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.

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 Process evaluation of integrated early child development care at private clinics in poor urban Pakistan: a mixed methods study

BJGP Open ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. bjgpopen17X101073 ◽  
Author(s):  
Muhammad Amir Khan ◽  
Syeda Somyyah Owais ◽  
Sehrish Ishaq ◽  
John Walley ◽  
Haroon Jehangir Khan ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Child Development ◽  
Qualitative Interviews ◽  
Public Health Care ◽  
Early Child Development ◽  
Care Providers ◽  
Structured Interviews ◽  
District Health ◽  
Healthcare Facilities ◽  
Early Child

BackgroundIn poor urban Pakistan, private GP clinics lack adequate services to promote early child development (ECD) care. A clinic-based contextualised ECD intervention was developed for quarterly tool-assisted counselling of mothers.AimTo explore the experience and implementation of ECD intervention by the private care providers and clients, for further adaptation for scaling of quality ECD care, at primary level private healthcare facilities in Pakistan.Design & settingA mixed methods approach using quantitative records review and qualitative interviews at poor urban clinics in Rawalpindi and Lahore, Pakistan.MethodQuantitative data from study-specific records were reviewed for 1242 mother–child pairs registered in the intervention. A total of 18 semi-structured interviews with clinic staff, mothers, and research staff were conducted at four clinics. The interviews were audiorecorded and transcribed verbatim.ResultsDistrict Health Office (DHO) support allowed transparent and effective selection and training of clinic providers. Public endorsement of ECD care at private clinics and the addition of community advocates promoted ECD care uptake. Clinic settings were found feasible for clinic assistants, and acceptable to mothers, for counselling sessions. Mothers found ECD counselling methods more engaging compared to the usual care provided.ConclusionIn poor urban settings where public health care is scarce, minimal programme investment on staff training and provision of minor equipment can engage private clinics effectively in delivering ECD care.

scholarly journals A mixed-methods pilot study to evaluate a collaborative anaesthetic and surgical training package for emergency surgical cricothyroidotomy

2019 ◽  
Vol 47 (4) ◽  
pp. 357-367 ◽  
Author(s):  
Richard J Berwick ◽  
William Gauntlett ◽  
Sergio A Silverio ◽  
Hilary Wallace ◽  
Simon Mercer ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Pilot Study ◽  
Self Efficacy ◽  
High Fidelity ◽  
Surgical Experience ◽  
Structured Interviews ◽  
Educational Training ◽  
Framework Analysis ◽  
Training Package ◽  
Fear And Anxiety

In a ‘can’t intubate, can’t oxygenate’ scenario, success of emergency front-of-neck access is dependent upon a clinician’s skill, competence and confidence to initiate the procedure. Surgical cricothyroidotomy is an important airway skill, as it can be employed as both the primary method of emergency front-of-neck access or as a rescue approach if a needle technique should fail. We designed a collaborative surgical and anaesthetic training package to address perceived anaesthetic reluctance to perform surgical cricothyroidotomy and undertook a pilot study of the package using a mixed-methods approach. The package consisted of three elements: theory teaching, surgical experience and repeated high-fidelity simulation. Ten anaesthetic trainees were trained using the package. Training comprised face-to-face tuition on the 2015 Difficult Airway Society guidelines, the Vortex cognitive aid, manikin-based surgical cricothyroidotomy instruction and surgical experience gained from an elective surgical tracheostomy. A standardised, high-fidelity in situ ‘can’t intubate, can’t oxygenate’ simulation was used to assess performance at baseline and at two weeks and six months after training. Participants scored their self-efficacy, underwent qualitative semi-structured interviews and had their performance quantitatively assessed to evaluate this training. Six months following training, participants’ performance had improved. They reported significantly increased self-efficacy and demonstrated significantly reduced deliberation time to initiate surgical cricothyroidotomy in the simulated ‘can’t intubate, can’t oxygenate’ emergency. Thematic framework analysis of interview transcripts revealed that reluctance to perform surgical cricothyroidotomy was related to fear and anxiety in regard to performing the procedure. These results support wider adoption of collaborative educational training packages, including hands-on surgical teaching, to improve trainees’ efficacy and confidence with surgical cricothyroidotomy and front-of-neck access in an emergency ‘can’t intubate, can’t oxygenate’ scenario.

Stress and family relationships among college student parents: A mixed methods study

2020 ◽  
pp. 026540752097519
Author(s):  
Aryn M. Dotterer ◽  
Audrey C. Juhasz ◽  
Kristin N. Murphy ◽  
SuJung Park ◽  
Lisa K. Boyce
Keyword(s):  
Mixed Methods ◽  
College Student ◽  
Low Income ◽  
Family Relationships ◽  
Online Survey ◽  
Qualitative Interviews ◽  
Multiple Roles ◽  
Structured Interviews ◽  
External Resources ◽  
Student Parents

College student parents represent a unique population because they are typically low-income, accrue more debt than traditional students, and must balance the role of student and parent. Using a mixed methods design, this study examined the relation between college student parents’ stress and distress in their relationships with their children and examined how parents managed their multiple roles. Parent participants ( n = 80; 54 mothers, 26 fathers; M age = 28.74 years, SD = 4.72) completed an online survey and a subsample ( n = 14) participated in semi-structured interviews. Results revealed that college student parents experience a variety of stressors that spillover into their relationships with their children and these associations appear more detrimental for father-child relationships. However, in-depth qualitative interviews not only highlighted the various sources of stress (e.g., time demands, multiple roles), but also revealed internal and external resources that college student parents draw on to help cope with stressors. Findings suggest that program efforts to strengthen the co-parenting relationship and to help college student parents more effectively manage their stress may be beneficial for improved parent-child relationships.

scholarly journals Reducing the blame culture through clinical audit in nuclear medicine: a mixed methods study

JRSM Open ◽  
2017 ◽  
Vol 8 (2) ◽  
pp. 205427041668143
Author(s):  
P Ross ◽  
J Hubert ◽  
WL Wong
Keyword(s):  
Mixed Methods ◽  
Pilot Study ◽  
Performance Feedback ◽  
Online Survey ◽  
Professional Competence ◽  
Clinical Audit ◽  
Structured Interviews ◽  
Sequential Approach ◽  
Survey Question ◽  
Survey Responses

Objectives To identify the barriers and facilitators of doctors’ engagement with clinical audit and to explore how and why these factors influenced doctors’ decisions to engage with the NHS National Clinical Audit Programme. Design A single-embedded case study. Mixed methods sequential approach with explorative pilot study and follow-up survey. Pilot study comprised 13 semi-structured interviews with purposefully selected consultant doctors over a six-month period. Interview data coded and analysed using directed thematic content analysis with themes compared against the study’s propositions. Themes derived from the pilot study informed the online survey question items. Exploratory factor analysis using STATA and descriptive statistical methods applied to summarise findings. Data triangulation techniques used to corroborate and validate findings across the different methodological techniques. Setting NHS National PET-CT Clinical Audit Programme. Participants Doctors reporting on the Audit Programme. Main Outcome measures Extent of engagement with clinical audit, factors that influence engagement with clinical audit. Results Online survey: 58/59 doctors responded (98.3%). Audit was found to be initially threatening (79%); audit was reassuring (85%); audit helped validate professional competence (93%); participation in audit improved reporting skills (76%). Three key factors accounted for 97.6% of the variance in survey responses: (1) perception of audit’s usefulness, (2) a common purpose, (3) a supportive blame free culture of trust. Factor 1 influenced medical engagement most. Conclusions The study documents performance feedback as a key facilitator of medical engagement with clinical audit. It found that medical engagement with clinical audit was associated with reduced levels of professional anxiety and higher levels of perceived self-efficacy.

Challenges in Inpatient Care Coordinators’ Clinical Workflow and Opportunities in Designing a Health IT Solution (Preprint)

2020 ◽  
Author(s):  
Danny T.Y. Wu ◽  
Paul Murdock ◽  
Scott Vennemeyer ◽  
Sarah Salomone ◽  
Keyin Jin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Travel Time ◽  
Inpatient Care ◽  
Qualitative Interviews ◽  
Critical Role ◽  
Structured Interviews ◽  
Clinical Workflow ◽  
Mixed Methods Approach ◽  
Event Logs ◽  
Care Coordinators

BACKGROUND Inpatient care coordinators (ICCs) play a critical role in case management and care transition because they address patient needs by referring them to available services and facilities prior to discharge. ICCs tend to spend a significant amount of time reviewing patient charts and documenting the cases using Electronic Health Record (EHR) systems. However, significant knowledge gaps exist regarding their clinical workflow and potential use of health information technology to improve work efficiency and job satisfaction. OBJECTIVE We aimed to address the gap by answering the research questions: 1) what is a typical day of an inpatient care coordinator? 2) what challenges exist in terms of their care delivery and documentation activities? and 3) what patterns in the EHR event logs reinforce our findings from the qualitative interviews? In addition, we aimed to demonstrate the feasibility of our novel mixed-method approach to study clinical workflow. METHODS A mixed-methods approach was developed and employed to understand ICCs workflow patterns and identify existing barriers to workflow. This approach involved data collection from semi-structured interviews and EHR event logs to construct a generalizable picture of all ICC workflow at the University of Cincinnati Medical Center (UCMC). The study consisted of 12 qualitative interviews with ICCs at UCMC, and their EHR event logs for one month. The qualitative interviews were analyzed using thematic analysis and the event logs were analyzed using statistical and pattern analysis. RESULTS We identified three major workflow barriers faced by ICCs: long travel time, heavy documentation load, and suboptimal communication. The event logs provided empirical evidence to support the workflow barriers identified during the semi-structured interviews, especially in travel time and documentation load. CONCLUSIONS ICC workflow has several inefficiencies. We recommend a mobile-based informatics solution with streamlined, intelligent, and EHR-linked documentation support. Our mixed-methods approach can be applied to other clinical settings and healthcare institutions. CLINICALTRIAL NA

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.

A Mixed-methods Pilot Study of Disaster Preparedness and Resiliency Among Faith-based Organizations

2014 ◽  
Vol 29 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Valerie M. Muller ◽  
Rita V. Burke ◽  
Bridget M. Berg ◽  
Ann C. Lin ◽  
Jeffrey S. Upperman
Keyword(s):  
Mixed Methods ◽  
Pilot Study ◽  
Social Services ◽  
Disaster Preparedness ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Publication Type ◽  
Frequency Distributions ◽  
Faith Based ◽  
Faith Based Organizations

AbstractIntroductionFaith-based organizations represent a source of stability and are an established presence in a community. They frequently serve their community following disasters. They are not formally included or identified as a disaster resource; thus, there is an opportunity to increase the effectiveness with which faith-based organizations prepare for and respond to disasters.ProblemThis pilot study aimed to assess perceptions of the level of disaster preparedness and resiliency among faith-based organizations as a first step in understanding how to improve disaster preparedness and resiliency among these organizations and their communities.MethodsSurvey and semi-structured interviews were conducted with six faith-based organizations, one with a leader and one with a staff member. Frequency distributions of survey questions were obtained. Interviews were transcribed and thematic analysis was supported by analytical software, ATLAS. ti.ResultsResults of the survey indicated strong social networks among congregation and community members. However, half of the members indicated that they did not socialize often with other races and other neighborhoods. Additionally, trust of other groups of people was generally low. Themes that emerged from qualitative analysis were: (1) perceived disaster preparedness and resiliency; (2) barriers to community preparedness and resiliency; (3) lessons learned from past disasters; (4) social services and networks; and (5) willingness to be prepared.ConclusionsThe results suggest that there is a need for interventions to improve disaster preparedness and resiliency among faith-based organizations.MullerV, BurkeR, BergB, LinA, UppermanJ. A mixed-methods pilot study of disaster preparedness and resiliency among faith-based organizations. Prehosp Disaster Med. 2014;29(2):1-7.

scholarly journals Does being a coach benefit clinician-educators? A mixed methods study of faculty self-efficacy, job satisfaction and burnout

2021 ◽  
Author(s):  
Martha J. Elster ◽  
Patricia S. O’Sullivan ◽  
Virginie Muller-Juge ◽  
Leslie Sheu ◽  
Sunitha V. Kaiser ◽  
...  
Keyword(s):  
Professional Development ◽  
Job Satisfaction ◽  
Mixed Methods ◽  
San Francisco ◽  
Self Efficacy ◽  
Qualitative Interviews ◽  
Mixed Methods Study ◽  
Full Time ◽  
Framework Analysis ◽  
Clinician Educators

Abstract Introduction Coaching is a growing clinician-educator role. Self-efficacy is a powerful faculty motivator that is associated positively with job satisfaction and negatively with burnout. This study examines self-efficacy, job satisfaction, and burnout in coaches and other clinician-educators. Methods We conducted a mixed methods study using a quantitative survey followed by qualitative interviews of faculty at the University of California, San Francisco. Coaches (funded 20% full-time equivalents), faculty with other funded education positions (“funded”), and faculty without funded education positions (“unfunded”) completed a 48-item survey addressing self-efficacy (teaching, professional development, and scholarship), job satisfaction, and burnout. Data were analyzed using analysis of variance followed by post-hoc tests and chi-square tests. To elaborate quantitative results, we conducted qualitative interviews of 15 faculty and analyzed data using framework analysis. Results 202 of 384 faculty (52.6%) responded to the survey; 187 complete surveys were analyzed. Teaching self-efficacy was similar across groups. Coaches and funded educators had significantly higher professional development self-efficacy and job satisfaction than unfunded educators. Burnout was more prevalent in coaches and unfunded educators. Qualitative analysis yielded three themes: sources of reward, academic identity, and strategies to mitigate burnout. Educator roles provide reward that enhances self-efficacy and job satisfaction but also generate competing demands. Coaches cited challenges in forming professional identities and working with struggling learners. Discussion The coaching role provides faculty with benefits similar to other funded educator roles, but the particular demands of the coach role may contribute to burnout.

scholarly journals Establishing key criteria to define and compare models of specialist palliative care: A mixed-methods study using qualitative interviews and Delphi survey

2019 ◽  
Vol 33 (8) ◽  
pp. 1114-1124 ◽  
Author(s):  
Alice M Firth ◽  
Suzanne M O’Brien ◽  
Ping Guo ◽  
Jane Seymour ◽  
Heather Richardson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Delphi Study ◽  
Qualitative Interviews ◽  
Models Of Care ◽  
Mixed Methods Study ◽  
Specialist Palliative Care ◽  
Structured Interviews ◽  
Care Services ◽  
Palliative Care Services

Background: Specialist palliative care services have various configurations of staff, processes and interventions, which determine how care is delivered. Currently, there is no consistent way to define and distinguish these different models of care. Aim: To identify the core components that characterise and differentiate existing models of specialist palliative care in the United Kingdom. Design: Mixed-methods study: (1) semi-structured interviews to identify criteria, (2) two-round Delphi study to rank/refine criteria, and (3) structured interviews to test/refine criteria. Setting/participants: Specialist palliative care stakeholders from hospice inpatient, hospital advisory, and community settings. Results: (1)  Semi-structured interviews with 14 clinical leads, from eight UK organisations (five hospice inpatient units, two hospital advisory teams, five community teams), provided 34 preliminary criteria. (2)  Delphi study: Round 1 (54 participants): thirty-four criteria presented, seven removed and seven added. Round 2 (30 participants): these 34 criteria were ranked with the 15 highest ranked criteria, including setting, type of care, size of service, diagnoses, disciplines, mode of care, types of interventions, ‘out-of-hours’ components (referrals, times, disciplines, mode of care, type of care), external education, use of measures, bereavement follow-up and complex grief provision. (3)  Structured interviews with 21 UK service leads (six hospice inpatients, four hospital advisory and nine community teams) refined the criteria from (1) and (2), and provided four further contextual criteria (team purpose, funding, self-referral acceptance and discharge). Conclusion: In this innovative study, we derive 20 criteria to characterise and differentiate models of specialist palliative care – a major paradigm shift to enable accurate reporting and comparison in practice and research.

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