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Wollney EN, Bylund CL, Bedenfield N, Parker ND, Rosselli M, Curiel Cid RE, Kitaigorodsky M, Armstrong MJ. Persons living with dementia and caregivers' communication preferences for receiving a dementia diagnosis. PEC Innov 2024; 4:100253. [PMID: 38298558 PMCID: PMC10828581 DOI: 10.1016/j.pecinn.2024.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 02/02/2024]
Abstract
Objective As the number of individuals diagnosed with dementia increases, so does the need to understand the preferences of persons living with dementia (PLWD) and caregivers for how clinicians can deliver a dementia diagnosis effectively, which can be a difficult process. This study describes the diagnostic communication preferences of PLWD and caregivers. Methods We conducted semi-structured individual phone interviews with two groups: PLWD who were diagnosed in the past two years (n = 11) and family caregivers of PLWD (n = 19) living in Florida. PLWD and caregivers were not recruited/enrolled as dyads. Results The groups' communication preferences were largely similar. Data were analyzed thematically into five themes: communicate the diagnosis clearly, meet information needs, discuss PLWD/caregiver resources, prepare for continued care, and communicate to establish and maintain relationships. Conclusion Participants wanted clear communication, information, and support, but differed in some details (e.g. the language used to describe the diagnosis and the amount/type of desired information). Clinicians can apply general principles but will need to tailor them to individual preferences of PLWD and caregivers. Innovation Limited research has elicited PLWD and caregivers' communication preferences for receiving dementia diagnoses, particularly through an individualized data collection method allowing for richer descriptions and deeper understanding.
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Affiliation(s)
- Easton N. Wollney
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Carma L. Bylund
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Noheli Bedenfield
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Naomi D. Parker
- College of Journalism & Communication, University of Florida, Gainesville, FL, United States of America
| | - Mónica Rosselli
- Department of Psychology, Florida Atlantic University, Boca Raton, FL, United States of America
| | - Rosie E. Curiel Cid
- Department of Psychiatry & Behavioral Sciences, Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | | | - Melissa J. Armstrong
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States of America
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Veitch E, Alsos OA, Saghafian M, Petermann FM, Sitompul TA, Park J. Dataset on passenger acceptance during autonomous ferry public trials: Questionnaires and interviews. Data Brief 2024; 54:110282. [PMID: 38524839 PMCID: PMC10957376 DOI: 10.1016/j.dib.2024.110282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/05/2024] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
This paper presents a dataset from the first public trial of an urban autonomous passenger ferry. The dataset contains questionnaires designed to assess passenger acceptance in terms of perceived safety, trustworthiness, and reliability. Questionnaires and their responses are paired samples collected before and after use (N = 884). The dataset also contains transcripts of semi-structured interviews on the themes of perceived safety, trustworthiness, and reliability (N = 25). The public trial was held in Trondheim, Norway, during the period September-October 2022. The autonomous ferry used in the trial was the "milliAmpere2," which is owned and operated by the Norwegian University of Science and Technology (NTNU). The data represents a state-of-the-art data collection effort owing to on-site data collection immediately before and after interactions with an Autonomous Vehicle (AV) in a public transportation context. The dataset is suitable for producing quantitative and qualitative analyses and for developing indicators of technology acceptance and related social phenomena regarding AVs, either in the maritime context or beyond.
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Affiliation(s)
- Erik Veitch
- Department of Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ole Andreas Alsos
- Department of Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Mina Saghafian
- Department of Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Felix-Marcel Petermann
- Department of Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Taufik Akbar Sitompul
- Department of Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jooyoung Park
- Department of Design, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Li C, Gong X, Wei Z, Gao L, Graham Y, Yang W. Novice Chinese Bariatric Nurses' Perceptions of Their Role as Bariatric Case Managers: A Qualitative Study. Obes Surg 2024; 34:1464-1470. [PMID: 38504064 DOI: 10.1007/s11695-024-07177-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Bariatric case managers (BCM) are integral healthcare team members for patients undergoing bariatric surgery in China. As the demand for bariatric surgery increases in China, the number of BCMs has also risen. However, more is needed to know about the perceptions of novice bariatric nurses toward their role as case managers. This study aims to investigate the perceptions of novice Chinese bariatric nurses toward their roles during the early stages of their careers. METHODS This qualitative study employed semi-structured individual interviews with 15 novice bariatric nurses who received training as BCMs. The interviews were audio-recorded, transcribed line-by-line, and analyzed thematically. The study was conducted in a bariatric surgery center of a public tertiary hospital in Southern China. RESULTS Three themes emerged from the data related to the perceptions of being a BCM: "negotiating the ambiguity of the BCM role," "establishing a core set of behaviors for the BCM role," and "identifying areas of competence to develop a BCM role framework." The novice bariatric nurses expressed both positive and negative feelings toward their role. They highlighted the need for further training to improve their qualifications and the importance of support from colleagues, and hospital management. CONCLUSIONS The findings illuminate the role of the BCM in China. Future research should investigate effective and acceptable job descriptions and cooperation modes between BCMs, colleagues and hospital management. We recommend using these findings to develop training programs for novice BCMs and improve their capacity to provide quality care to patients undergoing bariatric surgery.
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Affiliation(s)
- Chunqun Li
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Xue Gong
- School of Medical Technology and Nursing, Shenzhen Polytechnic University, Xili Lake, Nanshan District, Shenzhen, Guangdong Province, China
| | - Zhuoqi Wei
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Lilian Gao
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Yitka Graham
- Helen McArdle Nursing and Care Research Institute, University of Sunderland, Sunderland, SR1 3SD, UK.
- Bariatric Surgical Unit, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, SR4 7TP, UK.
- Faculty of Psychology, University of Anahuac, Mexico City, Mexico.
- Department of Biomedical Sciences, University Hospital Austral, Buenos Aires, Argentina.
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China.
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Eager S, Johnson S, Pitman A, Uribe M, Qualter P, Pearce E. Young people's views on the acceptability and feasibility of loneliness interventions for their age group. BMC Psychiatry 2024; 24:308. [PMID: 38654301 DOI: 10.1186/s12888-024-05751-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Loneliness is a frequently reported problem for young people aged 16 to 24 years old. A variety of interventions have been developed (but in most cases not extensively evaluated) to try and tackle loneliness in this age group. These include interpersonal, intrapersonal, and social approaches that vary in their content and mechanisms of action. The current study aimed to qualitatively examine young peoples' views on the acceptability and feasibility of different loneliness interventions. METHODS Young people from 16 to 24 years old living in the United Kingdom who self-identified as having experienced loneliness were recruited to participate in this study. We conducted semi-structured qualitative interviews to assess their views on the acceptability and feasibility of loneliness interventions for their age group. Interviews were analysed using inductive reflexive thematic analysis. RESULTS Our analysis of 23 individual interview transcripts identified six themes. These related to the appropriate stage for intervention and how different types of strategies may be best suited to particular contexts; the key facilitators and barriers to engaging young people in an intervention; considerations for optimising the delivery of an intervention; divergent views on technology use in strategies to manage loneliness; the scope of an intervention and whether it takes a targeted or general approach; and the idea of combining different options within an intervention to allow tailoring to individual preferences and nature of loneliness. CONCLUSIONS These findings demonstrate the need for continued development of individualised interventions designed to help manage loneliness in this age group. Future loneliness strategies should be co-produced with young people to ensure that they suit the varying needs of this population.
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Affiliation(s)
- Sharon Eager
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK.
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Manuela Uribe
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
| | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Eiluned Pearce
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
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Roeser A, Martin de Frémont G, Chevalier K. [New section: "The journal's portraits"]. Rev Med Interne 2024:S0248-8663(24)00090-0. [PMID: 38575439 DOI: 10.1016/j.revmed.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Affiliation(s)
- A Roeser
- Équipe auto-immunité et immunité lymphocytaire B, Institut Necker-Enfants-Malades, 156-160, rue de Vaugirard, 75015 Paris, France.
| | - G Martin de Frémont
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Suède
| | - K Chevalier
- Service de médecine interne, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, Boulogne-Billancourt, France
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Kenzie ES, Wakeland W, Jetter A, Lich KH, Seater M, Gunn R, Davis MM. Protocol for an interview-based method for mapping mental models using causal-loop diagramming and realist interviewing. Eval Program Plann 2024; 103:102412. [PMID: 38471326 DOI: 10.1016/j.evalprogplan.2024.102412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/05/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
Causal-loop diagramming, a method from system dynamics, is increasingly used in evaluation to describe individuals' understanding of how policies or programs do or could work ("mental models"). The use of qualitative interviews to inform model development is common, but guidance for how to design and conduct these interviews to elicit causal information in participant mental models is scant. A key strength of semi-structured qualitative interviews is that they let participants speak freely; they are not, however, designed to elicit causal information. Moreover, much of human communication about mental models-particularly larger causal structures such as feedback loops-is implicit. In qualitative research, part of the skill and art of effective interviewing and analysis involves listening for information that is expressed implicitly. Similarly, a skilled facilitator can recognize and inquire about implied causal structures, as is commonly done in group model building. To standardize and make accessible these approaches, we have formalized a protocol for designing and conducting semi-structured interviews tailored to eliciting mental models using causal-loop diagramming. We build on qualitative research methods, system dynamics, and realist interviewing. This novel, integrative method is designed to increase transparency and rigor in the use of interviews for system dynamics and has a variety of potential applications.
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Affiliation(s)
- Erin S Kenzie
- OHSU-PSU School of Public Health, Oregon Health & Science University, USA; Oregon Rural Practice-based Research Network, Oregon Health & Science University, USA; Systems Science Program, Portland State University, USA.
| | | | - Antonie Jetter
- Department of Engineering & Technology Management, Portland State University, USA
| | | | - Mellodie Seater
- Oregon Rural Practice-based Research Network, Oregon Health & Science University, USA
| | | | - Melinda M Davis
- OHSU-PSU School of Public Health, Oregon Health & Science University, USA; Oregon Rural Practice-based Research Network, Oregon Health & Science University, USA; Department of Family Medicine, Oregon Health & Science University, USA
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7
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Garoufalia Z, Bellato V, Cunha MF, Avellaneda N, Dudi-Venkata NN, Gallardo C, Meyer J, Zaffaroni G, Christensen P, Aytac E, Brady RRW, Pellino G. A narrative on diversity, equity, and inclusion in surgery: insights from the European Society of Coloproctology and identification of points for action. Updates Surg 2024; 76:529-537. [PMID: 38280108 PMCID: PMC10995079 DOI: 10.1007/s13304-023-01685-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/25/2023] [Indexed: 01/29/2024]
Abstract
The focus of the 2022 European Society of Coloproctology (ESCP) annual campaign was diversity, equity, and inclusion (DEI) in surgery. The ESCP "Operation Equal Access" campaign sought to interview key-opinion leaders and trainees, to raise awareness on inequalities, inform the community of the status of the topic, and to identify future areas for improvement. The ESCP Social Media Working Group interviewed experts who have made significant contributions to DEI in colorectal surgery and were acknowledged opinion leaders in the field. The interviews focused on their career, professional life, experiences, and opportunities during their training, and their views on DEI in colorectal surgery. DEI principles, education, and values need further promotion to reduce and address bias within the profession and overall improve the experience of minority community including health professionals and patients. International Societies are working to facilitate training opportunities and overcome DEI, and networking have contributed to that. Collaborations between societies will be pivotal to contribute to offering research and leadership opportunities equally. Access to advanced workshops including cadaveric training and simulation can be consistently promoted and provided globally via societies through telemonitoring. Involving patients in research should be encouraged, as it brings the perspective of a living experience.
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Affiliation(s)
- Zoe Garoufalia
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
| | - Vittoria Bellato
- ESCP Social Media Committee Co-Chair, ESCP, Portsmouth, United Kingdom
- Minimally Invasive Surgery Unit, Università di Tor Vergata, Rome, Italy
- Gastroenterology Surgery Department, San Raffaele Hospital, Milan, Italy
| | - Miguel F Cunha
- ESCP Social Media Committee Co-Chair, ESCP, Portsmouth, United Kingdom
- Surgical Department, Algarve University Hospital, Portimão, Portugal
| | - Nicolas Avellaneda
- Nueva Proctologia, Buenos Aires, Argentina
- CEMIC, Buenos Aires, Argentina
- Danish Cancer Society National Research Centre for Survivorship and Late Side Effect to Cancer in the Pelvic Organs, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Nagendra N Dudi-Venkata
- Colorectal Unit, Department of Surgery, Royal Adelaide Hospital, Port Road, Adelaide, 5000, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Cristián Gallardo
- Servicio de Coloproctologia, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - Jeremy Meyer
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Genève 14, Switzerland
- Medical School, University of Geneva, Rue Michel-Servet 1, 1205, Genève, Switzerland
| | | | - Peter Christensen
- Danish Cancer Society National Research Centre for Survivorship and Late Side Effect to Cancer in the Pelvic Organs, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Erman Aytac
- Department of Surgery, School of Medicine, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, Instanbul, Turkey
- Incoming ESCP Communication Committee Chair, ESCP, Portsmouth, United Kingdom
| | - Richard R W Brady
- Newcastle Centre for Bowel Disease Research Group, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Queen Victoria Road, Newcastle Upon Tyne, United Kingdom
- ESCP Communication Committee Chair, ESCP, Portsmouth, United Kingdom
| | - Gianluca Pellino
- Colorectal Surgery, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona UAB, Barcelona, Spain.
- Department of Advanced Medical and Surgical Sciences, Universitá Degli Studi Della Campania "Luigi Vanvitelli, Naples, Italy.
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8
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Hwang DY, Bannon SM, Meurer K, Kubota R, Baskaran N, Kim J, Zhang Q, Reichman M, Fishbein NS, Lichstein K, Motta M, Muehlschlegel S, Reznik ME, Jaffa MN, Creutzfeldt CJ, Fehnel CR, Tomlinson AD, Williamson CA, Vranceanu AM. Thematic Analysis of Psychosocial Stressors and Adaptive Coping Strategies Among Informal Caregivers of Patients Surviving ICU Admission for Coma. Neurocrit Care 2024; 40:674-688. [PMID: 37523110 DOI: 10.1007/s12028-023-01804-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Family caregivers of patients with severe acute brain injury (SABI) admitted to intensive care units (ICUs) with coma experience heightened emotional distress stemming from simultaneous stressors. Stress and coping frameworks can inform psychosocial intervention development by elucidating common challenges and ways of navigating such experiences but have yet to be employed with this population. The present study therefore sought to use a stress and coping framework to characterize the stressors and coping behaviors of family caregivers of patients with SABI hospitalized in ICUs and recovering after coma. METHODS Our qualitative study recruited a convenience sample from 14 US neuroscience ICUs. Participants were family caregivers of patients who were admitted with ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, traumatic brain injury, or hypoxic-ischemic encephalopathy; had experienced a comatose state for > 24 h; and completed or were scheduled for tracheostomy and/or gastrostomy tube placement. Participants were recruited < 7 days after transfer out of the neuroscience ICU. We conducted live online video interviews from May 2021 to January 2022. One semistructured interview per participant was recorded and subsequently transcribed. Recruitment was stopped when thematic saturation was reached. We deductively derived two domains using a stress and coping framework to guide thematic analysis. Within each domain, we inductively derived themes to comprehensively characterize caregivers' experiences. RESULTS We interviewed 30 caregivers. We identified 18 themes within the two theory-driven domains, including ten themes describing practical, social, and emotional stressors experienced by caregivers and eight themes describing the psychological and behavioral coping strategies that caregivers attempted to enact. Nearly all caregivers described using avoidance or distraction as an initial coping strategy to manage overwhelming emotions. Caregivers also expressed awareness of more adaptive strategies (e.g., cultivation of positive emotions, acceptance, self-education, and soliciting social and medical support) but had challenges employing them because of their heightened emotional distress. CONCLUSIONS In response to substantial stressors, family caregivers of patients with SABI attempted to enact various psychological and behavioral coping strategies. They described avoidance and distraction as less helpful than other coping strategies but had difficulty engaging in alternative strategies because of their emotional distress. These findings can directly inform the development of additional resources to mitigate the long-term impact of acute psychological distress among this caregiver population.
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Affiliation(s)
- David Y Hwang
- Division of Neurocritical Care, Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, CB# 7025, Chapel Hill, NC, 27599-7025, USA.
| | - Sarah M Bannon
- Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Kate Meurer
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Rina Kubota
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Nithyashri Baskaran
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Jisoo Kim
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Qiang Zhang
- David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Mira Reichman
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Nathan S Fishbein
- Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Kaitlyn Lichstein
- Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Melissa Motta
- Program in Trauma, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Susanne Muehlschlegel
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Michael E Reznik
- Department of Neurology, Alpert Medical School, Brown University, Providence, RI, USA
| | - Matthew N Jaffa
- Department of Neurointensive Care, Hartford Hospital, Hartford, CT, USA
| | - Claire J Creutzfeldt
- Department of Neurology, University of Washington and Harborview Medical Center, Seattle, WA, USA
| | - Corey R Fehnel
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Amanda D Tomlinson
- Department of Critical Care Medicine, College of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | | | - Ana-Maria Vranceanu
- Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Tolle H, Castro MDM, Wachinger J, Putri AZ, Kempf D, Denkinger CM, McMahon SA. From voice to ink (Vink): development and assessment of an automated, free-of-charge transcription tool. BMC Res Notes 2024; 17:95. [PMID: 38553773 PMCID: PMC10981346 DOI: 10.1186/s13104-024-06749-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Verbatim transcription of qualitative audio data is a cornerstone of analytic quality and rigor, yet the time and energy required for such transcription can drain resources, delay analysis, and hinder the timely dissemination of qualitative insights. In recent years, software programs have presented a promising mechanism to accelerate transcription, but the broad application of such programs has been constrained due to expensive licensing or "per-minute" fees, data protection concerns, and limited availability of such programs in many languages. In this article, we outline our process of adapting a free, open-source, speech-to-text algorithm (Whisper by OpenAI) into a usable and accessible tool for qualitative transcription. Our program, which we have dubbed "Vink" for voice to ink, is available under a permissive open-source license (and thus free of cost). RESULTS We conducted a proof-of-principle assessment of Vink's performance in transcribing authentic interview audio data in 14 languages. A majority of pilot-testers evaluated the software performance positively and indicated that they were likely to use the tool in their future research. Our usability assessment indicates that Vink is easy-to-use, and we performed further refinements based on pilot-tester feedback to increase user-friendliness. CONCLUSION With Vink, we hope to contribute to facilitating rigorous qualitative research processes globally by reducing time and costs associated with transcription and by expanding free-of-cost transcription software availability to more languages. With Vink running on standalone computers, data privacy issues arising within many other solutions do not apply.
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Affiliation(s)
- Hannah Tolle
- Division of Infectious Diseases and Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.
| | - Maria Del Mar Castro
- Division of Infectious Diseases and Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Jonas Wachinger
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Agrin Zauyani Putri
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Dominic Kempf
- Scientific Software Center, Heidelberg University, Heidelberg, Germany
| | - Claudia M Denkinger
- Division of Infectious Diseases and Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Partner Site Heidelberg University Hospital, German Centre for Infection Research (DZIF), Heidelberg, Germany
| | - Shannon A McMahon
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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10
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Dubovsky SL. Will Interviewing Become a Lost Art? Psychother Psychosom 2024; 93:75-79. [PMID: 38461812 DOI: 10.1159/000537783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Steven L Dubovsky
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
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Molin S, Larsen LS, Joensson P, Oesterdal ML, Arbuckle R, Grant L, Skingley G, Schuttelaar MLA. Development and Psychometric Validation of a Patient-Reported Outcome Measure to Assess the Signs and Symptoms of Chronic Hand Eczema: The Hand Eczema Symptom Diary (HESD). Dermatol Ther (Heidelb) 2024; 14:643-669. [PMID: 38485862 DOI: 10.1007/s13555-024-01114-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/09/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Chronic Hand Eczema (CHE) is an inflammatory skin disease of the hands. The Hand Eczema Symptom Diary (HESD) is a new patient-reported outcome measure of worst severity of core CHE signs/symptoms. This study aimed to evaluate content and psychometric validity of the HESD. METHODS The HESD was developed based on the literature and concept elicitation interviews. Qualitative cognitive debriefing interviews were conducted with CHE patients to assess relevance and understanding of items, response options and recall period. Psychometric properties of the HESD (item performance, dimensionality, reliability, validity, responsiveness and estimation of meaningful change thresholds) were then assessed, first using data from a phase 2b trial (NCT03683719), and confirmed using data from the first 280 participants completing the 16-week treatment phase of a phase 3 trial (NCT04871711). RESULTS Cognitive debriefing supported item refinement and removal of items and confirmed all items were well understood and relevant to patients. Item properties and dimensionality analyses in the phase 2b data supported removal of additional items, resulting in the 6-item HESD included in the phase 3 trial. Unidimensionality was supported by inter-item correlations (all > 0.70) and Rasch analysis. Internal consistency (Cronbach's alpha = 0.96) and test-retest reliability (Intraclass Correlation Coefficient > 0.89) results were very strong. Construct validity was supported by moderate correlations with concurrent measures (0.53-0.64) and significant differences between severity groups (p < 0.001). Large effect sizes for mean change scores in participants that improved and significant differences between change groups indicated the ability to detect change. Anchor-based analyses supported within-individual responder definitions of ≥ 4-points for improvements in 7-day average HESD scores. CONCLUSION The HESD is the first CHE-specific, patient-reported outcome measure of CHE signs/symptoms developed and validated in line with regulatory guidance. This article provides evidence of strong content validity and psychometric validity and shows improvements of ≥ 4 points on 7-day average HESD scores represent clinically meaningful, important changes. TRIAL REGISTRATION NCT03683719, NCT04871711.
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Affiliation(s)
- Sonja Molin
- Division of Dermatology, Queen's University, Kingston, ON, Canada.
| | | | | | | | - Rob Arbuckle
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Laura Grant
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - George Skingley
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, UK
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12
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Viegas R, Silva F, Nørgaard LS, Duarte-Ramos F, Mendes R, Alves da Costa F. Physical activity promotion in the community pharmacy: An opportunity for an expanded role? Res Social Adm Pharm 2024; 20:345-352. [PMID: 38129220 DOI: 10.1016/j.sapharm.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Physical inactivity is a major risk factor for the development of chronic diseases, and it is increasingly prevalent in the Portuguese population. Pharmacists' role in promoting physical activity (PA) is still not well established, although health promotion is foreseen by law in Portugal. Competing tasks and location where the pharmacy is embedded can hinder this promotion in their daily practice. OBJECTIVE The aim of this study was to identify the main barriers and facilitators of physical activity promotion (PAP) in Portuguese community pharmacies and explore possible pathways for future implementation of physical activity promotion. METHODS In-depth, semi-structured interviews were conducted with purposively enrolled community pharmacists. Participant recruitment was aligned with data saturation. Data analysis comprised a mixed model of a deductive theme mapping strategy using the Theoretical Domains Framework (TDF) for the behaviour of promoting physical activity and an inductive approach for any other relevant themes and which might influence PA promotion. RESULTS Data saturation was reached at eleven interviews. Barriers and facilitators for the behaviour of promoting PA were identified from 11 out of the 14 TDF domains. Following an inductive approach, other emerging codes were clustered in additional seven major themes. Highlighted barriers focused on domains #1 - Knowledge, #10 - Memory, Attention and Decision Processes and #13 - Environmental Context and Resources. Community mapping, establishment of remuneration models and the use of digital technologies were suggested as additional potential contributors to scale up PAP. CONCLUSION Community pharmacists are well placed inside their communities to serve as a focal point for signposting, engagement with other healthcare professionals and community resources and activities organized by the pharmacy itself. Pharmacists should be supported in being knowledgeable, aware, and available when promoting PA in their daily counseling.
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Affiliation(s)
- Ruben Viegas
- Faculty of Pharmacy, University of Lisbon - imed, Research Institute for Medicines, Lisboa, Portugal.
| | - Filipa Silva
- Faculty of Sciences and Technology, University of the Algarve, Faro, Portugal
| | - Lotte Stig Nørgaard
- Faculty of Health and Medical Sciences, Department of Pharmacy, University of Copenhagen, Denmark
| | - Filipa Duarte-Ramos
- Faculty of Pharmacy, University of Lisbon - imed, Research Institute for Medicines, Lisboa, Portugal
| | - Romeu Mendes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; ACES Douro I - Marão e Douro Norte, Administração Regional de Saúde do Norte, Vila Real, Portugal
| | - Filipa Alves da Costa
- Faculty of Pharmacy, University of Lisbon - imed, Research Institute for Medicines, Lisboa, Portugal
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13
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Mason JJ, Coleman L, Dawod M, Wathen K, Houston S, Waldron M, Hinds PS. Child and caregiver voices about inpatient care: What do they report as positive and as needing improvement? J Pediatr Nurs 2024; 75:213-220. [PMID: 38272712 DOI: 10.1016/j.pedn.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/27/2024]
Abstract
PURPOSE In pediatric healthcare, patient satisfaction queries exclude children and solicit quantitative ratings from caregivers. We sought satisfaction perspectives from hospitalized children 7 to 17 years and their caregivers by qualitatively analyzing interview responses. DESIGN AND METHODS English and Spanish-speaking children and their parents on five inpatient units completed two open-ended questions about their satisfaction at hospital discharge (T1, face to face) and 7 to 10 days later (T2, telephone). The questions asked about what was good and what could be better at the hospital. Responses were analyzed using descriptive semantic content analysis and consensus coding methods. RESULTS Patients' mean age was 11.9 years (SD = 3.17); 51% were male. At T1, 362 patients offered 833 responses; 600 parents offered 1496 responses. At T2, 252 patients offered 552 responses; 488 parents offered 1290 responses. At T1 and T2, the most frequent patient response to what was good was 'Staff took good care of me' and for caregivers was 'Staff behaving professionally'. At T1, the most frequent patient response about what could be better was 'more activities for kids', and at T2, 'Nothing' and 'More food options and better food quality'; for caregivers at T1, 'Nothing' and 'Not liking the physical space', and at T2, 'Nothing', and 'More communication and professionalism from hospital staff'. CONCLUSIONS Pediatric patients and their caregivers are willing and able to offer perspectives about satisfaction with care, and suggestions for improvement before discharge. PRACTICE IMPLICATIONS Pediatric patients and their caregivers' perspectives about care yield actionable recommendations for hospital systems.
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Affiliation(s)
- Janice J Mason
- Department of Nursing Science, Professional Practice, and Quality, Children's National Hospital, Washington, D.C., USA; School of Medicine and Health Sciences, The George Washington University of America, The George Washington University, USA.
| | - Lael Coleman
- Child Health Advocacy Institute, Children's National Hospital, Washington, D.C., USA.
| | - Mark Dawod
- Department of Nursing Science, Professional Practice, and Quality, Children's National Hospital, Washington, D.C., USA.
| | - Kourtney Wathen
- Department of Nursing Science, Professional Practice, and Quality, Children's National Hospital, Washington, D.C., USA.
| | - Sasha Houston
- Revenue Cycle Operations & Analytics, Children's National Hospital, Washington, D.C., USA.
| | - Mia Waldron
- Department of Nursing Science, Professional Practice, and Quality, Children's National Hospital, Washington, D.C., USA; School of Medicine and Health Sciences, The George Washington University of America, The George Washington University, USA.
| | - Pamela S Hinds
- Department of Nursing Science, Professional Practice, and Quality, Children's National Hospital, Washington, D.C., USA; School of Medicine and Health Sciences, The George Washington University of America, The George Washington University, USA.
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Hurden A, Cotter I, Mowszowski L, Naismith S, Anderson CS. Perspectives of general practitioners and memory clinic patients on ageing and cognitive decline to inform the design of a decentralised antihypertensive dementia prevention trial. Cereb Circ Cogn Behav 2024; 6:100215. [PMID: 38419837 PMCID: PMC10899054 DOI: 10.1016/j.cccb.2024.100215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The global burden dementia is growing each year. Clinical trials investigating approaches to preventing dementia have been occurring for decades, but they are particularly challenging including the requirement to include large numbers of healthy 'at-risk' people who need to be followed up for a long period of time. Community and consumer involvement in trial design helps to ensure that the methods are acceptable to the involved stakeholders, the design and operation of clinical trials are suitable and applicable to the target population, and that key areas of concern are identified and addressed at an early stage. OBJECTIVES To gain insights from samples of memory clinic patients without dementia and general practitioners on the acceptability of, and attitudes towards, the proposed design of a decentralised antihypertensive dementia prevention trial. Topics addressed included the assessment of cognition, antihypertensive medication use, and motivation to participate in research. METHODS Two focus groups (total n = 7) with memory clinic patients and individual interviews with GPs (n = 5) were conducted. Transcripts were analysed using qualitative thematic framework analysis. RESULTS The proposed design was acceptable, with some possible barriers identified regarding computer use, GP time restraints, and concerns about medication interactions. Additional themes included the importance of communication and social connectedness in research participation and perceptions of ageing in medical settings. Future directions of research into larger studies and consumer-led research practices were discussed. CONCLUSION The proposed trial design was agreed to be acceptable with some operational considerations, which were incorporated in the trial design.
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Affiliation(s)
- Alexandra Hurden
- The George Institute, Sydney, Australia
- Faculty of Medicine, The University of New South Wales, Australia
| | | | - Loren Mowszowski
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, Australia
| | - Sharon Naismith
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, Australia
| | - Craig S Anderson
- The George Institute, Sydney, Australia
- Faculty of Medicine, The University of New South Wales, Australia
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15
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Huang M, Yang L, Zhang C, Gan X. Glucose management in critically ill adults: A qualitative study from the experiences of health care providers. Heliyon 2024; 10:e24545. [PMID: 38322901 PMCID: PMC10845247 DOI: 10.1016/j.heliyon.2024.e24545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 12/21/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024] Open
Abstract
Aims and objective To explain the components and elements of glucose management in critically ill adult patients from the healthcare providers' experiences. Background Critically ill adults are highly susceptible to stress-induced hyperglycaemia due to glucose metabolic disorders. Healthcare workers play a key role in the glycaemic management of critically ill patients. However, there is a lack of qualitative studies on the content and elements of glycaemic management and healthcare workers' perceptions about glycaemic management in China. Design Qualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Methods Individual semi-structured interviews were conducted from January to April 2022. Fifteen physicians and nurses were recruited from ten hospitals in mainland China. Data were analysed using inductive thematic analysis. Results Glucose management in critically ill adult patients from their experiences included two parts: the inner ring (practice behaviours) and the external space (methods and drivers). The practice behaviours of glucose management include five elements, while the methods and drivers of glucose management focus on three elements. The content covered under each element was identified. Conclusion This study developed a glycaemic management model for critically ill adult patients, clarified its elements based on the perceptions of healthcare providers and elaborated on the methods and drivers covered under each element to provide a reference for physicians and nurses to develop a comprehensive glycaemic management guideline for critically ill adult patients. Relevance to clinical practice Our study proposed a glucose management practice model for critically ill adult patients, and the elements and components included in this model can provide a reference for physicians and nurses when performing glucose management in critically ill patients.
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Affiliation(s)
- Miao Huang
- Department of Nursing, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Li Yang
- Department of Nursing, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chuanlai Zhang
- Gneral ICU, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiuni Gan
- Department of Nursing, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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16
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Johansson M, Amir LH. 'I don't want to be a guinea pig' - Swedish women's experiences of breast abscess treatment. BMC Womens Health 2024; 24:106. [PMID: 38331786 PMCID: PMC10851594 DOI: 10.1186/s12905-024-02937-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/29/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND It is well known that breastfeeding plays an important role in the health of women and children. However, women are not always given optimal support and most do not reach their breastfeeding goals. About one in five, breastfeeding women report mastitis and a small proportion of these develop a breast abscess. Our aim was to describe the experiences of a group of Swedish breastfeeding women who developed a breast abscess. METHODS A qualitative cross-sectional study with 18 study participants was undertaken in Sweden in 2017-2018. Potential participants were identified through electronic medical records at a university hospital and invited to participate in audio-recorded telephone interviews. Women were between 2 and 24 months postpartum at the time of the interview, on average 8 months. We conducted a thematic analysis in six steps according to Braun and Clark. RESULTS Our analysis identified two themes: 1) Seeking care and receiving treatment was long and unpleasant, and 2) Importance of adequate professional care. Women who experienced a breast abscess were uncertain about where to ask for professional help. They often had a long wait for the right time to undergo the unpleasant and painful procedure of draining their breast abscess. The women felt it was important to receive professional care with respectful communication, continuity of care, and to receive adequate information, but they did not always receive this level of care. CONCLUSIONS Women with puerperal breast abscesses often fall between medical specialty areas. No longer under the care of obstetricians and maternity services, their problem is too complicated for general practitioners or emergency departments, but not regarded as serious by breast surgeons. Healthcare professionals urgently need adequate training in order to deal with breastfeeding problems and be able to offer women-centred care.
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Affiliation(s)
- Margareta Johansson
- Department of Women's and Children's Health, Uppsala University, Akademiska University Hospital, SE-751 85, Uppsala, Sweden.
| | - Lisa H Amir
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
- Breastfeeding Service, Royal Women's Hospital, Melbourne, Australia
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17
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Coles T, Mkumba LS, Leiva LZ, Plyler K, McDonald SR, Lagoo-Deenadayalan S, Reeve BB. Facilitators and barriers to eliciting physical function goals before and after surgery: A qualitative study with clinicians. Patient Educ Couns 2024; 119:108078. [PMID: 38070300 DOI: 10.1016/j.pec.2023.108078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/25/2023] [Accepted: 11/14/2023] [Indexed: 01/02/2024]
Abstract
OBJECTIVE Describe clinicians' perspectives of facilitators and barriers to eliciting physical function goals from patients with multiple chronic conditions pre- and post-surgery. METHODS Semi-structured qualitative interviews were conducted with clinicians, recruited from an academic medical center, who treat adult patients with multiple chronic conditions. Purposive sampling ensured multiple provider types were represented. Interviews were conducted in person or via web conference and were audio recorded. Findings were summarized using descriptive qualitative content analysis. RESULTS Of the 12 participating clinicians, 92% were female and 83% specialized in geriatrics. Clinicians had a mean of 10.7 (min-max: 1-30) years of experience. Key facilitators to goal-setting conversations were sufficient time, familial support, and patient cognitive ability. Barriers included lack of time, lack of training, patient challenges in choosing realistic and specific actionable goals, emotional barriers, and cognitive challenges. CONCLUSION Some facilitators and barriers are modifiable, including time, inclusion of family members in the clinical encounter, and clinician training to enable actionable goal setting. These results highlight areas for intervention to facilitate goal elicitation for physical function in clinical care settings. PRACTICE IMPLICATIONS Clinicians should be aware of the barriers impacting eliciting goals. Healthcare organizations could consider providing effective goal elicitation training and tools to facilitate goal setting conversation.
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Affiliation(s)
- Theresa Coles
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Laura S Mkumba
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Leslie Zapata Leiva
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kate Plyler
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Shelley R McDonald
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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18
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Kohler BE, Baque E, Sandler CX, Jones T, Terranova CO, Brookes DSK, Hassall T, Bradford NK, Trost SG. Goal-directed therapeutic exercise for paediatric posterior fossa brain tumour survivors: a qualitative analysis of experiences. Support Care Cancer 2024; 32:125. [PMID: 38252320 PMCID: PMC10803389 DOI: 10.1007/s00520-024-08327-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE To explore child and parent experiences of a 12-week goal-directed therapeutic exercise intervention in paediatric posterior fossa brain tumours survivors and to identify features of the program that influenced program adherence and acceptability. METHODS Eleven interviews were conducted; five parent-child dyads (mothers = 83%) and one parent only (mean child age = 10.6 ± 3.0 years; 83% male). Posterior fossa brain tumour survivors, who participated in a weekly goal-directed exercise program for 12 weeks, completed semi-structured interviews to discuss their experience of the program. An inductive content analysis was undertaken. Interviews were transcribed, imported into NVivo and independently coded by two reviewers. Code and content categories were iteratively discussed and refined. RESULTS Five content categories were generated: (1) perceived improvements, (2) program logistics, (3) activity selection, (4) connection with the therapist and (5) options for technology. All participants valued the tailored exercise program and described improvements in movement competence. Children and their parents discussed preferring home- and community-based locations and favoured face-to-face delivery. Occasionally, parents reported difficulty completing the home program due to low child motivation or family time restrictions. Multiple families suggested an interactive digital application would be an effective delivery channel for the supplemental home-based program. CONCLUSION A goal-directed exercise program delivered at home and in community-based locations was considered valuable and helpful for improving movement competence in paediatric survivors of posterior fossa brain tumour. TRIAL REGISTRATION ACTRN12619000841178 June 12, 2019.
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Affiliation(s)
- Brooke E Kohler
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Emmah Baque
- School of Health Sciences and Social Work, Griffith University, Nathan, Australia
| | - Carolina X Sandler
- Sport and Exercise Science, School of Health Sciences, Western Sydney University, Sydney, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Taryn Jones
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Caroline O Terranova
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Denise S K Brookes
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | | | - Natalie K Bradford
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
- Cancer and Palliative Care Outcomes Centre, at Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Australia
| | - Stewart G Trost
- Children's Health Queensland, Brisbane, Australia.
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.
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Toft BS, Rodkjær LØ, Sørensen L, Saugbjerg MR, Bekker HL, Modrau IS. Feasibility of early digital health rehabilitation after cardiac surgery in the elderly: a qualitative study. BMC Health Serv Res 2024; 24:113. [PMID: 38254129 PMCID: PMC10801932 DOI: 10.1186/s12913-024-10601-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Increasing numbers of elderly patients experience prolonged decreased functional capacity and impaired quality of life after seemingly successful cardiac surgery. After discharge from hospital, these patients experience a substantial gap in care until centre-based cardiac rehabilitation commences. They may benefit from immediate coaching by means of mobile health technology to overcome psychological and physiological barriers to physical activity. The aim of this study was to explore the usability, acceptability, and relevance of a mobile health application designed to support remote exercise-based cardiac rehabilitation of elderly patients early after cardiac surgery from the perspective of patients, their relatives, and physiotherapists. METHODS We adapted a home-based mobile health application for use by elderly patients early after cardiac surgery. Semi-structured dyadic interviews were conducted with a purposive sample of patients (n = 9), their spouses (n = 5), and physiotherapists (n = 2) following two weeks of the intervention. The transcribed interviews were analysed thematically. RESULTS Three themes were identified: 1) creating an individual fit by tailoring the intervention; 2) prioritizing communication and collaboration; and 3) interacting with the mobile health application. Overall, the findings indicate that the mobile health intervention has the potential to promote engagement, responsibility, and motivation among elderly patients to exercise early after surgery. However, the intervention can also be a burden on patients and their relatives when roles and responsibilities are unclear. CONCLUSION The mobile health intervention showed potential to bridge the intervention gap after cardiac surgery, as well as in fostering engagement, responsibility, and motivation for physical activity among elderly individuals. Nevertheless, our findings emphasize the necessity of tailoring the intervention to accommodate individual vulnerabilities and capabilities. The intervention may be improved by addressing a number of organizational and communicational issues. Adaptions should be made according to the barriers and facilitators identified in this study prior to testing the effectiveness of the intervention on a larger scale. Future research should focus on the implementation of a hybrid design that supplements or complements face-to-face and centre-based cardiac rehabilitation. TRIAL REGISTRATION Danish Data Protection Agency, Central Denmark Region (1-16-02-193-22, 11 August 2022).
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Affiliation(s)
- Bente Skovsby Toft
- Research Centre for Patient Involvement, Aarhus University Hospital, Aarhus, Denmark.
- Department of Clinical Medicine, Cardiothoracic Surgery, Aarhus University, Aarhus, Denmark.
- Department of Clinical Medicine, Cardiothoracic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, 8200 Aarhus N, Denmark.
| | - Lotte Ørneborg Rodkjær
- Research Centre for Patient Involvement, Aarhus University Hospital, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lotte Sørensen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Marianne Rørbæk Saugbjerg
- Department of Clinical Medicine, Cardiothoracic Surgery, Aarhus University, Aarhus, Denmark
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Hilary Louise Bekker
- Research Centre for Patient Involvement, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Leeds Unit of Complex Intervention Development (@LUCID_Leeds), School of Medicine, University of Leeds, Leeds, UK
| | - Ivy Susanne Modrau
- Department of Clinical Medicine, Cardiothoracic Surgery, Aarhus University, Aarhus, Denmark
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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).
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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
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Laskay NMB, Boudreau HS, Estevez-Ordonez D, George JA, Atchley TJ, Bentley JN, Rozzelle CJ. Applicant Perceptions of Post interview Communication During the 2022 to 2023 Neurosurgery Recruitment Cycle: A Cross-Sectional Survey Study. World Neurosurg 2024; 181:e597-e606. [PMID: 37914078 DOI: 10.1016/j.wneu.2023.10.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES To evaluate and describe neurosurgery applicant perceptions of the postinterview communication (PIC) process during the US residency match. METHODS A voluntary and anonymous postmatch web-based survey was developed and sent to 209 candidates who applied to 1 academic neurosurgery practice during the 2022-2023 recruitment cycle, approximately 1 week following match day. Survey questions focused on their perceptions of and participation behaviors with PIC and how this impacted their final rank list. RESULTS Seventy-eight (37.3%) of the 209 candidates responded to the survey. Sixty-four (84.2%) respondents reported submitting a letter of intent (LOI) to their number 1 ranked program. Sixty-one (82%) felt pressured to send a LOI to improve their rank status, fearing that it may harm them if they did not. Fifty-four (73.0%) respondents felt pressured to send an early LOI despite not seeing the program in person to communicate interest before programs certified their rank lists. Fourteen (18.9%) respondents agreed that a second look experience impacted their rank list enough to where they regretted an early LOI. Fifty-five (76.4%) respondents disagreed that second-look attendance had no impact on their rank status with a program. Fifty (71.4%) respondents agreed that PIC causes undue stress during the match process. Sixty-one (84.7%) respondents agreed that aspects of PIC require universal guidelines. CONCLUSIONS This is the first study to describe the perceptions of PIC and behaviors of neurosurgery applicants during the US residency match process. Standardized PIC practices may help to ensure transparency and relieve stress for applicants during the match process.
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Affiliation(s)
- Nicholas M B Laskay
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA.
| | - Hunter S Boudreau
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
| | | | - Jordan A George
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
| | - Travis J Atchley
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
| | - J Nicole Bentley
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
| | - Curtis J Rozzelle
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
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Puhlmann N, Vidaurre R, Kümmerer K. Designing greener active pharmaceutical ingredients: Insights from pharmaceutical industry into drug discovery and development. Eur J Pharm Sci 2024; 192:106614. [PMID: 37858896 DOI: 10.1016/j.ejps.2023.106614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/15/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
Active pharmaceutical ingredients (APIs), their metabolites and transformation products (TPs) are found as pollutants in the environment. They can impact human and environmental health. To address this issue, an efficient, long-term prevention strategy could be the design of APIs that have less impact on the natural environment, i.e. the design of greener APIs, by the implementation of environmental parameters into the drug discovery and development process (also abbreviated R&D for 'research and development'). Our study aimed to evaluate the feasibility of the design of greener APIs based on insights from drug design experts working in large, research-based pharmaceutical companies. The feasibility evaluation also identified needs and incentives for process modification. For this purpose, 30 R&D and environmental experts from seven globally active pharmaceutical companies were interviewed along a structured questionnaire. Main findings are that the interviewed experts saw manifold opportunities to include properties rendering APIs greener in different stages along the R&D process. This implementation would be favoured by the fact that the pharmaceutical R&D process is very flexible and relies on balancing multiple parameters. Furthermore, some API properties that reduce environmental risks were considered compatible with common desirable properties for application. Environmental properties should be considered early during R&D, i.e. when molecules are screened and optimized. It has been found that availability of suitable in silico models and in vitro assays is crucial for this environmental consideration. Their attributes, e.g. throughput and costs, determine at which process stage they can be successfully applied. An intensified exchange between R&D and environmental experts within and outside companies would push the industrial application of the benign by design approach for APIs forward. Collaboration across pharmaceutical companies, authorities, and academia is seen as highly promising in this respect. Financial, social, and regulatory incentives would support future design of greener APIs.
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Affiliation(s)
- Neele Puhlmann
- Institute of Sustainable Chemistry, Leuphana University of Lüneburg, Universitätsallee 1, 21335 Lüneburg, Germany
| | - Rodrigo Vidaurre
- Ecologic Institute, Pfalzburger Strasse 43/44, 10717 Berlin, Germany
| | - Klaus Kümmerer
- Institute of Sustainable Chemistry, Leuphana University of Lüneburg, Universitätsallee 1, 21335 Lüneburg, Germany; Research and Education Hub, International Sustainable Chemistry Collaborative Center ISC3, Niedersachsen, Germany.
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Granviken F, Meisingset I, Vasseljen O, Bach K, Bones AF, Klevanger NE. Acceptance and use of a clinical decision support system in musculoskeletal pain disorders - the SupportPrim project. BMC Med Inform Decis Mak 2023; 23:293. [PMID: 38114970 PMCID: PMC10731802 DOI: 10.1186/s12911-023-02399-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND We have developed a clinical decision support system (CDSS) based on methods from artificial intelligence to support physiotherapists and patients in the decision-making process of managing musculoskeletal (MSK) pain disorders in primary care. The CDSS finds the most similar successful patients from the past to give treatment recommendations for a new patient. Using previous similar patients with successful outcomes to advise treatment moves management of MSK pain patients from one-size fits all recommendations to more individually tailored treatment. This study aimed to summarise the development and explore the acceptance and use of the CDSS for MSK pain patients. METHODS This qualitative study was carried out in the Norwegian physiotherapy primary healthcare sector between October and November 2020, ahead of a randomised controlled trial. We included four physiotherapists and three of their patients, in total 12 patients, with musculoskeletal pain in the neck, shoulder, back, hip, knee or complex pain. We conducted semi-structured telephone interviews with all participants. The interviews were analysed using the Framework Method. RESULTS Overall, both the physiotherapists and patients found the system acceptable and usable. Important findings from the analysis of the interviews were that the CDSS was valued as a preparatory and exploratory tool, facilitating the therapeutic relationship. However, the physiotherapists used the system mainly to support their previous and current practice rather than involving patients to a greater extent in decisions and learning from previous successful patients. CONCLUSIONS The CDSS was acceptable and usable to both the patients and physiotherapists. However, the system appeared not to considerably influence the physiotherapists' clinical reasoning and choice of treatment based on information from most similar successful patients. This could be due to a smaller than optimal number of previous patients in the CDSS or insufficient clinical implementation. Extensive training of physiotherapists should not be underestimated to build understanding and trust in CDSSs.
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Affiliation(s)
- Fredrik Granviken
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, Trondheim, 7491, Norway.
- Clinic of Rehabilitation, St. Olavs Hospital, Trondheim, Norway.
| | - Ingebrigt Meisingset
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, Trondheim, 7491, Norway
- Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway
| | - Ottar Vasseljen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, Trondheim, 7491, Norway
| | - Kerstin Bach
- Department of Computer Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anita Formo Bones
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, Trondheim, 7491, Norway
| | - Nina Elisabeth Klevanger
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, Trondheim, 7491, Norway
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Li WY, Fang Y, Liang YQ, Zhu SQ, Yuan L, Xu Q, Li Y, Chen YL, Sun CX, Zhi XX, Li XY, Zhou R, Du M. Building bridges of excellence: a comprehensive competence framework for nurses in hospice and palliative care-a mixed method study. BMC Palliat Care 2023; 22:197. [PMID: 38087276 PMCID: PMC10714629 DOI: 10.1186/s12904-023-01318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Hospice and Palliative Care (HPC) is in high demand in China; however, the country is facing the shortage of qualified HPC nurses. A well-suited competence framework is needed to promote HPC human resource development. Nevertheless, existing unstandardized single-structured frameworks may not be sufficient to meet this need. This study aimed at constructing a comprehensive multi-structured HPC competence framework for nurses. METHODS This study employed a mixed-method approach, including a systematic review and qualitative interview for HPC competence profile extraction, a two-round Delphi survey to determine the competences for the framework, and a cross-sectional study for framework structure exploration. The competence profiles were extracted from publications from academic databases and interviews recruiting nurses working in the HPC field. The research team synthesized profiles and transferred them to competences utilizing existing competence dictionaries. These synthesized competences were then subjected to Delphi expert panels to determine the framework elements. The study analyzed theoretical structure of the framework through exploratory factor analysis (EFA) based on a cross-sectional study receiving 491 valid questionnaires. RESULTS The systematic review involved 30 publications from 10 countries between 1995 and 2021, while 13 nurses from three hospitals were interviewed. In total, 87 and 48 competence profiles were respectively extracted from systematic review and interview and later synthesized into 32 competences. After the Delphi survey, 25 competences were incorporated into the HPC competence framework for nurses. The EFA found a two-factor structure, with factor 1 comprising 18 competences namely Basic Competences; factor 2 concluding 7 competences namely Developmental Competences. CONCLUSIONS The two-factor HPC competence framework provided valuable insights into the need and directions of Chinese HPC nurses' development.
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Affiliation(s)
- Wei-Ying Li
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China
| | - Ying Fang
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China
| | - Yi-Qing Liang
- School of Medicine, Jiangsu University, Zhenjiang, 212000, China
| | - Shu-Qin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China.
| | - Ling Yuan
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, Nanjing, 210008, P. R. China.
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China.
| | - Yue Li
- Jiangsu Institute of Quality and Standardization, Nanjing, 210029, China
| | - Yin-Long Chen
- Jiangsu Institute of Quality and Standardization, Nanjing, 210029, China
| | - Chang-Xian Sun
- School of Health Sciences, Jiangsu Vocational Institute of Commerce, Nanjing, 211168, China
| | - Xiao-Xu Zhi
- Nursing Department, Jiangsu Cancer Hospital and Nanjing Medical University Affiliated Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, 210009, China
| | - Xiao-Yan Li
- Hospice Unit, The Air Force Hospital From Eastern Theater of PLA, Nanjing, 210002, China
| | - Rong Zhou
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China
| | - Mai Du
- School of Nursing, Nanjing Medical University, Nanjing, 211166, P. R. China
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Moolla A, Constance M, Ngcobo N, Mngadi S, Govathson C, Long L, Pascoe SJ. "I want one nurse who is friendly to talk to me properly like a friend": Learner preferences for HIV and contraceptive service provision in Gauteng, South Africa. Res Sq 2023:rs.3.rs-3725260. [PMID: 38168214 PMCID: PMC10760307 DOI: 10.21203/rs.3.rs-3725260/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Background Research with adolescents indicates that youth aged 15-24 years, especially females, are at high risk for HIV infection. The overall HIV prevalence among youth in this age group was 6.2% estimated in 2022. In addition, > 800,000 adolescents are newly infected with HIV every year and 79% of these infections occur in sub-Saharan Africa. The health service provision preferences and needs of adolescents are critical to reaching this population. Methods This qualitative study was conducted with learners from three public secondary schools in Gauteng, South Africa. Using convenience sampling, 22 in-depth stakeholder interviews (KIIs) with stakeholders and 8 focus group discussions (FGDs) with 55 learners aged ≥ 15, were conducted between March and October 2018. Learners < 18 were given assent and parental consent forms, whilst those ≥ 18 could consent of their own accord. KIIs and FGDs were conducted in private venues in the preferred language by trained interviewers and audio-recorded. Audio files were transcribed verbatim and translated into English if needed. Data were analysed thematically using NVivo version 11. Results The findings from both stakeholders and learners indicate many critical accessibility barriers which include: negative healthcare staff attitudes from older judgemental staff; stigmatisation from healthcare workers, the community as well as family; a lack of private consulting spaces and no confidentiality of patient information at facilities; inconvenient clinic operating times; long queues and facility resource issues. Both groups of participants suggested that accessibility to healthcare could be improved through value-added services (including free Wi-Fi and food), social gatherings and educational information sessions, as well as being staffed by younger, friendlier, confidential and non-judgemental staff in a private healthcare setting. Conclusion It is clear that there are many critical barriers that deter learners from accessing HIV and contraceptive services. Provision of private rooms and trying to ensure information confidentiality for youth-friendly services at locations and times that can be easily accessed by learners is key. Greater emphasis on learner-parent-teacher communication around sexual health education at school is needed along with making this information being more readily available to learners.
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Bölenius K, Lämås K, Edvardsson D. Older adults' experiences of self-determination when needing homecare services-an interview study. BMC Geriatr 2023; 23:824. [PMID: 38066429 PMCID: PMC10709827 DOI: 10.1186/s12877-023-04533-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Self-determination has been shown to be an important factor in mental health and wellbeing, but from the homecare recipients' point of view, autonomy and self-determination is not fully integrated into homecare services. The aim of this study was to explore older adults' experiences of self-determination when needing homecare services. METHODS In 2018, a qualitative descriptive study was conducted and a convenience sample of 15 older adults from 3 homecare service facilities were invited to participate in individual interviews. Data were analysed using qualitative content analyse. RESULTS The theme Transitioning from self-determination as independence towards self-determination as shared decision-making emerged through the older adults' narratives. This 'transition' is one in which older adult's understanding of self-determination and self-esteem was transitioning towards the acceptance of shared decision-making. The person's inner strength and willingness to make decisions was promoting to enact and preserve independence. Accepting one's dependence on others and being in a positive atmosphere were described as promoting self-determination and shared decision-making, and vice versa. The above overarching theme permeated all subthemes, which included: mobilising inner strength to enact independence; accepting increasing dependence on others; and being influenced by the atmosphere. CONCLUSIONS The study contributes increased understanding of older adults' experiences of self-determination. The results can act as a guide when planning future person-centred care interventions in the context of homecare services and help improve homecare services' ability to meet the needs of older adults. To summarise, older adults' reflections on their own self-determination highlighted relationships with other people as important for shared decision-making, which could help preserve older adults' autonomy and self-esteem.
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Affiliation(s)
- Karin Bölenius
- Department of Nursing, Umeå University, Umeå, 90187, Sweden.
| | - Kristina Lämås
- Department of Nursing, Umeå University, Umeå, 90187, Sweden
| | - David Edvardsson
- Department of Nursing, Umeå University, Umeå, 90187, Sweden
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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Geipel M, Pelizäus A, Hamann J. Returning-to-work after mental health-associated sick leave: a qualitative interview study exploring the experiences of general practitioners in Germany. BMC Prim Care 2023; 24:261. [PMID: 38042796 PMCID: PMC10693165 DOI: 10.1186/s12875-023-02219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/21/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND AND AIM Psychiatric disorders are increasing globally. Especially when these disorders affect working people, this places a financial burden on society due to long-term sick leave, the incapacity to work and the inability to earn and pay taxes. General practitioners (GPs) are often the first health professionals to be consulted by those suffering from mental health disorders. This study investigated the experiences of GPs regarding their patients with mental health disorders and identified factors that are important for a successful return to work. METHODS This qualitative study used semi-structured interviews to explore the opinions of GPs (n = 12) working in Munich, Germany, or its metropolitan area. The interviews were audio-recorded, transcribed, and analyzed using the reflexive thematic analysis method. RESULTS GPs think of themselves as important players in the rehabilitation process of patients with mental health disorders. In their daily routine, they face many obstacles to ensure the best treatment and outcome for their patients. They also suffer from poor collaboration with other stakeholders, such as psychiatric hospitals, therapists or employers. They indicate that the mental health disorder of each patient is unique, including the barriers to and possibilities of a successful return to work. Additionally, the workplace appears to play a crucial role in the success rate of re-entry into work. It can exacerbate the course of mental health disorders or support recovery. Fear, shame and stigmatization of the patients are personal factors responsible for prolonged sick leave. CONCLUSION We conclude that GPs believe that they can have a major impact on the rehabilitation of patients with mental health disorders. As such, special focus should be placed on supporting them in this context.
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Affiliation(s)
- Martina Geipel
- Department of Psychiatry and Psychotherapy, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Straße 1, 86156, Augsburg, Germany
| | - Anna Pelizäus
- Department of Psychiatry and Psychotherapy, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Johannes Hamann
- Department of Psychiatry and Psychotherapy, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
- Bezirkskrankenhaus Mainkofen, Mainkofen A 3, 94469, Deggendorf, Germany.
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Oosterhaven J, Pell CD, Schröder CD, Popma H, Spierenburg L, Devillé WL, Wittink H. Health literacy and pain neuroscience education in an interdisciplinary pain management programme: a qualitative study of patient perspectives. Pain Rep 2023; 8:e1093. [PMID: 37868618 PMCID: PMC10586826 DOI: 10.1097/pr9.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/17/2023] [Accepted: 06/10/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Pain neuroscience education is part of interdisciplinary pain management programs (IPMPs). To date, the role of health literacy on patients' understanding of pain neuroscience education has not sufficiently been examined. Objectives Drawing on interviews with patients with diverse levels of health literacy, this article explores patient perspectives on pain neuroscience education. Methods Purposively sampled patients from an IPMP were interviewed twice (waiting list and after 4 weeks). A directed qualitative content analysis was performed with the Integrated Conceptual Model of Health Literacy as an analytic framework. Results Thirteen patients with chronic musculoskeletal pain were interviewed: 4 men and 9 women aged from 21 to 77 years with diverse educational and mostly low health literacy. One participant dropped out after baseline. Some participants gained access to health information actively; others relied on the expertise of their healthcare providers. Most participants did not seem to receive the information in the pain neuroscience education as intended, experienced difficulties with understanding the message, negatively appraised the information, and were not able to apply this in their daily lives. Health literacy levels likely played a role in this. Conclusions Pain neuroscience education tailored to patients' health literacy levels, information needs, and learning strategies is needed.
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Affiliation(s)
- Janke Oosterhaven
- Research Group Lifestyle and Health, University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
| | - Christopher D. Pell
- Department of Global Health, Academic Medical Centre, Amsterdam Institute for Global Health and Development (AIGHD), University of Amsterdam, Amsterdam, the Netherlands
| | - Carin D. Schröder
- Ecare4you, Amersfoort, the Netherlands
- Center of Excellence for Rehabilitation Medicine Utrecht, UMC Utrecht Brain Center, University Medical Center Utrecht, and de Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Hans Popma
- Rehabilitation Centre Heliomare, Wijk aan Zee, the Netherlands
| | - Loes Spierenburg
- Research Group Lifestyle and Health, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Walter L.J.M. Devillé
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands
| | - Harriet Wittink
- Research Group Lifestyle and Health, University of Applied Sciences Utrecht, Utrecht, The Netherlands
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Yu J, Dong D, Sumerlin TS, Kim JH. Feasibility of introducing effective alcohol harms reduction strategies in a low regulation region: A qualitative study from Hong Kong. Health Policy 2023; 138:104920. [PMID: 37797444 DOI: 10.1016/j.healthpol.2023.104920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023]
Abstract
To counter the harms of excessive alcohol use, the World Health Organization (WHO) outlined a series of alcohol policy recommendations, including the most cost-effective "Best Buys". This study aims to obtain key stakeholder views on feasibility of implementing various publicly endorsed alcohol policies in Hong Kong, a relatively low alcohol consumption region with few extant alcohol regulations. Between 2019 and 2021, we conducted semi-structured interviews with stakeholders involved in alcohol policy adoption and implementation. Interviewees included hospitality/alcohol sales workers (n = 13) and government officers (n = 4). The stakeholders noted that although WHO advocacy facilitated local policy considerations, the adoption of stringent measures was challenged by low political priority due to the low visibility of harms. For implementing strategies, the stakeholders cited alignment with social norms as a major facilitator, whereas law enforcement difficulties and resistance from industry/business sectors were viewed as major obstacles. There was a general belief that population-level alcohol policies would be effective for certain groups of drinkers but would also harm the local economy and detract from Hong Kong's image as a "world city". Hong Kong may not be ready to adopt a wide range of highly restrictive population-level alcohol policies. Local governments should carefully consider contextual factors when following international recommendations.
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Affiliation(s)
- Jiazhou Yu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Dong Dong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Timothy S Sumerlin
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jean H Kim
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
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Jaffar A, Krishnapillai A, Samad BHA, Fakuradzi WFS, Ma NN, Lugova H. Enhancing public health resilience in urban disaster settings: A study protocol on civil-military coordination in Malaysia. MethodsX 2023; 11:102456. [PMID: 38023317 PMCID: PMC10643285 DOI: 10.1016/j.mex.2023.102456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
In Malaysia, the increasing frequency and severity of disasters emphasize the urgent need for enhancing disaster management. Given their significant impact on public health and healthcare, effective disaster management becomes a top priority. This study focuses on urban disasters and aims to identify health needs, assess multi-sectorial response gaps, and propose civil-military coordination mechanisms. To achieve this, a qualitative single-case approach will be employed, involving document reviews, in-depth interviews, and focus group discussions with representatives from key governmental agencies responsible for disaster management. The study will specifically concentrate on Kuala Lumpur, the densely populated and commercially active city. Thematic analysis will be used to systematize and verify the collected data, providing comprehensive insights into the current state of civil-military coordination in disaster response and management from stakeholders' perspectives. By examining their perceptions and experiences, the study will identify existing gaps and challenges in civil-military coordination. Ultimately, the findings will contribute to evidence-based policies and strategies aimed at improving disaster management coordination throughout Malaysia.
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Affiliation(s)
- Aida Jaffar
- Primary Care Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Wilayah Persekutuan Kuala Lumpur 57000, Malaysia
| | - Ambigga Krishnapillai
- Primary Care Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Wilayah Persekutuan Kuala Lumpur 57000, Malaysia
| | - Badrul Hisham Abd Samad
- Humanitarian Assistance and Disaster Relief Research Centre, Faculty Of Defence Studies And Management, Universiti Pertahanan Nasional Malaysia, Wilayah Persekutuan Kuala Lumpur 57000, Malaysia
- Community Medicine Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Wilayah Persekutuan Kuala Lumpur 57000, Malaysia
| | - Wan Farizatul Shima Fakuradzi
- Community Medicine Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Wilayah Persekutuan Kuala Lumpur 57000, Malaysia
| | - Nurhan Norris Ma
- Humanitarian Assistance and Disaster Relief Research Centre, Faculty Of Defence Studies And Management, Universiti Pertahanan Nasional Malaysia, Wilayah Persekutuan Kuala Lumpur 57000, Malaysia
| | - Halyna Lugova
- Faculty of Medicine and Health Science, University College Sedaya International (UCSI), Bandar Springhill, Mukim Jimah, Port Dickson, Negeri Sembilan 71010, Malaysia
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Walliar T, Khan B, Newstead S, Al-Assadi G, Salter SM, Seubert L, Carlson SJ, Attwell K. "Fighting the pandemic!" Western Australian pharmacists' perspectives on COVID-19 vaccines: A qualitative study. Vaccine 2023; 41:7234-7243. [PMID: 37891049 DOI: 10.1016/j.vaccine.2023.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 08/28/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND In Western Australia, community pharmacists are authorized to administer a range of vaccines without a prescription. Since mid-July 2021, pharmacists can also administer Coronavirus Disease 2019 (COVID-19) vaccines. Little is known about how pharmacists think and feel about giving and receiving COVID-19 vaccines and how they discuss it with patients. AIM This study aimed to explore Western Australian pharmacists' perceptions on being vaccinated with, administering, and communicating about COVID-19 vaccines. METHODS Semi structured interviews were conducted with 20 pharmacists from metropolitan and regional areas of Western Australia across a two-week period in July and early August 2021. Interview transcripts were coded using NVivo 20 and data was thematically analyzed using the framework method. RESULTS Most pharmacists (n = 16, 80 %) had received at least one dose of a COVID-19 vaccine. Some expressed difficulty accessing the vaccine while two unvaccinated pharmacists were hesitant to receive it due to concerns about vaccine development. The majority of pharmacists spoke positively about administering the vaccines, discussing perceived facilitators such as designated vaccination days but also perceived barriers such as inadequate financial reimbursement compared to other healthcare providers. Many pharmacists obtained their information from Australian government sources and training modules. Pharmacists were only passively promoting COVID-19 vaccines, with conversations mostly initiated by patients. Most pharmacists specified they would highlight the common side effects when administering the vaccine and would provide patients with written information. CONCLUSION The majority of pharmacists were willing to administer and be vaccinated with COVID-19 vaccines. Since pharmacists play an important role in increasing vaccine uptake, governments should provide equitable reimbursement to pharmacists in line with other vaccinators such as General Practitioners. We welcome the recent resources produced by governments and pharmacy professional organizations to help pharmacists actively promote the vaccines since this work was undertaken.
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Affiliation(s)
- Taaiba Walliar
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Basil Khan
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Sophie Newstead
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Ghoufran Al-Assadi
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Sandra M Salter
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Liza Seubert
- Pharmacy Discipline, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Katie Attwell
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia.
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Watson E, Fletcher-Watson S, Kirkham EJ. Views on sharing mental health data for research purposes: qualitative analysis of interviews with people with mental illness. BMC Med Ethics 2023; 24:99. [PMID: 37964278 PMCID: PMC10648337 DOI: 10.1186/s12910-023-00961-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/24/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Improving the ways in which routinely-collected mental health data are shared could facilitate substantial advances in research and treatment. However, this process should only be undertaken in partnership with those who provide such data. Despite relatively widespread investigation of public perspectives on health data sharing more generally, there is a lack of research on the views of people with mental illness. METHODS Twelve people with lived experience of mental illness took part in semi-structured interviews via online video software. Participants had experience of a broad range of mental health conditions including anxiety, depression, schizophrenia, eating disorders and addiction. Interview questions sought to establish how participants felt about the use of routinely-collected health data for research purposes, covering different types of health data, what health data should be used for, and any concerns around its use. RESULTS Thematic analysis identified four overarching themes: benefits of sharing mental health data, concerns about sharing mental health data, safeguards, and data types. Participants were clear that health data sharing should facilitate improved scientific knowledge and better treatments for mental illness. There were concerns that data misuse could become another way in which individuals and society discriminate against people with mental illness, for example through insurance premiums or employment decisions. Despite this there was a generally positive attitude to sharing mental health data as long as appropriate safeguards were in place. CONCLUSIONS There was notable strength of feeling across participants that more should be done to reduce the suffering caused by mental illness, and that this could be partly facilitated by well-managed sharing of health data. The mental health research community could build on this generally positive attitude to mental health data sharing by following rigorous best practice tailored to the specific concerns of people with mental illness.
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Affiliation(s)
- Emily Watson
- University of Edinburgh Medical School, Edinburgh, UK
| | | | - Elizabeth Joy Kirkham
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
- Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
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Denis MA, Iwaz J, Dumetier F, Poyard-Berger G, Vézina M. Screening for psychosocial risks among physicians in a pediatric hospital. Arch Pediatr 2023; 30:530-536. [PMID: 37777348 DOI: 10.1016/j.arcped.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/14/2023] [Accepted: 09/01/2023] [Indexed: 10/02/2023]
Abstract
Over the past decades, productivity practices at hospital resulted in staff overload and burnout. Prompted by physicians' complaints, this study assessed the level of psychosocial risk among senior pediatricians in a university hospital. The survey used the checklist of Quebec's National Institute of Public Health that comprises two six-indicator parts: "Context" and "Key Components" of the Organization. The psychosocial risk level was evaluated by a physician-psychologist duo during interviews of homogeneous groups of workers. The indicators were scored, tabulated, and discussed. The survey led to a substantial qualitative and quantitative clarification of physicians' working conditions, claims, and needs. Regarding Context, the staff reported mainly: (a) cumbersome organization and norms vs. limited human resources (lack of stability, incentives, and promotions); (b) absenteeism and presenteeism; (c) reluctance to seek care or advice for fear of discredit; (d) presence of verbal violence; (e) self-imposed harsh returns-to-work; (f) work-life conflicts and difficult mental disconnection from work. Regarding the Key Components, the staff reported mainly: (a) work overload (physical, mental, psychological, and relational/social), continuous stress, and perceived exhaustion; (b) low job satisfaction and insufficient recognition; (c) inconstant support by their superiors; (d) poor job relationships and colleagues' support; (e) occasional participation and lack of real autonomy and/or strategy sharing. The survey succeeded in underlining concerning issues that required the immediate attention of occupational physicians and managers. It proved the method feasible and valuable in the medical context despite a high diversity of staff functions and degrees.
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Affiliation(s)
- Marie-Agnès Denis
- Université de Lyon, Lyon, France; Université Claude Bernard, Lyon 1, Villeurbanne, France; Unité Mixte de Recherche Épidémiologique et de Surveillance Transport Travail Environnement, UMRESTTE, UMR_9405 (Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux, IFSTTAR; Université Eiffel; Université Lyon 1), Bron, France; Service de médecine et santé au travail, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.
| | - Jean Iwaz
- Université de Lyon, Lyon, France; Université Claude Bernard, Lyon 1, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | - Fabienne Dumetier
- Service de médecine et santé au travail, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | | | - Michel Vézina
- Direction des risques biologiques et de la santé au travail, Institut National de Santé Publique du Québec, Montréal, Canada
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Apps LD, Chantrell S, Majd S, Eglinton E, Singh SJ, Murphy AC, Green RH, Hudson N, Bradding P, Evans RA. Enabling Adults With Severe Asthma to Exercise: A Qualitative Examination of the Challenges for Patients and Health Care Professionals. J Allergy Clin Immunol Pract 2023; 11:3435-3444.e2. [PMID: 37453572 DOI: 10.1016/j.jaip.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/29/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Adults living with severe asthma have lower physical activity levels, particularly high-intensity physical activity, compared with their healthy peers. Physical inactivity is associated with increased morbidity and mortality. OBJECTIVE To understand patient and health care professional attitudes toward exercise and physical activity to inform future strategies for the improvement of healthy lifestyle behaviors, including exercise. METHODS Participants recruited from a specialist difficult asthma service were interviewed individually, and health care professionals (HCPs) from primary care, secondary care, and a tertiary center were invited to attend focus groups. Interviews and focus groups were transcribed verbatim. We performed thematic analysis on interviews and focus groups separately, followed by an adapted framework analysis to analyze datasets together. RESULTS Twenty-nine people with severe asthma participated in a semi-structured interview. A total of 51 HCPs took part in eight focus groups across the East Midlands, United Kingdom. Final analysis resulted in three major themes: barriers to exercise and exercise counseling - in which patients and HCPs identified disease and non-disease factors affecting those living with severe asthma; attitudes toward HCP support for exercise - highlighting education needs for HCPs and preference for supervised exercise programs; and areas for system improvement in supporting patients and HCPs - challenges exist across health sectors that limit patient support are described. CONCLUSIONS Patients identified the important role of HCPs in supporting and advising on lifestyle change. Despite a preference for supervised exercise programs, both patient and HCP barriers existed. To meet patients' varied support needs, improved integration of services is required and HCP skills need extending.
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Affiliation(s)
- Lindsay D Apps
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; School of Applied Social Sciences, De Montfort University, Leicester, United Kingdom
| | - Stacey Chantrell
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Sally Majd
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Science, University of Leicester, Leicester
| | | | - Sally J Singh
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Science, University of Leicester, Leicester
| | - Anna C Murphy
- NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; School of Pharmacy, De Montfort University, Leicester, United Kingdom
| | - Ruth H Green
- NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Science, University of Leicester, Leicester
| | - Nicky Hudson
- School of Applied Social Sciences, De Montfort University, Leicester, United Kingdom
| | - Peter Bradding
- NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Science, University of Leicester, Leicester
| | - Rachael A Evans
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre-Respiratory Theme, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Science, University of Leicester, Leicester.
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Pituc DM, Smith S, Kane LMY, Cooper JG. Patient and staff perceptions of short procedural sedation with propofol for joint and fracture reductions in the Emergency Department: A qualitative study. Int Emerg Nurs 2023; 71:101373. [PMID: 37852060 DOI: 10.1016/j.ienj.2023.101373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 09/19/2023] [Accepted: 09/30/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Emergency Department (ED) propofol sedation is widely used to facilitate reduction of fractures and dislocations, but little is known about patient and staff perceptions of the practice. Better understanding of these aspects may improve patient care. METHODS A qualitative exploratory study involving semi-structured patient interviews and ED healthcare professional focus groups. Interviews with adult patients (≥16 years) >1 hour after their sedation episode were audio-recorded, anonymised and transcribed verbatim to an electronic database. Thematic analysis using a general inductive method led to development of codes and themes. ED focus groups recordings were similarly transcribed and triangulated to patient interview outcomes. RESULTS Data saturation was reached after 16 patient interviews. Emergent central themes from a patient perspective were: 'fear of the unknown' and 'expressed relief that the procedure was comfortable.' Key themes included 'trust in the clinical team,' 'efficacy of pain management prior to sedation' and 'quality of the information delivered to patients.' Focus group discussions around patient interview outcomes identified triage, analgesia delivery, communication, and consideration of the environment as areas for improvement. CONCLUSIONS ED procedural sedation with propofol is generally very well accepted by patients and clinical staff but there is scope to improve patient-focus and increase satisfaction.
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Affiliation(s)
- Diana M Pituc
- School of Medicine, University of Aberdeen, Aberdeen, UK
| | - Sarah Smith
- Department of Academic General Practice, University of Aberdeen, Aberdeen, UK
| | - Leia M Y Kane
- Emergency Department, Aberdeen Royal Infirmary, Aberdeen, UK; School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Jamie G Cooper
- Emergency Department, Aberdeen Royal Infirmary, Aberdeen, UK; School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
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Knudsen RK, Ammentorp J, Storkholm MH, Skovbjerg S, Tousig CG, Timmermann C. The influence of mindfulness-based stress reduction on the work life of healthcare professionals - A qualitative study. Complement Ther Clin Pract 2023; 53:101805. [PMID: 37837781 DOI: 10.1016/j.ctcp.2023.101805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/14/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND and purpose: Quantitative studies show that mindfulness-based interventions can reduce stress and burnout in healthcare professionals. Few qualitative studies have explored healthcare professionals' experiences with mindfulness training. The aim of the study was to explore healthcare professionals' experiences of how attending a course in Mindfulness-Based Stress Reduction influenced their work life, including their relationship with patients and colleagues. METHODS Fifty-six healthcare professionals attended a Mindfulness-Based Stress Reduction course between January and June 2022. Participant observation followed by six semi-structured focus group interviews and 15 individual interviews were conducted. Data were collected in a cardiology department and in an obstetrics and gynaecology department. Thematic data analysis was performed. Reporting followed COREQ guidelines. RESULTS Six themes were identified: 1) Allowing a pause and focusing on one thing at a time, 2) Awareness of the freedom to choose, 3) The need for self-compassion, as a prerequisite for taking care of others, 4) The value of presence and calmness in patient encounters, 5) Awareness of how stressful behavior affects oneself and others, 6) The value of practicing mindfulness with colleagues. CONCLUSION This study suggests that offering Mindfulness-Based Stress Reduction to healthcare professionals can start a positive process of change from a tendency to neglect personal needs to becoming more compassionate towards oneself and others. Mindfulness training may thus prevent burnout and lead to a more compassionate workplace culture that also manifests in better patient care. However, a collective understanding and knowledge of mindfulness in the work setting may be necessary to sustain these changes.
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Affiliation(s)
- Randi Karkov Knudsen
- Department of Gynecology and Obstetrics, Horsens Regional Hospital, Sundvej 30C, 8700, Horsens, Denmark; Department of Cardiology, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark; Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000, Odense C, Denmark.
| | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000, Odense C, Denmark.
| | - Marie Højriis Storkholm
- Department of Gynecology and Obstetrics, Horsens Regional Hospital, Sundvej 30C, 8700, Horsens, Denmark; Department of Clinical Medicine, Aarhus University Hosipital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Sine Skovbjerg
- Danish Center for Mindfulness, Aarhus University, Hack Kampmanns Plads 1-3, 8000, Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University Hosipital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Charlotte Gad Tousig
- Department of Cardiology, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.
| | - Connie Timmermann
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000, Odense C, Denmark.
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Kerr WT. Using Verbally-Reported and Video-Observed Semiology to Identify Functional Seizures. Neurol Clin 2023; 41:605-617. [PMID: 37775193 DOI: 10.1016/j.ncl.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Diagnosis of functional seizures, also known as psychogenic nonepileptic seizures, starts with a clinical interview and description of the seizures. A targeted approach to this evaluation can provide valuable information to gauge the likelihood of functional seizures as compared with other similar conditions including but not limited to epileptic seizures. This review focuses on the use of patient and witness descriptions and seizure videos to identify patients with probable functional seizures. Particular emphasis is given to recognizing the limitations of the available data and the influence of health-care provider expertise on diagnostic accuracy.
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Affiliation(s)
- Wesley T Kerr
- Department of Neurology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
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Tobiesen Pedersen L, Ipsen JA, Egebæk HK, Bruun IH, Viberg B, Andersen PT. From fear to control: Older adults' thoughts and feelings about empowerment-oriented rehabilitation after a hip fracture. Int J Orthop Trauma Nurs 2023:101061. [PMID: 37907389 DOI: 10.1016/j.ijotn.2023.101061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND It is essential to focus on how older adults remain active and regain control of their daily lives after hip fractures. 'Rehabilitation of Life' is an empowerment-orientated hip fracture intervention focused on continuous rehabilitation and care between sectors in Denmark. We aimed to understand and explore older adults' experience participating in the intervention 'Rehabilitation of Life' and how this relates to their sense of empowerment. METHOD Qualitative data were generated from 16 semi-structured interviews with patients experiencing a hip fracture and subsequent rehabilitation in the program "Rehabilitation of Life' The data was analysed using Graneheim and Lundman's concept-guided qualitative content analysis method. RESULTS The analysis revealed five themes that the participants emphasised as vital to their rehabilitation: getting information and care when hospitalised, early visits from healthcare professionals after returning to their homes, the social aspect of training together with others, rehabilitation provision by skilled and empathic staff, and acceptance of a new me. The five themes indicated that adults aged >65 years generally experienced rehabilitation after hip fractures as motivating and reassuring. CONCLUSION Social support and peer programs can significantly improve the rehabilitation of older adults with hip fractures. The Rehabilitation of Life intervention has shown that promoting successful rehabilitation requires patient-centred strategies that encourage collaboration between different sectors. To increase patients' empowerment and engagement in their health journey, it is important to consider changes in patients' behaviour, increase their autonomy and ensure their independence after rehabilitation.
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Affiliation(s)
- Lars Tobiesen Pedersen
- Department of Physical Therapy and Occupational Therapy, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Health Education, University College South Denmark, Esbjerg, Denmark.
| | - Jonas Ammundsen Ipsen
- Department of Physical Therapy and Occupational Therapy, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Heidi Klakk Egebæk
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, The Capital Region, Denmark; Department of Exercise Epidemiology, Institute for Sports Science and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Inge H Bruun
- Department of Physical Therapy and Occupational Therapy, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Bjarke Viberg
- Department of Orthopedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Odense, Denmark; Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Pernille Tanggaard Andersen
- Department of Public Health, Unit for Health Promotion, University of Southern Denmark, Odense & Esbjerg, Denmark
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Bradley H, Trennery C, Jones AM, Lydon A, White F, Williams-Hall R, Arbuckle R, Tomaszewski E, Shih VH, Haughney J, Eisen A, Winders T, Coons SJ, Eremenco S. Assessing asthma symptoms in children: qualitative research supporting the development of the Pediatric Asthma Diary-Child (PAD-C) and Pediatric Asthma Diary-Observer (PAD-O). J Patient Rep Outcomes 2023; 7:104. [PMID: 37863864 PMCID: PMC10589163 DOI: 10.1186/s41687-023-00639-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 09/26/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Pediatric asthma has been identified by regulators, clinicians, clinical trial sponsors, and caregivers as an area in need of novel fit-for-purpose clinical outcome assessments (COAs) developed in accordance with the U.S. Food and Drug Administration's (FDA's) regulatory guidance for evaluating clinical benefit in treatment trials. To address this gap, the Patient-Reported Outcome (PRO) Consortium's Pediatric Asthma Working Group has continued development of 2 COAs to assess asthma signs and symptoms in pediatric asthma clinical trials to support efficacy endpoints: a PRO measure, the Pediatric Asthma Diary-Child (PAD-C) for children 8-11 years old (y.o.) and an observer-reported outcome measure, the Pediatric Asthma Diary-Observer (PAD-O) for caregivers of children 4-11 y.o. This qualitative research aimed to generate evidence regarding the content validity of the PAD-C and PAD-O. METHODS Semi-structured combined concept elicitation and cognitive interviews were conducted with a diverse sample of U.S. participants (15 children 8-11 y.o. and 30 caregivers of children 4-11 y.o.). All children had clinician-diagnosed mild to severe asthma. Interviews explored the experience of pediatric asthma and assessed the understanding and relevance of both measures. Interviews were conducted across 3 iterative rounds to allow for modifications. RESULTS Concept elicitation findings demonstrated that the core sign/symptom and impact concepts assessed in the PAD-C (cough, hard to breathe, out of breath, wheezing, chest tightness, and nighttime awakenings/symptoms) and PAD-O (cough, difficulty breathing, short of breath, wheezing, and nighttime awakenings/signs) correspond to those most frequently reported by participants; concept saturation was achieved. All PAD-C and PAD-O instructions and core items were well understood and considered relevant by most participants. Feedback from participants, the Pediatric Asthma Working Group, advisory panel, and FDA supported modifications to the measures, including addition of 1 new item to both measures and removal of 1 caregiver item. CONCLUSIONS Findings provide strong support for the content validity of both measures. The cross-sectional measurement properties of both measures and their user experience and feasibility in electronic format will be assessed in a future quantitative pilot study with qualitative exit interviews, intended to support the reliability, construct validity, final content, and, ultimately, FDA qualification of the measures.
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Affiliation(s)
| | | | - Amy M Jones
- Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Aoife Lydon
- Adelphi Values Ltd, Bollington, Cheshire, UK
| | | | | | | | | | | | - John Haughney
- NHS Greater Glasgow and Clyde R&I, Queen Elizabeth University Hospital, Glasgow, UK
| | | | - Tonya Winders
- Global Allergy and Airways Patient Platform, Vienna, Austria
| | - Stephen Joel Coons
- Patient-Reported Outcome Consortium, Critical Path Institute, Tucson, AZ, USA
| | - Sonya Eremenco
- Patient-Reported Outcome Consortium, Critical Path Institute, Tucson, AZ, USA
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Kilfoy A, Panesar P, Hashemi E, Masama T, Pereira M, Liu W, Alexander S, Korenblum C, Jibb LA. "It just made me feel better": qualitative examination of the implementation of a novel virtual psychosocial support program for adolescents with cancer. Support Care Cancer 2023; 31:610. [PMID: 37792141 DOI: 10.1007/s00520-023-08054-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Adolescents with cancer routinely report feelings of isolation and exclusion, including from medical decision-making. To address this problem and support adolescents, we designed and implemented the novel, virtual, weekly Teens4Teens peer support group and patient education program. We examined the views of participating adolescents, program guest speakers, and program moderators as they pertained to the need for the program, its feasibility, acceptability, and perceived impact. METHODS We recruited all available adolescents, moderators, and guest speakers who participated in Teens4Teens to take part in audio-recorded, semi-structured interviews. Interviews were transcribed, coded, and analyzed using thematic analysis. RESULTS We conducted 21 interviews across participant groups. We identified four broad themes: pathways into the Teen4Teens program, Teens4Teens implementation capacity, perspectives of the positive impact of Teens4Teens, and suggestions to improve Teens4Teens. These themes described a perceived need for adolescent-centered psychosocial programming in pediatric cancer care, provided lessons on how best to build and apply such a program, and highlighted the value of the program for both adolescents' and clinicians' acceptability, feasibility, and perceived utility. CONCLUSION Adolescents, guest speakers, and moderators valued Teens4Teens and made suggestions to improve capacity to routinely implement the program. Adolescent-tailored psychosocial programming, such as Teens4Teens, is positioned to be integrated into clinical care with relative ease and may serve to improve the cancer care experience of adolescents and their families. This study has potential to provide researchers and clinicians with valuable information about the content, design, and delivery of virtual peer support programming for adolescents with cancer.
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Affiliation(s)
- A Kilfoy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, ON, M5T 1P8, Canada
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - P Panesar
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, ON, Hamilton, L8S 4L8, Canada
| | - E Hashemi
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - T Masama
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
| | - M Pereira
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - W Liu
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - S Alexander
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, ON, Toronto, M5S 1A8, Canada
| | - C Korenblum
- Department of Supportive Care, University Health Network, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M6G 2C4, Canada
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, ON, Toronto, M5S 1A8, Canada
- Division of Adolescent Medicine, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
| | - L A Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, ON, M5T 1P8, Canada.
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada.
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
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Wells I, Simons G, Kanacherril JP, Mallen CD, Raza K, Falahee M. Stakeholder perceptions of preventive approaches to rheumatoid arthritis: qualitative study of healthcare professionals' perspectives on predictive and preventive strategies. BMC Rheumatol 2023; 7:35. [PMID: 37789489 PMCID: PMC10548722 DOI: 10.1186/s41927-023-00361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND There is increasing research interest in the development of preventive treatment for individuals at risk of rheumatoid arthritis (RA). Previous studies have explored the perceptions of at-risk groups and patients about predictive and preventive strategies for RA, but little is known about health care professionals' (HCPs) perspectives. METHODS One-to-one semi-structured qualitative interviews were conducted (face-to-face or by telephone) with HCPs. Audio recordings of the interviews were transcribed, and the data were analysed by thematic analysis. RESULTS Nineteen HCPs (11 female) were interviewed, including ten GPs, six rheumatologists and three rheumatology nurse specialists. The thematic analysis identified four organising themes: 1) Attributes of predictive and preventive approaches; 2) Ethical and psychological concerns; 3) Implementation issues and 4) Learning from management of other conditions. Theme 1 described necessary attributes of predictive and preventive approaches, including the type and performance of predictive tools, the need for a sound evidence base and consideration of risks and benefits associated with preventive treatment. Theme 2 described the ethical and psycho-social concerns that interviewees raised, including the potential negative economic, financial and psychological effects of risk disclosure for 'at-risk' individuals, uncertainty around the development of RA and the potential for benefit associated with the treatments being considered. Theme 3 describes the implementation issues considered, including knowledge and training needs, costs and resource implications of implementing predictive and preventive approaches, the role of different types of HCPs, guidelines and tools needed, and patient characteristics relating to the appropriateness of preventive treatments. Theme 4 describes lessons that could be learned from interviewees' experiences of prediction and prevention in other disease areas, including how preventive treatment is prescribed, existing guidelines and tools for other diseases and issues relating to risk communication. CONCLUSIONS For successful implementation of predictive and preventative approaches in RA, HCPs need appropriate training about use and interpretation of predictive tools, communication of results to at-risk individuals, and options for intervention. Evidence of cost-efficiency, appropriate resource allocation, adaptation of official guidelines and careful consideration of the at-risk individuals' psycho-social needs are also needed.
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Affiliation(s)
- Imogen Wells
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2WB, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Gwenda Simons
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2WB, UK
| | | | | | - Karim Raza
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2WB, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
- Sandwell and West Birmingham NHS Trust, Birmingham, UK
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and the Research into Inflammatory Arthritis Centre Versus Arthritis, University of Birmingham, Birmingham, UK
| | - Marie Falahee
- Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2WB, UK.
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK.
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Pallin ND, O'Connor M, Gannon A, Browne J, Cahill MR, O'Shea D. Experiences of and preferences for self-management among low grade non-Hodgkin's lymphoma survivors: A qualitative interview study. Eur J Oncol Nurs 2023; 66:102378. [PMID: 37506608 DOI: 10.1016/j.ejon.2023.102378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE Supporting self-management is one strategy to help cancer survivors optimise their quality of life. Low grade non-Hodgkin's lymphoma is often incurable with a chronic disease trajectory requiring lifelong self-management. This study explored the views on self-management and preferences for self-management support among survivors of low grade non-Hodgkin's lymphoma and their informal caregivers more than 6 months after completion of systemic anti-cancer therapy. METHOD In-depth semi-structured telephone interviews were conducted. Key themes and subthemes were determined using inductive and deductive thematic analysis. RESULTS The sample included eight survivors of low grade non-Hodgkin's lymphoma and two family caregivers. There were four themes. 1) The chronic nature of low grade non-Hodgkin's lymphoma shapes perceptions of self-management; participants described their cancer as a chronic condition and self-management strategies reflected this. 2) Social networks enable self-management; participants emphasised the importance of making low grade non-Hodgkin's lymphoma survivors aware of social networks. 3) Support and monitoring are needed immediately after the initial treatment phase ends. 4) Preferred components of self-management support; this included regular review with monitoring, advice on diet, and strategies to manage the psychosocial consequences of low grade non-Hodgkin's lymphoma. CONCLUSIONS Providing self-management support to those diagnosed with low grade non-Hodgkin's lymphoma is relevant given the chronic trajectory of the disease. Findings suggest that necessary components of a self-management support programme for those with low grade non-Hodgkin's lymphoma should include regular review with monitoring and practical support around facilitating engagement with social networks.
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Affiliation(s)
- Nickola D Pallin
- School of Public Health, University College Cork, Cork, Ireland.
| | | | - Alannah Gannon
- HSE National Data Protection Office, Dr Steevens Hospital, Steevens Lane, Dublin, Ireland
| | - John Browne
- School of Public Health, University College Cork, Cork, Ireland
| | - Mary R Cahill
- Department of Haematology, Cork University Hospital, Wilton, Ireland
| | - Derville O'Shea
- Department of Haematology, Cork University Hospital, Wilton, Ireland
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Xing J, Gong C, Wu B, Li Y, Liu L, Yang P, Wang T, Hei Z, Zhou S, Chen C. Effect of an educational video about ERAS on reducing preoperative anxiety and promoting recovery. Heliyon 2023; 9:e20536. [PMID: 37842611 PMCID: PMC10568319 DOI: 10.1016/j.heliyon.2023.e20536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/17/2023] Open
Abstract
Video propaganda is reported effectively improving patients' understanding of operation. However, whether a video introducing patients' most concerns can reduce preoperative anxiety and promote recovery stays unsealed. In this study, we investigated the effects of complementary therapy of educational video during preoperative visit. The results showed that thirty-five (23.2%) parents in Group Control were diagnosed as anxiety according to SAS, and nineteen (12.3%) patients were diagnosed after video intervention. The APAIs anxiety score and APAIs information score in Group Video were lower than those in Group Control. Compared with Group Control, video visit helped to increase the first-attempt pass rate of the knowledge retention exam and solve the patient's most worried concerns, and decrease incidence of emergence agitation, total cost of hospitalization and length of hospital stay. Moreover, video visit improved satisfaction degrees of patients and their main family members. Briefly, our study demonstrated video visit can improve patients' knowledge of anesthesia and decrease their preoperative anxiety, which may represent an important complementary therapy to routine preoperative visits.
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Affiliation(s)
- Jibin Xing
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chulian Gong
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bin Wu
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, China
| | - Yanting Li
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liling Liu
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, China
| | - Panyang Yang
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Tienan Wang
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ziqing Hei
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shaoli Zhou
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chaojin Chen
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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He Y, Li N, Wang Q, Wang Y, Dai Z, Wu M, Song H, Wen Q, Li N, Zhang Y. Factors influencing the quality of acupuncture clinical trials: a qualitative interview of stakeholders. BMC Complement Med Ther 2023; 23:326. [PMID: 37716936 PMCID: PMC10504711 DOI: 10.1186/s12906-023-04020-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 06/01/2023] [Indexed: 09/18/2023] Open
Abstract
OBJECTIVE To investigate the influencing factors on the quality of acupuncture clinical trials from the stakeholders, and to provide references for improving the quality of acupuncture clinical trials. METHODS A qualitative study based on semi-structured interviews was performed. Experts, acupuncturists, editors, and patients were interviewed. The interview results were thematically analyzed from transcribed audio recordings. RESULTS A total of 38 stakeholders were interviewed, including 12 experts, 14 acupuncturists, 2 editors, and 10 patients. There were 25 tree nodes and 106 sub-nodes, with 1141 reference points. The key factors influencing the quality of acupuncture clinical trials could be divided into five core theme frameworks: a) trial design, b) trial conduction, c) research results reporting and publication, d) research evidence dissemination, and e) research evidence transformation and application. CONCLUSIONS The results reveal that to improve the quality of acupuncture trials, it should consider each step of trial design, trial conduction, research results reporting and publication, research evidence dissemination, and research evidence transformation and application. A guideline for quality control of the whole process of acupuncture clinical trials is needed.
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Affiliation(s)
- Ying He
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Nian Li
- Department of Medical Administration, West China Hospital, Sichuan University, Chengdu, China
| | - Qin Wang
- Department of Evidence Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Wang
- Department of Medical Administration, West China Hospital, Sichuan University, Chengdu, China
| | - Zelei Dai
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Miaomiao Wu
- International Medical Center, General Practice Unit, West China Hospital, Sichuan University, Chengdu, China
| | - Haiqi Song
- International Medical Center, General Practice Unit, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Wen
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Ning Li
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China.
| | - Yonggang Zhang
- Department of Evidence Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Department of Periodical Press, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Krohner S, Yamin JB, Ziadni MS, Carty McIntosh JN, Schubiner H, Lumley MA. Emotional Awareness and Expression Interview: Examining Interview Content and Patient Experiences in Two Medical Samples. J Clin Psychol Med Settings 2023; 30:520-530. [PMID: 36190608 PMCID: PMC10122833 DOI: 10.1007/s10880-022-09913-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/29/2022]
Abstract
A single session of Emotional Awareness and Expression Therapy (EAET)-the EAET Interview-was previously shown to lead to clinical benefits for patients with centralized somatic conditions in primary care (Ziadni et al. in Health Psychol 37(3):282-290, 2018) and tertiary care (Carty et al. in Pain Med 20(7):1321-1329, 2019) settings. There has yet to be an examination of patients' experiences of and reactions to the EAET Interview, which is crucial in evaluating possible clinical implementation of the interview. We conducted secondary analyses on 88 patients (M age = 41.32, 90.9% women) from the two prior trials (primary care N = 51; tertiary care N = 37). Analyses examined interview processes (stress disclosure themes, working alliance, and emotional processing) and patients' reactions to the interview (interview credibility and perceived value of the interview), comparing the two samples and examining correlations among these variables. All patients disclosed at least one stressful life experience, commonly interpersonal problems (89.2%) and childhood adversity (51.5%). Patients had moderately high levels of working alliance and emotional processing during the interview and reported high interview credibility and perceived value of the interview. More extensive emotional processing of stressors was associated with more positive patient reactions to the interview, including higher interview credibility (r = .23) and perceived value (r = .32). We conclude that the single-session EAET Interview was valued by most patients, and patients' emotional processing is particularly beneficial. Addressing the trauma and emotional conflicts of patients with centralized somatic conditions is both feasible and valuable in front-line medical settings.
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Affiliation(s)
- Shoshana Krohner
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Jolin B Yamin
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Maisa S Ziadni
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | | | - Howard Schubiner
- Department of Internal Medicine, Ascension Health/Providence Park Hospital, Michigan State University, Southfield, MI, USA
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, MI, USA.
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Rickwood DJ, Coleman-Rose CL. The effect of survey administration mode on youth mental health measures: Social desirability bias and sensitive questions. Heliyon 2023; 9:e20131. [PMID: 37809858 PMCID: PMC10559918 DOI: 10.1016/j.heliyon.2023.e20131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/31/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
Aim Research on trends in youth mental health is used to inform government policy and service funding decisions. It often uses interviewer-administered surveys, which may be affected by mode effects related to social desirability bias. This study sought to determine the impact of survey administration mode on mental health measures, comparing mode effects for sensitive mental health measures (psychological distress and wellbeing) and non-sensitive (physical activity) measures. Methods Data were from two large national community samples of young Australians aged 12-25 years conducted in 2020 (N = 6238) and 2022 (N = 4122), which used both interviewer-administered and self-report modes of data collection. Results Results showed participants reported lower psychological distress and higher wellbeing in the interviewer-assisted compared with the self-report mode. No mode effects were found for the non-sensitive physical activity measures. No interaction between mode and gender was found, but an age group by mode interaction revealed that those in the 18-21 and 22-25-year age groups were more strongly affected than younger adolescents. Conclusions These findings suggest underestimates of mental health issues from interview survey formats, particularly for young adults. The results show how even a weak mode effect can have a large impact on mental health prevalence indicators. Researchers and policy makers need to be aware of the impact social desirability bias can have on mental health measures and consider taking steps to mitigate this effect.
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Bebb DG, Murray C, Giannopoulou A, Felip E. Symptoms and Experiences with Small Cell Lung Cancer: A Mixed Methods Study of Patients and Caregivers. Pulm Ther 2023; 9:435-450. [PMID: 37310567 PMCID: PMC10262931 DOI: 10.1007/s41030-023-00229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/15/2023] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Understanding of the patient-perceived symptom burden of small cell lung cancer (SCLC) is limited. The objective of this study was to explore patients' experiences with SCLC, identify which treatment-/disease-related symptoms have the greatest impact on their well-being, and gain caregiver perspectives. METHODS A noninterventional, cross-sectional, multimodal, mixed methods study was conducted from April-June 2021. Adult patients with SCLC and unpaid caregivers were eligible to participate. Patients' experiences, captured via 5-day video diaries and follow-up interviews, were scored 1-10 on how bothersome the patients perceived each symptom/symptomatic adverse event. Patients indicated if they believed a symptom was disease or treatment related. Caregivers participated in an online community board. RESULTS The study included nine patients (five with extensive-stage [ES] disease, four with limited-stage [LS] disease) and nine caregivers. Except for one patient/caregiver pairing, patients and caregivers were unmatched. The most common impactful symptoms in patients with ES-SCLC were shortness of breath, fatigue, coughing, chest pain, and nausea/vomiting; in LS-SCLC, these were fatigue and shortness of breath. Among patients with ES disease, SCLC had a high impact on physical (leisure/hobbies, work, sleep, ability to do household chores and errands/responsibilities outside home), social (family dynamics, extrafamilial social interaction), and emotional (mental health) aspects. Patients with LS-SCLC faced the long-term physical effects of treatment, financial implications, and emotional toll of an uncertain prognosis. SCLC had a high personal and psychologic burden among caregivers, whose duties consumed much of their time. Caregivers observed similar symptoms and impacts of SCLC as those reported by patients. CONCLUSIONS This study provides valuable insight into patient- and caregiver-perceived burden of SCLC and can inform the design of prospective studies. Clinicians should seek to understand patients' opinions and priorities before making treatment decisions.
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Affiliation(s)
- D Gwyn Bebb
- Global Development, Amgen, One Amgen Centre Drive, Thousand Oaks, CA, 91320, USA.
- Cumming School of Medicine, University of Calgary, 3285 Hospital Drive, NW, Calgary, AB, T2N 4N1, Canada.
| | | | | | - Enriqueta Felip
- Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain
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Prinds C, Timmerman C, Hvidtjørn D, Ammentorp J, Christian Hvidt N, Larsen H, Toudal Viftrup D. Existential aspects of parenthood transition seen from the health professionals' perspective - an interview and theatre workshop study. Sex Reprod Healthc 2023; 37:100884. [PMID: 37454585 DOI: 10.1016/j.srhc.2023.100884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/15/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES A sense of existential vulnerability is embedded in parenthood transition. It is linked to meaning in life, relationship changes, awareness of death, and sometimes a transcendent belief. Nevertheless, in most maternity service guidelines, the existential aspects of life are not an explicit focus. Therefore, this study aimed to explore how health professionals in maternity services experience and understand existential aspects of parenthood transition among new parents. STUDY DESIGN Data were generated through a user-involving two-phase process inspired by action research consisting of three focus group interviews with health professionals (n = 10) and, subsequently, a theatre workshop for parents, health professionals, and researchers (n = 40). Between the two phases, case narratives were constructed using information from the interviews and, in collaboration with a dramatist, dramatized and then played out at a workshop by professional actors. We used thematic analysis for all data. RESULTS We identified five themes in the data material: 1. Death and fragility in maternity care, 2. Existential aspects in camouflage, 3. Existential and spiritual aspects of being professional in maternity care, 4. Talking about existential aspects of care, 5. Equipped for providing existential care? CONCLUSIONS Existential aspects were often recognized during birth, specially in traumatic situations or discerned in the physical and non-verbal relational energy between the birthing woman and midwife or partner. Less often, existential aspects were recognized during pregnancy and the post-partum period.
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Affiliation(s)
- Christina Prinds
- Hospital Sønderjylland, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark; University College South Denmark, Degnevej 16, 6705 Esbjerg Ø, Denmark.
| | - Connie Timmerman
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000 Odense C, Denmark
| | - Dorte Hvidtjørn
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark; Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, 8000 Aarhus, Denmark
| | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000 Odense C, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9A, 5000 Odense, Denmark
| | - Henry Larsen
- Institute of Entrepreneurship and Relationship Management, University of Southern Denmark, Universitetsparken 1, 6000 Kolding, Denmark
| | - Dorte Toudal Viftrup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9A, 5000 Odense, Denmark
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Mahdi Salehi M, Maragha T, Brondani M. Application of the Life Grid in Oral Health Research: A Scoping Review. Community Dent Health 2023; 40:187-194. [PMID: 37655484 DOI: 10.1922/cdh_00088salehi08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/28/2023] [Indexed: 09/02/2023]
Abstract
AIM The life grid is a retrospective interview-based tool used to enhance recall of past events. This scoping review examines the use of the life grid in oral health research and its applications. METHODS Using the Joanna Briggs Institute framework, Medline (Ovid), CINAHL, PsycInfo, ERIC, MedEdPortal, Web of Science Core Collection, ProQuest, and Google Scholar were searched with "life grid" and "oral" as initial keywords. Then, two reviewers screened the records independently. Studies published until April 21, 2022, were added, regardless of language. Data were summarised narratively and in a comprehensive table focused on seven main areas. RESULTS A total of 22 studies were included from 724 initially identified records. The life grid was used in different forms, in various qualitative, longitudinal, and cross-sectional studies with participants of different ages. Eight studies used the life grid at the beginning of the interview, four during the process, and one at the end. The ability to reduce recall bias, increase data reliability, establish rapport with participants, and ensure information accuracy were among the most commonly cited benefits of using the life grid in oral health research, particularly in oral cancer research. CONCLUSIONS The life grid is a flexible tool used in a variety of structures and applications in oral health research. Positive impacts have been reported by both researchers and participants. This review highlights the potential of the life grid as a data collection and interview tool in oral health research and dental education.
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Affiliation(s)
- M Mahdi Salehi
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
| | - T Maragha
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
| | - M Brondani
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Canada
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Pichonnaz C, Foley RA. In-between duty and hope for recognition, the experience of physiotherapists working in a university hospital during the COVID-19 first wave in Switzerland: a qualitative study based on focus groups. Arch Physiother 2023; 13:16. [PMID: 37592333 PMCID: PMC10436384 DOI: 10.1186/s40945-023-00169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/12/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Learning more about the physiotherapists' experience, perceived role and perception of events during the COVID-19 crisis, as well as their recovery and projection into the post-crisis future, may be useful to inform stakeholders about the impact of the crisis. The objective of this study was to investigate the experience of physiotherapists working in a university hospital in Switzerland during the 1st wave of the COVID-19 crisis, more specifically their subjective experience, professional involvement, perception of management and perceived implications for the future. METHODS This interpretative qualitative study investigated the subjective experience of a purposeful sample of 12 physiotherapists using two 2 h semi-directive focus group interviews conducted by a physiotherapist in June 2020. Data were recorded, transcribed, and analysed using a thematic analysis approach. The report was approved by participants and the study was audited by a health anthropologist. RESULTS The most impressive points were the unprecedented nature of the crisis, the health threat, the hospital's capacity to reorganise on a large scale and the solidarity between colleagues. Participants expressed a high level of commitment to their role despite the potentially serious repercussions at an individual level. Pride and stress coexisted for those directly involved in the crisis, while those working in a reduced activity department felt anxious and idle. The need for immediacy in decision-making and action led to a flattening of hierarchies and an increase of uncertainties. Communication management was seen as the main area for improvement. Physiotherapists hoped that their involvement would improve recognition of the profession but feared that working conditions would deteriorate after the crisis. CONCLUSIONS The physiotherapists expressed high dedication to their profession and pride to be part of the "war effort" during the crisis. The stress level was partly tempered by the solidarity amongst health professionals and distraction by engaging in action. Despite the mental load, this situation was also seen as an opportunity to grow at a personal and professional level. The healthcare system capacity having not been exceeded in Switzerland, less distress related to death and powerlessness were expressed than in other studies investigating healthcare professionals' experience of the COVID-19 crisis.
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Affiliation(s)
- Claude Pichonnaz
- Department of Orthopaedic Surgery and Traumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.
| | - Rose-Anna Foley
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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