Doctors’ Attitudes to Patient Question Asking, Patient-Generated Question Lists, and Question Prompt Lists: A Qualitative Study

2021 ◽  
pp. 0272989X2110295
Author(s):  
Marguerite Clare Tracy ◽  
Danielle Maree Muscat ◽  
Heather L. Shepherd ◽  
Lyndal Jane Trevena
Keyword(s):  
Focus Groups ◽  
General Practitioners ◽  
Quality And Safety ◽  
Australian Government ◽  
Question Asking ◽  
Online Tool ◽  
Individual Interviews ◽  
Semistructured Interviews ◽  
Few Data ◽  
Question Prompt

Background Participation by patients in their own health care improves quality and safety. Question prompt lists (QPLs) can improve participation, particularly with doctors’ endorsement. Few data have explored doctors’ attitudes on these tools. We sought the experiences and attitudes of general practitioners and other specialists toward patient question asking and QPLs in their practice. Methods In-depth, semistructured interviews and focus groups with purposively selected Australian doctors were conducted. Interview guides were used to explore doctors’ experiences of patient question asking, patients’ lists, and a sample QPL created using an Australian government-funded online tool, “Question Builder.” Recordings were transcribed verbatim and data analyzed thematically using the method by Braun and Clarke. Results Focus groups with 3 to 9 participants and a further 17 individual interviews were conducted. There was a total of 40 participants, 23 general practitioners and 17 other specialists (e.g., physicians, surgeons, pediatricians). Our analysis was summarized into several themes. 1) The doctors expected, encouraged, and had significant experience of patient question asking and patients’ lists. They described many barriers for patients and their efforts to ensure patients had the information they needed. 2) The doctors felt responsible for creating an environment conducive to patient question asking, the delivery of answers, having strategies for unanswered questions, and balancing the agendas of both parties in the consultation. 3) Structured QPLs that prepared patients and facilitated the consultation agenda were viewed positively. The degree of time pressures participating doctors experienced in their context had a strong influence on how they responded to the sample QPL. Conclusion Doctors in this study expected patients to ask questions and endorsed the benefits of QPLs. However, there were more diverse views about the feasibility of implementing them in practice. Designing QPLs to fit within current workflows, via more succinct and tailored designs, may result in wider doctor acceptance and endorsement, hence maximizing the benefits of QPLs with improved patient participation and patient safety.

French patterns of psychotropic drug use

1990 ◽  
Vol 5 (5) ◽  
pp. 301-308
Author(s):  
V Kovess ◽  
M Ortun
Keyword(s):  
Drug Use ◽  
General Practitioners ◽  
Psychotropic Drug ◽  
Psychotropic Drugs ◽  
Elderly Population ◽  
The Elderly ◽  
Population Surveys ◽  
Minor Tranquilizers ◽  
French People ◽  
Few Data

SummaryFrench publications on psychotropics are curiously few. Data are available and French consumption of psychotropics, at least minor tranquilizers has been consistently reported as being higher than that found in other countries. The authors attempt to answer three questions: is French consuption of psychotropics really higher than other countries? Who is consuming those drugs? In which context? After having reviewed comparative data on sales, data from population surveys are analysed together with samples of prescriptions by different categories of physicians. It seems likely that French people consume more anxiolytics but this does not apply to other psychotropic drugs. Given the fact that drugs are almost free of charge in France, it is always difficult to discriminate between what has been prescribed and what has been taken. Overconsumption of anxiolytics is due to the overconsumption of the elderly population (over 60). Minor tranquilizers are mainly prescribed by general practitioners for psychological reasons.

scholarly journals Understanding decisions about antibiotic prescribing in ICU: an application of the Necessity Concerns Framework

2021 ◽  
pp. bmjqs-2020-012479
Author(s):  
Alyssa M Pandolfo ◽  
Robert Horne ◽  
Yogini Jani ◽  
Tom W Reader ◽  
Natalie Bidad ◽  
...  
Keyword(s):  
Focus Groups ◽  
Antibiotic Prescribing ◽  
Negative Consequences ◽  
Out Of Hours ◽  
Team Members ◽  
Clinical Vignettes ◽  
Molecular Microbiology ◽  
Semistructured Interviews ◽  
Decision Making Processes ◽  
The Individual

BackgroundAntibiotics are extensively prescribed in intensive care units (ICUs), yet little is known about how antibiotic-related decisions are made in this setting. We explored how beliefs, perceptions and contextual factors influenced ICU clinicians’ antibiotic prescribing.MethodsWe conducted 4 focus groups and 34 semistructured interviews with clinicians involved in antibiotic prescribing in four English ICUs. Focus groups explored factors influencing prescribing, whereas interviews examined decision-making processes using two clinical vignettes. Data were analysed using thematic analysis, applying the Necessity Concerns Framework.ResultsClinicians’ antibiotic decisions were influenced by their judgement of the necessity for prescribing/not prescribing, relative to their concerns about potential adverse consequences. Antibiotic necessity perceptions were strongly influenced by beliefs that antibiotics would protect patients from deterioration and themselves from the ethical and legal consequences of undertreatment. Clinicians also reported concerns about prescribing antibiotics. These generally centred on antimicrobial resistance; however, protecting the individual patient was prioritised over these societal concerns. Few participants identified antibiotic toxicity concerns as a key influencer. Clinical uncertainty often complicated balancing antibiotic necessity against concerns. Decisions to start or continue antibiotics often represented ‘erring on the side of caution’ as a protective response in uncertainty. This approach was reinforced by previous experiences of negative consequences (‘being burnt’) which motivated prescribing ‘just in case’ of an infection. Prescribing decisions were also context-dependent, exemplified by a lower perceived threshold to prescribe antibiotics out-of-hours, input from external team members and local prescribing norms.ConclusionEfforts to improve antibiotic stewardship should consider clinicians’ desire to protect with a prescription. Rapid molecular microbiology, with appropriate communication, may diminish clinicians’ fears of not prescribing or of using narrower-spectrum antibiotics.

scholarly journals The Challenges of Intersectionality in the Lives of Older Adults Living in Rural Areas with Limited Financial Resources

2021 ◽  
Vol 7 ◽  
pp. 233372142110093
Author(s):  
Adrienne Cohen
Keyword(s):  
Focus Groups ◽  
Rural Areas ◽  
Financial Resources ◽  
Policy Recommendations ◽  
Community Members ◽  
Individual Interviews ◽  
Study Population ◽  
Southern Georgia ◽  
Multiplicative Effects ◽  
Limit Access

The objective of this study was to use intersectionality to better understand the challenges of having the combined statuses of being an older adult, living in a rural area and having limited financial resources. Eight focus groups and 38 individual interviews were conducted in southern Georgia. Participants included program participants and staff, community members, and community leaders. Thematic analysis was done using verbatim transcripts from focus groups and interviews. Results demonstrate that the multiplicative and intersecting statuses of the study population create challenges in the areas of transportation, health care, food, and housing. The challenges of these intersectional statuses limit access to services in ways that each individual status did not, thereby compounding challenges. While previous literature describes the challenges of one or two of these statuses, this work explores the multiplicative effects of the combination of the three statuses using intersectionality. Programmatic and policy recommendations and implications are discussed.

Medicine use of elderly Chinese and Vietnamese immigrants and attitudes to home medicines review

2012 ◽  
Vol 18 (1) ◽  
pp. 50 ◽  
Author(s):  
Lesley White ◽  
Christiane Klinner
Keyword(s):  
Focus Groups ◽  
General Practitioners ◽  
Health Care Providers ◽  
Service Use ◽  
Unmet Need ◽  
Care Providers ◽  
Public Health Services ◽  
Elderly Chinese ◽  
Chinese Group ◽  
Home Medicines Review

There is a paucity of research into the perceptions of elderly Australian ethnic minorities towards public health services related to quality use of medicines. Among the six fastest growing ethnic groups in Australia, the Mandarin-speaking Chinese and Vietnamese constitute the largest elderly populations with poor English skills. This paper investigates the relationships of elderly Chinese and Vietnamese migrants with medicines, general practitioners and pharmacists, and how these relationships influence their awareness and attitudes of the home medicines review (HMR) program. Two semi-structured focus groups were held with a total of 17 HMR-eligible patients who have never received a HMR, one with Chinese and one with Vietnamese respondents, each in the respective community language. Confusion about medications and an intention to have a HMR were pronounced among all participants although none of them had heard of the program before participating in the focus groups. Respondents reported difficulties locating a pharmacist who spoke their native language, which contributed to an increased unmet need for medicine information. The Chinese group additionally complained about a lack of support from their general practitioners in relation to their medicine concerns and was adamant that they would prefer to have a HMR without the involvement of their general practitioner. Our results indicate a distinct HMR need but not use among elderly Chinese and Vietnamese eligible patients with poor English skills. Home medicines review service use and perceived medication problems are likely to improve with an increasing availability of bilingual and culturally sensitive health care providers.

scholarly journals Appetite for or resistance to consumption relationships? A trans-European perspective on the marketisation of football fan relationships

2018 ◽  
Vol 18 (2) ◽  
pp. 317-335 ◽  
Author(s):  
Guillaume Bodet ◽  
James A. Kenyon ◽  
Alain Ferrand
Keyword(s):  
Focus Groups ◽  
Professional Sport ◽  
European Countries ◽  
European Perspective ◽  
Cultural Contexts ◽  
Individual Interviews ◽  
Football Fans

Although most sport organisations are encouraged to better manage the relationships they maintain with fans, little is still known about the types of relationships that fans want to establish with sport organisations. Also, as most suggested management and marketing practices come from professional sport organisations and European contexts, it is questionable whether they can apply to all sports organisations, and whether they are received in the same way by diverse fans from various socio-cultural contexts. Thus, the study aimed to explore football fans’ relational expectations towards their national football association across Europe and attitudes towards this marketisation. Focus groups and individual interviews were conducted with several casual and die-hard fans from three European countries chosen for their heterogeneity: Armenia, Lithuania and England. Overall, and possibly in contradiction with numerous publications dealing with club football, the fans from the three countries did not express clear opposition or resistance towards the marketisation of their relationships towards their national teams and associations. English fans seemed quite neutral or indifferent although Armenian and Lithuanian fans presented many characteristics of brandom demonstrating an appetite for this marketisation.

scholarly journals How young children learn independent asthma self-management: a qualitative study in Malaysia

2020 ◽  
Vol 105 (9) ◽  
pp. 819-824
Author(s):  
Siti Nurkamilla Ramdzan ◽  
Ee Ming Khoo ◽  
Su May Liew ◽  
Steven Cunningham ◽  
Marilyn Kendall ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Primary Schools ◽  
Health Centre ◽  
Smooth Transition ◽  
Self Management ◽  
Theory Approach ◽  
Individual Interviews ◽  
National Medical ◽  
Children With Asthma

ObjectiveWe aimed to explore the views of Malaysian children with asthma and their parents to enhance understanding of early influences on development of self-management skills.DesignThis is a qualitative study conducted among children with asthma and their parents. We used purposive sampling and conducted focus groups and interviews using a semi-structured topic guide in the participants’ preferred language. All interviews were audio-recorded, transcribed verbatim, entered into NVivo and analysed using a grounded theory approach.SettingsWe identified children aged 7–12 years with parent-reported, physician-diagnosed asthma from seven suburban primary schools in Malaysia. Focus groups and interviews were conducted either at schools or a health centre.ResultsNinety-nine participants (46 caregivers, 53 children) contributed to 24 focus groups and 6 individual interviews. Children mirrored their parents’ management of asthma but, in parallel, learnt and gained confidence to independently self-manage asthma from their own experiences and self-experimentation. Increasing independence was more apparent in children aged 10 years and above. Cultural norms and beliefs influenced children’s independence to self-manage asthma either directly or indirectly through their social network. External influences, for example, support from school and healthcare, also played a role in the transition.ConclusionChildren learnt the skills to self-manage asthma as early as 7 years old with growing independence from the age of 10 years. Healthcare professionals should use child-centred approach and involve schools to facilitate asthma self-management and support a smooth transition to independent self-management.Trial registration numberMalaysian National Medical Research Register (NMRR-15-1242-26898).

scholarly journals Chat Transcript Analysis Reveals that Undergraduate Students are Open to Instruction, While Instructors and Librarians Care About Supporting Student Learning

2017 ◽  
Vol 12 (1) ◽  
pp. 128
Author(s):  
Elaine Sullo
Keyword(s):  
Focus Groups ◽  
Customer Service ◽  
Undergraduate Students ◽  
The United States ◽  
Library Instruction ◽  
Research Project ◽  
Individual Interviews ◽  
Chat Reference ◽  
Composition Course ◽  
The Impact

A Review of: Jacoby, J., Ward, D., Avery, S., & Marcyk, E. (2016). The value of chat reference services: A pilot study. portal: Libraries and the Academy, 16(1), 109-129. https://doi.org/10.1353/pla.2016.0013 Abstract Objective – To investigate student, instructor, and librarian perspectives of chat reference service in the context of first-year undergraduate students conducting research for an introductory composition course. Design – Focus groups, individual interviews, and surveys. Setting – A large, public university in the United States of America. Subjects – 57 library reference providers, 36 instructors of an introductory composition course, and approximately 936 undergraduate students in certain sections of the introductory composition course who were assigned a specific research project. Methods – In spring of 2014, all participants were invited via email to respond to an anonymous chat transcript of a librarian interacting with a student working on his or her research project. Study participants could participate via a brief survey or by taking part in a focus group or individual interview. The invited instructors were asked to forward the invitation to the students in their sections, and reminder emails were sent two weeks after the initial email. Main Results – Nine instructors, 24 students, and 25 library reference providers participated in the study, representing a response rate of 25%, 3% (estimated), and 44%, respectively. The authors conducted a qualitative analysis of key themes that were derived from both the focus groups or individual interviews and the survey questions. The themes were: students as novice researchers, question negotiation, open and closed questions, instruction, speed and convenience, customer service, and referrals. The theme of “students as novice researchers” is based on student comments related to their frustrations of being inexperienced researchers, as well as librarian comments on strategies for helping these students. Opinions regarding the traditional reference interview, including specific techniques that made the interaction successful, were categorized as “question negotiation.” The “open and closed questions” theme focused on feedback on the types of questions used by librarians in the reference interview. Several components related to chat and instruction were encompassed within the “instruction” theme, including whether those participating in the study were conscious of librarians providing instructions via chat and whether it was deemed valuable; the impact of a library instruction session in which students participated; and identification of missed teachable moments during the chat. The “speed and convenience” theme represented thoughts regarding the balance of instruction and librarian support of news skills, with the student expectation of having their question answered quickly and efficiently. The “customer service” theme focused on the service quality of the reference transaction, while the “referrals” theme encompassed thoughts related to whether students were referred to subject specialists, writing specialists, instructors, or if there was a lack of a referral altogether. Conclusion – Based on the research results, the authors highlighted the importance of the interconnectedness of teaching that is done in the classroom, in library instruction sessions, and on the reference desk, as all three types of instruction should align. Furthermore, because students are open to instruction via the chat service when they are creating and revising their research question and delving into subject research, chat can be viewed as a key teaching and learning opportunity.

Older Australians' Expectations of their Interactions with their GPs

2005 ◽  
Vol 11 (3) ◽  
pp. 38 ◽  
Author(s):  
Simone Pettigrew ◽  
Katherine Mizerski ◽  
Robert Donovan
Keyword(s):  
Older People ◽  
Focus Groups ◽  
Medical History ◽  
General Practitioners ◽  
Information Flow ◽  
Older Patients ◽  
Telephone Survey ◽  
General Medicine ◽  
Personal Relevance ◽  
New Developments

This article reports the findings of a study into older Australians' expectations when interacting with their general practitioners (GPs). Six focus groups and a national telephone survey (n=505) were conducted to identify those aspects of interactions with GPs considered to be the most important and relevant to older people. The results indicate that the three most important issues relate to ability of GPs to: (1) provide prompt referrals to specialists and ensure an ongoing information flow between GPs and specialists (2) remain abreast of new developments in geriatric and general medicine, and (3) demonstrate a familiarity with the patient's medical history. These issues were considered important to older patients in general and to be of personal relevance to the large majority of those sampled.

scholarly journals General practitioners’ views on providing nutrition care to patients with chronic disease: a focus group study

2016 ◽  
Vol 8 (4) ◽  
pp. 357 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Anne-Thea McGill ◽  
Stephen Buetow ◽  
Bruce Arroll ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Focus Groups ◽  
General Practitioners ◽  
Nutrition Knowledge ◽  
Focus Group Study ◽  
Knowledge And Skills ◽  
Practice Nurses ◽  
Nutrition Care ◽  
Descriptive Approach ◽  
Consultation Time

ABSTRACT INTRODUCTION Nutrition care refers to practices conducted by health professionals to support patients to improve their dietary intake. General practitioners (GPs) are expected to provide nutrition care to patients for prevention and management of chronic disease. AIM This study explores GPs’ opinions regarding nutrition care provision to patients with chronic disease. METHODS An interpretive descriptive approach to qualitative research using seven semi-structured focus groups with 48 GPs in Auckland was used. Focus groups investigated how GPs felt about providing nutrition care; the perceived barriers to and support required for this care; the development of further nutrition knowledge and skills; and possible roles for Practice Nurses. Recorded interviews were transcribed verbatim and analysed using a thematic approach. RESULTS GPs indicated routine provision of basic nutrition care to patients with chronic disease, but perceived their limited consultation time and nutrition competence constrained their capacity to provide nutrition care. GPs felt they needed further information to provide culturally, socially and economically sensitive nutrition care. GPs displayed variable opinions on the benefits of developing their nutrition knowledge and skills, and the idea of Practice Nurses providing nutrition care. CONCLUSIONS Despite perceiving that nutrition care is important for patients with chronic disease and facing barriers to providing nutrition care, GPs appear reluctant to further develop their knowledge and skills and for Practice Nurses to provide this care. Strategies to enhance GPs’ nutrition-related self-efficacy, nutrition cultural competence and attitudes towards further training care may be warranted.

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