A qualitative exploration of the feasibility of incorporating depression apps into integrated primary care clinics

2021 ◽  
Author(s):  
Danae Dinkel ◽  
Jennifer Harsh Caspari ◽  
Louis Fok ◽  
Maxine Notice ◽  
David J Johnson ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Management ◽  
Mobile Apps ◽  
Healthcare Providers ◽  
Cost Effective ◽  
Integrated Primary Care ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Potential Cost ◽  
Share Data

Abstract The use of mobile applications or “apps” is beginning to be identified as a potential cost-effective tool for treating depression. While the use of mobile apps for health management appears promising, little is known on how to incorporate these tools into integrated primary care settings—especially from the viewpoints of patients and the clinic personnel. The purpose of this study was to explore patient- and clinic-level perceptions of the use of depression self-management apps within an integrated primary care setting. Patients (n = 17), healthcare providers, and staff (n = 15) completed focus groups or semi-structured interviews in-person or via Zoom between January and July 2020. Participants were asked about barriers and facilitators to app use, how to best integrate it into care, and reviewed pre-selected mental health apps. Data were analyzed using a directed content analysis approach. From a patient perspective, features within the app such as notifications, the provision of information, easy navigation, and a chat/support function as well as an ability to share data with their doctor were desirable. Providers and staff identified integration of app data into electronic health records to be able to share data with patients and the healthcare team as well as clear evidence of effectiveness as factors that could facilitate implementation. All participants who reviewed apps identified at least one of them they would be interested in continuing to use. Overall, patients, healthcare providers, and staff believed depression apps could be beneficial for both patients and the clinic.

scholarly journals Self-fill oxygen technology: benefits for patients, healthcare providers and the environment

Breathe ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Phyllis Murphie ◽  
Nick Hex ◽  
Jo Setters ◽  
Stuart Little
Keyword(s):  
Positive Impact ◽  
Healthcare Providers ◽  
Cost Savings ◽  
Cost Effective ◽  
Evidence Base ◽  
Environmental Benefits ◽  
List Type ◽  
Potential Cost ◽  
Unlimited Supply ◽  
Technology Benefits

“Non-delivery” home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers.Educational aimsProvide update for oxygen prescribers on options for home oxygen provision.Provide update on the evidence base for available self-fill oxygen technologies.Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems.

scholarly journals Operational failures and how they influence the work of GPs: a qualitative study in primary care

2020 ◽  
Vol 70 (700) ◽  
pp. e825-e832
Author(s):  
Carol Sinnott ◽  
Alexandros Georgiadis ◽  
Mary Dixon-Woods
Keyword(s):  
Primary Care ◽  
Work Environment ◽  
Information Transfer ◽  
Healthcare Providers ◽  
Comparison Method ◽  
Care Work ◽  
System Level ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Operational Failures

BackgroundOperational failures, defined as inadequacies or errors in the information, supplies, or equipment needed for patient care, are known to be highly consequential in hospital environments. Despite their likely relevance for GPs’ experiences of work, they remain under-explored in primary care.AimTo identify operational failures in the primary care work environment and to examine how they influence GPs’ work.Design and settingQualitative interview study in the East of England.MethodSemi-structured interviews were conducted with GPs (n = 21). Data analysis was based on the constant comparison method.ResultsGPs reported a large burden of operational failures, many of them related to information transfer with external healthcare providers, practice technology, and organisation of work within practices. Faced with operational failures, GPs undertook ‘compensatory labour’ to fulfil their duties of coordinating and safeguarding patients’ care. Dealing with operational failures imposed significant additional strain in the context of already stretched daily schedules, but this work remained largely invisible. In part, this was because GPs acted to fix problems in the here-and-now rather than referring them to source, and they characteristically did not report operational failures at system level. They also identified challenges in making process improvements at practice level, including medicolegal uncertainties about delegation.ConclusionOperational failures in primary care matter for GPs and their experience of work. Compensatory labour is burdensome with an unintended consequence of rendering these failures largely invisible. Recognition of the significance of operational failures should stimulate efforts to make the primary care work environment more attractive.

scholarly journals Understanding patient outcomes to develop a multimorbidity adapted patient-reported outcomes measure: a qualitative description of patient and provider perspectives.

2021 ◽  
Author(s):  
Maxime Sasseville ◽  
Maud-Christine Chouinard ◽  
Martin Fortin
Keyword(s):  
Health Management ◽  
Healthcare Providers ◽  
Psychosocial Health ◽  
Qualitative Description ◽  
Valuable Insight ◽  
Structured Interviews ◽  
Respiratory Therapists ◽  
Wide Range ◽  
Patient Reported ◽  
Data Saturation

Abstract Background: Multimorbidity is a complex health situation that requires interventions tailored to patient needs; the outcomes of such interventions are difficult to evaluate. The purpose of this study was to describe the outcomes of patient-centred interventions for people with multimorbidity from the patients’ and healthcare providers’ perspectives.Methods: This study followed a qualitative descriptive design. Nine patients with multimorbidity and 18 healthcare professionals (nurses, general practitioners, nutritionists, and physical and respiratory therapists), participating in a multimorbidity-adapted intervention in primary care were recruited. Data were collected using semi-structured interviews with 12 open-ended questions. Triangulation of disciplines among interviewers, research team debriefing, data saturation assessment and iterative data collection and analysis ensured a rigorous research process.Results: Outcome constructs described by participants covered a wide range of themes and were grouped into seven outcome domains: Health Management, Physical Health, Functional Status, Psychosocial Health, Health-related Behaviours, General Health and Health Services. The description of constructs by stakeholders provides valuable insight on how outcomes are experienced and worded by patients.Conclusion: Participants described a wide range of outcome constructs, which were relevant to and observable by patients and were in line with the clinical reality. The description provides a portrait of multimorbidity-adapted intervention outcomes that are significant for the selection and development of clinical research outcome measures.

Presenting primary care teams to the public: a qualitative exploration of general practice websites

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697049
Author(s):  
Helen Anderson ◽  
Joy Adamson ◽  
Yvonne Birks
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Nurse Practitioners ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Patient Choice ◽  
Healthcare Team ◽  
Sufficient Information ◽  
The Public ◽  
Professional Groups

BackgroundIncreasing demand and expanded primary care provision, coupled with a reduced GP workforce present challenges for primary care. New workforce models aim to reduce general practitioner workload by directing patients to a variety of alternative clinicians. Concurrently, the principle of patient choice in relation to healthcare providers has gained prominence. It is, therefore, necessary to provide patients with sufficient information to negotiate access to appropriate primary healthcare professionals.AimTo explore how practice websites present three exemplar healthcare professional groups (GPs, advanced nurse practitioners [ANPs], and practice nurses [PNs]) to patients and the implications for informing appropriate consultation choices.MethodQualitative thematic analysis of a sample of general practice websites. 79 accessible websites from a district in England were thematically analysed in relation to professional representation and signposting of the three identified professional groups.ResultsInformation about each group was incomplete, inconsistent and sometimes inaccurate across the majority of general practice websites. There was a lack of coherence and strategy in representation and direction of website users towards appropriate primary healthcare practitioners.ConclusionLimited and unclear representation of professional groups on general practice websites may have implications for the direction of patients to the wider clinical healthcare team. Patients may not have appropriate information to make choices about consulting with different healthcare practitioners. This constitutes a missed opportunity to signpost patients to appropriate clinicians and enhance understanding of different professional roles. Potential for websites to disseminate information to the public is not being maximised.

Roles, Attitudes, and Training Needs of Behavioral Health Clinicians in Integrated Primary Care

2015 ◽  
Vol 37 (2) ◽  
pp. 175-188 ◽  
Author(s):  
Bethany Glueck
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Training Needs ◽  
Integrated Primary Care ◽  
Mental Health Providers ◽  
Health Providers ◽  
Structured Interviews ◽  
And Training ◽  
Health Clinician

As integrated primary care (IPC) evolves, so does the new role of the behavioral health clinician (BHC). At present, mental health providers from various specialties are working as BHCs and adapting their training and skills to work as part of the medical team. The purpose of this qualitative study is to explore the experiences of BHCs who work in IPC so as to better understand their roles, attitudes, and training needs. The themes that emerged from semi-structured interviews suggest that the roles of a BHC are multifaceted and rooted in a holistic mind-body approach. Participants supported the need for additional training in graduate programs and internships for integrated care. The results informed a conceptual model of BHCs working in IPC.

scholarly journals Assessment of eHealth behaviors in national surveys: a systematic review of instruments

2018 ◽  
Vol 25 (12) ◽  
pp. 1675-1684
Author(s):  
Y Alicia Hong ◽  
Jinmyoung Cho
Keyword(s):  
Systematic Review ◽  
Health Information ◽  
Technology Development ◽  
Health Management ◽  
Mobile Apps ◽  
Healthcare Providers ◽  
Standardized Measures ◽  
National Surveys ◽  
Future Assessment ◽  
Survey Instruments

Abstract Objectives To conduct a systematic review of instruments used in national surveys of eHealth behaviors. Materials and Methods Major databases and websites of federal agencies were searched with pre-determined inclusion and exclusion criteria. National surveys with measures of eHealth behaviors were identified. The survey instruments were retrieved, and their measures of eHealth behaviors were categorized and critiqued. Results We located 13 national surveys containing eHealth behavior assessment questions that were administered from 1999 to 2017. Most surveys were conducted annually or biennially and typically covered topics on searching health information, obtaining social support, communicating with healthcare providers, and buying medicine online; recent surveys included items related to personal health management and use of mobile tools. There were redundant measures of searching health information online but insufficient measures of use of mobile apps, social media, and wearable devices. Discussion Future assessment of eHealth behaviors should reflect the growing varieties of behaviors enabled by technology development and reflect the current mobile ownership patterns in diverse social groups. More studies also need to include longitudinal surveys, integrative and standardized measures, and better designs to allow data linkage and comparison. Conclusion The existing survey instruments covering eHealth behaviors are rather limited compared to fast technological progress. We call for more national surveys on eHealth behaviors that are more responsive to technology development; we also advocate for more analysis and dissemination of existing national data on eHealth behaviors for evidence-based health policies.

Implementing International Board-Certified Lactation Consultants Intervention into Routine Care: Barriers and Recommendations

2012 ◽  
Vol 3 (4) ◽  
pp. 131-137 ◽  
Author(s):  
Scott Hartman ◽  
Josephine Barnett ◽  
Karen A. Bonuck
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Healthcare Providers ◽  
Routine Care ◽  
System Level ◽  
Healthcare Team ◽  
Call To Action ◽  
Department Of Health ◽  
Lactation Consultants ◽  
Breastfeeding Education

The Surgeon General’s 2011 Call to Action on Breastfeeding (U. S. Department of Health and Human Services, 2011) encourages greater use of International Board-Certified Lactation Consultants (IBCLCs) to increase breastfeeding rates. The objective was to examine IBCLCs’ experiences as part of a routine, primary-care based team serving low income, minority populations, and to elicit their recommendations for implementing IBCLC support as routine in prenatal care. Using a predesigned interview guide, a debriefing session was held with three IBCLCs who served as interventionists in two NIH-funded randomized controlled trials (RCTs) of breastfeeding promotion interventions. Themes were identified through coding and analysis of the session transcript. The results indicated that healthcare provider (HCP) support for breastfeeding was undermined by inadequate education and experience, often resulting in support "in name only." In addition, IBCLCs rapport and expertise—with both women and the healthcare team—helped overcome individual- and system-level barriers to breastfeeding. IBCLCs’ acceptance and integration into the primary-care team validated their work and increased their effectiveness. IBCLCs comments suggest that mothers cannot rely solely upon their healthcare providers for breastfeeding education and support. IBCLCs integrated into routine antenatal and postpartum care are pivotal to encouraging and reinforcing a woman’s choice to breastfeed through education, as well as emotional and skill-based support.

scholarly journals Patients’ accounts of living with and managing inflammatory bowel disease in rural Southern New Zealand: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041789
Author(s):  
Lauralie Richard ◽  
Geoff Noller ◽  
Sarah Derrett ◽  
Trudy Sullivan ◽  
Fiona Doolan-Noble ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
New Zealand ◽  
Bowel Disease ◽  
Healthcare Providers ◽  
Strong Relationship ◽  
Healthcare Team ◽  
Specialist Care ◽  
Structured Interviews ◽  
Urban Centre ◽  
Inflammatory Bowel

ObjectiveTo explore how adults living with inflammatory bowel disease (IBD) in rural New Zealand manage their condition and engage with healthcare providers.DesignQualitative exploratory design with semi-structured interviews analysed thematically.Setting and participantsInterviews were conducted with 18 people living with IBD in the Otago region of the South Island.ResultsFive important constructs were identified: (1) journey to confirming and accepting diagnosis; (2) importance of the relationship with the healthcare team; (3) support from others; (4) learning how to manage IBD and (5) care at a distance—experiences of rurality. Pathways to confirming diagnosis involved two contrasting journeys: a long and slow process where diagnosis remained unclear for a prolonged period, and a more acute process where diagnosis typically came as a shock. Central to the acceptance process was acknowledging the chronicity of the condition, which involved feelings of grief but also the fear of judgement and stigma. Building a strong relationship with the specialist was central to medical management, particularly in the initial stage following diagnosis. Support from others was critical, enabling participants to progress through acceptance of the disease and developing confidence in its everyday management. Participants shared different strategies on how to manage IBD, describing a ‘trial and error’ process of ‘finding what is right’ at different stages of the condition. Managing IBD rurally involved challenges of access to specialist care, with perceptions of delayed referrals and concerns about disparities in specialist access compared with urban counterparts. Rural living also had financial implications—cost of time and cost of mobilising resources for long travels to the urban centre for treatments.ConclusionsFindings from this study provide a rich understanding of the complex health journeys of people living with IBD and the challenges of managing the condition rurally.

scholarly journals Presenting the primary care team to the public: a qualitative exploration of general practice websites

2018 ◽  
Vol 68 (668) ◽  
pp. e178-e186 ◽  
Author(s):  
Helen Anderson ◽  
Joy Adamson ◽  
Yvonne Birks
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Nurse Practitioners ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Patient Choice ◽  
Healthcare Team ◽  
Sufficient Information ◽  
The Public ◽  
Professional Groups

BackgroundIncreasing demand and expanded primary care provision, coupled with a reduced GP workforce, present challenges for primary care. New workforce models aim to reduce GP workload by directing patients to a variety of alternative clinicians. Concurrently, the principle of patient choice in relation to healthcare providers has gained prominence. It is, therefore, necessary to provide patients with sufficient information to negotiate access to appropriate primary healthcare professionals.AimTo explore how practice websites present three exemplar healthcare professional groups (GPs, advanced nurse practitioners [ANPs], and practice nurses [PNs]) to patients and the implications for informing appropriate consultation choices.Design and settingQualitative thematic analysis of a sample of general practice websites.MethodIn total, 79 accessible websites from a metropolitan district in the north of England were thematically analysed in relation to professional representation and signposting of the three identified professional groups.ResultsInformation about each group was incomplete, inconsistent, and sometimes inaccurate across the majority of general practice websites. There was a lack of coherence and strategy in representation and direction of website users towards appropriate primary healthcare practitioners.ConclusionLimited and unclear representation of professional groups on general practice websites may have implications for the direction of patients to the wider clinical healthcare team. Patients may not have appropriate information to make choices about consulting with different healthcare practitioners. This constitutes a missed opportunity to signpost patients to appropriate clinicians and enhance understanding of different professional roles. The potential for websites to disseminate information to the public is not being maximised.

Survival in the gap: experiences of health management among people at high risk of stroke in China: A qualitative study (Preprint)

2019 ◽  
Author(s):  
Lina Guo ◽  
Lin Wang ◽  
Jo Booth ◽  
Yanjin Liu ◽  
Yiru Zhu ◽  
...  
Keyword(s):  
Social Support ◽  
High Risk ◽  
Family Income ◽  
Health Management ◽  
Healthcare Providers ◽  
Service Development ◽  
System Reform ◽  
Management Service ◽  
Structured Interviews ◽  
Step Method

BACKGROUND Effective health management of people at high risk of stroke is challenging. OBJECTIVE To identify and explore the experiences of health management among people at high risk of stroke in order to inform ideas for health management service development for this population. METHODS Semi-structured interviews were conducted with 31stroke people at high risk of stroke. The interviews were collated and analyzed using Colaizzi’s 7-step method. RESULTS The experiences of health management in people at high risk of stroke were described as ‘Survival in the gap’. Themes identified limited knowledge of health management, lack of confidence in health management and poor adherence with health management. The value of health management experience was highlighted and included: becoming active learners, promoting social interaction and enhancing self-health management. Health management was seen to be sensitive to multiple influencing factors including: The severity and complexity of diseases, family income and social support. CONCLUSIONS Health management of people at high risk of stroke is challenging and they ‘survive in the gap’. They learn to manage their ongoing health based mainly on their own experiences. Government and healthcare providers should pay attention to the situation for this special population and be devoted to health system reform, financial support and social support to manage the condition in the longer term.

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