scholarly journals A Qualitative Study of User Perspectives on Outcomes of Orthotic Interventions

2020 ◽  
Author(s):  
Natalie Hall ◽  
Daniel Parker ◽  
Anita Ellen Williams
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Outcome Measurement ◽  
Waiting Times ◽  
Measurement Tool ◽  
Advisory Group ◽  
Professional Relationship ◽  
Positive Health ◽  
The Uk ◽  
The Impact

Abstract Background: Orthotic services offer various health benefits and it is estimated that for every £1 spent on orthotic care the savings to the NHS are up to £4. Several reports into orthotic services in the UK have reported a lack of data relating to outcomes of orthotic care. This lack of data means it is difficult to demonstrate the overall efficacy of orthotic services. There is also lack of clarity about the influences on positive outcomes and we do not know what outcomes are relevant to users. This qualitative study aimed to explore the influences on outcomes of orthotic interventions and opinions on outcome measurement from the user’s perspective. Method: An advisory group involving experts in the field along with a review of the literature was conducted. From this, semi-structured questions were developed, ethical approval obtained, and a focus group was undertaken with five users. Data was transcribed and analysed using thematic analysis.Results: The participants expressed a need for orthotic provision which enables them to function physically and psychologically in the context of all life’s activities. Current practice neglects the impact of altered body image and there is dissatisfaction related to waiting times, impacting on their desired outcomes. However, they expressed positive thoughts about the patient professional relationship and being involved in decision making. They identified fundamental issues around usability of three current outcome measure tools with no one outcome measurement tool being suitable for their complex conditions and interventions. Conclusions: Communication of the clinicians understanding about the physical, psychological and socio-economic impact of living with a chronic condition, being involved in decision making, continuity of care and timeliness of provision were identified as key factors influencing positive health outcomes. Due to the complexity of conditions presenting to orthotic services it would seem that there needs to be a range of outcome measures specific to the user’s condition and the orthoses provided for it. Mutually agreed and individualised goal setting may be a solution that ensure the user can self-monitor positive health gains and services can provide evidence for effective outcomes.

scholarly journals Impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases in the UK: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048772
Author(s):  
Toby O Smith ◽  
Pippa Belderson ◽  
Jack R Dainty ◽  
Linda Birt ◽  
Karen Durrant ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Healthcare Provision ◽  
Social Restriction ◽  
The Uk ◽  
The Impact

ObjectivesTo determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time.DesignMixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study.SettingUK online survey and interviews with community-dwelling individuals in the East of England.ParticipantsPeople in the UK with RMDs were invited to participate in an online survey. A subsection of respondents were invited to participate in the embedded qualitative study.Primary and secondary outcome measuresThe online survey, completed fortnightly over 10 weeks from April 2020 to August 2020, investigated changes in symptoms, social isolation and loneliness, resilience and optimism. Qualitative interviews were undertaken assessing participant’s perspectives on changes in symptoms, exercising, managing instrumental tasks such a shopping, medication and treatment regimens and how they experienced changes in their social networks.Results703 people with RMDs completed the online survey. These people frequently reported a deterioration in symptoms as a result of COVID-19 pandemic social restrictions (52% reported increase vs 6% reported a decrease). This was significantly worse for those aged 18–60 years compared with older participants (p=0.017). The qualitative findings from 26 individuals with RMDs suggest that the greatest change in daily life was experienced by those in employment. Although some retired people reported reduced opportunity for exercise outside their homes, they did not face the many competing demands experienced by employed people and people with children at home.ConclusionsPeople with RMDs reported a deterioration in symptoms when COVID-19 pandemic social restriction measures were enforced. This was worse for working-aged people. Consideration of this at-risk group, specifically for the promotion of physical activity, changing home-working practices and awareness of healthcare provision is important, as social restrictions continue in the UK.

Inequalities in awareness and availability of bereavement services in North-East England

2020 ◽  
pp. bmjspcare-2020-002422
Author(s):  
Donna Wakefield ◽  
Elizabeth Fleming ◽  
Kate Howorth ◽  
Kerry Waterfield ◽  
Emily Kavanagh ◽  
...  
Keyword(s):  
Phase 1 ◽  
Waiting Times ◽  
Financial Strain ◽  
Web Based ◽  
North East ◽  
The North ◽  
Referral Criteria ◽  
National Guidance ◽  
The Uk ◽  
The Impact

ObjectivesNational guidance recommends equality in access to bereavement services; despite this, awareness and availability appears inconsistent. The aim of this study was to explore availability and accessibility of bereavement services across the North-East of England and to highlight issues potentially applicable across the UK, at a time of unprecedented need due to the impact of COVID-19.MethodsPhase 1: an eight item, web-based survey was produced. A survey link was cascaded to all GP practices (General Practitioners) in the region. Phase 2: an email was sent to all services identified in phase 1, requesting details such as referral criteria and waiting times.ResultsAll 392 GP practices in the region were invited to participate. The response rate was 22% (85/392). Twenty-one per cent (18/85) of respondents reported that they do not refer patients, comments included ‘not aware of any services locally’. A total of 36 services were contacted with 72% responding with further information. Most bereavement specific support was reliant on charity-funded services including hospices, this sometimes required a pre-existing link with the hospice. Waiting times were up to 4 months.ConclusionsAlthough multiple different, usually charity-funded services were identified, awareness and accessibility were variable. This survey was conducted prior to the COVID-19 pandemic, where complex situations surrounding death is likely to impact on the usual grieving process and increase the need for bereavement support. Meanwhile, charities providing this support are under severe financial strain. There is an urgent need to bridge the gap between need and access to bereavement services.

scholarly journals Understanding Relationship between Milestone and Decision-Making in Project Management: A Qualitative Study among Project Managers in Saudi Arabia

2018 ◽  
Vol 13 (8) ◽  
pp. 184 ◽  
Author(s):  
Umar Altahtooh ◽  
Thamir Alaskar
Keyword(s):  
Decision Making ◽  
Saudi Arabia ◽  
Project Management ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Project Managers ◽  
Structured Interviews ◽  
Pragmatic Research ◽  
The Impact ◽  
The Relationship

Despite the importance of milestone as a key knowledge in project management, there has been lack of research to understand the relationship between milestones and decision-making. This paper presents a pragmatic research context that aims understanding the nature of milestones and their relationship with different decision-making structures and responsibilities across projects. Data were collected through 14 semi-structured interviews with project managers and analyzed using thematic analysis. The findings explore the concepts of project milestones among project managers in Saudi Arabia. The paper finds that there is a relationship between milestones and the impact on decision-making.

scholarly journals Defending the media from itself: Reforming media regulations to minimise the impact of misinformation

European View ◽  
2019 ◽  
Vol 18 (2) ◽  
pp. 210-219
Author(s):  
Juha-Pekka Nurvala ◽  
Amelia Buckell
Keyword(s):  
Decision Making ◽  
Social Media ◽  
Case Studies ◽  
Search Engines ◽  
Behavioural Changes ◽  
Social Media Platforms ◽  
The Media ◽  
The Uk ◽  
The Impact

This article argues that media regulations on correcting incorrect articles are in dire need of reform due to technological and behavioural changes. By using case studies from the UK, the authors demonstrate the huge difference between the number of people who were reached by the original article before the Independent Press Standards Organisation (the regulator in the UK) ruled it incorrect and the number reached by the correction or corrected article. The authors argue that media regulations must be reformed to ensure that corrections reach the same people as the original incorrect article to avoid misinformation impacting peoples’ decision-making, and that reforms must include social media platforms and search engines.

scholarly journals Impact of Universal Credit in North East England: a qualitative study of claimants and support staff

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029611 ◽  
Author(s):  
Mandy Cheetham ◽  
Suzanne Moffatt ◽  
Michelle Addison ◽  
Alice Wiseman
Keyword(s):  
Mental Health ◽  
Local Government ◽  
Qualitative Study ◽  
Low Income ◽  
Welfare Benefits ◽  
North East ◽  
The Uk ◽  
The Impact ◽  
Community Sector ◽  
Roll Out

ObjectivesTo understand the impact of the roll-out of Universal Credit (UC) from the perspectives of claimants and staff supporting them in North East England.DesignQualitative study comprising interviews and focus groups.SettingGateshead and Newcastle, two localities in North East England characterised by high levels of socioeconomic deprivation, where the roll-out of UC started in 2017 as a new way to deliver welfare benefits for the UK working age population.Participants33 UC claimants with complex needs, disabilities and health conditions and 37 staff from local government, housing, voluntary and community sector organisations.ResultsParticipants’ accounts of the UC claims process and the consequences of managing on UC are reported; UC negatively impacts on material wellbeing, physical and mental health, social and family lives. UC claimants described the digital claims process as complicated, disorientating, impersonal, hostile and demeaning. Claimants reported being pushed into debt, rent arrears, housing insecurity, fuel and food poverty through UC. System failures, indifference and delays in receipt of UC entitlements exacerbated the difficulties of managing on a low income. The threat of punitive sanctions for failing to meet the enhanced conditionality requirements under UC added to claimant’s vulnerabilities and distress. Staff reported concerns for claimants and additional pressures on health services, local government and voluntary and community sector organisations as a result of UC.ConclusionsThe findings add considerable detail to emerging evidence of the deleterious effects of UC on vulnerable claimants’ health and wellbeing. Our evidence suggests that UC is undermining vulnerable claimants’ mental health, increasing the risk of poverty, hardship, destitution and suicidality. Major, evidence-informed revisions are required to improve the design and implementation of UC to prevent further adverse effects before large numbers of people move on to UC, as planned by the UK government.

scholarly journals Parenting while living with advanced cancer: A qualitative study

2016 ◽  
Vol 31 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Eliza M Park ◽  
Devon K Check ◽  
Mi-Kyung Song ◽  
Katherine E Reeder-Hayes ◽  
Laura C Hanson ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Functional Status ◽  
Advanced Cancer ◽  
Metastatic Cancer ◽  
Eastern Cooperative Oncology Group ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Parental Concerns ◽  
The Impact

Background: Patients with advanced cancer who have dependent children are an important population with a life-limiting illness and high levels of psychological distress. Few studies have addressed the experience of being a parent with advanced cancer and their potential palliative needs. Aim: To describe the experience of living with advanced cancer as a parent, including illness experience, parental concerns, and treatment decision making and to explore whether these experiences differ by their functional status. Design: We conducted a cross-sectional, qualitative study using in-depth, semi-structured interviews. Data were analyzed using thematic content analysis. Setting and participants: A total of 42 participants with metastatic cancer and with at least one child under the age of 18 years were recruited from a comprehensive cancer center. 25 participants were rated as having high functional status (the Eastern Cooperative Oncology Group (ECOG) Performance Status Scale = 0–1) and 17 with low functional status (ECOG=2–4). Results: We identified four themes regarding the experience of being a parent with advanced cancer: (1) parental concerns about the impact of their illness and death on their children, (2) “missing out” and losses of parental role and responsibilities, (3) maintaining parental responsibilities despite life-limiting illness, and (4) parental identity influencing decision making about treatment. Parental functional status influenced not only physical responsibilities but also intensified parenting psychological concerns. Conclusion: Parents with metastatic cancer may have unique palliative care needs as they experience parenting concerns while managing the psychological and physical demands of advanced cancer.

‘Wish YOU Weren’t Here!’: Interpersonal Conflicts and the Touristic Experiences of Norwegian and British Women Travelling with Friends

2011 ◽  
Vol 11 (3) ◽  
pp. 271-290 ◽  
Author(s):  
Bente Heimtun ◽  
Fiona Jordan
Keyword(s):  
Qualitative Study ◽  
Tourism Industry ◽  
Social Identities ◽  
Interpersonal Conflicts ◽  
The Uk ◽  
The Impact

Tourism is often portrayed by the tourism industry, tourists themselves and tourism scholars as a liminoid site of escape, happiness and freedom from constraint. For many, however, holidays do not live up to this expectation. This paper challenges the dominant tourism discourse of holidays as sites of unproblematic pleasure in examining contestation, conflicts and negotiations between women and their travelling companions. Drawing on conceptualizations of in-group interpersonal conflicts and theorization of the mobile social identities of women travellers, we explore the impact of holiday conflicts on women’s holiday experiences and friendships. The findings of this qualitative study of female tourists from Norway and the UK suggest that women adopt various strategies to deal with open and hidden conflicts that may threaten their friendships and holiday experiences. Such strategies include avoidance of conflict through compromise, negotiation of appropriate holiday behaviours prior to travel, or ultimately choosing to travel solo.

scholarly journals Identifying attributes of food literacy: a scoping review

2017 ◽  
Vol 20 (13) ◽  
pp. 2406-2415 ◽  
Author(s):  
Elsie Azevedo Perry ◽  
Heather Thomas ◽  
H Ruby Samra ◽  
Shannon Edmonstone ◽  
Lyndsay Davidson ◽  
...  
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Risk Groups ◽  
Measurement Tool ◽  
Literacy Interventions ◽  
Food Literacy ◽  
Food And Nutrition ◽  
Food Decisions ◽  
The Uk ◽  
The Impact

AbstractObjectiveAn absence of food literacy measurement tools makes it challenging for nutrition practitioners to assess the impact of food literacy on healthy diets and to evaluate the outcomes of food literacy interventions. The objective of the present scoping review was to identify the attributes of food literacy.DesignA scoping review of peer-reviewed and grey literature was conducted and attributes of food literacy identified. Subjects included in the search were high-risk groups. Eligible articles were limited to research from Canada, USA, the UK, Australia and New Zealand.ResultsThe search identified nineteen peer-reviewed and thirty grey literature sources. Fifteen identified food literacy attributes were organized into five categories. Food and Nutrition Knowledge informs decisions about intake and distinguishing between ‘healthy’ and ‘unhealthy’ foods. Food Skills focuses on techniques of food purchasing, preparation, handling and storage. Self-Efficacy and Confidence represent one’s capacity to perform successfully in specific situations. Ecologic refers to beyond self and the interaction of macro- and microsystems with food decisions and behaviours. Food Decisions reflects the application of knowledge, information and skills to make food choices. These interdependent attributes are depicted in a proposed conceptual model.ConclusionsThe lack of evaluated tools inhibits the ability to assess and monitor food literacy; tailor, target and evaluate programmes; identify gaps in programming; engage in advocacy; and allocate resources. The present scoping review provides the foundation for the development of a food literacy measurement tool to address these gaps.

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