Transitional care of adolescents with Multiple Osteochondromas: a convergent mixed-method study ‘Patients’, parents’ and healthcare providers’ perspectives on the transfer process’

ObjectivesMultiple osteochondromas (MO) is a rare hereditary disease characterised by numerous benign bone tumours. Its chronic aspect requires a well-organised transition from paediatric care to adult care; however, little is known on organising this care specific for patients with MO. This study aims to gain insight on this topic.DesignConvergent mixed-method study.SettingThis study was conducted at the orthopaedic and paediatrics department of an MO-expertise centre in the Netherlands.Participants12 patients, 10 parents and 10 healthcare professionals were interviewed. An additional survey was completed by 2 young adults.Primary and secondary outcomesThe (1) themes on transition, identified through template analysis and (2) transfer experience and satisfaction assessed by an 18-item On Your Own Feet-Transfer Experience Scale (OYOF-TES, range: 18–90) and by Numeric Rating Scale (NRS, range: 1–10).ResultsThe following three key themes were identified in the qualitative analysis: (1) patient and parent in the lead can be encouraged by self-management tools, (2) successful transfers need interprofessional collaboration and communication and (3) how can we prepare patients for the transitional process? Stakeholders’ insights to improve transition were listed and divided into these three themes.Several important aspects were underlined, particularly within the first theme; speaking-up was difficult for patients especially when parents were not directly involved. Moreover, the high psychological impact of the disease requires coaching of self-management and psychological counselling to facilitate stakeholders in their changing roles.Twenty patients completed the quantitative survey. Mean satisfaction score with the transfer process was poor, which was assessed with the NRS (mean=5.7±2.1; range: 1–9) and the OYOF-TES (mean=56.3±14.2; range: 32–85). The OYOF-TES only showed a negative correlation (R2=0.25; p=0.026) with the number of surgical interventions in the past.ConclusionOverall, the transfer process was found unsatisfactory. Improvement can be achieved by supporting and guiding the patients to be in the lead of their care. Moreover, preparation for transfer and a multidisciplinary approach may enhance successful transition.

Download Full-text

A Mixed-Method Study to Explore Patients' Perspective of Self-Management Tasks in the Early Phase after Kidney Transplant

Progress in Transplantation ◽

10.7182/pit2014728 ◽

2014 ◽

Vol 24 (1) ◽

pp. 8-18 ◽

Cited By ~ 24

Author(s):

Gabriela Schmid-Mohler ◽

Petra Schäfer-Keller ◽

Anja Frei ◽

Thomas Fehr ◽

Rebecca Spirig

Keyword(s):

Kidney Transplant ◽

Mixed Method ◽

Early Phase ◽

Self Management ◽

Mixed Method Study ◽

Patients Perspective

Download Full-text

Improving the quality of self-management support in ambulatory cancer care: a mixed-method study of organisational and clinician readiness, barriers and enablers for tailoring of implementation strategies to multisites

BMJ Quality & Safety ◽

10.1136/bmjqs-2020-012051 ◽

2021 ◽

pp. bmjqs-2020-012051

Author(s):

Doris Howell ◽

Melanie Powis ◽

Ryan Kirkby ◽

Heidi Amernic ◽

Lesley Moody ◽

...

Keyword(s):

Mixed Method ◽

Cancer Care ◽

Implementation Strategies ◽

Self Management ◽

Normalisation Process Theory ◽

Mixed Method Study ◽

Successful Implementation ◽

Management Support ◽

Specific Implementation

IntroductionImproving the quality of self-management support (SMS) for treatment-related toxicities is a priority in cancer care. Successful implementation of SMS programmes depends on tailoring implementation strategies to organisational readiness factors and barriers/enablers, however, a systematic process for this is lacking. In this formative phase of our implementation-effectiveness trial, Self-Management and Activation to Reduce Treatment-Related Toxicities, we evaluated readiness based on constructs in the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT) and developed a process for mapping implementation strategies to local contexts.MethodsIn this convergent mixed-method study, surveys and interviews were used to assess readiness and barriers/enablers for SMS among stakeholders in 3 disease site groups at 3 regional cancer centres (RCCs) in Ontario, Canada. Median survey responses were classified as a barrier, enabler or neutral based on a priori cut-off values. Barriers/enablers at each centre were mapped to CFIR and then inputted into the CFIR-Expert Recommendations for Implementing Change Strategy Matching Tool V.1.0 (CFIR-ERIC) to identify centre-specific implementation strategies. Qualitative data were separately analysed and themes mapped to CFIR constructs to provide a deeper understanding of barriers/enablers.ResultsSMS in most of the RCCs was not systematically delivered, yet most stakeholders (n=78; respondent rate=50%) valued SMS. For centre 1, 7 barriers/12 enablers were identified, 14 barriers/9 enablers for centre 2 and 11 barriers/5 enablers for centre 3. Of the total 46 strategies identified, 30 (65%) were common across centres as core implementation strategies and 5 tailored implementation recommendations were identified for centres 1 and 3, and 4 for centre 2.ConclusionsThe CFIR and CFIR-ERIC were valuable tools for tailoring SMS implementation to readiness and barriers/enablers, whereas NPT helped to clarify the clinical work of implementation. Our approach to tailoring of implementation strategies may have relevance for other studies.

Download Full-text

Rating scale impact on EFL essay marking: A mixed-method study

Assessing Writing ◽

10.1016/j.asw.2007.07.001 ◽

2007 ◽

Vol 12 (2) ◽

pp. 86-107 ◽

Cited By ~ 31

Author(s):

Khaled Barkaoui

Keyword(s):

Mixed Method ◽

Rating Scale ◽

Mixed Method Study

Download Full-text

Time to change the paradigm? A mixed method study of the preferred and potential features of an asthma self-management app

Health Informatics Journal ◽

10.1177/1460458219853381 ◽

2019 ◽

Vol 26 (2) ◽

pp. 862-879 ◽

Cited By ~ 1

Author(s):

Chi Yan Hui ◽

Robert Walton ◽

Brian McKinstry ◽

Hilary Pinnock

Keyword(s):

Thematic Analysis ◽

Mixed Method ◽

Paradigm Shift ◽

Quantitative Data ◽

Self Management ◽

Mixed Method Study ◽

Management Support ◽

Support Strategies ◽

Patient Dependency ◽

Purposive Sample

We explored the potential of asthma apps to support self-management and identified preferred features that enable users to live with asthma. We recruited patients from five UK practices and social media; observed their usage of our app, administered a questionnaire and interviewed a purposive sample of patients and professionals to explore preferred features. Thematic analysis of interview was synthesised with quantitative data. A total of 111 patients used our app for 3 months. We interviewed 15 patients and 16 professionals. Participants were interested in a broad range of self-management support strategies, including action plans, monitoring with feedback, allergy/weather warnings and tailor-made running coaching. Professionals wanted to integrate patients’ logs with practice records, though were concerned about data overload and risk of patient dependency. We propose a paradigm shift - from apps developed to provide features that are easy to implement technologically, to an approach in which apps are designed to deliver theoretically grounded preferred components.

Download Full-text