From concept to practice, is multidimensional care the leading principle in hospice care? An exploratory mixed method study

2017 ◽  
Vol 10 (1) ◽  
pp. e5-e5 ◽  
Author(s):  
Everlien de Graaf ◽  
Merel van Klinken ◽  
Danielle Zweers ◽  
Saskia Teunissen
Keyword(s):  
Clinical Reasoning ◽  
Mixed Method ◽  
Hospice Care ◽  
Interdisciplinary Collaboration ◽  
Assessment Tools ◽  
Mixed Method Study ◽  
Patient Records ◽  
Multiprofessional Team ◽  
Primary Focus ◽  
Group Interviews

BackgroundHospice care (HC) aims to optimise the quality of life of patients and their families by relief and prevention of multidimensional suffering. The aim of this study is to gain insight into multidimensional care (MC) provided to hospice inpatients by a multiprofessional team (MT) and identify facilitators, to ameliorate multidimensional HC.MethodsThis exploratory mixed-method study with a sequential quantitative–qualitative design was conducted from January to December 2015. First a quantitative study of 36 patient records (12 hospices, 3 patient records/hospice) was performed. The outcomes were MC, clinical reasoning and assessment tools. Second, MC was qualitatively explored using semistructured focus group interviews with multiprofessional hospice teams. Both methods had equal priority and were integrated during analysis.ResultsThe physical dimension was most prevalent in daily care, reflecting the patients' primary expressed priority at admission and the nurses' and physicians' primary focus. The psychological, social and spiritual dimensions were less frequently described. Assessment tools were used systematically by 4/12 hospices. Facilitators identified were interdisciplinary collaboration, implemented methods of clinical reasoning and structures.ConclusionsMC is not always verifiable in patient records; however, it is experienced by hospice professionals. The level of MC varied between hospices. The use of assessment tools and a stepped skills approach for spiritual care are recommended and multidimensional assessment tools should be developed. Leadership and commitment of all members of the MT is needed to establish the integration of multidimensional symptom management and interdisciplinary collaboration as preconditions for integrated multidimensional HC.

Suitable support for anxious hospice patients: what do nurses ‘know’, ‘do’ and ‘need’? An explanatory mixed method study

2017 ◽  
Vol 10 (2) ◽  
pp. e15-e15 ◽  
Author(s):  
Danielle Zweers ◽  
Everlien de Graaf ◽  
Saskia Teunissen
Keyword(s):  
Mixed Method ◽  
Online Survey ◽  
Hospice Care ◽  
Prediction Models ◽  
Assessment Tools ◽  
Panic Attacks ◽  
Future Research ◽  
Mixed Method Study ◽  
Anxiety Management ◽  
Late Night

ObjectiveTo provide insight into what nurses know, do and need to provide support to anxious patients in hospice care (HC).MethodsA mixed method study consisted of an online survey and focus groups (FGs) about what nurses know, do, and need was conducted. 336 HC nurses were invited to participate. Descriptive statistics were computed using SPSS. The χ2 and t-tests were conducted to compare. The FGs were transcribed verbatim and thematically analysed.ResultsThe survey was completed by 265 nurses (79%), and five FGs (n=25) were conducted. Most nurses had >10 years working experience; mean age was 52. The majority (59%) felt that they were equipped with sufficient knowledge; however, lack of knowledge (31%) as well as lack of time (50%) were hampering factors. Identification of anxiety was difficult due to the variety of its expression. Tools for identifying were used by 37%. Interventions were generally chosen intuitively. A major responsibility was experienced in caring for patients with panic attacks during late night shifts, making immediate decisions necessary.ConclusionThis study highlights the struggles of nurses caring for anxious patients in HC. Anxiety management is dependent on the competencies and preferences of the individual nurse. One-third of the nurses require additional training. According to HC nurses, the intervention set should include guidelines for applying assessment tools, effective communication strategies and decision models as well as prediction models in order to select tailored interventions. Future research should focus on patients’ perspectives in order to understand crucial measures for anxiety management.

scholarly journals Characteristics of influential peers in the eyes of secondary school students: a mixed method study

2017 ◽  
Vol 18 (05) ◽  
pp. 429-440 ◽  
Author(s):  
Alice Y. Loke ◽  
Yim-wah Mak ◽  
Cynthia S.T. Wu
Keyword(s):  
Focus Group ◽  
Health Risk ◽  
Risk Behaviors ◽  
Mixed Method ◽  
At Risk Students ◽  
Health Risk Behaviors ◽  
Mixed Method Study ◽  
Focus Group Interviews ◽  
School Students ◽  
Group Interviews

Aim It is the aim of this study to explore the characteristics of influential peers identified by schoolmates, and the mechanism by which they exert their influence on their peers. Background Adolescent crowds are a salient influence on the health-risk behaviors of peers, contributing to adolescent substance use such as drinking alcohol, smoking cigarettes, and taking drugs. Methods A mixed method study. Three schools granted us access to students and those who had been nominated as influential by their peers. The students were asked to nominate and indicated the characteristics of peers whom they considered influential in a quantitative study. Those peers whom they considered influential were invited to take part in focus group interviews. A total of six focus group interviews were conducted, comprised of two groups from each school, with an average of seven participants in each group. Findings Students considered caring and friendliness (91.0%), being a buddy (88.5%), and entertaining/humor (86.8%) as the top three characteristics of influential peers. The interviews revealed that the students believed that they are influential because of their cheerfulness and humor, considerateness, ability to communicate, popularity and sociability, sincerity and trustworthiness, and because they possess the characteristics of a leader. They also believed that their power to influence came about through their helpfulness, accommodation, and the closeness of their relationships. Their influence was manifested in both positive and negative ways on the academic pursuits and health-risk behaviors of their peers. In order to engage at-risk students in health promotion programs, it is important to identify their influential peers, and to understand how adolescent friends may help one another to resist behaviors that pose a risk to their health.

scholarly journals Preventing ventilator-associated pneumonia—a mixed-method study to find behavioral leverage for better protocol adherence

2018 ◽  
Vol 39 (10) ◽  
pp. 1222-1229 ◽  
Author(s):  
Aline Wolfensberger ◽  
Marie-Theres Meier ◽  
Lauren Clack ◽  
Peter W. Schreiber ◽  
Hugo Sax
Keyword(s):  
Focus Group ◽  
Mixed Method ◽  
University Hospital ◽  
Mixed Method Study ◽  
Ventilator Associated Pneumonia ◽  
Theory Approach ◽  
Prevention Measures ◽  
Focus Group Interviews ◽  
Protocol Adherence ◽  
Group Interviews

AbstractObjectivePreventing ventilator-associated pneumonia (VAP) is an important goal for intensive care units (ICUs). We aimed to identify the optimal behavior leverage to improve VAP prevention protocol adherence.DesignMixed-method study using adherence measurements to assess 4 VAP prevention measures and qualitative analysis of semi-structured focus group interviews with frontline healthcare practitioners (HCPs).SettingThe 6 ICUs in the 900-bed University Hospital Zurich in Zurich, Switzerland.Patients and participantsAdherence to VAP prevention measures were assessed in patients with a device for invasive ventilation (ie, endotracheal tube, tracheostomy tube). Participants in focus group interviews included a convenience samples of ICU nurses and physicians.ResultsBetween February 2015 and July 2017, we measured adherence to 4 protocols: bed elevation showed adherence at 27% (95% confidence intervals [CI], 23%–31%); oral care at 41% (95% CI, 36%–45%); sedation interruption at 81% (95% CI, 74%–85%); and subglottic suctioning at 88% (95% CI, 83%–92%). Interviews were analyzed first inductively according a grounded theory approach then deductively against the behavior change wheel (BCW) framework. Main behavioral facilitators belonged to the BCW component ‘reflective motivation’ (ie, perceived seriousness of VAP and self-efficacy to prevent VAP). The main barriers belonged to ‘physical capability’ (ie, lack of equipment and staffing and side-effects of prevention measures). Furthermore, 2 primarily technical approaches (ie, ‘restructuring environment’ and ‘enabling HCP’) emerged as means to overcome these barriers.ConclusionsOur findings suggest that technical, rather than education-based, solutions should be promoted to improve VAP prevention. This theory-informed mixed-method approach is an effective means of guiding infection prevention efforts.

Evaluation of nutritional status, food intake and food waste costs in ‎hospitalized patients, considering relevant causes and finding possible ‎solutions: Protocol of a mixed-method study (Preprint)

2020 ◽  
Author(s):  
Maryam Amini ◽  
Bahareh Nikooyeh ◽  
Delaram Ghodsi ◽  
Parisa Torabi ◽  
Tirang Reza Neyestani
Keyword(s):  
Food Intake ◽  
Nutritional Status ◽  
Food Waste ◽  
Mixed Method ◽  
Nutritional Assessment ◽  
Financial Burden ◽  
Mini Nutritional Assessment ◽  
Assessment Tools ◽  
Mixed Method Study ◽  
Inflammatory Status

BACKGROUND Hospitalization may seriously affect patients’ nutritional status and may ‎occasionally be accompanied by malnutrition development or aggravation. Food intake is ‎often altered during hospitalization, which is tightly connected to malnutrition. On the other ‎hand, a huge amount of plate food wasted by patients, in addition to its health consequences, ‎has enormous economic and environmental expenses for governments and societies. OBJECTIVE This ‎investigation aims firstly to assess the nutritional status of the patients hospitalized in general ‎wards and secondly to evaluate the quantity and financial burden of patients’ food waste ‎along with its possible nutritional outcomes.‎ METHODS A mixed-method study is performed in three general hospitals in Tehran. Adult ‎inpatients with eligibility criteria are recruited to the study from medical and surgical ‎wards. Anthropometric and demographic data are collected and energy and protein intakes ‎are extracted from a 24-hour food recall. Plate food wastes of eligible patients are weighed ‎in breakfast, lunch, and snacks during one day. Then, the economic cost of food waste is ‎calculated for each meal, patient, and ward. Nutritional status is determined through the ‎following methods: 1. Subjective criteria (Mini Nutritional Assessment and Subjective ‎Global Assessment tools) for malnutrition; 2. Measuring serum albumin, pre-albumin and ‎total protein for protein status; 3. Measuring serum retinol and 25-hydroxycalciferol assay ‎to assess certain micronutrient status (vitamins A and D); and 4. Examination of serum β-‎carotene, total antioxidant capacity, malondialdehyde, and highly sensitive C-reactive ‎protein to determine oxidative stress and inflammatory status. Also, a qualitative study is ‎conducted to evaluate the possible reasons for wasting food in these hospitals.‎ RESULTS ----- CONCLUSIONS This study will provide appropriate data regarding the health and economic burden ‎of food waste in studied hospitals. These data are especially useful to healthcare authorities ‎and policymakers for planning efficient solutions to decrease food waste and to improve ‎patients' nutritional status. ‎

scholarly journals ‘A volunteer for life’

2020 ◽  
Vol 7 (2) ◽  
pp. 296-302
Author(s):  
Blessings N. Kaunda-Khangamwa
Keyword(s):  
Knowledge Production ◽  
Mixed Method ◽  
Sexual And Reproductive Health ◽  
Service Use ◽  
Mixed Method Study ◽  
Resilience Theory ◽  
Multiple Perspectives ◽  
Group Interviews ◽  
Methodological Considerations ◽  
Living With Hiv

In a time of renewed interest in the challenges of adolescent sexual and reproductive health (SRH) and service use, increased scholarly attention paid to fieldwork and knowledge production is critical. I describe the pleasure and challenges of engaging with multiple perspectives, spaces, places, and roles at a family centre in Malawi to understand the complexity of the interactions and relationships related to my doctoral fieldwork. This work is part of a large mixed-method study that explores SRH, service use, and resilience among adolescents living with HIV and attending a teen-club clinic in Blantyre, Malawi. Drawing from resilience theory and experiences of reflexivity, I reflect on my roles as a student of medical anthropology and public health, a ‘friend’, an ‘aunt’, and a ‘volunteer’; on my occupation of diverse spaces (clinics, homes, school grounds, digital); and on my use of multiple methods (including participants’ observations, individual and group interviews, workshops, feedback sessions, and fieldnotes), which make up the data collection, analysis, and interpretation processes. The reflections contained in this essay advance our understanding of the implications of the methodological considerations and ethical questions underscoring approaches to adolescents research.

scholarly journals The decision for hospice care in patients with terminal illness in Shanghai: A mixed-method study

2021 ◽  
Author(s):  
Chunyan Chen ◽  
Xiaobin Lai ◽  
Aiping Xu ◽  
Shuangshuang Yang ◽  
Jingxian Jin ◽  
...  
Keyword(s):  
Mixed Method ◽  
Terminal Illness ◽  
Hospice Care ◽  
Mixed Method Study

scholarly journals Social streaming? Navigating music as personal and social

2016 ◽  
Vol 23 (6) ◽  
pp. 643-659 ◽  
Author(s):  
Anja N Hagen ◽  
Marika Lüders
Keyword(s):  
Focus Group ◽  
Mixed Method ◽  
Social Awareness ◽  
Mixed Method Study ◽  
Focus Group Interviews ◽  
Self Reports ◽  
Social Features ◽  
Streaming Services ◽  
Group Interviews ◽  
Music Streaming

Music-streaming services embed social features that enable users to connect to one another and use music as social objects. This article examines how these features are experienced within negotiations of music as personal and social through the acts of sharing music and of following others. The analysis relies on 23 focus-group interviews with 124 Spotify and/or Tidal users and a mixed-method study including music-diary self-reports, online observation and interviews with 12 heavy users. Our findings suggest that users incorporate social awareness in non-sharing, selective-sharing and all-sharing approaches with strong, weak and absent ties. These ties are characterized by different configurations of social and music homophily. Negotiations of music as personal and social shape how music-streaming services are experienced.

scholarly journals The Benefits of Spiritual Diaries: A Mixed-Method Study in Korea

2021 ◽  
Author(s):  
Suk-Sun Kim ◽  
Yeounsoo Kim-Godwin ◽  
Minji Gil ◽  
DaEun Kim ◽  
Yeon Kum Cheon
Keyword(s):  
Focus Group ◽  
Mixed Method ◽  
Spiritual Growth ◽  
Healthcare Providers ◽  
Self Care ◽  
Well Being ◽  
Psychological Wellbeing ◽  
Mixed Method Study ◽  
Focus Group Interviews ◽  
Group Interviews

AbstractThis mixed study examined the benefits of spiritual diaries in Korea. Quantitatively, differences in spiritual growth and psychological well-being were examined in relation to the frequency of writing spiritual diaries among 385 participating adults. The group who wrote spiritual diaries ‘5–7 times a week’ had significantly higher scores relating to spiritual growth and psychological wellbeing than other groups across the outcome variables. Qualitatively, the study also explored the benefits of writing spiritual diaries among 37 adults. Three major themes using four focus group interviews, were identified: (a) the acquisition of godly habits, (b) a closer walk with Jesus, and (c) the fullness of God’s presence. These findings are particularly important for healthcare providers who want to facilitate patient self-care.

An Investigation of the Sexual and Relational Difficulties of Women Who Survived Sexual Assault: A Mixed-Method Study

2013 ◽  
Author(s):  
David Martinez Alpizar ◽  
Patricia Cabral ◽  
Mohena Moreno ◽  
Nouha H. Hallak ◽  
Luciana Lagana
Keyword(s):  
Sexual Assault ◽  
Mixed Method ◽  
Mixed Method Study ◽  
Relational Difficulties
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