scholarly journals Improving preoperative breast reconstruction consultations: a qualitative study on the impact of personalised audio-recordings

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Josipa Petric ◽  
Bahara Sadri ◽  
Phillipa van Essen ◽  
Nicola Ruth Dean
Keyword(s):  
Breast Reconstruction ◽  
Standard Care ◽  
Positive Response ◽  
Qualitative Interviews ◽  
Structured Interviews ◽  
Legal Implications ◽  
Audio Recordings ◽  
Standard Information ◽  
Study Participants ◽  
The Impact

Abstract Background To investigate the value of audio-recordings in aiding patient understanding and recall of preoperative breast reconstruction information. Methods This was a prospective cohort study. Participants were randomly allocated into either a recording group who were offered the opportunity to record their breast reconstruction explanation of surgery, or a standard information package group who received standard care. The value of having an audio-recording was assessed by semi-structured interviews and analysis of recurring themes. Results Between 21/2/19 and 19/3/20, 32 women attending consultations for breast reconstruction consented to participate in the study, 17 were randomly assigned to the recording group and 15 the standard information package group. Twenty-eight of the 32 participants completed qualitative interviews. All participants agreed that audio-recordings were a beneficial resource which allowed them to have a better understanding of the concepts discussed. Commonly reported themes included the ability to listen to the recording multiple times to refresh memory, as well as usefulness in helping to inform other family members. Participants also reported increased levels of trust in their clinician for allowing the audio-recordings. Very few participants raised any medico-legal implications of the recordings, their focus was more on the potential of the audio-recordings to alleviate the overwhelming nature of a pre-operative breast reconstruction consultation. Conclusions There was a positive response from participants to the use of audio-recordings in the setting of breast reconstruction consultations. These types of recordings could potentially be used in other complex appointments where detailed information is discussed, with similar success.

scholarly journals Lived Experiences of Palestinian Patients With COVID-19: A Multi-center Phenomenological Study of Recovery Journey

2021 ◽  
Author(s):  
Aidah Alkaissi ◽  
Fadi AlZiben ◽  
Mohammad Abu Rajab ◽  
Mahdia Alkony
Keyword(s):  
Mental Health ◽  
Lived Experiences ◽  
Phenomenological Study ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Sampling Technique ◽  
Care Plan ◽  
Structured Interviews ◽  
Study Participants

Abstract Background: Exploring lived experiences of recovered COVID-19 patients might have scientific, social, and policy relevance that apply to the healthcare infrastructure. This multi-center phenomenological study was conducted to explore lived experiences of Palestinian patients who recovered from COVID-19.  Methods: In this qualitative study, a phenomenological descriptive approach was used. A purposive sampling technique was employed to select the study participants. Semi-structured qualitative interviews were conducted with patients who recovered from COVID-19 (n = 20). The transcripts of the audio recorded interviews were analyzed by using Giorgio’s phenomenological analysis method. Results: Semi-structured interviews were conducted with 14 male and 6 female participants. The age of the participants ranged from 25-50 years. Nine themes and multiple subthemes emerged from the qualitative data. The themes were relevant to patient’s feelings about the experience, mental issues, social discriminations/stigma, symptoms, life in isolation, using supportive treatment, personal preventive measures, social support, and life after recovery.Conclusion: Survivors who were interviewed in this study recounted devastating experiences with regard to their mental health, social stigmatization, feeling guilt, shame, and hesitant to regain contact with others. Mental health issues should be addressed as a part of the care plan for patients with COVID-19. More studies are still needed to investigate if introducing mental healthcare providers to the care team of patients with COVID-19 can improve the experiences of the patients.

scholarly journals The application and deployment of welfare technology in Swedish municipal care: a qualitative study of procurement practices among municipal actors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanna Kuoppamäki
Keyword(s):  
Ethical Issues ◽  
Qualitative Interviews ◽  
Political Strategy ◽  
Structured Interviews ◽  
Procurement Process ◽  
Ethical Competence ◽  
Care Services ◽  
Welfare Technology ◽  
Process Perspective ◽  
The Impact

Abstract Background Welfare technology has been launched as a concept to accelerate digital transformation in care services, but the deployment of these technologies is still hindered by organisational resistance, lack of infrastructure, and juridical and ethical issues. This paper investigates decision-making among municipal actors in the application and deployment of welfare technology from a procurement process perspective. The study explores the perceptions and negotiations involved in purchasing welfare technology at each stage of the procurement model, revealing the impact of technical, economic, juridical and ethical competence on the mapping, planning, procurement, implementation and management of welfare technology. Methods The study presents empirical findings from qualitative interviews conducted among municipal actors in Sweden. Semi-structured interviews were gathered in 2020 among procurement managers, IT managers, and managers in social administration in three different municipalities (n = 8). Content analysis and systematic categorisation were applied resulting in the division of procurement practices into sub-categories, generic categories and main categories. Results Challenges in the application and deployment of welfare technology occur at all stages of the procurement model. In mapping and planning, barriers are identified in the need analysis, requirement specification and market analysis. In the procurement stage, economic resources, standardisation and interoperability hinder the procurement process. Implementation and management are complicated by supplier assessment, legislation, cross-organisational collaboration and political strategy. Building on these findings, this study defines ‘procurement competence’ as consisting of technical, economic, juridical and ethical expertise in order to assess and evaluate welfare technology. Technical and ethical competence is needed in early stages of procurement, whereas juridical and economic competence relates to later stages of the model. Conclusions Procurement competence is associated with the application and deployment of welfare technology in (1) assessment of the end-user’s needs, (2) estimation of the costs and benefits of welfare technology and (3) management of juridical and legislative issues in data management. Economic and juridical decisions to purchase welfare technology are not value-neutral, but rather associated with socially shared understandings of technological possibilities in care provision. Optimisation of procurement processes requires a combination of capabilities to introduce, apply and deploy welfare technology that meets the demands and needs of end-users.

scholarly journals Redesign of computerized decision support to improve antimicrobial prescribing

2017 ◽  
Vol 08 (03) ◽  
pp. 949-963 ◽  
Author(s):  
Jessica Del Gigante ◽  
Maria Moran ◽  
Indy Sandaradura ◽  
Ling Li ◽  
Katrina Richardson ◽  
...  
Keyword(s):  
Decision Support ◽  
Qualitative Interviews ◽  
Prescribing Practices ◽  
Structured Interviews ◽  
Computerized Decision Support ◽  
Hospital Policy ◽  
Antimicrobial Prescribing ◽  
System 2 ◽  
General Wards ◽  
The Impact

SummaryObjective: To determine the impact of the introduction of new pre-written orders for antimicrobials in a computerized provider order entry (CPOE) system on 1) accuracy of documented indications for antimicrobials in the CPOE system, 2) appropriateness of antimicrobial prescribing, and 3) compliance with the hospital’s antimicrobial policy. Prescriber opinions of the new decision support were also explored to determine why the redesign was effective or ineffective in altering prescribing practices.Methods: The study comprised two parts: a controlled pre-post study and qualitative interviews. The intervention involved the redesign of pre-written orders for half the antimicrobials so that approved indications were incorporated into pre-written orders. 555 antimicrobials prescribed before (September – October, 2013) and 534 antimicrobials prescribed after (March – April, 2015) the intervention on all general wards of a hospital were audited by study pharmacists. Eleven prescribers participated in semi-structured interviews.Results: Redesign of computerized decision support did not result in more appropriate or compliant antimicrobial prescribing, nor did it improve accuracy of indication documentation in the CPOE system (Intervention antimicrobials: appropriateness 49% vs. 50%; compliance 44% vs. 42%; accuracy 58% vs. 38%; all p>0.05). Via our interviews with prescribers we identified five main reasons for this, primarily that indications entered into the CPOE system were not monitored or followed-up, and that the antimicrobial approval process did not align well with prescriber workflow.Conclusion: Redesign of pre-written orders to incorporate appropriate indications did not improve antimicrobial prescribing. Workarounds are likely when compliance with hospital policy creates additional work for prescribers or when system usability is poor. Implementation of IT, in the absence of support or follow-up, is unlikely to achieve all anticipated benefits.Citation: Baysari MT, Del Gigante J, Moran M, Sandaradura I, Li L, Richardson KL, Sandhu A, Lehnbom EC, Westbrook JI, Day RO. Redesign of computerized decision support to improve antimicrobial prescribing. Appl Clin Inform 2017; 8: 949–963 https://doi.org/10.4338/ACI2017040069

scholarly journals SOCIAL FRAILTY IN RECENTLY RELOCATED SEMI-INDEPENDENT OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S899-S899
Author(s):  
Suzanne Dupuis-Blanchard ◽  
Catherine Bigonnesse ◽  
Danica Maillet ◽  
Odette Gould ◽  
Melissa Andrews ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Determinants ◽  
Continuum Of Care ◽  
Structured Interviews ◽  
Care Community ◽  
The Social ◽  
Qualitative Descriptive ◽  
Demographic Surveys ◽  
Study Participants ◽  
The Impact

Abstract Although most older adults live outside of care institutions, not all seniors choose to live in traditional family homes. Among those who relocate, some relocate too early while others are pre-frail or frail when they relocate. Social frailty – the interaction between social vulnerability and frailty – could contribute to these untimely relocations. The goal of this study was to inform the concept of social frailty by examining a population of semi-independent older adults who recently relocated to a continuum of care community. The objectives of this study were to: 1) understand the influence of the social determinants of health on the relocation process; 2) explore whether relocation increases or reduces social frailty; and 3) measure the level of post-relocation frailty in study participants. This mixed method study combined semi-structured interviews on the relocation process, the frailty identification tool PRISMA-7, and socio-demographic surveys. Twenty-nine recently relocated seniors were recruited with the assistance of a Citizens' Advisory Committee along with advertisements, presentations, information booths, and word of mouth. Qualitative descriptive thematic analysis and descriptive statistical analyses were used to examine the relationship between frailty, socio-demographic variables and relocation. Findings indicated that several social determinants contributed to frailty and that relocation into a continuum of care community could mitigate some aspects of social frailty. A conceptual framework on the influence of social frailty on relocation is discussed. More research is needed to inform the concept of social frailty and to better understand the impact of social factors on frailty.

scholarly journals Bridging the Gap: Parent and Child Perspectives of Living With Cerebral Visual Impairments

2021 ◽  
Vol 15 ◽  
Author(s):  
Trudy Goodenough ◽  
Anna Pease ◽  
Cathy Williams
Keyword(s):  
Thematic Analysis ◽  
Family Life ◽  
Qualitative Interviews ◽  
Ocular Motility ◽  
Limited Information ◽  
Structured Interviews ◽  
Face To Face ◽  
Parents And Children ◽  
The Impact

Cerebral Visual Impairment (CVI) is an umbrella term which includes abnormalities in visual acuity, or contrast sensitivity or colour; ocular motility; visual field and the conscious and unconscious filtering or processing of visual input. Children with CVI have specific needs and problems relating to their development from infancy to adulthood which can impact on their wellbeing. Recent research indicates the complexities of living with CVI but there remains limited information of the full impact of CVI on families’ everyday lives. The qualitative interviews reported here explored families’ experiences to discover the impact of CVI on all aspects of everyday life. Parents and children (aged 6–18) were invited to participate in semi-structured interviews, either face to face, by phone or video call between January 2018 and February 2019. Topics covered everyday practicalities of living with CVI, focusing on challenges and what worked well at school and home. Interviews were audio-recorded and subject to thematic analysis to look for patterns across the data. Twenty families took part in interviews, with eight children/young people within those families contributing interviews of their own. Four themes were developed from the interviews: (1) Assessment and understanding implications of CVI, (2) Education, (3) Family life, (4) Psychological wellbeing and quality of life. The interviews provide valuable insights into the impact of living with CVI and highlight the need for more awareness of the condition among professionals in both health and education settings.

scholarly journals Facilitating trial recruitment: A qualitative study of patient and staff experiences of an orthopaedic trauma trial

2018 ◽  
Author(s):  
Emma Phelps ◽  
Elizabeth Tutton ◽  
Xavier Griffin ◽  
Janis Baird
Keyword(s):  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Feasibility Trial ◽  
Orthopaedic Trauma ◽  
Trial Recruitment ◽  
Research Culture ◽  
Structured Interviews ◽  
Randomised Controlled ◽  
The Right ◽  
The Impact

Abstract Background: Qualitative research has been used to explore patients’ and healthcare professionals’ experiences of surgical randomised controlled trials (RCTs). From this research, reasons why patients accept or decline participation and barriers to engaging clinicians in trials have been identified. In a trauma setting, recruitment to surgical trials can be particularly difficult as patients may require urgent treatment and their ability to consider their options, ask questions and reach a decision may be hindered by the impact of their injury. Little research however, has explored patients’ and healthcare professionals’ experiences of surgical RCTs in a trauma setting. This study aimed to understand participants’ and staffs’ experiences of an orthopaedic trauma trial. Methods: We carried out semi-structured interviews with 11 participants and 24 staff (10 surgeons and 14 research associates) participating in a UK multi-centre feasibility trial comparing intramedullary nails versus distal locking plates for fractures of the distal femur (TrAFFix). Interviews explored patients’ experience of TrAFFix and their reason for participating and staffs’ experience of recruiting to TrAFFix and trauma trials more generally. Interviews were audio recorded and transcribed verbatim. Transcripts were analysed using thematic analysis. Results: Three themes were identified. These were i) navigating research with patients after orthopaedic trauma, ii) knowing that it is the right decision and iii) making it work. These themes reflect: i) how research associates supported and guided patients through the consent process enabling them to participate, ii) the difficulty in engaging surgeons in a trial when individual equipoise and experience of the interventions is low despite the presence of community equipoise and iii) the way in which research teams worked together and encouraged the development of a research culture within the clinical teams in order to facilitate recruitment. Conclusions: Our findings highlight the pivotal role of research associates (RAs) in facilitating trial recruitment. RAs supported patients to enable them to make a decision about participation and assisted in developing a research culture within the team by promoting studies and communicating research to clinical staff. Our findings also reinforce surgeons’ difficulty with equipoise and suggest that accepting community equipoise could facilitate recruitment. Keywords: Qualitative, Interviews, experience, recruitment, trials,

scholarly journals Protocol for a mixed-methods evaluation of a massive open online course on real world evidence

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e025188 ◽  
Author(s):  
Edward Meinert ◽  
Abrar Alturkistani ◽  
David Brindley ◽  
Alison Carter ◽  
Glenn Wells ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Data Science ◽  
Online Courses ◽  
Course Delivery ◽  
Structured Interviews ◽  
Massive Open Online ◽  
Mixed Methods Evaluation ◽  
Real World Evidence ◽  
Study Participants ◽  
The Impact

IntroductionIncreasing number of Massive Open Online Courses (MOOCs) are being used to train learners at scale in various healthcare-related skills. However, many challenges in course delivery require further understanding, for example, factors exploring the reasons for high MOOC dropout rates, recorded low social interaction between learners and the lack of understanding of the impact of a course facilitators’ presence in course engagement. There is a need to generate further evidence to explore these detriments to MOOC course delivery to enable enhanced course learning design. The proposed mixed-methods evaluation of the MOOC was determined based on the MOOC’s aims and objectives and the methodological approaches used to evaluate this type of a course. The MOOC evaluation will help appraise the effectiveness of the MOOC in delivering its intended objectives. This protocol aims to describe the design of a study evaluating learners knowledge, skills and attitudes in a MOOCs about data science for healthcare.Methods and analysisStudy participants will be recruited from learners who have registered for the MOOC. On registration, learners will be given an opportunity to opt into the study and complete informed consent. Following completion of the course, study participants will be contacted to complete semistructured interviews. Interviews will be transcribed and coded using thematic analysis, with data analysed using two evaluation models: (1) the reach, effectiveness, adoption, implementation, maintenance framework and the (2) Kirkpatrick model drawing data from pre and post-course surveys and post-MOOC semi-structured interviews. The primary goal of the evaluation is to appraise participants' knowledge, skills and attitude after taking the MOOC.Ethics and disseminationEthics approval for this study was obtained from Imperial College London through the Education Ethics Review Process (EERP) (EERP1617-030). A summary of the research findings will be reported through a peer-reviewed journal and will be presented at an international conference.

scholarly journals Older people's experiences of cash-for-care schemes: evidence from the English Individual Budget pilot projects

2012 ◽  
Vol 33 (5) ◽  
pp. 826-851 ◽  
Author(s):  
NICOLA MORAN ◽  
CAROLINE GLENDINNING ◽  
MARK WILBERFORCE ◽  
MARTIN STEVENS ◽  
ANN NETTEN ◽  
...  
Keyword(s):  
Older People ◽  
Social Services ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Leisure Activities ◽  
Welfare States ◽  
Personal Care ◽  
Structured Interviews ◽  
Pilot Projects ◽  
The Impact

ABSTRACTCash-for-care schemes offering cash payments in place of conventional social services are becoming commonplace in developed welfare states; however, there is little evidence about the impact of such schemes on older people. This paper reports on the impact and outcomes for older people of the recent English Individual Budget (IB) pilot projects (2005–07). It presents quantitative data on outcome measures from structured interviews with 263 older people who took part in a randomised controlled trial and findings from semi-structured interviews with 40 older people in receipt of IBs and with IB project leads in each of the 13 pilot sites. Older people spent their IBs predominantly on personal care, with little resources left for social or leisure activities; and had higher levels of psychological ill-health, lower levels of wellbeing, and worse self-perceived health than older people in receipt of conventional services. The qualitative interviews provide insights into these results. Potential advantages of IBs included increased choice and control, continuity of care worker, and the ability to reward some family carers. However, older people reported anxieties about the responsibility of organising their own support and managing their budget. For older people to benefit fully from cash-for-care schemes they need sufficient resources to purchase more than basic personal care; and access to help and advice in planning and managing their budget.

scholarly journals Delivering Breast Reconstruction Information to Patients: Women Report on Preferred Information Delivery Styles and Options

2018 ◽  
Vol 26 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Carmen Webb ◽  
Vishal Sharma ◽  
Claire Temple-Oberle
Keyword(s):  
Breast Reconstruction ◽  
Information Provision ◽  
Immediate Breast Reconstruction ◽  
Information Delivery ◽  
Nipple Reconstruction ◽  
Structured Interviews ◽  
Multiple Sources ◽  
Oncological Safety ◽  
Operative Recovery ◽  
The Impact

Purpose: To discover missed opportunities for providing information to women undergoing breast reconstruction in an effort to decrease regret and improve patient education, teaching modalities, and satisfaction. Method: Thirty- to 45-minute semi-structured interviews were conducted exploring patient experiences with information provision on breast reconstruction. Purposeful sampling was used to include women with a variety of reconstruction types at different time points along their recovery. Using grounded theory methodology, 2 independent reviewers analyzed the transcripts and generated thematic codes based on patient responses. BREAST-Q scores were also collected to compare satisfaction scores with qualitative responses. Results: Patients were interested in a wide variety of topics related to breast reconstruction including the pros and cons of different options, nipple-sparing mastectomies, immediate breast reconstruction, oncological safety/monitoring and the impact of chemotherapy and radiotherapy, secondary procedures (balancing, nipple reconstruction), post-operative recovery, and long-term expectations. Patients valued accessing information from multiple sources, seeing numerous photographs, being guided to reliable information online, and having access to a frequently asked questions file or document. Information delivery via interaction with medical personnel and previously reconstructed patients was most appreciated. Compared with BREAST-Q scores for satisfaction with the plastic surgeon (mean: 95.7, range: 60-100), informational satisfaction scores were lower at 74.7 (50-100), confirming the informational gaps expressed by interviewees. Conclusions: Women having recently undergone breast reconstruction reported key deficiencies in information provided prior to surgery and identified preferred information delivery options. Addressing women’s educational needs is important to achieve appropriate expectations and improve satisfaction.

scholarly journals Development of the Patient and Public Involvement Questionnaire (PPIQ) for Canadian Drug Funding Committees

2020 ◽  
Author(s):  
Zahava Rosenberg-Yunger ◽  
Lee Verweel ◽  
Rachel Goren ◽  
Ahmed M. Bayoumi ◽  
Kelly K. O’Brien ◽  
...  
Keyword(s):  
Literature Review ◽  
Public Involvement ◽  
Qualitative Interviews ◽  
Evaluation Criteria ◽  
Patient And Public Involvement ◽  
User Feedback ◽  
Item Bank ◽  
Structured Interviews ◽  
Pilot Testing ◽  
The Impact

Abstract Background There is limited evidence evaluating the impact of patient and public involvement in setting priorities for healthcare, specifically drug funding recommendation committees. We describe the development phases of the Patient and Public Involvement Questionnaire (PPIQ). Methods The development of the PPIQ was informed by previous work, which established nine criteria to evaluate patient and public involvement. The PPIQ was developed with a multi-method, multi-phased approach: 1) item generation and refinement (item bank creation, user feedback sessions); 2) sensibility testing (using Feinstein’s criteria and structured interviews); and 3) pilot testing with drug funding committee’s in Canada. Results In phase one of development, a bank of 846 items were derived from key informant interviews and a literature review. Guided by the nine evaluation criteria, an initial draft of the PPIQ was created using the item bank. Two user feedback sessions (n=7) resulted in further revisions of the PPIQ. In phase two, participants (n=21) completed a sensibility questionnaire with a median score 6 out of 7 on 80% of items. Interview participants (n=14) articulated the PPIQ was clear and appropriate. In phase three, response rate for pilot testing the PPIQ was 25% (n=14) and the average time for participants to complete the PPIQ was 00:19:00 minutes (SD ± 13:46). Conclusions The methods used for the development of the PPIQ including qualitative interviews, literature review, user feedback, sensibility and pilot testing have resulted in a questionnaire that may be used with committees making drug funding recommendations in Canada.

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