scholarly journals Understanding the role of hospice pharmacists: a qualitative study

2021 ◽  
Author(s):  
Zoe Edwards ◽  
Emma Chapman ◽  
Simon Pini ◽  
Michael I. Bennett
Keyword(s):  
Geographical Area ◽  
Clinical Information ◽  
Barriers And Facilitators ◽  
Multidisciplinary Teams ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Standards Of Practice ◽  
Team Working ◽  
The Hours

AbstractBackground Pharmacists are important members of multidisciplinary teams but, despite surveys of provision, the role of the hospice pharmacist is not well described. Objective To explore the role of the hospice pharmacist and identify barriers and facilitators to the role. Setting Hospices offering in-patient services caring for adults towards the end of life in one geographical area of northern England. Method Pharmacists providing services to hospices were invited to take part in qualitative semi-structured interviews asking about experience, patient contact, team working and barriers and facilitators to the role. These were recorded verbatim and data were analysed thematically using framework analysis. Main outcome measure The hospice pharmacist’s perceptions of their role and barriers and facilitators to it. Results Fifteen pharmacists took part. Two themes and ten subthemes were identified focused on tasks and communication. Practise was varied and time limited the quantity and depth of services carried out but was often spent navigating complex drug supply routes. Participants found methods of communication suited to the hours they spent in the hospice although communication of data was a barrier to effective clinical service provision. Participants identified the need for appropriate training and standards of practice for hospice pharmacists would enable better use of their skills. Conclusion Barriers to the role of hospice pharmacist include time, access to role specific training, access to clinical information and complex medicines supply chains. The role would benefit from definition to ensure that hospices are able to use hospice pharmacists to their greatest potential.

scholarly journals “You’ve Got to Be Old to Go There”: Psychosocial Barriers and Facilitators to Social Eating in Older Adults

2019 ◽  
Vol 60 (4) ◽  
pp. 628-637 ◽  
Author(s):  
Anisa Saeed ◽  
Jenny Fisher ◽  
Zinnia Mitchell-Smith ◽  
Laura J E Brown
Keyword(s):  
Older Adults ◽  
Gender Differences ◽  
Barriers And Facilitators ◽  
Physical And Mental Health ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Psychosocial Barriers ◽  
Social Eating ◽  
Design And Methods

Abstract Background and Objectives Social eating is associated with a range of physical and mental health benefits for older adults. Previous research has identified some of the practical barriers that may limit social eating, such as cost and access to public transport. However, little is known about the psychosocial issues that can affect older adults’ engagement with social eating. This study examines psychosocial barriers and facilitators to attending community-based social eating opportunities for older adults. Design and Methods Forty-two older people aged between 59 and 89 years living in Manchester, UK, participated in semi-structured interviews or focus groups about their experiences and perceptions of social eating opportunities. Interview transcripts were analyzed using inductive thematic analyses. As there are known gender differences in relation to attitudes and behaviors relating to food and social activities, a framework analysis was applied to explore how these themes were differentially expressed by gender. Results Four themes were identified that related to the importance of (a) offering more than food; (b) participants’ social identity; (c) taking the first step; and (d) embarrassment and self-consciousness about physical health. Gender differences related to perceptions of the relevance and attractiveness of social eating, and the role of social support. Discussion and Implications This study improves our understanding of older adults’ social eating experiences and highlights clear strategies by which social eating opportunities could be made more attractive, accessible, and acceptable to older adults.

scholarly journals The PROMISES study: a mixed methods approach to explore the acceptability of salivary progesterone testing for preterm birth risk among pregnant women and trained frontline healthcare workers in rural India

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040268
Author(s):  
Danielle Ashworth ◽  
Pankhuri Sharma ◽  
Sergio A Silverio ◽  
Simi Khan ◽  
Nishtha Kathuria ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Barriers And Facilitators ◽  
Rural India ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Thematic Framework

IntroductionIndia has an overall neonatal mortality rate of 28/1000 live births, with higher rates in rural India. Approximately 3.5 million pregnancies in India are affected by preterm birth (PTB) annually and contribute to approximately a quarter of PTBs globally. Embedded within the PROMISES study (which aims to validate a low-cost salivary progesterone test for early detection of PTB risk), we present a mixed methods explanatory sequential feasibility substudy of the salivary progesterone test.MethodsA pretraining and post-training questionnaire to assess Accredited Social Health Activists (ASHAs) (n=201) knowledge and experience of PTB and salivary progesterone sampling was analysed using the McNemar test. Descriptive statistics for a cross-sectional survey of pregnant women (n=400) are presented in which the acceptability of this test for pregnant women is assessed. Structured interviews were undertaken with ASHAs (n=10) and pregnant women (n=9), and were analysed using thematic framework analysis to explore the barriers and facilitators influencing the use of this test in rural India.ResultsBefore training, ASHAs’ knowledge of PTB (including risk factors, causes, postnatal support and testing) was very limited. After the training programme, there was a significant improvement in the ASHAs’ knowledge of PTB. All 400 women reported the salivary test was acceptable with the majority finding it easy but not quick or better than drawing blood. For the qualitative aspects of the study, analysis of interview data with ASHAs and women, our thematic framework comprised of three main areas: implementation of intervention; networks of influence and access to healthcare. Qualitative data were stratified and presented as barriers and facilitators.ConclusionThis study suggests support for ongoing investigations validating PTB testing using salivary progesterone in rural settings.

scholarly journals The anticipated and the lived experience of home and in-centre haemodialysis: Is there a disconnect?

2016 ◽  
Vol 22 (12) ◽  
pp. 1524-1533 ◽  
Author(s):  
Rabiya Majeed-Ariss ◽  
A Jayanti ◽  
T Schulz ◽  
A Wearden ◽  
S Mitra
Keyword(s):  
Qualitative Study ◽  
Lived Experience ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Patient Factors ◽  
Home Haemodialysis ◽  
Advantages And Disadvantages ◽  
Patients Experience

This qualitative study aimed to explore home haemodialysis and in-centre haemodialysis patients’ experience, to illuminate barriers and facilitators in the uptake and maintenance of home haemodialysis. Thirty-two semi-structured interviews with patients receiving home haemodialysis or in-centre haemodialysis were analysed using framework analysis. Four themes emerged: ‘perceptions of self’; ‘impact of haemodialysis on family’; ‘perceived advantages and disadvantages of home haemodialysis and in-centre haemodialysis’ and ‘practical issues and negotiating haemodialysis’. The lived experience of home haemodialysis was in contrast to the lived experience of in-centre haemodialysis and to the anticipated experience of home haemodialysis, highlighting patient factors that contributed to under-usage of home haemodialysis.

scholarly journals Exploring The Role of Advanced Clinical Practitioners (ACPs) and Their Contribution To Health Services in England.

2021 ◽  
Author(s):  
Claire Mann ◽  
Stephen Timmons ◽  
Catrin Evans ◽  
Ruth Pearce ◽  
Charlotte Overton Research ◽  
...  
Keyword(s):  
Health Services ◽  
Workforce Development ◽  
Sampling Technique ◽  
Barriers And Facilitators ◽  
Positive Contribution ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Contributing Factors ◽  
National Implementation

Abstract Background An extended role being explored globally is that of the advanced clinical practitioner (ACP). In England this is an extended role for allied health professions, nurses and midwives. ACP education is organised by Health Education England (HEE) who organise an accredited training programme for ACPs alongside a multi-professional framework. This paper draws on research commissioned to evaluate the national implementation of the ACP role to inform the development of a Centre for Advancing Practice in the UK but has implications for others considering their ACP provision. This paper focuses on three key research questions: 1) What is the role of ACPs in England? 2) What are the barriers and facilitators to implementing the role? and 3) What is the contribution of ACPs to health services in England? Methods Semi-structured interviews were conducted in 2020 with 63 participants across a range of stakeholder groups and clinical areas. A purposive snowball sampling technique was used to identify participants meeting the inclusion criteria. Interviews were recorded and transcribed verbatim, anonymised and thematically analysed. Results We report on three aspects as highlighted from the data (1) The role of ACPs, (2) Barriers to and facilitators of the ACP role implementation (3) Contribution of ACPs to health services in England. The ACP role in England was undertaken in a broad range of clinical contexts. ACPs worked towards being an autonomous practitioner and most were independent prescribers. In England ‘advanced clinical practitioner’ was not a protected title. There were high levels of variability and ambiguity of understanding and deployment of the ACP role in England. Conclusions This study outlines the contribution that ACPs make to health services and contributing factors to the success of the ACP role in England. We demonstrated the range in which the role is successful in England. We identified key barriers and facilitators to implementing this role. Finally, the work showed the positive contribution that ACPs can make to service redesign and workforce development as well as patient outcomes, whilst accepting that there is much work to do to ensure protected status and parity across all professions and clinical contexts.

scholarly journals The Role of Human Values and Relations in the Employment of People with Work-Relevant Disabilities

2016 ◽  
Vol 4 (4) ◽  
pp. 176-187 ◽  
Author(s):  
Lieke Kuiper ◽  
Minne Bakker ◽  
Jacques Van der Klink
Keyword(s):  
Emotional Support ◽  
The Other ◽  
Human Values ◽  
Human Relations ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Central Value ◽  
Professional Network ◽  
Private Network

The aim of this study is to discuss the role of human values and relations in the employment of people with work-relevant disabilities. <em>Purpose:</em> Finding and maintaining a paid job is known to be more difficult for people with a disability. The aim of the study is to explore the use which people with a disability make of their private and professional network in finding and maintaining a paid job and the role values play in these relations. This was placed in the context of three complementary perspectives: a perspective that stresses the importance of other than merely rationalistic values, a perspective that stresses the importance of values in work and an interpersonal perspective in which ‘the Other’ is central. <em>Methods:</em><strong> </strong>Semi-structured interviews were held with 8 people with a working disability. As well, 4 interviews were held with people from their private network (family and partner) and 4 interviews with people from their professional network (colleagues and employers). All interviews were audio-taped and transcribed verbatim. A framework analysis was used to identify the different values in the interviews. This was done with use of MAXqda. <em>Results:</em> The interviews showed that both romantic and rational values and arguments were mentioned by the employers in the context of hiring people with a work-relevant disability; they need to be willing to adjust. The importance of human relations was emphasised in the values mentioned by the respondents when talking about having a paid job. Moreover, ‘the Other’ played an important role in the employment process of people with a work-relevant disability. People with such a disability asked their private network to help them and to provide emotional support. <em>Conclusion:</em><strong> </strong>Enabling values and relations had more chance if they were in line with the mission and central value of the organisation. This was one of the first studies on the role that human values and relations play in maintaining a paid job for people with a work-relevant disability. The study gives a first impression of how human values and relations play a role, but more research is needed to provide more detailed insights, for example in different groups (e.g. non-employed people with a disability).

scholarly journals Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study

2020 ◽  
Author(s):  
Patrick Redmond ◽  
Khalid Munir ◽  
Oludare Alabi ◽  
Tamasine Grimes ◽  
Barbara Clyne ◽  
...  
Keyword(s):  
Medication Error ◽  
Healthcare Professionals ◽  
Community Pharmacists ◽  
Information And Communications Technology ◽  
Barriers And Facilitators ◽  
Transitions Of Care ◽  
Multidisciplinary Teams ◽  
Structured Interviews ◽  
Medicines Reconciliation ◽  
Wide Range

Abstract Background: Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process.Methods: Semi-structured interviews were conducted in Ireland with a wide range of healthcare professionals (HCPs) involved with medicines reconciliation at transitions of care. Thematic analysis was undertaken using an adaptation of a combined theoretical framework of Grol, Cabana and Sluisveld to classify the barriers and facilitators to implementation of medicines reconciliation.Results : Thirty-five participants were interviewed, including eleven community pharmacists (CPs), eight hospital pharmacists (HPs), nine hospital consultants (HCs), five general practitioners (GPs), and two non-consultant hospital doctors (NCHDs). Themes were categorized into barriers and facilitators. Barriers included resistance from existing professional cultures, staff interest and training, poor communication and minimal information and communications technology (ICT) support. Solutions (facilitators) suggested included supporting effective multidisciplinary teams, greater involvement of pharmacists in medicines reconciliation, ICT solutions (linked prescribing databases, decision support systems) and increased funding to provide additional (e.g. admission and discharge reconciliation) and more advanced services (e.g. community pharmacist delivered medicines use review).Conclusions: Medicines reconciliation is advocated as a solution to the known problem of medication error at transitions of care. This study identifies the key challenges and potential solutions that policy makers, managers and HCPs should consider when reviewing the practices and processes of medicines reconciliation in their own organisations.

scholarly journals THU0646-HPR EXPLORING THE ROLE OF NURSE IN RHEUMATIC CARE AND FEASIBILITY OF ENHANCING TREAT TO TARGET STRATEGIES IN JAPAN.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 568.3-568
Author(s):  
M. Fusama ◽  
M. Uda ◽  
H. Matsumura ◽  
Y. Van Eijk-Hustings ◽  
S. Oliver ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Quality Care ◽  
Basic Knowledge ◽  
Treat To Target ◽  
Multidisciplinary Teams ◽  
Evidence Based ◽  
Structured Interviews ◽  
Eular Recommendations ◽  
Real Clinical Practice

Background:The role of rheumatology nurses is considered important for the implementation of T2T [1]. For nurses’ contribution to implementation of the T2T strategy, it is necessary to explore the nurses’ opinion on their roles in real clinical practice.Objectives:The aim of this study is to evaluate what is required for nurses to implement T2T in real clinical practice in Japan.Methods:Registered nurses engaged in rheumatic care in clinical practice in Japan were enrolled. Focus group interviews were conducted exploring ‘What is necessary for RA nurses to implement T2T’using semi-structured interviews. Data analysis was used with Krippendorff’s content analysis method.Results:24 nurses (all females) from 10 hospitals were enrolled in this study. The results of the qualitative analysis were categorized in 10 main categories, derived from 37 subcategories based on 64 different codes: (1) provide basic knowledge of RA, (2) provide knowledge of RA drugs, (3) provide knowledge and skills of self-monitoring, (4) enhance self-efficacy and support self-management, (5) support decision-making, (6) psychological and social support, (7) understand the diversity and feelings of patients and their families, (8) support based on individual needs, (9) ensure continuing educational opportunities for nurses to enable the provision of high quality care, (10) collaborate with multidisciplinary teams.These categories are mostly covered in the contents of the 2018 updated EULAR recommendations for the role of nurses except “evidence-based rheumatic care”, “telehealth” and “comprehensive participation in disease management”.Conclusion:These findings indicate the areas of exploration including further educational and training needs, attitudes and the professional scope for nurses to extend their roles to provide greater value to patient care.In Japan, evidence-based RA nursing and telehealth systems have not yet been established. In addition, therapeutic intervention by nurses and nurse-led clinic are not permitted. Our results might reflect this situation and possibly elucidates the gap between EULAR’s evidence-based recommendations and opinions of Japanese nurses working in daily clinical practice. As evidence-based nursing is considered to be crucial from both cost-effectiveness and improvement of patients QOL, this result also might shed light on what we need for future better rheumatic nursing in Japan.References:[1]van Eijk- Hustings Y, et al. Ann Rheum Dis 2012;71: 13–19.Disclosure of Interests:MIE FUSAMA: None declared, Miyabi Uda: None declared, Harumi Matsumura: None declared, Yvonne van Eijk-Hustings Grant/research support from: grand from sanofi and UCB, Consultant of: fee from amgen, Susan Oliver: None declared, Hideko Nakahara: None declared

scholarly journals A study to investigate the implementation process and fidelity of a hospital to community pharmacy transfer of care intervention

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260951
Author(s):  
Sarah M. Khayyat ◽  
Zachariah Nazar ◽  
Hamde Nazar
Keyword(s):  
Community Pharmacy ◽  
Implementation Process ◽  
Evidence Base ◽  
Outcome Evaluation ◽  
Barriers And Facilitators ◽  
Intervention Fidelity ◽  
Intervention Implementation ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Transfer Of Care

Background Hospital to community pharmacy transfer of care medicines-related interventions for inpatients discharged home aim to improve continuity of care and patient outcomes. One such intervention has been provided for seven years within a region in England. This study reports upon the implementation process and fidelity of this intervention. Methods The process evaluation guidance issued by the Medical Research Council has informed this study. A logic model to describe the intervention and causal assumptions was developed from preliminary semi-structured interviews with project team members. Further semi-structured interviews were undertaken with intervention providers from hospital and community pharmacy, and with patient and public representatives. These aimed to investigate intervention implementation process and fidelity. The Consolidated Framework for Implementation Research and the Consolidated Framework for Intervention Fidelity informed interview topic guides and underpinned the thematic framework analysis using a combined inductive and deductive approach. Results Themes provided information about intervention fidelity and implementation that were mapped across the sub processes of implementation: planning, execution, reflection and evaluation, and engagement. Interviewees described factors such as lack of training, awareness, clarity on the service specification, governance and monitoring and information and feedback which caused significant issues with the process of intervention implementation and suboptimal intervention fidelity. Conclusions This provides in-depth insight into the implementation process and fidelity of a ToC intervention, and the extant barriers and facilitators. The findings offer learning to inform the design and implementation of similar interventions, contribute to the evidence base about barriers and facilitators to such interventions and provides in-depth description of the implementation and mechanisms of impact which have the potential to influence clinical and economic outcome evaluation.

scholarly journals Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study

2020 ◽  
Author(s):  
Patrick Redmond ◽  
Khalid Munir ◽  
Oludare Alabi ◽  
Tamasine Grimes ◽  
Barbara Clyne ◽  
...  
Keyword(s):  
Medication Error ◽  
Healthcare Professionals ◽  
Community Pharmacists ◽  
Information And Communications Technology ◽  
Barriers And Facilitators ◽  
Transitions Of Care ◽  
Multidisciplinary Teams ◽  
Structured Interviews ◽  
Medicines Reconciliation ◽  
Wide Range

Abstract Background Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. Aim The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process. Design Setting Semi-structured interviews were conducted in Ireland with a wide range of healthcare professionals (HCPs) involved with medicines reconciliation at transitions of care. Method Thematic analysis was undertaken using an existing theoretical framework previously applied to implementation of medicines reconciliation. Results and conclusion Thirty-five participants were interviewed, including eleven community pharmacists (CPs), eight hospital pharmacists (HPs), nine hospital consultants (HCs), five general practitioners (GPs), and two non-consultant hospital doctors (NCHDs). Themes were categorized into barriers and facilitators. Barriers included resistance from existing professional cultures, staff interest and training, poor communication and minimal information and communications technology (ICT) support. Solutions (facilitators) suggested included supporting effective multidisciplinary teams, greater involvement of pharmacists in medicines reconciliation, ICT solutions (linked prescribing databases, decision support systems) and increased funding to provide additional (e.g. admission and discharge reconciliation) and more advanced services (e.g. community pharmacist delivered medicines use review). Medicines reconciliation is advocated as a solution to the known problem of medication error at transitions of care. This study identifies the key challenges and potential solutions that policy makers, managers and HCPs should consider when reviewing the practices and processes of medicines reconciliation in their own organisations.

GPs’ and patients’ views on recovery from psychosis

2014 ◽  
Vol 19 (2) ◽  
pp. 99-109 ◽  
Author(s):  
Seamus Ryan ◽  
Anne Rogers ◽  
Helen Lester
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Multiple Perspectives ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Peer Supervision ◽  
Content Type ◽  
Whole Person ◽  
Clinical Interest

Purpose – Recovery is a key organising principle underlying mental health services, but remains under-researched in primary care. The purpose of this paper is to explore what recovery from psychosis means from multiple perspectives, the role of primary care in fostering recovery, and interventions that might enhance its promotion in primary care. Design/methodology/approach – A total of 20 patients who had experienced psychosis and 24 General Practitioners (GPs) with varying expressed interest in mental health participated in semi-structured interviews, and were invited to two subsequent mixed focus groups. Data were analysed using Framework Analysis. Findings – Recovery was conceptualised by GPs without a specialist clinical interest in mental health as improvements in symptomatic outcomes, by GPs with a special interest as improvements in social or functional outcomes, and by patients as a process involving a “whole person” approach. Both GPs and patients highlighted benefits of primary care including continuity, accessibility, and the role primary care professionals can play in supporting patients’ families, and helping patients expand social support networks. Despite feeling “fobbed off” at times, patients desired a shift in responsibility for psychosis from secondary to primary care. Practical implications – Reflective peer supervision meetings for GPs and patient-led training might improve primary care's ability to provide a more recovery-focused environment. Originality/value – This study provided original and valuable findings regarding how GPs viewed their own role in promoting recovery from psychosis. This study also provided original findings regarding how patients viewed the role of primary care in promoting recovery from psychosis.

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