scholarly journals Barriers to home bowel screening test in South Asians in the UK

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Smith ◽  
S Howcutt ◽  
P Saini ◽  
J Brett ◽  
C Henshall ◽  
...  
Keyword(s):  
Screening Test ◽  
South Asians ◽  
Theoretical Domains Framework ◽  
Target Population ◽  
Bowel Cancer ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Home Test ◽  
Early Results ◽  
The Uk

Abstract Background Bowel cancer is common and accounts for 10% of all cancer mortality. Early detection significantly reduces mortality. In the UK, the NHS Bowel Cancer Screening Programme invites adults aged 60-74 years to carry out a home screening test biennially. The national target for test completion is 60%; completion is substantially lower (∼30%) amongst South Asian populations. Our aim was to develop a community-based intervention to increase completion of the home bowel screening test in South Asians. Methods Multi-methods comprising two stages: 1) group and individual interviews with South Asians aged 50-74 years purposively sampled from community groups for maximum variation. Semi-structured interviews based on the Theoretical Domains Framework (TDF) investigated determinants of bowel screening completion. Interviews were recorded, transcribed, and analysed using framework analysis and findings mapped onto the COM-B Behaviour Change Wheel; 2) Co-production of intervention during two workshops with key stakeholders and target population. Results To-date 25 adults recruited of Indian, Pakistani and Bangladeshi ethnicity with variation in age, gender, first language, faith, and compliance with bowel screening. Key barriers and TDF domains that they mapped to were: - lack of knowledge about bowel cancer and screening; lack of language, literacy and physical ability (skills) to carry out the home test; confidence to carry it out correctly (belief about capabilities); appropriate space and time to carry out the test (environmental context and resources); putting off undertaking the test (memory attention and decision processes); risk perception and fear of cancer (emotions). Enablers were: social influences from peers; goals and motivations. Conclusions Early results suggest an intervention comprising education, persuasion, modelling and enablement functions could increase completion of the home test. Key messages Community engagement and working with community leaders enhanced the success of recruitment. The TDF was a useful framework for identifying barriers to home bowel screening test by South Asians in the South East of England.

scholarly journals Transforming community nursing services in the UK; lessons from a participatory evaluation of the implementation of a new community nursing model in East London based on the principles of the Dutch Buurtzorg model

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mirza Lalani ◽  
Jane Fernandes ◽  
Richard Fradgley ◽  
Caroline Ogunsola ◽  
Martin Marshall
Keyword(s):  
The Netherlands ◽  
Patient Experience ◽  
Social Care ◽  
Professional Autonomy ◽  
Community Nursing ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Model Based ◽  
Health And Social Care ◽  
The Uk

Abstract Background Buurtzorg, a model of community nursing conceived in the Netherlands, is widely cited as a promising and evidence-based approach to improving the delivery of integrated nursing and social care in community settings. The model is characterised by high levels of patient and staff satisfaction, professional autonomy exercised through self-managing nursing teams, client empowerment and holistic, patient centred care. This study aimed to examine the extent to which some of the principles of the Buurtzorg model could be adapted for community nursing in the United Kingdom. Methods A community nursing model based on the Buurtzorg approach was piloted from June 2017–August 2018 with a team of nurses co-located in a single general practice in the Borough of Tower Hamlets, East London, UK. The initiative was evaluated using a participatory methodology known as the Researcher-in-Residence model. Qualitative data were collected using participant observation of meetings and semi-structured interviews with nurse team members, senior managers, patients/carers and other local stakeholders such as General Practitioners (GP) and social workers. A thematic framework analysis of the data was carried out. Results Implementation of a community nursing model based on the Buurtzorg approach in East London had mixed success when assessed against its key principles. Patient experience of the service was positive because of the better access, improved continuity of care and longer appointment times in comparison with traditional community nursing provision. The model also provided important learning for developing service integration in community care, in particular, how to form effective collaborations across the care system with other health and social care professionals. However, some of the core features of the Buurtzorg model were difficult to put into practice in the National Health Service (NHS) because of significant cultural and regulatory differences between The Netherlands and the UK, especially the nurses’ ability to exercise professional autonomy. Conclusions Whilst many of the principles of the Buurtzorg model are applicable and transferable to the UK, in particular promoting independence among patients, improving patient experience and empowering frontline staff, the successful embedding of these aims as normalised ways of working will require a significant cultural shift at all levels of the NHS.

scholarly journals Living life in limbo: experiences of healthcare professionals during the HCPC fitness to practice investigation process in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill Maben ◽  
Linda Hoinville ◽  
Dawn Querstret ◽  
Cath Taylor ◽  
Magdalena Zasada ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Psychological Impact ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Individual Level ◽  
Healthcare Settings ◽  
Lack Of Information ◽  
The Uk ◽  
The Impact ◽  
Investigation Process

Abstract Background It is the responsibility of healthcare regulators to ensure healthcare professionals remain fit for practice in healthcare settings. If there are concerns about an individual healthcare professional they may undergo a fitness to practice investigation. This process is known to be hugely stressful for doctors and social workers, but little is known about the impact of this experience on other professions. This study explores the experiences of registrants going through the process of being reported to the UK’s Health and Care Professions Council (HCPC) and attending fitness to practice (FTP) hearings. We discuss the implications of this process on registrants’ wellbeing and, from our findings, present recommendations based on registrants experiences. In doing so we articulate the structural processes of the HCPC FTP process and the impact this has on individuals. Methods This study uses semi-structured interviews and framework analysis to explore the experiences of 15 registrants who had completed the FTP process. Participants were sampled for maximum variation and were selected to reflect the range of possible processes and outcomes through the FTP process. Results The psychological impact of undergoing a FTP process was significant for the majority of participants. Their stories described influences on their wellbeing at both a macro (institutional/organisational) and micro (individual) level. A lack of information, long length of time for the process and poor support avenues were macro factors impacting on the ability of registrants to cope with their experiences (theme 1). These macro factors led to feelings of powerlessness, vulnerability and threat of ruin for many registrants (theme 2). Suggested improvements (theme 3) included better psychological support (e.g. signposting or provision); proportional processes to the incident (e.g. mediation instead of hearings); and taking context into account. Conclusions Findings suggest that improvements to both the structure and conduct of the FTP process are warranted. Implementation of better signposting for support both during and after a FTP process may improve psychological wellbeing. There may also be value in considering alternative ways of organising the FTP process to enable greater consideration of and flexibility for registrants’ context and how they are investigated.

scholarly journals Using Theoretical Domains Framework for Exploring Appropriate Sitting Posture Determinants Among Office Workers: A Content Analysis Study

Health Scope ◽  
2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Parisa Hosseini-Koukamari ◽  
Mohtasham Ghaffari ◽  
Sedigheh Sadat Tavafian ◽  
Ali Ramezankhani
Keyword(s):  
Content Analysis ◽  
Theoretical Domains Framework ◽  
Office Workers ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Related Factors ◽  
Convenience Sample ◽  
Sitting Posture ◽  
Starting Point ◽  
Structured Interventions

Background: Sedentary occupations frequently expose employees to prolonged periods with poor posture, which has been considered as the cause of musculoskeletal disorder. Objectives: The study set out to identify the related factors of a taking healthy sitting posture in office workers. Methods: This qualitative study aimed to use the theoretical domains framework (TDF) to investigate perceived determinants to taking a proper sitting posture in office workers. Semi-structured interviews with 25 office workers according to purposive sampling was conducted with a convenience sample of university office workers in Iran. Recorded interviews were transcribed into MAXQDA version 10. Directed content analysis and framework analysis were used for drawing the 12 domains of the TDF. Results: Explored themes were mapped onto the TDF domains, including skills, knowledge, behavioral regulation, goals, environmental context and resources, social influences, beliefs about capability, intentions, emotion, beliefs about consequences, memory, and attention and reinforcement. Conclusions: This study is a theoretical starting point in making structured interventions to change improper sitting posture among office workers. Also, the identified factors provide organizational managers with a wide list of factors by which they can encourage their employees to use proper postures in the workplace, leading to a significant reduction in job absenteeism and insurance fees associated with health problems. In addition, this study enriches the literature by providing additional empirical evidence for the TDF theory.

scholarly journals PP14  Improving access to, and experience of, ambulance care for eastern european migrants: a paramedic interview study

2020 ◽  
Vol 37 (10) ◽  
pp. e8.1-e8
Author(s):  
Viet-Hai Phung ◽  
Zahid Asghar ◽  
Milika Matiti ◽  
Niro Siriwardena
Keyword(s):  
Service Providers ◽  
Ambulance Service ◽  
Eastern European ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Quality Healthcare ◽  
European Languages ◽  
East Midlands ◽  
The Uk ◽  
Key Terms

BackgroundThe UK has experienced significant immigration from Eastern Europe following European Union (EU) expansion in 2004. Lincolnshire is a predominantly rural county in the East Midlands region of the UK with a large Eastern European migrant population requiring healthcare, including urgent ambulance care. The Equality Act 2010 requires public bodies such as health services to provide access to high quality healthcare, while the Equality Delivery System seeks to ensure that NHS organisations comply with the legislation. This study aimed to explore the perceptions and experiences of ambulance staff attending Eastern European migrants in Lincolnshire.MethodsQualitative semi-structured interviews were conducted with 15 ambulance staff at locations across Lincolnshire. Purposive and maximum variation sampling ensured that participants were knowledgeable about Eastern European migrants’ use of ambulance care and covered a range of demographic characteristics. The data were analysed using framework analysis.ResultsDifficulty in accessing professional interpreters meant that some patients relied instead on family members. Some Eastern European migrants brought back foreign language medication, which ambulance staff could not understand. It was common for patients to not be registered with GPs because they were temporarily resident, did not understand how the UK healthcare system worked or preferred to go to their home country for treatment. By not registering with GPs, patients were sometimes transported to the Emergency Department for primary care conditions.ConclusionsThe practical recommendations for service delivery improvements may be valuable for service providers and could be incorporated into future protocols. These include: having a glossary of key terms in Eastern European languages; simple packs explaining how and when to use the ambulance service translated into different languages where necessary; encouraging patients to register with GPs; and face-to-face meetings where the ambulance service inform the Eastern European communities about how to use their services.

scholarly journals A school-commissioned model of speech and language therapy

2018 ◽  
Vol 34 (2) ◽  
pp. 141-153 ◽  
Author(s):  
Sarah White ◽  
Sarah Spencer
Keyword(s):  
Special Educational Needs ◽  
Speech And Language ◽  
Structured Interviews ◽  
Language Therapy ◽  
Framework Analysis ◽  
Speech And Language Therapy ◽  
Outcomes For Children ◽  
Communication Needs ◽  
Uk National Health Service ◽  
The Uk

Many speech and language therapy (SLT) services have limited capacity for providing school-based input. Some offer commissioned SLT input, to enhance the service provided by the UK National Health Service (NHS), giving schools the option to increase the amount and scope of SLT intervention. This two-tiered model of service provision is relatively new and has not been researched. This study investigated the experiences of schools who had commissioned input from the local SLT service, in terms of (1) describing how this was utilized and (2) exploring perceptions of its value. Semi-structured interviews were carried out with special educational needs co-ordinators (SENCos) from 11 schools and were thematically analysed using Framework Analysis. SENCos reported many positive aspects of the commissioned model, including better communication with Speech and Language Therapists (SLTs) and improved outcomes for children. SENCos felt that the numbers of children with speech, language and communication needs (SLCN) had reduced following commissioned input. Very few disadvantages of the model were identified. SLTs delivered a range of activities, including training staff and providing direct input for children. SENCos would recommend the service, and perceived the cost to be moderate. These data suggest that SENCos place a high value on SLT in schools, and welcome the opportunity to purchase additional input.

scholarly journals Transforming community nursing services in the UK: lessons from a participatory evaluation of the implementation of a new model of community nursing in East London

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X703385
Author(s):  
Mirza Lalani ◽  
Jane Fernandes ◽  
Richard Fradgley ◽  
Caroline Ogunsola ◽  
Martin Marshall
Keyword(s):  
The Netherlands ◽  
Patient Experience ◽  
Participant Observation ◽  
Community Nursing ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Frontline Staff ◽  
Team Members ◽  
Nursing Services ◽  
The Uk

BackgroundBuurtzorg, a model of community nursing conceived in the Netherlands, is widely cited as a promising and evidence-based approach to improving the delivery of integrated nursing and social care in community settings.AimThis study aimed to examine the transferability of some of the principles of the Buurtzorg model to community nursing in the UK NHS.MethodA community nursing model based on the Buurtzorg approach was piloted between June 2017 and August 2018 with a team of nurses co-located in a single general practice in the Borough of Tower Hamlets, East London. The initiative was evaluated using a qualitative approach within the participatory Researcher-in-Residence model. Participant observation of meetings and semi-structured interviews with team members, patients/carers, and other local stakeholders were undertaken. A thematic framework analysis of the data was carried out.ResultsPatient experience of the service was positive, in particular because of the better access, improved continuity of care and longer appointment times in comparison with traditional district nursing provision. However, certain aspects of the Buurtzorg model were difficult to put into practice in the NHS because of significant cultural, human resource, and regulatory differences between The Netherlands and the UK.ConclusionWhile many of the principles of the Buurtzorg model are applicable and transferable to the UK, in particular promoting independence among patients, improving patient experience, and empowering frontline staff, the successful embedding of these aims as normalised ways of working will require a significant cultural shift at all levels of the NHS.

scholarly journals It's possibly made us feel a little more alienated: How people from ethnic minority communities conceptualise COVID-19 and its influence on engagement with testing.

2021 ◽  
Author(s):  
Tushna F Vandrevala ◽  
Lailah Alidu ◽  
Jane Hendy ◽  
Shuja Shafi ◽  
Aftab Ala
Keyword(s):  
Ethnic Minority ◽  
Minority Groups ◽  
South Asians ◽  
Cultural Beliefs ◽  
Structured Interviews ◽  
Community Members ◽  
The Family ◽  
Testing Uptake ◽  
The Will ◽  
The Uk

Objectives:The cultural beliefs, practices and experiences of ethnic minority groups, alongside structural inequalities and the political economy play a critical, but overlooked role in health promotion. The current study aims to address this deficit, understanding how these groups conceptualise COVID–19, and how this influences engagement in testing, with the future aim of developing targeted communications to address the challenges of testing uptake. Method:Black (African and Caribbean) and South (Asian Indian, Pakistani and Bangladeshi) community members were purposefully recruited across the UK. Fifty seven semi–structured interviews were conducted and analysed using principles of Grounded Theory. Results:The findings illustrate that Black and South Asians conceptualise COVID–19 as a disease that makes them visible to others outside their community, in having more severe risk and suffering worst consequences, resulting in fear, stigmatisation and alienation. Views about COVID-19 were embedded in cultural beliefs, relating to culturally specific ideas around disease, such as ill-health being the will of God. Challenges brought about by the pandemic were conceptualised as one of many struggles, with the saliency of the virus contextualised against life experiences. These themes and others influenced engagement with COVID–19 testing. Testing was less about accessing timely and effective treatment for themselves, and more about acting to protect the family and community. Testing symbolised a loss of income, anxiety and isolation, accentuated by issues of mistrust of the system, and not being valued, or being treated unfairly. Conclusion:In tackling these challenges, we conclude that health communications should focus on counterbalancing the mistrust, alienation and stigmatisation that act as barriers to testing, with trust built using local credible sources.

Stakeholders’ views of UK nurse and pharmacist supplementary prescribing

2008 ◽  
Vol 13 (4) ◽  
pp. 215-221 ◽  
Author(s):  
Richard Cooper ◽  
Claire Anderson ◽  
Tony Avery ◽  
Paul Bissell ◽  
Louise Guillaume ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Access To Medicines ◽  
Structured Interviews ◽  
Implementation Barriers ◽  
Framework Analysis ◽  
Independent Prescribing ◽  
Supplementary Prescribing ◽  
Theory Versus ◽  
Barriers And Challenges ◽  
The Uk

Objectives: Supplementary prescribing (SP) by pharmacists and nurses in the UK represents a unique approach to improving patients’ access to medicines and better utilizing health care professionals’ skills. Study aims were to explore the views of stakeholders involved in SP policy, training and practice, focusing upon issues such as SP benefits, facilitators, challenges, safety and costs, thereby informing future practice and policy. Method: Qualitative, semi-structured interviews were conducted with 43 purposively sampled UK stakeholders, including pharmacist and nurse supplementary prescribers, doctors, patient groups representatives, academics and policy developers. Analysis of transcribed interviews was undertaken using a process of constant comparison and framework analysis, with coding of emergent themes. Results: Stakeholders generally viewed SP positively and perceived benefits in terms of improved access to medicines and fewer delays, along with a range of facilitators and barriers to the implementation of this form of non-medical prescribing. Stakeholders’ views on the economic impact of SP varied, but safety concerns were not considered significant. Future challenges and implications for policy included SP being potentially superseded by independent nurse and pharmacist prescribing, and the need to improve awareness of SP. Several potential tensions emerged including nurses’ versus pharmacists’ existing skills and training needs, supplementary versus independent prescribing, SP theory versus practice and prescribers versus non-prescribing peers. Conclusion: SP appeared to be broadly welcomed by stakeholders and was perceived to offer patient benefits. Several years after its introduction in the UK, stakeholders still perceived several implementation barriers and challenges and these, together with various tensions identified, might affect the success of supplementary and other forms of non-medical prescribing.

PP10 ‘The ones that don’t say’; challenges in managers identifying potentially traumatised ambulance staff

2019 ◽  
Vol 36 (1) ◽  
pp. e4.3-e5
Author(s):  
Joshua Miller ◽  
Keyword(s):  
Emergency Services ◽  
Small Sample Size ◽  
Small Sample ◽  
Ambulance Service ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Face To Face ◽  
Ethical Approval ◽  
Changing Roles ◽  
The Uk

BackgroundStress and psychological illness among emergency services personnel is reported at higher prevalence than the general population, with one UK ambulance service ascribing it to 15% of staff sickness. Research in this field has focused on ambulance crew views, while manager experiences are limited to EMS systems outside the UK. This qualitative study explored how UK ambulance service managers try to identify staff at risk of becoming traumatised by their work.MethodsFace-to-face, semi-structured interviews were audio-recorded with a purposive sample of six paramedic managers working for an NHS ambulance service. The author transcribed these interviews and analysed them using framework analysis. Ethical approval and informed consent were obtained.ResultsAll participants claimed to see the identification of potentially traumatised staff as a vital part of their role. They outlined the use of case factors such as visceral elements and child involvement, and staff factors such as home life and resilience. Interviewees talked about their changing roles as managers, peers, parent figures, clinicians, and adjudicators.Factors found as enabling the identification of potentially traumatised staff included: knowing the staff, formalising handover to other managers, and manager presence – both at incidents and on station. Disabling factors included: atypical cases, hierarchical culture, and isolated remote staff. All participants reported concerns about staff being reluctant to report distress.ConclusionsLimitations of this study include the small sample size, possible response bias, and respondents conforming to social norms, as their practice was self-reported, rather than observed. Manager presence was highlighted as very important by participants; services should consider this in their structures and policies. Further studies could examine staff reluctance to report psychological distress, as well as staff resilience, which participants saw as beneficial, yet difficult to define or predict.

scholarly journals Community Pharmacists' Roles in Optimising Opioids Therapy for Chronic Non-malignant Pain Patients: a Qualitative Study.

2021 ◽  
Author(s):  
Aziza Ali Alenezi ◽  
Vibhu Paudyal ◽  
Asma Yahyouche
Keyword(s):  
Theoretical Domains Framework ◽  
Community Pharmacists ◽  
Opioid Therapy ◽  
Personal Factors ◽  
Structured Interviews ◽  
Professional Networks ◽  
Policy Makers ◽  
Delivery Services ◽  
Systemic Constraints ◽  
The Uk

Abstract Background: Opioids are currently widely used to manage chronic non-malignant pain, but there is a growing concern about harm resulting from opioid misuse, and the need for medicine optimisation, in which pharmacists could potentially play a key role.Objective: This study seeks to identify challenges to community pharmacists’ role in optimizing prescribed opioids for Chronic Non-Malignant Pain (CNMP).Setting: Community pharmacies in the UK.Method: Semi-structured interviews based on the Theoretical Domains Framework were conducted with 20 community pharmacists recruited through professional networks and analysed thematically.Result: Pharmacists perceive themselves as guardians of patients’ welfare and aspire to contribute to prescribed opioid optimisation. However, they are challenged by the lack of relevant training, inadequate time and resources, infrastructural and systemic constraints (such as repeat prescribing and prescription delivery services, lack of access to medical records and information about diagnosis), personal factors, including communication with doctors, and relationship with patients.Conclusion: The role of community pharmacists in optimising chronic opioid therapy is neither well-defined nor implemented in the UK. Utilisation of their potential skills and knowledge in this area requires an appropriate training curriculum, tackling the infrastructural and systemic constraints, support and resources to facilitate pharmacists’ engagement in patient monitoring and education. The findings in this study can contribute to inform policy makers with potentials to enhance pharmacists’ role in opioids therapy optimisation and, hence, ensure patients' safety when using prescribed opioids.

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