scholarly journals P.024 Educational needs in migraine care: results from a mixed-methods study among Canadian primary care providers and specialists

2018 ◽  
Vol 45 (s2) ◽  
pp. S22-S22
Author(s):  
S Peloquin ◽  
E Leroux ◽  
G Shapero ◽  
S Labbe ◽  
S Murray ◽  
...  
Keyword(s):  
Mixed Methods ◽  
General Practitioners ◽  
Online Survey ◽  
Medical Training ◽  
Phase 1 ◽  
Primary Care Providers ◽  
Educational Needs ◽  
Phase 2 ◽  
Care Providers ◽  
Structured Interviews

Background: Migraines are sub-optimally treated, affect millions of Canadians, and are underrepresented in medical training. A study was conducted to identify the needs of Canadian Healthcare Providers (HCPs) for migraine education, with the aim to inform the development of learning activities. Methods: This ethics-approved study was deployed in two consecutive phases using a mixed-methods approach. Phase 1 (qualitative) explored the causes of challenges to migraine care via a literature review, input from an expert working group, and semi-structured interviews with multiple stakeholders. Phase 2 (quantitative) validated these causes using an online survey. Results: The study included 103 participants (28 in phase 1; 75 in phase 2): general practitioners=37; neurologists=24; nurses=14; pharmacists=20; administrators, policy influencers and payers=8. Four areas of sub-optimal knowledge were identified: (1) Canadian guidelines, (2) diagnostic criteria, (3) preventive treatment, and (4) non-pharmacological therapies. Attitudinal issues related to the management of migraine patients were also identified. Detailed data including the frequencies of knowledge gaps among general practitioners and general neurologists will be presented along with qualitative findings. Conclusions: Educational activities for general practitioners and general neurologists who treat patients with migraines should be designed to address the four educational needs described in this study.

scholarly journals Strategies in Primary Care to Face the SARS-CoV-2 / COVID-19 Pandemic: An Online Survey

2021 ◽  
Vol 8 ◽  
Author(s):  
Marion Eisele ◽  
Nadine Janis Pohontsch ◽  
Martin Scherer
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Health Care Providers ◽  
Online Survey ◽  
Qualitative Content Analysis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Sources Of Information ◽  
Pandemic Preparedness ◽  
Team Meetings

Background: Primary care plays a key role in pandemics like the SARS-CoV-2 pandemic in 2020. We aimed to investigate the challenges faced and the solutions implemented in primary care.Methods: One hundred and twenty-one general practitioners in Germany completed the online survey. We used open questions to examine challenges experienced and solutions implemented during the early pandemic and chose qualitative content analysis to extract and describe the meaning of the answers. We derived deductive categories from the research questions and formed inductive categories during the material reviews.Results: Main challenges were: insufficient information, lack of protective equipment, need to restructure practice procedures and insufficient individual and structural pandemic preparedness, resulting in secondary challenges: fear of infection, impaired patient care, aggravated steering of patients, difficult cooperation with external entities and a not viable hygiene concept advised by authorities. Strategies to address these challenges included establishing regular team-meetings to develop new solutions, focusing on few reliable sources of information, working in alternating shifts, increasing telemedicine, establishing window and open-air practices and building networks with other health care providers. Respondents criticized the lack of consideration of their experiences in planning pandemic measures within primary care.Conclusions: General practitioners successfully applied pragmatic and creative strategies in their practices during the early phase of the pandemic. Among these, communication within and between practices emerged as a key strategy. These strategies should be provided with pandemic preparedness plans. The lacking consideration of the primary care providers' experiences in planning and implementing pandemic measures needs to be addressed by stakeholders.

scholarly journals Personal Sun Protection and Counseling Patterns among Primary Care Providers

2019 ◽  
Author(s):  
Daniel Alexander Nadelman ◽  
Joel J. Heidelbaugh
Keyword(s):  
Primary Care ◽  
Online Survey ◽  
Formal Education ◽  
Medical Training ◽  
Primary Care Providers ◽  
Sun Protection ◽  
Training Methods ◽  
Care Providers ◽  
Patient Counseling ◽  
The Relationship

Abstract Background: Personal sun protection and patient counseling patterns among primary care providers is an important topic that has not previously been studied in great detail. Our report evaluates the relationship between sun protection habits among providers, patterns in discussions with patients about sun protection, and prior education on this topic during medical training. Methods: An online survey was sent to family medicine faculty and house officers. Four survey questions about personal sun protection and patient counseling habits were provided. Participants were then asked whether they had received formal education concerning sun protection during their medical training. Results: Our results suggest that providers who received formal education on sun protection during their medical training were more likely to personally use adequate protection and counsel their patients on this topic. Conclusions: This study highlights the importance of sun protection education among primary care providers. Our findings suggest that improving education on this topic among physicians may lead to increased awareness among both patients and providers. Productive discussions about sun protection in the primary care setting has the potential to improve sun protective habits among patients, which can in turn decrease the incidence of skin cancer.

scholarly journals Perceptions of primary care providers on TB care for migrants: a mixed methods study in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A M Tavares ◽  
A C Garcia ◽  
A Gama ◽  
A B Abecasis ◽  
M Viveiros ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Online Survey ◽  
Social Protection ◽  
Close Contact ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Foreign Born ◽  
Structured Interviews

Abstract Background Tuberculosis (TB) is one of the main causes of death worldwide. In 2017, the proportion of TB cases among foreign-born individuals in Portugal was of 19%, and this proportion has been increasing. TB control among migrant populations largely depends on the role of the healthcare providers and their close contact with the patients. We aimed to explore the perspectives of primary care providers on the provision of TB care for migrant patients in Portugal. Methods An online survey and semi-structured interviews were conducted with healthcare providers from primary care settings in Portugal. Overall, 120 participated in the survey, and 17 were interviewed. Data from the survey and interviews were analysed using descriptive statistics and thematic analysis, respectively. Results Many participants (36.9%) considered that migrants arrive at an advanced stage of TB disease, and the main reason referred was migrants’ unawareness of the disease and its symptoms. Moreover, half (50.0%) of the providers considered that migrants frequently interrupt treatment, mainly due to their mobility, which causes difficulties in follow-up, and their social isolation that hampers social support. Overall, three main barriers for migrants’ access and use of TB care were mentioned: migrants’ low socioeconomic status, great bureaucracy required to register at services, and obstacles to benefit from social protection. Providers also suggested more training to improve their cultural competence and updating training on TB care. Conclusions Our study have shown social and economic factors that must be addressed to improve migrants’ access and use of TB care. In addition, increased health literacy for migrants and more training initiatives for providers can also contribute to improve TB care for migrants. Key messages Perspectives from primary care providers in Portugal highlighted social, economic, and administrative obstacles hampering the provision of TB care for migrants. With this work we expected to contribute with evidence to improve TB care for migrant patients in Portugal.

From maternity paper hand-held records to electronic health records: what do women tell us about their use?

2016 ◽  
Vol 22 (4) ◽  
pp. 339 ◽  
Author(s):  
Glenda Hawley ◽  
Julie Hepworth ◽  
Shelley A. Wilkinson ◽  
Claire Jackson
Keyword(s):  
Electronic Health Record ◽  
Health Care Providers ◽  
Qualitative Content Analysis ◽  
Phase 1 ◽  
Antenatal Visit ◽  
Health Record ◽  
Phase 2 ◽  
Care Providers ◽  
Structured Interviews ◽  
Electronic Health

The paper hand-held record (PHR) has been used extensively in general practice (GP) shared care management of pregnant women, and recently, the first Mater Shared Electronic Health Record (MSEHR) was introduced. The aim of this qualitative study was to examine women’s experiences using the records and the contribution of the records to integrate care. At the 36-week antenatal visit in a maternity tertiary centre clinic, women were identified as a user of either the PHR or the MSEHR and organised into Phase 1 and Phase 2 studies respectively. Fifteen women were interviewed in Phase 1 and 12 women in Phase 2. Semi-structured interviews were used for data collection, and analysed using qualitative content analysis. Four main themes were identified: (1) purpose of the record, (2) perceptions of the record; (3) content of the record, and (4) sharing the record. Findings indicate that the PHR is a well-liked maternity tool. The findings also indicate there is under-usage of the MSEHR due to health-care providers failing to follow up and discuss the option of using the electronic health record option or if a woman has completed the log-in process. This paper adds to an already favourable body of knowledge about the use of the PHR. It is recommended that continued implementation of the MSEHR be undertaken to facilitate its use.

scholarly journals Systematic development of an mHealth app to prevent healthcare-associated infections by involving patients: Participatient

2021 ◽  
Author(s):  
R.G. Bentvelsen ◽  
R. van der Vaart ◽  
K.E. Veldkamp ◽  
N.H. Chavannes
Keyword(s):  
Phase 1 ◽  
Healthcare Associated Infections ◽  
Phase 2 ◽  
Care Providers ◽  
Plain Language ◽  
Structured Interviews ◽  
Usability Tests ◽  
Systematic Development ◽  
Tract Infections ◽  
Healthcare Associated

ABSTRACTIntroductionIn hospital care, urinary catheters are frequently used, causing a substantial risk for catheter-associated urinary tract infections (CAUTI). Patient awareness and evaluation of appropriateness of their catheter through mHealth could decrease these healthcare-associated infections. However, patient engagement via mHealth in infection prevention is still limited. Therefore, we describe the systematic development and usability evaluation of the mHealth intervention Participatient, to prevent CAUTI, aiming for optimal adoption of the app in the clinical setting.MethodThe CeHRes roadmap was used as development guideline, operationalizing phases for (1) contextual inquiry (observations and interviews), (2) value specification (interviews with probing) and (3) design in multiple steps and in co-creation with end-users. During phases 1 and 2, semi-structured interviews were conducted with fifteen patients and three nurses. The design phase was combined with the minimum viable product development strategy, with a focus on early cyclic steps of prototyping.ResultsIn phase 1, patients acknowledged the risks of catheter use. Patients in phase 2 valued endorsement of a mHealth application by healthcare workers and reported to own a smartphone. Both patients and nurses recognized the need for useful modules in the app besides catheter care. Based on the needs and values as found in phase 2, the Participation app was developed. Based on usability tests in phase 3, content, text size, plain language, and navigation structures were further amended, and images were added.ConclusionThis study provides real-world insight in the developmental strategy for mHealth interventions by involving both patients and care providers. Development of an app using thorough needs-assessment provided understanding for its content and design. By developing an app providing patients with reliable information and daily checklists, we aim to provide a tailored tool for communication and awareness on catheter use for the whole ward, and a potential blueprint for mHealth development.

scholarly journals Development and Early Feasibility of Chatbots for Educating Patients With Lung Cancer and Their Caregivers in Japan: Mixed Methods Study

JMIR Cancer ◽  
10.2196/26911 ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e26911
Author(s):  
Yuki Kataoka ◽  
Tomoyasu Takemura ◽  
Munehiko Sasajima ◽  
Naoki Katoh
Keyword(s):  
Lung Cancer ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Medical Information ◽  
Phase 1 ◽  
Test Phase ◽  
Mixed Methods Study ◽  
Phase 2 ◽  
Care Providers ◽  
Web Based

Background Chatbots are artificial intelligence–driven programs that interact with people. The applications of this technology include the collection and delivery of information, generation of and responding to inquiries, collection of end user feedback, and the delivery of personalized health and medical information to patients through cellphone- and web-based platforms. However, no chatbots have been developed for patients with lung cancer and their caregivers. Objective This study aimed to develop and evaluate the early feasibility of a chatbot designed to improve the knowledge of symptom management among patients with lung cancer in Japan and their caregivers. Methods We conducted a sequential mixed methods study that included a web-based anonymized questionnaire survey administered to physicians and paramedics from June to July 2019 (phase 1). Two physicians conducted a content analysis of the questionnaire to curate frequently asked questions (FAQs; phase 2). Based on these FAQs, we developed and integrated a chatbot into a social network service (phase 3). The physicians and paramedics involved in phase I then tested this chatbot (α test; phase 4). Thereafter, patients with lung cancer and their caregivers tested this chatbot (β test; phase 5). Results We obtained 246 questions from 15 health care providers in phase 1. We curated 91 FAQs and their corresponding responses in phase 2. In total, 11 patients and 1 caregiver participated in the β test in phase 5. The participants were asked 60 questions, 8 (13%) of which did not match the appropriate categories. After the β test, 7 (64%) participants responded to the postexperimental questionnaire. The mean satisfaction score was 2.7 (SD 0.5) points out of 5. Conclusions Medical staff providing care to patients with lung cancer can use the categories specified in this chatbot to educate patients on how they can manage their symptoms. Further studies are required to improve chatbots in terms of interaction with patients.

scholarly journals Engaging primary care providers in managing pediatric eating disorders: a mixed methods study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jocelyn Lebow ◽  
Cassandra Narr ◽  
Angela Mattke ◽  
Janna R. Gewirtz O’Brien ◽  
Marcie Billings ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Mixed Methods ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Care Providers ◽  
Evidence Based Treatment

Abstract Background The primary care setting offers an attractive opportunity for, not only the identification of pediatric eating disorders, but also the delivery of evidence-based treatment. However, constraints of this setting pose barriers for implementing treatment. For interventions to be successful, they need to take into consideration the perspectives of stakeholders. As such, the purpose of this study was to examine in-depth primary care providers’ perspective of challenges to identifying and managing eating disorders in the primary care setting. Methods This mixed methods study surveyed 60 Pediatric and Family Medicine providers across 6 primary care practices. Sixteen of these providers were further interviewed using a qualitative, semi-structured interview. Results Providers (n = 60, response rate of 45%) acknowledged the potential of primary care as a point of contact for early identification and treatment of pediatric eating disorders. They also expressed that this was an area of need in their practices. They identified numerous barriers to successful implementation of evidence-based treatment in this setting including scarcity of time, knowledge, and resources. Conclusions Investigations seeking to build capacities in primary care settings to address eating disorders must address these barriers.

Bureaucratic organization and innovation : a mixed-methods study of U.S. State Department of Transportation website adoption

2017 ◽  
Author(s):  
◽  
A. J. Million
Keyword(s):  
Mixed Methods ◽  
Online Survey ◽  
State Level ◽  
State Department ◽  
Third Parties ◽  
Department Of Transportation ◽  
Structured Interviews ◽  
University Of Missouri ◽  
Bureaucratic Organization ◽  
Barriers To Change

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] This study explores bureaucratic organization and innovation in U.S. state department of transportation (DOT) websites. To determine if working with third parties fosters change in state DOT websites, it employs a two-part, explanatory sequential mixed-methods design. In phase one, an online survey was disseminated to IT managers and communications officers in all 50 states to collect data regarding agency demographics, bureaucratic models, and Web infrastructure. In total, 45 valid responses (or 90 percent) were received from DOTs indicating that most built, hosted, and managed their websites in-house, but that state-level IT consolidations required many to pool resources with third parties. In research phase two, 12 semi-structured interviews were conducted of a maximum variation sample of survey respondents. These interviews were conducted to explain why DOTs built and operated their websites with the support of third parties. Employing a grounded theoretical approach, analysis revealed 6 themes explaining website adoption and showed that working with third parties can foster innovation; however, not all change is positive. Therefore, a need exists for governments to selectively work with others, ascertain future barriers to change, and ensure that adopted innovations meet desired ends. Finally, five best practices informed by study findings are presented that may help decision-makers and civil servants provide e-government services in a flexible manner.

scholarly journals Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study

2020 ◽  
Author(s):  
Anne van Tuijl ◽  
Hub C. Wollersheim ◽  
Cornelia R.M.G. Fluit ◽  
Petra. J. van Gurp ◽  
Hiske Calsbeek
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Learning By Doing ◽  
Mixed Methods Study ◽  
Quality Improvement Initiative ◽  
Structured Interviews ◽  
Priority Score ◽  
A Priority

Abstract Background: Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice. Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about the determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative . A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts were performed to gain insight on how to analyse and address the determinants in our tool Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.

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