scholarly journals Using Multidisciplinary Focus Groups to Inform the Development of mI SMART: A Nurse-Led Technology Intervention for Multiple Chronic Conditions

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Jennifer A. Mallow ◽  
Laurie A. Theeke ◽  
Elliott Theeke ◽  
Brian K. Mallow
Keyword(s):  
Focus Groups ◽  
Chronic Conditions ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Healthcare Team ◽  
User Friendliness ◽  
Team Members ◽  
Outcomes Of Care ◽  
Care Technology ◽  
Improve Access

Used as integrated tools, technology may improve the ability of healthcare providers to improve access and outcomes of care. Little is known about healthcare teams’ preferences in using such technology. This paper reports the findings from focus groups aimed at evaluating a newly developed primary care technology platform. Focus groups were completed in academic, outpatient, and community settings. Focus groups were attended by 37 individuals. The participants included professionals from multiple disciplines. Both prescribing (N=8) and nonprescribing healthcare team members (n=21) completed the focus groups and survey. The majority were practicing for more than 20 years (44.8%) in an outpatient clinic (62%) for 20–40 hours per week (37.9%). Providers identified perceived obstacles of patient use as ability, willingness, and time. System obstacles were identified as lack of integration, lack of reimbursement, and cost. The positive attributes of the developed system were capability for virtual visits, readability, connectivity, user-friendliness, ability to capture biophysical measures, enhanced patient access, and incorporation of multiple technologies. Providers suggested increasing capability for biophysical and symptom monitoring for more common chronic conditions. Technology interventions have the potential to improve access and outcomes but will not be successful without the input of users.

scholarly journals HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Family Caregivers ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Team Approach ◽  
Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

scholarly journals Medication understanding and health literacy among patients with multiple chronic conditions: a study conducted in Bangladesh

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Fahad Imtiaz Rahman ◽  
Farina Aziz ◽  
Sumaiya Huque ◽  
Sadia Afruz Ether
Keyword(s):  
Health Literacy ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Healthcare Providers ◽  
Poor Health ◽  
Multiple Chronic Conditions ◽  
Multiple Chronic Condition ◽  
Convenience Sample ◽  
Individual Interviews ◽  
Reduce Medication Error

Objectives: Medication understanding is critical for patients who suffer from multiple chronic conditions in order to reduce medication error and is often associated with poor health outcomesand low adherence. This study aims to identify the gap of medication knowledge among multiple chronic condition patients in Bangladesh, in order to aid physicians and other healthcare providers in improving health literacy.Methods: Individual interviews of a convenience sample of multiple chronic condition patients in Bangladesh were heldwhere they were asked a number of questions for assessing medication related literacy.Results: More than 26% patients failed to cite the brand name of all their prescribed medications while the rate of patients not knowing the generic names was far worse (88.1%). Nearly 1 out of every 4 patients did not know the purpose of all their medications and more than half of the participants (55%) did not know the strengths of their drugs. While knowledge about medication routes and regimen was satisfactory, awareness regarding risk factors of medicine was lowest of all. Only 1 out of every 4 patients had a habit of reading drug information leaflet. Patient’s ability to correctly state the purpose of their medication seemed to be positively associated with age (p=0.004) and negatively associated with number of medicines taken (p=0.03).Conclusions: Many patients demonstrated poor health literacy regarding medication. Routine review of medications from physician or health provider can significantly improve their health literacy, leading to better treatment outcome and medication adherence.

scholarly journals Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study

2019 ◽  
Author(s):  
Kah Mun Foo ◽  
Meena Sundram ◽  
Helena Legido-Quigley
Keyword(s):  
Qualitative Study ◽  
Waiting Time ◽  
Chronic Conditions ◽  
Resource Constraints ◽  
Healthcare Providers ◽  
Policy Formulation ◽  
Care Quality ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Facilitators And Barriers

Abstract Background About one-third of all adults worldwide were diagnosed with multiple chronic conditions (MCCs). Literature had found several challenges of providers and patients coping with managing MCCs in the community, and yet limited research studies that consider their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. Methods This involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provides subsidised primary care services. Topic guides were developed with reference from literature review, Chronic Care Model (CCM) and Framework for patient-centred access to healthcare. Results Despite perceived affordable charges and availability of support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of the healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those that did not turn up might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges of delivering safe and quality care with limited consultation duration due to the need to manage waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle related guidelines, patients’ actions are influenced by multiple factors including work nature, beliefs and environment. Conclusions There were barriers on care access, delivery and self-management as reported. It is crucial to adopt whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCCs management. This study has also highlighted the importance to consider different viewpoints of healthcare providers and users in policy formulation and community care planning.

scholarly journals Adaptation of a mobile health platform to the needs of cystic fibrosis patients, caregivers, and clinicians in the United States (Preprint)

2020 ◽  
Author(s):  
Sarah B. Rutland ◽  
Rikard Palmer Bergquist ◽  
Andreas Hager ◽  
Robin Geurs ◽  
Cathy Mims ◽  
...  
Keyword(s):  
United States ◽  
Cystic Fibrosis ◽  
Focus Groups ◽  
Mobile Health ◽  
Healthcare Providers ◽  
The United States ◽  
Standards Of Care ◽  
Healthcare Team ◽  
Daily Care ◽  
Clinic Visits

BACKGROUND Cystic fibrosis (CF) is an inherited chronic condition that requires extensive daily care and quarterly clinic visits with a multidisciplinary care team. The limited exchange of information outside of the quarterly clinic visits impedes optimal disease self-management, patient engagement, and shared decision-making. OBJECTIVE This study adapted a mobile health (mHealth) application originally developed in Sweden to the needs of people with CF, their caregivers, and healthcare providers in the United States, and tested it as a platform for sharing patient-generated health data (PGHD) with the CF healthcare team. METHODS Focus groups with CF healthcare providers, adolescents with CF, and caregivers of children and adolescents with CF were conducted to determine what modifications were necessary. Focus group data were analyzed using a thematic analysis, and emergent themes were ranked according to desirability and technical feasibility. The mHealth platform was then modified to meet the identified needs and preferences, and the flow of PGHD to a secure REDCap database was tested. Protocols for data management and clinical follow-up were also developed. RESULTS Five focus groups with 21 participants were conducted. Recommended modifications pertained to all functionalities of the mHealth platform, including tracking of symptoms, treatments, and activities of daily care; creating and organizing medication lists and setting up reminders; generating reports for the healthcare team; language and presentation; sharing and privacy; as well as settings and accounts. Overall, healthcare providers recommended changes to align the mHealth platform with U.S. standards of care, people with CF and their caregivers requested to track more disease symptoms and clinical outcomes, and both groups suggested the inclusion of a mental health tracker as well as more detailed response options and precise language. Beta-testers of the modified platform reported issues related to translatability to U.S. environment and various bugs. CONCLUSIONS This study demonstrated the importance of identifying the needs and preferences of target users and stakeholders before adopting existing mHealth solutions. All relevant perspectives, including those of clinicians, patients, and caregivers, should be thoroughly considered in order to meet both end-user needs and evidence-based practice recommendations. CLINICALTRIAL NCT03910881

scholarly journals A systematic literature review of the assessment of treatment burden experienced by patients and their caregivers

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Orla C. Sheehan ◽  
Bruce Leff ◽  
Christine S. Ritchie ◽  
Sarah K. Garrigues ◽  
Lingsheng Li ◽  
...  
Keyword(s):  
New York ◽  
Literature Review ◽  
Chronic Conditions ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Assessment Method ◽  
Cochrane Library ◽  
York Academy ◽  
Multiple Chronic Conditions ◽  
Treatment Burden

Abstract Background Many older adults with multiple chronic conditions, particularly those who are functionally impaired, spend considerable time juggling the competing demands of managing their conditions often assisted by caregivers. We examined methods of assessing the treatment burden experienced by this population as a first step to identifying strategies to reduce it. Methods Systematic searches were performed of the peer-reviewed and grey-literature (PubMed, Cochrane library, CINAHL, EMBASE, Web of Science, SCOPUS, New York Academy of Medicine Grey Literature Review, NLM catalog and ProQuest Digital Theses and Dissertations). After title and abstract screening, both qualitative and quantitative articles describing approaches to assessment of treatment burden were included. Results Forty-five articles from the peer reviewed and three items from the grey literature were identified. Most articles (34/48) discussed treatment burden associated with a specific condition. All but one examined the treatment burden experienced by patients and six addressed the treatment burden experienced by caregivers. Qualitative studies revealed many aspects of treatment burden including the burdens of understanding the condition, juggling, monitoring and adjusting treatments, efforts to engage with others for support as well as financial and time burdens. Many tools to assess treatment burden in different populations were identified through the qualitative data. The most commonly used instrument was the Treatment Burden Questionnaire. Conclusions Many instruments are available to assess treatment burden, but no one standardized assessment method was identified. Few articles examined approaches to measuring the treatment burden experienced by caregivers. As people live longer with more chronic conditions healthcare providers need to identify patients and caregivers burdened by treatment and engage in approaches to ameliorate treatment burden. A standard and validated assessment method to measure treatment burden in the clinical setting would help to enhance the care of people with multiple chronic conditions, allow comparison of different approaches to reducing treatment burden, and foster ongoing evaluation and monitoring of burden across conditions, patient populations, and time.

Developmentally appropriate patient education during transition: A study of healthcare providers’ and parents’ perspective

2019 ◽  
Vol 79 (4) ◽  
pp. 377-389
Author(s):  
Maxime Morsa ◽  
Rémi Gagnayre ◽  
Marie-Pascale Pomey ◽  
Carole Deccache ◽  
Pierre Lombrail
Keyword(s):  
Patient Education ◽  
Young People ◽  
Focus Groups ◽  
Psychosocial Development ◽  
Chronic Conditions ◽  
Developmentally Appropriate ◽  
Healthcare Providers ◽  
Adolescent And Young Adult ◽  
Educational Approach ◽  
Hospital System

Introduction: Patient education is recommended to improve the transition from paediatric to adult care for young people with chronic conditions. But a consensus has not been reached regarding a particular model. This study aimed to understand how to prepare for the implementation of a Developmentally Appropriate Patient Education during Transition (DAPET), which would revolve around the young person’s psychosocial development. Method: Three focus groups were organised with healthcare providers and two focus groups took place with the parents of young people with chronic conditions. We used activity theory to explore practices and to identify obstacles to the implementation of DAPET, as well as to recognise which resources might be available to implement DAPET. Results: Healthcare providers agreed on the need to engage in an educational approach centred on the psychosocial development of young people during transition. However, study findings highlight the following obstacles to doing so: a lack of competencies in adolescent and young adult medicine and a lack of available resources to meet these goals. Furthermore, parents wanted to redefine their role in the transition process and to allow their children to develop self-management skills. Conclusion: Healthcare providers and parents considered the implementation of DAPET to be acceptable and even advisable. However, the programme’s feasibility was questioned due to perceived shortfalls in the hospital system as it currently stands and the ways in which an educational approach would be applied. An environment that facilitates healthcare providers’ educational initiatives and encourages the participation of parents is required.

scholarly journals A Developmentally Appropriate Patient Education during Transition

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R G Gagnayre ◽  
P L Lombrail
Keyword(s):  
Patient Education ◽  
Young People ◽  
Focus Groups ◽  
Psychosocial Development ◽  
Chronic Conditions ◽  
Developmentally Appropriate ◽  
Healthcare Providers ◽  
Adult Care ◽  
Educational Approach ◽  
Enabling Environment

Abstract Introduction Patient education is recommended to improve transition from pediatric to adult care for young people living with chronic conditions. But a consensus has not been reached regarding a particular model. Our study aims to understand how to implement a Developmentally Appropriate Patient Education during Transition (DAPET), which would revolve around the young people’s psychosocial development. Methods Three focus groups were organized with healthcare providers and two focus groups took place with the parents of young people with chronic conditions. We relied on Activity Theory to explore practices and to identify obstacles, as well as recognize which resources were available to implement a DAPET. Results Six themes were identitified via the thematic analysis. In summary, healthcare providers agreed on the need to engage in an educational approach centered on the psychosocial development of young people during transition. They did, however, highlight a lack of competencies in adolescent and young adult medicine and a lack of available resources to meet these goals. The parents wanted to redefine their role with healthcare providers in order to apprehend transition to adult care and to allow their children to develop self-management skills. Conclusions Healthcare providers and parents considered the implementation of a DAPET to be acceptable and even advisable. However, this program’s feasibility was questioned due to the perceived shortfalls of the hospital system as it currently stands and the ways in which an educational approach would be applied. An enabling environment is therefore required to facilitate the educational initiatives of healthcare providers and to encourage the participation of parents. The means and modalities for achieving this are discussed. Key messages Patient Education during transition from pediatric to adult care need to be developmentally appropriate. Healthcare providers need en enabling environment to carry on a developmentally appropriate approach during transition.

scholarly journals Healthcare providers’ perspectives on care coordination for adults with cancer and multiple chronic conditions: a systematic review

2020 ◽  
Vol 11 (2) ◽  
pp. 97-116
Author(s):  
Natalie S. Hohmann ◽  
Cassidi C. McDaniel ◽  
S. Walker Mason ◽  
Winson Y. Cheung ◽  
Michelle S. Williams ◽  
...  
Keyword(s):  
Systematic Review ◽  
Care Coordination ◽  
Chronic Conditions ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions

scholarly journals Peer support workers as a bridge: a qualitative study exploring the role of peer support workers in the care of people who use drugs during and after hospitalization

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Robin Lennox ◽  
Larkin Lamarche ◽  
Tim O’Shea
Keyword(s):  
Qualitative Study ◽  
Peer Support ◽  
Healthcare Providers ◽  
People Who Use Drugs ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Support Worker ◽  
Team Members ◽  
Key Stakeholders

Abstract Background To describe the key qualities and unique roles of peer support workers in the care of people who inject drugs during and after hospitalization. Methods We conducted a qualitative study. Key stakeholders were recruited including: people who use drugs who had been hospitalized, healthcare team members, peer support workers, and employers of peer support workers. Data were collected from 2019 to 2020 using semi-structured interviews that were audio-recorded, transcribed, and analyzed thematically. Results Fourteen participants were interviewed: 6 people who use drugs who had been hospitalized, 5 healthcare team members, 2 peer support workers, and 1 employer of peer support workers. At the core of the data was the notion of peer workers acting as a bridge. We found four themes that related to functions of this bridge: overcoming system barriers, advocacy, navigating transitions within the healthcare system, and restoring trust between HCPs and PWUD. We found two themes for building a strong bridge and making the role of a peer support worker function effectively (training and mentorship, and establishing boundaries). We found three themes involving characteristics of an effective peer worker (intrinsic qualities, contributions of shared experiences, and personal stability). Conclusion Peer support workers are highly valued by both people who use drugs and members of the healthcare team. Peer support workers act as a bridge between patients and healthcare providers and are critical in establishing trust, easing transitions in care, and providing unique supports to people who use drugs during and after hospitalization.

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