Improving care coordination in community physical rehabilitation: A qualitative study of the change framework

2019 ◽  
Vol 22 (3-4) ◽  
pp. 140-147 ◽  
Author(s):  
Jane L Symons ◽  
Julie Jamison ◽  
Jane Dening ◽  
Linda Murray ◽  
Sue Pearson
Keyword(s):  
Qualitative Study ◽  
Social Interactions ◽  
Care Coordination ◽  
Physical Rehabilitation ◽  
Rehabilitation Service ◽  
Change Processes ◽  
Improvement Project ◽  
Study Objective ◽  
Mixed Response ◽  
Change Framework

Introduction Contemporary rehabilitation change relies on effective collaboration and ongoing social interactions among stakeholders. The study objective was to explore the influence of the selected change framework and underlying social interactions during a care coordination improvement project. Methods A qualitative study collected data from 35 employees in a community physical rehabilitation service. Participants were not only undergoing change to improve client care coordination but were also facilitating the change processes themselves. Symbolic interactionism guided the research design, and data were collected using interviews and observation. Blumer’s six root beliefs were used for deductive data analysis and provided the framework for the findings. Results Findings highlight that the perceptions of the selected change framework were mixed yet dynamic, with modification occurring via social interaction. Elements of Kotter’s eight steps, lean thinking, and transformational change models were trialed. Implementation of the change processes required formal and informal group social interactions. Participants’ different outlooks explained their mixed response to the change processes. Participants who supported the implemented changes believed the processes and outcomes were clear, appropriate, and inclusive. Time, energy, and positive social interactions enabled employees to drive change, with more of these resources desired to refine the vision, problem-solve implementation, and further improve care coordination. Discussion This study enhances the understanding of how employees and the community physical rehabilitation service shaped each other during the change processes. The focus on social interactions highlights the slow rate of improved care coordination and need for increased resources and/or duration for successful change.

A qualitative study of care coordination in community physical rehabilitation

2019 ◽  
Vol 22 (3-4) ◽  
pp. 148-156 ◽  
Author(s):  
Jane L Symons ◽  
Julie Jamison ◽  
Jane Dening ◽  
Linda Murray ◽  
Sue Pearson
Keyword(s):  
Qualitative Study ◽  
Care Coordination ◽  
Communication Systems ◽  
Interprofessional Collaboration ◽  
Physical Rehabilitation ◽  
Rehabilitation Service ◽  
Additional Time ◽  
Team Members ◽  
Effective Care ◽  
Regional Service

Introduction This study explored the factors influencing effective care coordination in a community physical rehabilitation service. The two research questions answered were “What was effective care coordination?” and “What were the barriers and enablers?” Methods This qualitative study, influenced by an interprofessional skill framework, was conducted in a regional service in Australia. Participants were 35 allied health, nursing, and client administration team members. Individual interviews, group observations, and focus groups generated data. This article will present the descriptive thematic analysis method and results. Results Care coordination resulted from a suite of informal and formal tools that smoothed the client’s rehabilitation journey. Effectiveness and efficiency were sought alongside client-centred, holistic, and flexible yet consistent approaches to care coordination. All staff undertook care coordination relevant to their managerial, clinical, or administration support roles. The involvement of many people and processes required effective teamwork, notably communication, collaboration, coordination, and navigation of stakeholder differences. The barriers to and enablers of care coordination were the service’s resources including integrated workspaces, transport and communication systems, and the individuals’ resources including clinical reasoning skills in, and familiarity and buy in with care coordination and rehabilitation. Discussion Staff viewed care coordination as an integral and valued part of rehabilitation, with some responsibilities shared by all staff. Additional time and support were required for stakeholders to enact their assigned care coordination roles. Effective care coordination required staff to be trained and competent in interprofessional collaboration. Systems that were efficient to use and encouraged accountability were desired.

Change processes related to long-term outcomes in eating disorders with childhood trauma: An explorative qualitative study.

2020 ◽  
Vol 67 (1) ◽  
pp. 51-65
Author(s):  
Malin E. Olofsson ◽  
Hanne W. Oddli ◽  
Asle Hoffart ◽  
Hanna P. Eielsen ◽  
KariAnne R. Vrabel
Keyword(s):  
Eating Disorders ◽  
Qualitative Study ◽  
Childhood Trauma ◽  
Change Processes ◽  
Long Term Outcomes

scholarly journals Perceived Changes in Sexuality during the COVID-19 Pandemic among Adults in the United States

Sexes ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 331-344
Author(s):  
Jessamyn Bowling ◽  
Erika Montanaro ◽  
Sarai Guerrero-Ordonez ◽  
Stuti Joshi ◽  
Diana Gioia
Keyword(s):  
United States ◽  
Sexual Behavior ◽  
Qualitative Study ◽  
Social Interactions ◽  
Nationwide Survey ◽  
The United States ◽  
Self Reflection ◽  
Sex Drive ◽  
Stress Changes ◽  
Sexual Experimentation

In the United States, the COVID-19 pandemic has decreased partnered sexual behavior and increased the use of enhancement (e.g., toys). This has been partly attributed to reduced social interactions and stress. However, individuals’ perceptions of changes are missing in research. This study aims to examine how adults perceive changes in their sexuality during the pandemic. We conducted a nationwide survey of US adults from April–June 2020 (N = 326). This qualitative study examines the open-ended responses using thematic analyses. The following themes emerged from the data: (1) changes in the purpose of sex; (2) changes in sexual identity; (3) decreases in sex drive and desire; (4) increases in sex drive and desire; (5) fluctuations in sex drive and desire; (6) increased sexual experimentation and reflection. The stress, changes in home responsibilities and living situations, and time spent with partners (more or less) has affected individuals by increasing or decreasing their sex drive and desire. Participants responded to changes with self-reflection and awareness, and incorporating new practices (e.g., technology, kink). The purpose of sex has shifted in order to gain intimacy or connect, or to pass time. These changes were perceived as both positive and negative, and more research is needed to determine the durability of these changes.

scholarly journals Cultural Influences on the Regulation of Energy Intake and Obesity: A Qualitative Study Comparing Food Customs and Attitudes to Eating in Adults from France and the United States

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 63
Author(s):  
Maria Carlota Dao ◽  
Sophie Thiron ◽  
Ellen Messer ◽  
Camille Sergeant ◽  
Anne Sévigné ◽  
...  
Keyword(s):  
United States ◽  
Qualitative Study ◽  
Social Interactions ◽  
Weight Management ◽  
Food Consumption ◽  
Eating Behavior ◽  
The United States ◽  
Food Culture ◽  
External Pressures ◽  
The U.S

(1) Background: The influence of food culture on eating behavior and obesity risk is poorly understood. (2) Methods: In this qualitative study, 25 adults in France with or without overweight/obesity participated in semi-structured interviews (n = 10) or focus groups (n = 15) to examine attitudes to food consumption and external pressures that influence eating behavior and weight management. Results were compared to an equivalent study conducted in the United States, thereby contrasting two countries with markedly different rates of obesity. Emerging key themes in the French data were identified through coding using a reflexive approach. (3) Results: The main themes identified were: (1) influence of commensality, social interactions, and pleasure from eating on eating behavior, (2) having a balanced and holistic approach to nutrition, (3) the role of environmental concerns in food consumption, (4) relationship with “natural” products (idealized) and food processing (demonized), (5) perceptions of weight status and management. Stress and difficulties in hunger cue discernment were viewed as important obstacles to weight management in both countries. External pressures were described as a major factor that explicitly influences food consumption in the U.S., while there was an implicit influence of external pressures through eating-related social interactions in France. In France, products considered “natural” where idealized and juxtaposed against processed and “industrial” products, whereas this was not a salient aspect in the U.S. (4) Conclusions: This first comparative qualitative study assessing aspects of food culture and eating behaviors across countries identifies both common and divergent attitudes to food and eating behavior. Further studies are needed to inform the development of effective behavioral interventions to address obesity in different populations.

scholarly journals From strategy to action: a qualitative study on salient factors influencing knowledge transfer in project-based experiential learning in healthcare organisations in Kenya

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031100
Author(s):  
Tecla Chelagat ◽  
Joseph Onyango ◽  
Gilbert Kokwaro ◽  
Jim Rice
Keyword(s):  
Qualitative Study ◽  
Knowledge Transfer ◽  
Leadership Training ◽  
Work Teams ◽  
Healthcare Management ◽  
Transfer Of Knowledge ◽  
Completion Rates ◽  
Design Work ◽  
Improvement Project ◽  
High Staff Turnover

ObjectivesKnowledge transfer is recognised as a key determinant of organisational competitiveness. Existing literature on the transfer of knowledge and skills imply diminutive return on investment in training and development due to the low application of learnt knowledge. Following devolution of health services provision to new counties in Kenya in 2013, Strathmore Business School designed an experiential facility improvement project-based leadership training programme for healthcare managers in the new counties. Selected healthcare management teams participated in the leadership training to improve health systems performance in the devolved counties in Kenya. Despite similar training, the projects implementation contexts were different, leading to different implementation completion rates. The aim of this study was to investigate the reasons for this disparity and then recommend solutions.DesignA qualitative study using semi-structured interviews. A thematic framework approach was used in data analysis.Setting and participantsThirty-nine projects teams constituting; 33 successful and 6 unsuccessful project teams, were purposively selected based on their project implementation success rates at the end of the leadership training. The managers had undertaken a team-based institutional improvement project. The prioritised projects were housed within; 23 public, 10 faith-based and 6 private health facilities in 19 counties in Kenya.ResultsOur findings indicate projects completion rates were influenced by (training design, work environment climate, trainee characteristics, team-based coaching and leveraging on occurring opportunities). Transfer barriers were (inadequate management support, inadequate team and staff support, high staff turnover, misalignment of board’s verses manager’s priorities, missing technical expertise, endemic strikes, negative politics and poor communication). Recommendations were (need-driven curriculum, effective allocation and efficient utilisation of resources, proper prioritisation, effective communication, longitudinal coaching and work-teams recruitment).ConclusionThe findings reveal that unless training interventions are informed by a need-driven curriculum customised to real-world work teams, the potential knowledge and skill transfer can be thwarted.

Change processes underlying “good outcome”: A qualitative study on recovered and improved patients’ experiences in psychotherapy for major depression

2020 ◽  
Vol 30 (7) ◽  
pp. 948-964 ◽  
Author(s):  
Melissa Miléna De Smet ◽  
Reitske Meganck ◽  
Femke Truijens ◽  
Rosa De Geest ◽  
Shana Cornelis ◽  
...  
Keyword(s):  
Major Depression ◽  
Qualitative Study ◽  
Change Processes ◽  
Good Outcome

scholarly journals Convergences of Joint, Positive Interactions and Regulation in Collaborative Learning

2019 ◽  
Vol 51 (2) ◽  
pp. 229-264 ◽  
Author(s):  
Jaana Isohätälä ◽  
Piia Näykki ◽  
Sanna Järvelä
Keyword(s):  
Social Interaction ◽  
Collaborative Learning ◽  
Qualitative Study ◽  
Social Interactions ◽  
Student Teachers ◽  
Small Groups ◽  
Environmental Science ◽  
Positive Interactions ◽  
Learning Progress

This qualitative study explores the convergences of small groups’ joint, positive interactions and regulation in social interaction during collaborative learning. We analyzed the video-recorded social interactions of five groups of student teachers during environmental science tasks. We examined the frequency and functions of the situations in which joint participation and positive socioemotional interaction converged with regulation (planning, monitoring, and evaluating) in social interaction. The results show that when groups planned, monitored, or evaluated their learning, they participated more jointly in social interaction and showed more socioemotional support than in interactions with no observed regulation. The situations in which these elements converged served three functions: establishing agreement, responding to challenges or mistakes, and discussing strengths and weaknesses. The results suggest that the convergences of joint, positive interactions and regulation in social interaction can serve a function that is meaningful for collaborative learning progress.

scholarly journals P62 Getting to know you: a quality improvement project designed to enhance paediatric inpatient rehabilitation for those with non-inflammatory musculoskeletal pain

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_4) ◽  
Author(s):  
Dearbhla McKenna ◽  
Madeline Rooney ◽  
Paul Jackson ◽  
Cathyrn Harkness
Keyword(s):  
Conflicts Of Interest ◽  
School Attendance ◽  
Inpatient Rehabilitation ◽  
Self Management ◽  
Rehabilitation Service ◽  
Management Approach ◽  
Improvement Project ◽  
Time To Build ◽  
Self Discovery ◽  
Typical Day

Abstract Background In November 2018 the paediatric rheumatology team in Belfast attended the Bridges self-management course. Bridges reflects on what works well as a team and how you can build upon current practice, with an emphasis upon a self-management approach. There are eleven Bridges principles aiming to help interdisciplinary team’s co-ordinate their service around the patient. Bridges believes that the language we use can improve our clinical practice, especially with regards to problem solving, encouraging self-discovery, encouraging patients to reflect and enabling them to take action. Our team felt that we should use this approach to enhance our inpatient rehabilitation service. We chose this group of patients as we felt that this can be a challenging group to treat and it can take a long time to build supportive and trusting relationships. Methods Prior to commencing this project each member of the multidisciplinary team assessed the patient individually on the first day of admission. In retrospect we discovered that this led to repetition for the patient and this assessment was very clinician led. It also focused on clinician led (SMART) goals and achieving these. We furthermore realised we did not separately ask patients and parents what they wanted to gain from our service. Our method of improvement was to devise three questionnaires. One for a parent, one for a child under fourteen and over fourteen. These are distributed prior to being assessed by the team, allowing us to gather information and negating the need for repetition. The questionnaire gathers information regarding family members, education, school attendance, additional educational assistance, past medical history. For the patient we ask, what are their main concerns, what has helped so far, what support the patient has, what activities they enjoy as a family and what they hope to gain from their inpatient stay. The patient must fill out a description of their typical day, including their mood. Questions specifically for the parents are asking why their child has been referred, what their main concerns are, to outline their typical day, what do they feel has helped and what do they aim to gain from our team. Results We have utilised the questionnaires for every inpatient since January 2019. All team members feel that this new approach allows us to gain valuable information from patients and their parents thus encouraging them to adopt a self-management approach and to prioritise the patient’s story. As a team we feel that we learn a lot about our patients using this method and that it is more time effective. It allows us to identify unrealistic hopes and discuss these. Conclusion We believe that using the Bridges approach and by mainly adapting our language skills and organisation we have improved this service. Conflicts of Interest The authors declare no conflicts of interest.

Sign in / Sign up

Export Citation Format

Share Document