What are the risk factors for avoidable transitions in the last year of life? A qualitative exploration of professionals’ perspectives for improving care in Germany

Abstract Background Little is known about the nature of patients’ transitions between healthcare settings in the last year of life (LYOL) in Germany. Patients often experience transitions between different healthcare settings, such as hospitals and long-term facilities including nursing homes and hospices. The perspective of healthcare professionals can therefore provide information on transitions in the LYOL that are avoidable from a medical perspective. This study aims to explore factors influencing avoidable transitions across healthcare settings in the LYOL and to disclose how these could be prevented. Methods Two focus groups (n = 11) and five individual interviews were conducted with healthcare professionals working in hospitals, hospices and nursing services from Cologne, Germany. They were asked to share their observations about avoidable transitions in the LYOL. The data collection continued until the point of information power was reached and were audio recorded and analysed using qualitative content analysis. Results Four factors for potentially avoidable transitions between care settings in the LYOL were identified: healthcare system, organization, healthcare professional, patient and relatives. According to the participants, the most relevant aspects that can aid in reducing unnecessary transitions include timely identification and communication of the LYOL; consideration of palliative care options; availability and accessibility of care services; and having a healthcare professional taking main responsibility for care planning. Conclusions Preventing avoidable transitions by considering the multicomponent factors related to them not only immediately before death but also in the LYOL could help to provide more value-based care for patients and improving their quality of life.

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Encounters with Persons Who Frequently Use Psychiatric Emergency Services: Healthcare Professionals’ Views

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17031012 ◽

2020 ◽

Vol 17 (3) ◽

pp. 1012

Author(s):

Manuela Schmidt ◽

Sigrid Stjernswärd ◽

Pernilla Garmy ◽

Ann-Christin Janlöv

Keyword(s):

Healthcare Professionals ◽

Emergency Services ◽

Qualitative Content Analysis ◽

Healthcare Services ◽

Psychiatric Emergency ◽

Psychiatric Nurses ◽

Psychiatric Emergency Services ◽

Individual Interviews ◽

Self Compassion ◽

Assistant Nurses

Encounters and interactions between healthcare professionals and patients are central in healthcare services and delivery. Encountering persons who frequently use psychiatric emergency services (PES), a complex patient group in a complex context, may be particularly challenging for healthcare professionals. The aim of the study was to explore healthcare professionals’ experiences of such encounters. Data were collected via individual interviews (N = 19) and a focus group interview with healthcare professionals consisting of psychiatric nurses, assistant nurses, and physicians. The data were analyzed with qualitative content analysis. This study focused on the latent content of the interview data to gain a rich understanding of the professionals’ experiences of the encounters. Two themes were identified: “Nurturing the encounter with oneself and colleagues for continuous, professional improvement” and “Striving for a meaningful connection with the patient”. The professionals experienced their encounters with persons who frequently use PES as caring, professional, and humane processes. Prerequisites to those encounters were knowing and understanding oneself, having self-acceptance and self-compassion, and working within person-centered cultures and care environments.

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Diabetes-Related Healthcare Services in Nepal—A Qualitative Exploration of Healthcare Professionals’ Opinions

Pharmacy ◽

10.3390/pharmacy8030131 ◽

2020 ◽

Vol 8 (3) ◽

pp. 131

Author(s):

Sujata Sapkota ◽

Jo-anne E. Brien ◽

Parisa Aslani

Keyword(s):

Diabetes Care ◽

Healthcare Professionals ◽

Diabetes Management ◽

Diabetes Education ◽

Healthcare Services ◽

Pharmacy Staff ◽

Related Services ◽

Care Services ◽

Healthcare Settings ◽

Large Patient

Healthcare professionals’ level of engagement in diabetes care and their perceptions of challenges to effective diabetes care are key indicators impacting diabetes management. This study investigated diabetes-related healthcare services provided in Nepal, and explored healthcare professionals’ opinions of the barriers to, and strategies for, effective diabetes care. In-depth face-to-face interviews were conducted with thirty healthcare professionals providing healthcare or medication-related services to patients with type 2 diabetes within Kathmandu Valley. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Participants were physicians, dieticians, nurses and pharmacy staff. Diabetes care services varied between healthcare institutions, between healthcare professionals and between patients, with the overall patient-care model reported as sub-optimal. Diabetes related services were mostly limited to physician-patient consultations. Only a few hospitals or clinics provided additional diabetes education classes, and individual dietician or nurse consultations. Limited collaboration, large patient-load and workforce shortages (particularly lack of diabetes educators) were reported as major issues affecting diabetes care. Regulatory measures to address healthcare system barriers were identified as potential facilitators for effective diabetes management. Whilst the findings are specific to Nepal, there are lessons to be learnt for other healthcare settings as the fundamental barriers to optimal diabetes care appear to be similar worldwide.

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Helsepersonells erfaringer og tanker om bruk av frivillige i palliativ omsorg

Nordisk tidsskrift for helseforskning ◽

10.7557/14.4075 ◽

2017 ◽

Vol 13 (1) ◽

Author(s):

Ragnhild Skaar ◽

Marthe M. F. Fensli ◽

Sylvi M. Flateland ◽

Ulrika Söderhamn

Keyword(s):

Health Care ◽

Palliative Care ◽

Community Health ◽

Health Care Services ◽

Qualitative Content Analysis ◽

Health Care Personnel ◽

Close Monitoring ◽

Community Health Care ◽

Individual Interviews ◽

Care Services

Health care personnel’s experiences and thoughts on the use of volunteers in palliative care in a social perspectiveThe government of Norway is planning for the municipalities’ health care resources, including volunteering. The purpose of this study was to shed light on the experiences and thoughts of a group of health care personnel on the use of volunteers in palliative care in the community health care services, and to discuss the findings in a social perspective. Individual interviews were conducted with seven nurses and three nursing assistants. Using a qualitative content analysis three categories emerged: "The importance of organization, clarification and responsibility," "Qualifications" and "Different types of tasks," with the overarching theme: “Close monitoring and good clarification of roles can contribute to suitable volunteers functioning as an appropriate supplement for patients in palliative care in the community health care services”. The informants stated that trained health care personnel must perform the nursing tasks in palliative care while volunteers can be a positive supplement for the patient.

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Discursive Tensions in Green Care – Communication, Collaboration and Policy Formation

Journal of Social Science Studies ◽

10.5296/jsss.v3i2.8059 ◽

2016 ◽

Vol 3 (2) ◽

pp. 133

Author(s):

Mark S. Hopfenbeck ◽

Ragnfrid E. Kogstad ◽

Jan Kaare Hummelvoll

Keyword(s):

Cultural Change ◽

Social Connectedness ◽

Qualitative Content Analysis ◽

Recovery Process ◽

Policy Formation ◽

Problem Situation ◽

Good Communication ◽

Individual Interviews ◽

Care Services ◽

Multi Stage

<p>This article investigates how discursive tensions concerning language use and worldviews amongst Norwegian actors in Green Care services influence communication, collaboration and the dynamics of policy formation. The study combines qualitative content analysis and discourse analysis based on individual interviews and multi-stage focus group interviews. It focuses on a critical perspective in the analysis of interests and perspectives that dominate the field of Green Care. The study shows how Green Care is understood based on the actors’ perceptions of the users’ problem situation and their recovery process. The results also highlight the conditions for good communication and collaboration amongst the actors in the field. The overarching challenge for the actors involved is in creating cultural change where both the ‘green’ and ‘care’ are seen as legitimate qualities. Green Care must be continually explored and nuanced based on the healing potential inherent in both nature and basic human compassion. Adequate meeting places for the actors involved should be established in order to develop a mutual understanding of each other’s interests, intentions and perspectives. In doing so Green Care can become a form of social and environmental entrepreneurship integrating the value of community, the autonomy of individual voices, natural and social connectedness, and the importance of supportive relationships on the path towards recovery.</p>

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Effective safety netting in acute childhood illness: an important contribution to avoiding preventable deaths

British Journal of General Practice ◽

10.3399/bjgp18x696893 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X696893

Author(s):

Sarah Neill ◽

Damian Roland ◽

Matthew Thompson ◽

Sue Palmer-Hill ◽

Natasha Bayes ◽

...

Keyword(s):

Research Programme ◽

Safety Net ◽

Childhood Illness ◽

Urgent Care ◽

Video Capture ◽

Delivery Modes ◽

Care Services ◽

The Right ◽

Qualitative Exploration ◽

Safety Netting

BackgroundChildren’s use of urgent care services continues to increase. If families are to access the right services at the right time they need access to information to inform their decision making. Providing a safety net of information has the potential to reduce morbidity and avoidable mortality and has been shown to reduce re-consultation safely.AimOur research programme aims to provide parents with information they can use to help them determine when to seek help for an acutely ill child.MethodOur programme includes: ASK SARA, a systematic review of existing interventions; ASK PIP, qualitative exploration of safety netting information used by parents and professionals; ASK SID, development of the content and delivery modes for the intervention; ASK ViC, video capture of children with acute illness; and ASK Petra, safety netting tool development using consensus methodology.ResultsThe ASK SNIFF programme findings demonstrate the need for professionally endorsed and co-produced safety netting resources focussing on symptoms of acute childhood illness. We now have consensus on the scripted content for a safety netting tool supported by video materials to enable parents to see symptoms for real.ConclusionSafety netting tools are a valuable aid to general practice enabling GPs to show parents what to look out for when their child is sick so that they know when to (re)consult. Recent reports of failure to recognise and appropriately safety net children with sepsis highlights the importance of such tools.

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COVID-19: The Importance of Adequate Personal Protective Equipment in Healthcare Medical Staff

Journal of Regenerative Biology and Medicine ◽

10.37191/mapsci-2582-385x-2(2)-021 ◽

2020 ◽

Cited By ~ 1

Author(s):

Anne Weissenstein

Keyword(s):

Health Care ◽

Personal Protective Equipment ◽

Health Care Services ◽

Infection Prevention And Control ◽

Protective Equipment ◽

Emotional Resilience ◽

Healthcare Facilities ◽

Care Services ◽

Healthcare Settings ◽

And Control

We present an update on infection prevention and control for COVID-19 in healthcare settings. This update focuses on measures to be applied in settings with increasing community transmission, growing demand for concern about COVID-19 patients, and subsequent staffing issues in the event of shortages of personal protective equipment for healthcare facilities worldwide. The comfort and emotional resilience of health care workers are key components in maintaining essential health care services during the COVID-19 virus (coronavirus) outbreak.

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Occupational Health and Safety Measures in German Outpatient Care Services during the COVID-19 Pandemic: A Qualitative Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062987 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2987

Author(s):

Mara Shirin Hetzmann ◽

Natascha Mojtahedzadeh ◽

Albert Nienhaus ◽

Volker Harth ◽

Stefanie Mache

Keyword(s):

Occupational Health ◽

Outpatient Care ◽

Qualitative Content Analysis ◽

Health And Safety ◽

Occupational Health And Safety ◽

Work Organisation ◽

Safety Measures ◽

Care Services ◽

Health Threats ◽

Company Doctor

Due to the coronavirus disease 2019 (COVID-19) pandemic, outpatient caregivers are exposed to new serious health threats at work. To protect their health, effective occupational health and safety measures (OHSM) are necessary. Outpatient caregivers (n = 15) participated in semi-structured telephone interviews in May/June 2020 (1) to examine the pandemic-related OHSM that have been implemented in their outpatient care services, as well as (2) to identify their corresponding unmet needs. Interviews were recorded, transcribed and analysed by using qualitative content analysis in accordance with Mayring. Available OHSM in outpatient care services described by outpatient caregivers mainly included personal protective equipment (PPE) and surface disinfection means after an initial shortage in the first peak of the pandemic. Further OHSM implied social distancing, increased hygiene regulations and the provision of pandemic-related information by the employer, as well as the possibility to consult a company doctor. Our study revealed that OHSM were largely adapted to the health threats posed by COVID-19, however an optimum has not yet been achieved. There is still a need for improvement in the qualitative and quantitative supply of PPE, as well as on the organisational level, e.g., with regard to the development of pandemic plans or in work organisation.

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Life-Changing Experiences of Mothers with School-Age Children during the COVID-19 Pandemic: Focusing on Their Health Risk Perceptions and Health-Related Behaviors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094523 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4523

Author(s):

Hye Jin Yoo ◽

JaeLan Shim ◽

Namhee Kim

Keyword(s):

Health Risk ◽

Risk Perceptions ◽

Qualitative Content Analysis ◽

School Age Children ◽

School Age ◽

Individual Interviews ◽

The Family ◽

Health Related Behaviors ◽

Health Related ◽

Prevention Methods

This study aimed to explore health risk perceptions, changes in health-related behaviors, and life experiences of mothers with school-age children during the early coronavirus disease (COVID-19) pandemic. Data were collected between 16 July and 10 September 2020, by individual interviews and analyzed through qualitative content analysis. After the twelve participants’ experiences were analyzed, four themes and ten sub-themes were derived. The four themes were: “Struggling to identify the substance of COVID-19,” “Taking the initiative to protect the health of the family,” “Frustrated by the brutal reality of no end in sight,” and “Trying to adjust wisely to an inevitable new lifestyle.” The findings suggest that while the world remains in an ongoing battle with COVID-19, national health institutions should prepare a health education system for specific infection prevention methods that can be practiced by individuals in daily life.

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A Qualitative Exploration on the Challenges of Transfer Students in an Asian Educational Context

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063238 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3238

Author(s):

Shirley Siu Yin Ching ◽

Kin Yuen Tam ◽

Lillian Weiwei Zhang ◽

Jeremy Ng ◽

Kin Cheung

Keyword(s):

Community College ◽

Hong Kong ◽

Transfer Students ◽

Educational Context ◽

Individual Interviews ◽

Self Perceptions ◽

Induced Stress ◽

Extra Curricular Activities ◽

Research Gap ◽

Qualitative Exploration

Limited research has been conducted on community college (CC) transfer students’ (TS) experiences in four-year universities, particularly in Asian contexts. To fill this research gap, in this qualitative study, 124 TS from various disciplines in a Hong Kong university participated in 39 focus groups and seven individual interviews. Unlike their Western counterparts, our TS were relatively better prepared and more academically adaptive. Nevertheless, their social integration was restricted by a lack of time for extra-curricular activities, a sense of inferiority and incompetence, and restricted social circles that did not enable interaction with non-TS. These challenges and their implications are discussed. In particular, this study has highlighted differences between the special education systems for CC transfer in Hong Kong and those in Western CC models. The study has also highlighted the study-induced stress, and poor self-perceptions that TS experience, despite their academic abilities.

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