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Labbé-Pinlon B, Lombart C, Berger V, Louis D. Patient satisfaction with therapeutic education in oncology: Antecedents, consequences, and the moderating effect of perceived value. Health Serv Manage Res 2024; 37:43-51. [PMID: 36632645 DOI: 10.1177/09514848231151825] [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] [Indexed: 01/13/2023]
Abstract
This research aims to deepen our understanding of patients' satisfaction with therapeutic patient education (TPE) in oncology. The research model proposed was tested, with structural equation modeling, on 207 French breast-cancer patients who participated in a TPE program. The results confirm that post-TPE empowerment and relational proximity to the TPE team are two major antecedents of patient's satisfaction-and attitude and word-of-mouth toward TPE are two important consequences of this concept of satisfaction. However, the established relationships are moderated by the patients' profiles (i.e., utilitarin believers, passionate followers, or holistic followers) in terms of the perceived value of their own experience of patient education. These results will enable stakeholders to adapt their TPE promotion strategies to the profiles of the patients. The study will also help to demonstrate and highlight the patient benefits of TPE to various stakeholders and thus will favor access to this personalized care practice, which is essential in the management of chronic diseases, but is still limited in oncology.
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Affiliation(s)
| | | | - Virginie Berger
- Department of Patient Education, Institut de Cancérologie de l'Ouest, Angers, France
| | - Didier Louis
- IUT Saint-Nazaire, University of Nantes, Saint-Nazaire, France
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Hassan FH, Zakaria AS, Ahmad Rusli Y, Haris SM, Mohd Azraai H. Comparisons of Clients' and Caregivers' Satisfaction Across Conventional, Virtual, and Hybrid Speech-Language Therapy Services in Malaysia. Patient Prefer Adherence 2023; 17:1731-1740. [PMID: 37492636 PMCID: PMC10363485 DOI: 10.2147/ppa.s407347] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/28/2023] [Indexed: 07/27/2023] Open
Abstract
Purpose This study compared the satisfaction of recipients of conventional speech-language therapy (C-SLT), speech-language teletherapy (SLTT), and hybrid speech-language therapy (H-SLT), and determined sociodemographic factors that affect their satisfaction. Patients and Methods Participants were clients and caregivers of a speech-language clinic at a public university. Services were primarily provided by student clinicians, who were undergoing supervised clinical training. An online survey was distributed, which consisted of three sections: Background Information, Overall Satisfaction in SLT, and Satisfaction in SLTT. All participants completed the first two sections, while the third section was completed only by those who experienced SLTT or H-SLT. Results Most of the respondents were caregivers (89.7%), female (79.4%), of Malay ethnicity (80.9%), have received tertiary education (77.9%), within the low-income category (66.2%), held a job (76.5%), and resided in central West Malaysia (83.8%). Many participants experienced C-SLT (51%), followed by H-SLT (34%), and SLTT (15%). There were no significant differences in the overall satisfaction of the participants across three modes of services delivery (F[2,67] = 0.02, p = 0.95), and in the satisfaction with teletherapy between the H-SLT and SLTT groups (t = 0.90, p = 0.38). Income was the only sociodemographic factor that was correlated with the satisfaction level in teletherapy (r = 0.37, p = 0.04).
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Affiliation(s)
- Fatimah Hani Hassan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Yazmin Ahmad Rusli
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Munirah Haris
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hafizah Mohd Azraai
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Gonçalves I, Mendes DA, Caldeira S, Jesus É, Nunes E. The Primary Nursing Care Model and Inpatients' Nursing-Sensitive Outcomes: A Systematic Review and Narrative Synthesis of Quantitative Studies. Int J Environ Res Public Health 2023; 20:2391. [PMID: 36767759 PMCID: PMC9915435 DOI: 10.3390/ijerph20032391] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The delivery of quality, safe, and patient-centered care is foundational for professional practice. The primary nursing model allows nurses to have excellent knowledge about patients and families and to plan and coordinate care from admission to discharge, with better management of health situations. Nurses play a crucial role in improving patients' outcomes, namely those sensitive to nursing care. The knowledge of the relationship between the primary nursing model and the nursing-sensitive outcomes provides new scientific evidence that strengthens the relevance of this nursing care organization model in the inpatients' health outcomes. This systematic review describes the relationship between nurse-sensitive inpatients' outcomes and the primary nursing care model. METHODS A systematic review was conducted with a narrative synthesis, and the following databases were searched: MEDLINE, CINAHL, Web of Science, Nursing & Allied Health Collection, SciELO Collections, and Cochrane. RESULTS A total of 22 full texts were assessed, of which five were included in the study according to the selection criteria. The analysis results indicated that the primary nursing care model was related to nursing-sensitive patient safety outcomes. Patients' experience was also considered a nursing-sensitive outcome, namely in the satisfaction with nursing care. CONCLUSION The negative outcomes are clearly related to the primary nursing care model. There is scarce research that relates primary nursing to positive outcomes, such as patients' functional status and self-care abilities, and more studies are needed.
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Affiliation(s)
- Isabel Gonçalves
- Universidade Católica Portuguesa, Institute of Health Sciences, Center for Interdisciplinary Research in Health, Palma de Cima, 1649-023 Lisbon, Portugal
- Hospital da Luz Lisboa, Avenida Lusíada, 100, 1500-650 Lisbon, Portugal
| | - Diana Arvelos Mendes
- Instituto Politécnico de Setúbal, Escola Superior de Saúde, NURSE’IN-UIESI, Estefanilha, 2910-761 Setúbal, Portugal
| | - Sílvia Caldeira
- Universidade Católica Portuguesa, Institute of Health Sciences, Center for Interdisciplinary Research in Health, Palma de Cima, 1649-023 Lisbon, Portugal
| | - Élvio Jesus
- Universidade Católica Portuguesa, Institute of Health Sciences, Center for Interdisciplinary Research in Health, Palma de Cima, 1649-023 Lisbon, Portugal
| | - Elisabete Nunes
- Escola Superior de Enfermagem de Lisboa, Nursing Research, Innovation and Development Centre of Lisbon, 1600-190 Lisbon, Portugal
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Hu L, Jin X, Li Y, Yang D, Zhang Z, He X, Chen W, Gong N. A Mixed Methods Assessment of Self- Management Needs and Preferences of People with Type 2 Diabetes Mellitus in China. Patient Prefer Adherence 2023; 17:653-666. [PMID: 36935941 PMCID: PMC10022447 DOI: 10.2147/ppa.s394003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/25/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Consistent and effective self-management is a major challenge for people with diabetes and long-term effects can be difficult to sustain despite the many interventions. Interventions often fail to take patients' perceptions of self-management into account from their perspective. Exploring the needs preferences and the influencing factors of self-management in patients can improve the effectiveness of self-management. METHODS This study used a mixed research approach, exploring patient needs and preferences through web crawl methods and using qualitative interviews to explore the logic of preferences. 1605 data were obtained from 4 online health communities through web crawlers. Data were coded using grounded theory to analyze self-management needs. The codes were also coded for frequency statistics and ranked to explain the self-management preferences. The second phase explained the logic of the ranked distribution of preferences through one-on-one interviews with 22 patients. RESULTS This study summarized six self-management needs of people with diabetes through web crawler data, among which medication management and conflict between disease and daily life were the most important concerns of patients. The reasons why patients are particularly concerned about these two needs were explored through qualitative interviews, and it was found that patients' concerns about medication were mainly due to the following three aspects: the effect of drugs is direct and obvious, medication use makes life less complicated, and progressive side effects. The patients' concerns about the conflict between disease and daily life are often caused by the following three aspects: diabetes impacts social roles, disease complicates life, and reducing the impact of the disease on life. CONCLUSION The self-management needs of Chinese diabetics have six themes. Medication management, conflict between disease and daily life, diet, diabetes knowledge, blood glucose monitoring and exerciseIn order of frequency of mention and possible preference: medication management, conflict between disease and daily life were the most frequent needs, while diet, knowledge about diabetes, blood glucose monitoring and exercise were their least frequent needs.Understanding the individual's perception and understanding of diabetes self-management and the expression of the patient's daily life situations can guide the medical team to optimize collaboration on personalized care plans.
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Affiliation(s)
- Lei Hu
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Xiaoyuan Jin
- Department of Social Medicine of School of Public Health, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yundong Li
- School of Ethnology and Sociology, Yunnan University, Kunming, Yunnan, People’s Republic of China
| | - Dan Yang
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Ziqing Zhang
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Xiaoyu He
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Weiju Chen
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Ni Gong
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
- Correspondence: Ni Gong; Weiju Chen, School of Nursing, Jinan University, No. 601 West Huangpu Avenue, Tianhe District, Guangzhou, Guangdong, People’s Republic of China, Tel +86 15013217344;+86 18688898425, Email ;
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Ali H, Fatemi Y, Cole A, Tahat S, Ali D. Listening to the Voice of the Hospitalized Child: Comparing Children's Experiences to Their Parents. Children (Basel) 2022; 9:children9121820. [PMID: 36553265 PMCID: PMC9777132 DOI: 10.3390/children9121820] [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] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/21/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pediatric patients can provide feedback about their healthcare experiences. However, most do not and are instead represented by their parents. A widely accepted notion is that pediatric patients lack the capacity, vocabulary, and preferences needed to answer meaningful questions related to their healthcare. However, because the pediatric patients' experience can differ from the perspective of their parents, the use of proxy reporting ultimately reduces the hospital's ability to address the concerns of pediatric patients directly. OBJECTIVES The overall goals of this survey study were (1) to identify the key domains whereby pediatric patient and parent preferences differ and (2) to investigate the extent to which pediatric patients perceive their healthcare experiences differently from their parents. METHODS This study employed an adult version, an older child version, and a younger child version of a 47-question survey instrument divided into seven key domains: experience with the admission process, interactions with nurses, interactions with doctors, care in the hospital, hospital environment, experience before discharge, and overall score. The instrument was developed to survey children (ages 4-17) recently discharged from the hospital and their parents or guardian. RESULTS The findings suggest pediatric patients reported interest in engaging with their doctors about their healthcare. However, pediatric patients younger than 13 years old reported having fewer pediatric doctors ask them about their healthcare, with the youngest group reporting the worst experiences. Moreover, differences in perceptions were identified between pediatric patients and their parents regarding hospital quality and performance. Pediatric patients reported less pain and higher satisfaction regarding the cleanliness of the room and their experience in the admission process than their parents. Patient and parent responses were significantly different within each of the seven domains. CONCLUSION The results speak to the larger discussion of whether current hospital settings can engage with small children at the level necessary to capture meaningful feedback about their healthcare experience. By providing additional evidence to the contrary, this survey study brings further context to misconceptions regarding pediatric patients' involvement as crucial actors in the patient-and-family-centered care model.
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Affiliation(s)
- Haneen Ali
- Health Services Administration Program, Auburn University, Auburn, AL 36849, USA
- Department of Industrial and Systems Engineering, Auburn University, Auburn, AL 36849, USA
- 351 W Thach Concourse, 7080 Haley Center, Auburn University, Auburn, AL 36849, USA
- Correspondence:
| | - Yasin Fatemi
- Department of Industrial and Systems Engineering, Auburn University, Auburn, AL 36849, USA
| | - Astin Cole
- Public Administration and Public Policy, Auburn University, Auburn, AL 36849, USA
| | - Sufyan Tahat
- Department of Industrial and Systems Engineering, Auburn University, Auburn, AL 36849, USA
| | - Duha Ali
- Department of Industrial and Systems Engineering, Auburn University, Auburn, AL 36849, USA
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HaGani N, Sznitman S, Dor M, Bar-Sela G, Oren D, Margolis-Dorfman L, Goor-Aryeh I, Green MS. Attitudes Toward the Use of Medical Cannabis and the Perceived Efficacy, Side-effects and Risks: A Survey of Patients, Nurses and Physicians. J Psychoactive Drugs 2022; 54:393-402. [PMID: 34893011 DOI: 10.1080/02791072.2021.2009598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/31/2022]
Abstract
Gaps between physician and patient perceptions may lead to misunderstandings and mismanage of treatment. There are sparse data about the differences in opinions toward medical cannabis (MC) between patients and health professionals. The aim of this study was to examine the attitudes toward MC, its perceived efficacy, side effects and risk of dependency, among patients, nurses and physicians. A cross-sectional study of samples of 430 patients, 65 nurses and 65 physicians in two large medical centers in Israel. Questionnaires were administered on attitudes, perceived efficacy, side-effects and perceived risks of dependency. Compared with nurses and physicians, patients who were using MC had the most positive attitudes toward MC (p < .001). Younger age, high school education, being Jewish and ever using MC, were associated with more positive attitudes toward MC among patients (p < .001). Among nurses and physicians, having an oncology specialty predicted more positive attitudes toward MC. Physicians had a less positive attitude toward MC compared to nurses (p < .01). Our study provides evidence that physicians are less positive in their views toward MC compared to nurses and patients. More information and awareness to MC may reduce the gap in perceptions between physicians and patients.
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Affiliation(s)
- Neta HaGani
- School of Public Heath, University of Haifa, Haifa, Israel.,Rambam Medical Center, Haifa, Israel
| | | | - Michael Dor
- Department of Health Systems Management, Ariel University, Ari'el, Israel
| | - Gil Bar-Sela
- Oncology and Hematology Division, Emek Medical Center, Afula, Israel.,Faculty of Medicine, Technion, Haifa, Israel
| | - Dana Oren
- Pain Medicine Institute, Sheba Medical Center, Ramat Gan, Israel
| | | | - Itay Goor-Aryeh
- Pain Medicine Institute, Sheba Medical Center, Ramat Gan, Israel
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Shalaby R, Vuong W, Eboreime E, Surood S, Greenshaw AJ, Agyapong VIO. Patients' Expectations and Experiences With a Mental Health-Focused Supportive Text Messaging Program: Mixed Methods Evaluation. JMIR Form Res 2022; 6:e33438. [PMID: 35014972 PMCID: PMC8790698 DOI: 10.2196/33438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/07/2021] [Revised: 11/07/2021] [Accepted: 11/17/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Web-based services are an economical and easily scalable means of support that uses existing technology. Text4Support is a supportive, complementary text messaging service that supports people with different mental health conditions after they are discharged from inpatient psychiatric care. OBJECTIVE In this study, we aim to assess user satisfaction with the Text4Support service to gain a better understanding of subscribers' experiences. METHODS This was a mixed methods study using secondary data from a pilot observational controlled trial. The trial included 181 patients discharged from acute psychiatric care and distributed into 4 randomized groups. Out of the 4 study groups in the initial study, 2 groups who received supportive text messages (89/181, 49.2% of patients), either alone or alongside a peer support worker, were included. Thematic and descriptive analyses were also performed. Differences in feedback based on sex at birth and primary diagnosis were determined using univariate analysis. The study was registered with ClinicalTrials.gov (trial registration number: NCT03404882). RESULTS Out of 89 participants, 36 (40%) completed the follow-up survey. The principal findings were that Text4Support was well perceived with a high satisfaction rate either regarding the feedback of the messages or their perceived impact. Meanwhile, there was no statistically significant difference between satisfactory items based on the subscriber's sex at birth or primary diagnosis. The patients' initial expectations were either neutral or positive in relation to the expected nature or the impact of the text messages received on their mental well-being. In addition, the subscribers were satisfied with the frequency of the messages, which were received once daily for 6 consecutive months. The participants recommended more personalized messages or mutual interaction with health care personnel. CONCLUSIONS Text4Support was generally well perceived by patients after hospital discharge, regardless of their sex at birth or mental health diagnosis. Further personalization and interactive platforms were recommended by participants that may need to be considered when designing similar future services.
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Affiliation(s)
- Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Wesley Vuong
- Addiction and Mental Health, Alberta Health services, Edmonton, AB, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Shireen Surood
- Addiction and Mental Health, Alberta Health services, Edmonton, AB, Canada
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Sylvie G, Farré Coma J, Ota G, Aoife L, Anna S, Johanne S, Tiago M. Co-designing an Integrated Care Network With People Living With Parkinson's Disease: From Patients' Narratives to Trajectory Analysis. Qual Health Res 2021; 31:2585-2601. [PMID: 34629008 PMCID: PMC8649812 DOI: 10.1177/10497323211042605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Indexed: 05/05/2023]
Abstract
An integrated care model for people living with Parkinson's disease (PD) offers the promise of meeting complex care needs in a person-centered way that addresses fragmentation and improves quality of life. The purpose of our research was to co-design a care delivery model that supports both social and medical care from the perspective of patients and care partners. In the first step of our co-design approach, participants from five countries were invited to share their experiences of living with PD during a narrative interview. A qualitative analysis of these narrative interviews based on the Corbin and Strauss model was done to map out patients' trajectories. Three typical trajectories were identified: (a) the "unpredictable" trajectory, (b) the "situated" trajectory, and (c) the "demanding" trajectory. Based on the analysis of these trajectories, we were able to integrate various patient experiences into the design of an integrated care network.
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Affiliation(s)
- Grosjean Sylvie
- University of Ottawa, Ottawa, Ontario, Canada
- Grosjean Sylvie, University of Ottawa, 55 Laurier east, Desmanarais Building, 11112, Ottawa, Ontario, Canada K1N 6N5.
| | | | - Gal Ota
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital, Charles University, Prague, Czech Republic
| | - Laffan Aoife
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Stuempel Johanne
- University of Cologne, Cologne Centre for Ethics, Rights, Economics, and Social Sciences of Health (ceres), Cologne, Germany
| | - Mestre Tiago
- Parkinson’s Disease and Movement Disorders Clinic, Division of Neurology, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
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Harrichandparsad A, Mahomed OH. Patient and health system determinants of experiences of care at primary health care clinics in eThekwini, KwaZulu-Natal, 2018. Afr J Prim Health Care Fam Med 2021; 13:e1-e8. [PMID: 34636611 PMCID: PMC8517733 DOI: 10.4102/phcfm.v13i1.2884] [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: 12/22/2020] [Revised: 07/31/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Respect for persons includes three sub-elements: dignity, autonomy and confidentiality, whilst client orientation has four sub-elements: prompt attention, quality of basic amenities, access to social support for hospitalised individuals and choice of health providers. Aim This study sought to determine patient and health system determinants of experiences of care. Setting Study was conducted at primary health care clinics in eThekwini, KwaZula-Natal. Methods A self-administered questionnaire was used to collect data from 384 patients who received ambulatory care at six primary health care facilities (three community healthcare centres and three clinics) between June 2018 and November 2018. Results Three hundred and sixty nine respondents were included in the study. Eighty one percent (299) of the respondents were female, 67.2% (248) were single and 89.7% (331) were black Africans. Fifty (13.6%) respondents reported their health status to be poor, whilst 47 (12.5%) reported excellent health, with the majority (72.0%) reporting ‘good’ or ‘fair’ health. The patients’ experience score for the study population was 89.0% (IQR 81% – 98%). Patients who attended clinics had a 6.53 (p < 0.001) times increased odds of reporting good patients’ experience score compared with patients who attended community healthcare centres. Although ideal clinic status had a positive association with patients’ experience score (odds ration [OR]: 1.75; p > 0.05) this was not significant. Conclusion Patients attending clinics had a better experience compared with community health centres. Ideal clinic status showed a positive but not statistical significant association with good patient experiences. This may suggest that factors other than structural improvements play an important role in patients’ experience.
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Wang Y, Pan X, Bai Y. The Experience of Patients with COVID-19 in China: An Interpretative Phenomenological Analysis. Psychol Res Behav Manag 2021; 14:877-887. [PMID: 34234585 PMCID: PMC8253888 DOI: 10.2147/prbm.s310266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/12/2021] [Accepted: 06/10/2021] [Indexed: 12/28/2022] Open
Abstract
Aim The present study examined the experiences of patients diagnosed with COVID-19 to better understand their concerns and inspiration and provide better care. Methods Semistructured interviews were performed with 10 COVID-19 patients from the Optical Valley Branch of Maternity and Child Healthcare Hospital of Hubei Province. Interviews were recorded on audiotape and transcribed verbatim. Transcripts were analysed using an interpretative phenomenological analysis. Results Four superordinate themes emerged: psychological distress caused by COVID-19 uncertainty, ethical dilemmas that will be faced after returning to the family and society, resources to cope with COVID-19, and event-related growth experience. Conclusion Patients with COVID-19 were generally at high risk of having mental and social health challenges. Although the epidemic obviously affected their overall health, which led to their negative emotions or concerns, it also had a positive effect, such as viewing their relationship with families or others more positively and having more thoughts and outlooks on life. The study prompted medical staff to take their time listening to patients and pay more attention to specific psychological and social health problems in future care.
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Affiliation(s)
- Yanbo Wang
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, 200122, People's Republic of China
| | - Xiao Pan
- Department of Medical Psychology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, People's Republic of China
| | - Yonghai Bai
- Department of Medical Psychology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, People's Republic of China
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11
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Baumas V, Zebdi R, Julien-Sweerts S, Carrot B, Godart N, Minier L, Rigal N. Patients and Parents' Experience of Multi-Family Therapy for Anorexia Nervosa: A Pilot Study. Front Psychol 2021; 12:584565. [PMID: 33584467 PMCID: PMC7876305 DOI: 10.3389/fpsyg.2021.584565] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Family therapy is considered as the gold standard in treatment of adolescents with anorexia nervosa (AN). Among the different types of family therapy, multi-family therapy (MFT) is increasingly used for treating AN, and shows promising results. In this article, our focus relied on the patients' and their parents' perceptions of the effectiveness and the underlying mechanisms of the MFT. METHODS The present pilot exploratory qualitative study included two focus groups conducted using a semi-structured approach: one with the adolescents (n = 3), and another with one or two of their parents (n = 4 mothers; n = 2 fathers). The subjects discussed were the changes observed in both AN symptoms and family interactions following therapy, and the mechanisms underlying these changes. We crossed the perspectives of the adolescents and of the parents on these two points. RESULTS Qualitative analysis revealed that while both adolescents and parents had difficulties relating the changes they observed in the last year to MFT, they were able to say that the group cohesion had several positive effects and that their family dynamics had improved. In the light of analysis the adolescents perceived more improvements related eating disorders symptoms than their parents did, while parents were concerned about a negative effect of MFT on their children. DISCUSSION While both patients and parents perceived improvements in both AN symptoms and family interactions in the past year, it was not clear if they considered MFT to have led to these improvements. FG also explored the MFT mechanisms underlying changes. Both adolescents and their parents stressed the beneficial effects of identification to others members of the group and shared experience to overcome social isolation. Parents also mentioned the sympathy they felt for each other. The idea that they give a central place to families in the therapy was also described by the families.
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Affiliation(s)
- Victoria Baumas
- Psychiatric Unit, Institut Mutualiste Montsouris, Paris, France.,Département de Psychologie, Université Paris-Nanterre, Nanterre, France
| | - Rafika Zebdi
- Département de Psychologie, Université Paris-Nanterre, Nanterre, France
| | | | - Benjamin Carrot
- Psychiatric Unit, Institut Mutualiste Montsouris, Paris, France.,CESP, INSERM, UMR 1018, University Paris-Sud, UVSQ, University Paris-Saclay, Villejuif, France
| | - Nathalie Godart
- CESP, INSERM, UMR 1018, University Paris-Sud, UVSQ, University Paris-Saclay, Villejuif, France.,UFR des Sciences de la Santé Simone Veil (UVSQ), Versailles, France.,Fondation de Santé des Etudiants de France, Paris, France
| | - Lisa Minier
- Psychiatric Unit, Institut Mutualiste Montsouris, Paris, France.,Fondation de Santé des Etudiants de France, Paris, France
| | - Natalie Rigal
- Département de Psychologie, Université Paris-Nanterre, Nanterre, France
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Wongtaweepkij K, Corlett S, Krska J, Pongwecharak J, Jarernsiripornkul N. Patients' Experiences and Perspectives of Receiving Written Medicine Information About Medicines: A Qualitative Study. Patient Prefer Adherence 2021; 15:569-580. [PMID: 33727802 PMCID: PMC7955729 DOI: 10.2147/ppa.s298563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/18/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Written medicine information informs patients about the benefits and risks of medicines and supports their safe and effective use. In Thailand, patient information leaflets (PILs) are not obligatory and therefore not routinely supplied. This study aimed to explore the experiences and information needs of patients, their views on PILs and the likely impact of PILs on their knowledge, perceptions and behaviors towards medicines. These factors are important to establish the value of PILs. METHODS Semi-structured interviews with outpatients who received simvastatin or atorvastatin were conducted exploring their experiences of receiving medicine information, their views on the utility of and need for PILs, the impact of PILs on their behaviors, and recommendations for how PILs could be improved. All interviews were audio-recorded, transcribed verbatim, and analyzed using a framework approach. RESULTS Thirty interviews were conducted from which four themes emerged: experience of receiving medicine information, views of package inserts and PILs, impact of PILs on knowledge, perceptions and behaviors, and patients' need for medicine information. Most participants received verbal information from healthcare professionals, as well as written information. Verbal information was perceived as being particularly useful to inform about changes to medicine regimens or the long-term adverse effects of medicines. Patients perceived that the PILs had influenced their knowledge about medicines, and also their behaviors including safety awareness, adherence, and engagement with healthcare professionals. Participants suggested that the information in electronic format could provide an additional resource. Some changes to improve the content and general format of the PIL were identified. CONCLUSION PILs are perceived as useful by patients and met their information needs, although they were viewed as an adjunct to verbal advice provided by healthcare professionals. PILs influenced patients' medicine taking behaviors and encouraged sharing of information with their physicians.
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Affiliation(s)
- Kamonphat Wongtaweepkij
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Sarah Corlett
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Kent, UK
- Sarah Corlett Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham, Maritime, Kent, UK Email
| | - Janet Krska
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Kent, UK
| | - Juraporn Pongwecharak
- Pharmacy Practice and Management Research Unit, Division of Pharmaceutical Care, Faculty of Pharmacy, Rangsit Center, Thammasat University, Pathumthani, Thailand
| | - Narumol Jarernsiripornkul
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Correspondence: Narumol Jarernsiripornkul Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand Email
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Pizzoli SFM, Marton G, Pricolo P, Oliveri S, Summers P, Petralia G, Pravettoni G. Patients' experience with MRI-guided in-bore biopsy versus TRUS-guided biopsy in prostate cancer: a pilot study. Ecancermedicalscience 2020; 14:1127. [PMID: 33209118 PMCID: PMC7652422 DOI: 10.3332/ecancer.2020.1127] [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] [Received: 05/21/2020] [Indexed: 11/06/2022] Open
Abstract
Background Ultrasound-guided magnetic resonance imaging (MRI)-fusion biopsy and in-bore MRI-guided biopsy (MRGB) have improved the diagnostic pathway in patients with suspected prostate cancer compared to the traditional random sampling of the prostate gland under transrectal ultrasound guidance (TRUS-Bx). The aim of our study was to assess the psychological experiences of patients undergoing MRGB and TRUS-Bx. Method Participants completed an ad hoc set of 11 items to be rated from 0 (not at all) to 10 (very much) on visual analogue scales and one open question on the most worrisome aspect of the procedure. The set of items evaluated satisfaction with the information received and the possibility to ask questions to the staff; the tolerability of the irritation, duration and discomfort associated with the exam; their level of worry or calm before the exam; the perceived need to undergo the exam; their satisfaction with the exam and willingness to repeat it in the future; and acceptability of the exam. Results Between May 2018 and June 2019, 47 participants were enrolled on the day of their MRGB; 24 had previously undergone TRUS-Bx. The MRGB was rated with high positive scores on all 11 items. The lowest ratings regarded the duration of the exam (mean = 6.6) and feeling calm (mean = 6.6). Participants were significantly more satisfied with MRGB than TRUS-Bx, rating it as less painful and more comfortable, necessary and tolerable. Conclusion These preliminary results indicate that the MRGB is likely to be more tolerable and acceptable to patients than TRUS-Bx.
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Affiliation(s)
- Silvia Francesca Maria Pizzoli
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan 20132, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Giulia Marton
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan 20132, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Paola Pricolo
- Division of Radiology, IEO European Institute of Oncology IRCCS, Milan 20132, Italy
| | - Serena Oliveri
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan 20132, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Paul Summers
- Division of Radiology, IEO European Institute of Oncology IRCCS, Milan 20132, Italy
| | - Giuseppe Petralia
- Department of Oncology and Hemato-Oncology, University of Milan, Italy.,Precision Imaging and Research Unit-Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, Milan 20132, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan 20132, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
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14
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Graarup J, Højskov IE. Patients' perspective of attending nursing consultations-A pilot and feasibility study. Nurs Open 2020; 7:1482-1488. [PMID: 32802368 PMCID: PMC7424430 DOI: 10.1002/nop2.522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/25/2019] [Revised: 02/18/2020] [Accepted: 05/04/2020] [Indexed: 11/07/2022] Open
Abstract
Aim The aims were to explore: (a) how patients with advanced heart and lung failure accept the overall framework of the nursing consultations and (b) the patients' acceptability and applicability of the nursing consultations. Design Qualitative study. Methods Interviews were conducted in an holistic frame and analysed using Graneheim and Lundman's qualitative content thematic analysis. Patients were interviewed between April and May 2018 regarding their general view of the nursing consultation and their experience of the framework inspired by R. R. Parse. Results The overall theme was A confidential moment with the nurse to deal with and become more aware of what is important, based on following subthemes: "An option that makes sense," "Scheduled time with the nurse is important" and "To find a new normality in everyday life." The framework addressed a space of freedom requested by the informants, for whom attending nursing consultations was useful and meaningful, enabling them to reflect on everyday challenges.
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Affiliation(s)
- Jytte Graarup
- Department of Cardiothoracic SurgeryThe Centre for Cardiac, Vascular‐ Pulmonary and Infectious DiseasesRigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Ida Elisabeth Højskov
- Department of Cardiothoracic SurgeryThe Centre for Cardiac, Vascular‐ Pulmonary and Infectious DiseasesRigshospitaletUniversity of CopenhagenCopenhagenDenmark
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15
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Wozniak LA, Rowe BH, Ingstrup M, Johnson JA, McAlister FA, Bellerose D, Beaupre LA, Majumdar SR. Patients' Experiences of Nurse Case-Managed Osteoporosis Care: A Qualitative Study. J Patient Exp 2020; 7:251-257. [PMID: 32851148 PMCID: PMC7427371 DOI: 10.1177/2374373519827340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 12/15/2022] Open
Abstract
Background: Osteoporosis is a chronic condition that is often left untreated. Nurse case-managers can double rates of appropriate treatment in those with new fractures. However, little is known about patients’ experiences of a nurse case-managed approach to osteoporosis care. Objective: Our aim was to describe patients’ experiences of nurse case-managed osteoporosis care. Methods: A qualitative, descriptive design was used. We recruited patients enrolled in a randomized controlled trial of a nurse case-management approach. Individual semi-structured interviews were conducted which were transcribed and analyzed using content analysis. Data were managed with ATLAS.ti version 7. Results: We interviewed 15 female case-managed patients. Most (60%) were 60-years or older, 27% had previous fracture, 80% had low bone mineral density tests, and 87% had good osteoporosis knowledge. Three major themes emerged from our analysis: acceptable information to inform decision-making; reasonable and accessible care provided; and appropriate information to meet patient needs. Conclusions: This study provides important insights about older female patients’ experiences with nurse case-managed care for osteoporosis. Our findings suggest that this model to osteoporosis clinical care should be sustained and expanded in this setting, if proven effective. In addition, our findings point to the importance of applying patient-centered care across all dimensions of quality to better enhance the patients’ experience of their health care.
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Affiliation(s)
- Lisa A Wozniak
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Brian H Rowe
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Meghan Ingstrup
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Finlay A McAlister
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Debbie Bellerose
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Lauren A Beaupre
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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16
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Despins LA, Wakefield BJ. Making sense of blood glucose data and self-management in individuals with type 2 diabetes mellitus: A qualitative study. J Clin Nurs 2020; 29:2572-2588. [PMID: 32279366 DOI: 10.1111/jocn.15280] [Citation(s) in RCA: 4] [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: 07/19/2019] [Revised: 02/25/2020] [Accepted: 03/14/2020] [Indexed: 12/15/2022]
Abstract
AIMS AND OBJECTIVES To describe individuals' with type 2 diabetes mellitus sense-making of blood glucose data and other influences impacting self-management behaviour. BACKGROUND Type 2 diabetes mellitus prevalence is increasing globally. Adherence to effective diabetes self-management regimens is an ongoing healthcare challenge. Examining individuals' sense-making processes can advance staff knowledge of and improve diabetes self-management behaviour. DESIGN A qualitative exploratory design examining how individuals make sense of blood glucose data and symptoms, and the influence on self-management decisions. METHODS Sixteen one-on-one interviews with adults diagnosed with type 2 diabetes mellitus using a semi-structured interview guide were conducted from March-May 2018. An inductive-deductive thematic analysis of data using the Sensemaking Framework for Chronic Disease Self-Management was used. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in completing this paper. RESULTS Three main themes described participants' type 2 diabetes mellitus sense-making and influences on self-management decisions: classifying blood glucose data, building mental models and making self-management decisions. Participants classified glucose levels based on prior personal experiences. Participants learned about diabetes from classes, personal experience, health information technology and their social network. Seven participants expressed a need for periodic refreshing of diabetes knowledge. CONCLUSION Individuals use self-monitored glucose values and/or HbA1C values to evaluate glucose control. When using glucose values, they analyse the context in which the value was obtained through the lens of personal parameters and expectations. Understanding how individuals make sense of glycaemic data and influences on diabetes self-management behaviour with periodic reassessment of this understanding can guide the healthcare team in optimising collaborative individualised care plans. RELEVANCE TO CLINICAL PRACTICE Nurses must assess sense-making processes in self-management decisions. Periodic "refresher" diabetes education may be needed for individuals with type 2 diabetes mellitus.
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Affiliation(s)
- Laurel A Despins
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
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17
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Veneroni L, Bagliacca EP, Sironi G, Silva M, Casanova M, Bergamaschi L, Terenziani M, Trombatore J, Clerici CA, Prunas A, Silvaggi M, Massimino M, Ferrari A. Investigating sexuality in adolescents with cancer: patients talk of their experiences. Pediatr Hematol Oncol 2020; 37:223-234. [PMID: 32022619 DOI: 10.1080/08880018.2020.1712502] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 12/14/2022]
Abstract
Objective. The aim of the present study is to understand which areas of sexuality were regarded as most important and/or problematic among adolescents with cancer.Methods. A questionnaire was administered to adolescent and young adult patients who had been receiving treatments at the Pediatric Oncology Unit of our Institution, for at least 2 months, and those in follow-up who had completed their treatments no more than two years previously. The questionnaire was devised to investigate patients' experiences in various areas, i.e. personal relations, sexual relations; functional aspects, body image, and communication.Results. Questionnaires were given to 70 patients and completed by 66. As main results, the survey showed that disease and treatment might negatively affect patients' way of relating with others (53% of cases) and their body image (56%), though their sexual desire remains unchanged (69.7%). Most patients (67%) reported not having the chance to talk to someone about having sex while receiving their treatments; 79% of patients felt this topic deserved more attention.Conclusion. This study promotes the discussion of an important topic for young people with cancer, which is inadequately addressed today. When establishing an age-specific model of care, aspects related to sexuality should be considered and managed.
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Affiliation(s)
- Laura Veneroni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Matteo Silva
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Jessica Trombatore
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo Alfredo Clerici
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,SSD Psicologia Clinica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Antonio Prunas
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Marco Silvaggi
- Dipartimento di Urologia e Ginecologia, Istituto di Sessuologia Clinica, Rome, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Abstract
Little is known about chronic obstructive pulmonary disease (COPD) patients experience with home-based health treatments, which are currently rapidly evolving. A previous randomized controlled trial investigated the use of long-term oxygen enriched high flow nasal cannula (HFNC) treatment at home. The aim of this study was to explore COPD patients' experience using home HFNC treatment. Patients in this qualitative study were included from the previous RCT. All patients used long-term oxygen therapy and HFNC, the latter as a primarily nocturnal add-on. Data were collected using semi-structured interviews focused on four themes: 'Description of daily use', 'Experienced changes', 'Treatment benefits and disadvantages' and 'User-friendliness'. The interviewer played an encouraging, non-normative neutral facilitator role in order to give the participants possibility to explain themselves as fully as possible. Participants were recruited until themes were saturated. A total of 12 patients (5 males, 7 females) and 8 relatives participated. Six themes were identified as important to patient adherence: Perceived lower work of breathing; reduced symptoms; improved quality of sleep; increased activity of daily living; feeling safe; technology use. The results increase our knowledge of patient experience of using HFNC for home treatment, which improved the patients' experience through reducing symptoms and increase the activity of daily living. Furthermore, they substantiate the necessity of perceived usefulness and ease of use as important factors for adherence to treatment.
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Affiliation(s)
- Line Hust Storgaard
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Ulla Møller Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Birgitte Schantz Laursen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
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Simonÿ C, Andersen IC, Bodtger U, Birkelund R. Breathing through a troubled life - a phenomenological-hermeneutic study of chronic obstructive pulmonary disease patients' lived experiences during the course of pulmonary rehabilitation. Int J Qual Stud Health Well-being 2020; 14:1647401. [PMID: 31432771 PMCID: PMC6713173 DOI: 10.1080/17482631.2019.1647401] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose: Exploring real-life experiences of Chronic Obstructive Pulmonary Disease (COPD) patients during rehabilitation can contribute with new knowledge of what has significance for their participation and chance for improved health and well-being. Therefore, this study aims to gain in-depth knowledge of COPD patients’ lived experiences while following standard pulmonary out-patient rehabilitation. Methods: Combined participant observations and interviews were conducted among 21 participants in pulmonary rehabilitation. A three-leveled phenomenological-hermeneutic interpretation was applied. Results: Living with COPD was challenging due to dyspnea and other physical troubles. This caused a lack of trust in the body and complicated rehabilitation participation. When improving management of breath during rehabilitation, the patients gained a new sense of trust in the body. This was accompanied by a nascent hope and increased well-being. However, not succeeding in this left patients with a persistent lack of hope. Conclusions: Comprehensive troubles in living with COPD paradoxically prevents patients’ prospect of overcoming a perceived lack of trust in their body during standard pulmonary rehabilitation. Enhancing breath management has a significant impact on COPD patients’ trust in own capabilities to improve well-being and health. Future rehabilitation must accommodate COPD patients’ troubles by longer-lasting, well-coordinated, individually supportive and more easily accessible programmes.
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Affiliation(s)
- Charlotte Simonÿ
- Department of Physiotherapy and Occupational Therapy, Slagelse Hospital , Slagelse , Denmark.,Institute of Regional Health, University of Southern Denmark , Odense , Denmark.,Section of Nursing Science, Institute of Health, Aarhus University , Aarhus , Denmark
| | - Ingrid Charlotte Andersen
- Institute of Regional Health, University of Southern Denmark , Odense , Denmark.,Department of Internal Medicine M1, Slagelse Hospital , Slagelse , Denmark
| | - Uffe Bodtger
- Department of Respiratory Medicine (M1), Naestved Hospital , Naestved , Denmark.,Department of Respiratory Medicine, Zealand University Hospital , Roskilde , Denmark.,Institute of Regional Health Science, University of Southern Denmark , Odense , Denmark
| | - Regner Birkelund
- Department of Health Research , Lillebaelt Hospital , Vejle , Denmark.,Institute of Regional Health Research, University of Southern Denmark , Odense , Denmark
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Wright AL, Jack SM, Ballantyne M, Gabel C, Bomberry R, Wahoush O. Indigenous mothers' experiences of using acute care health services for their infants. J Clin Nurs 2019; 28:3935-3948. [PMID: 31410925 DOI: 10.1111/jocn.15034] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 02/20/2019] [Revised: 08/05/2019] [Accepted: 08/05/2019] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To develop an understanding of how Indigenous mothers experience selecting and using health services for their infants can assist nurses in improving their access to care. This understanding may ultimately lead to improved health outcomes for Indigenous infants and their families. BACKGROUND Access to acute care services is important to minimise morbidity and mortality from urgent health issues; however, Indigenous people describe difficulties accessing care. Indigenous infants are known to use the emergency department frequently, yet little is known about the facilitators and barriers their mothers experience when accessing these services. DESIGN This study undertook a qualitative, interpretive description design. METHODS This article adheres to the reporting guidelines of COREQ. Data collection methods included interviews and a discussion group with Indigenous mothers (n = 19). Data analysis was collaborative and incorporated both Indigenous and Western ways of knowing, through the application of Two-Eyed Seeing. RESULTS A thematic summary resulted in six themes: (a) problematic wait times; (b) the hidden costs of acute care; (c) paediatric care; (d) trusting relationships; (e) racism and discrimination; and (f) holistic care. CONCLUSIONS The experiences of Indigenous mothers using acute care services for their infants suggest a role for culturally safe and trauma and violence-informed care by health providers in the acute care context. RELEVANCE TO CLINICAL PRACTICE Nurses can improve access to acute care services for Indigenous mothers and infants through the provision of culturally safe and trauma and violence-informed approaches care, by building rapport with families, providing care that is respectful and nonjudgemental, eliminating fees associated with using acute care services and linking families with cultural resources both in hospital and within the community.
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Affiliation(s)
- Amy L Wright
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | | | - Marilyn Ballantyne
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,McMaster University, Hamilton, ON, Canada
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21
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Hultstrand Ahlin C, Hörnsten Å, Coe AB, Lilja M, Hajdarevic S. Wishing to be perceived as a capable and resourceful person-A qualitative study of melanoma patients' experiences of the contact and interaction with healthcare professionals. J Clin Nurs 2019; 28:1223-1232. [PMID: 30549354 DOI: 10.1111/jocn.14730] [Citation(s) in RCA: 5] [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: 06/07/2018] [Revised: 10/03/2018] [Accepted: 12/05/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore patients' experiences of contact and interaction with healthcare professionals (HCPs) during the diagnostic process of melanoma. BACKGROUND In Sweden, most patients with suspected skin lesions seek care at the primary level of services in the first instance. Previous research describes the diagnostic process as a complex journey with uncertainty. Nonetheless, the importance of contact and interaction between patient and HCPs during the diagnostic process is rarely explored. DESIGN This study adopted a qualitative design in which semi-structured interviews were conducted and the COREQ-checklist for qualitative studies employed (EQUATOR guidelines). METHODS A sample of 30 patients (15 women, 15 men) diagnosed with melanoma was included. Secondary analysis of interviews was carried out using qualitative content analysis. RESULTS One theme emerged: Wishing to be perceived as a capable and resourceful person that consisted of three categories: (a) The need of being valued, (b) The need of being informed and (c) The need of taking actions. CONCLUSIONS Our results suggest that patients wish to be valued as capable and resourceful persons as well as to be provided with honest and sufficient information about the diagnosis and subsequent procedures. By fulfilling these wishes, HCPs can involve patients in the diagnostic process and reduce patients' uncertainty. A need of supportive and accessible health care to manage the diagnostic process and to reduce patients' struggle for care was also identified. RELEVANCE TO THE CLINICAL PRACTICE Patients are satisfied when health care is organised in a patient-/person-centred manner, that is, in accordance with patients' needs, avoiding gatekeeping, and when HCPs interact respectfully in encounters. Accessible HCPs during the diagnostic process of melanoma are required to inform, support and navigate patients within the healthcare system and through their diagnostic journey.
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Affiliation(s)
| | - Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Mikael Lilja
- Department of Public Health and Clinical Medicine, Unit of Research, Education, and Development, Östersund Hospital, Umeå University, Umeå, Sweden
| | - Senada Hajdarevic
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
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Larsen KSR, Petersen AK, Lisby M, Knudsen MV. Dyspnoea and self-management strategies in patients admitted to the emergency department: A study of patients' experiences. J Clin Nurs 2018; 27:4112-4118. [PMID: 29893435 DOI: 10.1111/jocn.14560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 09/20/2017] [Revised: 04/24/2018] [Accepted: 06/03/2018] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVE To explore patients' experiences of acute dyspnoea, physical functioning and perspectives on course of illness prior to admission to the emergency department. BACKGROUND Many emergency admissions are considered unnecessary and avoidable. In this perspective, it seems relevant to gain insight into the patients' perspective on acute dyspnoea and the need for emergency admission. However, only few studies have investigated reasons for emergency admission from a patient perspective. DESIGN A qualitative study was conducted with semi-structured interviews among six patients previously admitted to the emergency department due to dyspnoea. Data collection and analysis were carried out according to Kvale & Brinkmann using meaning condensation. FINDINGS Dyspnoea was experienced as an unpleasant breathlessness in the form of pain or suffocation, which limited usual physical activities, negatively impacting on quality of life. Self-management strategies such as medication, breathing exercises, distraction from breathing, and mental and physical relaxation in general were used to avoid hospital admission. The chronically ill patients saw the following ways to alternate course of disease to avoid admissions to the emergency department: easier access to specialised emergency medical care, medical supplies in the patient's home and making existing physical exercise programmes more accessible and interesting. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE It would be relevant to further investigate whether prehospital interventions may remedy acute dyspnoea among chronically ill patients, and whether such interventions are cost-effective.
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Affiliation(s)
- Karoline Stentoft Rybjerg Larsen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Centre of Research in Rehabilitation (CORIR), Aarhus University, Aarhus N, Denmark
| | - Annemette Krintel Petersen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Centre of Research in Rehabilitation (CORIR), Aarhus University, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Marianne Lisby
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.,Emergency Department, Aarhus University Hospital, Aarhus N, Denmark
| | - Marie Veje Knudsen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Centre of Research in Rehabilitation (CORIR), Aarhus University, Aarhus N, Denmark
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Malley AM, Bourbonniere M, Naylor M. A qualitative study of older adults' and family caregivers' perspectives regarding their preoperative care transitions. J Clin Nurs 2018; 27:2953-2962. [PMID: 29633436 DOI: 10.1111/jocn.14377] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2018] [Indexed: 12/22/2022]
Abstract
AIMS AND OBJECTIVES To explore how older patients with multiple chronic conditions and their family caregivers perceive their engagement and overall care experience throughout the preoperative phase of elective orthopaedic hip or knee joint replacement. BACKGROUND Patient engagement is a critical component of care necessary for improving patient outcomes. Little is known about how older adults with multiple chronic conditions and their family caregivers engage in preoperative care transitions and the subsequent impact of this experience on postoperative health outcomes. DESIGN Prospective qualitative descriptive design was used. METHODS Semi-structured telephone interviews with a convenience sample of older adults coping with multiple chronic conditions and their family caregivers. Interviews were conducted prior to surgery and, again 21 days postsurgery, were audio-recorded and transcribed for qualitative content analysis. The Quality Health Outcomes Model was used to categorise study findings. RESULTS Eleven patients and five family caregivers participated. Guided by the Quality Health Outcomes Model, four major themes were identified. (i) Older adults perceive that joint replacement is about quality of life. (ii) Standardised interventions often fail to address the unique needs of complex older adults. (iii) Family caregivers perceive they are the primary care coordinators. (iv) Postoperative outcomes and resource utilisation vary widely in complex older adults. CONCLUSION Findings suggest that current preoperative care interventions are often not designed to effectively engage complex older patients and their family caregivers. Coordinated patient-centred preoperative care that reflects the needs and goals of complex older patients and their family caregivers may positively influence perioperative care transitions and outcomes beyond this episode of care. RELEVANCE TO CLINICAL PRACTICE The current research documents the need for more in-depth knowledge about the relationship between older adults' and their family caregivers' engagement preoperatively and postoperative outcomes and resource utilisation.
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Affiliation(s)
- Ann M Malley
- NewCourtland Center for Transitions in Health, University of Pennsylvania, Philadelphia, Pennsylvania.,Massachusetts General Hospital, Boston, Massachusetts
| | | | - Mary Naylor
- NewCourtland Center for Transitions in Health, University of Pennsylvania, Philadelphia, Pennsylvania
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Abstract
This article focuses on the patients’ acceptance of a subcutaneous injection device for patients with systemic lupus erythematosus, which in the upcoming years could be introduced beside the intravenous infusion of biological therapy. An online questionnaire was completed by 548 patients from different Italian regions. The preference for subcutaneous injection was 41.2%, for intravenous infusion was 36.9%, and 21.9% were uncertain. Patients with previous experience of biological therapies were less uncertain (P = .001). The reported motivations for the preference were analyzed through a lexicometric approach with the software T-LAB. Results revealed that respondents who preferred subcutaneous injections reported motivations that were more related to convenience, avoiding the discomfort of reaching the hospital. Patients who preferred intravenous infusion emphasized the importance of safety feelings related to the presence of qualified assistance during the therapy administration. In conclusion, patients appreciated the convenience that characterizes subcutaneous injections but also emphasized the importance of feeling safe during the administration. The study suggests that the choice of prescribing subcutaneous injections or intravenous infusions should be shared with patients, discussing possible resistances and avoiding preconceptions about patients’ preferences.
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Affiliation(s)
| | | | - Davide Mazzoni
- Gruppo Italiano LES, Roma, Italy.,Department of Psychology, University of Bologna, Bologna, Italy
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25
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Jensen PS, Green SM, Petersen J, Andersen O, Poulsen I. Perceptions and experiences of nutritional care following the overwhelming experience of lower extremity amputation: A qualitative study. J Clin Nurs 2017; 27:e808-e819. [PMID: 29193468 DOI: 10.1111/jocn.14192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Good nutritional care of people following major lower extremity amputation is essential as poor nutritional status can lead to delayed wound healing. Working with patients to identify their perspectives on food, views on nutritional care and the need for dietary counselling enables the development of optimised nutritional care. AIMS AND OBJECTIVES To explore hospital patients' perspectives on food, dietary counselling and their experiences of nutritional care following lower extremity amputation. DESIGN A qualitative, explorative study design was employed. METHOD An inductive content analysis of semi-structured interviews with a purposive sample of 17 people over 50 years of age, who had recently undergone major lower extremity amputation, was undertaken. The study was reported according to the consolidated criteria for reporting qualitative research guideline. FINDINGS Three themes emerged: responsible for own dietary intake, diet based on preferences and experiences with dietary counselling and feeling overwhelmed. The participants expressed motivation to ensure their nutritional needs were met but described feeling emotionally overwhelmed by the experience of amputation. They appeared not to expect nursing staff to focus on nutritional issues as they expressed belief that they themselves were solely responsible for their dietary intake. They described being motivated to receive nutritional counselling but indicated advice should be compatible with their lifestyle and eating habits. CONCLUSION Lower extremity amputation can be an overwhelming experience which affects nutritional intake. People appear to consider themselves responsible for their nutritional care and describe not experiencing or expecting nursing staff to engage in this aspect of care. Dietary counselling by nurses who respect and incorporate patient preferences and experiences following amputation has the potential to enhance nutritional care. RELEVANCE TO CLINICAL PRACTICE This study illustrates that nurses caring for people who undergo lower extremity amputation need to recognise that nutritional care is an essential component of nursing and should focus on working in partnership with the patient.
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Affiliation(s)
- Pia Søe Jensen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.,Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
| | - Sue M Green
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Janne Petersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ove Andersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | - Ingrid Poulsen
- RUBRIC (Research Unit on Brain Injury Rehabilitation Copenhagen), Department of Neurorehabilitation, Traumatic Brain Injury Unit, Rigshospitalet, Copenhagen, Denmark.,Section of Nursing Science, Department of Health, Aarhus University, Aarhus, Denmark
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26
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Abstract
AIMS AND OBJECTIVES To explore how patients with Chronic Heart Failure describe their experiences of breathlessness, the pattern of their breathlessness, how daily life is affected and how they adjust to and manage these symptoms. BACKGROUND Chronic Heart Failure is a highly prevalent syndrome often with poor outcomes and in a patient group who are predominately elderly. Breathlessness is the main symptom experienced by patients and often relates to decompensation and hospitalisation, yet subtle changes described by patients are often not discussed with health care professionals. DESIGN A descriptive qualitative design. METHODS Twenty-five participants with heart failure with reduced ejection fraction (HF-rEF) from a tertiary referral centre in England were recruited. Each participant took part in a semi-structured interview exploring the effect of breathlessness had on their lives. Data was analysed through Braun and Clarke's framework for thematic analysis. RESULTS All participants reported experiencing breathlessness daily. Four sub-themes were identified in their accounts: nature of breathlessness, emotional impact of breathlessness, impact of breathlessness on daily life and managing breathlessness. CONCLUSION Participants were able to give vivid descriptions of breathlessness and the way it affected their lives. RELEVANCE TO CLINICAL PRACTICE Health care professionals need to take account of each patient's personal assessment of their own breathlessness and how this is having an effect on their life and ability to undertake activities of daily living. Self-care management strategies need to be developed so that subtle changes can be assessed by the patient and reviewed by the healthcare professional to avoid hospitalisation and increased mortality risks.
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Affiliation(s)
- Helen Walthall
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mary Boulton
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Emsfors Å, Christensson L, Elgán C. Nursing actions that create a sense of good nursing care in patients with wet age-related macular degeneration. J Clin Nurs 2017; 26:2680-2688. [PMID: 28152206 DOI: 10.1111/jocn.13749] [Citation(s) in RCA: 7] [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] [Accepted: 01/21/2017] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To identify and describe nursing actions performed by nurses that create a sense of good nursing care in patients with wet age-related macular degeneration. BACKGROUND People who suffer from wet age-related macular degeneration risk central vision loss. Treatment with antivascular endothelial growth factor is the only available option at present that preserves vision and no definitive cure currently exists. Patients feel that they are compelled to accept this treatment because they might otherwise become blind. DESIGN An explorative and descriptive design based on the critical incident technique was used. METHOD Interviews with 16 Swedish patients who all had received intravitreal treatment for wet age-related macular degeneration. RESULTS Two main areas of good nursing care were identified: 'Being perceived as an individual' and 'Being empowered'. The first area was divided into two categories: being respectful and being engaged. Being respectful was observed when nurses had a benevolent attitude towards their patients and answered questions kindly and politely. Patients saw themselves as individuals when nurses were available for conversation and focused on them. The second area was divided into two categories: encouraging participation and creating confidence. Encouraging participation refers to when nurses provided information continuously. Nurses instilled confidence and trust in their patients by keeping promises and by being honest. CONCLUSIONS A respectful interaction between patients and caregivers is necessary for patients to obtain beneficial health care. RELEVANCE TO CLINICAL PRACTICE Patient interviews revealed important information about nursing actions that created a sense of good nursing care in patients with wet age-related macular degeneration. Nurses acknowledged people as individuals and created trust by building partnerships and sharing decision-making. To address each patient's concerns, nurses need to prioritise each patient's narrative and participation by documenting agreements in their medical record.
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Affiliation(s)
- Åsa Emsfors
- Department of Ophthalmology, Central Hospital, Kristianstad, Sweden
| | - Lennart Christensson
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Carina Elgán
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
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Chien TW, Lin WS. Improving Inpatient Surveys: Web-Based Computer Adaptive Testing Accessed via Mobile Phone QR Codes. JMIR Med Inform 2016; 4:e8. [PMID: 26935793 PMCID: PMC4795329 DOI: 10.2196/medinform.4313] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 02/03/2015] [Revised: 05/27/2015] [Accepted: 06/24/2015] [Indexed: 12/19/2022] Open
Abstract
Background The National Health Service (NHS) 70-item inpatient questionnaire surveys inpatients on their perceptions of their hospitalization experience. However, it imposes more burden on the patient than other similar surveys. The literature shows that computerized adaptive testing (CAT) based on item response theory can help shorten the item length of a questionnaire without compromising its precision. Objective Our aim was to investigate whether CAT can be (1) efficient with item reduction and (2) used with quick response (QR) codes scanned by mobile phones. Methods After downloading the 2008 inpatient survey data from the Picker Institute Europe website and analyzing the difficulties of this 70-item questionnaire, we used an author-made Excel program using the Rasch partial credit model to simulate 1000 patients’ true scores followed by a standard normal distribution. The CAT was compared to two other scenarios of answering all items (AAI) and the randomized selection method (RSM), as we investigated item length (efficiency) and measurement accuracy. The author-made Web-based CAT program for gathering patient feedback was effectively accessed from mobile phones by scanning the QR code. Results We found that the CAT can be more efficient for patients answering questions (ie, fewer items to respond to) than either AAI or RSM without compromising its measurement accuracy. A Web-based CAT inpatient survey accessed by scanning a QR code on a mobile phone was viable for gathering inpatient satisfaction responses. Conclusions With advances in technology, patients can now be offered alternatives for providing feedback about hospitalization satisfaction. This Web-based CAT is a possible option in health care settings for reducing the number of survey items, as well as offering an innovative QR code access.
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Affiliation(s)
- Tsair-Wei Chien
- Chi Mei Medical Center, Taiwan, Research Department, Chi Mei Medical Center, Taiwan, Tainan, Taiwan
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Jarernsiripornkul N, Phueanpinit P, Pongwecharak J, Krska J. Experiences of and attitudes towards receiving information about non-steroidal anti-inflammatory drugs: a cross-sectional survey of patients in Thailand. Expert Opin Drug Saf 2016; 15:417-26. [PMID: 26742855 DOI: 10.1517/14740338.2016.1139571] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 11/05/2022]
Abstract
OBJECTIVE To determine sources of information about NSAIDs used by out-patients, factors related to receipt of information and patient attitudes towards receiving safety information. RESEARCH DESIGN AND METHODS Cross-sectional survey, using self-completed questionnaires distributed directly to 500 outpatients prescribed any NSAIDs from an orthopaedic clinic in Thailand, over a 4-month period. RESULTS There were 548 patients approached and 474 completed questionnaires returned (94.8%). The most frequent aspects of medicines information that were provided related to administration (97.2%), mostly provided by pharmacists, and indication (85.8%), mostly provided by physicians. Information on identifying, monitoring and managing adverse effects was received by fewer than 50% of patients. Safety information was received significantly more frequently by younger patients (P<0.01), those using non-selective COX-2 inhibitors (P<0.001), intermittent NSAIDs (P<0.05) and fewer concomitant medicines (P<0.05). Only 14.1% patients used additional information sources. Attitudes towards receiving medicines safety information were positive. Most patients agreed they should know about ADRs (98.1%) and receive information leaflets with first prescription (96.8%). CONCLUSIONS Patients received medicines information mostly from healthcare professionals, but safety information was limited. Type of NSAIDs, regularity of NSAID use and age affected receipt of safety information about NSAIDs. Provision of more medicine information is needed, particularly written documents.
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Affiliation(s)
| | | | | | - Janet Krska
- c Medway School of Pharmacy , Universities of Greenwich and Kent , Kent , UK
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Specht K, Kjaersgaard-Andersen P, Pedersen BD. Patient experience in fast-track hip and knee arthroplasty--a qualitative study. J Clin Nurs 2015; 25:836-45. [PMID: 26708610 DOI: 10.1111/jocn.13121] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2015] [Indexed: 01/13/2023]
Abstract
AIMS AND OBJECTIVES To explore the lived experience of patients in fast-track primary unilateral total hip and knee arthroplasty from the first visit at the outpatient clinic until discharge. BACKGROUND Fast-track has resulted in increased effectiveness, including faster recovery and shorter length of stay to about two days after hip and knee arthroplasty. However, the patient perspective in fast-track with a median length of stay of less than three days has been less investigated. DESIGN A qualitative design. METHODS A phenomenological-hermeneutic approach was used, inspired by Paul Ricoeur's theory of narrative and interpretation. Eight patients were included. Semi-structured interviews and participant observation were performed. RESULTS Three themes emerged: dealing with pain; feelings of confidence or uncertainty - the meaning of information; and readiness for discharge. Generally, the patients were resistant to taking analgesics and found it difficult to find out when to take supplementary analgesics; therefore, nursing staff needed enough expertise to take responsibility. Factors that increased patients' confidence: information about fast-track, meeting staff before admission and involving relatives. In contrast, incorrect or conflicting information and a lack of respect for privacy led to uncertainty. In preparing for early discharge, sufficient pain management, feeling well-rested and optimal use of time during hospitalisation were important. CONCLUSION The study shows the importance of dealing with pain and getting the right information and support to have confidence in the fast-track programme, to be ready for discharge and to manage postoperatively at home. RELEVANCE TO CLINICAL PRACTICE In fast-track focusing on early discharge, there is an increased need for evidence-based nursing practice, including a qualified judgement of what is best for the patient in certain situations. The knowledge should be gleaned from: research; the patients' expertise, understanding and situation; and nurses' knowledge, skills and experience.
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Affiliation(s)
- Kirsten Specht
- Research Unit of Nursing, Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Orthopaedic Surgery, Vejle Hospital, Vejle, Denmark.,The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen, Denmark
| | - Per Kjaersgaard-Andersen
- Department of Orthopaedic Surgery, Vejle Hospital, Vejle, Denmark.,The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Birthe D Pedersen
- Research Unit of Nursing, Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Flinterud SI, Andershed B. Transitions in the communication experiences of tracheostomised patients in intensive care: a qualitative descriptive study. J Clin Nurs 2015; 24:2295-304. [PMID: 25850361 DOI: 10.1111/jocn.12826] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2015] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe how tracheostomised patients in intensive care experience acts of communication and to better understand their experiences in the context of the transitions theory. BACKGROUND Waking up in an intensive care unit unable to speak because of mechanical ventilation can be challenging. Communication aids are available, but patients still report difficulties communicating. Investigating how mechanically ventilated patients experience communication in the context of the transitions theory might elucidate new ways of supporting them during their transitions while being ventilated. DESIGN A qualitative, descriptive design. METHODS Eleven patients who had previously been tracheostomised in an intensive care unit were included in this quality improvement project conducted in a university hospital in Norway. Participants were tracheostomised from 3-27 days. Semistructured interviews were conducted from June 2013-August 2013, 3-18 months after hospital discharge. Transcripts were analysed using inductive content analysis. RESULTS Participants reported a great diversity of emotions and experiences attempting to communicate while being tracheostomised. One overarching theme emerging from the analysis was the 'Experience of caring and understanding despite having uncomfortable feelings due to troublesome communication.' The theme consists of three categories. The category 'Emotionally challenging' shows that patients struggled initially. With time, their coping improved, as revealed in the category 'The experience changes with time.' Despite difficulties, participants described positive experiences, as shown in the category 'Successful communication.' CONCLUSION The importance of patients experiencing caring and understanding despite their difficult situation constitutes the core finding. The findings suggest that participants went through different transitions. Some reached the end of their transition, experiencing increased stability. RELEVANCE TO CLINICAL PRACTICE Despite challenges with communication, participants reported that caring and safety provided by health care professionals were significant experiences. They viewed nonverbal communication as being very important.
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Affiliation(s)
- Stine Irene Flinterud
- Haukeland University Hospital, Bergen, Norway.,Haraldsplass Deaconess University College, Bergen, Norway
| | - Birgitta Andershed
- Department of Nursing, Gjøvik University College, Gjøvik, Norway.,Department of Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden
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Abstract
BACKGROUND The experience of pain associated with surgery has been a challenge for health care professionals for many years, and culture is said to influence pain. PURPOSE This study focused on patients' experiences of postoperative pain (POP) and factors that affect POP. DESIGN The study employed qualitative ethnographic principles. METHOD Data were collected through individual face-to-face interviews. Data were saturated after analyzing data from 13 patients from two hospitals in Ghana. FINDINGS Themes that emerged were the subjective nature of pain, which described pain dimensions and communication; psycho-sociocultural factors, such as personal inclinations and sociocultural background; and health system factors, such as personnel attitudes and health financing. IMPLICATIONS FOR FUTURE RESEARCH AND PRACTICE Health professionals need to understand the sociocultural effects of pain in order to give effective care. CONCLUSION The study highlighted the need for patient education and the importance that health care professionals understand context-specific factors that influence POP management.
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