scholarly journals The presence and potential impact of psychological safety in the healthcare setting: an evidence synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
K. E. Grailey ◽  
E. Murray ◽  
T. Reader ◽  
S. J. Brett
Keyword(s):  
Thematic Analysis ◽  
Healthcare Workers ◽  
Evidence Synthesis ◽  
Psychological Safety ◽  
Structured Interviews ◽  
Situational Context ◽  
Safety Research ◽  
Modifiable Factors ◽  
Wide Range ◽  
Facilitators And Barriers

Abstract Introduction Psychological safety is the shared belief that the team is safe for interpersonal risk taking. Its presence improves innovation and error prevention. This evidence synthesis had 3 objectives: explore the current literature regarding psychological safety, identify methods used in its assessment and investigate for evidence of consequences of a psychologically safe environment. Methods We searched multiple trial registries through December 2018. All studies addressing psychological safety within healthcare workers were included and reviewed for methodological limitations. A thematic analysis approach explored the presence of psychological safety. Content analysis was utilised to evaluate potential consequences. Results We included 62 papers from 19 countries. The thematic analysis demonstrated high and low levels of psychological safety both at the individual level in study participants and across the studies themselves. There was heterogeneity in responses across all studies, limiting generalisable conclusions about the overall presence of psychological safety. A wide range of methods were used. Twenty-five used qualitative methodology, predominantly semi-structured interviews. Thirty quantitative or mixed method studies used surveys. Ten studies inferred that low psychological safety negatively impacted patient safety. Nine demonstrated a significant relationship between psychological safety and team outcomes. The thematic analysis allowed the development of concepts beyond the content of the original studies. This analytical process provided a wealth of information regarding facilitators and barriers to psychological safety and the development of a model demonstrating the influence of situational context. Discussion This evidence synthesis highlights that whilst there is a positive and demonstrable presence of psychological safety within healthcare workers worldwide, there is room for improvement. The variability in methods used demonstrates scope to harmonise this. We draw attention to potential consequences of both high and low psychological safety. We provide novel information about the influence of situational context on an individual’s psychological safety and offer more detail about the facilitators and barriers to psychological safety than seen in previous reviews. There is a risk of participation bias - centres involved in safety research may be more aligned to these ideals. The data in this synthesis are useful for institutions looking to improve psychological safety by providing a framework from which modifiable factors can be identified.

Facilitators and barriers to developing firefighter resilience

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rebecca Rose Conway ◽  
Sara Waring
Keyword(s):  
Thematic Analysis ◽  
Design Methodology ◽  
Evidence Base ◽  
Structured Interviews ◽  
Content Type ◽  
Formal Support ◽  
The United Kingdom ◽  
Support Mechanisms ◽  
Facilitators And Barriers ◽  
Potential Improvement

PurposeDeveloping resilience is vital for firefighters and other practitioners exposed to trauma as part of their day-to-day work in maintaining physical and mental resilience. However, further understanding of what factors facilitate and hinder the development of firefighter resilience and why is needed. The current study evaluates efficacy of support mechanisms currently in place and develops an evidence base for interventions to support development of firefighter resilience.Design/methodology/approachSemi-structured interviews were conducted with 12 firefighters from across two regions in the United Kingdom, the Northwest and Southeast of England. Thematic analysis was used to analyse transcripts, highlighting themes within, and across, services to identify what factors affect development of firefighter resilience and why.FindingsThematic analysis highlighted four key themes shared by firefighters across regions: “informal support”, “formal support”, “basic welfare measures” and “trust”. Importantly, how effective formal measures are perceived to be and the willingness for firefighters to access these resources was dependent upon the level of trust held in senior management. Firefighters across locations highlighted levels of trust were affected by industrial actions which created divides. Accordingly, one way firefighter resilience may be further promoted is by altering how formal support mechanisms are accessed.Originality/valueAlthough existing research has found factors which promote resilience of firefighters, evaluation of specific services is lacking. The current research highlights areas among two UK services where resilience is effectively being promoted and areas for potential improvement.

Facilitators and Barriers of Mother Engagement in a Home-based Parenting Program Following Concerns of Child Maltreatment

2022 ◽  
pp. 0192513X2110675
Author(s):  
Alison Fogarty ◽  
Holly Rominov ◽  
Monique Seymour ◽  
Kirsty Evans ◽  
Catherine Fisher ◽  
...  
Keyword(s):  
Child Maltreatment ◽  
Young Children ◽  
Therapeutic Relationship ◽  
Thematic Analysis ◽  
Home Visiting ◽  
Parenting Program ◽  
Structured Interviews ◽  
Home Based ◽  
Strength Based ◽  
Facilitators And Barriers

The current study aimed to explore mothers’ perceptions of facilitators and barriers to engagement in the HoPES program, an intensive home-visiting intervention for families with young children identified as having child maltreatment concerns. Seven mothers who had participated in the program participated in semi-structured interviews about their experiences. Thematic analysis was conducted using NVivo Version 12. Themes relating to facilitators of engagement included the following: (1) clinician behaviours; (2) treatment relevance/acceptability; (3) strong therapeutic relationship; (4) mothers’ cognitions and beliefs about treatment and (5) program delivery. Themes relating to barriers to engagement included the following: (1) contextual/external barriers to treatment; (2) treatment relevance/acceptability; (3) mothers’ cognitions and beliefs about treatment and (4) program processes. This study highlights the important role which services and clinicians have in engaging parents at risk of child maltreatment. Specifically, the prioritisation of the therapeutic relationship through all intervention processes, and the utilisation of strength-based approaches, may facilitate engagement.

scholarly journals Radiologists in the loop: the roles of radiologists in the development of AI applications

2021 ◽  
Author(s):  
Damian Scheek ◽  
Mohammad. H. Rezazade Mehrizi ◽  
Erik Ranschaert
Keyword(s):  
Artificial Intelligence ◽  
Thematic Analysis ◽  
Development Process ◽  
Key Factors ◽  
Structured Interviews ◽  
Development Teams ◽  
Key Points ◽  
Wide Range ◽  
Quality Controller

Abstract Objectives To examine the various roles of radiologists in different steps of developing artificial intelligence (AI) applications. Materials and methods Through the case study of eight companies active in developing AI applications for radiology, in different regions (Europe, Asia, and North America), we conducted 17 semi-structured interviews and collected data from documents. Based on systematic thematic analysis, we identified various roles of radiologists. We describe how each role happens across the companies and what factors impact how and when these roles emerge. Results We identified 9 roles that radiologists play in different steps of developing AI applications: (1) problem finder (in 4 companies); (2) problem shaper (in 3 companies); (3) problem dominator (in 1 company); (4) data researcher (in 2 companies); (5) data labeler (in 3 companies); (6) data quality controller (in 2 companies); (7) algorithm shaper (in 3 companies); (8) algorithm tester (in 6 companies); and (9) AI researcher (in 1 company). Conclusions Radiologists can play a wide range of roles in the development of AI applications. How actively they are engaged and the way they are interacting with the development teams significantly vary across the cases. Radiologists need to become proactive in engaging in the development process and embrace new roles. Key Points • Radiologists can play a wide range of roles during the development of AI applications. • Both radiologists and developers need to be open to new roles and ways of interacting during the development process. • The availability of resources, time, expertise, and trust are key factors that impact how actively radiologists play roles in the development process.

scholarly journals Developing an Intervention to Reduce Sedentary Behavior: Assisted Living Resident Feedback

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 381-381
Author(s):  
Katelyn Webster ◽  
Janet Larson
Keyword(s):  
Sedentary Behavior ◽  
Thematic Analysis ◽  
Assisted Living ◽  
Functional Decline ◽  
Functional Abilities ◽  
Structured Interviews ◽  
Light Physical Activity ◽  
Wide Range ◽  
Intervention Message ◽  
Short Intervention

Abstract Older adults in assisted living (AL) tend to be highly sedentary, which increases their risk of functional decline and frailty. Reducing sedentary behavior (SB) and replacing it with light physical activity (LPA) could have important implications for maintenance of functional abilities. The purpose of this qualitative study was to gather feedback from AL residents on a proposed exercise-specific self-efficacy enhancing intervention designed to promote LPA and reduce SB. We conducted one-on-one semi-structured interviews at four AL facilities with 20 residents ages 65-99 (mean age 83.1; 60% women). They were presented with the proposed intervention and were asked questions to inform the development and modification of the intervention. Data were analyzed with a thematic analysis approach. Specific recommendations included short intervention sessions of one hour and scheduled in the morning. Many residents thought a 16 week intervention was too long. We identified broader themes, including concerns about how the intervention would work for residents with a wide range of abilities and concerns about safety. They suggested that exercises will need to be highly modifiable. Most residents recommended framing the intervention message as increasing LPA rather than decreasing SB, because it would be more positive. All except one said they would want to participate in the intervention, but they were unsure how many other residents would want to be more active. The resident feedback and suggestions will guide development of the intervention and are important for increasing the probability that a future feasibility and acceptability trial of the intervention will be successful.

scholarly journals Exploring the barriers and facilitators of psychological safety in primary care teams: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ridhaa Remtulla ◽  
Arwa Hagana ◽  
Nour Houbby ◽  
Kajal Ruparell ◽  
Nivaran Aojula ◽  
...  
Keyword(s):  
Primary Care ◽  
Interpersonal Relationships ◽  
Psychological Safety ◽  
Multidisciplinary Teams ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Authoritarian Leadership ◽  
Shared Beliefs ◽  
Primary Care Teams ◽  
Facilitators And Barriers

Abstract Background Psychological safety is the concept by which individuals feel comfortable expressing themselves in a work environment, without fear of embarrassment or criticism from others. Psychological safety in healthcare is associated with improved patient safety outcomes, enhanced physician engagement and fostering a creative learning environment. Therefore, it is important to establish the key levers which can act as facilitators or barriers to establishing psychological safety. Existing literature on psychological safety in healthcare teams has focused on secondary care, primarily from an individual profession perspective. In light of the increased focus on multidisciplinary work in primary care and the need for team-based studies, given that psychological safety is a team-based construct, this study sought to investigate the facilitators and barriers to psychological safety in primary care multidisciplinary teams. Methods A mono-method qualitative research design was chosen for this study. Healthcare professionals from four primary care teams (n = 20) were recruited using snowball sampling. Data collection was through semi-structured interviews. Thematic analysis was used to generate findings. Results Three meta themes surfaced: shared beliefs, facilitators and barriers to psychological safety. The shared beliefs offered insights into the teams’ background functioning, providing important context to the facilitators and barriers of psychological safety specific to each team. Four barriers to psychological safety were identified: hierarchy, perceived lack of knowledge, personality and authoritarian leadership. Eight facilitators surfaced: leader and leader inclusiveness, open culture, vocal personality, support in silos, boundary spanner, chairing meetings, strong interpersonal relationships and small groups. Conclusion This study emphasises that factors influencing psychological safety can be individualistic, team-based or organisational. Although previous literature has largely focused on the role of leaders in promoting psychological safety, safe environments can be created by all team members. Members can facilitate psychological safety in instances where positive leadership behaviours are lacking - for example, strengthening interpersonal relationships, finding support in silos or rotating the chairperson in team meetings. It is anticipated that these findings will encourage practices to reflect on their team dynamics and adopt strategies to ensure every member’s voice is heard.

scholarly journals Use of the Washington Group Questions in Non-Government Programming

2021 ◽  
Vol 18 (21) ◽  
pp. 11143
Author(s):  
Alex Robinson ◽  
Liem Nguyen ◽  
Fleur Smith
Keyword(s):  
Data Collection ◽  
Thematic Analysis ◽  
Online Survey ◽  
Exploratory Research ◽  
Structured Interviews ◽  
Government Organizations ◽  
Raising Awareness ◽  
Wide Range ◽  
Staged Approach ◽  
Purposive Sample

The Washington Group questions (WGQ) on functioning have been widely promoted as the go-to tool for disability data collection. Designed for use by government, the WGQ have been adopted by non-government organizations (NGOs) for use in programming. However, little is known about how the WGQs are being used by NGOs or how use may be contributing to disability inclusion. Method: This paper describes exploratory research on the use of the WGQ in NGO programming. An online survey provided an overview of adoption followed by semi-structured interviews from a purposive sample to explore data collection, analysis, and use. Results: Thematic analysis showed limited inclusion outcomes directly attributable to use of the WGQ, adoption driven by individual champions rather than systematically across organizations, and challenges in data collection resulting in a wide range of prevalence rates. What information the WGQ can realistically contribute to programs was also overestimated. However, the process of using the WGQ was raising awareness on disability inclusion within program teams and communities. Conclusion: Acknowledging differences in emerging use by NGOs beyond the WGQ’s intended purpose, alongside promoting a flexible and staged approach to adoption and use in programming, may improve utility and disability inclusion outcomes over time.

scholarly journals Patient and befriender experiences of participating in a befriending programme for adults with psychosis: A qualitative study.

2020 ◽  
Author(s):  
Erin Burn ◽  
Agnes Chevalier ◽  
Monica Leverton ◽  
Stefan Priebe
Keyword(s):  
Thematic Analysis ◽  
Structured Interviews ◽  
Patient Interviews ◽  
People With Mental Illness ◽  
Wide Range ◽  
Participant Preferences ◽  
Trial Testing ◽  
Conflicting Interests ◽  
Development And Management ◽  
Over Time

Abstract Background Befriending is a popular form of volunteering in healthcare, and research suggests that it can be beneficial for people with mental illness. This study aimed to explore the experiences of a large sample of volunteer befrienders and patients who participated in the VOLUME trial, testing the efficacy of a structured befriending programme for individuals with psychosis. This is the first study to explore the specific challenges and benefits of befriending in both volunteers and patients in this population within the same programme. Methods A series of in-depth semi-structured interviews were conducted with 34 volunteer befrienders and 28 participating patients. All participants who had taken part in at least one befriending session were invited to be interviewed about their experiences with the aim of including a wide range of views, including those who were more or less engaged with the befriending programme. The data were analysed using Thematic Analysis. Results Four broad themes were developed from the analysis of the befriender and patient interviews which, although were largely discrete, captured the overall experiences of participating in the befriending programme: 1) Bridging the gap, 2) A genuine relationship that developed over time, 3) A big commitment, and 4) A flexible approach. Conclusions These results further support that, befriending programmes for individuals with psychosis can be a worthwhile experience for both befrienders and patients. However, participation also requires perseverance and flexibility from both sides. Different factors, such as incorporating participant preferences for frequency of meetings, have to be considered in the development and management of a befriending programme in order to provide effective support to both befrienders and patients. Declaration of conflicting interests None

scholarly journals Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Siew Lim ◽  
Caroline A. Smith ◽  
Michael F. Costello ◽  
Freya MacMillan ◽  
Lisa Moran ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Thematic Analysis ◽  
Lifestyle Modification ◽  
Lifestyle Changes ◽  
Future Research ◽  
Presenting Symptoms ◽  
Wide Range ◽  
Facilitators And Barriers ◽  
The Impact

Abstract Background Lifestyle modification targeting weight management is the first-line treatment for women with Polycystic Ovary Syndrome (PCOS) regardless of presenting symptoms. Women with PCOS are more likely to gain more weight compared with women without PCOS, which may be related to barriers in engaging in lifestyle modification. The aim of this study is to explore the experience of women with PCOS in weight management and to determine the facilitators and barriers to lifestyle modifications in women with PCOS. Methods Ten women with PCOS participated in focus groups and semi-structured telephone interviews on lifestyle and weight management in PCOS. Discussions were audio-recorded and transcribed verbatim. Thematic analysis of the transcripts was conducted. Thematic analysis of the transcripts were conducted using the method of constant comparison. Results Women in the current study attempted a wide range of weight loss interventions, but had difficulties losing weight and preventing weight regain. Women felt that having PCOS affected their ability to lose weight and to keep it off. Facilitators to lifestyle modification for weight management were reported as structured approaches such as having balanced meals and support by health professionals, peers, friends or family. Barriers to lifestyle changes in women with PCOS included logistical barriers such as time and cost, motivational barriers including tiredness or feeling unrewarded, environmental barriers such as not having access to safe places to exercise, emotional barriers such as having depressive and defeating thoughts, and relational barriers such as having unsupportive partner or prioritising children’s meal preferences. Conclusions Women with PCOS face a number of personal, environmental and social facilitators and barriers to lifestyle modification for weight loss. While many of these are also experienced by women without PCOS, women with PCOS face additional barriers in having low sense of self-confidence and high prevalence of negative thoughts which may impair their ability to maintain efforts in lifestyle modification over the long term. Future research should further explore the impact of the emotional and mental burden of PCOS on the management of weight and other aspects of PCOS. Future lifestyle intervention should also address the psychosocial aspect of PCOS.

scholarly journals Social marginalization and its relationship with cultural participation in Mexico

Córima ◽  
2020 ◽  
Vol 6 (10) ◽  
pp. 1-23
Author(s):  
Javier Reyes-Martínez ◽  
◽  
Óscar Alfonso Martínez-Martínez
Keyword(s):  
Mexico City ◽  
Thematic Analysis ◽  
Exploratory Study ◽  
Cultural Policy ◽  
Policy Design ◽  
Central Question ◽  
Cultural Participation ◽  
Structured Interviews ◽  
Social Marginalization ◽  
Wide Range

Mexico is a country with a wide range of social marginalization. The intersection of this phenomenon and cultural participation has been little studied. Bearing this in mind, the central question of this work is: can the attendance toc ultural events and the type of events in which Mexicans participate be related to their marginalization level? In order to answer this question, a qualitative exploratory study was designed. Data were collected through semi-structured interviews (N=247) infour Mexican states (Mexico City, Tamaulipas, Estado de Mexico, and Oaxaca). Data were processed through a thematic analysis that shows a relationship between marginalization and cultural participation in three large subjects: the facility or difficulty to participate incultural activities and events,the expressed interest in it, and the perceived benefits of the interviewee on these actions. These topics vary according to the marginalization level, confirming the need for cultural policy design to include marginalization as a key issue of cultural participation.

scholarly journals The use of playing by the nursing staff on palliative care for children with cancer

2014 ◽  
Vol 35 (3) ◽  
pp. 111-116 ◽  
Author(s):  
Vanessa Albuquerque Soares ◽  
Liliane Faria da Silva ◽  
Emília Gallindo Cursino ◽  
Fernanda Garcia Bezerra Goes
Keyword(s):  
Palliative Care ◽  
Nursing Staff ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Public Hospital ◽  
Structured Interviews ◽  
Children With Cancer ◽  
Descriptive Research ◽  
Qualitative Descriptive ◽  
Facilitators And Barriers

This study aimed to describe ways of using play by the nursing staff on palliative care of children with cancer and analyze the facilitators and barriers of the use of playing on this type of care. Qualitative, descriptive research developed on November 2012 with 11 health professionals, in a public hospital of the state of Rio de Janeiro. Semi-structured interviews and thematic analysis of the information were conducted. The use of playing before procedures was highlighted as a facilitator on palliative care. The child's physical condition, one's restriction, resistance of some professionals and the lack of time for developing this activity, made the use of play harder. We concluded that playing enables the child with cancer, in palliative care, a humanized assistance, being fundamental to integrate it on the care for these children.

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