scholarly journals Examining the course of transitions from hospital to home-based palliative care: A mixed methods study

2021 ◽  
pp. 026921632110236
Author(s):  
Stephanie Saunders ◽  
Marianne E Weiss ◽  
Chris Meaney ◽  
Tieghan Killackey ◽  
Jaymie Varenbut ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Future Research ◽  
Healthcare Needs ◽  
Palliative Care Consultation ◽  
Home Based ◽  
Patient Reported ◽  
Discharge Readiness ◽  
Hospital To Home

Background: Hospital-to-home transitions in palliative care are fraught with challenges. To assess transitions researchers have used patient reported outcome measures and qualitative data to give unique insights into a phenomenon. Few measures examine care setting transitions in palliative care, yet domains identified in other populations are likely relevant for patients receiving palliative care. Aim: Gain insight into how patients experience three domains, discharge readiness, transition quality, and discharge-coping, during hospital-to-home transitions. Design: Longitudinal, convergent parallel mixed methods study design with two data collection visits: in-hospital before and 3–4 weeks after discharge. Participants completed scales assessing discharge readiness, transition quality, and post discharge-coping. A qualitative interview was conducted at both visits. Data were analyzed separately and integrated using a merged transformative methodology, allowing us to compare and contrast the data. Setting and participants: Study was set in two tertiary hospitals in Toronto, Canada. Adult inpatients ( n = 25) and their caregivers ( n = 14) were eligible if they received a palliative care consultation and transitioned to home-based palliative care. Results: Results were organized aligning with the scales; finding low discharge readiness (5.8; IQR: 1.9), moderate transition quality (66.7; IQR: 33.33), and poor discharge-coping (5.0; IQR: 2.6), respectively. Positive transitions involved feeling well supported, managing medications, feeling well, and having healthcare needs met. Challenges in transitions were feeling unwell, confusion over medications, unclear healthcare responsibilities, and emotional distress. Conclusions: We identified aspects of these three domains that may be targeted to improve transitions through intervention development. Identified discrepancies between the data types should be considered for future research exploration.

What Matters Most? A Mixed Methods Study of Critical Aspects of a Home-Based Palliative Program

2017 ◽  
Vol 35 (2) ◽  
pp. 236-243 ◽  
Author(s):  
Claire K. Ankuda ◽  
Kaileen Kersting ◽  
Timothy C. Guetterman ◽  
Jessica Haefner ◽  
Evan Fonger ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Social Services ◽  
Functional Disability ◽  
Symptom Burden ◽  
Mixed Methods Study ◽  
Spiritual Support ◽  
Medical Monitoring ◽  
Home Based ◽  
The Impact

Background: Home-based palliative care programs have shown value in improving quality of care and lowering costs for seriously ill patients. It is unknown what specific elements of these programs matter most to patients and caregivers. Aim: To identify what services are critical and why they matter to patients in a home-based palliative program. Setting/Participants: A mixed methods study of 18 participants in the At Home Support (AHS) program in Southeast Michigan. Measurements: Two semistructured interviews were conducted for each participant, one while enrolled in AHS and another 3 months after the program ended to elicit the impact of AHS on their care. Qualitative theme data were merged with quantitative data on demographics, social and financial resources, symptoms, medical conditions, functional status, and utilization of health care while in AHS. Results: Four major themes of critical services reported by distinct populations of participants were described—medical support, endorsed by nearly every participant; emotional and spiritual support, endorsed by those with serious illness and symptom burden; practical assistance, endorsed by those with functional disability and isolation; and social services, endorsed by those in poverty. Medical monitoring was also described as critical but only by healthier participants. Conclusion: This study presents a conceptual model of the critical services in home-based palliative care and why these services are important to high-risk patients. This model may be used to guide further research and evaluation work on the benefits of home-based palliative care.

Home-based spirometry telemonitoring after allogeneic hematopoietic cell transplantation: a mixed methods evaluation of acceptability and usability (Preprint)

2021 ◽  
Author(s):  
Ajay Sheshadri ◽  
Sukh Makhnoon ◽  
Amin Majid Alousi ◽  
Lara Bashoura ◽  
Rene Andrade Ruiz ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Early Detection ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Mixed Methods Study ◽  
Cell Transplant ◽  
Patient’S Perspective ◽  
Home Based ◽  
Patient Reported ◽  
Study Participants

BACKGROUND Home-based spirometry (HS) allows for early detection of lung complications in allogeneic hematopoietic cell transplant (A-HCT) recipients. Although usability and acceptability oWe designed a longitudinal, mixed-methods study to understand the usability and acceptability of HS among A-HCT recipients.f HS is critical for adherence, patient-reported outcomes of HS use remain poorly understood in this setting. OBJECTIVE We designed a longitudinal, mixed-methods study to understand the usability and acceptability of HS among A-HCT recipients. METHODS Study participants performed HS using a Bluetooth-capable spirometer that transmitted spirometry data to the study team in real-time. In addition, participants completed usability questionnaires and in-depth interviews, and reported their experience with HS. Analysis of interview data was guided by the constructs of performance expectancy, effort expectancy, and social influence from the Unified Theory of Acceptance and Use of Technology model. RESULTS A-HCT recipients found HS to be highly acceptable despite modest technological barriers. On average, participants believed that the HS was helpful in managing symptoms related to A-HCT (scores ranging from 2.22 – 2.68 on a scale of 0-4) and for early detection of health related problems (score range: 2.88 – 3.12). Participants viewed HS favorably and were generally supportive of continued use. No significant barriers to implementation were identified from the patient’s perspective. Age and gender were not associated with patient perception of HS. CONCLUSIONS Study participants found HS acceptable and easy to use. Some modifiable technical barriers to performing HS were identified, but wider implementation for pulmonary screening is feasible from the patient’s perspective.

scholarly journals Identifying positive deviants in healthcare quality and safety: a mixed methods study

2018 ◽  
Vol 111 (8) ◽  
pp. 276-291 ◽  
Author(s):  
Jane K O’Hara ◽  
Katja Grasic ◽  
Nils Gutacker ◽  
Andrew Street ◽  
Robbie Foy ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Statistical Modelling ◽  
Service Level ◽  
Knee Surgery ◽  
Mixed Methods Study ◽  
Quality And Safety ◽  
Hospital Data ◽  
Local Improvement ◽  
Patient Reported ◽  
Hip And Knee Surgery

Objective Solutions to quality and safety problems exist within healthcare organisations, but to maximise the learning from these positive deviants, we first need to identify them. This study explores using routinely collected, publicly available data in England to identify positively deviant services in one region of the country. Design A mixed methods study undertaken July 2014 to February 2015, employing expert discussion, consensus and statistical modelling to identify indicators of quality and safety, establish a set of criteria to inform decisions about which indicators were robust and useful measures, and whether these could be used to identify positive deviants. Setting Yorkshire and Humber, England. Participants None - analysis based on routinely collected, administrative English hospital data. Main outcome measures We identified 49 indicators of quality and safety from acute care settings across eight data sources. Twenty-six indicators did not allow comparison of quality at the sub-hospital level. Of the 23 remaining indicators, 12 met all criteria and were possible candidates for identifying positive deviants. Results Four indicators (readmission and patient reported outcomes for hip and knee surgery) offered indicators of the same service. These were selected by an expert group as the basis for statistical modelling, which supported identification of one service in Yorkshire and Humber showing a 50% positive deviation from the national average. Conclusion Relatively few indicators of quality and safety relate to a service level, making meaningful comparisons and local improvement based on the measures difficult. It was possible, however, to identify a set of indicators that provided robust measurement of the quality and safety of services providing hip and knee surgery.

An Affair to Remember: A Mixed-Methods Survey Examining Therapists’ Experiences Treating Infidelity

2021 ◽  
pp. 106648072110618
Author(s):  
Taylor J. Irvine ◽  
Paul R. Peluso
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Study ◽  
Personal History ◽  
Future Research ◽  
Present Survey ◽  
Training Standards ◽  
Recovery Treatment ◽  
And Training

In this mixed-methods study, we analyzed data from 351 couple therapists who completed our Therapists' Experiences Treating Infidelity (TETI) survey. The present survey is a follow-up of previous iterations that examined therapists' attitudes toward infidelity and affair recovery treatment. Our TETI survey provided additional questions pertaining to therapists' personal history with affairs and perceptions on current research and training standards. Results showed that various therapist and couple factors serve to impede affair recovery treatment. Additionally, this survey revealed several similarities in therapists' attitudes from prior surveys, despite decades having passed between when the present survey and previous versions. In this article, we (a) outline findings from this mixed-methods survey, (b) discuss implications for the field, and (c) offer directions for future research.

A Mixed Methods Study of Relationship Satisfaction in Parents of Children With Down Syndrome

2021 ◽  
pp. 0192513X2110598
Author(s):  
Kristen Krueger ◽  
Paige Alexander ◽  
Meghan Dyster ◽  
Robert Steele ◽  
Briana S. Nelson Goff ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Mixed Methods ◽  
Relationship Satisfaction ◽  
National Sample ◽  
Mixed Methods Study ◽  
Future Research ◽  
Negative Effects ◽  
Children With Down Syndrome ◽  
Parental Relationship ◽  
And Coping

Much of the research on parents of children with intellectual and developmental disabilities (IDD) has focused on the negative effects on the couple relationship. The current study contributes to the understanding of parental relationship satisfaction in a sample of parents of children with Down syndrome (DS), through a mixed methods study that included data from a large national sample. Parents of children with DS were divided into two groups based on high and low relationship satisfaction scores, with quantitative and qualitative data analyses comparing these two groups. Results indicated differences between high relationship satisfaction and low relationship satisfaction groups on measures of hope, life satisfaction, and coping scores. Qualitative results also indicated group differences. Future research and implications for professionals working with parents of children with DS and other IDD diagnoses should include understanding the unique factors that affect interpersonal functioning.

Case series of introducing palliative care consultation in psychiatry

2020 ◽  
Vol 34 (5) ◽  
pp. 680-683 ◽  
Author(s):  
Thorleif Etgen
Keyword(s):  
Mental Illness ◽  
Palliative Care ◽  
Case Series ◽  
Future Research ◽  
First Year ◽  
Problem Solution ◽  
Actual Case ◽  
Persistent Mental Illness ◽  
Palliative Care Consultation ◽  
Care Consultation

Background: The significance of palliative care consultation in psychiatry is unclear. Actual case series: Analysis of the introduction of palliative care consultation in a large psychiatric hospital. Possible courses of action: Continue without offering, survey the need for or offer palliative care consultation, and analyse its introduction. Formulation of a plan: Palliative care consultation was established and details including patient age, department, diagnosis, main problem, solution and discharge were analysed during the first 2 years. Outcome: Two consultations in the first year and 18 consultations in the second year were requested (18 geriatric, 2 addiction, 0 general, clinical social and forensic psychiatry) involving two domains: delirium associated with dementia or another condition (75%) and mental illness (e.g. alcoholic psycho-syndrome, psychosis, suicidal tendency, schizophrenia, depression) and cancer (25%). Recommendations of consultations were realized in 95%. Lessons from the case series: Implementation of palliative care consultation in psychiatry is one possible method of how to introduce palliative care in a field of medicine with lack of palliative care. View: Future research should focus on reasons for reservations about palliative care in psychiatry, include more patients with severe persistent mental illness and assess the value of palliative care consultation in resolving this problem.

Sign in / Sign up

Export Citation Format

Share Document