized their own strengths. They highlighted the prejudice from the Western doctors on their diagnostic approach. The TCM practitioners felt that they were actually more open-minded than the Western doctors, who often discouraged the patients to see them. Regarding integration with Western medicine, they considered it as a complicated issue due to the different concepts and forms of integration, as well as the balance between the two types of medicine. While there was a concern that learning Western medicine might overshadow their TCM mindset, they thought that TCM had always welcomed new elements to be added into it over the centuries, Western medicine being no exception.

CONCLUSIONS

The TCM practitioners are adapted to a supportive role to Western doctors under a predominant Western medical setting. Despite the uncertainties for collaboration, the TCM practitioners tend to support the trend of integration.

It's time for updating primary nursing in pediatric oncology care: qualitative study highlighting the perceptions of nurses, physicians and parents

PURPOSE

The aim of the study was to describe nurses', physicians' and parents' perceptions of primary nursing as a working model in a paediatric oncology care setting.

METHOD

The qualitative descriptive approach was selected in order to obtain rich content by exploring of individual perceptions related to the experiences of primary nursing. Focus group interviews were used with staff and individual interviews with the parents. Data from different participants were analysed together by using inductive content analysis.

RESULTS

Primary nursing was revealed as a confused and unstructured tradition which allowed variation in the role of the primary nurse and in the process. Within the role of a primary nurse, the orientation to primary nursing varied consisting of coordinating of care, task orientated and relation orientated primary nursing. The starting of the process was sudden and accidental by nature involving the aspects of commencement and allocation of the process. At the end of the process different emphasis existed in terms of the length of the process as highlighting early phase, comprehensive process and never getting to the end. Staff notions varied more than those of the parents.

CONCLUSION

Perceptions related to primary nursing as a working model were revealed to be confusing by nature from the point of view of all involved. Thus, clarification is needed in the role of primary nurses and the process of primary nursing in order to gain expected family and organisational outcomes.