scholarly journals Evaluation of a novel intervention to reduce burnout in doctors-in-training using self-care and digital wellbeing strategies: a mixed-methods pilot

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Antonia Rich ◽  
Amira Aly ◽  
Marta E. Cecchinato ◽  
Laura Lascau ◽  
Magdalen Baker ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Boundary Control ◽  
Group Discussion ◽  
Self Care ◽  
Work Life ◽  
Mindfulness Practice ◽  
Mental Wellbeing ◽  
Structured Interviews ◽  
Post Intervention ◽  
Oldenburg Burnout Inventory

Abstract Background Burnout for doctors-in-training is increasingly cause for concern. Our objectives were to assess the feasibility, acceptability and impact of a novel intervention to reduce burnout and improve wellbeing. This is the first wellbeing intervention for medical doctors to include strategies for work-life boundary management and digital wellbeing. Methods Twenty-two doctors participated in face-to-face workshops which included group discussion of challenges experienced and strategies to enhance self-care and wellbeing. A pre-post-test mixed-methods evaluation was undertaken. Questionnaire measures were the Oldenburg Burnout Inventory, Warwick-Edinburgh Mental Wellbeing Scale and the boundary control subscale of the Work-Life Indicator (i.e., the degree of perception of control of the boundaries between work and personal life). Paired t-tests examined whether there were statistically significant differences. Eleven doctors also participated in post-intervention semi-structured interviews. Transcripts were analysed using thematic analysis. Results The intervention was well-received, with all trainees finding the workshop useful and saying they would recommend it to others. At baseline most participants had scores indicative of burnout on both the disengagement (82%) and exhaustion (82%) subscales of the Oldenburg Burnout Inventory. One month post-intervention, participants had a statistically significant reduction in burnout (both disengagement and exhaustion) and improvement in boundary control. Wellbeing scores also improved, but differences were not statistically significant. Qualitative analysis indicated participants had welcomed a safe space to discuss stressors and many had implemented digital wellbeing strategies to manage their smartphone technology, and increased self-care such as mindfulness practice and walking in green space. Conclusions The intervention reduced burnout and improved boundary control. We suggest that having protected time for doctors to share personal experiences, adopt digital wellbeing and self-care strategies are effective tools to support doctors’ wellbeing and should be investigated further.

scholarly journals Health-related quality of life among 13–14 year old adolescents with overweight - a mixed methods approach

2019 ◽  
Author(s):  
Turid Kristin Bigum Sundar ◽  
Kirsti Riiser ◽  
Milada Småstuen ◽  
Randi Opheim ◽  
Knut Løndal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Well Being ◽  
Reference Population ◽  
Health Related Quality ◽  
Structured Interviews ◽  
Post Intervention ◽  
Related Quality ◽  
Health Related

Abstract BackgroundOverweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study with the aim of increasing PA, reducing BMI and promoting HRQoL.Methods Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents’ HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13–14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52.ResultsHRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. ConclusionThe use of the KIDSCREEN 52 instrument gave important indications about the adolescents’ HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL, indicating better ways of providing help. More research using the benefits of mixed methods approaches is needed to further elucidate these findings.

scholarly journals Effects of training podiatrists to use imagery-based motivational interviewing when treating people with diabetes-related foot disease: a mixed-methods pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Tracey Kaczmarek ◽  
Jaap J. Van Netten ◽  
Peter A. Lazzarini ◽  
David Kavanagh
Keyword(s):  
Job Satisfaction ◽  
Mixed Methods ◽  
Pilot Study ◽  
Motivational Interviewing ◽  
Qualitative Interviews ◽  
Self Care ◽  
Substantial Effect ◽  
Subjective Experiences ◽  
Structured Interviews ◽  
Foot Disease

Abstract Background Self-care in diabetes related foot disease (DFD) is challenging and contributes to poor outcomes. Motivational Interviewing (MI) can engage people in self-care and modifying it by integrating imagery may further improve its outcomes. No previous studies have trained podiatrists in using MI to address DFD self-care. This was the first study on training podiatrists to conduct imagery-based motivational interviewing (MI) when treating people with DFD, and to examine impacts on MI related skills, job satisfaction and subjective experiences in a mixed-methods pilot study. Methods Eleven recruited podiatrists (median age: 35 years, 9 female and 2 male) received two 4-h training sessions, and three received subsequent mentoring. MI and imagery skills were rated using validated tools during two clinical sessions per participant at baseline, and 2- and 12-weeks post-training. Job satisfaction was assessed at baseline and 12 weeks. Semi-structured interviews at 12 weeks were analysed using the framework approach. Results Significant improvements over time (p = .006–.044) with substantial effect sizes (η2 = .50–.67) were found in three of four global MI related communication skills and two of four MI behaviours. However, effects on these indices were not sustained to 12 weeks, and imagery was rarely used. Job satisfaction was high at baseline and unchanged at follow-up (p = 0.34, η2 = .100). In qualitative interviews, MI training and skills were valued, but significant challenges in using MI when treating people with DFD were reported. Conclusion Training podiatrists in MI may have potential but more training, observation and mentoring appear needed to obtain sustained communication changes in practice.

Implementing a healthy food retail policy: a mixed-methods investigation of change in stakeholders’ perspectives over time

2020 ◽  
pp. 1-12
Author(s):  
Miranda R Blake ◽  
Tara Boelsen-Robinson ◽  
Lisa Hanna ◽  
Angela Ryan ◽  
Anna Peeters
Keyword(s):  
Mixed Methods ◽  
Organisational Change ◽  
Healthy Food ◽  
Policy Outcomes ◽  
Structured Interviews ◽  
Post Intervention ◽  
Sales Data ◽  
Food And Beverage ◽  
Community Sports ◽  
Over Time

Abstract Objectives: To investigate (i) changes in stakeholder commitment and (ii) perceptions of the purpose, challenges and benefits of healthy food and beverage provision in community sports settings during the stepwise implementation of a healthy beverage policy. Design: Convergent, parallel, mixed-methods design complemented (i) repeat semi-structured interviews with council stakeholders (n 17 interviews, n 6 interviewees), with (ii) repeat quantitative stakeholder surveys measuring Commitment to Organisational Change; (iii) weekly sales data examining health behaviour and revenue effects (15 months pre-intervention; 14 months post-intervention); (iv) customer exit surveys (n 458); and (v) periodic photographic audits of beverage availability. Interviews were analysed inductively. Stakeholder surveys, sales data, customer surveys and audits were analysed descriptively. Setting: Four local government-owned sports and recreation centres in Melbourne, Australia, completed a 3-month trial to increase the availability of healthy beverages and decrease the availability of unhealthy beverages in food outlets. Participants: Interviews were conducted with council managers and those involved in implementation (September 2016–October 2017). Customers were surveyed (September–October 2017). Results: Interviews and surveys indicated that stakeholders’ commitment to policies varied such that, over time, optimism that changing beverage availability could increase the healthiness of customers’ purchases became more widespread among interviewees. Stakeholder focus generally progressed from anticipatory concern to solutions-focused discussions. Sales, audit and customer survey data supported interview findings. Conclusions: We found a general increase in optimism regarding policy outcomes over time during the implementation of a healthy beverage policy. Stepwise trials should be further explored as an engagement tool within community retail settings.

Tidying rooms and tending hearts: An explorative, mixed-methods study of hospital cleaning staff’s experiences with seriously ill and dying patients

2016 ◽  
Vol 31 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Karin Jors ◽  
Svenja Tietgen ◽  
Carola Xander ◽  
Felix Momm ◽  
Gerhild Becker
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Descriptive Analysis ◽  
Group Discussion ◽  
Death And Dying ◽  
Team Work ◽  
Structured Interviews ◽  
Dying Patients ◽  
Cleaning Staff ◽  
Seriously Ill

Background/aim: Palliative care is based on multi-professional team work. In this study, we investigated how cleaning staff communicate and interact with seriously ill and dying patients as well as how cleaning staff cope with the situation of death and dying. Design: Sequential mixed methods, consisting of semi-structured interviews, focus groups, and a questionnaire. Interviews and focus group discussions were content analyzed and results were used to create a questionnaire. Quantitative data were submitted to descriptive analysis. Setting: Large university clinic in southern Germany. Participants: A total of 10 cleaning staff participated in the interviews and 6 cleaning staff took part in the focus group discussion. In addition, three managerial cleaning staff participated in a separate focus group. Questionnaires were given to all cleaning staff ( n = 240) working at the clinic in September 2008, and response rate was 52% (125/240). Results: Cleaning staff described interactions with patients as an important and fulfilling aspect of their work. About half of participants indicated that patients talk with them every day, on average for 1–3 min. Conversations often revolved around casual topics such as weather and family, but patients also discussed their illness and, occasionally, thoughts regarding death with cleaning staff. When patients addressed illness and death, cleaning staff often felt uncomfortable and helpless. Conclusion: Cleaning staff perceive that they have an important role in the clinic—not only cleaning but also supporting patients. Likewise, patients appreciate being able to speak openly with cleaning staff. Still, it appears that cleaning staff may benefit from additional training in communication about sensitive issues such as illness and death.

scholarly journals Effects of training podiatrists to use imagery-based motivational interviewing to improve self-care for people with diabetes-related foot disease: A mixed-methods pilot study

2020 ◽  
Author(s):  
Tracey Kaczmarek ◽  
Jaap Van Netten ◽  
Peter Lazzarini ◽  
David Kavanagh
Keyword(s):  
Job Satisfaction ◽  
Mixed Methods ◽  
Pilot Study ◽  
Motivational Interviewing ◽  
Qualitative Interviews ◽  
Self Care ◽  
Substantial Effect ◽  
Subjective Experiences ◽  
Structured Interviews ◽  
Foot Disease

Abstract Background Self-care in diabetic foot disease (DFD) is challenging and can contribute to poor outcomes. Motivational Interviewing (MI) engages people in self-care and integrating imagery may further improve its outcomes. No previous studies have trained podiatrists in using MI to address DFD self-care. This was the first study on training podiatrists to conduct imagery-based motivational interviewing (MI) when treating people with diabetes-related foot disease (DFD), and to examine impacts on MI related skills, job satisfaction and subjective experiences in a mixed-methods pilot study. Methods Eleven recruited podiatrists (Median age 35, 9 female) received two 4-hour training sessions and three received later mentoring. MI and imagery skills were rated using validated tools during two clinical sessions per participant at baseline, and 2- and 12-weeks post-training. Job satisfaction was assessed at baseline and 12 weeks. Semi-structured interviews at 12 weeks were analysed using the framework approach. Results Significant improvements over time ( p =.006-.044) with substantial effect sizes (η 2 =.50-.67) were found in three of four global MI related communication skills and two of four MI behaviours. However, effects on these indices were not sustained to 12 weeks, and imagery was rarely used. Job satisfaction was high at baseline and unchanged at follow-up ( p =0.34, η 2 =.100). In qualitative interviews, MI training and skills were valued, but significant challenges in using MI when treating people with DFD were reported. Conclusion Training podiatrists in MI may have potential but more training, observation and mentoring appear needed to obtain sustained communication changes in practice.

scholarly journals Feasibility and Effect of Adding a Concurrent Parental Component to a School-Base Wellness Program Using Two Modes of Mobile-Based Technology – Mixed Methods Evaluation of RCT

2021 ◽  
Author(s):  
Moria Golan ◽  
Shakked Benifla ◽  
Aviv Samo ◽  
Noa Alon ◽  
Maya Mozeikov
Keyword(s):  
Mixed Methods ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Feasibility Studies ◽  
Smartphone Application ◽  
Self Report ◽  
Structured Interviews ◽  
Post Intervention ◽  
Staff Members ◽  
Small Effect Size

Abstract Background: This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a specially designed app) in their delivery of updates and assignments to parents.Methods: Two three-armed, randomized, controlled feasibility studies were conducted. Participants were randomly allocated to the control arm, youth-only arm, or youth & parental component arm. In the parental component, parents received updates and were requested to complete shared assignments with their children. In the first year, the assignments were sent through WhatsApp and in the following year via the specially designed smartphone application. Students and parents filled out questionnaires at three measure points: pre and post intervention and at three months follow-up. Mixed-methods assessments were performed using semi-structured interviews with parents and school staff members, as well as a computerized self-report questionnaire.Results: The addition of the concurrent parental component via WhatsApp was associated with superior improvement in self-esteem and identification of advertisement strategies, compared with the youth-only program. However, adolescents in the youth-only program delivered via the specially designed application demonstrated superior improvement compared to those in the youth & parental component arm.Conclusions: Although the addition of the concurrent parenting component was praised by the actively participating parents, overall, this intervention was not statistically superior to the youth-only arm. Only a few variables demonstrated statistically significant improvement, usually with a small effect size. The use of WhatsApp had higher feasibility and uptake than the use of the specially designed application. Under the chosen structure and population, it seems that the program did not have the intended impact. Parents who expressed specific resistance may have negatively affected their children, causing them to be less engaged. A cost-benefit analysis of programs with parental components as well as the development of strategies to enhance parent-school partnership are warranted.Trial registrations: NCT04129892 (1.11.2017) and NCT03540277 (26.4.2018)

Study-work-life balance of international students in the context of temporal boundaries

2019 ◽  
Vol 7 (2) ◽  
pp. 63-79
Author(s):  
Megan O'Mahony ◽  
Debora Jeske
Keyword(s):  
International Students ◽  
Social Withdrawal ◽  
Work Life ◽  
Work Life Balance ◽  
Boundary Management ◽  
Structured Interviews ◽  
Time Zone ◽  
Life Balance ◽  
Postgraduate Students ◽  
Personal Challenges

The goal of this qualitative study was to examine the experience of study-work-life balance among international students who were separated from their family both geographically and temporally. Using 10 semi-structured interviews with postgraduate students and thematic analysis, several themes were identified. These included boundary management shifts due to study/work demands and time zone differences. In addition, students reported social and personal challenges (in terms of family’s expectations, relationships maintenance, socialization in host country). Temporal boundaries contributed to social withdrawal and isolation among students, many of which were heavily reliant on their own family network for support. The findings strengthen the argument that time difference impacts the boundary management and social experience of international students.

Effect and acceptability of AKI education using peer review audit in primary care

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696977
Author(s):  
Mufaza Asrar ◽  
Joanna McKinnell ◽  
Nitin Kolhe ◽  
Lynn Woods ◽  
Sally Bassett ◽  
...  
Keyword(s):  
Primary Care ◽  
Peer Review ◽  
Secondary Care ◽  
Group Discussion ◽  
Risk Groups ◽  
Risk Identification ◽  
Care Staff ◽  
Small Group Teaching ◽  
Post Intervention ◽  
Early Management

BackgroundThis was part of the Southern Derby shire CCG AKI awareness and improved management in primary and secondary care. The programme involved educating the primary care staff (GPs nurses) about AKI, identifying and early management in at risk groups. The secondary care aspect involved protocol development for AKI risk/identification to reduce morbidity.AimAs two-thirds of AKI originates in the community we aimed to increase awareness and knowledge levels of AKI in primary care via a CCG wide education programme. This included nephrology a peer review audit of cases with an evaluation of the programme’s acceptability and impact.MethodOver a 12month period, peer review audit sessions were delivered to GPs and the primary care MDT. These sessions consisted of a short presentation by a consultant nephrologist followed by discussion of cases. Qualitative feedback was collected from all participants. Web-based, CCG-wide questionnaires incorporating factual and clinical questions were used to assess baseline and post-intervention knowledge level.Results93% of participants (94 responses) found the peer review audit sessions useful, particularly the presence of nephrologist. 45% of participants were anxious about group discussion of cases, although 36% thought they were the most useful component of the sessions. Formal presentations were ranked as the most popular format of receiving education. 996 individuals completed the questionnaires. At baseline 61% were GPs, 27% practice nurses and 8% Advanced Practitioners, with similar proportions at 1yr. Exposure to AKI teaching, self-reported awareness and confidence levels were higher in the second questionnaire and there was a significant improvement in test scores.ConclusionPrimary care education can improve knowledge and awareness of AKI. Small group teaching with involvement of a nephrologist was popular. These results suggest that there is a need to tailor education styles to individual preferences, and peer review audit may not be universally acceptable in primary care.

scholarly journals Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Åse Lundin ◽  
Anna Bergenheim
Keyword(s):  
At Risk ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Qualitative Content Analysis ◽  
Western Hemisphere ◽  
Mental Wellbeing ◽  
Healthcare Personnel ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Patients At Risk

Abstract Background Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. Methods Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. Results The analysis of the material revealed an overarching theme, Through barriers and taboos – the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. Conclusions The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.

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