Cooperation networks of ambulatory health care providers: exploration of mechanisms that influence coordination and uptake of recommended cardiovascular care (ExKoCare): a mixed-methods study protocol

BACKGROUND Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)–based simulation, MPathic-VR, was developed to train health care providers in empathic communication with patients and in interprofessional settings and evaluated through a randomized controlled trial. OBJECTIVE This mixed methods study aimed to investigate the differential effects of a VH-based simulation developed to train health care providers in empathic patient-provider and interprofessional communication. METHODS We employed a mixed methods intervention design, involving a comparison of 2 quantitative measures—MPathic-VR–calculated scores and the objective structured clinical exam (OSCE) scores—with qualitative reflections by medical students about their experiences. This paper is a secondary, focused analysis of intervention arm data from the larger trial. Students at 3 medical schools in the United States (n=206) received simulation to improve empathic communication skills. We conducted analysis of variance, thematic text analysis, and merging mixed methods analysis. RESULTS OSCE scores were significantly improved for learners in the intervention group (mean 0.806, SD 0.201) compared with the control group (mean 0.752, SD 0.198; <italic>F</italic>1,414=6.09; <italic>P</italic>=.01). Qualitative analysis revealed 3 major positive themes for the MPathic-VR group learners: gaining useful communication skills, learning awareness of nonverbal skills in addition to verbal skills, and feeling motivated to learn more about communication. Finally, the results of the mixed methods analysis indicated that most of the variation between high, middle, and lower performers was noted about nonverbal behaviors. Medium and high OSCE scorers most often commented on the importance of nonverbal communication. Themes of motivation to learn about communication were only present in middle and high scorers. CONCLUSIONS VHs are a promising strategy for improving empathic communication in health care. Higher performers seemed most engaged to learn, particularly nonverbal skills.

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Management of antithrombotic therapy after gastrointestinal bleeding: A mixed methods study of health‐care providers

Journal of Thrombosis and Haemostasis ◽

10.1111/jth.15111 ◽

2020 ◽

Vol 19 (1) ◽

pp. 153-160

Author(s):

Derek H. W. Little ◽

Tara Robertson ◽

James Douketis ◽

Joanna C. Dionne ◽

Anne Holbrook ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Gastrointestinal Bleeding ◽

Health Care Providers ◽

Antithrombotic Therapy ◽

Mixed Methods Study ◽

Care Providers

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The paradox of compassionate work: a mixed-methods study of satisfying and fatiguing experiences of animal health care providers

Anxiety Stress & Coping ◽

10.1080/10615806.2017.1392224 ◽

2017 ◽

Vol 31 (2) ◽

pp. 228-243 ◽

Cited By ~ 3

Author(s):

Alicia J. Polachek ◽

Jean E. Wallace

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Animal Health ◽

Mixed Methods Study ◽

Care Providers

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Uptake challenges of intermittent preventive malaria therapy among pregnant women and their health care providers in the Upper West Region of Ghana: A mixed-methods study

Parasite Epidemiology and Control ◽

10.1016/j.parepi.2021.e00222 ◽

2021 ◽

Vol 15 ◽

pp. e00222

Author(s):

Frederick Dun-Dery ◽

Peter Meissner ◽

Claudia Beiersmann ◽

Naasegnibe Kuunibe ◽

Volker Winkler ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Pregnant Women ◽

Health Care Providers ◽

Mixed Methods Study ◽

Care Providers ◽

Malaria Therapy ◽

West Region

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An Exploratory Mixed Methods Study of Diabetes self-management in Blind Americans

Western Journal of Nursing Research ◽

10.1177/01939459211019421 ◽

2021 ◽

pp. 019394592110194

Author(s):

Nazanin Heydarian ◽

Allyson S. Hughes ◽

Osvaldo F. Morera

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Mixed Methods Study ◽

Self Management ◽

Diabetes Distress ◽

Management Support ◽

Care Providers ◽

Health Significance ◽

Coverage Policy

This study used mixed methods to investigate the experiences of 33 participants who are blind (PWB) and have diabetes in managing their diabetes, support (or lack thereof) from their health care providers, and diabetes distress as PWB. Participants most frequently reported barriers to check blood glucose (55%), maintaining a healthy diet (45%), and distress due to their intersectional status of having blindness and diabetes. Those who mentioned intersectional distress of managing diabetes as a PWB tended to be Braille illiterate and less likely to use mobility tools that are symbolic of blindness (e.g., white cane, guide dog). These results illuminate heterogenous characteristics of PWB with diabetes, an understudied population of public health significance, to be considered when setting priorities for diabetes self-management support and health care coverage policy.

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Barriers to Gestational Diabetes Management and Preferred Interventions for Women With Gestational Diabetes in Singapore: Mixed Methods Study (Preprint)

10.2196/preprints.14486 ◽

2019 ◽

Author(s):

Sumali Hewage ◽

Jananie Audimulam ◽

Emily Sullivan ◽

Claudia Chi ◽

Tong Wei Yew ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Blood Glucose ◽

Gestational Diabetes ◽

Health Care Providers ◽

Working Women ◽

Mixed Methods Study ◽

Blood Glucose Monitoring ◽

Care Providers ◽

Diet Control

BACKGROUND Gestational diabetes mellitus (GDM) is associated with risks for both the mother and child. The escalated prevalence of GDM because of obesity and changes in screening criteria demands for greater health care needs than before. OBJECTIVE This study aimed to understand the perception of patients and health care providers of the barriers to GDM management and preferred interventions to manage GDM in an Asian setting. METHODS This mixed methods study used a convergent parallel design. Survey data were collected from 216 women with GDM, and semistructured interviews were conducted with 15 women and with 8 health care providers treating patients with GDM. Participants were recruited from 2 specialized GDM clinics at the National University Hospital, Singapore. RESULTS The patients were predominantly Chinese (102/214, 47.6%), employed (201/272, 73.9%), with higher education (150/216, 69.4%) and prenatal attendance at a private clinic (138/214, 64.2%), already on diet control (210/214, 98.1%), and receiving support and information from the GDM clinic (194/215, 90.2%) and web-based sources (131/215, 60.9%). In particular, working women reported barriers to GDM management, including the lack of reminders for blood glucose monitoring, diet control, and insufficient time for exercise. Most women preferred getting such support directly from health care providers, whether at the GDM clinic (174/215, 80.9%) or elsewhere (116/215, 53.9%). Smartphone apps were the preferred means of additional intervention. Desirable intervention features identified by patients included more information on GDM, diet and exercise options, reminders for blood glucose testing, a platform to record blood glucose readings and illustrate or understand trends, and a means to communicate with care providers. CONCLUSIONS A GDM-focused smartphone app that is able to integrate testing, education, and communication may be a feasible and acceptable intervention to provide support to women with GDM, particularly for working women.

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Health Care Providers’ Trusted Sources for Information About COVID-19 Vaccines: Mixed Methods Study (Preprint)

10.2196/preprints.33330 ◽

2021 ◽

Author(s):

Eden Brauer ◽

Kristen Choi ◽

John Chang ◽

Yi Luo ◽

Bruno Lewin ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Information Sources ◽

Mixed Methods Study ◽

Government Agencies ◽

Advanced Practice ◽

Care Providers ◽

Sources Of Information ◽

Vaccine Information

BACKGROUND Information and opinions shared by health care providers can affect patient vaccination decisions, but little is known about who health care providers themselves trust for information in the context of new COVID-19 vaccines. OBJECTIVE The purpose of this study is to investigate which sources of information about COVID-19 vaccines are trusted by health care providers and how they communicate this information to patients. METHODS This mixed methods study involved a one-time, web-based survey of health care providers and qualitative interviews with a subset of survey respondents. Health care providers (physicians, advanced practice providers, pharmacists, nurses) were recruited from an integrated health system in Southern California using voluntary response sampling, with follow-up interviews with providers who either accepted or declined a COVID-19 vaccine. The outcome was the type of information sources that respondents reported trusting for information about COVID-19 vaccines. Bivariate tests were used to compare trusted information sources by provider type; thematic analysis was used to explore perspectives about vaccine information and communicating with patients about vaccines. RESULTS The survey was completed by 2948 providers, of whom 91% (n=2683) responded that they had received ≥1 dose of a COVID-19 vaccine. The most frequently trusted source of COVID-19 vaccine information was government agencies (n=2513, 84.2%); the least frequently trusted source was social media (n=691, 9.5%). More physicians trusted government agencies (n=1226, 93%) than nurses (n=927, 78%) or pharmacists (n=203, 78%; P<.001), and more physicians trusted their employer (n=1115, 84%) than advanced practice providers (n=95, 67%) and nurses (n=759, 64%; P=.002). Qualitative themes (n=32 participants) about trusted sources of COVID-19 vaccine information were identified: processing new COVID-19 information in a health care work context likened to a “war zone” during the pandemic and communicating information to patients. Some providers were hesitant to recommend vaccines to pregnant people and groups they perceived to be at low risk for COVID-19. CONCLUSIONS Physicians have stronger trust in government sources and their employers for information about COVID-19 vaccines compared with nurses, pharmacists, and advanced practice providers. Strategies such as role modeling, tailored messaging, or talking points with standard language may help providers to communicate accurate COVID-19 vaccine information to patients, and these strategies may also be used with providers with lower levels of trust in reputable information sources.

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Validation and Acceptability of a Cuffless Wrist-Worn Wearable Blood Pressure Monitoring Device Among Users and Health Care Professionals: Mixed Methods Study (Preprint)

10.2196/preprints.14706 ◽

2019 ◽

Author(s):

Sheikh Mohammed Shariful Islam ◽

Susie Cartledge ◽

Chandan Karmakar ◽

Jonathan Charles Rawstorn ◽

Steve F Fraser ◽

...

Keyword(s):

Blood Pressure ◽

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Health Care Professionals ◽

Mixed Methods Study ◽

Care Providers ◽

Long Term Monitoring ◽

Term Monitoring

BACKGROUND Blood pressure (BP) is an important modifiable cardiovascular risk factor, yet its long-term monitoring remains problematic. Wearable cuffless devices enable the capture of multiple BP measures during everyday activities and could improve BP monitoring, but little is known about their validity or acceptability. OBJECTIVE This study aimed to validate a wrist-worn cuffless wearable BP device and assess its acceptability among users and health care professionals. METHODS A mixed methods study was conducted to examine the validity and comparability of a wearable cuffless BP device against ambulatory and home devices. BP was measured simultaneously over 24 hours using wearable and ambulatory devices and over 7 days using wearable and home devices. Pearson correlation coefficients compared the degree of association between the measures, and limits of agreement (LOA; Bland-Altman plots) were generated to assess measurement bias. Semistructured interviews were conducted with users and 10 health care professionals to assess acceptability, facilitators, and barriers to using the wearable device. Interviews were audio recorded, transcribed, and analyzed. RESULTS A total of 9090 BP measurements were collected from 20 healthy volunteers (mean 20.3 years, SD 5.4; N=10 females). Mean (SD) systolic BP (SBP)/diastolic BP (DBP) measured using the ambulatory (24 hours), home (7 days), and wearable (7 days) devices were 126 (SD 10)/75 (SD 6) mm Hg, 112 (SD 10)/71 (SD 9) mm Hg and 125 (SD 4)/77 (SD 3) mm Hg, respectively. Mean (LOA) biases and precision between the wearable and ambulatory devices over 24 hours were 0.5 (−10.1 to 11.1) mm Hg for SBP and 2.24 (−17.6 to 13.1) mm Hg for DBP. The mean biases (LOA) and precision between the wearable and home device over 7 days were −12.7 (−28.7 to 3.4) mm Hg for SBP and −5.6 (−20.5 to 9.2) mm Hg for DBP. The wearable BP device was well accepted by participants who found the device easy to wear and use. Both participants and health care providers agreed that the wearable cuffless devices were easy to use and that they could be used to improve BP monitoring. CONCLUSIONS Wearable BP measures compared well against a gold-standard ambulatory device, indicating potential for this user-friendly method to augment BP management, particularly by enabling long-term monitoring that could improve treatment titration and increase understanding of users’ BP response during daily activity and stressors.

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