A qualitative study using the Theoretical Domains Framework to investigate why patients were or were not assessed for rehabilitation after stroke

2016 ◽  
Vol 31 (7) ◽  
pp. 966-977 ◽  
Author(s):  
Elizabeth A Lynch ◽  
Julie A Luker ◽  
Dominique A Cadilhac ◽  
Caroline E Fryer ◽  
Susan L Hillier
Keyword(s):  
Qualitative Study ◽  
Acute Stroke ◽  
Health Professionals ◽  
Assessment Tool ◽  
Theoretical Domains Framework ◽  
Assessment Practices ◽  
Stroke Units ◽  
Changing Practice ◽  
Referral Practices ◽  
Rehabilitation Assessment

Objective: To explore the factors perceived to affect rehabilitation assessment and referral practices for patients with stroke. Design: Qualitative study using data from focus groups analysed thematically and then mapped to the Theoretical Domains Framework. Setting: Eight acute stroke units in two states of Australia. Subjects: Health professionals working in acute stroke units. Interventions: Health professionals at all sites had participated in interventions to improve rehabilitation assessment and referral practices, which included provision of copies of an evidence-based decision-making rehabilitation Assessment Tool and pathway. Results: Eight focus groups were conducted (32 total participants). Reported rehabilitation assessment and referral practices varied markedly between units. Continence and mood were not routinely assessed (4 units), and people with stroke symptoms were not consistently referred to rehabilitation (4 units). Key factors influencing practice were identified and included whether health professionals perceived that use of the Assessment Tool would improve rehabilitation assessment practices (theoretical domain ‘social and professional role’); beliefs about outcomes from changing practice such as increased equity for patients or conversely that changing rehabilitation referral patterns would not affect access to rehabilitation (‘belief about consequences’); the influence of the unit’s relationships with other groups including rehabilitation teams (‘social influences’ domain) and understanding within the acute stroke unit team of the purpose of changing assessment practices (‘knowledge’ domain). Conclusion: This study has identified that health professionals’ perceived roles, beliefs about consequences from changing practice and relationships with rehabilitation service providers were perceived to influence rehabilitation assessment and referral practices on Australian acute stroke units.

scholarly journals Nurses' preferred items for dysphagia screening in acute stroke patients: A qualitative study

2020 ◽  
Author(s):  
Isabel de Jesus Oliveira ◽  
Germano Rodrigues Couto ◽  
Liliana Andreia Neves da Mota
Keyword(s):  
Clinical Practice ◽  
Qualitative Study ◽  
Acute Stroke ◽  
Clinical Data ◽  
Clinical Pathways ◽  
Working Hours ◽  
Speech Disorders ◽  
Stroke Patients ◽  
Early Screening ◽  
Stroke Units

Background & Aim: Formal dysphagia screening protocols are not yet implemented in some hospitals although there is growing evidence that early dysphagia screening reduces pneumonia rates in stroke patients. Trained professionals are not often available outside weekdays working hours in stroke units, meaning that early screening is usually performed by nurses that use informal detection to screen dysphagia in acute stroke patients. The purpose of this study was to identify which items stroke nurses prioritize in their clinical practice to screen dysphagia in acute stroke patients. Methods & Materials: A qualitative study was developed using a focus group technique in five stroke units with a total of 20 stroke nurses selected by purposive sampling in march 2019. Qualitative Data Analysis Software Miner Lite 4.0 was used to assist in content analysis. Results: Two categories emerged: clinical data and swallowing and non-swallowing signs, each with a set of dimensions. In the category clinical data, relevance was noted for the dimension Glasgow Coma Scale and sex, identified as the most and least relevant, respectively, for dysphagia screening. In the category swallowing and non-swallowing signs no relevance evolved for preferred items. However, in this category, data suggest that nurses find less relevant in clinical practice speech disorders for dysphagia screening. Conclusions: Results reinforce the importance of a standardized approach through the use of valid and reliable dysphagia screening protocols, arguing the need for clear guidance in acute stroke clinical pathways on procedures for dysphagia screening.

RANCANG BANGUN DAN VALIDASI LEMBAR KAJI IDENTITAS PROFESIONAL PERAWAT ISLAM INDONESIA

2016 ◽  
Vol 2 (2) ◽  
pp. 111
Author(s):  
Christmas Warastiko ◽  
Sapti H. Widiyarti
Keyword(s):  
Pilot Study ◽  
Qualitative Study ◽  
Construct Validity ◽  
Professional Identity ◽  
Assessment Tool ◽  
Cross Cultural ◽  
Transcultural Nursing ◽  
Nursing Competence ◽  
Professional Nurses ◽  
Nurse Professional

ABSTRAK Indonesia dikenal dengan negara yang memiliki beragam suku, budaya, dan bahasa. Pada tahun 2010, data jumlah penduduk Indonesia yang paling terakhir menyatakan jumlah penduduk Indonesia sebesar 237,56 juta jiwa dengan 85.1% nya beragama Islam dan 288.405 penduduknya berprofesi sebagai seorang perawat. Pemahaman perawat tentang keperawatan transkultural saat ini sangatlah dibutuhkan. Agama, salah satu dari tujuh faktor yang menurut Leininger memiliki andil besar dalam mempengaruhi perilaku dan sikap para perawat maupun para klien. Simanjuntak (2011) berdasarkan studi kualitatif mengutarakan 13 karakteristik yang perlu di validasi sebagai karakteristik dari perawat Islam saat melakukan perawatan kepada klien. Penelitian ini dilakukan untuk memvalidasi butir-butir gambaran identitas profesional perawat Islam Indonesia melalui rancang bangun dari lembar kaji. Desain dalam penelitian ini adalah validasi kuesioner terhadap faktor rancang bangun, dimensi dan construct validity. Penelitian ini dilakukan dengan melakukan pilot study terlebih dahulu di Rumah Sakit Cibabat dan Rumah Sakit Imanuel dengan kemudian meminta responden untuk mengisi kuesioner serta memberikan komentar terhadap setiap butir-butir pernyataan, Data aktual berasal dari Rumah Sakit Santosa Bandung, Rumah Sakit Meilia Cibubur, dan Rumah Sakit Umum Daerah Koja Jakarta dengan cara meminta responden untuk mengisi kuesioner. Sampel dipilih dengan menggunakan metode snowballing kepada perawat Islam Indonesia yang bekerja di Bandung dan Jakarta. Data dianalisa dengan Cronbach α, didapatkan hasil pada uji validitas terhadap 13 karakteristik identitas profesional perawat Islam Indonesia masing-masing memiliki nilai Cronbach α >0,70. Hasil penelitian ini menyarankan agar perawat Islam Indonesia dapat menjadi perawat yang profesional dalam mengkaji diri agar dapat menuju keperawatan lintas budaya yang berkompetensi.   Kata Kunci: Validasi, Identitas Profesional, Perawat Islam Indonesia.   ABSTRACT Indonesia is known as a country with diverse in ethnic, cultural, and dialect. The population of Indonesian as declared in 2010 is 237.56 million, with 85.1% of them are Muslims and 288.405 people work as nurses. Religion is one of the seven factors that according Leininger determined the behavior and attitudes of nurses and clients. Therefore, understanding of transcultural nursing is imperatively necessary. In a qualitative study, Simanjuntak (2011) states 13 characteristics of Indonesian Islam nurse professional identity need to be validated. This study conducted to validate the grains picture of Indonesian Islam nurses professional identity through the design of identity assessment tool. This study validates the identity assessment tool, its design, dimensions and the construct validity. Pilot study was done in the Cibabat Hospital and Immanuel Hospital, and the actual data were collected from Santosa Bandung Hospital, Meilia Cibubur Hospital, and the Koja General Hospital in Jakarta. Samples were selected using snow-ball method among Islam nurses who work in Bandung and Jakarta. The result obtained on the validity of the 13 characteristics of professional identity of Indonesian Islam professional nurses with the value of Cronbach α> 0.70. The results of this study suggest that Indonesian Islam nurses can become a professional nurse in assessing themselves in order to lead a cross-cultural nursing competence. Keywords: Validation, Professional Identity, Indonesian Islam Nurses.

scholarly journals A Systematic Review of Healthcare Professionals’ Knowledge, Self-Efficacy and Attitudes Towards Working with Autistic People

2021 ◽  
Author(s):  
Kirsten Corden ◽  
Rebecca Brewer ◽  
Eilidh Cage
Keyword(s):  
Health Professionals ◽  
Self Efficacy ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Vital Role ◽  
Narrative Synthesis ◽  
Quality Assessment Tool ◽  
Professional Background ◽  
Autistic People

AbstractHealthcare professionals play a vital role in identifying and supporting autistic people. This study systematically reviewed empirical research examining healthcare professionals’ knowledge, self-efficacy and attitudes towards working with autistic people. Thirty-five studies were included. The included studies sampled a range of countries and professional backgrounds. A modified quality assessment tool found the quality of the included studies was moderately good. Narrative synthesis indicated that healthcare professionals report only moderate levels of autism knowledge and self-efficacy, and often lack training. Variation within and between countries and professional background was not explained by demographic factors. The reviewed evidence suggests health professionals’ limited knowledge and self-efficacy in working with autistic people is a challenge to the provision of healthcare for autistic individuals.

scholarly journals Medication Experience and Adherence to Oral Chemotherapy: A Qualitative Study of Patients’ and Health Professionals’ Perspectives

2021 ◽  
Vol 18 (8) ◽  
pp. 4266
Author(s):  
Amparo Talens ◽  
Mercedes Guilabert ◽  
Blanca Lumbreras ◽  
María Teresa Aznar ◽  
Elsa López-Pintor
Keyword(s):  
Qualitative Study ◽  
Health Professionals ◽  
Real Life ◽  
Positive Influence ◽  
Barriers And Facilitators ◽  
University Hospital ◽  
Nominal Group ◽  
Care Plans ◽  
Individualized Care ◽  
Medication Experience

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients’ experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in treatment with ANEO, to describe the barriers and facilitators related to the disease and its treatment and to compare them with the healthcare professionals’ perspectives. We carried out an exploratory qualitative study in the University Hospital of San Juan de Alicante, Spain. Three focus groups and two nominal group discussions were conducted with 23 onco-hematological patients treated with ANEO and 18 health professionals, respectively. The data were analyzed using content analyses and were eventually triangulated. The most impactful aspects in patients’ ME were the presence of adverse effects; lack of information about treatment; beliefs, needs and expectations regarding medications; social and family support; and the relationship with the health professionals. Both patients and professionals agreed on considering the negative side effects and the information about treatment as the main barriers and facilitators of adherence, respectively, although the approaches differed between both profiles. The professionals offered a more technical vision while patients prioritized the emotional burden and motivation associated with the disease and medication. This study allowed us to understand the real-life experiences of patients being treated with ANEO and explore the factors which had an impact on adherence to treatment. This understanding enables professionals to have a positive influence on patients’ behavior and provide individualized care plans. Pharmacists’ assistance is relevant to support patients’ adherence and self-management.

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