The Quality of Written Comments on Professional Behaviors in a Developmental Multisource Feedback Program

BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (Hb A1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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Hermeneutic comprehensions on female vulnerabilities belonging to the collective of lesbians, bisexuals, and transexuals

Revista Gaúcha de Enfermagem ◽

10.1590/1983-1447.2021.20200133 ◽

2021 ◽

Vol 42 ◽

Author(s):

Myllena Ferreira Peixoto ◽

Vander Monteiro da Conceição ◽

Silvio Eder Dias da Silva ◽

Manoel Antônio dos Santos ◽

Lucila Castanheira Nascimento ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

Qualitative Research ◽

Health Professionals ◽

Professional Training ◽

Health Unit ◽

Professional Behaviors ◽

The Feminine ◽

Specific Care

ABSTRACT Objective To reveal the comprehension of women and health professionals about the feminine vulnerability belonging to the collective of lesbians, bisexuals, and transsexuals’ women. Method Qualitative research, carried out from October 2018 to March 2019, in a Basic Health Unit located in Marabá - Pará, Brazil, using the hermeneutic-dialectic circle and inductive hermeneutic analysis. Five lesbians, bisexuals, and transsexuals’ women and five health professionals participated, through interviews. Results Health care for women, as described by the participants, promoted social and programmatic vulnerabilities structured by taboos and preconception, which endorsed exclusive professional behaviors in the provision of specific care, which consequently amplified risks and threatened the quality of life of this population. Conclusion The dissemination of this evidence is configured as an indicator to support future decisions regarding priorities, application of resources and professional training in the care of lesbians, bisexuals and transsexuals’ women.

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Advancing Our Understanding of Narrative Comments Generated by Direct Observation Tools: Lessons From the Psychopharmacotherapy-Structured Clinical Observation

Journal of Graduate Medical Education ◽

10.4300/jgme-d-19-00207.1 ◽

2019 ◽

Vol 11 (5) ◽

pp. 570-579 ◽

Cited By ~ 5

Author(s):

John Q. Young ◽

Rebekah Sugarman ◽

Eric Holmboe ◽

Patricia S. O'Sullivan

Keyword(s):

Direct Observation ◽

Clinical Observation ◽

High Quality ◽

Written Comments ◽

Checklist Score ◽

Observation Tools ◽

Assess Quality ◽

The Relationship ◽

Narrative Comments

ABSTRACT Background While prior research has focused on the validity of quantitative ratings generated by direct observation tools, much less is known about the written comments. Objective This study examines the quality of written comments and their relationship with checklist scores generated by a direct observation tool, the Psychopharmacotherapy-Structured Clinical Observation (P-SCO). Methods From 2008 to 2012, faculty in a postgraduate year 3 psychiatry outpatient clinic completed 601 P-SCOs. Twenty-five percent were randomly selected from each year; the sample included 8 faculty and 57 residents. To assess quality, comments were coded for valence (reinforcing or corrective), behavioral specificity, and content. To assess the relationship between comments and scores, the authors calculated the correlation between comment and checklist score valence and examined the degree to which comments and checklist scores addressed the same content. Results Ninety-one percent of the comments were behaviorally specific. Sixty percent were reinforcing, and 40% were corrective. Eight themes were identified, including 2 constructs not adequately represented by the checklist. Comment and checklist score valence was moderately correlated (Spearman's rho = 0.57, P < .001). Sixty-seven percent of high and low checklist scores were associated with a comment of the same valence and content. Only 50% of overall comments were associated with a checklist score of the same valence and content. Conclusions A direct observation tool such as the P-SCO can generate high-quality written comments. Narrative comments both explain checklist scores and convey unique content. Thematic coding of comments can improve the content validity of a checklist.

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An international stakeholder survey of the role of chiropractic qualifying examinations: A qualitative analysis

Journal of Chiropractic Education ◽

10.7899/jce-19-22 ◽

2020 ◽

Vol 34 (1) ◽

pp. 15-30 ◽

Cited By ~ 4

Author(s):

Bart N. Green ◽

Claire D. Johnson ◽

Richard Brown ◽

Charmaine Korporaal ◽

Doug Lawson ◽

...

Keyword(s):

Quality Of Care ◽

Qualitative Analysis ◽

Response Rate ◽

Minimum Standard ◽

Ethical Practices ◽

Electronic Survey ◽

Written Comments ◽

The Cost

Objective: Many countries require examinations as a gateway to chiropractic licensure; however, the relevance of these exams to the profession has not been explored. The purposes of this study were to analyze perceptions of international stakeholders about chiropractic qualifying examinations (CQEs), observe if their beliefs were in alignment with those that society expects of professions, and suggest how this information may be used when making future decisions about CQEs. Methods: We designed an electronic survey that included open-ended questions related to CQEs. In August 2019, the survey was distributed to 234 international stakeholders representing academic institutions, qualifying boards, students, practitioners, association officers, and others. Written comments were extracted, and concepts were categorized and collapsed into 4 categories (benefits, myths, concerns, solutions). Qualitative analysis was used to identify themes. Results: The response rate was 56.4% representing 43 countries and yielding 775 comments. Perceived benefits included that CQEs certify a minimum standard of knowledge and competency and are part of the professionalization of chiropractic. Myths included that CQEs are able to screen for future quality of care or ethical practices. Concerns included a lack of standardization between jurisdictions and uncertainty about the cost/value of CQEs and what they measure. Solutions included suggestions to standardize exams across jurisdictions and focus on competencies. Conclusion: International stakeholders identified concepts about CQEs that may facilitate or hinder collaboration and efforts toward portability. Stakeholder beliefs were aligned with those expected of learned professions. This qualitative analysis identified 9 major themes that may be used when making future decisions about CQEs.

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Experiences of specialist social workers for asylum seeking patients at a large Swedish hospital

European Journal of Public Health ◽

10.1093/eurpub/ckz186.060 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

V Svärd ◽

M Nilsson ◽

E Sernbo

Keyword(s):

Social Workers ◽

Working Conditions ◽

Asylum Seekers ◽

Accurate Information ◽

Detailed Knowledge ◽

Staff Members ◽

Written Comments ◽

Loading Function ◽

Health And Social Care

Abstract Background In 2016, the Karolinska University Hospital introduced a one-year-project with a mobile team of five asylum social workers (ASW), specializing in migration. This study evaluates the ordinary hospital social workers (HSW) experiences of introducing ASWs for asylum seeking patients. Methods Descriptive analysis was made of answers from a questionnaire sent to all 144 HSW at the hospital (57% response rate). Qualitative content analysis was made of written comments. Results Of the HSWs, 51% always and 29% sometimes contacted an ASW in relation to asylum seeking patients. Of those who contacted an ASW, 74% stated that the ASWs increased the efficiency of care of asylum seeking patients. 65% agreed that ASWs had an improving effect on the quality of encounters between staff and asylum seekers. Also, 67% agreed that the ASWs off-loading function improved the HSWs working conditions. Even though the ASWs were working at two hospitals located in different parts of the region, 78% of HSWs found them to be available. The main reason to not always contact an ASW was that it was not necessary in the specific case (55%). A majority (66%) reported increased knowledge about asylum processes as an outcome of introducing the ASWs at the hospital. This was also highlighted in the written comments, where ASWs detailed and updated knowledge as well as established contacts with e.g. the Swedish Migration Board was emphasized. ASWs specialist competence enabled patients to quickly receive legally correct and accurate information, which decreased worries among patients as well as staff members. Conclusions The HSWs described the ASWs as being important to patients as well as to staff. The ASWs improved the quality of encounters between staff and asylum seekers and strengthened the patient’s right to health and social care. The HSWs also reported an off-loading function, improving the working conditions and the over-all efficiency of care. Key messages The HSWs found that the ASWs increased the efficiency of care and quality of encounters between staff and asylum seekers. ASWs detailed knowledge and established external contacts enabled patient to receive accurate information quickly, which decreased worries among both patients and staff members.

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The Effects of Massage Therapy on Multiple Sclerosis Patients’ Quality of Life and Leg Function

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/640916 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Brittany Schroeder ◽

Jennifer Doig ◽

Kalyani Premkumar

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Massage Therapy ◽

Rest Period ◽

Noninvasive Treatment ◽

Written Comments ◽

Disability Status ◽

Before And After ◽

Multiple Sclerosis Patients

Background. Massage therapy is a noninvasive treatment that many individuals with multiple sclerosis (MS) use to supplement their conventional treatment.Objective. We hypothesize that massage therapy will improve the leg function and overall quality of life (QoL) of MS patients.Design. A two-period (rest, massage) crossover design was used. Twenty-four individuals with MS ranging from 3.0 to 7.0 on the Expanded Disability Status Scale (EDSS) received Swedish massage treatments for four weeks. Exercise capacity and leg function as well as QoL were assessed using the Six-Minute Walk Test (6MWT) and the Hamburg Quality of Life in Multiple Sclerosis (HAQUAMS) instrument, respectively. Assessments were measured before and after a massage period and a rest period where no massages were employed.Results. The results displayed no significant changes in 6MWT distances or HAQUAMS scores. However, the participants perceived improvement in overall health as expressed in written comments.Conclusions. Massage is a safe, noninvasive treatment that may assist MS patients in managing the stress of their symptoms. Future studies with larger sample size and cortisol measures are warranted.

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Feasibility, quality and validity of narrative multisource feedback in postgraduate training: a mixed-method study

BMJ Open ◽

10.1136/bmjopen-2020-047019 ◽

2021 ◽

Vol 11 (7) ◽

pp. e047019

Author(s):

Ellen Astrid Holm ◽

Shaymaa Jaafar Lafta Al-Bayati ◽

Toke Seierøe Barfod ◽

Maurice A Lembeck ◽

Hanne Pedersen ◽

...

Keyword(s):

Internal Medicine ◽

Descriptive Analysis ◽

Multisource Feedback ◽

Face Validity ◽

Quantitative Descriptive Analysis ◽

Educational Value ◽

Consequential Validity ◽

Negative Comments ◽

Quantitative Descriptive

ObjectivesTo examine a narrative multisource feedback (MSF) instrument concerning feasibility, quality of narrative comments, perceptions of users (face validity), consequential validity, discriminating capacity and number of assessors needed.DesignQualitative text analysis supplemented by quantitative descriptive analysis.SettingInternal Medicine Departments in Zealand, Denmark.Participants48 postgraduate trainees in internal medicine specialties, 1 clinical supervisor for each trainee and 376 feedback givers (respondents).InterventionThis study examines the use of an electronic, purely narrative MSF instrument. After the MSF process, the trainee and the supervisor answered a postquestionnaire concerning their perception of the process. The authors coded the comments in the MSF reports for valence (positive or negative), specificity, relation to behaviour and whether the comment suggested a strategy for improvement. Four of the authors independently classified the MSF reports as either ‘no reasons for concern’ or ‘possibly some concern’, thereby examining discriminating capacity. Through iterative readings, the authors furthermore tried to identify how many respondents were needed in order to get a reliable impression of a trainee.ResultsOut of all comments coded for valence (n=1935), 89% were positive and 11% negative. Out of all coded comments (n=4684), 3.8% were suggesting ways to improve. 92% of trainees and supervisors preferred a narrative MSF to a numerical MSF, and 82% of the trainees discovered performance in need of development, but only 53% had made a specific plan for development. Kappa coefficients for inter-rater correlations between four authors were 0.7–1. There was a significant association (p<0.001) between the number of negative comments and the qualitative judgement by the four authors. It was not possible to define a specific number of respondents needed.ConclusionsA purely narrative MSF contributes with educational value and experienced supervisors can discriminate between trainees’ performances based on the MSF reports.

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EVALUASI PROGRAM TUNJANGAN PROFESI GURU DI SMP NEGERI KABUPATEN KENDAL

Kelola Jurnal Manajemen Pendidikan ◽

10.24246/j.jk.2016.v3.i2.p277-293 ◽

2016 ◽

Vol 3 (2) ◽

pp. 277

Author(s):

Akhmad Yantono

Keyword(s):

Time Management ◽

Quality Education ◽

Assessment Tools ◽

Not Given ◽

Test Results ◽

Written Comments ◽

Evaluation Models ◽

Teachers And Students ◽

Data Source

<p><em>This study aimed to evaluate the level of achievement of teachers’ professional allowance goal in SMP Negeri 1 Pageruyung Kendal. This study useds a goal-oriented evaluation models developed by Ralph Winfred Tyler. Data were collected through interviews, questionnaires, observation, documentation and triangulation to ensure the validity of the data. Source of data was from the principal, teachers and students. Data were analyzed using qualitative analysis. The results showed that teachers’ professional allowance in SMP Negeri 1 Pageruyung: 1) has been able to raise the dignity of teachers, although the elements of scientific research has not been done by all teachers, and done only by one teacher. 2) has been able to improve the competence of teachers, although the elements of time management in the classroom has not been effective; the element of teachers questioning skill was not maximum; and the elements of evaluation, assessment tools have not been developed in accordance with the purpose of learning. 3) have not been able to advance the teachers professional because the teachers thoughts has not been communicated yet in the environment of the school and scientific forums. 4) has been able to improve the quality of learning, although in the assessment, teachers have not provided written comments on the test results, and has not given an assignment to write or read the related materials that have been learned. 5) has been able to improve the quality education services for learners.</em></p>

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Process evaluation of a tailored multifaceted feedback program to improve the quality of intensive care by using quality indicators

BMJ Quality & Safety ◽

10.1136/bmjqs-2012-001375 ◽

2013 ◽

Vol 22 (3) ◽

pp. 233-241 ◽

Cited By ~ 22

Author(s):

Maartje L G de Vos ◽

Sabine N van der Veer ◽

Wilco C Graafmans ◽

Nicolette F de Keizer ◽

Kitty J Jager ◽

...

Keyword(s):

Intensive Care ◽

Process Evaluation ◽

Quality Indicators ◽

Feedback Program

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Behavioral adjustments, supplements, and medications to manage bowel dysfunction in rectal cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.150 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 150-150

Author(s):

Virginia Sun ◽

Christopher Wendel ◽

Marcia Grant ◽

Joanna E Bulkley ◽

Carmit K. McMullen ◽

...

Keyword(s):

Rectal Cancer ◽

Self Care ◽

Bowel Dysfunction ◽

Term Treatment ◽

Kaiser Permanente ◽

Written Comments ◽

Long Term Treatment ◽

Bowel Control

150 Background: Bowel dysfunction is a common long-term treatment effect that adversely impacts the quality of life (QOL) of rectal cancer (RC) survivors. Research suggests that self-care strategies such as behavioral adjustments and supplements/medications are used to achieve bowel control. Evidence describing the specific types of self-care strategies is lacking. The purpose of this study is to describe behavioral adjustments and supplement/medications use in long-term ( ≥ 5 years) RC survivors for managing bowel dysfunction. Methods: Long-term RC survivors with or without permanent ostomies who were enrolled in two Kaiser Permanente Regions completed a survey that included questions eliciting behavioral adjustments and supplements/medications used for bowel control. Written comments from the questions were coded for content and themes. The themes were reviewed and agreed upon by the research team. Responses mentioned < 9 times were combined into broader categories; those mentioned ≥ 9 times were coded separately. Results: A total of 577 RC survivors responded to the survey. 118 survivors (20.4%) responded to the behavioral adjustment question, while 248 (43%) responded to the helpful supplements/medications question. Behavioral adjustments included controlling meal portions (38.9%), eating meals at regular times (19.4%), not eating late or before bedtime (10.1%), and grazing (8.4%); they mitigated constipation, obstruction, bloating, frequency, urgency, and improved bowel predictability. Other behavioral adjustments include not eating before or after activities (5.9%), not eating (5.1%), snacking at regular times (2.5%), and eating less when traveling (1.6%). Helpful supplements/medications include anti-diarrheals (23.6%), dietary fiber supplements (16.6%), stool softeners (15.0%), laxatives (12.6%), antacid (5.6%), probiotics (5.0%), and opioids (3.6%). Conclusions: RC survivors used multiple behavioral adjustments and supplements/medications to achieve bowel control. The specific adjustments and strategies varied greatly. Findings will aid in developing personalized strategies to manage bowel symptoms during survivorship.

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