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Preest E, Greenhalgh T, Farrier C, van der Westhuizen HM. Children's experiences of mask-wearing: a systemic review and narrative synthesis. J Eval Clin Pract 2024. [PMID: 38534010 DOI: 10.1111/jep.13982] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/21/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
RATIONALE Masks have been widely used as a preventative tool during the COVID-19 pandemic. However, the use of masks by children has been controversial, with international guidelines recommending a risk-based approach to national policymakers. AIMS AND OBJECTIVES We aimed to conduct a systematic review that explores children's experiences of mask-wearing, drawing on an evidence base that describes mask-wearing in different contexts including air pollution, and to prevent the spread of infectious disease. METHODS We searched MEDLINE, Embase and PsycINFO in June 2021, with repeat searches in August 2022 and January 2024, for primary research studies exploring children's experiences of masks. Included studies reported on participants between 4 and 14 years (inclusive), with no restrictions on language where an English translation was available. Two reviewers independently screened titles and abstracts and reviewed full texts, with discrepancies resolved by a third reviewer. We used the Mixed Methods Appraisal Tool for quality appraisal and narrative synthesis to identify key findings. We also conducted stakeholder consultation (Patient and Public Involvement (PPI)) with nine children, where they submitted annotated drawings of their preferred masks to complement our review findings. RESULTS We screened 982 titles and abstracts and reviewed 94 full texts. 45 studies were included in the synthesis. Children's experiences of mask-wearing were influenced by their perceived necessity, social norms around their use and parental attitudes. Challenges related to mask-wearing were described, including difficulty reading facial expressions and physical discomfort. Children found it easier to wear masks when sitting and in cooler environments, and they benefited from unmasking during outdoor break time at school. As part of the PPI consultation, children highlighted the importance of mask design and the environmental impact of masks. CONCLUSION Children's experiences of mask-wearing were varied and context-dependent, with several mask-design challenges raised. Future policy on mask-wearing needs to consider the context in which mask-wearing would be most beneficial, and how local adaptations to policy can respond to children's needs.
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Affiliation(s)
- Elin Preest
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Christian Farrier
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Speechley J, McTernan M. How will AI make sense of our messy lives and improve our mental health? Front Psychiatry 2024; 15:1347358. [PMID: 38304287 PMCID: PMC10832992 DOI: 10.3389/fpsyt.2024.1347358] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024] Open
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Hosie A, Firdaus M, Clarkson J, Gupta E, Laidlaw L, Lamont T, Mooney M, Nevin G, Ramsay C, Rutherford S, Sardo AM, Soulsby I, Richards D, Stirling D, West M, Goulao B. Citizen science to improve patient and public involvement in GUideline Implementation in oral health and DEntistry (the GUIDE platform). Health Expect 2023; 27:e13921. [PMID: 38014917 PMCID: PMC10768863 DOI: 10.1111/hex.13921] [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: 06/12/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Citizen science is a way to democratise science by involving groups of citizens in the research process. Clinical guidelines are used to improve practice, but their implementation can be limited. Involving patients and the public can enhance guideline implementation, but there is uncertainty about the best approaches to achieve this. Citizen science is a potential way to involve patients and the public in improving clinical guideline implementation. We aimed to explore the application of citizen science methods to involve patients and the public in the dissemination and implementation of clinical guidelines in oral health and dentistry. METHODS We developed GUIDE (GUideline Implementation in oral health and DEntistry), a citizen science online platform, using a participatory approach with researchers, oral health professionals, guideline developers and citizens. Recruitment was conducted exclusively online. The platform focused on prespecified challenges related to oral health assessment guidelines, and asked citizens to generate ideas, as well as vote and comment on other citizens' ideas to improve those challenges. Citizens also shared their views via surveys and two online synchronous group meetings. Data were collected on participant's demographics, platform engagement and experience of taking part. The most promising idea category was identified by an advisory group based on engagement, feasibility and relevance. We presented quantitative data using descriptive statistics and analysed qualitative data using inductive and deductive thematic analysis. RESULTS The platform was open for 6 months and we recruited 189 citizens, from which over 90 citizens actively engaged with the platform. Most citizens were over 34 years (64%), female (58%) and had a university degree (50%). They generated 128 ideas, 146 comments and 248 votes. The challenge that led to most engagement was related to prevention and oral health self-care. To take this challenge forward, citizens generated a further 36 ideas to improve a pre-existing National Health Service oral care prevention leaflet. Citizens discussed motivations to take part in the platform (understanding, values, self-care), reasons to stay engaged (communication and feedback, outputs and impact, and relevance of topics discussed) and suggestions to improve future platforms. CONCLUSION Citizen science is an effective approach to generate and prioritise ideas from a group of citizens to improve oral health and dental services. Prevention and oral health self-care were of particular interest to citizens. More research is needed to ensure recruitment of a diverse group of citizens and to improve retention in citizen science projects. PATIENT OR PUBLIC CONTRIBUTION This project was inherently conducted with the input of public partners (citizen scientists) in all key aspects of its conduct and interpretation. In addition, two public partners were part of the research team and contributed to the design of the project, as well as key decisions related to its conduct, analysis, interpretation and dissemination and are co-authors of this manuscript.
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Affiliation(s)
- Annabel Hosie
- Health Services Research UnitUniversity of AberdeenAberdeenUK
| | - Maria Firdaus
- Health Services Research UnitUniversity of AberdeenAberdeenUK
| | - Jan Clarkson
- Dental Health Services Research Unit, Dundee Dental SchoolThe University of DundeeDundeeUK
| | - Ekta Gupta
- Institute of DentistryUniversity of AberdeenAberdeenUK
| | | | - Thomas Lamont
- Dental Health Services Research Unit, Dundee Dental SchoolThe University of DundeeDundeeUK
| | - Margaret Mooney
- Scottish Dental Clinical Effectiveness Programme (SDCEP)NHS Education for ScotlandEdinburghUK
| | - Gillian Nevin
- NHS Education for Scotland (Dental), DundeeScotlandUK
| | - Craig Ramsay
- Health Services Research UnitUniversity of AberdeenAberdeenUK
| | - Samantha Rutherford
- Scottish Dental Clinical Effectiveness Programme (SDCEP)NHS Education for ScotlandEdinburghUK
| | | | | | - Derek Richards
- Dental Health Services Research Unit, Dundee Dental SchoolThe University of DundeeDundeeUK
| | - Douglas Stirling
- Scottish Dental Clinical Effectiveness Programme (SDCEP)NHS Education for ScotlandEdinburghUK
| | - Michele West
- Scottish Dental Clinical Effectiveness Programme (SDCEP)NHS Education for ScotlandEdinburghUK
| | - Beatriz Goulao
- Health Services Research UnitUniversity of AberdeenAberdeenUK
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4
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Kroll T, Escorpizo R. Editorial: Patient and public involvement in disability and rehabilitation research. Front Rehabil Sci 2023; 4:1307386. [PMID: 38035183 PMCID: PMC10682761 DOI: 10.3389/fresc.2023.1307386] [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] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Thilo Kroll
- Midwifery and Health Systems, School of Nursing, University College Dublin, Dublin, Ireland
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, United States
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, O'Connor C, McGuire T, Leahy LM, Gonzalez JG, Stasiewicz M, Maughan J, Gouveia PJ, Murphy PJ, Quinlan J, Casey S, Holton A, Smith É, Moriarty F, O'Brien FJ, Flood M. Applying Patient and Public Involvement in preclinical research: A co-created scoping review. Health Expect 2022; 25:2680-2699. [PMID: 36217557 DOI: 10.1111/hex.13615] [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: 07/28/2022] [Revised: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patient and Public Involvement (PPI) in research aims to improve the quality, relevance and appropriateness of research. PPI has an established role in clinical research where there is evidence of benefit, and where policymakers and funders place continued emphasis on its inclusion. However, for preclinical research, PPI has not yet achieved the same level of integration. As more researchers, including our team, aim to include PPI in preclinical research, the development of an evidence-based approach is important. Therefore, this scoping review aimed to identify and map studies where PPI has been used in preclinical research and develop principles that can be applied in other projects. METHODS A scoping review was conducted to search the literature in Medline (PubMed), EMBASE, CINAHL, PsycInfo and Web of Science Core Collection to identify applied examples of preclinical PPI. Two independent reviewers conducted study selection and data extraction separately. Data were extracted relating to PPI in terms of (i) rationale and aims, (ii) approach used, (iii) benefits and challenges, (iv) impact and evaluation and (v) learning opportunities for preclinical PPI. Findings were reviewed collaboratively by PPI contributors and the research team to identify principles that could be applied to other projects. RESULTS Nine studies were included in the final review with the majority of included studies reporting PPI to improve the relevance of their research, using approaches such as PPI advisory panels and workshops. Researchers report several benefits and challenges, although evidence of formal evaluation is limited. CONCLUSION Although currently there are few examples of preclinical research studies reporting empirical PPI activity, their findings may support those aiming to use PPI in preclinical research. Through collaborative analysis of the scoping review findings, several principles were developed that may be useful for other preclinical researchers. PATIENT OR PUBLIC CONTRIBUTION This study was conducted as part of a broader project aiming to develop an evidence base for preclinical PPI that draws on a 5-year preclinical research programme focused on the development of advanced biomaterials for spinal cord repair as a case study. A PPI Advisory Panel comprising seriously injured rugby players, clinicians, preclinical researchers and PPI facilitators collaborated as co-authors on the conceptualization, execution and writing of this review, including refining the findings into the set of principles reported here.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anthony Maher
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Rachel Kavanagh
- Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicines, RCSI University of Medicine and Health Sciences & Royal College of Physicians in Ireland, Dublin, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Cian O'Connor
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tara McGuire
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Liam M Leahy
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Javier Gutierrez Gonzalez
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Martyna Stasiewicz
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Jack Maughan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Pedro Jose Gouveia
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul J Murphy
- RCSI Library, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Sarah Casey
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Alice Holton
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dún Laoghaire, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Rose DC, Poliakoff E, Hadley R, Guérin SMR, Phillips M, Young WR. Levelling the Playing Field: The Role of Workshops to Explore How People With Parkinson's Use Music for Mood and Movement Management as Part of a Patient and Public Involvement Strategy. Front Rehabil Sci 2022; 3:873216. [PMID: 36188900 PMCID: PMC9397793 DOI: 10.3389/fresc.2022.873216] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022]
Abstract
From a humanistic perspective, participatory processes in research find support on both ethical and moral grounds. In practical terms however, it is often difficult to establish protocols that best honour (i.e., elicit, capture, and integrate) the opinions of individuals and groups that represent the various specific stakeholders (e.g., from allied health, scientific, and academic disciplines) needed to investigate complex phenomena. Here, we describe a consultation process (funded by Parkinson's UK) devised to explore use of music among people with Parkinson's in relation to potential applications to enhance quality of life. People with Parkinson's were paired with researchers in order to discuss music on an equal footing so as to enable participant empowerment. We describe outcomes that demonstrate avenues of success as a result of this approach and additional insights gained through these processes in the hope of informing future practise. It has been our experience that researchers must establish a balance between (a) ensuring methodological rigour within an appropriate framework, and (b) facilitating informal "playtime" that develops connectivity between participants and enables both creative thinking and reflexive practise amongst stakeholders. We encourage researchers not to underestimate "playtime" as an important vehicle to foster this social interactivity and fuel the good will required to conduct inclusive and relevant research.
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Affiliation(s)
- Dawn C. Rose
- School of Music, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
- *Correspondence: Dawn C. Rose
| | - Ellen Poliakoff
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, United Kingdom
| | | | - Ségolène M. R. Guérin
- Univ. Lille, UMR 9193–SCALab–Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - William R. Young
- School of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, Murphy P, Quinlan J, Holton A, Casey S, Moriarty F, Smith É, O'Brien FJ, Flood M. Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol. HRB Open Res 2021; 4:61. [PMID: 34522837 PMCID: PMC8420886 DOI: 10.12688/hrbopenres.13303.2] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing 'basic', 'fundamental', 'translational' or 'lab-based' research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
| | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Anthony Maher
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Rachel Kavanagh
- Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicine, (RCPI & RCSI), RCSI House, 121 St Stephen's Green, Dublin 2, D02 H903, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Paul Murphy
- RCSI Library, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 P796, Ireland
| | - John Quinlan
- Tallaght University Hospital, Tallaght, Dublin, D24 NR04, Ireland
| | - Alice Holton
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Sarah Casey
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dún Laoghaire, Dublin, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
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Needham J, Taylor J, Nomikos D. Integrating Patient-Centred Research in the Canadian Cancer Trials Group. ACTA ACUST UNITED AC 2021; 28:630-639. [PMID: 33494312 PMCID: PMC7924353 DOI: 10.3390/curroncol28010062] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 11/24/2022]
Abstract
The inclusion of patients as partners in research is a key link in the delivery of patient-centred care in healthcare systems. Despite genuine intentions to engage patients in authentic partnerships, efforts can result in tokenism and benefits of engagement are missed. Understanding how patient engagement provides value along the research to patient-care continuum and how to best engage patients as partners are key. This document describes the method taken by the Canadian Cancer Trials Group (CCTG) to implement meaningful patient centricity and engagement and the benefits realized. Originally, Patient Representatives were recruited and assigned to CCTG Committees. Lacking guidance, the role was one of a passive meeting attendee. A gap analysis identified a need for clarity in expectations, understanding of the linkage to CCTG strategic objectives, and supporting tools and training. A plan was developed and successfully implemented in three phases, each phase building on the previous, the level of patient engagement simultaneously changing from “Inform” to “Involve” to “Collaborate” on the International Association for Public Participation (IAP2) scale. Results include significant contributions to increased patient accrual in CCTG trials, to increased CCTG grant funding, as well as recognition and adoption of these practices within Canada and internationally.
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Gurung G, Richardson A, Wyeth E, Edmonds L, Derrett S. Child/youth, family and public engagement in paediatric services in high-income countries: A systematic scoping review. Health Expect 2020; 23:261-273. [PMID: 31981295 PMCID: PMC7104655 DOI: 10.1111/hex.13017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/02/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 01/02/2023] Open
Abstract
Background Patient and public engagement in paediatric health‐care decision making is under‐researched, and there is a lack of systematically reviewed literature in this area. Objective To examine the extent, range and nature of published research investigating the engagement of children/youth, families and the public in paediatric service improvement, to summarize key aspects of the research identified and to identify gaps to help inform future research needs. Methods Literature was sought in MEDLINE, EMBASE, PsycINFO and CINAHL. Eligible articles presented research focused on patient, family and public engagement strategies in the paediatric health‐care setting. Two reviewers extracted and charted data and analysed findings using a descriptive numerical summary analysis and a thematic analysis. Results From 4331 articles, 21 were eligible. Most were from the United States. The majority of studies were undertaken in hospital settings and used quantitative methods. Various patient and public engagement strategies/interventions were examined, including shared decision‐making tools, questionnaires, youth councils/family advisory groups, patient portals and online networks. Most of the studies examined child/youth/parent satisfaction, with fewer investigating treatment outcomes or service improvement. The majority of studies investigated an engagement strategy at the ‘individual treatment’ level of engagement. Regarding the continuum of engagement, most of the studies were at either the ‘consultation’ or ‘involvement’ stage. Conclusion Future research needs to focus on the investigation of engagement strategies delivered in primary care, and the use of more qualitative and mixed methods approaches is recommended. There is a gap in the area of engagement strategies directed towards ‘service design and resources’ and ‘macro/policy’ levels.
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Affiliation(s)
- Gagan Gurung
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.,Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Amy Richardson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Emma Wyeth
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Liza Edmonds
- Children's Health and NICU, Southern District Health Board, Dunedin, New Zealand.,Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Hamilton C, Snow ME, Clark N, Gibson S, Dehnadi M, Lui M, Koster A, McLean J, Li LC. Quality of patient, family, caregiver and public engagement in decision-making in healthcare systems: a scoping review protocol. BMJ Open 2019; 9:e032788. [PMID: 31699750 PMCID: PMC6858224 DOI: 10.1136/bmjopen-2019-032788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION To advance person- and family-centred healthcare, government initiatives have supported the engagement of patients and family caregivers in decision-making in healthcare systems. There is, however, no consensus on how to define success for such initiatives. This scoping review aims to identify the key elements for defining the quality of patient and family caregiver engagement in decision-making across the engagement domains (individual, community/organisation, system) of British Columbia's healthcare system. We will use those elements to develop a conceptual evaluation framework. METHODS AND ANALYSIS This scoping review follows Arskey and O'Malley's methodology. (1) The research question was identified through team discussions. (2) Articles for data source will be identified using a librarian-informed search strategy for seven bibliographic databases as well as grey literature sources. (3) Selected articles will be relevant to the evaluation of patient and family caregiver engagement in healthcare systems. (4) Two researchers will independently extract data into predefined and emerging categories. (5) The researchers will reconcile and organise the identified elements. The research team's collective perspective will then refine the elements, and select, interpret and summarise the results. (6) Persons from key stakeholder groups will be consulted to refine the emergent conceptual framework. ETHICS AND DISSEMINATION We will seek ethics approval for the stakeholder consultation. This study follows an integrated knowledge translation approach. The results will inform evaluation of the Patients as Partners Initiative of the British Columbia Ministry of Health, and will be disseminated as a scientific article, a research brief, and presentations at conferences and stakeholder meetings.
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Affiliation(s)
- Clayon Hamilton
- Arthritis Research Centre of Canada, Richmond, British Columbia, Canada
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- Primary Care Division, British Columbia Ministry of Health, Victoria, British Columbia, Canada
| | - M Elizabeth Snow
- Program Evaluation, Centre for Health Evaluation & Outcome Sciences, Vancouver, British Columbia, Canada
| | - Nancy Clark
- Faculty of Human and Social Development, University of Victoria, Victoria, British Columbia, Canada
| | - Shannon Gibson
- Primary Care Division, British Columbia Ministry of Health, Victoria, British Columbia, Canada
| | - Maryam Dehnadi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Michelle Lui
- School of Population & Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Janet McLean
- Family Caregivers of British Columbia, Victoria, British Columbia, Canada
| | - Linda C Li
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
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Abstract
The "problem" of public resistance to hospital closure is a recurring trope in health policy debates around the world. Recent papers have argued that when it comes to major change to hospitals, "the public" cannot be persuaded by clinical evidence, and that mechanisms of public involvement are ill-equipped to reconcile opposition with management desire for radical change. This paper presents data from in-depth qualitative case studies of three hospital change processes in Scotland's National Health Service, including interviews with 44 members of the public. Informed by sociological accounts of both hospitals and publics as heterogeneous, shifting entities, I explore how hospitals play meaningful roles within their communities. I identify community responses to change proposals which go beyond simple opposition, including evading, engaging with and acquiescing to changes. Explicating both hospitals and the publics they serve as complex social phenomena strengthens the case for policy and practice to prioritise dialogic processes of engagement. It also demonstrates the continuing value of careful, empirical research into public perspectives on contentious healthcare issues in the context of everyday life.
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Affiliation(s)
- Ellen Stewart
- Centre for Biomedicine, Self and SocietyUsher InstituteUniversity of EdinburghUK
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12
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Abelson J, Tripp L, Kandasamy S, Burrows K. Supporting the evaluation of public and patient engagement in health system organizations: Results from an implementation research study. Health Expect 2019; 22:1132-1143. [PMID: 31373754 PMCID: PMC6803403 DOI: 10.1111/hex.12949] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/24/2019] [Accepted: 07/12/2019] [Indexed: 01/26/2023] Open
Abstract
Background As citizens, patients and family members are participating in numerous and expanding roles in health system organizations, attention has turned to evaluating these efforts. The context‐specific nature of engagement requires evaluation tools to be carefully designed for optimal use. We sought to address this need by assessing the appropriateness and feasibility of a generic tool across a range of health system organizations, engagement activities and patient groups. Methods We used a mixed‐methods implementation research design to study the implementation of an engagement evaluation tool in seven health system organizations in Ontario, Canada focusing on two key implementation outcome variables: appropriateness and feasibility. Data were collected through respondent feedback questions (binary and open‐ended) at the end of the tool's three questionnaires as well as interviews and debriefing discussions with engagement professionals and patient partners from collaborating organizations. Results The three questionnaires comprising the evaluation tool were collectively administered 29 times to 405 respondents yielding a 52% response rate (90% and 53% of respondents respectively assessed the survey's appropriateness and feasibility [quantitatively or qualitatively]). The questionnaires' basic properties were rated highly by all respondents. Concrete suggestions were provided for improving the appropriateness and feasibility of the questionnaires (or components within) for different engagement activity and organization types, and for enhancing the timing of implementation. Discussion and Conclusions Our study findings offer guidance for health system organizations and evaluators to support the optimal use of engagement evaluation tools across a variety of health system settings, engagement activities and respondent groups.
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Affiliation(s)
- Julia Abelson
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Ontario, Canada
| | - Laura Tripp
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sujane Kandasamy
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kristen Burrows
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,Physician Assistant Education Program, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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13
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Zarzeczny A, Atkins H, Illes J, Kimmelman J, Master Z, Robillard JM, Snyder J, Turner L, Zettler PJ, Caulfield T. The stem cell market and policy options: a call for clarity. J Law Biosci 2018; 5:743-758. [PMID: 31143461 PMCID: PMC6534752 DOI: 10.1093/jlb/lsy025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Amy Zarzeczny
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK S4S 0A2, Canada
| | - Harold Atkins
- Ottawa Hospital Research Institute, Ottawa Hospital & University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Jonathan Kimmelman
- Biomedical Ethics Unit/Social Studies of Medicine, McGill University. Montreal, QC H3A 1X1, Canada
| | - Zubin Master
- Biomedical Ethics Research Program, Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Julie M Robillard
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Leigh Turner
- Center for Bioethics, School of Public Health, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Patricia J Zettler
- Centre for Law, Health and Society, College of Law, Georgia State University, Atlanta, GA 30302, USA
| | - Timothy Caulfield
- Faculty of Law and School of Public Health & Health Law Institute, University of Alberta, Edmonton, AB T6G 2H5, Canada
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14
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Boivin A, L'Espérance A, Gauvin FP, Dumez V, Macaulay AC, Lehoux P, Abelson J. Patient and public engagement in research and health system decision making: A systematic review of evaluation tools. Health Expect 2018; 21:1075-1084. [PMID: 30062858 PMCID: PMC6250878 DOI: 10.1111/hex.12804] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [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] [Accepted: 05/21/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Patient and public engagement is growing, but evaluative efforts remain limited. Reviews looking at evaluation tools for patient engagement in individual decision making do exist, but no similar articles in research and health systems have been published. OBJECTIVE Systematically review and appraise evaluation tools for patient and public engagement in research and health system decision making. METHODS We searched literature published between January 1980 and February 2016. Electronic databases (Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO) were consulted, as well as grey literature obtained through Google, subject-matter experts, social media and engagement organization websites. Two independent reviewers appraised the evaluation tools based on 4 assessment criteria: scientific rigour, patient and public perspective, comprehensiveness and usability. RESULTS In total, 10 663 unique references were identified, 27 were included. Most of these tools were developed in the last decade and were designed to support improvement of engagement activities. Only 11% of tools were explicitly based on a literature review, and just 7% were tested for reliability. Patients and members of the public were involved in designing 56% of the tools, mainly in the piloting stage, and 18.5% of tools were designed to report evaluation results to patients and the public. CONCLUSION A growing number of evaluation tools are available to support patient and public engagement in research and health system decision making. However, the scientific rigour with which such evaluation tools are developed could be improved, as well as the level of patient and public engagement in their design and reporting.
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Affiliation(s)
- Antoine Boivin
- University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada.,Department of family medicine, University of Montreal, Montreal, QC, Canada.,Center of Excellence on Partnership with Patients and the Public (CEPPP), Montreal, QC, Canada.,Department of health management, evaluation and policy, Ecole de santé publique de l'Université de Montréal, Montreal, QC, Canada
| | - Audrey L'Espérance
- Center of Excellence on Partnership with Patients and the Public (CEPPP), Montreal, QC, Canada
| | - François-Pierre Gauvin
- Center of Excellence on Partnership with Patients and the Public (CEPPP), Montreal, QC, Canada.,McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Vincent Dumez
- Center of Excellence on Partnership with Patients and the Public (CEPPP), Montreal, QC, Canada.,Direction Collaboration et Partenariat Patient, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
| | - Ann C Macaulay
- Participatory Research at McGill, Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Pascale Lehoux
- Department of health management, evaluation and policy, Ecole de santé publique de l'Université de Montréal, Montreal, QC, Canada
| | - Julia Abelson
- Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada
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15
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Abstract
This article develops the sociology of hope and patient engagement by exploring how patients' perceptions and actions are shaped by narratives of hope surrounding the clinical introduction of novel reproductive techniques. In 2015, after extensive public debates, the UK became the first country to legalise a mitochondrial donation technique aimed at preventing the transmission of inherited disorders. The article draws on the accounts of twenty-two women of reproductive age who are at risk of having a child with mitochondrial disease and would be the potential target of the technique. We explore the extent to which our participants engaged with the public debates and how they accounted for their support of mitochondrial donation. We show that while the majority of our participants were in favour of legalisation, they did not necessarily wish to use the technique themselves. We found that hope was multi-faceted, involving hope for self, hope for family and hope for society. We conclude by considering the implications of hope narratives for patients and families and the important but potentially limited role that patients can play as advocates for technology.
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Affiliation(s)
- Cathy Herbrand
- Centre for Reproduction Research, De Montfort University, Leicester, UK
| | - Rebecca Dimond
- School of Social Sciences, Cardiff University, Cardiff, UK
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16
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Abstract
The case of cultured red blood cells (RBCs) currently being grown in a laboratory for future use in human transfusion raises questions about the ontological status of such products of modern biotechnology. This paper presents results from a six-year ethnographic study involving interviews, focus groups and other forms of engagement with the scientific research team and other stakeholders, including public groups, which sought to understand respondents' reactions to cultured RBCs. These cells, derived from stem cell technology, have the potential to address the global shortage of donated blood. How these blood cells are situated within the spectrum of 'natural' to 'synthetic' will shape expectations and acceptance of this product, both within the scientific community and by wider publics: these blood cells are both novel and yet, at the same time, very familiar. Drawing on discussions related to classification and 'anchoring', we examine the contrasting discourses offered by our respondents on whether these blood cells are 'natural' or not and consider the impact that naming might have on both their future regulation and the eventual uptake of cultured RBCs by society.
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Affiliation(s)
- Emma King
- NMAHP Research, University of Stirling, UK
| | - Catherine Lyall
- School of Social and Political Science, University of Edinburgh, UK
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17
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Abstract
Patient and public involvement in health research and care has been repeatedly theorised using the metaphor of spaces, knowledge spaces and participatory citizenship spaces. Drawing on data from a three year qualitative study of people involved in health research with organisations across England, this article explores where these spaces fit in a wider social, political and historical landscape. It outlines a theme recurring frequently in the study data: a unified public/patient/service-user perspective in opposition to a professional/clinical/academic view. This is discussed in relation to Habermas's division between the lifeworld and system. Patient and public involvement is mapped as spaces between these spheres, therefore between the social norms pertaining to them. In this way, involvement spaces are seen as liminal, in-between or threshold spaces; this concept provides us with new insights on both the opportunities and the conflicts that are integral in the ambiguous, complex interactions which take place in these spaces.
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18
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Abstract
The sociology of childbirth emerged in the 1970s largely as a result of influences from outside sociology. These included feminism, maternity care activism, the increasing medicalisation of childbirth, and evidence-based health care. This paper uses the author's own sociological 'career' to map a journey through four decades of childbirth research. It demonstrates the importance of social networks and interdisciplinary work, particularly across the medical-social science divide and including cross-cultural perspectives, argues that the study of reproduction has facilitated methodological development within the social sciences, and suggests that childbirth remains on the periphery of mainstream sociological concerns.
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Affiliation(s)
- Ann Oakley
- UCL Institute of Education, Social Science Research Unit, London, UK
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19
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Abstract
An enduring debate concerns how responsibility for patient safety should be distributed between organisational systems and individual professionals. Though rule-based, calculus-like approaches intended to support a 'just culture' have become popular, they perpetuate an asocial and atomised account. In this article, we use insights from practice theory--which sees organisational phenomena as accomplished in everyday actions, with individual agency and structural conditions as a mutually constitutive, dynamic duality--along with contributions from the political science and ethics literature as a starting point for analysis. Presenting ethnographic data from five hospitals, three in one high-income country and two in low-income countries, we offer an empirically informed, normative rethinking of the role of personal accountability, identifying the collective nature of the healthcare enterprise and the extent to which patient safety depends on contributions from many hands. We show that moral responsibility for actions and behaviours is an irreducible element of professional practice, but that individuals are not somehow 'outside' and separate from 'systems': they create, modify and are subject to the social forces that are an inescapable feature of any organisational system; each element acts on the other. Our work illustrates starkly the structuring effects of the broader institutional and socioeconomic context on opportunities to 'be good'. These findings imply that one of the key responsibilities of organisations and wider institutions in relation to patient safety is the fostering of the conditions of moral community.
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Affiliation(s)
- Emma‐Louise Aveling
- Department of health SciencesUniversity of LeicesterUK
- Department of Health Policy and Management, Harvard T.H. Chan School of Public HealthBostonUSA
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20
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Abstract
This ethnographic study examines how participatory spaces and citizenship are co-constituted in participatory healthcare improvement efforts. We propose a theoretical framework for participatory citizenship in which acts of citizenship in healthcare are understood in terms of the spaces they are in. Participatory spaces consist of material, temporal and social dimensions that constrain citizens' actions. Participants draw on external resources to try to make participatory spaces more productive and collaborative, to connect and expand them. We identify three classes of tactics they use to do this: 'plotting', 'transient combination' and 'interconnecting'. All tactics help participants assemble to a greater or lesser extent a less fragmented participatory landscape with more potential for positive impact on healthcare. Participants' acts of citizenship both shape and are shaped by participatory spaces. To understand participatory citizenship, we should take spatiality into account, and track the ongoing spatial negotiations and productions through which people can improve healthcare.
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21
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Renedo A, Marston C. Developing patient-centred care: an ethnographic study of patient perceptions and influence on quality improvement. BMC Health Serv Res 2015; 15:122. [PMID: 25903663 PMCID: PMC4407290 DOI: 10.1186/s12913-015-0770-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 02/27/2015] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Understanding quality improvement from a patient perspective is important for delivering patient-centred care. Yet the ways patients define quality improvement remains unexplored with patients often excluded from improvement work. We examine how patients construct ideas of 'quality improvement' when collaborating with healthcare professionals in improvement work, and how they use these understandings when attempting to improve the quality of their local services. METHODS We used in-depth interviews with 23 'patient participants' (patients involved in quality improvement work) and observations in several sites in London as part of a four-year ethnographic study of patient and public involvement (PPI) activities run by Collaborations for Leadership in Applied Health Research and Care for Northwest London. We took an iterative, thematic and discursive analytical approach. RESULTS When patient participants tried to influence quality improvement or discussed different dimensions of quality improvement their accounts and actions frequently started with talk about improvement as dependent on collective action (e.g. multidisciplinary healthcare professionals and the public), but usually quickly shifted away from that towards a neoliberal discourse emphasising the role of individual patients. Neoliberal ideals about individual responsibility were taken up in their accounts moving them away from the idea of state and healthcare providers being held accountable for upholding patients' rights to quality care, and towards the idea of citizens needing to work on self-improvement. Participants portrayed themselves as governed by self-discipline and personal effort in their PPI work, and in doing so provided examples of how neoliberal appeals for self-regulation and self-determination also permeated their own identity positions. CONCLUSIONS When including patient voices in measuring and defining 'quality', governments and public health practitioners should be aware of how neoliberal rationalities at the heart of policy and services may discourage consumers from claiming rights to quality care by contributing to public unwillingness to challenge the status quo in service provision. If the democratic potential of patient and public involvement initiatives is to be realised, it will be crucial to help citizens to engage critically with how neoliberal rationalities can undermine their abilities to demand quality care.
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Affiliation(s)
- Alicia Renedo
- Department of Social & Environmental Health Research, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Cicely Marston
- Department of Social & Environmental Health Research, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
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Robinson N, Lorenc A. 'No one wants to be the face of Herpes London': a qualitative study of the challenges of engaging patients and the public in sexual and reproductive health and HIV/AIDS services. Health Expect 2015; 18:221-32. [PMID: 23194419 PMCID: PMC5060775 DOI: 10.1111/hex.12024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Accepted: 10/22/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To explore barriers, challenges and best practice within patient and public engagement (PPE) in sexual and reproductive health and HIV (SRHH) services in London. METHODS Consultation exercise using qualitative interviews with 27 stakeholders including commissioners, managers, voluntary/community organizations (VCOs) clinicians and patients, analysed using Framework Analysis and Atlas.ti software. RESULTS Participants recognized PPE's importance, echoing recent political and NHS drives, and highlighted the need for meaningful, empowering PPE, including user-designed methods, peer research and participatory approaches. Although challenging in SRHH and requiring training and support, PPE may help tackle stigma, and promote self-management and patient-centred-care, including peer education and role modelling. Expertise may come from experienced VCOs. Themes in priority order were: organizational commitment (including lack of dedicated staff, time and money); motivating patients; changing NHS philosophy; informing patients/public; using public awareness/education campaigns; overcoming stigma; working with VCOs. 'Reaching out' to engage underrepresented groups in this sensitive area was emphasized through community outreach, incentivization and linking with existing organizations. Making engagement easy and addressing issues of public value were also important. Stigma was less hindering than anticipated, except for ethnic minorities. PPE was seen to improve patient satisfaction, increase service uptake and reduce inequalities, key priorities in SRHH, and identify innovative service delivery ideas. CONCLUSIONS PPE is crucial in creating a patient-led NHS and responsible society. If organizations, including the NHS, commit to implementing meaningful PPE which actively targets those at risk of poor SRHH, services can be truly patient-led and patients and communities empowered to tackle the stigma of SRHH.
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Affiliation(s)
- Nicola Robinson
- Faculty of Health and Social CareLondon South Bank UniversityLondonUK
| | - Ava Lorenc
- Faculty of Health and Social CareLondon South Bank UniversityLondonUK
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Buck D, Gamble C, Dudley L, Preston J, Hanley B, Williamson PR, Young B. From plans to actions in patient and public involvement: qualitative study of documented plans and the accounts of researchers and patients sampled from a cohort of clinical trials. BMJ Open 2014; 4:e006400. [PMID: 25475243 PMCID: PMC4256646 DOI: 10.1136/bmjopen-2014-006400] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 11/12/2014] [Accepted: 11/13/2014] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED : Patient and public involvement (PPI) in research is increasingly required, although evidence to inform its implementation is limited. OBJECTIVE Inform the evidence base by describing how plans for PPI were implemented within clinical trials and identifying the challenges and lessons learnt by research teams. METHODS We compared PPI plans extracted from clinical trial grant applications (funded by the National Institute for Health Research Health Technology Assessment Programme between 2006 and 2010) with researchers' and PPI contributors' interview accounts of PPI implementation. Analysis of PPI plans and transcribed qualitative interviews drew on the Framework technique. RESULTS Of 28 trials, 25 documented plans for PPI in funding applications and half described implementing PPI before applying for funding. Plans varied from minimal to extensive, although almost all anticipated multiple modes of PPI. Interview accounts indicated that PPI plans had been fully implemented in 20/25 trials and even expanded in some. Nevertheless, some researchers described PPI within their trials as tokenistic. Researchers and contributors noted that late or minimal PPI engagement diminished its value. Both groups perceived uncertainty about roles in relation to PPI, and noted contributors' lack of confidence and difficulties attending meetings. PPI contributors experienced problems in interacting with researchers and understanding technical language. Researchers reported difficulties finding 'the right' PPI contributors, and advised caution when involving investigators' current patients. CONCLUSIONS Engaging PPI contributors early and ensuring ongoing clarity about their activities, roles and goals, is crucial to PPI's success. Funders, reviewers and regulators should recognise the value of preapplication PPI and allocate further resources to it. They should also consider whether PPI plans in grant applications match a trial's distinct needs. Monitoring and reporting PPI before, during and after trials will help the research community to optimise PPI, although the need for ongoing flexibility in implementing PPI should also be recognised.
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Affiliation(s)
- Deborah Buck
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Carrol Gamble
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Louise Dudley
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Jennifer Preston
- Department of Women's and Children's Health, NIHR Clinical Research Network: Children, Coordinating Centre, University of Liverpool, Institute of Translational Medicine (Child Health), Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | | | | | - Bridget Young
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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