Using a Theoretical Framework in a Qualitative Metasummary About Fatigue Adaptation After Stroke

Abstract We describe how we used a theoretical framework, Adaptive Leadership Framework for Chronic Illness (ALFCI), to complete a qualitative metasummary in a scoping review of 26 articles. We abstracted and grouped qualitative findings relevant to fatigue adaptation in stroke survivors using constructs of the ALFCI as 4 main themes: 1) adaptive challenges, 2) adaptive work, 3) adaptive leadership and collaborative work, and 4) technical challenges and technical work. We found that stroke survivors encountered different aspects of challenges (e.g., physical dysfunction vs. mental distress) and utilized various adaptive work (e.g., conserving energy vs. restructuring normality) as well as what stroke survivors needed from healthcare professionals (e.g., basic knowledge about fatigue). The ALFCI provides a useful lens to synthesize qualitative findings regarding fatigue adaptation and therefore researchers can target different problems that need to be tackled for stroke survivors, care partners, or healthcare professionals, respectively.

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Abstract P115: Fatigue Adaptation Among Stroke Survivors: A Sc oping Review

Stroke ◽

10.1161/str.52.suppl_1.p115 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Chiao-Hsin Teng ◽

Ratchanok Phonyiam ◽

Leslie L Davis ◽

Ruth A Anderson

Keyword(s):

Mixed Method ◽

Adaptive Leadership ◽

Conservation Strategies ◽

Stroke Survivors ◽

Daily Routines ◽

Care Partners ◽

Leadership Framework ◽

Adaptive Challenges ◽

Physical Functions ◽

Adaptive Work

Introduction: No study has systematically examined stroke survivors’ challenges with fatigue. We use the Adaptive Leadership Framework for Chronic Illness (ALFCI) to synthesize what survivors’ challenges are with fatigue and how they respond or collaborate with others to achieve poststroke fatigue adaptation. Methods: We searched PubMed, CINAHL, Embase, and PsycInfo using PRISMA-ScR guidelines, gathering studies between 2012 and 2020. Qualitative studies or qualitative findings in mixed-method studies were included if they described stroke survivors’ (cerebral infarction, TIA, and brain hemorrhage) experiences with fatigue and/or care partners’ experiences to help survivors adapt to fatigue. We excluded studies which were not full-text English and did not report empirical data (e.g., literature review or editorial). We used interpretive synthesis to analyze the published qualitative data. Results: Of 714 papers identified, we retained 25 papers (22 qualitative and 3 mixed-method studies). Using ALFCI to synthesize data, we found that survivors with fatigue had many types of adaptive challenges. Fatigue made them less productive and it affected their cognitive, language, and physical functions, as well as sleeping patterns and social activities. To respond to these challenges, survivors did adaptive work such as changing mindset, using energy-conservation strategies, restructuring routines, and exercising. Care partners, health professionals, and others showed leadership by helping survivors adapt to fatigue by giving information about fatigue, assessing survivors’ fatigue levels, reducing survivors’ workload, and collaboratively negotiating for new daily routines. However, some studies indicated survivors needed fatigue education from professionals. No study interviewed care partners to examine their experiences helping survivors adapt to fatigue. Conclusions: Survivors had many types of challenges and responses towards fatigue. Care partners and others showed leadership by facilitating survivors with fatigue adaptation. Future studies can identify targets for interventions to address poor adaptation to fatigue and also explore care partners’ perspectives.

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Adaptive Challenges and Family Support: Patient Self-Management during Treatment for Chronic Hepatitis C

Nursing Science Quarterly ◽

10.1177/08943184211031602 ◽

2021 ◽

Vol 34 (4) ◽

pp. 405-412

Author(s):

Donald E. Bailey ◽

Andrew J. Muir ◽

Michael P. Cary ◽

Natalie Ammarell ◽

Sarah Seaver ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Medical Records ◽

Family Intervention ◽

Adaptive Leadership ◽

Self Management ◽

Leadership Framework ◽

Adaptive Challenges ◽

Adaptive Work

The authors describe a family’s adaptive challenges and adaptive work during a family member’s treatment for Chronic Hepatitis C. We audiorecorded index and final clinical visits and interviewed participants (patients and providers) following the visits. We interviewed by telephone and reviewed medical records over the course of treatment. Transcripts were analyzed using directed content analysis. Three themes were identified: family adaptive challenges, patient-described aspects of family members’ adaptive challenges, and family adaptive work. There were four subthemes related to family adaptive work. The adaptive leadership framework for chronic illness provided direction for future family intervention.

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Adaptive Challenges, Adaptive Work, and Adaptive Leadership Among Women Living With HIV in the Southern United States

Journal of the Association of Nurses in AIDS Care ◽

10.1097/jnc.0000000000000288 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Donald E. Bailey ◽

Courtney Caiola ◽

Adaora A. Adimora ◽

Catalina Ramirez ◽

Lauren Holt ◽

...

Keyword(s):

United States ◽

Adaptive Leadership ◽

Southern United States ◽

Women Living With Hiv ◽

Adaptive Challenges ◽

Adaptive Work ◽

Living With Hiv

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Adaptive leadership of doctors during COVID-19

Leadership in Health Services ◽

10.1108/lhs-08-2021-0073 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Sayoni Santra ◽

Priya Alat

Keyword(s):

Information Overload ◽

Leadership Competencies ◽

Adaptive Leadership ◽

Structured Interviews ◽

Content Type ◽

Competency Frameworks ◽

Adaptive Challenges ◽

Organizational Linkages ◽

Adaptive Work ◽

Fourth Theme

Purpose This study aims to examine the adaptive leadership of doctors during COVID-19 to understand the leadership competencies required for adaptive events. Design/methodology/approach Phenomenology-based qualitative design was used. Data were collected from six doctors from the state of Kerala, India using semi-structured interviews. Findings Five themes were identified. The first theme, core leadership shows that doctors perceive leaders as educators, learners and social beings. The second theme, adaptive challenges, describes the ambiguous pandemic-related challenges that doctors are facing including, unusual occupational demands, information overload, sociocultural issues and personal intricacies. The third theme reflects that for doctors, adaptive work during the pandemic included – new learning to address unique issues, changing perspectives and establishing and maintaining a safe and engaging workplace environment. The fourth theme describes the adaptive leadership competencies such as regulating distress, providing direction, maintaining disciplined action, fostering collaboration, empowering, understanding organizational linkages, strategic vision and communication skills. The fifth theme elucidates the lacunae in leadership training as perceived by the doctors. Research limitations/implications The findings can help in developing and enhancing competency frameworks for doctors’ adaptive leadership. Originality/value This is one of the earliest studies to systematically examine components of adaptive leadership for doctors during COVID-19 and identify associated competencies.

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Patients perspectives on drug shortages in six European hospital settings – a cross sectional study

BMC Health Services Research ◽

10.1186/s12913-021-06721-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Darija Kuruc Poje ◽

Domagoj Kifer ◽

Isabelle Huys ◽

Joao Miranda ◽

Helena Jenzer ◽

...

Keyword(s):

Management Practices ◽

Healthcare Professionals ◽

Demographic Data ◽

General Information ◽

Basic Knowledge ◽

Drug Shortage ◽

Cross Sectional ◽

Drug Shortages ◽

Good Communication ◽

Information Preferences

Abstract Background It is known that drug shortages represent a major challenge for all stakeholders involved in the process, but there is little evidence regarding insights into patients′ awareness and perspectives. This study aimed to investigate the patients-perceived drug shortages experience and their view on outcomes in different European hospital settings. Furthermore, we wanted to explore information preferences on drug shortages. Methods A retrospective, cross sectional, a mixed method study was conducted in six European hospital settings. One hospital (H) from each of this country agreed to participate: Bosnia and Herzegovina (H-BiH), Croatia (H-CR), Germany (H-GE), Greece (H-GR), Serbia (H-SE) and Poland (H-PO). Recruitment and data collection was conducted over 27 months from November 2017 until January 2020. Overall, we surveyed 607 patients which completed paper-based questionnaire. Questions related to: general information (demographic data), basic knowledge on drug shortages, drug shortages experienced during hospitalization and information preferences on drug shortage. Differences between hospital settings were analyzed using Chi-squared test or Fisher’s exact test. For more complex contingency tables, Monte Carlo simulations (N = 2000) were applied for Fisher’s test. Post-hoc hospital-wise analyses were performed using Fisher’s exact tests. False discovery rate was controlled using the Bonferroni method. Analyses were performed using R: a language and environment for statistical computing (v 3.6.3). Results 6 % of patients reported experiences with drug shortages while hospitalized which led to a deterioration of their health. The majority of affected patients were hospitalized at hematology and/or oncology wards in H-BiH, H-PO and H-GE. H-BiH had the highest number of affected patients (18.1 %, N = 19/105, p < 0.001) while the fewest patients were in H-SE (1 %, N = 1/100, p = 0.001). In addition, 82.5 %, (N = 501/607) of respondents wanted to be informed of alternative treatment options if there was a drug shortage without a generic substitute available. Majority of these patients (66.4 %, N = 386/501) prefer to be informed by a healthcare professional. Conclusions Although drug shortages led to serious medical consequences, our findings show that most of the patients did not perceive shortages as a problem. One possible interpretation is that good hospital management practices by healthcare professionals helped to mitigate the perceived impact of shortages. Our study highlights the importance of a good communication especially between patients and healthcare professionals in whom our patients have the greatest trust.

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Focus groups to explore healthcare professionals’ experiences of care coordination: towards a theoretical framework for the study of care coordination

BMC Family Practice ◽

10.1186/s12875-014-0177-6 ◽

2014 ◽

Vol 15 (1) ◽

Cited By ~ 11

Author(s):

Sabine Van Houdt ◽

Walter Sermeus ◽

Kris Vanhaecht ◽

Jan De Lepeleire

Keyword(s):

Focus Groups ◽

Care Coordination ◽

Healthcare Professionals ◽

Theoretical Framework

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Applied Competences for Students by Using M-Learning Devices in Higher Education

Handbook of Research on Mobile Devices and Applications in Higher Education Settings - Advances in Mobile and Distance Learning ◽

10.4018/978-1-5225-0256-2.ch019 ◽

2016 ◽

pp. 453-476

Author(s):

José-Alberto Herrera-Bernal ◽

Darinka del Carmen Ramírez-Hernández ◽

María-Soledad Ramírez-Montoya

Keyword(s):

Higher Education ◽

Collaborative Work ◽

Research Question ◽

Basic Knowledge ◽

Learning Technology ◽

Learning Tools ◽

Online Distance Education ◽

Management Evaluation ◽

Self Study ◽

Online Distance

The purpose of this chapter is to present a case study for evaluating the competences (knowledge, skills, and attitudes) applied by students in Higher Education by using m-learning devices in a course taught in an online distance education. The research question was: Which skills do the students need to learn through m-learning devices? Two variables used in this study were: m-learning and learning technology skills. The results shows that m-learning becomes an extension, addition and/or evolution of online studying and that the student requires a set of basic knowledge and skills to handle cell phones and iPods as learning tools. Students also develop skills in computing, communication, productivity, relationships, leadership, self-study while being involved in a study mode such as mobile learning. Students also require competences such as self-management, evaluation and selection of information, creativity, communication and collaborative work.

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The role of single pill combination therapy in the prevention of ischaemic stroke

Scottish Medical Journal ◽

10.1177/0036933019876155 ◽

2019 ◽

Vol 64 (4) ◽

pp. 126-132

Author(s):

Wan Y Ho ◽

Azmil H Abdul-Rahim ◽

Jesse Dawson ◽

Alan C Cameron

Keyword(s):

Combination Therapy ◽

Clinical Outcomes ◽

Stroke Prevention ◽

Healthcare Professionals ◽

Evidence Base ◽

Stroke Survivors ◽

Perceived Benefit ◽

Single Pill ◽

Individualised Care

Background and aims The role of single pill combination therapy for stroke prevention remains to be established. We explored the perspectives of stroke survivors and healthcare professionals on single pill combination therapy for stroke prevention. Methods We conducted focus groups involving stroke survivors and healthcare professionals. Results We recruited six stroke survivors: four (67%) were female and mean age was 70 ± 12 years; and eight healthcare professionals (three Stroke Consultants, two Nurse Specialists, three General Practitioners). Improved adherence is the main perceived benefit of single pill combination therapy, although concerns exist surrounding less individualised care, unsuitability for use in the acute setting, reduced ability to titrate doses and difficulty identifying the cause of side effects. The clinical stability of patients, alongside single pill combination therapy efficacy, cost, side effect profile and evidence base for impact on risk factors and clinical outcomes are key factors influencing acceptability. Stroke survivors and healthcare professionals feel single pill combination therapy is most suitable for stable patients, although there is no evidence base for its use in this context. Conclusion Stroke healthcare professionals and stroke survivors are most amenable to using single pill combination therapy for stable patients, although its role in this context should be evaluated in studies with risk factor targets and clinical outcomes as endpoints.

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