scholarly journals Setting up a rapid diagnostic clinic for patients with vague symptoms of cancer: a mixed method process evaluation study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christos Vasilakis ◽  
Paul Forte
Keyword(s):  
Focus Groups ◽  
Process Evaluation ◽  
Cancer Diagnosis ◽  
Mixed Method ◽  
Online Survey ◽  
Evaluation Study ◽  
Health Board ◽  
And Performance ◽  
New Diagnosis ◽  
The Impact

Abstract Background The study sought to evaluate the impact of a Rapid Diagnostic Clinic (RDC) service designed to improve general practitioner (GP) referral processes for patients who do not meet existing referral criteria yet present with vague - but potentially concerning - symptoms of cancer. We sought to investigate how well the RDC has performed in the views of local GPs and patients, and through analysis of its activity and performance in the first two years of operation. Methods The study setting was a single, hospital-based RDC clinic in a University Health Board in South Wales. We used a mixed-method process evaluation study, including routinely collected activity and diagnosis data. All GPs were invited to participate in an online survey (34/165 responded), and a smaller group (n = 8) were interviewed individually. Two focus groups with patients and their carers (n = 7) provided in-depth personal accounts of their experiences. Results The focus groups revealed high rates of patient satisfaction with the RDC. GPs were also overwhelmingly positive about the value of the RDC to their practice. There were 574 clinic attendances between July 2017 and March 2019; the mean age of attendees was 68, 57% were female, and approximately 30% had three or more vague symptoms. Of those attending, we estimated between 42 to 71 (7.3 and 12.3%) received preliminary cancer diagnoses. Median time from GP referral to RDC appointment was 12 days; from GP referral to cancer diagnosis was 34 days. Overall, 73% of RDC patients received either a new diagnosis (suspected cancer 23.2%, non-cancer 35.9%) or an onward referral to secondary care for further investigation with no new diagnosis (13.9%), and 27% were referred to primary care with no new diagnosis. Conclusions The RDC appears to enable a good patient experience in cancer diagnosis. Patients are seen in timely fashion, and the service is highly regarded by them, their carers, and referring GPs. Although too early to draw conclusions about long-term patient outcomes, there are strong indications to suggest that this model of service provision can set higher standards for a strongly patient-centred service.

scholarly journals Deliberating science in Italian high school. The case of the Scienza Attiva project

2017 ◽  
Vol 16 (01) ◽  
pp. A02
Author(s):  
Federica Cornali ◽  
Gianfranco Pomatto ◽  
Selena Agnella
Keyword(s):  
High School ◽  
Secondary School ◽  
Focus Groups ◽  
Deliberative Democracy ◽  
Mixed Method ◽  
Secondary School Students ◽  
Evaluation Study ◽  
School Students ◽  
National Project

This paper provides an analysis of the implementation and the outcomes of Scienza Attiva, an Italian national project for secondary school students, that makes use of deliberative democracy tools to address socio-scientific issues of great impact. The analysis has required a mixed method including surveys of students' pre- and post-project opinions, focus groups and interviews with students and teachers. The results from this evaluation study provide evidence that the project improves students' understanding of socio-scientific issues, strengthens their awareness of the importance of discussion and positively influences interactions in the classroom.

scholarly journals Implementation, mechanisms of impact and key contextual factors involved in outcomes of the Modification of Diet, Exercise and Lifestyle (MODEL) randomised controlled trial in Australian adults: protocol for a mixed-method process evaluation

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e036395
Author(s):  
Reindolf Anokye ◽  
Simone Radavelli-Bagatini ◽  
Catherine P Bondonno ◽  
Marc Sim ◽  
Lauren C Blekkenhorst ◽  
...  
Keyword(s):  
Process Evaluation ◽  
Mixed Method ◽  
Controlled Trial ◽  
Behavioural Change ◽  
Implementation Strategies ◽  
Pictorial Representation ◽  
Model Study ◽  
Study Results ◽  
Qualitative Component ◽  
The Impact

IntroductionThe Modification of Diet, Exercise and Lifestyle (MODEL) study aims to examine the impact of providing visualisation and pictorial representation of advanced structural vascular disease (abdominal aortic calcification), on ‘healthful’ improvements to diet and lifestyle. This paper reports the protocol for the process evaluation for the MODEL study.Methods and analysisThe overall aim of the process evaluation is to understand the processes that took place during participation in the MODEL study trial and which elements were effective or ineffective for influencing ‘healthful’ behavioural change, and possible ways of improvement to inform wider implementation strategies. A mixed-method approach will be employed with the use of structured questionnaires and semistructured in-depth interviews. All 200 participants enrolled in the trial will undertake the quantitative component of the study and maximum variation sampling will be used to select a subsample for the qualitative component. The sample size for the qualitative component will be determined based on analytical saturation. Interviews will be digitally recorded and transcribed verbatim. Qualitative data will be analysed thematically and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.Ethics and disseminationThe MODEL study process evaluation has received approval from Edith Cowan University Human Research Ethics Committee (Project Number: 20513 HODGSON). Written informed consent will be obtained from all participants before they are included in the study. The study results will be shared with the individuals and institutions associated with this study as well as academic audiences through peer-reviewed publication and probable presentation at conferences.Trial registration numberACTRN12618001087246.

scholarly journals Expressive Writing to Relieve Academic Stress at University Level

2021 ◽  
Vol 23 (2) ◽  
pp. 17-33
Author(s):  
Juanita Argudo
Keyword(s):  
Focus Groups ◽  
Undergraduate Students ◽  
Mixed Method ◽  
Expressive Writing ◽  
Academic Stress ◽  
Mixed Method Study ◽  
University Level ◽  
The Impact ◽  
Positive Effect ◽  
Shed Light

This paper reports on a descriptive mixed-method study that aimed to identify the impact of expressive writing on relieving the academic stress of 157 undergraduate students at an Ecuadorian university. Data were gathered through two questionnaires and from focus groups. Results showed enduring relief of academic stress. Furthermore, they help to shed light on the need to study the impact of academic stress on university students and to look for different strategies that can alleviate it. These findings could help to understand students’ needs, as they have essential implications in teachers’ practices and, consequently, in students’ performance. In conclusion, expressive writing has a positive effect on helping to ease academic stress and overcome some difficulties caused by this issue.

scholarly journals Exploring Specialist Palliative Care Practitioner Perspectives on the Face Validity of the Attitude to Health Change Scales in Assessing the Impact of Life-limiting Illness on Patients and Carers

2021 ◽  
pp. 082585972110640
Author(s):  
Linda Machin ◽  
Catherine Walshe ◽  
Lesley Dunleavy
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Online Survey ◽  
Face Validity ◽  
Attitude To Health ◽  
Specialist Palliative Care ◽  
Framework Analysis ◽  
Coping Responses ◽  
Focus Group Data ◽  
The Impact

Background: Identifying and assessing vulnerability and resilience through reflexive reactions and conscious coping responses to life-limiting illness is an important, but rarely assessed, component of care. The novel Attitude to Health Change scales can contribute to this, but require fuller development and testing. Objectives: Exploring face validity of the Attitude to Health Change Scales (patient and carer versions) from the perspective of specialist palliative care professionals. Design: A two-stage study: (i) focus groups to explore experiences of scale use and wording, (ii) online survey to gather preferences on possible scale modifications. Focus group data were analysed using framework analysis. A hermeneutic approach was used to modify the wording of the scales, ensuring adherence to the underpinning concepts used in the design of the scale, congruence with the palliative care context, and simplicity of language. Setting/Subjects: Specialist palliative care practitioners in UK hospice settings who had been involved in pilot use of the scales in clinical practice. Results: 21 practitioners participated in 3 focus groups across 3 UK hospice sites, 9 of those participants responded to the survey. Four themes are presented: the importance and distinctiveness of the scales; maintaining conceptual integrity; ensuring a palliative care focus; and ensuring linguistic clarity. New iterations of the patient and carer versions of the Attitude to Health Change scales were developed. Conclusion: The scales appear to reflect the intended theoretical constructs, and are worded in a way which is congruent with the experience of specialist palliative care practitioners.

scholarly journals The Team at Work – The Society for Acute Medicine’s Benchmarking Audit 2014 (SAMBA’14)

2015 ◽  
Vol 14 (3) ◽  
pp. 99-103
Author(s):  
Christian P Subbe ◽  
◽  
Ivan Le Jeune ◽  
Caroline Burford ◽  
Rahul S Mudannayake ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Online Survey ◽  
Performance Indicator ◽  
Standard Of Care ◽  
Quality Standards ◽  
Early Warning Score ◽  
Acute Medicine ◽  
Staffing Levels ◽  
And Performance ◽  
The Impact

Background: The Society for Acute Medicine’s Benchmarking Audit (SAMBA) serves as a tool for Acute Medical Units to compare and improve their quality of care. Aim: To audit the performance of Acute Medical Units against clinical quality indicators, standards by the Royal College of Physicians and Specialist Societies relevant to the practice of Acute Medicine. Methods: An online survey of unit profiles and staffing levels on the audit day was followed by a 24-hour data collection on Thursday the 19th of June 2014 for all patients seen by the local Acute Medicine teams as part of the general medical take. Patients were followed-up for 72 hours. We reviewed the impact of staffing levels on performance indicators. Results: 66 Acute Medical Units admitted 2333 patients during the 24-hour period. Compliance with the quality standards of SAM was as follows: 84% of patients had an early warning score recorded within 30 minutes of admission, 81% of patients had been seen by a competent decision maker within four hours and 73% of patients were seen by a consultant physician within the appropriate period of time. Only 56% of patients received a standard of care compatible with all three quality standards. We found no relation between unit characteristics, staffing and performance indicator. Conclusion: There remains a gap between the standard described by the quality indicators and the performance of Acute Medical Units during a one-day audit.

scholarly journals Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit

2017 ◽  
Vol 68 (666) ◽  
pp. e63-e72 ◽  
Author(s):  
Ruth Swann ◽  
Sean McPhail ◽  
Jana Witt ◽  
Brian Shand ◽  
Gary A Abel ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Diagnosis ◽  
Clinical Audit ◽  
Patient Characteristics ◽  
Diagnostic Process ◽  
Comorbid Condition ◽  
Key Aspects ◽  
New Diagnosis ◽  
Diagnostic Delays ◽  
The Impact

BackgroundContinual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this.AimTo characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit.Design and settingClinical audit of cancer diagnosis in general practices in England.MethodInformation on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management.ResultsData were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15–86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0–27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more.ConclusionThe findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer.

scholarly journals Impact of Business Communication Determinants on Business Profitability: An Empirical Evidence of Citibank in Greece

2021 ◽  
Vol 11 (2) ◽  
pp. 137
Author(s):  
Stavros Kalogiannidis ◽  
Stamatis Kontsas
Keyword(s):  
Online Survey ◽  
Business Communication ◽  
Survey Questionnaire ◽  
Long Time ◽  
Business Profitability ◽  
Improved Performance ◽  
And Performance ◽  
Descriptive Survey ◽  
The Impact

The aim of this research was to assess the impact of business communication on business profitability using Citibank Greece as the case study. Communication has been for a long time a great tool of improved performance in organizations because it contributes in bridging the gap between the organstaion and its different stakeholders. However, little focus is normally given on how communication influences profitability of different businesses. Therefore, the aim of this study was to determine the link between business communication and business profitability by employing literature and contextual based research instrument. The research was conducted as a descriptive survey from where data were collected using an online survey questionnaire. The analysis of data was conducted using various expository statistical methods of analysis. Finally, the obtained results strongly suggest that effective communication in business has an obvious and indisputable influence on business profitability and performance.

scholarly journals Medical Student Perception of Plastic Surgery and the Impact of Mainstream Media

2017 ◽  
Vol 25 (1) ◽  
pp. 48-53 ◽  
Author(s):  
S. J. Fraser ◽  
S. Al Youha ◽  
P. J. Rasmussen ◽  
J. G. Williams
Keyword(s):  
Medical Students ◽  
Focus Groups ◽  
Plastic Surgery ◽  
Primary Care Physicians ◽  
Online Survey ◽  
Student Perception ◽  
School Curriculum ◽  
Mainstream Media ◽  
Television Plays ◽  
The Impact

Background: Plastic surgery as a discipline is poorly understood by many, including primary care physicians, nurses, medical students, and the public. These misconceptions affect the specialty in a number of ways, including referral patterns and recruitment of medical students into residency programs. The reason for these commonly held misconceptions has not yet been addressed in the plastic surgery literature. As such, we assessed medical students’ knowledge and perceptions of plastic surgery as a discipline and explored factors influencing these opinions. Methods: To assess medical students’ knowledge and perceptions of plastic surgery, we conducted an online survey. A total of 231 medical students responded. Interviews were then conducted with 2 focus groups, in which we explored the survey results and reasons behind these misconceptions. Results: As with previous studies, medical students showed a gap in knowledge with respect to plastic surgery. Although they were generally aware that plastic surgeons perform cosmetic procedures and treat burns, they were largely unaware that plastic surgeons perform hand and craniofacial surgeries. Focus groups revealed that television plays a large role in shaping their ideas of plastic surgery. Conclusion: Medical students have a skewed perception of the discipline of plastic surgery, and this is largely influenced by television. Interventions aimed at educating medical students on the matter are recommended, including a greater presence in the preclerkship medical school curriculum.

scholarly journals Removing a barrier – the effect of plant-based cooking skills on dietary habits. A mixed-method study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Malou Reipurth ◽  
Charlotte G. Gregersen ◽  
Federico J. Armando Perez-Cueto
Keyword(s):  
Mixed Method ◽  
Online Survey ◽  
Dietary Habits ◽  
Mixed Method Study ◽  
Higher Plant ◽  
Animal Products ◽  
Cluster Membership ◽  
Logistic Regression Models ◽  
Cooking Skills ◽  
The Impact

AbstractPrevious reports have shown that people perceive lack of cooking skills as a barrier to adopting a plant-based diet (Reipurth et al., 2018; Klöckner, 2017; Haverstock and Forgays, 2012; Pohjolainen, Vinnari, and Jokinen, 2015; Mullee et al., 2017). Cooking skills have been defined as “a set of mechanical or physical skills used in meal preparation” by Ternier (2010), whereas some perceive them as more complex and abstract, involving ideas, knowledge, and planning skills (Short, 2003; Caraher, 1999). This mixed-method study was conducted with the aim of investigating the impact of cooking skills as a barrier, and which effect applied cooking skills have on consumers adopting and sustaining a plant-based diet. This was done by looking at people who had gained plant-based cooking skills by receiving a product that educated them in plant-based foods and delivered recipes and ingredients, with which the recipients cooked plant-based meals. The mixed-method study was comprised of a qualitative part (two focus group interviews with 10 participants) and a quantitative part (an online survey of 303 respondents).The survey respondents were segmented based on their change in dietary habits after receiving the products, which was measured by their recalled change in intake of meat, fish, dairy, eggs, and plant-based foods. Four segments were identified; “Same All”, “Lower Omni Higher Plant”, “Lower Meat Higher Plant”, and “Lower Meat”. Clusters were profiled applying logistic regression models with cluster membership as the dependent variable, whereas the independent variables were the 12 attitudes towards consumption of plant-based diets, and the reasons for buying the product (also referred to as motivations), respectively.The results from the qualitative study showed that the participants experienced minor changes while receiving the product, but lacked the menu planning skills, convenience, and habits necessary to maintain their plant-based diets after-wards. The results from the quantitative study suggested that changes towards plant-based consumption are affected by ethical factors, health, and sensory characteristics. A main finding of the quantitative survey was that it demonstrated how applying new cooking skills and experience with plant-based meals increase consumers’ intake of plant-based food and decrease their intake of animal products. This effect was greatest while receiving the product, although still evident up to six months after. The findings from the study concur with and add more depth to the findings from preceding literature on the subject and can be used to inform and inspire research towards promoting plant-based diets.

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