3361 Feasibility, Acceptability, and Appropriateness of an Insertable Vaginal Cup to Manage Urinary Incontinence Among Women with Obstetric Fistula in Ghana: A Mixed Methods Study

OBJECTIVES/SPECIFIC AIMS: 1. To assess feasibility (efficacy, safety, acceptability) of the menstrual cup for managing urinary incontinence among women with obstetric fistula 2. To examine pre-implementation facilitators and barriers (including appropriateness) among additional stakeholders METHODS/STUDY POPULATION: Sequential explanatory mixed methods study whereby repeated measures clinical trial results are explained by subsequent interviews with additional women with OF on coping and stigma and other stakeholders on perceptions of fistula self-management. RESULTS/ANTICIPATED RESULTS: Of the 32 patients screened, 11 were eligible (100% consent rate). At baseline, mean (±SD) leakage in ml was 63.2 (±49.2) (95% CI: 30.2-96.3) over two hours, while the mean leakage over two hours of use of the cup was 16.8 (±16.5) (95% CI: 5.7-27.9). The mean difference of 46.4 (±52.1) ml with use of the cup (95% CI: 11.4-81.4) was statistically significant (p = 0.02). With the cup, women experienced an average 61.0% (±37.4) (95% CI: 35.9-86.2) leakage reduction, a difference 10/11 users (91.0%) perceived in reduced leakage. One participant, reporting four previous surgical attempts, experienced a 78.7% leakage reduction. Acceptability was high–women could easily insert (8/11), remove (8/11), and comfortably wear (11/11) the cup and most (10/11) would recommend it. No adverse effects attributable to the intervention were observed on exam, although some women perceived difficulties with insertion and removal. Data collection tools were appropriate with slight modification advised. Interviews highlighted that women were already using various active coping and resistance strategies but lacked access to tools to support coping. Additional stakeholders reported the innovation was a simple, low-cost device that is an appropriate fit with ongoing fistula programming. Pre-implementation facilitators include the clear relative advantage to existing self-management strategies, the potential to build upon existing partnerships to implement, and a tension for change to address surgical gaps. Barriers included additional stakeholder’s perceptions of low user acceptability and appropriateness in some cases and the need for additional study data to inform decision making for practice and policy. DISCUSSION/SIGNIFICANCE OF IMPACT: The innovation is efficacious, acceptable, adds to current coping strategies, and fits within existing fistula programs. Stakeholders’ pre-implementation perceptions highlight the importance of partnerships and the need for an evidence base related to effectiveness, acceptability, and cost. Challenges to address include access to resources within these contexts (water, soap, and safe space to empty cup) and development of a culturally appropriate counseling message. Future research warranted.

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Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

BMC Family Practice ◽

10.1186/s12875-021-01466-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Stijn Crutzen ◽

Tessa van den Born-Bondt ◽

Petra Denig ◽

Katja Taxis

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Mixed Methods ◽

Food Intake ◽

Mixed Methods Study ◽

Self Management ◽

Hypoglycaemic Event ◽

Glucose Levels ◽

Management Issues

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

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Self-Care for Nurse Leaders in Acute Care Environment Reduces Perceived Stress: A Mixed-Methods Pilot Study Merits Further Investigation

Journal of Holistic Nursing ◽

10.1177/0898010116685655 ◽

2017 ◽

Vol 36 (1) ◽

pp. 79-90 ◽

Cited By ~ 4

Author(s):

Susan Mac Leod Dyess ◽

Angela S. Prestia ◽

Doren-Elyse Marquit ◽

David Newman

Keyword(s):

Mixed Methods ◽

Acute Care ◽

Perceived Stress ◽

Repeated Measures ◽

Self Care ◽

Nurse Leaders ◽

Future Research ◽

Care Practice ◽

Meditation Practice ◽

Significant Drop

Acute care practice settings are stressful. Nurse leaders face stressful demands of numerous competing priorities. Some nurse leaders experience unmanageable stress, but success requires self-care. This article presents a repeated measures intervention design study using mixed methods to investigate a self-care simple meditation practice for nurse leaders. Themes and subthemes emerged in association with the three data collection points: at baseline (pretest), after 6 weeks, and after 12 weeks (posttest) from introduction of the self-care simple meditation practice. An analysis of variance yielded a statistically significant drop in perceived stress at 6 weeks and again at 12 weeks. Conducting future research is merited.

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Correction: Combined Use of Web-Based and In-Person Education on Ill Health Self-management Skills in Adults With Bipolar Disorder: Protocol for a Mixed Methods Study

JMIR Research Protocols ◽

10.2196/33506 ◽

2021 ◽

Vol 10 (9) ◽

pp. e33506

Author(s):

Anna Hatzioannou ◽

Andreas Chatzittofis ◽

Virginia Sunday Koutroubas ◽

Evridiki Papastavrou ◽

Maria Karanikola

Keyword(s):

Bipolar Disorder ◽

Mixed Methods ◽

Mixed Methods Study ◽

Self Management ◽

Management Skills ◽

Web Based ◽

Combined Use

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An Affair to Remember: A Mixed-Methods Survey Examining Therapists’ Experiences Treating Infidelity

The Family Journal ◽

10.1177/10664807211061826 ◽

2021 ◽

pp. 106648072110618

Author(s):

Taylor J. Irvine ◽

Paul R. Peluso

Keyword(s):

Mixed Methods ◽

Mixed Methods Study ◽

Personal History ◽

Future Research ◽

Present Survey ◽

Training Standards ◽

Recovery Treatment ◽

And Training

In this mixed-methods study, we analyzed data from 351 couple therapists who completed our Therapists' Experiences Treating Infidelity (TETI) survey. The present survey is a follow-up of previous iterations that examined therapists' attitudes toward infidelity and affair recovery treatment. Our TETI survey provided additional questions pertaining to therapists' personal history with affairs and perceptions on current research and training standards. Results showed that various therapist and couple factors serve to impede affair recovery treatment. Additionally, this survey revealed several similarities in therapists' attitudes from prior surveys, despite decades having passed between when the present survey and previous versions. In this article, we (a) outline findings from this mixed-methods survey, (b) discuss implications for the field, and (c) offer directions for future research.

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A Mixed Methods Study of Relationship Satisfaction in Parents of Children With Down Syndrome

Journal of Family Issues ◽

10.1177/0192513x211059827 ◽

2021 ◽

pp. 0192513X2110598

Author(s):

Kristen Krueger ◽

Paige Alexander ◽

Meghan Dyster ◽

Robert Steele ◽

Briana S. Nelson Goff ◽

...

Keyword(s):

Down Syndrome ◽

Mixed Methods ◽

Relationship Satisfaction ◽

National Sample ◽

Mixed Methods Study ◽

Future Research ◽

Negative Effects ◽

Children With Down Syndrome ◽

Parental Relationship ◽

And Coping

Much of the research on parents of children with intellectual and developmental disabilities (IDD) has focused on the negative effects on the couple relationship. The current study contributes to the understanding of parental relationship satisfaction in a sample of parents of children with Down syndrome (DS), through a mixed methods study that included data from a large national sample. Parents of children with DS were divided into two groups based on high and low relationship satisfaction scores, with quantitative and qualitative data analyses comparing these two groups. Results indicated differences between high relationship satisfaction and low relationship satisfaction groups on measures of hope, life satisfaction, and coping scores. Qualitative results also indicated group differences. Future research and implications for professionals working with parents of children with DS and other IDD diagnoses should include understanding the unique factors that affect interpersonal functioning.

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