scholarly journals Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabell Gragoll ◽  
Lukas Schumann ◽  
Monique Neubauer ◽  
Christina Westphal ◽  
Hermann Lang
Keyword(s):  
Dental Care ◽  
Patient Characteristics ◽  
Direct Access ◽  
Structured Interviews ◽  
Individual Interviews ◽  
Type D ◽  
Framework Approach ◽  
German Region ◽  
Dmft Index ◽  
Spectrum Of Patients

Abstract Background The treatment of acute pain is part of everyday dental practice. Often, these symptoms result from years of patients' inadequate or missing dental routines and lead to a reduction in the quality of life or health of the patients and to high costs for the health care system. Despite the enormous advantages of modern dentistry, many patients avoid going to the dentist. Therefore, the study aimed to determine the reasons and behaviours that cause patients to avoid visits to the dentist. Methods We conducted semi-structured interviews with patients who had an above-average DMFT index and had been going to the dentist only irregularly for years. The sample participants were recruited from the northern German region of Mecklenburg-Western Pomerania. 20 individual interviews were recorded, transcribed verbatim and coded. We used a qualitative framework approach to code the transcripts in order to establish a consensus among the researchers. Ultimately, through discussions and reviews of the attributes and meaning of the topics, a typology could be established. Results A typology of patients who avoid the dentist was developed. Four independent characteristic patterns of dentist avoidance could be developed: avoiding the dentist due to "distance" (type A; includes subtype A1 "avoiding the dentist due to negligence" and subtype A2 "dental avoidance due to neutralization"), "disappointment" (type B), "shame" (type C), and "fear" (type D). Using the typology as a generalised tool to determine the minimum and maximum contrasts, it was possible to capture the diversity and multidimensionality of the reasons and behaviours for avoidance. All patients had negative dental experiences, which had led to different avoidance patterns and strategies. Conclusions The identified avoidance characteristics represent a spectrum of patients from Northern Germany who avoid going to the dentist. This is the first comprehensive study in Germany representing avoidance behaviour of dentist patients in the form of a typology. The results suggest that dentistry also needs qualitative research to better understand patient characteristics and provide direct access to patients who avoid regular dental visits. Thus, the results make a potentially fundamental contribution to the improvement of dental care and enrich its understanding.

scholarly journals Young adults understanding and readiness to engage with palliative care: extending the reach of palliative care through a public health approach: a qualitative study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anita Mallon ◽  
Felicity Hasson ◽  
Karen Casson ◽  
Paul Slater ◽  
Sonja McIlfatrick
Keyword(s):  
Public Health ◽  
Palliative Care ◽  
Young Adults ◽  
Death And Dying ◽  
Population Based ◽  
Public Health Approach ◽  
Structured Interviews ◽  
Comfort Care ◽  
Positive Attitudes ◽  
Framework Approach

Abstract Background Moving palliative care from a solely clinical focus to a more population based and community orientated approach is the hallmark of a much advocated public health approach to palliative care. Young adults are a vital cohort of the public, yet their understanding of palliative care has not been investigated. This study aimed to explore young adults’ understanding of palliative care and identify factors that influence their engagement. Methods A purposive sample of young adults (n = 24) aged 18–29 years were recruited from one UK University. Semi-structured interviews were undertaken face to face or via telephone or Skype between November 2017 and February 2018. Thematic analysis using a framework approach and underpinned by a socioecological perspective was used to analyse the interviews. Results Three thematic categories were identified relating to intrapersonal and interpersonal influences, cultural and social influences and organisational and public policy influences. Palliative care was understood as supportive comfort care, delivered in the absence of cure, associated with the end of life and specifically focused on death and dying. Negative attitudes related to the context of care, which represented a static and hopeless situation. Whilst some reported positive attitudes, potential engagement was seen to be governed by a lack of knowledge and protective cultural norms. In terms of demonstrating readiness to engage with palliative care, participants requested clear information and suggested a normalising of palliative care through the education system. Conclusion Young adults in this study were ready to find out more about palliative care and identified social media as a platform upon which to engage this population. However, their perception of a society that views palliative care as a subject for those directly affected, creates a barrier to engagement. This study identified the ingredients of a public health message and mediums for disseminating the message. However, findings also suggest that a cultural shift is required to recognise the potential of engaging young adults in health issues that cross the life span, empowering them not only as individuals but as vital members of community and society.

scholarly journals Providing telecare for older adults: understanding the care navigators’ experience

2018 ◽  
Vol 19 (1) ◽  
pp. 31-41 ◽  
Author(s):  
Madeline Naick
Keyword(s):  
Older Adults ◽  
Knowledge Exchange ◽  
Structure Interview ◽  
Small Sample ◽  
Structured Interviews ◽  
Content Type ◽  
Experience Of Care ◽  
Framework Approach ◽  
Standard Of Practice ◽  
Hospital Teams

Purpose The provision of telecare for older adults in England is increasingly being facilitated by care navigators in the non-statutory sector. The purpose of this paper is to explore the experiences of care navigators when assessing older adults for telecare and to understand what contextual and organisational factors impact on their practice. Design/methodology/approach A purposeful sample of care navigators and telecare installers was selected. Care navigators were recruited from five non-statutory organisations. In order to provide an insight into telecare provision by this sector, telecare installers were also recruited. Semi-structured interviews were conducted with 11 participants covering: role, training, assessment, reviews, installation, suitability, impact, aims, outcomes, and organisational structure. Interview data were analysed using the framework approach. Findings Five main themes emerged from the analysis: responsiveness, autonomy, knowledge exchange, evolving practice, and sustaining performance. Research limitations/implications This study included a small sample, and was only based in one local authority, focusing on the experience of care navigators in only one sector. Practical implications The findings suggest that strategic placement of care navigators could support the demand for telecare assessment to facilitate discharges from hospital. This study highlights the perception of home assessment as a gold standard of practice for care navigators. In order to develop a more sustainable model for care navigators’ capacity to work within hospital teams and provide home assessments needs further consideration. Originality/value This study is one of the first to explore the role of the care navigator and their involvement in the provision of telecare for older adults.

scholarly journals P142: Perspectives of medical students and undergraduate students on their experience as medical scribes in the Saint John Regional Hospital Emergency Department

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S115-S116
Author(s):  
I. Abelev ◽  
D. Lewis ◽  
J. Fraser ◽  
P. Atkinson
Keyword(s):  
Medical Students ◽  
Undergraduate Students ◽  
Medical Profession ◽  
Value Added ◽  
School Curriculum ◽  
Health Care Team ◽  
Direct Access ◽  
Theory Approach ◽  
Medical Terminology ◽  
Structured Interviews

Introduction: Electronic medical records (EMR) have placed increasing demand on emergency physicians and may contribute to physician burnout and stress. The use of scribes to reduce workload and increase productivity in emergency departments (ED) has been reported. This objective of this study was to evaluate the educational and experiential value of scribing among medical and undergraduate students. We asked: “Will undergraduates be willing to scribe in exchange for clinical exposure and experience?”; and, “Should scribing be integrated into the medical school curriculum?” Methods: A mixed-methods model was employed. The study population included 5 undergraduate, and 5 medical students. Scribes received technical training on how to take physician notes. Undergraduate students were provided with optional resources to familiarize themselves with common medical terminology. Scribes were assigned to physicians based on availability. An exit interview and semi-structured interviews were conducted at the conclusion of the study. Interviews were transcribed and coded into thematic coding trees. A constructivist grounded theory approach was used to analyze the results. Themes were reviewed and verified by two members of the research team. Results: Undergraduate students preferred volunteering in the ED over other volunteer experiences (5/5); citing direct access to the medical field (5/5), demystification of the medical profession (4/5), resume building (5/5), and perceived value added to the health care team (5/5) as main motivators to continue scribing. Medical students felt scribing should be integrated into their curriculum (4/5) because it complemented their shadowing experience by providing unique value that shadowing did not. Based on survey results, five undergraduate students would be required to cover 40 volunteer hours per week. Conclusion: A student volunteer model of scribing is worthwhile to students and may be feasible; however, scribe availability, potentially high scribe turnover, and limited time to develop a rapport with their physician may impact any efficiency benefit scribes might provide. Importantly, scribing may be an invaluable experience for directing career goals and ensuring that students intrinsically interested in medicine pursue the profession. Medical students suggested that scribing could be added to the year one curriculum to help them develop a framework for how to take histories and manage patients.

Factors Affecting Dental Attendance following Treatment for Dental Anxiety in Primary Dental Care

2001 ◽  
Vol os8 (2) ◽  
pp. 51-56 ◽  
Author(s):  
Yvonne-Marie Dailey ◽  
Alex N Crawford ◽  
Gerry Humphris ◽  
Michael A Lennon
Keyword(s):  
Dental Care ◽  
Dental Anxiety ◽  
Structured Interviews ◽  
Factors Affecting ◽  
Community Clinic ◽  
Face To Face ◽  
Dental Attendance ◽  
General Dental Practitioner ◽  
Mean Time

Aim To explore factors affecting patients’ dental attendance behaviour following referral from a dental anxiety clinic to a general dental practitioner. Design A four-year follow up of patients who completed a course of treatment for dental anxiety by conducting semi-structured interviews, face-to-face or by telephone, with confirmation of dental attendance from the dental records. Subjects Forty-one patients who had completed a course of treatment for dental anxiety, in a specially designed community clinic. Mean time since last dental visit before treatment was 7.8 years (range 0.5–29). Results Twenty-three patients were successfully followed up and 11 (47%) were receiving regular asymptomatic dental care. The dental anxiety scores of those who subsequently became asymptomatic attenders were significantly lower at follow-up than the patients who became symptomatic attenders (P=0.01). Effective dentist-patient communication was a common theme of the interviews. Conclusions At four-year follow-up, dental anxiety was substantially lower in those who subsequently became asymptomatic attenders than those who became symptomatic attenders. A positive dentist-patient relationship had developed with the asymptomatic attenders.

STAKEHOLDER INVOLVEMENT IN HEALTH TECHNOLOGY ASSESSMENT AT NATIONAL LEVEL: A STUDY FROM IRAN

2016 ◽  
Vol 32 (3) ◽  
pp. 181-189 ◽  
Author(s):  
Bahareh Yazdizadeh ◽  
Safoura Shahmoradi ◽  
Reza Majdzadeh ◽  
Shila Doaee ◽  
Mohammad Bazyar ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Interest Groups ◽  
Technology Assessment ◽  
National Level ◽  
Stakeholder Involvement ◽  
Health Technology ◽  
Policy Dialogue ◽  
Structured Interviews ◽  
Framework Approach ◽  
Two Stages

Objectives:This study was carried out to evaluate the opinions of stakeholders on their roles in health technology assessment (HTA) in Iran and to determine the barriers and facilitators existing in the organizations to help increase their involvement in the HTA program.Methods:The study was conducted in two stages, semi-structured interviews, and “policy dialogue” with stakeholders. The data were analyzed through the framework approach.Results:The interviews were held with ten stakeholder representatives from various organizations. In addition, Twenty-one representatives participated in the policy dialogue. Based on the findings, all the stakeholder organizations considered themselves as interest groups in all the stages of the HTA process; however, their tendencies and methods of involvement differed from one another. According to the participants, the most important issue to be considered in the context of HTA was that the structures, stages, and procedures of the HTA process must be made transparent.Conclusions:Stakeholder involvement in the HTA program cannot readily take place. Various stakeholders have different interests, responsibilities, infrastructures, and barriers. If a program does not meet these considerations, its chances of succeeding will substantially decrease. Therefore, to prevent overlooking the needs and expectations of stakeholders from the HTA process, it is essential to create opportunities in which their thoughts and ideas are taken into account.

scholarly journals Nine Recommendations for Decision Aid Implementation from the Clinician Perspective

2020 ◽  
Author(s):  
Anshu Ankolekar ◽  
Ben G.L. Vanneste ◽  
Esther Bloemen-van Gurp ◽  
Joep van Roermund ◽  
Adriana Berlanga ◽  
...  
Keyword(s):  
Decision Making ◽  
Time Pressure ◽  
Decision Aids ◽  
Patient Activation ◽  
Patient Characteristics ◽  
Active Role ◽  
Economic Incentives ◽  
Structural Factors ◽  
Structured Interviews ◽  
Practice Methods

Abstract Background Shared decision-making (SDM) aims to empower patients to take an active role in their treatment choices, supported by clinicians and patient decision aids (PDAs). The purpose of this study is to explore barriers and possible facilitators to SDM and a PDA in the prostate cancer trajectory. In the process we identify possible actions that organizations and individuals can take to support implementation in practice. Methods We use the Ottawa Model of Research Use as a framework to determine the barriers and facilitators to SDM and PDAs from the perspective of clinicians. Semi-structured interviews were conducted with urologists (n = 4), radiation oncologists (n = 3), and oncology nurses (n = 2), focusing on the current decision-making process experienced by these stakeholders. Questions included their attitudes towards SDM and PDAs, barriers to implementation and possible strategies to overcome them. Results Time pressure and patient characteristics were cited as major barriers by 55% of the clinicians we interviewed. Structural factors such as external quotas for certain treatment procedures were also considered as barriers by 44% of the clinicians. Facilitating factors involved organizational changes to embed PDAs in the treatment trajectory, training in using PDAs as a tool for SDM, and clinician motivation by disseminating positive clinical outcomes. Our findings also suggest a role for external stakeholders such as healthcare insurers in creating economic incentives to facilitate implementation. Conclusion Our findings highlight the importance of a multi-faceted implementation strategy to support SDM. While clinician motivation and patient activation are essential, structural/economic barriers may hamper implementation. Action must also be taken at the administrative and policy levels to foster a collaborative environment for SDM and in the process for PDAs.

scholarly journals Does applicant specialty ambition influence medical school choice?

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X703685
Author(s):  
Eliot Rees ◽  
David Harrison ◽  
Karen Mattick ◽  
Katherine Woolf
Keyword(s):  
General Practice ◽  
School Choice ◽  
Medical School ◽  
Medical Schools ◽  
First Year ◽  
Structured Interviews ◽  
Individual Interviews ◽  
Group Interviews ◽  
The Uk ◽  
First Year Medical Students

BackgroundThe NHS is critically short of doctors. The sustainability of the UK medical workforce depends on medical schools producing more future GPs who are able and willing to care for under-served patient populations. The evidence for how medical schools should achieve this is scarce. We know medical schools vary in how they attract, select, and educate future doctors. We know some medical schools produce more GPs, but it is uncertain whether those school recruit more students who are interested in general practice.AimThis study seeks to explore how applicants’ future speciality ambitions influence their choice of medical school.MethodOne-to-one semi-structured interviews and focus groups were conducted with medical applicants and first year medical students at eight medical schools around the UK. Interviews were audiorecorded and transcribed verbatim. Transcripts were analysed through thematic analysis by one researcher. A sample of 20% of transcripts were analysed by a second researcher.ResultsSixty-six individuals participated in 61 individual interviews and one focus group. Interviews lasted a mean of 54 minutes (range 22–113). Twelve expressed interest in general practice, 40 favoured other specialities, and 14 were unsure. Participants’ priorities varied by speciality aspiration; those interested in general practice described favouring medical schools with early clinical experience and problem-based learning curricula, and were less concerned with cadaveric dissection and the prestige of the medical school.ConclusionMany applicants consider future speciality ambitions before applying to medical school. Speciality aspiration appears to influence priority of medical schools’ attributes.

scholarly journals Snacktivity™ to Promote Physical Activity: a Qualitative Study

2021 ◽  
Author(s):  
Natalie Tyldesley-Marshall ◽  
Sheila M. Greenfield ◽  
Helen M. Parretti ◽  
Kajal Gokal ◽  
Colin Greaves ◽  
...  
Keyword(s):  
Physical Activity ◽  
Research Programme ◽  
Structured Interviews ◽  
Physically Active ◽  
The Public ◽  
Potential Barriers ◽  
Complementary Approach ◽  
Framework Approach ◽  
Intensity Physical Activity ◽  
Barriers To Implementation

Abstract Background Adults should achieve a minimum of 150 min of moderate-to-vigorous intensity physical activity per week, but many people do not achieve this. Changes to international guidance have removed the requirement to complete physical activity in bouts of at least 10 min. Snacktivity is a novel and complementary approach that could motivate people to be physically active. It focuses on promoting shorter (2–5 min) and more frequent bouts, or ‘snacks’ of physical activity throughout the day. It is not known whether promoting physical activity in shorter bouts is acceptable to the public, or whether it likely to translate into health behaviour change. Methods As part of a larger research programme, this study explored the merits of using small bouts of physical activity to help the public become physically active (the Snacktivity™ programme). Thirty-one inactive adults used the approach for five days then participated in semi- structured interviews about their experiences. The data were analysed using the Framework approach. Results Whilst participants highlighted some potential barriers to implementation, they expressed the ease with which Snacktivity could be achieved, which gave them a new awareness of opportunities to do more physical activity throughout the day. Participants raised the importance of habit formation to achieve regular small bouts of physical activity. Conclusions Findings demonstrated that participants liked the Snacktivity concept and viewed it as a motivating approach. Guidance about physical activity must lead to advice that has the best chance of preserving and promoting health and Snacktivity has potential to meet this ambition.

scholarly journals Exploring utilisation of the allied health assistant workforce in the Victorian health, aged care and disability sectors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. Huglin ◽  
L. Whelan ◽  
S. McLean ◽  
K. Greer ◽  
D. Mitchell ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Health Professionals ◽  
Allied Health ◽  
Aged Care ◽  
Structured Interviews ◽  
Allied Health Professionals ◽  
Individual Interviews ◽  
Care Services ◽  
Group Data ◽  
Health Assistant

Abstract Background Allied health assistants (AHAs) support allied health professionals (AHPs) to meet workforce demands in modern healthcare systems. Previous studies have indicated that AHAs may be underutilised in some contexts. This study aims to identify factors contributing to the effective utilisation of AHAs across health, aged care and disability sectors and possible pathway elements that may optimise AHA careers in Victoria. Methods Using an interpretive description approach data collection included a workforce survey and semi structured interviews (individual and group). Data analysis included descriptive statistics, independent t-tests and thematic analysis. Participants included allied health assistants, allied health professionals and allied health leaders in the health, aged care or disability sectors; educators, managers or student of allied health assistance training; and consumers of Victorian health, disability or aged care services. Results The literature scan identified numerous potential barriers to and enablers of AHA workforce utilisation. A total of 727 participants completed the survey consisting of AHAs (n = 284), AHPs & allied health leaders (n = 443). Thirteen group and 25 individual interviews were conducted with a total of 119 participants. Thematic analysis of the interview data identified four interrelated factors (system, training, individual and workplace) in pre-employment training and workplace environments. These factors were reported to contribute to effective utilisation of the AHA workforce across health, aged care and disability sectors. Study findings were also used to create a conceptual diagram of potential AHA career pathway elements. Conclusion This study identified pre-employment and workplace factors which may contribute to the optimal utilisation of the AHA workforce across Victorian health, aged care and disability sectors. Further study is needed to investigate the transferability of these findings to national and global contexts, and testing of the conceptual model.

scholarly journals Daily Life and Challenges Faced By Households With Permanent Childhood Developmental Disability in Rural Tanzania – A Qualitative Study

2021 ◽  
Author(s):  
Joëlle Castellani ◽  
Omari Kimbute ◽  
Charles Makasi ◽  
Zakayo E. Mrango ◽  
Aggie T. G. Paulus ◽  
...  
Keyword(s):  
Developmental Disabilities ◽  
Qualitative Study ◽  
Developmental Disability ◽  
Structured Interviews ◽  
Individual Interviews ◽  
Rural Tanzania ◽  
Severe Developmental Disabilities ◽  
Specialized School ◽  
Digital Stories ◽  
Cerebral Infection

AbstractSevere developmental disability in children affects the life of the child and entire household. We conducted a qualitative study to understand how caregivers manage severe developmental disabilities in children in rural Africa. Families and six children (out of 15 children) who had serious permanent sequelae from a cerebral infection in Handeni, Tanzania, were contacted and invited to a workshop to recount their experience living with severe developmental disabilities. After consent, individual interviews were conducted first through recording of individual digital stories and then through individual semi-structured interviews. Pre-determined key categories were used to analyse the data. Our results showed that developmental disabilities required constant care and reduced the autonomy of the children. Schooling had not been attempted or was halted because of learning problems or inability to meet specialized school costs. Parents were under constant physical, emotional and financial stress. Their occupational earnings decreased. Some families sold their assets to survive. Others began to rely on relatives. Understanding the consequences of developmental disability helps to identify where social support should be focused and improved.

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