Can we determine burdensome transitions in the last year of life based on time of occurrence and frequency? An explanatory mixed-methods study

2021 ◽  
pp. 1-9
Author(s):  
Nicolas Schippel ◽  
Gloria Dust ◽  
Christian von Reeken ◽  
Raymond Voltz ◽  
Julia Strupp ◽  
...  
Keyword(s):  
Content Analysis ◽  
Mixed Methods ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Mixed Methods Study ◽  
Subjective Burden ◽  
Insufficient Information ◽  
Cross Sectional ◽  
Explanatory Mixed Methods ◽  
Patients Experience

Abstract Objective Burdensome transitions are typically defined as having a transition in the last three days or multiple hospitalizations in the last three months of life, which is seldom verified with qualitative accounts from persons concerned. This study analyses types and frequencies of transitions in the last year of life and indicators of burdensome transitions from the perspective of bereaved relatives. Method Cross-sectional explanatory mixed-methods study with 351 surveyed and 41 interviewed bereaved relatives in a German urban area. Frequencies, t-tests, and Spearman correlations were computed for quantitative data. Qualitative data were analyzed using content analysis with provisional and descriptive coding/subcoding. Results Transitions rise sharply during the last year of life. 8.2% of patients experience a transition in the last three days and 7.8% three or more hospitalizations in the last three months of life. An empathetic way of telling patients about the prospect of death is associated with fewer transitions in the last month of life (r = 0.185, p = 0.046). Professionals being aware of the preferred place of death corresponds to fewer hospitalizations in the last three months of life (1.28 vs. 0.97, p = 0.021). Qualitative data do not confirm that burden in transitions is linked to having transitions in the last three days or multiple hospitalizations in the last three months of life. Burden is associated with (1) late and non-empathetic communication about the prospect of death, (2) not coordinating care across settings, and (3) not considering patients’ preferences. Significance of results Time of occurrence and frequency appear to be imperfect proxies for burdensome transitions. The subjective burden seems to be associated rather with insufficient information, preparation, and management of transitions.

Uncertainty about cellulitis and unmet patient information needs: a mixed methods study

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697349
Author(s):  
Anna Lalonde ◽  
Emma Teasdale ◽  
Ingrid Muller ◽  
Joanne Chalmers ◽  
Peter Smart ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Information Needs ◽  
Qualitative Data ◽  
Information Provision ◽  
Mixed Methods Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Face To Face ◽  
Patient Information Needs ◽  
History Of

BackgroundCellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis and their information needs.MethodMixed methods study comprising semi-structured, face-to-face interviews and cross-sectional survey, recruiting through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.ResultsThirty interviews were conducted between August 2016 and July 2017. Qualitative data revealed low prior awareness of cellulitis, uncertainty around diagnosis, concern/surprise at the severity of cellulitis, and perceived insufficient information provision. People were surprised they had never heard of the condition and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this bewildering. Two hundred and forty surveys were completed (response rate 17%). These showed that, while most people received information on the treatment of cellulitis (60.0%, n = 144), they reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need for provision of basic information for people with cellulitis, particularly being informed of the name of their condition, how to manage acute episodes, and how to reduce risk of recurrence.

scholarly journals Companion Animal Type and Level of Engagement Matter: A Mixed-Methods Study Examining Links between Companion Animal Guardianship, Loneliness and Well-Being during the COVID-19 Pandemic

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2349
Author(s):  
Heather Clements ◽  
Stephanie Valentin ◽  
Nicholas Jenkins ◽  
Jean Rankin ◽  
Nancy R. Gee ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Quantitative Data ◽  
Online Survey ◽  
Qualitative Data ◽  
Companion Animals ◽  
Well Being ◽  
Companion Animal ◽  
Mixed Methods Study ◽  
The Impact ◽  
Mental Well Being

To reduce the spread of COVID-19, countries worldwide placed limitations on social interaction, which is anticipated to have severe psychological consequences. Although findings are inconsistent, prior research has suggested that companion animals may positively influence human well-being and reduce loneliness. In the context of COVID-19, this has important implications, as companion animal guardians may be less negatively affected by the pandemic. The primary aim of this research was to investigate the influence of companion animals on mental well-being and loneliness during the pandemic, with specific interest in the role of ornamental fishes. A mixed-methods study was conducted, using an international sample. Quantitative data were collected via an online survey (n = 1199) and analysed using robust hierarchical multiple regression analyses; the influence of level of engagement with companion animals was examined for dogs, cats and ornamental fishes. There was no evidence that companion animal guardianship was associated with loneliness and mental well-being during the pandemic but spending more time engaging physically or socially with dogs (and to a lesser extent cats) was generally associated with poorer outcomes. Qualitative data were collected through open-ended survey responses (n = 757) and semi-structured interviews (n = 25) and analysed using reflexive thematic analysis. Two themes were developed—one related to companion animals as providers of social and emotional support, and the other to companion animals as providers of purpose and perspective. Concerns regarding the impact of the pandemic on animal welfare were also identified. Compared to other animal types, more participants expressed indifference regarding the impact of their fishes on their well-being during the pandemic, possibly because fishes cannot provide comfort via physical touch. The findings of this study reflect the wider field of human–animal interaction; although qualitative data suggest guardians believe their companion animals are a positive influence in their lives, there is little convincing quantitative data to support these beliefs. This highlights the need to refine theories regarding which aspects of companion animal guardianship may influence human well-being; the findings from this research may be useful in the refinement of such theories.

scholarly journals Investigating dementia literacy among community-dwelling adults and older adults in Macau: A mixed methods study

2019 ◽  
Author(s):  
Angela YM Leung ◽  
Cindy S. U Leong ◽  
Pak Leng Cheong ◽  
Alice S. M. Tsang ◽  
Bernice O. C. Lam Nogueira ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Quantitative Data ◽  
Attitude Scale ◽  
Community Dwelling ◽  
Mixed Methods Study ◽  
Focus Group Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Group Interviews

Abstract Background: As population ageing and dementia incidence continue to increase worldwide, health systems are urged to empower the public to address factors related to dementia. This study aims to assess Macau citizens’ knowledge of dementia, attitudes towards persons with dementia, and help-seeking behaviours and intention toward dementia.Methods: This is a mixed-methods study with both quantitative (cross-sectional survey) and qualitative components (focus group interviews). The Alzheimer’s Disease Knowledge Scale (ADKS) and Dementia Attitude Scale (DAS) were utilized in the quantitative data collection, whereas focus group interviews were employed to gather context-specific understanding of dementia in the local setting. Descriptive statistics and Chi-square tests were used to analyze quantitative data, while content analysis was used for qualitative data.Results: The overall level of knowledge on dementia was low (ADKS mean total score = 17.38, SD = 3.31), with the least amount of knowledge in the caregiving domain. Meanwhile, attitudes toward persons with dementia was generally positive (mean [SD] = 89.07 [11.99]). Many of the focus group participants were also uncertain regarding the availability of dementia services in the region. The general public was interested to obtain dementia information through social media.Conclusions: Efforts should be made to build up dementia literacy in Macau, especially in terms of caregiving. Information about dementia could be disseminated in social media and by healthcare professionals.

scholarly journals Assessment of the Challenges and Opportunities of Women Entrepreneurs in Sodo Town, Wolaita Zone, SNNPR

2019 ◽  
pp. 1-8
Author(s):  
Yesuneh Gizaw ◽  
Sintayehu Tsega ◽  
Kibrehewan Hailegiorgis
Keyword(s):  
Content Analysis ◽  
Women Entrepreneurs ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Working Capital ◽  
Cross Sectional ◽  
Capital Shortage ◽  
Challenges And Opportunities ◽  
Back Ground ◽  
Husband Support

This study was aimed to assess the challenges that hinder the performance of women engaged in service enterprises. It also aimed to find out the main opportunities that women entrepreneurs might access to attain their goal. Accordingly, it identified lack of working place, shortage of working capital, shortage of training, lack of credit facility, burden of double responsibility and absence of husband support, and poor education back ground were major challenges that constrained the performance of women entrepreneurs. The various institutions providing support to women together with the current constitution were considered as opportunities for women entrepreneurs in the study area. The study utilized descriptive cross sectional statistics to analyze quantitative data and content analysis to compute qualitative data. Various points to tackle the challenges and to utilize the different opportunities available to improve the performance of women entrepreneurs were recommended.

scholarly journals Why women choose abortion through telemedicine outside the formal health sector in Germany? A mixed-methods study

2020 ◽  
Author(s):  
Margit Endler ◽  
Kristina Killinger ◽  
Hazal Atay ◽  
Rebecca Gomperts ◽  
Sophie Gunther
Keyword(s):  
Content Analysis ◽  
Mixed Methods ◽  
Health Sector ◽  
Mixed Methods Study ◽  
Vulnerable Groups ◽  
Formal Sector ◽  
Provider Attitudes ◽  
Cross Sectional ◽  
Telemedicine Service ◽  
Barriers To Access

Introduction: In April 2019 the abortion telemedicine service Women on Web (WoW) opened their helpdesk to Germany and saw a progressive rise in consultations. Our aim was to understand the motivations, and perceived barriers to access, for women who choose telemedicine abortion outside the formal health sector in Germany. Methods: We conducted a parallel convergent mixed-methods study among 1090 women in Germany, who requested medical abortion through WoW between January 1st and December 31st, 2019. We performed a cross-sectional study of data contained in online consultations and a content analysis of 108 email texts. Analysis was done until saturation; results were merged, and triangulation was used to validate results. Results: Frequent reported reasons for choosing telemedicine abortion in the consultation forms were quote: I need to keep the abortion a secret from my partner or family (48%), and quote: I would rather keep my abortion private (48%). The content analysis developed two main themes and seven subsidiary categories: 1) internal motivations for seeking telemedicine abortion encompassing i) autonomy, ii) perception of external threat, iii) shame and stigma, and 2) external barriers to formal abortion care, encompassing : (iv) financial stress, v) logistic barriers to access vi) provider attitudes, and vii) vulnerability of foreigners). The findings in the quantitative and qualitative analysis were consistent. Conclusion: Women in Germany who choose telemedicine abortion outside the formal health sector do so both from a place of empowerment and a place of disempowerment. Numerous barriers to abortion access exist in the formal sector which are of special relevance to vulnerable groups such as adolescents and undocumented immigrants.

scholarly journals Social and Psychological Readiness to Take Collective Action Against Violence Against Women: A Mixed Methods Study of Informal Settlements in Mumbai, India

2020 ◽  
pp. 107780122097136
Author(s):  
Lu Gram ◽  
Proshant Chakraborty ◽  
Nayreen Daruwalla ◽  
David Osrin
Keyword(s):  
Mixed Methods ◽  
Collective Action ◽  
Violence Against Women ◽  
Gender Inequality ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Informal Settlements ◽  
Household Survey ◽  
Community Capacity ◽  
Mixed Methods Study

Past failures to mobilize communities in collective action against violence against women (VAW) have been ascribed to contextual challenges, but researchers have not systematically mapped community capacity for collective action against VAW. We conducted a mixed methods study in Mumbai, India using quantitative data from a household survey ( n = 2,642) and qualitative data from 264 community meetings. We found attitudes supporting gender inequality and violence coexisted with significant enthusiasm and support for collective action against VAW. These findings open up avenues for policymakers to treat communities as less vulnerable and more capable of changing situations and problems that affect them.

scholarly journals Why women choose at-home abortion via teleconsultation in France: drivers of telemedicine abortion during and beyond the COVID-19 pandemic

2021 ◽  
pp. bmjsrh-2021-201176
Author(s):  
Hazal Atay ◽  
Helene Perivier ◽  
Kristina Gemzell-Danielsson ◽  
Jean Guilleminot ◽  
Danielle Hassoun ◽  
...  
Keyword(s):  
Content Analysis ◽  
Mixed Methods ◽  
Medical Abortion ◽  
Cross Sectional Study ◽  
Mixed Methods Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Individual Level ◽  
Manifest Content ◽  
At Home

ObjectivesIn an attempt to understand the demand and main drivers of telemedicine abortion, we analysed the requests that Women on Web (WoW), an online telemedicine abortion service operating worldwide, received from France throughout 2020.MethodsWe conducted a parallel, convergent, mixed-methods study among 809 consultations received from France at WoW between 1 January and 31 December 2020. We performed a cross-sectional study of data obtained from the WoW consultation survey and a manifest content analysis of anonymised email correspondence of 140 women consulting with the WoW helpdesk from France.FindingsWe found that women encounter macro-level, individual-level and provider-level constraints while trying to access abortion in France. The preferences and needs over secrecy (n=356, 46.2%), privacy (n=295, 38.3%) and comfort (n=269, 34.9%) are among the most frequent reasons for women from France to choose telemedicine abortion through WoW. The COVID-19 pandemic seems to be an important driver for resorting to telemedicine (n=236, 30.6%). The lockdowns had a significant impact on the number of consultations received at WoW from France, increasing from 60 in March to 128 in April during the first lockdown and from 54 in October to 80 in November during the second lockdown.ConclusionsThe demand for at-home medical abortion via teleconsultation increased in France during the lockdowns. However, drivers of telemedicine abortion are multidimensional and go beyond the conditions unique to the pandemic.

scholarly journals Patient Experiences with Ambulatory Telehealth in Neurology: Results of a Mixed Methods Study

2021 ◽  
pp. 10.1212/CPJ.0000000000001072
Author(s):  
Carly Olszewski ◽  
Sharon Thomson ◽  
Lauren Strauss ◽  
Rachel Graham ◽  
Mustapha Ezzeddine ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Thematic Analysis ◽  
Qualitative Data ◽  
Telephone Interview ◽  
Patient Experiences ◽  
Mixed Methods Study ◽  
Neurologic Examination ◽  
Commute Time ◽  
Physician Relationship ◽  
Patients Experience

ABSTRACTObjective:To assess patient experiences with rapid implementation of ambulatory telehealth during the COVID-19 pandemic.Methods:A mixed methods study was performed to characterize the patients’ experience with neurology telehealth visits during the first eight weeks of the COVID-19 response. Consecutive patients who completed a telehealth visit were contacted by telephone. Assenting patients completed a survey quantifying satisfaction with the visit followed by a semi-structured telephone interview. Qualitative data were analyzed using the principles of thematic analysis.Results:2,280 telehealth visits were performed, 753 patients (33%) were reached for post-visit feedback. Of these, 47% of visits were by video and 53% by telephone. Satisfaction was high with 77% of patients reporting that all needs were met though only 51% would consider telehealth in the future. Qualitative themes emerged suggesting that positive patient experiences were associated with elimination of commute time and associated costs as well as a positive physician interaction. Negative patient experiences were associated with the inability to complete the neurologic examination. Overall, patients tended to view telehealth as a tool that should augment, and not replace, in-person visits.Conclusion:In ambulatory telehealth, patients valued convenience, safety, and physician relationship. Barriers were observed but can be addressed.

scholarly journals Why women choose abortion through telemedicine outside the formal health sector in Germany: a mixed-methods study

2020 ◽  
pp. bmjsrh-2020-200789
Author(s):  
Kristina Killinger ◽  
Sophie Günther ◽  
Rebecca Gomperts ◽  
Hazal Atay ◽  
Margit Endler
Keyword(s):  
Content Analysis ◽  
Mixed Methods ◽  
Health Sector ◽  
Mixed Methods Study ◽  
Vulnerable Groups ◽  
Formal Sector ◽  
Provider Attitudes ◽  
Cross Sectional ◽  
Telemedicine Service ◽  
Barriers To Access

IntroductionWomen on Web (WoW) is a global medical abortion telemedicine service operating outside the formal health sector. In April 2019 they opened their helpdesk to Germany. Our aim was to understand the motivations, and perceived barriers to access, for women who choose telemedicine abortion outside the formal health sector in Germany.MethodsWe conducted a parallel convergent mixed-methods study among 1090 women consulting WoW from Germany between 1 January and 31 December 2019. We performed a cross-sectional study of data contained in online consultations and a content analysis of 108 email texts. Analysis was done until saturation; results were merged and triangulation used to validate results.ResultsThe quantitative analysis found that the need for secrecy (n=502, 48%) and the wish for privacy (n=500, 48%) were frequent reasons for choosing telemedicine abortion. Adolescents were more likely to report secrecy, cost, stigma and legal restrictions as reasons for using telemedicine abortion compared with older women. The content analysis developed two main themes and seven subsidiary categories, (1) internal motivations for seeking telemedicine abortion encompassing (i) autonomy, (ii) perception of external threat and (iii) shame and stigma, and (2) external barriers to formal abortion care encompassing (iv) financial stress, (v) logistic barriers to access, (vi) provider attitudes and (vii) vulnerability of foreigners.ConclusionsWomen in Germany who choose telemedicine abortion outside the formal health sector do so both from a place of empowerment and a place of disempowerment. Numerous barriers to abortion access exist in the formal sector which are of special relevance to vulnerable groups such as adolescents and undocumented immigrants.

Determining Emotional Tone and Verbal Behavior in Patients With Tinnitus and Hyperacusis: An Exploratory Mixed-Methods Study

2019 ◽  
Vol 28 (3) ◽  
pp. 660-672
Author(s):  
Suzanne H. Kimball ◽  
Toby Hamilton ◽  
Erin Benear ◽  
Jonathan Baldwin
Keyword(s):  
Mixed Methods ◽  
Verbal Behavior ◽  
Coping Strategies ◽  
Mixed Methods Study ◽  
Self Report ◽  
Anxiety And Depression ◽  
Negative Consequences ◽  
Emotional Tone ◽  
Explanatory Mixed Methods ◽  
Quantitative Results

Purpose The purpose of this study was to evaluate the emotional tone and verbal behavior of social media users who self-identified as having tinnitus and/or hyperacusis that caused self-described negative consequences on daily life or health. Research Design and Method An explanatory mixed-methods design was utilized. Two hundred “initial” and 200 “reply” Facebook posts were collected from members of a tinnitus group and a hyperacusis group. Data were analyzed via the LIWC 2015 software program and compared to typical bloggers. As this was an explanatory mixed-methods study, we used qualitative thematic analyses to explain, interpret, and illustrate the quantitative results. Results Overall, quantitative results indicated lower overall emotional tone for all categories (tinnitus and hyperacusis, initial and reply), which was mostly influenced by higher negative emotion. Higher levels of authenticity or truth were found in the hyperacusis sample but not in the tinnitus sample. Lower levels of clout (social standing) were indicated in all groups, and a lower level of analytical thinking style (concepts and complex categories rather than narratives) was found in the hyperacusis sample. Additional analysis of the language indicated higher levels of sadness and anxiety in all groups and lower levels of anger, particularly for initial replies. These data support prior findings indicating higher levels of anxiety and depression in this patient population based on the actual words in blog posts and not from self-report questionnaires. Qualitative results identified 3 major themes from both the tinnitus and hyperacusis texts: suffering, negative emotional tone, and coping strategies. Conclusions Results from this study suggest support for the predominant clinical view that patients with tinnitus and hyperacusis have higher levels of anxiety and depression than the general population. The extent of the suffering described and patterns of coping strategies suggest clinical practice patterns and the need for research in implementing improved practice plans.

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