Ethical Issues in the Feeding of Patients Suffering from Dementia: a focus group study of hospital staff responses to conflicting principles

2002 ◽  
Vol 9 (6) ◽  
pp. 599-611 ◽  
Author(s):  
Stephen Wilmot ◽  
Lesley Legg ◽  
Janice Barratt
Keyword(s):  
Focus Groups ◽  
Ethical Issues ◽  
Hospital Staff ◽  
Care Staff ◽  
Ethical Principles ◽  
Focus Group Study ◽  
Feeding Difficulties ◽  
National Health Service Trust ◽  
Feeding Methods ◽  
Personal Attitudes

Feeding difficulties in older patients who are suffering from dementia present problems with balancing conflicting ethical principles. They have been considered by several writers in recent years, and the views of nursing and care staff have been studied in different contexts. The present study used focus groups to explore the way in which nursing and care staff in a National Health Service trust deal with conflict between ethical principles in this area. Three focus groups were convened, one each from the staff of three wards caring for patients with dementia. Case histories were discussed and transcripts analysed. It emerged that staff were aware of making fine judgements of utility concerning the spectrum of feeding methods available. Informants gave some weight to the principle of autonomy, but sought to balance that against their commitment to care. In explaining their perspectives, informants gave more weight to personal attitudes and trust culture than to professional ethics

scholarly journals Using Life Story Techniques with Diverse Communities: Lessons Learned from a Focus Group Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 844-845
Author(s):  
Christa Wilk ◽  
Ashlee Cordell ◽  
Silvia Orsulic-Jeras ◽  
Sara Powers ◽  
Farida Ejaz ◽  
...  
Keyword(s):  
Focus Groups ◽  
Residential Care ◽  
Life Story ◽  
Early Stage ◽  
Well Being ◽  
Lessons Learned ◽  
Care Staff ◽  
Focus Group Study ◽  
Diverse Communities ◽  
Story Work

Abstract Providing high quality, cost-effective dementia care remains a major health challenge. Life story work, used in residential care settings, helps engage persons living with dementia (PWD) at a low cost with minimal staff burden. LifeBio, one such intervention, is designed to elicit life history data and care preference information through comprehensive life story interviews. LifeBio Memory, an adaptation of LifeBio, utilizes novel speech-to-text technology to process life story data more efficiently. Seven focus groups were conducted to evaluate the acceptability and feasibility of LifeBio Memory. Three types of focus groups were held (n=35) and audio recorded: 1) One group of early-stage PWDs (n=5); 2) Two groups of current and former users of original LifeBio (n = 12); and 3) Four groups of residential care staff and directors (n=18). Sessions were transcribed and thematic analyses were conducted. Findings indicated high levels of acceptability and feasibility of LifeBio Memory. Further, a secondary theme emerged signaling the need to prioritize the emotional safety of PWDs participating in life story work. This poster will discuss: 1) the life story interview process, 2) identifying PWDs who would most benefit from a life story program, 3) involving family and staff care partners to identify sensitive topics, 4) interview question design, selection and order, and 5) expanding life story work across diverse communities. Discussion will highlight the importance of protecting the emotional well-being of marginalized communities by identifying potential underlying traumas that could impact the safe delivery of otherwise effective life story interventions.

Program experiences of adults with autism, their families, and providers: Findings from a focus group study

Autism ◽  
2017 ◽  
Vol 22 (3) ◽  
pp. 345-356 ◽  
Author(s):  
Kaitlin H Koffer Miller ◽  
Mary Mathew ◽  
Stacy L Nonnemacher ◽  
Lindsay L Shea
Keyword(s):  
Autism Spectrum Disorder ◽  
Focus Groups ◽  
The United States ◽  
Autism Spectrum ◽  
Program Improvement ◽  
Spectrum Disorder ◽  
Direct Care ◽  
Care Staff ◽  
Focus Group Study ◽  
Adults With Autism

A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum disorder in two Medicaid-funded programs in Pennsylvania through focus groups. Researchers conducted 20 focus groups with a total of 36 adults with autism spectrum disorder, 32 family members, 32 direct care staff, and 20 program administrators. Using thematic analysis, we identified three themes: training needs, community engagement and socialization, and employment. There was a need for additional training to meet the varying needs of program participants including co-occurring diagnoses, sexuality, and long-term planning. Adults with autism spectrum disorder prioritized more individualized community activities based on their interests. Finally, barriers to and strategies for successful employment were discussed. It will be crucial for policy makers to utilize the findings to inform program improvement and development based on the experiences of individuals impacted by these services and systems directly. Additionally, researchers should use the findings from this study to design interventions for adults with autism spectrum disorder as it includes their voices.

To collar or not to collar. Views of pre-hospital emergency care providers on immobilisation without cervical collars: a focus group study

2021 ◽  
Vol 6 (1) ◽  
pp. 38-45
Author(s):  
Lee Thompson ◽  
Gary Shaw ◽  
Charlotte Bates ◽  
Christopher Hawkins ◽  
Graham McClelland ◽  
...  
Keyword(s):  
Focus Groups ◽  
Hospital Care ◽  
Emergency Services ◽  
Rare Event ◽  
Hospital Staff ◽  
Professional Relationships ◽  
Care Providers ◽  
Focus Group Study ◽  
Specific Patient ◽  
Cord Injury

Background: Spinal cord injury (SCI) is a rare event, with high numbers of patients unnecessarily immobilised with no potential benefit based on limited evidence from the 1950s and 1960s. Contemporary opinion now challenges the notion that traditional immobilisation prevents movement and protects the spine. Current literature suggests that these methods which include semi-rigid collars can potentially cause more movement of the spine and harm the patient. The purpose of this study was to explore the views and perspectives of pre-hospital care providers on immobilising patients without the use of a semi-rigid collar.Methods: Focus groups were used to allow individuals to discuss and comment on a new method of immobilisation which omits the semi-rigid collar and to capture the thoughts, feelings and experiences of participants. Thematic analysis of the coded transcriptions was used to identify emerging themes.Results: Three focus groups were conducted with 15 participants in each. Participants were all exposed to patients sustaining trauma within their professional roles. Six intertwined themes emerged from the analysis: communication, conflict, education/training, empowerment, risk and the patient. Woven between these themes are the complex interactions that bring together the inter-professional relationships with other emergency services and hospital staff, the patient, the public and pre-hospital care providers.Discussion: Existing immobilisation practices are being challenged, with clinicians empowered to tailor practice to meet specific patient needs. There is limited empirical evidence to support current immobilisation practices. Contemporary literature suggests current practices may potentially cause harm. New pragmatic immobilisation practices are gradually being adopted by some pre-hospital care providers.Conclusion: This study explored the perspectives of pre-hospital care providers on immobilising patients without the use of a semi-rigid collar for potential SCI. The consensus of the participants supports a pragmatic approach to managing potential SCI that provides safe, high-quality patient-centred care.

Perspectives on the adoption and mediation implications of smart glasses: a qualitative focus group study in healthcare (Preprint)

2021 ◽  
Author(s):  
Niek Zuidhof ◽  
Somaya Ben Allouch ◽  
Oscar Peters ◽  
Peter-Paul Verbeek
Keyword(s):  
Focus Groups ◽  
Behavioral Change ◽  
Diffusion Of Innovations ◽  
Social Impact ◽  
Ethical Issues ◽  
New Technology ◽  
Empirical Studies ◽  
Focus Group Study ◽  
Theoretical Approaches ◽  
Smart Glasses

BACKGROUND Latest developments of smart glasses take place in a breathtaking speed, but the acceptance of smart glasses still remains in an early phase. Although smart glasses were perceived to be potential revolutionary for healthcare, there is only limited research on the acceptance and social impact of smart glasses in healthcare. Also the theoretical approaches which are used to study acceptance of new technology are limited applied to smart glasses. OBJECTIVE This study aims to get a better insight in the theoretical foundations and identify themes regarding adoption, mediation and the use of smart glasses from the perspective of healthcare professionals. METHODS a qualitative research design with focus groups was used to collect data. Three focus groups with 26 participants were conducted. Data were analyzed using content analysis. RESULTS Our analysis revealed six overarching themes related to the anticipated adoption of smart glasses: knowledge, innovativeness, use cases, ethical issues, anticipated adoption and attitude. Four overarching themes were found related to anticipated mediation and use of smart glasses: anticipated influences and behavioral change in yourself by using own smart glasses and influence and behavioral change through others who use smart glasses. CONCLUSIONS This study explored how acceptance and mediation of technology can complement each other in empirical studies. Most known acceptance models do not incorporate phasing in the acceptance process and the current study shows this is relevant. The acceptance of smart glasses seems to follow the process described in diffusion of innovations but seem to contradict the step-by-step sequence over time in decision making. Furthermore, in order to study implications from the mediation perspective, it seemed easier for respondents to evaluate the use of smart glasses by others than evaluate own anticipated use of smart glasses. Results from this study might inform designers from smart glasses about potential implications and future studies can examine the various propositions that can be derived from the results.

scholarly journals Development of a hybrid sleep and physical activity improvement intervention for adults with osteoarthritis-related pain and sleep disturbance: a focus group study with potential users

2021 ◽  
pp. 204946372110260
Author(s):  
Daniel Whibley ◽  
Kevin Stelfox ◽  
Alasdair L Henry ◽  
Nicole KY Tang ◽  
Anna L Kratz
Keyword(s):  
Physical Activity ◽  
Pain Management ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Sleep Disturbances ◽  
Physical Activity Intervention ◽  
Focus Group Study ◽  
Intervention Component ◽  
Beneficial Impact ◽  
Improvement Intervention

Objective: Suboptimal sleep and physical activity are common among people living with osteoarthritis (OA) and simultaneous improvements in both may have a beneficial impact on pain. This study aimed to gather perspectives of people living with OA on important aspects to incorporate in a hybrid sleep and physical activity improvement intervention for OA pain management. Design: Qualitative study using two rounds of two focus groups. Setting and participants: Focus groups were conducted with adults living with OA-related chronic pain and sleep disturbances. Eighteen people attended focus groups in January 2020 and, of these, 16 attended subsequent focus groups in February 2020. Methods: Discussion at the first round of focus groups informed generation of prototype intervention materials that were shared, discussed and refined at the second round of focus groups. Thematic analysis was used to identify themes and sub-themes from the data. Results: Three themes, each with three sub-themes, were identified: facilitators of engagement with the intervention (sub-themes: motivational language, accountability and education); barriers to engagement (sub-themes: suboptimal interaction with healthcare practitioners, recording behaviour as burdensome/disruptive and uncertainty about technique) and characteristics of a physical activity intervention component (sub-themes: tailored, sustainable and supported). Conclusion: We have identified important aspects to incorporate into the design and delivery of a hybrid sleep and physical activity improvement intervention for OA pain management. Insights will be incorporated into intervention materials and protocols, with feasibility and acceptability assessed in a future study.

scholarly journals Implementing interventions to reduce antibiotic use: a qualitative study in high-prescribing practices

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Aleksandra J. Borek ◽  
◽  
Anne Campbell ◽  
Elle Dent ◽  
Christopher C. Butler ◽  
...  
Keyword(s):  
Focus Groups ◽  
Point Of Care ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Focus Group Study ◽  
Clinical Uncertainty ◽  
Reactive Protein ◽  
Clinical Tools ◽  
The Many

Abstract Background Trials have shown that delayed antibiotic prescriptions (DPs) and point-of-care C-Reactive Protein testing (POC-CRPT) are effective in reducing antibiotic use in general practice, but these were not typically implemented in high-prescribing practices. We aimed to explore views of professionals from high-prescribing practices about uptake and implementation of DPs and POC-CRPT to reduce antibiotic use. Methods This was a qualitative focus group study in English general practices. The highest antibiotic prescribing practices in the West Midlands were invited to participate. Clinical and non-clinical professionals attended focus groups co-facilitated by two researchers. Focus groups were audio-recorded, transcribed verbatim and analysed thematically. Results Nine practices (50 professionals) participated. Four main themes were identified. Compatibility of strategies with clinical roles and experience – participants viewed the strategies as having limited value as ‘clinical tools’, perceiving them as useful only in ‘rare’ instances of clinical uncertainty and/or for those less experienced. Strategies as ‘social tools’ – participants perceived the strategies as helpful for negotiating treatment decisions and educating patients, particularly those expecting antibiotics. Ambiguities – participants perceived ambiguities around when they should be used, and about their impact on antibiotic use. Influence of context – various other situational and practical issues were raised with implementing the strategies. Conclusions High-prescribing practices do not view DPs and POC-CRPT as sufficiently useful ‘clinical tools’ in a way which corresponds to the current policy approach advocating their use to reduce clinical uncertainty and improve antimicrobial stewardship. Instead, policy attention should focus on how these strategies may instead be used as ‘social tools’ to reduce unnecessary antibiotic use. Attention should also focus on the many ambiguities (concerns and questions) about, and contextual barriers to, using these strategies that need addressing to support wider and more consistent implementation.

scholarly journals Quality of care for people with multimorbidity: a focus group study with patients and their relatives

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047025
Author(s):  
Nadine Janis Pohontsch ◽  
Josefine Schulze ◽  
Charlotte Hoeflich ◽  
Katharina Glassen ◽  
Amanda Breckner ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Focus Groups ◽  
Healthcare System ◽  
Qualitative Content Analysis ◽  
Coordinated Care ◽  
Treatment Standards ◽  
Focus Group Study ◽  
Treatment Regimens ◽  
Quality Aspects

BackgroundPrevalence of people with multimorbidity rises. Multimorbidity constitutes a challenge to the healthcare system, and treatment of patients with multimorbidity is prone to high-quality variations. Currently, no set of quality indicators (QIs) exists to assess quality of care, let alone incorporating the patient perspective. We therefore aim to identify aspects of quality of care relevant to the patients’ perspective and match them to a literature-based set of QIs.MethodsWe conducted eight focus groups with patients with multimorbidity and three focus groups with patients’ relatives using a semistructured guide. Data were analysed using Kuckartz’s qualitative content analysis. We derived deductive categories from the literature, added inductive categories (new quality aspects) and translated them into QI.ResultsWe created four new QIs based on the quality aspects relevant to patients/relatives. Two QIs (patient education/self-management, regular updates of medication plans) were consented by an expert panel, while two others were not (periodical check-ups, general practitioner-coordinated care). Half of the literature-based QIs, for example, assessment of biopsychosocial support needs, were supported by participants’ accounts, while more technical domains regarding assessment and treatment regimens were not addressed in the focus groups.ConclusionWe show that focus groups with patients and relatives adding relevant aspects in QI development should be incorporated by default in QI development processes and constitute a reasonable addition to traditional QI development. Our QI set constitutes a framework for assessing the quality of care in the German healthcare system. It will facilitate implementation of treatment standards and increase the use of existing guidelines, hereby helping to reduce overuse, underuse and misuse of healthcare resources in the treatment of patients with multimorbidity.Trial registration numberGerman clinical trials registry (DRKS00015718), Pre-Results.

scholarly journals Ethical issues relating to qualitative research

2005 ◽  
Vol 61 (1) ◽  
Author(s):  
J. Jelsma ◽  
S. Clow
Keyword(s):  
Qualitative Research ◽  
Health Research ◽  
Ethical Issues ◽  
Ethical Principles ◽  
Ethical Review ◽  
Paper Briefly ◽  
Ethical Problems ◽  
Scientific Rigour ◽  
Hands On

Qualitative research or naturalistic research has moved from the sidelines into the mainstream of health research and an increasing number of qualitative research proposals are being presented for ethical review Qualitative research presents ethical problems that which are unique to the intensive hands-on paradigm which characterises naturalistic research. This paper briefly outlines the most common methodologies used in this research. The four ethical principles of benevolence, non-maleficence, autonomy and justice will be used as a framework to explore specific ethical issues related to this form of inquiry. The need for scientific rigour will also be explored as research that is scientifically unsound can never be ethical.

scholarly journals Developing a recovery-focused therapy for older people with bipolar disorder: a qualitative focus group study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Focus Group ◽  
Older People ◽  
Focus Groups ◽  
Later Life ◽  
Focus Group Study ◽  
Age Related ◽  
Health Related ◽  
Age Related Changes

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).

Hospital Staff Perceptions of a Legislative Mandate for Methicillin-Resistant Staphylococcus aureus Screening

2011 ◽  
Vol 32 (6) ◽  
pp. 573-578 ◽  
Author(s):  
Matthew E. Wise ◽  
Stephen G. Weber ◽  
Amy Schneider ◽  
Meg Stojcevski ◽  
Anne Marie France ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Focus Group ◽  
Focus Groups ◽  
Hospital Staff ◽  
Negative Consequences ◽  
Staff Perceptions ◽  
Methicillin Resistant ◽  
Chicago Area ◽  
Use Of Resources ◽  
Implementation Plans

Objective.In August 2007, Illinois passed legislation mandating methicillin-resistant Staphylococcus aureus (MRSA) admission screening for intensive care unit patients. We assessed hospital staff perceptions of the implementation of this law.Design.Mixed-methods evaluation using structured focus groups and questionnaires.Setting.Eight Chicago-area hospitals.Participants.Three strata of staff (leadership, midlevel, and frontline) at each hospital.Methods.All participants completed a questionnaire and participated in a focus group. Focus group transcripts were thematically coded and analyzed. The proportion of staff agreeing with statements about MRSA and the legislation was compared across staff types.Results.Overall, 126 hospital staff participated in 23 focus groups. Fifty-six percent of participants agreed that the legislation had a positive effect at their facility; frontline staff were more likely to agree than midlevel and leadership staff (P < .01). Perceived benefits of the legislation included increased awareness of MRSA among staff and better knowledge of the epidemiology of MRSA colonization. Perceived negative consequences included the psychosocial effect of screening and contact precautions on patients and increased use of resources. Most participants (59%) would choose to continue the activities associated with the legislation but advised facilities in states considering similar legislation to educate staff and patients about MRSA screening and to draft clear implementation plans.Conclusion.Staff from Chicago-area hospitals perceived that mandatory MRSA screening legislation resulted in some benefits but highlighted implementation challenges. States considering similar initiatives might minimize these challenges by optimizing messaging to patients and healthcare staff, drafting implementation plans, and developing program evaluation strategies.

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