scholarly journals Health care professionals’ experiences of how an eHealth application can function as a value-creating resource - a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catharina Carlqvist ◽  
Heidi Hagerman ◽  
Markus Fellesson ◽  
Mirjam Ekstedt ◽  
Amanda Hellström
Keyword(s):  
Health Care ◽  
Value Creation ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Active Role ◽  
Formation Processes ◽  
Structured Interviews ◽  
A Value ◽  
Number Of Patients ◽  
Qualitative Interview Study

Abstract Background The number of patients with one or more chronic conditions is increasing globally. One strategy to achieve more sustainable care for these patients is by implementing use of home-based eHealth applications. Such services support patients to take on a more active role as value-creating co-producers of their own care, in collaboration with health care professionals. Health care professionals have a key role in the value creation process, but little is known about value formation within eHealth interactions, especially from their perspective. Therefore, this study aimed to provide a deeper understanding of how an eHealth application can function as a value-creating resource from the perspective of health care professionals. Methods Semi-structured interviews were conducted with thirteen health care professionals (nurses, physicians and first-line managers). Qualitative content analysis was used to analyze the interviews. Results The findings indicate that value formation processes are strongly influenced by the organizational preconditions and by the usability and functionality of technology. The experiences of the health care professionals indicated that value was conceptualized in dimensions of meaningfulness, building of relationships, building safety and feelings of trust. Although these dimensions were mainly expressed in a positive way, such as perceived improvement of medical care, accessibility and continuity, they also had a negative side that caused value destruction. This was primarily due to patient difficulties in using the application or making measurements. Subsequent efforts at value recovery resulted in value creation, but were often time-consuming for the professionals. Conclusions This study contributes by extending conceptualizations of value to the role of health care professionals and by highlighting technology as sometimes facilitating and sometimes hampering value formation processes. The findings indicate that the eHealth application was a value-creating resource, facilitating proactive communication and supporting patients’ engagement and control over their self-care. However, for the application to become a more valuable resource in practice and counteract inequity in care, it needs to be further developed to be adapted to the needs and preconditions of patients.

Challenges faced by peer support workers during the integration into hospital-based mental health-care teams: Results from a qualitative interview study

2020 ◽  
Vol 66 (3) ◽  
pp. 263-269
Author(s):  
Ina Otte ◽  
Anna Werning ◽  
Alexa Nossek ◽  
Jochen Vollmann ◽  
Georg Juckel ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Qualitative Content Analysis ◽  
Psychiatric Hospitals ◽  
Health Care Teams ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Specific Implementation

Background: Being aware of the challenges that may occur during the implementation of peer support work in psychiatry is important to facilitate the integration of peer support workers (PSWs) into multidisciplinary mental health-care teams. Aim: The purpose of this study is to explore the challenges faced by PSWs during their integration into hospital-based mental health-care teams. Methods: Qualitative content analysis of nine open-ended, semi-structured interviews with PSWs is undertaken in five adult psychiatric hospitals in North Rhine-Westphalia, Germany. Results: The analysis of the data revealed three themes: (1) ‘Pioneers and the pressure to succeed’; (2) ‘a colleague, a rival or yet another patient?’ and (3) ‘sharing of information, boundaries and professionalism’. All three themes relate to several concrete challenges on different systemic levels and have the potential to impede the PSWs’ integration process. Conclusion: Specific implementation strategies which address potential barriers on the different systemic levels should be developed and applied prior to the start of the integration of PSWs into multidisciplinary mental health-care teams.

scholarly journals Content of Heart failure education by Health-care professionals in Noorder-Kempen, Belgium and Maastricht, the Netherlands: the INTERACT-in-HF study

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
K Baldewijns ◽  
HP Brunner-La-Rocca ◽  
S Bektas ◽  
C Rhode ◽  
L De Maesschalck ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Patient Education ◽  
Health Care Professionals ◽  
Pharmacological Treatment ◽  
Qualitative Content Analysis ◽  
Self Care ◽  
Structured Interviews ◽  
Pharmacological Interventions ◽  
Care Support

Abstract Funding Acknowledgements INTERREG NWE IVb Background According to ESC-guidelines non-pharmacological interventions such as patient-education on lifestyle and self-care support are important to maintain quality of life (QOL) and to prevent (re)hospitalisation in Heart-Failure (HF). Additionally, these guidelines state that HF treatment should be organised in multidisciplinary programs. However, at this moment it remains unclear what kind of information and self-care support is provided by which health care (HC) professional in the regions Noorder-Kempen and Maastricht. Purpose The aim of this study is to describe which part of patient-education and self-care support is provided by different HC-providers in both regions Methods Semi-structured interviews with Cardiologists (CA), General Practitioners (GP’s) and Heart Failure Nurse (HFN) took place, followed by qualitative content analysis with a five-step approach, resulting in 2 main and 9 sub-themes. Results GP’s in both region express they spend very little time on life-style adjustments, symptom monitoring and self-care support.  GP’s in Noorder-Kempen spend most consultation time on physical follow-up and pharmacological treatment of HF-patients, leaving no or little time for non-pharmacological interventions. GP’s in Maastricht notice that non-pharmacological treatment is someone else"s responsibility e.g. practice nurses, HFN, CA. All interviewed HC-professionals  inform patients considering their diagnosis. GP’s and CA in both regions educate patients considering pharmacological treatment and implanted devices. Moreover GP’s and CA in Noorder-Kempen emphasize the importance of compliance to therapy.  HFN in both regions offer comprehensive advice regarding lifestyle adjustments. HFN in Maastricht explicitly mention self-care support as an important part of their interventions. Conclusion Little regional differences could be found in the non-pharmacological interventions offered by the different HC professions involved in HF-management, however each profession has its own focus. GP’s and CA mainly focus on pharmacological and device therapy and therefore educate patients considering these aspects of HF-treatment. HFN mainly focus on lifestyle adjustments and self-care support.

scholarly journals Mutual trust is a prerequisite for nurses’ sense of safety and work satisfaction – Mobile Integrated Care Model: A qualitative interview study

2021 ◽  
pp. 205715852110621
Author(s):  
Lina Hovlin ◽  
Catharina Gillsjö ◽  
Anna K. Dahl Aslan ◽  
Jenny Hallgren
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Home Health Care ◽  
Older Persons ◽  
Qualitative Content Analysis ◽  
Work Satisfaction ◽  
Care Model ◽  
Structured Interviews ◽  
Care Needs ◽  
Qualitative Interview Study

An increasing number of older persons have complex health care needs. This, along with the organizational principle of remaining at home, emphasizes the need to develop collaborations among organizations caring for older persons. A health care model developed in Sweden, the Mobile Integrated Care Model aims to promote work in teams across organizations. The aim of the study was to describe nurses’ experiences in working and providing health care in the Mobile Integrated Care Model in the home with home health care physicians. Semi-structured interviews were conducted with 18 nurses and analyzed through qualitative content analysis. The method was compliant with the COREQ checklist. A mutually trusting collaboration with physicians, which formed person-centered care, created work satisfaction for the nurses. Working within the Mobile Integrated Care Model was negatively impacted by being employed by different organizations, lack of time to provide health care, and physicians’ person-centered work abilities.

scholarly journals The Experiences of Intensive Care Nurses in Advocacy of COVID-19 Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110565
Author(s):  
Bahman Aghaie ◽  
Reza Norouzadeh ◽  
Ehsan Sharifipour ◽  
Alireza Koohpaei ◽  
Reza Negarandeh ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Qualitative Content Analysis ◽  
Active Role ◽  
Structured Interviews ◽  
Intensive Care Nurses ◽  
Clinical Nurses ◽  
Number Of Patients ◽  
Patient Advocates ◽  
Life Threatening

The lack of face-to-face interactions with families, the increase in the number of patients admitted to the ICU, nursing staff shortages, and inadequate personal protective equipment has created many challenges for nurses in advocacy of the COVID-19 patient with life-threatening conditions. This study aimed to explore the experiences of intensive care nurses in the advocacy of COVID-19 patients. This study was performed using a qualitative content analysis method with Graneheim and Lundman approach, Iran, 2020. Data were collected through semi-structured interviews with eighteen clinical nurses from the intensive care units of three hospitals. Themes extracted from the nurses’ statements were promoting patient safety (informing physicians about the complications and consequences of treatment, preventing medical errors, protecting patients from threats), respecting the patients’ values (providing comfort at the end of life, providing a comfortable environment, commitment to confidentiality, cultural observance, respect for individualism, fair care), and informing (clarifying clinical conditions, describing available services, and being the patients’ voice). ICU nurses in health crises such as COVID-19 as patient advocates should promote patient safety, respect patients’ values, and inform them. The results of this study could help enhance the active role of intensive care nurses in the advocacy of COVID-19 patients.

scholarly journals Embedded trials within national clinical audit programmes: A qualitative interview study of enablers and barriers

2021 ◽  
pp. 135581962110443
Author(s):  
Sarah Alderson ◽  
Tom A Willis ◽  
Su Wood ◽  
Fabiana Lorencatto ◽  
Jill Francis ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Audit Quality ◽  
Clinical Performance ◽  
Clinical Audit ◽  
Care Delivery ◽  
Audit And Feedback ◽  
Structured Interviews ◽  
Address Data ◽  
Qualitative Interview Study

Background Audit and feedback entails systematic documentation of clinical performance based on explicit criteria or standards which is then fed back to professionals in a structured manner. There are potential significant returns on investment from partnerships between existing clinical audit programmes in coordinated programmes of research to test ways of improving the effect of their feedback to drive greater improvements in health care delivery and population outcomes. We explored barriers to and enablers of embedding audit and feedback trials within clinical audit programmes. Methods We purposively recruited participants with varied experience in embedded trials in audit programmes. We conducted qualitative semi-structured interviews, guided by behavioural theory, with researchers, clinical audit programme staff and health care professionals. Recorded interviews were transcribed, and data coded and thematically analysed. Results We interviewed 31 participants (9 feedback researchers, 14 audit staff and 8 healthcare professionals, many having dual roles). We identified barriers and enablers for all 14 theoretical domains but no relationship between domains and participant role. We identified four optimal conditions for sustainable collaboration from the perspectives of stakeholders: resources, that is, recognition that audit programmes need to create capacity to participate in research, and research must be adapted to fit within each programme’s constraints; logistics, namely, that partnerships need to address data sharing and audit quality, while securing research funding to ensure operational success; leadership, that is, enthusiastic and engaged audit programme leaders must motivate their team and engage local stakeholders; and relationships, meaning that trust between researchers and audit programmes must be established over time by identifying shared priorities and meeting each partner’s needs. Conclusion Successfully embedding research within clinical audit programmes is likely to require compromise, logistical expertise, leadership and trusting relationships to overcome perceived risks and fully realise benefits.

scholarly journals Women, Exercise, and Eating Disorder Recovery: The Normal and the Pathological

2021 ◽  
pp. 104973232199204
Author(s):  
Hester Hockin-Boyers ◽  
Megan Warin
Keyword(s):  
Health Care ◽  
Eating Disorder ◽  
Affect Regulation ◽  
Health Care Professionals ◽  
Value Systems ◽  
Structured Interviews ◽  
Data Set ◽  
The United Kingdom ◽  
Theoretical Frame ◽  
Intensity Of Exercise

The appropriate form, regularity, and intensity of exercise for individuals recovering from eating disorders is not agreed upon among health care professionals or researchers. When exercise is permitted, it is that which is mindful, embodied, and non-competitive that is considered normative. Using Canguilhem’s concepts of “the normal and the pathological” as a theoretical frame, we examine the gendered assumptions that shape medical understandings of “healthy” and “dysfunctional” exercise in the context of recovery. The data set for this article comes from longitudinal semi-structured interviews with 19 women in the United Kingdom who engaged in weightlifting during their eating disorder recovery. We argue that women in recovery navigate multiple and conflicting value systems regarding exercise. Faced with aspects of exercise that are pathologized within the eating disorder literature (such as structure/routine, body transformations, and affect regulation), women re-inscribe positive value to these experiences, thus establishing exercise practices that serve them.

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

scholarly journals Patient factors driving overuse of cardiac catheterisation: a qualitative study with 25 participants from two German teaching practices

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024600 ◽  
Author(s):  
Anna Herwig ◽  
Dorothea Dehnen ◽  
Birgitta Weltermann
Keyword(s):  
Teaching Practices ◽  
Qualitative Content Analysis ◽  
Stable Coronary Artery Disease ◽  
Cardiac Catheterisation ◽  
Structured Interviews ◽  
Patient Factors ◽  
Qualitative Interview Study ◽  
Patient’S Experience ◽  
Artery Disease ◽  
Physician Adherence

ObjectivesPercutaneous coronary interventions do not provide a benefit over medical therapy for stable patients. However, an overuse of cardiac catheterisation (CC) for stable coronary artery disease (CAD) is documented in Germany and other countries. In this study, we aim to understand patient factors that foster this overuse.DesignOur study is an exploratory qualitative interview study with narrative, structured interviews. The interviews were analysed using qualitative content analysis by Mayring.SettingThe interviews were conducted in two German teaching practices.Participants24 interviews with 25 patients were conducted; 17 (68%) patients were male, the average age was 73.9 years (range 53–88 years). All patients suffered from CAD and had undergone at least one CC. Patients with known anxiety disorders were excluded from the study.ResultsThe analysis identified six patient factors which contributed to or prevented the overuse of CC: (1) unquestioned acceptance of prescheduled appointments for procedures/convenience; (2) disinterest in and/or lack of disease-specific knowledge; (3) helplessness in situations with varying opinions on the required care; (4) fear of another cardiac event, (5) patient–physician relationship and (6) the patient’s experience that repeat interventions did not result in a change of health status or care.ConclusionsConducted in a country with documented overuse of CC, we showed that most patients trusted their physicians’ recommendations for repeat coronary angiographies even if they were asymptomatic. Strategies to align physician adherence with guidelines and corresponding patient information are needed to prevent overuse.

scholarly journals Advance care planning in Norwegian nursing homes – limited awareness of the residents’ preferences and values? A qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lisbeth Thoresen ◽  
Reidar Pedersen ◽  
Lillian Lillemoen ◽  
Elisabeth Gjerberg ◽  
Reidun Førde
Keyword(s):  
Health Care ◽  
Nursing Homes ◽  
Advance Care Planning ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Care Planning ◽  
Next Of Kin ◽  
Medical Issues ◽  
Interdisciplinary Approaches ◽  
Advance Care

Abstract Background 52% of all deaths in Norway occur in nursing homes. Still advance care planning (ACP) is scarce and heterogeneous. To improve the implementation and practice of ACP in nursing homes, knowledge about health care professionals’ views on ACP is vital. The objective of this study is to explore nurses and physicians’ aims and experiences with carrying out ACP in nursing homes. Methods Semi-structured group interviews were conducted with 20 health care professionals, recruited from nursing homes where ACP was performed regularly. Qualitative content analysis was used to analyse the data. Results The primary aim of the nursing home professionals when doing ACP in nursing homes were to build alliances with next of kin to avoid misunderstandings and future conflicts. Two main experiences with ACP were described: i) due to the sensitivity of ACP issues, it was important to balance directness with being sensitive, and ii) when the physicians raised questions concerning future medical treatment, the answers from residents as well as next of kin were often hesitant and unclear. Conclusion Our study add insights into how ACP is practiced in nursing homes and the professionals’ agenda. A focus on medical issues and achieving consensus with next of kin may result in lack of involvement of the residents and limited awareness of the residents’ needs. Interdisciplinary approaches, ACP-training and tailored guidelines may improve the implementation and practice of ACP.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

Sign in / Sign up

Export Citation Format

Share Document