scholarly journals Qualitative study exploring patients experiences of being diagnosed and living with primary bone cancer in the UK

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028693 ◽  
Author(s):  
Ana Martins ◽  
Jeremy S Whelan ◽  
Lindsey Bennister ◽  
Lorna A Fern ◽  
Craig Gerrand ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Lower Limb ◽  
Social Life ◽  
Bone Cancer ◽  
Well Being ◽  
Limb Amputation ◽  
Primary Bone ◽  
The Uk ◽  
The Impact

ObjectiveThe aim of this study is to explore the experiences of patients with primary bone cancer.DesignQualitative study design using semistructured interviews and focus groups.SettingHospitals across the UK and recruitment through UK sarcoma charities and support groups.MethodsSemistructured telephone/face-to-face interviews and focus groups with a purposive sample of 26 participants. Data were analysed using Framework Analysis.ParticipantsPatients (n=26) with primary bone cancer aged 13–77 years. The majority were male (69%), white (85%); diagnosed within 4 years (54%); and had lower limb sarcoma (65%). Ten participants had undergone an upper/lower limb amputation (39%).ResultsThe health-related quality-of-life domains of physical, emotional and social well-being and healthcare professionals’ role were the overarching themes of analysis. The physical domain anchored patient experiences. The intensity and length of treatment, the severity of side-effects, the level of disability after surgery and the uncertainty of their prognosis had an impact on patient’s self-image, confidence, mood and identity, and caused disruption to various aspects of the patients’ social life, including their relationships (emotional and sexual) and participation in work/school and leisure activities. Adaptation was influenced by the way patients dealt with stress and adversity, with some finding a new outlook in life, and others struggling with finding their ‘new normal’. Family and friends were the main source of support. Healthcare professional’s expertise and support was critical. Rehabilitation services had a considerable role in patient’s physical and emotional well-being, but inequitable access to these services was apparent.ConclusionsThis study described the impact of primary bone cancer on patients’ well-being and adjustment over time with the identification of influencing factors of better/worse experiences. It showed that impact was felt after end of treatment and affected patients at different life stages. Holistic models of survivorship care are needed.

scholarly journals The Impact of the Brexit on the Living Standards and Quality of Life in Britain

2020 ◽  
Vol 16 (2) ◽  
pp. 51-60
Author(s):  
Yefim S. Khesin
Keyword(s):  
Quality Of Life ◽  
European Union ◽  
Great Britain ◽  
Social Life ◽  
Transition Period ◽  
Well Being ◽  
Living Standards ◽  
The Uk ◽  
The Impact

The Object of the Study. Living standards and quality of life of the population in Great Britain. The Subject of the Study. The Brexit. The Purpose of the Study is exposing the impact of the Brexit on the living standards and quality of life in the country. The Main Provisions of the Article. Following a June 2016 referendum on continued European Union membership in which 52% voted to leave and 48% voted to stay the UK government announced the country's withdrawal from the EC (Brexit). In March 2017 it formally began the withdrawal process. The withdrawal was delayed by deadlock in the UK parliament. Having failed to get her agreement with the EC approved, Theresa May resigned as Prime Minister in July 2019 and was succeeded by Boris Johnson, an active supporter of the Brexit. An early general election was then held on 12 December. The Conservatives won a large majority. As a result, the parliament ratified the withdrawal agreement, and the UK formally left the EU on 31 January 2020. This began a transition period that is set to end on 31 December 2020, during which the UK and EU will negotiate their future relationship. The first round of negotiations between London and Brussels began in March 2020. The author investigates the consequences of the withdrawal of Great Britain from the EC on the living standards and quality of life, economic situation, labour market, social policy of the government. in this country. It analyzes on the impact of the Brexit on the major elements of human capital: education, science, health, living conditions, ecology. It found that short-term forecasts of what would happen immediately after the Brexit referendum were too pessimistic. Nowadays it is very difficult to give an accurate estimate of the future effect of the Brexit on cost of living in Great Britain – many essential issues in the relations between the UK and the EC remain open. Besides, the coronavirus crisis and lockdown measures may cause the grave damage to growth and jobs. Much evidence shows that in the medium- and long-term leaving the European Union damage the British economy and thus reduce the UK's real per-capita income level and may adversely affect jobs and earnings, income and wealth, life expectancy, education and skills, academic research, health status, environmental quality and subjective well-being in the UK. Finally, the author analyses the impact on the economic and social life in Great Britain of different Brexit scenarios after the end of the transition period. The consequences will differ sharply depending on whether the UK does a Soft or Hard (no deal) Brexit.

scholarly journals Motivations, experiences and aspirations of Trainee Nursing Associates in England. A qualitative study

2020 ◽  
Author(s):  
Rachel Louise King ◽  
Emily Wood ◽  
Steve Robertson ◽  
Tony Ryan ◽  
Angela Tod
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Personal Development ◽  
Group Discussion ◽  
Policy And Practice ◽  
The North ◽  
Previous State ◽  
Academic Workload ◽  
The Uk ◽  
The Impact

Abstract Background: The nursing associate role was developed in England in response to the ‘Shape of Caring’ review. It has been implemented to fulfil two aims; to bridge the gap between registered nurses and healthcare assistants, and to provide an alternative route into registered nursing in light of workforce shortages. Other high income countries deploy second level nurses within their healthcare systems, however the UK has a turbulent history with such roles. The previous state enrolled nurse was phased out in the 1990s, and more recently the assistant practitioner (AP) role has faced wide variation in titles, scope and pay. Little is known about those who have embarked on the new nursing associate training course and their experiences of the role. Methods: An exploratory qualitative study was undertaken using focus groups of trainee nursing associates to generate in-depth discussion about their motivations, experiences of training, and career aspirations.Three focus groups (n=15) took place in December 2018 using a purposive sample of trainee nursing associates registered at a University in the North of England. Two researchers facilitated each group discussion at a time and place convenient for participants. The discussions were audio recorded, transcribed and data was analysed thematically.Results: This study found that trainee nursing associates are motivated by affordable, local, career development. During training they face challenges relating to clinical support, academic workload and uncertainty about future career opportunities. They experience role ambiguity both individually and across the wider organisation. Trainee nursing associates rely on broad support networks to build their occupational identity.Conclusions: The barriers and facilitators of trainee nursing associate personal development have implications for policy and practice relating to recruitment and retention. The results increase our understanding of this emerging role, and have informed the development of a larger longitudinal cohort study. Further research is required to evaluate the impact of this new role.

scholarly journals Motivations, experiences and aspirations of Trainee Nursing Associates in England. A qualitative study

2020 ◽  
Author(s):  
Rachel Louise King ◽  
Tony Ryan ◽  
Emily Wood ◽  
Angela Tod ◽  
Steve Robertson
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Personal Development ◽  
Group Discussion ◽  
Policy And Practice ◽  
The North ◽  
Previous State ◽  
Academic Workload ◽  
The Uk ◽  
The Impact

Abstract BackgroundThe nursing associate role was developed in England in response to the ‘Shape of Caring’ review. It has been implemented to fulfil two aims; to bridge the gap between registered nurses and healthcare assistants, and to provide an alternative route into registered nursing in light of workforce shortages.Other high income countries deploy second level nurses within their healthcare systems, however the UK has a turbulent history with such roles. The previous state enrolled nurse was phased out in the 1990s, and more recently the assistant practitioner (AP) role has faced wide variation in titles, scope and pay. Little is known about those who have embarked on the new nursing associate training course and their experiences of the role.MethodsAn exploratory qualitative study was undertaken using focus groups of trainee nursing associates to generate in-depth discussion about their motivations, experiences of training, and career aspirations.Three focus groups (n=15) took place in December 2018 using a purposive sample of trainee nursing associates registered at a University in the North of England. Two researchers facilitated each group discussion at a time and place convenient for participants. The discussions were audio recorded, transcribed and data was analysed thematically.ResultsThis study found that trainee nursing associates are motivated by affordable, local, career development. During training they face challenges relating to clinical support, academic workload and uncertainty about future career opportunities. They experience role ambiguity both individually and across the wider organisation. Trainee nursing associates rely on broad support networks to build their occupational identity.ConclusionsThe barriers and facilitators of trainee nursing associate personal development have implications for policy and practice relating to recruitment and retention. The results increase our understanding of this emerging role, and have informed the development of a larger longitudinal cohort study. Further research is required to evaluate the impact of this new role.

Let's talk about sex: lower limb amputation, sexual functioning and sexual well-being: a qualitative study of the partner's perspective

2013 ◽  
Vol 22 (23-24) ◽  
pp. 3557-3567 ◽  
Author(s):  
Jesse EA Verschuren ◽  
Mariya A Zhdanova ◽  
Jan HB Geertzen ◽  
Paul Enzlin ◽  
Pieter U Dijkstra ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Lower Limb ◽  
Sexual Functioning ◽  
Well Being ◽  
Lower Limb Amputation ◽  
Limb Amputation

scholarly journals Experiences and views of patients, carers and healthcare professionals on using modems in domiciliary non-invasive ventilation (NIV): a qualitative study

2020 ◽  
Vol 7 (1) ◽  
pp. e000510
Author(s):  
Stephanie K Mansell ◽  
Cherry Kilbride ◽  
Martin J Wood ◽  
Francesca Gowing ◽  
Swapna Mandal
Keyword(s):  
Clinical Practice ◽  
Qualitative Study ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Well Being ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Registration Number ◽  
The Impact

BackgroundAdvances in technology means that domiciliary non-invasive ventilation (NIV) devices can be remotely monitored via modems in patients’ homes. Possible benefits and challenges of modem technology have yet to be established. This study explored the perspectives and experiences of patients, their carers and healthcare professionals (HCPs) on the addition of modem technology in managing home NIV.MethodsA qualitative study using a combination of focus groups for HCPs and interviews for carers/patients was undertaken. 12 HCPs and 22 patients/carers participated. These focus groups and interviews were audio-recorded, transcribed verbatim and analysed thematically.ResultsFive main themes were identified. ‘Surveillance: a paradox of findings’: HCPs were concerned about unduly scrutinising patients’ lives, potentially impacting on HCP patient relationships. Conversely, patients welcomed modem monitoring and did not express concerns regarding invasion of privacy. ‘Sanctions’: HCPs reported the modem increased access to care and allowed appropriate assessment of ongoing treatment. ‘Complacency and ethics’: HCPs expressed concerns patients may become complacent in seeking help due to expectations of modem monitoring, as well as being concerned regarding the ethics of modems. There was a suggestion patients and carers' expectations of monitoring were different to that of clinical practice, resulting in complacency in some cases. ‘Increased time for patient focused care’: HCPs in the focus groups described a number of ways in which using modems was more efficient. ‘Confidence: can be improved with technology’: patients and carers were positive about the impact of the modems on their health and well-being, particularly their confidence.ConclusionHCPs expressed concerns about surveillance were not corroborated by patients, suggesting acceptability of remote monitoring. Data suggests a need for increased clarity to patients/carers regarding clinical practice relating to responsiveness to modem data. The issue of complacency requires further consideration. Modem technology was acceptable and considered a useful addition by HCPs, patients and carers.Trial registration numberNCT03905382

scholarly journals Motivations, experiences and aspirations of Trainee Nursing Associates in England. A qualitative study

2019 ◽  
Author(s):  
Rachel Louise King ◽  
Emily Wood ◽  
Steve Robertson ◽  
Tony Ryan ◽  
Angela Tod
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Personal Development ◽  
Group Discussion ◽  
Policy And Practice ◽  
The North ◽  
Previous State ◽  
Academic Workload ◽  
The Uk ◽  
The Impact

Abstract Background The nursing associate role was developed in England in response to the ‘Shape of Caring’ review. It has been implemented to fulfil two aims; to bridge the gap between registered nurses and healthcare assistants, and to provide an alternative route into registered nursing in light of national workforce shortages. Other high income countries successfully deploy second level nurses within their healthcare systems, however the UK has a turbulent history with such roles. The previous state enrolled nurse was phased out in the 1990s, and more recently the assistant practitioner (AP) role has faced wide variation in titles, scope and pay. Little is known about those who embark on the new nursing associate training course, or their perceptions of the experience.Methods An exploratory qualitative study was undertaken using focus groups of trainee nursing associates to generate in-depth discussion about their motivations, experiences of training, and career aspirations. Three focus groups (n=15) took place in December 2018 using a purposive sample of trainee nursing associates registered at a University in the North of England. Two researchers facilitated each group discussion at a time and place convenient for participants. The discussions were audio recorded, transcribed and data was managed using Quirkos software v 1.5.2 and analysed thematically.Findings This study found that trainee nursing associates are motivated by affordable, local, career development. During training they face challenges relating to clinical support, academic workload and uncertainty about future career opportunities. They experience role ambiguity both individually and across the wider organisation. Trainee nursing associates rely on broad support networks to build their occupational identity.Conclusion The barriers and facilitators of trainee nursing associate personal development have implications for policy and practice relating to recruitment and retention. The findings increase our understanding of this emerging role, and inform the development of a larger longitudinal cohort study. Further research is required to evaluate the impact of this new role.

scholarly journals Motivations, experiences and aspirations of Trainee Nursing Associates in England. A qualitative study

2020 ◽  
Author(s):  
Rachel Louise King ◽  
Emily Wood ◽  
Steve Robertson ◽  
Tony Ryan ◽  
Angela Tod
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Personal Development ◽  
Group Discussion ◽  
Policy And Practice ◽  
The North ◽  
Previous State ◽  
Academic Workload ◽  
The Uk ◽  
The Impact

Abstract Background The nursing associate role was developed in England in response to the ‘Shape of Caring’ review. It has been implemented to fulfil two aims; to bridge the gap between registered nurses and healthcare assistants, and to provide an alternative route into registered nursing in light of workforce shortages. Other high income countries deploy second level nurses within their healthcare systems, however the UK has a turbulent history with such roles. The previous state enrolled nurse was phased out in the 1990s, and more recently the assistant practitioner (AP) role has faced wide variation in titles, scope and pay. Little is known about those who have embarked on the new nursing associate training course and their experiences of the role. Methods An exploratory qualitative study was undertaken using focus groups of trainee nursing associates to generate in-depth discussion about their motivations, experiences of training, and career aspirations.Three focus groups (n=15) took place in December 2018 using a purposive sample of trainee nursing associates registered at a University in the North of England. Two researchers facilitated each group discussion at a time and place convenient for participants. The discussions were audio recorded, transcribed and data was analysed thematically.Results This study found that trainee nursing associates are motivated by affordable, local, career development. During training they face challenges relating to clinical support, academic workload and uncertainty about future career opportunities. They experience role ambiguity both individually and across the wider organisation. Trainee nursing associates rely on broad support networks to build their occupational identity.Conclusions The barriers and facilitators of trainee nursing associate personal development have implications for policy and practice relating to recruitment and retention. The findings increase our understanding of this emerging role, and have informed the development of a larger longitudinal cohort study. Further research is required to evaluate the impact of this new role.

59. General medicine residents' perception of the mini-CEXs

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
S. Malhotra ◽  
R. Hatala ◽  
C.-A. Courneya
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
General Medicine ◽  
Clinical History ◽  
Phenomenological Approach ◽  
Medical Teacher ◽  
The Impact

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.

scholarly journals Impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases in the UK: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048772
Author(s):  
Toby O Smith ◽  
Pippa Belderson ◽  
Jack R Dainty ◽  
Linda Birt ◽  
Karen Durrant ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Healthcare Provision ◽  
Social Restriction ◽  
The Uk ◽  
The Impact

ObjectivesTo determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time.DesignMixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study.SettingUK online survey and interviews with community-dwelling individuals in the East of England.ParticipantsPeople in the UK with RMDs were invited to participate in an online survey. A subsection of respondents were invited to participate in the embedded qualitative study.Primary and secondary outcome measuresThe online survey, completed fortnightly over 10 weeks from April 2020 to August 2020, investigated changes in symptoms, social isolation and loneliness, resilience and optimism. Qualitative interviews were undertaken assessing participant’s perspectives on changes in symptoms, exercising, managing instrumental tasks such a shopping, medication and treatment regimens and how they experienced changes in their social networks.Results703 people with RMDs completed the online survey. These people frequently reported a deterioration in symptoms as a result of COVID-19 pandemic social restrictions (52% reported increase vs 6% reported a decrease). This was significantly worse for those aged 18–60 years compared with older participants (p=0.017). The qualitative findings from 26 individuals with RMDs suggest that the greatest change in daily life was experienced by those in employment. Although some retired people reported reduced opportunity for exercise outside their homes, they did not face the many competing demands experienced by employed people and people with children at home.ConclusionsPeople with RMDs reported a deterioration in symptoms when COVID-19 pandemic social restriction measures were enforced. This was worse for working-aged people. Consideration of this at-risk group, specifically for the promotion of physical activity, changing home-working practices and awareness of healthcare provision is important, as social restrictions continue in the UK.

scholarly journals Three models for the regulation of polygenic scores in reproduction

2021 ◽  
pp. medethics-2020-106588
Author(s):  
Sarah Munday ◽  
Julian Savulescu
Keyword(s):  
Human Genetics ◽  
Ethical Issues ◽  
Well Being ◽  
Embryo Selection ◽  
Risk Scores ◽  
Regulatory Regime ◽  
Polygenic Scores ◽  
The Usa ◽  
The Uk ◽  
The Impact

The past few years have brought significant breakthroughs in understanding human genetics. This knowledge has been used to develop ‘polygenic scores’ (or ‘polygenic risk scores’) which provide probabilistic information about the development of polygenic conditions such as diabetes or schizophrenia. They are already being used in reproduction to select for embryos at lower risk of developing disease. Currently, the use of polygenic scores for embryo selection is subject to existing regulations concerning embryo testing and selection. Existing regulatory approaches include ‘disease-based' models which limit embryo selection to avoiding disease characteristics (employed in various formats in Australia, the UK, Italy, Switzerland and France, among others), and 'laissez-faire' or 'libertarian' models, under which embryo testing and selection remain unregulated (as in the USA). We introduce a novel 'Welfarist Model' which limits embryo selection according to the impact of the predicted trait on well-being. We compare the strengths and weaknesses of each model as a way of regulating polygenic scores. Polygenic scores create the potential for existing embryo selection technologies to be used to select for a wider range of predicted genetically influenced characteristics including continuous traits. Indeed, polygenic scores exist to predict future intelligence, and there have been suggestions that they will be used to make predictions within the normal range in the USA in embryo selection. We examine how these three models would apply to the prediction of non-disease traits such as intelligence. The genetics of intelligence remains controversial both scientifically and ethically. This paper does not attempt to resolve these issues. However, as with many biomedical advances, an effective regulatory regime must be in place as soon as the technology is available. If there is no regulation in place, then the market effectively decides ethical issues.

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