scholarly journals How young children learn independent asthma self-management: a qualitative study in Malaysia

2020 ◽  
Vol 105 (9) ◽  
pp. 819-824
Author(s):  
Siti Nurkamilla Ramdzan ◽  
Ee Ming Khoo ◽  
Su May Liew ◽  
Steven Cunningham ◽  
Marilyn Kendall ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Primary Schools ◽  
Health Centre ◽  
Smooth Transition ◽  
Self Management ◽  
Theory Approach ◽  
Individual Interviews ◽  
National Medical ◽  
Children With Asthma

ObjectiveWe aimed to explore the views of Malaysian children with asthma and their parents to enhance understanding of early influences on development of self-management skills.DesignThis is a qualitative study conducted among children with asthma and their parents. We used purposive sampling and conducted focus groups and interviews using a semi-structured topic guide in the participants’ preferred language. All interviews were audio-recorded, transcribed verbatim, entered into NVivo and analysed using a grounded theory approach.SettingsWe identified children aged 7–12 years with parent-reported, physician-diagnosed asthma from seven suburban primary schools in Malaysia. Focus groups and interviews were conducted either at schools or a health centre.ResultsNinety-nine participants (46 caregivers, 53 children) contributed to 24 focus groups and 6 individual interviews. Children mirrored their parents’ management of asthma but, in parallel, learnt and gained confidence to independently self-manage asthma from their own experiences and self-experimentation. Increasing independence was more apparent in children aged 10 years and above. Cultural norms and beliefs influenced children’s independence to self-manage asthma either directly or indirectly through their social network. External influences, for example, support from school and healthcare, also played a role in the transition.ConclusionChildren learnt the skills to self-manage asthma as early as 7 years old with growing independence from the age of 10 years. Healthcare professionals should use child-centred approach and involve schools to facilitate asthma self-management and support a smooth transition to independent self-management.Trial registration numberMalaysian National Medical Research Register (NMRR-15-1242-26898).

scholarly journals Chronic Pain Self-Management Program for Low-Income Patients: Themes from a Qualitative Inquiry

Pain Medicine ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. e1-e8 ◽  
Author(s):  
Barbara J Turner ◽  
Natalia Rodriguez ◽  
Raudel Bobadilla ◽  
Arthur E Hernandez ◽  
Zenong Yin
Keyword(s):  
Chronic Pain ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
Low Income ◽  
Pain Medication ◽  
Management Program ◽  
Qualitative Inquiry ◽  
Self Management ◽  
Theory Approach

Abstract Objective To examine factors influencing initial engagement, ongoing participation, learned behaviors, and subjective functional outcomes after a trial of the Living Better Beyond Pain (LBBP) chronic pain self-management program. Design Qualitative study using the Grounded Theory approach. Setting Two 60-minute focus groups and phone interviews in May 2017. Subjects Focus groups with 18 participants who completed LBBP and six-month measures; telephone interviews with 17 participants who stopped attending. Methods Study coordinators randomly selected program completers for focus groups and conducted phone interviews with noncompleters. Inductive thematic analysis was used to identify patterns in semantic content with a recursive process applied to focus group transcripts and interview transcriptions to codify into themes. Themes were categorized according to the Theory of Planned Behavior. Results Focus group and telephone interview participants were primarily Hispanic and unemployed. Attitudes fostering participation in LBBP included dissatisfaction with the status quo, need to reduce pain medication, and lack of training and knowledge about chronic pain. Positive social norms from meeting others with chronic pain and support from the LBBP team encouraged attendance and adoption of behaviors. Transportation, pain, and competing activities were barriers, whereas adapting activities for the disabled was a facilitator. Maintaining behaviors and activities at home was challenging but ultimately rewarding due to improvement in daily function with less pain medication. Conclusions This qualitative study complements quantitative results showing clinically significant improvements in function after the LBBP program by adding practical insights into ways to increase participation and outcomes. Participants strongly endorsed the need for chronic pain self-management training.

Acceptability of Serious Games in Pediatric Asthma Education and Self-Management: Qualitative study with a consensual qualitative design (Preprint)

2021 ◽  
Author(s):  
Nicole Silva-Lavigne ◽  
Alena Valderrama ◽  
Sandra Pelaez ◽  
Myriam Bransi ◽  
Fabio Balli ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Support System ◽  
Serious Games ◽  
Self Management ◽  
Asthma Education ◽  
Asthma Knowledge ◽  
Children With Asthma ◽  
The Impact

BACKGROUND Asthma is the most common chronic pediatric disease. Despite existing tools to manage asthma, 40-55% of children with asthma suffer from uncontrolled asthma. Serious games (SGs) represent a novel approach in promoting asthma education and self-management for children. OBJECTIVE In this qualitative study with an embedded quantitative design, we used focus groups and questionnaires to describe the perceived role of SGs in different aspects of asthma self-management by children and their parents. These aspects include asthma perception and knowledge, the impact of asthma and barriers to asthma self-management, and the support system for asthma self-management. METHODS Five children with asthma and their parents were invited to participate during an organized gaming session. Children and their parents filled out a pre-gaming questionnaire on their medical history and asthma knowledge. They were then invited to test four original SGs prototypes, after which the children answered a post-gaming questionnaire on their asthma knowledge and perception of the SGs. Children and their parents subsequently participated in parallel focus groups which were video- and/or audio-recorded, transcribed verbatim, and analyzed by reaching consensus among members of the research team. RESULTS The mean age of the children was 10.3 year, with 20% being male. Qualitative data from the transcripts were coded into three separate domains: 1) asthma self-management perception and knowledge, 2) impact of asthma and barriers to asthma self-management, and 3) support system for asthma self-management. We specifically explored the perceived roles of SGs within each of these domains. A key takeaway message was identified for each of these three domains: 1) Heterogeneity of asthma knowledge and the ability of SGs to encourage knowledge transfer through games, 2) Consequences and limitations of asthma and the ability of SGs to allow for identification and management of real-life situations through games, and 3) Insufficient support system and the ability of SGs to encourage playing with others for support and shared knowledge. CONCLUSIONS Our study explored the role of SGs in the self-management of asthma as perceived by children and their parents. Our findings support the acceptability of SGs in asthma education and self-management in pediatrics and the necessity for future development in this field.

scholarly journals Understanding how patients establish strategies for living with asthma: a qualitative study in UK primary care as part of IMP2ART

2020 ◽  
Vol 70 (694) ◽  
pp. e303-e311 ◽  
Author(s):  
Luke Daines ◽  
Susan Morrow ◽  
Sharon Wiener-Ogilvie ◽  
Caroline Scott ◽  
Liz Steed ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Cognitive Skills ◽  
Action Plan ◽  
Management Strategies ◽  
Asthma Patient ◽  
Self Management ◽  
Children With Asthma ◽  
Prompt Action

BackgroundIn the context of a variable condition such as asthma, patient recognition of deteriorating control and knowing what prompt action to take is crucial. Yet, implementation of recommended self-management strategies remains poor.AimTo explore how patients with asthma and parents/carers of children with asthma develop and establish recommended self-management strategies for living with asthma, and how clinicians can best support the process.Design and settingA qualitative study in UK primary care.MethodPatients with asthma and parents/carers of children with asthma from 10 general practices were purposively sampled (using age, sex, and duration of asthma) to participate in focus groups or interviews between May 2016 and August 2016. Participants’ experiences of health care, management of asthma, and views on supported self-management were explored. Interviews and focus group sessions were audio-recorded and transcribed verbatim. Iterative thematic analysis was conducted, guided by the research questions and drawing on habit theory in discussion with a multidisciplinary research team.ResultsA total of 49 participants (45 patients; 4 parents/carers) took part in 32 interviews and five focus groups. Of these, 11 reported using an action plan. Patients learnt how to self-manage over time, building knowledge from personal experience and other sources, such as the internet. Some regular actions, for example, taking medication, became habitual. Dealing with new or unexpected scenarios required reflective abilities, which may be supported by a tailored action plan.ConclusionPatients reported learning intuitively how to self-manage. Some regular actions became habitual; dealing with the unexpected required more reflective cognitive skills. In order to support implementation of optimal asthma self- management, clinicians should consider both these aspects of self-management and support, and educate patients proactively.

Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study

2016 ◽  
Vol 32 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Seth A. Brown ◽  
Theresa C. Hayden ◽  
Kimberly A. Randell ◽  
Lara Rappaport ◽  
Michelle D. Stevenson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Emergency Medical Services ◽  
Prehospital Care ◽  
Educational Interventions ◽  
Medical Services ◽  
Theory Approach ◽  
Publication Type ◽  
Pediatric Education ◽  
Emergency Medical

AbstractObjectivesPrevious studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements.MethodsPurposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data.ResultsForty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements.ConclusionFocus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care.BrownSA, HaydenTC, RandellKA, RappaportL, StevensonMD, KimIK. Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20–26.

Making the connection: a qualitative study of brokerage in Aboriginal health in a metropolitan area of Victoria and a regional area of New South Wales

2011 ◽  
Vol 35 (1) ◽  
pp. 18 ◽  
Author(s):  
Melanie S. Cheng ◽  
Angela Clarke ◽  
Timothy D. Moore ◽  
Phyllis M. Lau
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Focus Groups ◽  
Aboriginal Health ◽  
Theory Approach ◽  
Service Delivery Model ◽  
Aboriginal Community ◽  
Delivery Model ◽  
Objective Health ◽  
Key Stakeholders

Objective. Health brokerage is one method being employed by government health agencies in an attempt to improve Aboriginal and Torres Strait Islander people’s access to primary healthcare. This qualitative study explores key stakeholders’ understanding and acceptance of the health brokerage model, prior to the implementation of brokerage services. Methods. Semistructured interviews and focus groups were conducted with key stakeholders. The resulting data was analysed using a grounded theory approach. Results. Qualitative analysis of the interviews and focus groups revealed five major themes. These were: (1) the perceived limitations of brokerage as a service delivery model; (2) the benefits of health brokerage such as increased flexibility; (3) issues relating to patient independence; (4) the necessity for broker independence; and (5) a mistrust of health brokerage and the authority handling the brokerage funds. Conclusions. Since this study was conducted in 2008, ongoing funding for urban brokerage services has been suspended. Although the reasons for this are unclear, our study suggests that barriers to the acceptance of brokerage services by the community may have existed even before such services were implemented, thus highlighting the need for transparency when launching new health initiatives that hope to engage the Aboriginal community. What is known about the topic? Brokerage models have previously been described in the areas of mental health and aged care. In these examples, brokerage agencies have provided patients with a key entry point into the healthcare system. Benefits of the brokerage model, such as flexibility, have been contrasted with its limitations, such as a heavy reliance upon existing services. What does this paper add? This paper provides insight into the acceptability of health brokerage, as a service delivery model, to the Aboriginal community. Although findings from the study reinforce many of the benefits and limitations already described in the literature, they also introduce the new and important themes of patient empowerment and mistrust. What are the implications for practitioners? This study provides vital information about community perceptions of health brokerage. It is important that policy makers take heed of such insights when planning attempts to close the gap in Aboriginal health.

scholarly journals What do children, parents and staff think about a healthy lifestyles intervention delivered in primary schools? a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e038625
Author(s):  
Joanna Goldthorpe ◽  
Tracy Epton ◽  
Chris Keyworth ◽  
Rachel Calam ◽  
Joanna Brooks ◽  
...  
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Focus Groups ◽  
Primary Schools ◽  
Health Behaviours ◽  
Research Approach ◽  
Successful Implementation ◽  
Management Interventions ◽  
Diet And Physical Activity ◽  
Home And School

ObjectivePrimary schools are crucial settings for early weight management interventions but effects on children’s weight are small and evidence shows that deficiencies in intervention implementation may be responsible. Very little is known about the roles of multiple stakeholders in the process of implementation. We used a multiple-stakeholder qualitative research approach to explore the implementation of an intervention developed to improve the diet and increase the levels of physical activity for children living in some of the most deprived areas of England.DesignFor this qualitative study, interviews and focus groups were carried out using semi-structured topic guides. Data were analysed thematically.SettingSeven primary schools (pupils aged 4 to 11) in Manchester, England.ParticipantsWe conducted 14 focus groups with children aged 5 to 10 years and interviews with 19 staff members and 17 parents.InterventionManchester Healthy Schools (MHS) is a multicomponent intervention, developed to improve diet and physical activity in schools with the aim of reducing and preventing childhood obesity.ResultsThree themes were developed from the data: common understandings of health and health behaviours; congruence and consistency of messages; negotiations of responsibility.ConclusionAll participant groups had a common conceptualisation of health as having physical and psychological components and that action could be taken in childhood to change behaviours that protect long-term health. When parents and staff felt a shared sense of responsibility for children’s health and levels of congruence between home and school norms around diet and physical activity were high, parents and children were more likely to accept the policies implemented as part of MHS. Effective two-way communication between home and school is therefore vital for successful implementation of this intervention.

scholarly journals Developing a Shared Patient-Centered, Web-Based Medication Platform for Type 2 Diabetes Patients and Their Health Care Providers: Qualitative Study on User Requirements (Preprint)

2017 ◽  
Author(s):  
Gerda Bernhard ◽  
Cornelia Mahler ◽  
Hanna Marita Seidling ◽  
Marion Stützle ◽  
Dominik Ose ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Self Management ◽  
Care Providers ◽  
Patient Centered ◽  
Web Based ◽  
Access Methods

BACKGROUND Information technology tools such as shared patient-centered, Web-based medication platforms hold promise to support safe medication use by strengthening patient participation, enhancing patients’ knowledge, helping patients to improve self-management of their medications, and improving communication on medications among patients and health care professionals (HCPs). However, the uptake of such platforms remains a challenge also due to inadequate user involvement in the development process. Employing a user-centered design (UCD) approach is therefore critical to ensure that user’ adoption is optimal. OBJECTIVE The purpose of this study was to identify what patients with type 2 diabetes mellitus (T2DM) and their HCPs regard necessary requirements in terms of functionalities and usability of a shared patient-centered, Web-based medication platform for patients with T2DM. METHODS This qualitative study included focus groups with purposeful samples of patients with T2DM (n=25), general practitioners (n=13), and health care assistants (n=10) recruited from regional health care settings in southwestern Germany. In total, 8 semistructured focus groups were conducted. Sessions were audio- and video-recorded, transcribed verbatim, and subjected to a computer-aided qualitative content analysis. RESULTS Appropriate security and access methods, supported data entry, printing, and sending information electronically, and tracking medication history were perceived as the essential functionalities. Although patients wanted automatic interaction checks and safety alerts, HCPs on the contrary were concerned that unspecific alerts confuse patients and lead to nonadherence. Furthermore, HCPs were opposed to patients’ ability to withhold or restrict access to information in the platform. To optimize usability, there was consensus among participants to display information in a structured, chronological format, to provide information in lay language, to use visual aids and customize information content, and align the platform to users’ workflow. CONCLUSIONS By employing a UCD, this study provides insight into the desired functionalities and usability of patients and HCPs regarding a shared patient-centered, Web-based medication platform, thus increasing the likelihood to achieve a functional and useful system. Substantial and ongoing engagement by all intended user groups is necessary to reconcile differences in requirements of patients and HCPs, especially regarding medication safety alerts and access control. Moreover, effective training of patients and HCPs on medication self-management (support) and optimal use of the tool will be a prerequisite to unfold the platform’s full potential.

scholarly journals Implementation strategies in the context of medication reconciliation: a qualitative study

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Deonni P. Stolldorf ◽  
Sheila H. Ridner ◽  
Timothy J. Vogus ◽  
Christianne L. Roumie ◽  
Jeffrey L. Schnipper ◽  
...  
Keyword(s):  
Patient Safety ◽  
Qualitative Study ◽  
Focus Groups ◽  
Medication Reconciliation ◽  
Complex Interventions ◽  
Implementation Strategies ◽  
Professional Roles ◽  
Roles And Responsibilities ◽  
Individual Interviews ◽  
Professional Roles And Responsibilities

Abstract Background Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and providers) and limited organizational capacity. How to best implement MedRec interventions remains unclear. Guided by the Expert Recommendations for Implementing Change (ERIC) taxonomy, we report the differing strategies hospital implementation teams used to implement an evidence-based MedRec Toolkit (the MARQUIS Toolkit). Methods A qualitative study was conducted with implementation teams and executive leaders of hospitals participating in the federally funded “Implementation of a Medication Reconciliation Toolkit to Improve Patient Safety” (known as MARQUIS2) research study. Data consisted of transcripts from web-based focus groups and individual interviews, as well as meeting minutes. Interview data were transcribed and analyzed using content analysis and the constant comparison technique. Results Data were collected from 16 hospitals using 2 focus groups, 3 group interviews, and 11 individual interviews, 10 sites’ meeting minutes, and an email interview of an executive. Major categories of implementation strategies predominantly mirrored the ERIC strategies of “Plan,” “Educate,” “Restructure,” and “Quality Management.” Participants rarely used the ERIC strategies of finance and attending to policy context. Two new non-ERIC categories of strategies emerged—“Integration” and “Professional roles and responsibilities.” Of the 73 specific strategies in the ERIC taxonomy, 32 were used to implement the MARQUIS Toolkit and 11 new, and non-ERIC strategies were identified (e.g., aligning with existing initiatives and professional roles and responsibilities). Conclusions Complex interventions like the MARQUIS MedRec Toolkit can benefit from the ERIC taxonomy, but adaptations and new strategies (and even categories) are necessary to fully capture the range of approaches to implementation.

Patients’, carers’ and providers’ experiences and requirements for support in self-management of multiple sclerosis: a qualitative study

2013 ◽  
Vol 1 (2) ◽  
pp. 457 ◽  
Author(s):  
Francesca Deibel ◽  
Michelle Edwards ◽  
Adrian Edwards
Keyword(s):  
Multiple Sclerosis ◽  
Qualitative Study ◽  
Focus Groups ◽  
Management Strategies ◽  
Strong Relationship ◽  
Information Provision ◽  
Self Management ◽  
Management Skills ◽  
Long Term Conditions ◽  
Management Interventions

Background: Self-management is a process increasingly promoted for the management of long term conditions, both for ethical reasons of enhancing autonomy and for likely cost-effectiveness, but the nature and scope of self-management strategies are currently highly variable.Objective: To identify patients’, carers’ and clinicians’ current experiences of self-management in multiple sclerosis (MS) and their recommendations for the development of a future MS-specific self-management interventionMethods: Qualitative study using focus groups and semi-structured one-to-one interviews with a purposive sample. Three focus groups were held with 25 patients with moderate to advanced multiple sclerosis and 4 carers. Ten clinicians were interviewed. Data underwent thematic analysis.Results: Participants perceived multiple aspects of MS to be amenable to self-management, but identified a current lack of service provision to support their abilities to self-manage. Participants felt that to address both the physical and psychosocial challenges posed by MS required better information provision, a strong relationship with healthcare professionals and a toolkit of self-management skills. Participants expressed concern at the lack of consideration currently given to carers, which should be addressed in future provision.Conclusion: The diverse experiences of patients living with MS warrant a multidisciplinary, flexible and proactive approach to improve their self-management capabilities, acknowledging both patients’ and carers’ unmet needs. The findings can be used to guide the development of future self-management interventions specific to individuals with multiple sclerosis.

Exemplars' Experience of Self-Managing Type 2 Diabetes

1998 ◽  
Vol 24 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Geraldine C. Ellison ◽  
Kathleen M. Rayman
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Focus Groups ◽  
Comparative Method ◽  
Analysis Data ◽  
Self Management ◽  
Constant Comparative Method ◽  
Field Notes ◽  
Study Participants

The purpose of this qualitative study was to explore the experience of learning self-management among women with type 2 diabetes. The 17 study participants were nominated as exemplars of self-management by diabetes experts. Data were generated from four structured focus groups, clinic records of participants, and investigator field notes. Using the constant comparative method of analysis , data were examined for patterns and themes. Analysis revealed that participants moved through three distinct phases of learning to manage diabetes. Movement through phases was heralded by identifiable transitional events. The three phases — management-as-rules, management-as-work, and management-as-living — are described as a model by which healthcare practitioners and educators can better understand the socioclinical aspects in self-management of type 2 diabetes.

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