scholarly journals Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028436
Author(s):  
Rosie Dew ◽  
Scott Wilkes

ObjectiveExploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness.DesignThis was an in-depth qualitative semi-structured interview study.Participants and setting32 participants (GPs, hospital consultants, referral support, hospital managers, Clinical Commissioning Group manager) in the North East of England, UK.MethodInterviews using a grounded theory approach and thematic analysis.ResultsThe main benefit of RMS mentioned by participants was that it allowed for unnecessary referrals to be vetted by consultants, and helps ensure patients are sent to the correct clinic. Generally, the consultants in our study felt that RMS did not significantly help them reject referrals. Some GPs experienced that RMS undermined GP autonomy and did not help when they had exhausted their abilities to manage a patient in primary care, and it was suggested that in some cases RMS may delay rather than prevent a referral. The main perceived disadvantage of RMS was the additional workload for GPs and consultants, and RMS was felt to be a barrier to commutation between GPs and consultants. Frustration with the system design and lack of knowledge of its cost-effectiveness were articulated.ConclusionAlthough RMS was reported to reduce some unnecessary referrals, the effect of referral delay and rejection is unknown. Although there were some positive attributes described, RMS was mostly received negatively by the stakeholders.

2020 ◽  
Author(s):  
Ben Alderson-Day ◽  
Angela Woods ◽  
Peter Moseley ◽  
Stephanie Common ◽  
Felicity Deamer ◽  
...  

Background: Recent therapeutic approaches to auditory verbal hallucinations (AVH) exploit the person-like qualities of voices. Little is known, however, about how, why and when AVH become personified. We aimed to investigate personification in individuals’ early voice experiences. Methods: We invited users of Early Intervention in Psychosis (EIP) services aged 16–65 to participate in a semi-structured interview on AVH phenomenology. Voice-hearers in the first nine months of using EIP were recruited through two NHS trusts in the North-East of England. We used content and inductive thematic analysis to code the interviews, then examined key associations with personification using a variety of statistical methods. Results: Forty individuals participated between September 2017 and April 2019. Many participants reported a range of negative emotions (predominantly fear, 60%, 24/60, and anxiety, 62.5%, 26/40), visual hallucinations (75%, 30/40), bodily states (65%, 25/40), and “felt presences” (52.5%, 21/40) in relation to voices. Complex personification, reported by a sizeable minority (16/40, 40%), was associated with experiencing voices as conversational (OR = 2.56) and companionable (OR = 3.19), but not as commanding or connected to trauma. Neither age of onset nor time since voices were first reported related to voice personification. Conclusions: Our findings affirm recent investigations of the heterogeneity of AVH while offering new insights into the variety and significance of personified voices. Personified voices appear to be distinguished less by their intrinsic properties, commanding qualities or connection with trauma, than by their affordances for conversation and companionship.


2006 ◽  
Vol 1 (3) ◽  
pp. 63
Author(s):  
Lorie Andrea Kloda

A review of: Childs, Sue, Elizabeth Blenkinsopp, Amanda Hall, and Graham Walton. “Effective E-Learning for Health Professionals and Students—Barriers and Their Solutions. A Systematic Review of the Literature—Findings from the HeXL Project.” Health Information & Libraries Journal 22.S2 (2005): 20-32. Objective – To determine barriers or problems and possible solutions related to e-learning, and to determine the effectiveness of e-learning among health professionals and students. Design – Systematic review of qualitative literature, in addition to interviews and questionnaires, to allow for triangulation of the data. Setting – “The HeXL Project: Surmounting the Barriers to NHS E-Learning in the North-East.” The National Health Service (NHS) in the North-East of England, from May 2003 to March 2004. Subjects – A systematic review of 57 qualitative studies on health and e-learning, phone interviews with 13 managers and trainers, and 149 questionnaires completed by users and non-users of e-learning. All participants of the interviews and questionnaires were staff and students of the NHS in the North-East of England. Methods – The study used three methods to collect data to meet the objectives of the study. For the systematic review, the databases AMED (Allied and Alternative Medicine), ASSIA (Applied Social Sciences), CINAHL (Nursing and Allied Health), ERIC (Education), HMIC (health Management), LISA (Library and Information Sciences), PubMed (Medline), and Web of Science were searched using the terms “e-learning” or “computer assisted instruction”, and “health”, and “barriers.” Any type of research or comprehensive literature review was selected from the results to be included in analysis. Based on the findings from the systematic review, a semi-structured interview schedule was developed for use in phone interviews to be conducted with managers or e-learning trainers. Also based on the systematic review, questionnaires were developed and distributed to users and non-users of e-learning. The three methods permitted triangulation of the data. Main results – The search produced 161 results of which 57 met the methodological criteria. The 57 studies categorized e-learning barriers and solutions into eight different issues: organizational, economics, hardware, software, support, pedagogical, psychological, and skills. Results from the interviews and questionnaires mirrored those of the systematic review. Barriers to e-learning included managing change, lack of skills, costs, absence of face-to-face learning, and time commitment. Solutions to the barriers of e-learning included blended learning, better design, skills training, removal of costs, and improved access to technology. There were, however, some discrepancies between the results from the systematic review and the interviews and questionnaires: barriers due to “lack of access to technology” (29) were not perceived as serious, suggested solutions did not include better communication and scheduling, and the solutions to provide trainer incentives and employment admission criteria were rejected. Users and potential users of e-learning mentioned one solution not found in the review: protected time during work to partake in e-learning. Results from the interviews and questionnaires demonstrated that managers, trainers, and learners thought e-learning to be effective. Conclusion – The researchers answered the study’s questions to determine the perceived barriers and solutions to e-learning for the NHS in the North-East of England. Despite the barriers identified, it was also determined from the interviews conducted and questionnaires returned that managers, trainers, and learners perceive e-learning as an effective method of education for health professionals and students. Further research is needed to determine whether this perception is correct. The systematic review of the literature identified important “factors which need to be in place” for e-learning to effectively take place (29). The barriers and potential solutions identified are useful for those designing e-learning programs in any professional context. The results point to several requirements for e-learning success: national standards and strategies; curriculum integration; change management; flexible programming; skills training; and support and access to technology for managers, learners, and trainers. The authors of the article believe that librarians play an important role in e-learning and identify several areas in which librarians can contribute.


2022 ◽  
Vol 21 ◽  
pp. 160940692110624
Author(s):  
Yeshim Iqbal ◽  
Shikhty Sunny ◽  
Ahmed Alif ◽  
Hirokazu Yoshikawa ◽  
Mehzabeen A. Shorna

Objective of Protocol: The primary objective of this protocol is to record the process of conceptualizing a semi-structured interview protocol, training enumerators on the protocol, collecting data, translating findings into English, and analyzing data in English and Bengali, in a study of family socialization among a stateless and conflict-affected population, Rohingya refugees, in Cox’s Bazar, Bangladesh. Research Questions of Study: (1) What are the socialization goals that mothers have for their children, and how do they perceive these goals in relation to their future or current roles as caregivers? (2) What are parents’ experiences with their children’s participation in Humanitarian Play Labs (education/child care provisions in the camps), and what are their perceptions of how their child’s participation in the programs has influenced their child/family? (3) What were the experiences of parents with their children as they migrated from Myanmar to Bangladesh? Design of Study: The design of the study involved a qualitative grounded theory approach based on an analysis of the participants’ responses to a semi-structured interview protocol. Study population: Participants included a purposive sample of 28 mother/father dyads in the Rohingya camps in Cox’s Bazar.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hossein Bakhshi ◽  
Hiwa Weisi ◽  
Nouroddin Yousofi

PurposeThis paper explores the challenges of conducting qualitative research from ELT (English Language Teaching) Ph.D. candidates' perspectives.Design/methodology/approachThe participants of the study consisted of 30 Iranian Ph.D. students majoring in ELT. The semi-structured interview was employed to investigate the heart of experiences, issues and concerns of participants with regard to conducting qualitative research (QLR) challenges. To analyze the collected data, the recorded interviews were transcribed, and then the grounded theory approach was employed (Charmaz, 2006).FindingsThe results revealed that the major challenges of the participants consist of the credibility of QLR in ELT contexts, hermeneutic and fuzzy nature of QLR, qualitative data analysis and interpretation, publishing qualitative findings and the system of measuring professors' productivity.Originality/valueThe findings may help professors, mainly EFL ones, in research mentoring and developing research syllabi for graduate students. In addition, it may motivate Ph.D. candidates to employ QLR methods in their research studies. The pedagogical and theoretical implications of the study are discussed at the end of the paper.


2020 ◽  
Vol 12 (3) ◽  
pp. 611-627
Author(s):  
Tyler A. Beeton ◽  
Shannon M. McNeeley

AbstractAlthough drought is a natural part of climate across the north-central United States, how drought is experienced and responded to is the result of complex biophysical and social processes. Climate change assessments indicate drought impacts will likely worsen in the future, which will further challenge decision-making. Here, a drought management decision typology is empirically developed from synthesis of three in-depth case studies using a modified grounded-theory approach. The typology highlights 1) the entity or entities involved, 2) management sectors, 3) decision types, 4) spatial and temporal scale(s) of decision-making, and 5) barriers that inhibit decision-making. Findings indicate similarities in decision types and barriers across cases. Changes in operations, practices, or behaviors; information and technology; and legal or policy changes were the most common decision types, while commonly cited barriers were institutional constraints, fragmented decision-making, and limited personnel and financial resources. Yet barriers and responses also differed within and between sectors and jurisdictions. Several barriers inhibited anticipatory, regional, and interagency drought response, such as limited institutional support, competing mandates, limited resources, lack of usable information, limits to interagency fund transfers, and historical context and distrust among entities. Findings underscore the importance of documenting nuanced decision-making in local places and broader generalizations in decision-making across scales. This contributes to the goal of developing drought science that is actionable for decision-making.


2015 ◽  
Vol 10 (4) ◽  
pp. 338-348 ◽  
Author(s):  
Birte Meissner ◽  
Jason Bantjes ◽  
Ashraf Kagee

Worldwide suicide is a deeply gendered phenomenon. In South Africa, approximately 80% of suicide completers are male. This study aimed to investigate how a group of young South African men understand and think about suicidal behavior. In-depth semistructured interviews and thematic analysis using a grounded theory approach revealed that this group of young South African men had permissive attitudes to suicide and viewed suicide as a morally defensible alternative in specific situations. They spoke of suicide as a goal-directed behavior that provides a means of regaining control, asserting power, communicating, and rendering oneself visible. From this perspective, suicide was understood as a brave act requiring strength and determination. These data have congruence with the Theory of Gender and Health, which proposes that constructions of masculinity may be implicated in the attitudes and beliefs young men in South Africa hold toward suicide.


2020 ◽  
pp. 002246692094276
Author(s):  
Kristi Lane ◽  
Lauren J. Lieberman ◽  
Pamela Haibach-Beach ◽  
Melanie Perreault ◽  
Luis Columna

Using a grounded theory approach, the aim of this study was designed to explore parental perspectives with children who have CHARGE syndrome and their children’s experiences in physical education. Participants included 10 mothers of children with CHARGE syndrome ages 6 to 23 years old. The parents completed a demographic survey and participated in a semi-structured interview where they discussed their perspectives on their child’s physical education services. The interviews were audio-recorded, transcribed, and analyzed using an open coding analysis. Three independent themes were revealed: (a) holistic expectations, (b) multifaceted barriers, and (c) facilitators to quality physical education. The perspectives shared by parents indicated that parents do find physical education services, an important part of the educational program. However, the existing programs did not meet the parents’ expectations specific to programming for children with CHARGE syndrome.


Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 274
Author(s):  
Noriko Ozawa ◽  
Rieko Fukuzawa ◽  
Kayuri Furuya

Recently, proton beam therapy has been recommended in radiation therapy for child-hood cancer. However, facilities for children are limited, and parents who choose this treatment for their children face a variety of challenges. This study reveals mothers’ experiences about the decision to use the aforementioned therapy. A semi-structured interview was conducted with 16 mothers of children who received proton beam therapy in Japan, and a grounded theory approach was adopted. The results revealed that mothers were very worried about late complications concerning their children due to radiation. While the mothers strongly expected proton beam therapy to reduce the risk of late complications, they felt uncertainty and anxiety throughout the entire decision-making process. Despite having to deal with their feelings, they had to transfer to another hospital and prepare support for their children to begin treatment, and this put a lot of strain on them. From decision-making to start of treatment, these emotional fluctuations and the need for psychological support became apparent.


2020 ◽  
Vol 122 (14) ◽  
pp. 1-28
Author(s):  
Julie R. Kochanek ◽  
Carrie Scholz ◽  
Brianne Monahan ◽  
Max Pardo

Background/Context Emerging experiences suggest that research-practice partnerships (RPPs) can benefit both research and practice. As researchers and practitioners become part of the same social network, they also can become trusted sources of information for one another. By modeling the research use process, practitioners can incorporate what they learn into their own research acquisition and interpretation processes and researchers can gain a better understanding of how their work can be designed and conducted so that it is directly relevant to practice. Purpose/Focus of the Study Prior literature on research-practice partnerships has identified common challenges of these partnerships such as turnover, trust, common language, and complex systems. The study follows a grounded theory approach to better understand challenges and dynamics within research-practice partnerships. Setting The study included members of eight research-practice partnerships including two focused primarily on the use of early warning indicators to reduce high school dropout. Partnerships were diverse in their location and maturity. Five partnerships were located in the Midwest, one partnership was located in the South, and two partnerships were located in New England. Half of the partnerships were less than two years old at the time of the interviews, and the oldest partnership was 8 years old. Research Design Using a grounded theory approach to better understand challenges and dynamics within RPPs, we analyzed qualitative interview data inductively to identify common themes discussed by respondents. Data Collection and Analysis The study team conducted telephone interviews with two researchers and two practitioners from eight RPPs, for a total of 31 interviews – one researcher was interviewed for two different partnerships. The team used semi-structured interview protocols aligned to the four research questions. In analyzing the interview data, we identified themes, categories, and theories that emerged from the data and confirmed or refuted our initial impressions.


2021 ◽  
Vol 12 ◽  
Author(s):  
Maryam Azizi ◽  
Abbas Ebadi ◽  
Abbas Ostadtaghizadeh ◽  
Abbasali Dehghani Tafti ◽  
Juliet Roudini ◽  
...  

Objective: Pre-hospital personnels (PHPs) who work in disasters under extreme pressure, uncertainty, and complex situations are victims of disasters themselves, and there is a link between experiencing such incidents and mental health problems. Because most studies focus on the injured and less on the psychological issues of PHPs, the present study aimed to develop a model to provide relief for PHPs in disasters from a psychological perspective.Methods: A grounded theory methodology recommended by Corbin and Strauss (2015) was employed. PHPs (n = 24) participated in a semi-structured interview between July 2018 to May 2020.Results: In the analysis of the pre-hospital staff interviews, three main themes were extracted, namely, providing relief with struggle (complexity of incident scenes, command-organizational and occupational challenges), psychological distress (psychological regression and psychological empowerment), and consequences (resilience and job burnout). Seven categories and 22 subcategories were explored from our data via the grounded theory approachConclusions: The PHPs managed psychological distress with two approaches: psychological self-empowerment and regression, which resulted in resilience and burnout, respectively. Due to the lack of enough support, the resilience of the PHPs was short-term, turned into burnout over time, and affected the structural factors again as a cycle.


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