scholarly journals Examining Older Adults’ Attitudes and Perceptions of Cancer Screening and Overscreening: A Qualitative Study

2020 ◽  
Vol 11 ◽  
pp. 215013272095923
Author(s):  
Siddhartha Roy ◽  
Jennifer L. Moss ◽  
Sol M. Rodriguez-Colon ◽  
Chan Shen ◽  
Joie D. Cooper ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Screening ◽  
Focus Group ◽  
Focus Groups ◽  
Health Care Providers ◽  
Future Research ◽  
Specific Information ◽  
Care Providers ◽  
South Central ◽  
Attitudes And Perceptions

Introduction/Objectives: Screening guidelines for breast, cervical, and colorectal cancer (CRC) are less clear for older adults due to the potential harms that may result from screening. Understanding older adults’ attitudes and perceptions, especially racial/ethnic minority and underserved adults, of cancer screening can help health care providers determine how best to communicate with older adults about cancer screening and screening cessation. The objective of this study was to determine how older adults primarily from minority/underserved backgrounds perceive cancer screening and overscreening. Methods: Four focus groups (n = 39) were conducted with adults (>=65 years of age) in 3 community settings in south-central Pennsylvania. Two focus groups were conducted in Spanish and translated to English upon transcription. Focus group data was managed and analyzed using QSR NVivo 12. Inductive thematic analysis was used to analyze the data where themes emerged following the coding process. Results: The focus group participants had an average age of 74 years and were primarily female (74%) and Hispanic (69%), with 69% reporting having less than a high school degree. Four key themes were identified from the focus groups: (1) importance of tailored and targeted education/information; (2) impact of physician/patient communication; (3) impact of barriers and facilitators to screening on cancer screening cessation; and (4) awareness of importance of screening. Participants were more likely to be agreeable to screening cessation if they received specific information regarding their health status and previous medical history from their physician as to why screening should be stopped and told by their physician that the screening decision is up to them. Conclusions: Older adults prefer individualized information from their physician in order to justify screening cessation but are against incorporating life expectancy into the discussion. Future research should focus on developing interventions to test the effectiveness of culturally tailored screening cessation messages for older adults.

scholarly journals Identifying and describing a model region to evaluate the impact of telemedicine

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Harst ◽  
S Oswald ◽  
P Timpel
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Care Providers ◽  
Rural Areas ◽  
Demographic Data ◽  
Care Providers ◽  
Age Related ◽  
Model Region ◽  
The Impact

Abstract Background Telemedicine solutions providing patient-centered care over distance need to be integrated into the regional setting. The acceptance by both providers and patients hat to be continuously evaluated using methods of participatory implementation research. In controlled trials, often taking place in laboratory settings, these methods cannot be applied. In the following, research in progress is presented. Methods Based on socio-demographic data, epidemiology prevalence of age-related chronic diseases and data on the value of health care provision in Saxony, Germany a model region was chosen. Then, a focus group (n = 6) was conducted to differentiate the results and analyze the health networks of patients. For this, network maps putting the individual in the middle and his/her sources of information and support in case of illness in concentric circles around it, were used. The focus group was audiotaped, transcribed and analyzed by two researchers using MaxQDA. Results With a mean age of 47.8 years (n = 17,431), high prevalence of diabetes (>15.85 %) and hypertension (>39.1%) and an expected shortage of primary physicians in 2030, the town of Kamenz is a mirror image of the current health care challenges in rural areas of Saxony. Participants of the focus groups also stated problems in finding a primary physician or a dentist. Compensatory behavior, such as traveling large distances, relying on self-researched online diagnoses and immediately going to the emergency room for medical support was described. According to the network maps, primary sources of support in case of illness are partners and relatives, yet there is little connection between those and health care providers, as well as between different medical specialists. Conclusions The results will lead to potential use cases of telemedicine to be included into a standardized questionnaire for the assessment of telemedicine readiness in the model region. Key messages Telemedicine implementation in a rural area can be studied using a participatory approach. Focus groups and network maps are useful qualitative methods for participatory research and can inform the design of quantitative measurements.

Examining patterns of association with defensive information processing about colorectal cancer screening

2013 ◽  
Vol 19 (11) ◽  
pp. 1443-1458 ◽  
Author(s):  
Amy McQueen ◽  
Paul R Swank ◽  
Sally W Vernon
Keyword(s):  
Colorectal Cancer ◽  
Information Processing ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Health Care Providers ◽  
Future Research ◽  
Care Providers ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Four Levels

To reduce negative psychological affect from information or behavior that is inconsistent with one’s positive self-concept, individuals use a variety of defensive strategies. It is unknown whether correlates differ across defenses. We examined correlates of four levels of defensive information processing about colorectal cancer screening. Cross-sectional surveys were completed by a convenience sample of 287 adults aged 50–75 years. Defenses measures were more consistently associated with individual differences (especially avoidant coping styles); however, situational variables involving health-care providers also were important. Future research should examine changes in defenses after risk communication and their relative impact on colorectal cancer screening.

scholarly journals A design and focus group evaluation of dietary choices tools for an underserved population

2016 ◽  
Vol 6 (2) ◽  
pp. 101-108
Author(s):  
Tressa McMorris ◽  
Gary Sweet ◽  
Christopher J. Sullivan ◽  
Nicole B. Washington ◽  
Nancy Brahm
Keyword(s):  
Focus Group ◽  
Health Care Providers ◽  
Pilot Project ◽  
Mental Illnesses ◽  
Community Treatment ◽  
Specific Information ◽  
Care Providers ◽  
Visual Aids ◽  
Group Feedback ◽  
Dietary Choices

Abstract Introduction: Our objective was to develop and evaluate dietary teaching tools for a select population diagnosed with a severe mental illness and limited financial ability. Patients with severe mental illnesses face many challenges, including common health comorbidities of diabetes, high blood pressure, high cholesterol, and obesity. Cognitive deficits may limit educational programming; financial resources can affect access to a healthy diet. The Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) program, a university-based program, provides individualized services to this population. One focus is healthy nutritional choices. Methods: In Phase One, a clinical pharmacist and a first-year pharmacy resident created visual aids. These cards were given to health care providers (HCPs) to be used with IMPACT members. HCPs were asked to participate in a focus group and provide feedback. Phase Two: Based on specific focus group feedback, additional resources were created to address identified nutritional needs. Results: Phase One: Ten cards were created and distributed to the HCPs. A focus group was conducted. HCPs reported the cards were useful in opening dietary choices dialogues and were able to give more specific information on alternative choices. Phase Two: From focus group feedback, specific cards for disease states, calorie guidelines, and budget limitations were developed. HCPs immediately utilized them. Discussion: This pilot project was used to design and create educational cards to facilitate discussions on healthy or healthier dietary choices. Feedback from the HCPs participating in the focus group was positive, and they were enthusiastic about both sets of cards, particularly those pertaining to budget choices.

Transitional Care of Older Adults

2002 ◽  
Vol 20 (1) ◽  
pp. 127-147 ◽  
Author(s):  
MARY D. NAYLOR
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Health Care Providers ◽  
Planning Process ◽  
Transitional Care ◽  
Discharge Planning ◽  
Statistical Significance ◽  
Future Research ◽  
Care Providers ◽  
Care Needs

This chapter reviews 94 published research reports on transitional care of older adults by nurse researchers and researchers from other disciplines. Reports were identified through searches of MEDLINE, CINAHL, HealthSTAR, Sociological Abstracts and PsycINFO using combinations of the following search terms: transitional care, discharge planning, care coordination, case management, continuity of care, referrals, postdischarge follow-up, patient assessment, patient needs, interventions, and evaluation. Reports were included if published between 1985 and 2001, if conducted on samples age 55 and older, if relevant to nursing research, and if published in English. Intervention studies had to have a control or comparison group and a test for statistical significance. Four key findings from this review were identified. A high proportion of elders and their caregivers report substantial unmet transitional care needs, with the need for information and increased access to services consistently among the top priorities. Differences in expectations between and among patients, families, and health care providers, and the need for increased patient and family involvement in decision making, are common themes in discharge planning studies. Gaps in communication have been identified through the discharge planning process. Evidence about the effects of innovations in transitional care on quality and cost outcomes is sparse. Four main recommendations are made. Differences in older adults’ transitional care needs based on race, ethnicity, and educational level, with attention to potential disparities, require further study. Studies of strategies to promote effective involvement of patients and families in decision making throughout discharge planning are needed. The development and testing of referral and other information systems designed to promote the transfer of accurate and complete information across sites of care should be a research focus. A priority for future research should be continued study of strategies to improve transitional care outcomes of older adults and their caregivers.

scholarly journals Attitudes and Perceptions of Health Care Providers About the Implementation of Population Based Cancer Screening Program in India. A study From Assam

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 53s-53s
Author(s):  
A. Kedar ◽  
R. Hariprasad ◽  
R. Kanan ◽  
R. Mehrotra
Keyword(s):  
Health Care ◽  
Cancer Screening ◽  
Health Care Providers ◽  
Screening Program ◽  
Healthcare Providers ◽  
Population Based ◽  
Care Providers ◽  
Cancer Screening Program ◽  
Attitudes And Perceptions ◽  
Study Participants

Background: India is facing noncommunicable diseases epidemic with cancer as one of the main reasons of mortality. To bring this epidemic under control and as a measure of secondary prevention, government of India has rolled out operational framework for population cancer screening. As cancer screening is a new concept for Indian health care providers, this study focuses on the attitudes and perceptions of HCP from a district in Assam. Aim: To know the attitudes and perceptions of healthcare providers in Assam about the implementation of population based cancer screening program in India. Methods: This study was a part of ongoing Indian Council of Medical Research project at Cachar district, Assam. The study was conducted at Silchar, Assam and the study participants were attendees of the master trainers' workshop which was conducted for the pilot cancer screening program rolled out in Cachar district, Assam. Self-administered questionnaires were used to collect data from the health care providers on the last day of the training. Data were gathered from 58 participants. The participants were medical officers, auxillary nurse midwives (ANM), accredited social health activists (ASHA), staff nurses, nongovernmental organization (NGO) representatives and other health care providers from public health facilities. Results: Majority of the study participants agreed with the concept of screening. Half of the study participants stated that they could conduct screening comfortably along with their other responsibilities. Lack of human resources and an overburdened human resource were the main challenges foreseen in the implementation of the program. 91% of the participants wanted GOI to implement the cancer screening program. Majority of the health personnel were in favor of primary health center (PHC) as the first preferable site of population cancer screening followed by subcenter being second on preference for screening. One-third of study participants opined that screening should be done by specialist doctors. Almost one fifth of participants stated that ASHA should do the screening and almost same number of participants thought that medical officer at PHC should do the screening. Conclusion: This is the first pilot study on the population based cancer screening guidelines released by the government of India. The organized screening program is yet to be rolled out in the country. Though many challenges were foreseen by the healthcare providers in carrying out the population based cancer screening, majority were optimistic for the implementation of this screening program.

Assessments for Caregivers of Hospitalized Older Adults

2018 ◽  
Vol 29 (6) ◽  
pp. 382-391 ◽  
Author(s):  
Beth Fields ◽  
Rose L. Turner ◽  
Maharsi Naidu ◽  
Richard Schulz ◽  
Everette James ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Future Research ◽  
Care Providers ◽  
Quality Appraisal ◽  
Literature Searches ◽  
Full Text Review ◽  
Caregiver Needs ◽  
Hospitalized Older Adults ◽  
Selection Of

A systematic review was conducted to characterize assessments for caregivers of hospitalized older adults. Electronic literature searches of Medline, PsycINFO, and CINAHL of articles on caregiver assessments published in English between 2006 and present were completed. Thirty-three articles underwent full-text review; four included assessments designed to capture caregiver needs in hospital settings. Original articles on the development of these assessments were reviewed for quality appraisal. Four findings emerged from our review. Existing assessments (a) focus on caregivers of specific conditions of older adults, (b) contain a singular caregiving domain, (c) measure caregiver outcomes or simply describe caregiving experiences, and (d) neglect psychometric properties. Health care providers are limited in their selection of assessments with caregivers of hospitalized older adults. This barrier is problematic if we are to equip caregivers to be successful at providing care to older adults. Future research should develop a hospital assessment for caregivers.

scholarly journals Access to Five Nonprimary Health Care Services by Homebound Older Adults: An Integrative Review

2018 ◽  
Vol 31 (1) ◽  
pp. 55-69
Author(s):  
Cynthia Sterling-Fox
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Integrative Review ◽  
Future Research ◽  
Care Providers ◽  
Care Services ◽  
Homebound Older Adults ◽  
The Impact

Globally, the number of homebound older adults is rising exponentially as the aging population increases. Homebound older adults have complex medical and psychological issues for which many receive home-based primary care services. The purpose of this integrative review was to identify, analyze, and synthesize the existing literature regarding homebound older adults’ need for, use of, and access to five nonprimary health care services. They are dental, nutritional, optical, pharmacy, and psychological services. The integrative review was conducted using a database search of CINAHL, Health Source: Nursing Education, PubMed, Medline, PsycINFO, and Cochrane, that was supplemented by a hand search. Little research was found addressing the five nonprimary health care services. Five themes emerged from the 10 studies. They were (1) complex and interrelated health problems require more health care services; (2) perceived unimportance of nonprimary health care services; (3) barriers to use of and access to nonprimary health care services; (4) the impact of socioeconomic and demographical factors on access to services; and (5) the impact of psychological factors (depression and social isolation) on the use and access to health care services. These findings suggest further inequity and barriers to health care services by homebound older adults. Future research is needed with nonprimary health care providers to examine the clinical outcomes and costs of providing the services to homebound older adults.

scholarly journals “You Get Three Different Hats on and Try to Figure It Out:” Home-based Care Provision During a Disaster

2021 ◽  
Author(s):  
Sue Anne Bell ◽  
Sarah Dickey ◽  
Marie-Anne Rosemberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Groups ◽  
Health Care Providers ◽  
Well Being ◽  
Home Health ◽  
Qualitative Inquiry ◽  
Care Providers ◽  
Home Based ◽  
Home Based Care

Abstract Background: Home-based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home-based care remains a vital source of support for older adults. The purpose of this study was to describe the experiences of home-based care providers in providing care to older adults during a disaster in order to inform future disaster planning.Methods: Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home health nurses (n=25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results: Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65% were registered nurses, 20% were Licensed Vocational Nurses (LVN), and 15% were other types of health care providers. 12% of the sample was male and 88% was female. Seven themes were identified in the analysis: the importance of the community in preparedness and response, government and corporations were viewed as unreliable, disasters exacerbate inequalities, the role of the family bond, the breakdown of preparedness is at implementation, the tension between caring for self and family and caring for patients, and the resilience and adaptability of home based care providers.Conclusions: While home-based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and existing nursing models of care in the immediate period after the disaster were emphasized. This study informs the growing body of evidence on the value of home-based care in promoting safety and well-being for older adults during a disaster.

A Focus Group Evaluation of Breathe Easier: A Mindfulness-Based mHealth App for Survivors of Lung Cancer and Their Family Members

2020 ◽  
Vol 34 (7) ◽  
pp. 770-778
Author(s):  
Jenay M. Beer ◽  
Kasey N. Smith ◽  
Taylor Kennedy ◽  
George Mois ◽  
Dane Acena ◽  
...  
Keyword(s):  
Lung Cancer ◽  
South Carolina ◽  
African American ◽  
Focus Groups ◽  
Health Information ◽  
Health Care Providers ◽  
Family Members ◽  
Hospital Setting ◽  
Future Research ◽  
Care Providers

Purpose: To explore attitudes and acceptance (i.e., intent for future adoption) of survivors of lung cancer and their family members toward a dyad-focused mHealth mindfulness-based intervention (MBI). Approach: Focus groups. Setting: Community hospital setting in South Carolina. Participants: Survivors n = 11 (M = 64.6 years; 73% female; 64% African American) of non-small cell lung cancer (stage I-IIIa) and their family members, n = 8 (M = 58.6 years; 38% female; 75% African American). Intervention: A fully functional prototype mHealth app to deliver a tailored MBI for survivors of lung cancer and their family members. Method: Semi-structured focus groups were conducted and assessed using thematic data analysis to identify the benefits, concerns, needs, and expectations of the app. Results: Convenience and health were the top benefits of using the app, while cost and difficulty of use were the top concerns. Survivors mentioned benefits more than their family members did. Participants felt positively about adding a community network to the app. Finally, participants expected to hear about Breathe Easier from their care provider. Conclusion: Participants perceived a benefit to having credible health information delivered through an mHealth app. Guidance and credible health information regarding lung cancer survivorship should be accessible and convenient for everyone impacted by the disease. Thus, future research should explore platforms for a virtual support system and understanding dissemination of mHealth apps through health care providers.

scholarly journals A192 A MEDICAL SUMMARY TEMPLATE FOR THE TRANSFER OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE TRANSITIONING FROM PEDIATRIC TO ADULT CARE

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 209-210
Author(s):  
E I Benchimol ◽  
W Afif ◽  
S Plamondon ◽  
D Newhook ◽  
S G Nicholls ◽  
...  
Keyword(s):  
Focus Group ◽  
Focus Groups ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Mode Of Delivery ◽  
Current Status ◽  
Care Providers ◽  
Adult Care ◽  
Essential Information ◽  
Process Factors

Abstract Background The transfer of information in a medical summary letter is a key aspect of the transition of adolescent patients with IBD from pediatric to adult care. The existing template from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) is nearly 20 years old, and the many intervening changes to the care of children with IBD necessitate a new template to reflect modern care. Aims We developed a standardized medical summary template based on the feedback of adult and pediatric IBD health care providers. Methods We purposively sampled gastroenterologists (GIs) or nurse practitioners (NPs) caring for patients with IBD in Montreal, Ottawa, Toronto or Vancouver and invited them to take part in focus group discussions. Gastroenterologists caring for <50 IBD patients in the past 2 years were excluded. We invited 30 local academic or community-based physicians and nurse-practitioners, of whom 17 (56.7%) agreed to participate. Four focus groups were conducted, consisting of: 1) adult GIs practicing in Ottawa; 2) adult GIs practicing in Montreal and Sherbrooke; 3) paediatric GIs and NPs practicing in Ottawa, Montreal, Toronto or Vancouver; 4) a mixed group consisting of most participants from the preceding three groups. Focus groups employed a semi-structured approach and were recorded with consent. Informed by conventional content analysis, we inductively coded the focus group transcripts to identify all areas of priority for inclusion in the template. The final mixed focus group finalized the template content based information from the preceding groups. Results Content areas of importance (see Table) were: patient/disease characteristics, therapeutics history, clinical history and current status, noteworthy investigations, history of complications, family history, immunization history, and psychosocial history. In addition, the template addressed health system process factors (i.e., urgency of transfer, mode of delivery, confidentiality) to ensure a seamless transfer to adult care. Conclusions The standardized medical summary template should be used by pediatric providers to ensure that essential information is sent to the receiving adult provider. Funding Agencies Transition des patients avec Crohn et colite (TRACC) program

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