Preventing ventilator-associated pneumonia—a mixed-method study to find behavioral leverage for better protocol adherence

AbstractObjectivePreventing ventilator-associated pneumonia (VAP) is an important goal for intensive care units (ICUs). We aimed to identify the optimal behavior leverage to improve VAP prevention protocol adherence.DesignMixed-method study using adherence measurements to assess 4 VAP prevention measures and qualitative analysis of semi-structured focus group interviews with frontline healthcare practitioners (HCPs).SettingThe 6 ICUs in the 900-bed University Hospital Zurich in Zurich, Switzerland.Patients and participantsAdherence to VAP prevention measures were assessed in patients with a device for invasive ventilation (ie, endotracheal tube, tracheostomy tube). Participants in focus group interviews included a convenience samples of ICU nurses and physicians.ResultsBetween February 2015 and July 2017, we measured adherence to 4 protocols: bed elevation showed adherence at 27% (95% confidence intervals [CI], 23%–31%); oral care at 41% (95% CI, 36%–45%); sedation interruption at 81% (95% CI, 74%–85%); and subglottic suctioning at 88% (95% CI, 83%–92%). Interviews were analyzed first inductively according a grounded theory approach then deductively against the behavior change wheel (BCW) framework. Main behavioral facilitators belonged to the BCW component ‘reflective motivation’ (ie, perceived seriousness of VAP and self-efficacy to prevent VAP). The main barriers belonged to ‘physical capability’ (ie, lack of equipment and staffing and side-effects of prevention measures). Furthermore, 2 primarily technical approaches (ie, ‘restructuring environment’ and ‘enabling HCP’) emerged as means to overcome these barriers.ConclusionsOur findings suggest that technical, rather than education-based, solutions should be promoted to improve VAP prevention. This theory-informed mixed-method approach is an effective means of guiding infection prevention efforts.

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Characteristics of influential peers in the eyes of secondary school students: a mixed method study

Primary Health Care Research & Development ◽

10.1017/s1463423617000275 ◽

2017 ◽

Vol 18 (05) ◽

pp. 429-440 ◽

Cited By ~ 2

Author(s):

Alice Y. Loke ◽

Yim-wah Mak ◽

Cynthia S.T. Wu

Keyword(s):

Focus Group ◽

Health Risk ◽

Risk Behaviors ◽

Mixed Method ◽

At Risk Students ◽

Health Risk Behaviors ◽

Mixed Method Study ◽

Focus Group Interviews ◽

School Students ◽

Group Interviews

Aim It is the aim of this study to explore the characteristics of influential peers identified by schoolmates, and the mechanism by which they exert their influence on their peers. Background Adolescent crowds are a salient influence on the health-risk behaviors of peers, contributing to adolescent substance use such as drinking alcohol, smoking cigarettes, and taking drugs. Methods A mixed method study. Three schools granted us access to students and those who had been nominated as influential by their peers. The students were asked to nominate and indicated the characteristics of peers whom they considered influential in a quantitative study. Those peers whom they considered influential were invited to take part in focus group interviews. A total of six focus group interviews were conducted, comprised of two groups from each school, with an average of seven participants in each group. Findings Students considered caring and friendliness (91.0%), being a buddy (88.5%), and entertaining/humor (86.8%) as the top three characteristics of influential peers. The interviews revealed that the students believed that they are influential because of their cheerfulness and humor, considerateness, ability to communicate, popularity and sociability, sincerity and trustworthiness, and because they possess the characteristics of a leader. They also believed that their power to influence came about through their helpfulness, accommodation, and the closeness of their relationships. Their influence was manifested in both positive and negative ways on the academic pursuits and health-risk behaviors of their peers. In order to engage at-risk students in health promotion programs, it is important to identify their influential peers, and to understand how adolescent friends may help one another to resist behaviors that pose a risk to their health.

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Social streaming? Navigating music as personal and social

Convergence The International Journal of Research into New Media Technologies ◽

10.1177/1354856516673298 ◽

2016 ◽

Vol 23 (6) ◽

pp. 643-659 ◽

Cited By ~ 18

Author(s):

Anja N Hagen ◽

Marika Lüders

Keyword(s):

Focus Group ◽

Mixed Method ◽

Social Awareness ◽

Mixed Method Study ◽

Focus Group Interviews ◽

Self Reports ◽

Social Features ◽

Streaming Services ◽

Group Interviews ◽

Music Streaming

Music-streaming services embed social features that enable users to connect to one another and use music as social objects. This article examines how these features are experienced within negotiations of music as personal and social through the acts of sharing music and of following others. The analysis relies on 23 focus-group interviews with 124 Spotify and/or Tidal users and a mixed-method study including music-diary self-reports, online observation and interviews with 12 heavy users. Our findings suggest that users incorporate social awareness in non-sharing, selective-sharing and all-sharing approaches with strong, weak and absent ties. These ties are characterized by different configurations of social and music homophily. Negotiations of music as personal and social shape how music-streaming services are experienced.

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The Benefits of Spiritual Diaries: A Mixed-Method Study in Korea

Journal of Religion and Health ◽

10.1007/s10943-021-01277-8 ◽

2021 ◽

Author(s):

Suk-Sun Kim ◽

Yeounsoo Kim-Godwin ◽

Minji Gil ◽

DaEun Kim ◽

Yeon Kum Cheon

Keyword(s):

Focus Group ◽

Mixed Method ◽

Spiritual Growth ◽

Healthcare Providers ◽

Self Care ◽

Well Being ◽

Psychological Wellbeing ◽

Mixed Method Study ◽

Focus Group Interviews ◽

Group Interviews

AbstractThis mixed study examined the benefits of spiritual diaries in Korea. Quantitatively, differences in spiritual growth and psychological well-being were examined in relation to the frequency of writing spiritual diaries among 385 participating adults. The group who wrote spiritual diaries ‘5–7 times a week’ had significantly higher scores relating to spiritual growth and psychological wellbeing than other groups across the outcome variables. Qualitatively, the study also explored the benefits of writing spiritual diaries among 37 adults. Three major themes using four focus group interviews, were identified: (a) the acquisition of godly habits, (b) a closer walk with Jesus, and (c) the fullness of God’s presence. These findings are particularly important for healthcare providers who want to facilitate patient self-care.

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How accessible are grocery shops for people with dementia? A qualitative study using photo documentation and focus group interviews

Dementia ◽

10.1177/1471301218808591 ◽

2018 ◽

Vol 19 (6) ◽

pp. 1872-1888 ◽

Cited By ~ 3

Author(s):

Anna Brorsson ◽

Annika Öhman ◽

Stefan Lundberg ◽

Malcolm P Cutchin ◽

Louise Nygård

Keyword(s):

Grounded Theory ◽

Focus Group ◽

Qualitative Study ◽

Grocery Shopping ◽

Theory Approach ◽

Focus Group Interviews ◽

People With Dementia ◽

Photo Documentation ◽

Group Interviews ◽

Grounded Theory Approach

Background People with dementia who live in ordinary housing need to perform activities outside the home such as visiting friends, talking walks and doing grocery shopping. This article identifies and examines characteristics that may influence accessibility in the space of a grocery shop as perceived by people with dementia. Methods This is a qualitative study with a grounded theory approach. The data collection was done with two different methods. It started with photo documentation and continued with focus group interviews in combination with photo elicitation. Data from both photo documentation and focus groups were analysed according to a grounded theory approach. Results The categories “illogical arrangement”, “overload of products, information and people”, “visual illusions” and “intrusive auditory stimuli” showed characteristics in the grocery shop that influenced how accessible and usable the informants experienced a shop to be. Furthermore, personal capacities in relation to the specific characteristics of the grocery shop space had an influence on how accessible and usable the informants experienced the grocery shop to be. Capacities to find, stay focused and concentrated, meet stress, remember, interpret and discriminate sensory impressions through hearing and sight came to the fore as important. Conclusions Characteristics of both the shop and the person need to be taken into account when supporting people with dementia in grocery shopping.

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«Det er fint å være hos rådgiver, hun skjønner oss skjønner du». En empirisk studie av tema som anses som kjennetegn på kvalitet i skolens karriereveiledning

Nordisk tidsskrift i veiledningspedagogikk ◽

10.15845/ntvp.v2i1.1161 ◽

2017 ◽

Vol 2 (1) ◽

pp. 16

Author(s):

Erik Hagaseth Haug

Keyword(s):

Focus Group ◽

Career Guidance ◽

School Context ◽

Theory Approach ◽

Focus Group Interviews ◽

Relational Competence ◽

Theoretical Assumptions ◽

Administrative Leaders ◽

Group Interviews ◽

Grounded Theory Approach

The aim of the study is to contribute to a more nuanced and differentiated understanding of the concept of quality in career guidance in schools, and to see how the local understandings interrelate with theoretical assumptions. The study focuses on patterns of understanding of the phenomenon quality in career guidance in a Norwegian school context, as the following four actors describe it: Pupils at intermediate and secondary levels, Counsellors from both levels, Administrative leaders from the sampled schools and the School-owners (municipality-representatives). Methodologically, the study uses a grounded theory approach, and the results are based on analysis of focus group interviews with representatives from the different actor groups. The result indicate that the understandings of quality are centered around three interrelated thematic areas; the importance of the practitioners’ relational competence, a focus on the next career choice, and a variety of actors and activities involved in the provision of the service.

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Status Quo and Innovative Directions for Inpatient Fall Interventions

Journal of Korean Academy of Fundamentals of Nursing ◽

10.7739/jkafn.2020.27.4.356 ◽

2020 ◽

Vol 27 (4) ◽

pp. 356-365

Author(s):

Ji Yea Lee ◽

Juhee Lee ◽

Yeonsoo Jang ◽

Eun Chae Kim ◽

Yong Gu Ji ◽

...

Keyword(s):

Focus Group ◽

Medical Devices ◽

Physical Environment ◽

Status Quo ◽

University Hospital ◽

Nursing Interventions ◽

Focus Group Interviews ◽

Individual Interviews ◽

The Status ◽

Group Interviews

Purpose: The purpose of this study was to explore nurses’ experience of falls, and their perception of the status quo of inpatient fall interventions.Methods: The participants were 28 ward nurses in a university hospital, Seoul, Korea. Five focus group interviews and three individual interviews were conducted. The interviews were analyzed using thematic analysis.Results: The findings from this study suggest that nurses face limitations in providing conventional fall interventions due to patient disease related characteristics, situations in hospital, and medical devices used in the hospital settings. Although nurses adopted their own strategies to prevent falls effectively, they expressed the need for innovative approaches to overcome these limitations.Conclusion: Systematic, technology-based approaches are needed to create a safer physical environment and to improve current nursing interventions to prevent falls.

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Nutrition Therapy in the Transition between Hospital and Home: An Investigation of Barriers

Journal of Nutrition and Metabolism ◽

10.1155/2013/463751 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Mette Holst ◽

Henrik Højgaard Rasmussen

Keyword(s):

Focus Group ◽

Home Care ◽

Clinical Guidelines ◽

Nutrition Therapy ◽

University Hospital ◽

Nutritional Risk ◽

Focus Group Interviews ◽

Care Plans ◽

Group Interviews ◽

General Practise

Aims and Objectives. This study aimed to investigate barriers for nutrition therapy in the transition between hospital and home and hereby to identify areas for potential improvements.Background. Though the focus on nutritional risk is improving in hospital, there seems to be less effort to maintain or even improve nutritional status after discharge and during the rehabilitation period.Design. Qualitative focus group interviews.Methods. Semistructured focus group interviews with experienced multiprofessional staff from hospital, home care, nursing homes, and general practise. The study was done in the county of Aalborg with about 280.000 inhabitants regarding homecare and general practise as well as Aalborg University Hospital, Denmark.Results. Interviews were generated with 41 professionals from hospital, general practise, and home care. Barriers identified between settings included the following aspects: economic, organisation, and education. The impression of professionals was that few patients are discharged with nutrition therapy, compared to who could benefit from nutrition therapy after discharge. Most often, reasons were a short in-hospital stay and lack of knowledge and interest. Moreover, lack of clinical guidelines throughout all settings, time consumption, lack of transparency regarding economy and workflows, and lack of assistance from experts regarding complicated nutritional problems were identified.Conclusions. Many barriers were found in hospital as well as in the community and general practise. These were most often practical as well as organizational. Improvements of clinical guidelines and instructions and improvement of knowledge and communication at all levels are needed.Relevance to Clinical Practise. This study emphasizes that responsibility needs to be taken for patients whom are still at nutritional risk at discharge, and even before hospitalization. Nurses and doctors in and outside hospital are in need of improved knowledge, standard care plans, and instructions.

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Patients’ and clinicians’ experiences of the DSM-5 Cultural Formulation Interview: A mixed method study in a Swedish outpatient setting

Transcultural Psychiatry ◽

10.1177/1363461520938917 ◽

2020 ◽

Vol 57 (4) ◽

pp. 542-555 ◽

Cited By ~ 1

Author(s):

Malin Idar Wallin ◽

Marie Dahlin ◽

Lauri Nevonen ◽

Sofie Bäärnhielm

Keyword(s):

Focus Group ◽

Mixed Method ◽

Assessment Tool ◽

Response Rate ◽

Initial Contact ◽

Cultural Formulation ◽

Focus Group Interviews ◽

Dsm 5 ◽

Group Interviews ◽

Cultural Formulation Interview

This study is an evaluation of clinicians’ and patients’ experiences of the core Cultural Formulation Interview (CFI) in DSM-5. The CFI provides a framework for gathering culturally relevant information, but its final form has not been sufficiently evaluated. Aims were to assess the Clinical Utility (CU), Feasibility (F) and Acceptability (A) of the CFI for clinicians and patients, and to explore clinicians’ experiences of using the CFI in a multicultural clinical setting in Sweden. A mixed-method design was applied, using the CFI Debriefing Instrument for Clinicians ( N = 15) and a revised version of the Debriefing Instrument for Patients ( N = 114) (DIC and DIP, scored from −2 to 2). Focus group interviews were conducted with clinicians. For patients (response rate 50%), the CU mean was 0.98 ( SD = 0.93) and F mean 1.07 ( SD = 0.83). Overall rating of the interview was 8.30 ( SD = 1.75) on a scale from 0 and 10. For clinicians (response rate 94%), the CU mean was 1.14 ( SD = 0.52), F 0.58 ( SD = 0.93) and A 1.42 ( SD = 0.44). From clinician focus-group interviews, the following themes were identified: approaching the patient and the problem in a new manner; co-creating rapport and understanding; and affecting clinical reasoning and assessment. Patients and clinicians found the CFI in DSM-5 to be a feasible, acceptable, and clinically useful assessment tool. The focus group interviews suggested that using the CFI at initial contact can help make psychiatric assessment patient-centred by facilitating patients’ illness narratives. We argue for further refinements of the CFI.

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Satisfaction and usability of an ICT-based system for clinically healthy COVID-19 patients by patients and medical professionals (Preprint)

10.2196/preprints.26227 ◽

2020 ◽

Author(s):

Kyung Hwan Kim ◽

Ye Seul Bae ◽

Sae Won Choi ◽

Taehoon Ko ◽

Jun Seo Lim ◽

...

Keyword(s):

Focus Group ◽

Mobile Apps ◽

Wearable Devices ◽

Perceived Usefulness ◽

Information And Communications Technology ◽

University Hospital ◽

Medical Professionals ◽

Focus Group Interviews ◽

Group Interviews ◽

Remote Patient

BACKGROUND Digital healthcare is an important strategy in the war against COVID-19. South Korea introduced a Living and Treatment Support Center (LTSC) to control regional outbreaks and care for asymptomatic or mild COVID-19 patients. Seoul National University Hospital (SNUH) introduced information and communications technology (ICT)-based solutions to manage clinically healthy COVID-19 patients. OBJECTIVE This study aims to investigate satisfaction and usability for patients and health professionals in optimal use of the mobile apps and wearable devices that SNUH introduced to LTSC for clinically healthy COVID-19 patients. METHODS Online surveys and focus group interviews were conducted to collect quantitative and qualitative data. RESULTS Perceived usefulness of wearable devices was highest at 4.45 (±0.57) points, while usability was highest at 4.62 (±0.48) points out of 5. In medical professionals, “Self-reporting” was highest at 4.42 (±0.58) points out of 5. In focus group interviews of healthcare professionals, hospital information system interfacing was the most important functional requirement for ICT-based COVID-19 telemedicine. Improvement of patient safety and reduction of the burden on medical staff were expected positive outcomes. Stability and reliability of the device, patient education, accountability, and reimbursement issues should be considered in development of remote patient monitoring. CONCLUSIONS To respond to a novel contagious disease, telemedicine and wearable devices were shown to be useful during a global crisis.

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How should be the laboratory application? Prospective teachers' perspective

SHS Web of Conferences ◽

10.1051/shsconf/20196601007 ◽

2019 ◽

Vol 66 ◽

pp. 01007

Author(s):

Fatma Alkan

Keyword(s):

Focus Group ◽

Prospective Teachers ◽

Mixed Method ◽

Chemistry Laboratory ◽

Study Group ◽

Focus Group Interviews ◽

Practical Applications ◽

Mixed Method Design ◽

Group Interviews

The importance and effectiveness of laboratory applications should be find out by students or teachers. The aim of this study is to examine the perceptions on laboratory applications of prospective teachers and to determine the opinions about chemistry laboratory practices. The study group consisted of 1st grade prospective teachers. The research has been designed in a mixed method design. In the quantitative dimension of the study, the data obtained from the perceptions on laboratory applications scale were analysed. In the qualitative dimensions of the study was carried out in accordance with the situation pattern, and focus group interviews were conducted. According to quantitative findings of the research, the highest scores of sub-scales is in the effectiveness of laboratory. In qualitative findings, it has been emphasized that laboratory applications still bring chemistry lessons more enjoyable, provide knowledge retentions with practical applications, develop responsibility, improve the preparation behaviour of the course.

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