scholarly journals Healthcare professionals´ experiences of assessing, treating and preventing constipation among older patients during hospitalization: An interview study

2020 ◽  
Author(s):  
Veronica Lundberg ◽  
Anne-Marie Boström RN ◽  
Kristina Gottberg ◽  
Hanne Konradsen
Keyword(s):  
Older Patients ◽  
Healthcare Professionals ◽  
Quality Care ◽  
Individual Interviews ◽  
Healthcare Needs ◽  
Exploratory Approach ◽  
Centered Care ◽  
Patients At Risk ◽  
Group Interviews ◽  
Person Centered Approach

Abstract Background Constipation is a common and troublesome condition among older patients and can result in a variety of negative health consequences. It is often undiagnosed or undertreated. Healthcare professionals have a responsibility to understand and address patients’ overall healthcare needs so exploring their experiences is, therefore, highly relevant. The purpose of the study was to explore healthcare professionals’ experiences of assessing, treating and preventing constipation among older patients. Methods A qualitative design with an exploratory approach was used. The participants were purposively sampled from three wards in a geriatric department in a medium-sized hospital in Sweden. Data were collected through focus group interviews and individual interviews and analyzed using content analysis. Results Three categories were generated: depending on resources and uncertainties, using different strategies, and approaching the patients’ needs. In the care of older patients at risk of or with constipation, decisions were made based on personal knowledge, personal experience and clinical reasoning. A person-centered approach was highlighted but was not always possible to incorporate. Conclusions Different strategies for preventing and treating constipation were believed to be important, as was person-centered care, but were found to be difficult to perform. Healthcare professionals need adequate resources. Evidence-based clinical guidelines might help the delivery of high-quality care. Constipation needs to be given more focus in hospitals in order to potentially improve the care and patient outcomes for older people.

Providing Patient Centered Care for Adolescents with Chronic Conditions

2016 ◽  
Vol 6 (1) ◽  
pp. 22-29
Author(s):  
Nabeel Al-Yateem
Keyword(s):  
Young Adults ◽  
Healthcare Professionals ◽  
Transition Process ◽  
Healthcare Services ◽  
Adolescents And Young Adults ◽  
Study Phase ◽  
Patient Centered ◽  
Centered Care ◽  
Group Interviews ◽  
Depth Interviews

Background: It is well acknowledged that clear, structured healthcare services that are mutually developed between the patient and the healthcare professionals are likely to be of high quality, desirable, and effective. Such service should address the complexity of the illness-health experience in terms of the factors that influence it as well as the physical and psychosocial consequences on the patient. The required focus should be on treating the patient rather than just treating the disease.Objectives: To develop relevant and feasible care guidelines that may inform more competent and patient centered services for adolescents and young adults with chronic conditions.Methodology: A sequential exploratory mixed method design guided this study. The first qualitative phase employed in-depth interviews to explore the experiences of adolescents and young adults about the health services they were receiving. This was followed by focus group interviews with healthcare professionals to discuss the patients’ reported needs and to suggest interventions that would address them. Finally, a second quantitative phase was carried out through a survey to explore the views of a larger sample of service stakeholders about the relevance and feasibility of the suggested guidelines for clinical practice.Results: The in-depth interviews revealed four main themes, as follows: a current amorphous service, sharing knowledge, the need to be at the center of service, and easing the transition process to adulthood. The second study phase yielded 32 proposed guidelines that may contribute to more competent and patient centered health care.

scholarly journals Frail Older Persons’ Experiences of Information and Participation in Hospital Care

2019 ◽  
Vol 16 (16) ◽  
pp. 2829 ◽  
Author(s):  
Berit Forsman ◽  
Ann Svensson
Keyword(s):  
Health Literacy ◽  
Older Patients ◽  
Hospital Care ◽  
Older Persons ◽  
Qualitative Method ◽  
Healthcare Professionals ◽  
Frail Older People ◽  
Centered Care ◽  
Frail Older Persons ◽  
To Receive

The aim of this paper is to describe frail older persons’ experiences of hospital care of information and participation when being an inpatient at a hospital. A qualitative method was used. Data were collected at the hospital from 20 interviews with frail older patients, together with observations in the environment at the hospital ward. A content analysis was performed. Patients experienced not receiving information about their care and rehabilitation, or receiving such information in noisy surroundings. They experienced situations of misunderstanding related to their medication, which indicates the need for appropriate discharge calls for frail older patients. They expressed feelings of distress concerning the future, caused by hasty admissions or relatives’ problems to handle the situation. The results highlight the need to receive appropriate information and to participate in decision-making. The level of health literacy should be taken notice of when giving information, using peaceful and quiet environments when informing frail older persons. Person-centered care should be recognized to a greater extent in order for healthcare professionals to give information to frail older people in a health literacy-friendly way. This might make it easier for frail older persons to participate in a partnership in care.

scholarly journals Patient-centeredness in the multimorbid elderly: a focus group study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manuela Kanat ◽  
Jonas Schaefer ◽  
Laura Kivelitz ◽  
Jörg Dirmaier ◽  
Sebastian Voigt-Radloff ◽  
...  
Keyword(s):  
Focus Group ◽  
Older Patients ◽  
Integrative Model ◽  
Focus Group Interviews ◽  
Patient Centeredness ◽  
Care Needs ◽  
Patient Centered ◽  
Individual Care ◽  
Centered Care ◽  
Group Interviews

Abstract Background  Patient-centeredness (PC) aims to adapt health care to the individual needs and preferences of patients. An existing integrative model of PC comprises several dimensions of PC which have not yet been investigated from the patients’ perspective. Older patients with multimorbidity represent a target group for patient-centered care, as their care needs are particularly complex and should be addressed individually. We aimed to assess the perspective that older patients with multimorbidity have of patient-centered care and to examine the transferability of the integrative model of PC to this specific population. Method We performed 4 guided focus group interviews with a total of 20 older individuals with multimorbidity. The focus group interviews were audio-recorded and transcribed verbatim. Patients’ statements were content-analyzed applying an a priori designed system of categories that included the dimensions of PC from the integrative model and the additional category ‘prognosis and life expectancy’, which had emerged from an initial literature search on aspects of PC specific to the multimorbid elderly. Results The new category ‘prognosis and life expectancy’ was confirmed and expanded to ‘individual care needs related to aging and chronic disesase’. All dimensions of our integrative PC model were confirmed for older patients with multimorbidity. Among these, we found that eight dimensions (individual care needs related to aging and chronic disease, biopsychosocial perspective, clinician-patient communication, essential characteristics of the clinician, clinician-patient-relationship, involvement of family and friends, coordination and continuity of care, access to care) were complemented by aspects specific to this target population. Conclusions The integrative PC model is applicable to the population of older patients with multimorbidity. For a population-specific adaptation, it might be complemented by the dimension ‘individual care needs in aging and chronic disease’, in conjunction with age-specific aspects within existing dimensions. Together with corresponding results from a Delphi survey, our adapted PC model will serve as the basis for a subsequent systematic review of instruments measuring PC in older patients with multimorbidity. Trial registration PROSPERO (https://www.crd.york.ac.uk/prospero; CRD42018084057; 2018/02/01), German Clinical Trials Register (www.drks.de; DRKS00013309; 2018/01/23).

scholarly journals Talking about quality: how ‘quality’ is conceptualized in nursing homes and homecare

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ingunn Aase ◽  
Eline Ree ◽  
Terese Johannessen ◽  
Torunn Strømme ◽  
Berit Ullebust ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Healthcare Professionals ◽  
Daily Practice ◽  
Patient Centered ◽  
Cross Sectional ◽  
Individual Interviews ◽  
Centered Care ◽  
Perception Of Quality ◽  
Professional Pride ◽  
The Right

Abstract Background The delivery of high-quality service in nursing homes and homecare requires collaboration and shared understanding among managers, employees, users and policy makers from across the healthcare system. However, conceptualizing healthcare professionals’ perception of quality beyond hospital settings (e.g., its perspectives, defining attributes, quality dimensions, contextual factors, dilemmas) has rarely been done. This study therefore explores the meaning of “quality” among healthcare managers and staff in nursing homes and homecare. Methods The study applies a cross-sectional qualitative design with focus groups and individual interviews, to capture both depth and breadth of conceptualization of quality from healthcare professionals in nursing homes and homecare. We draw our data from 65 managers and staff in nursing homes and homecare services in Norway and the Netherlands. The participants worked as managers (n = 40), registered nurses (RNs) or assistant nurses (n = 25). Results The analysis identified the two categories and four sub-categories: “Professional issues: more than firefighting” (subcategories “professional pride” and “competence”) and “patient-centered approach: more than covering basic needs” (subcategories “dignity” and “continuity”). Quality in nursing homes and homecare is conceptualized as an ongoing process based on having the “right competence,” good cooperation across professional groups, and patient-centered care, in line with professional pride and dignity for the patients. Conclusion Based on the understanding of quality among the healthcare professionals in our study, quality should encompass the softer dimensions of professional pride and competence, as well as a patient-centered approach to care. These dimensions should be factors in improvement activities and in daily practice.

Adaptation and implementation of the Batz guide for bedside advocacy in two hospitals

2021 ◽  
pp. 1-10
Author(s):  
Viviana Rodríguez ◽  
Dolores Machiavello ◽  
Cintia Spira ◽  
Juan Ruiz ◽  
Fernando Canteros ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Formative Research ◽  
Local Context ◽  
Focus Group Discussions ◽  
Patient Centered ◽  
Group Discussions ◽  
Individual Interviews ◽  
Before And After ◽  
Centered Care ◽  
Local Healthcare

BACKGROUND: The patients’ guide by the Batz Patient Safety Foundation promotes patients’ active participation in healthcare and a safe hospital experience. OBJECTIVE: The aim was to adapt the Spanish version of the guide to the local context and evaluate its acceptability from healthcare professionals’ and patients’ perspectives in two hospitals in Buenos Aires, Argentina. METHODS: This implementation study had a formative research phase to adapt the guide with input from individual interviews and focus group discussions. The intervention comprised training sessions for professionals on patient-centered care and use of the guide, the appointment of coordinators, and distribution of the guide. The adapted guide (section During Admission) was distributed in two hospitals. Before and after intervention, we administered surveys to explore acceptability, utility, and patient satisfaction. RESULTS: Findings from formative research showed that the Batz guide needed to be shortened and adapted to the local healthcare context Although professionals had agreed on the importance of clinical guidelines; after using the Batz guide, they found it complex and difficult to implement. Patients’ satisfaction with healthcare before and after implementing the guide did not differ significantly. Best scores were found in items related to availability of nurses, staff competence and staff kindness. A 78% of patients found the Batz guide useful. CONCLUSION: It is of critical importance to adapt the guide to the local culture, pilot it, and provide training to promote its implementation, improving acceptability and utility.

Positionings in healthcare: diabetes training for Arabic-speaking immigrants

2014 ◽  
Vol 114 (2) ◽  
pp. 133-151 ◽  
Author(s):  
Nanna Ahlmark ◽  
Susan Reynolds Whyte ◽  
Tine Curtis ◽  
Tine Tjørnhøj-Thomsen
Keyword(s):  
Healthcare Professionals ◽  
Teaching Practice ◽  
Local Authority ◽  
Chronically Ill ◽  
Positioning Theory ◽  
Content Type ◽  
Individual Interviews ◽  
Group Interviews ◽  
Arabic Speaking ◽  
Static Concept

Purpose – The purpose of this study is to explore how healthcare professionals in Denmark perceived and enacted their role as diabetes trainers for Arabic-speaking immigrants in three new local authority settings. The paper used positioning theory, which is a dynamic alternative to the more static concept of role in that it seeks to capture the variable, situationally specific, multiple and shifting character of social interaction, as the analytical tool to examine how people situationally produce and explain behaviour of themselves and others. Design/methodology/approach – The paper generated data through observation of diabetes training and of introductory interviews with training participants in three local authority healthcare centres over a total of five months. The authors conducted 12 individual interviews and two group interviews with healthcare professionals. Findings – Healthcare professionals shifted between three positionings – caregiver, educator and expert. The caregiver was dominant in professionals’ ideals but less in their practice. Healthcare professionals other-positioned participants correspondingly as: vulnerable, difficult students and chronically ill. The two first other-positionings drew on dominant images of an ethnic other as different and problematic. Practical implications – Becoming more reflexive and explicit about one's positionings offer the potential for a more conscious, confident, flexible and open-ended teaching practice. Such reflexivity may also reduce the perception that teaching challenges are rooted in participants’ ethnic background. Originality/value – The paper provides a new understanding of healthcare practice by showing professionals’ multiple and reciprocal positionings and the potential and risks in this regard. The paper demonstrates the need for healthcare workers to reflect on their positionings not only in relation to immigrants, but to all patients.

scholarly journals Providing person-centered care for patients with complex healthcare needs: A qualitative study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242418
Author(s):  
Vincent J. T. Peters ◽  
Bert R. Meijboom ◽  
Jan Erik H. Bunt ◽  
Levinus A. Bok ◽  
Marianne W. van Steenbergen ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Chronic Conditions ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Service Architecture ◽  
Children With Down Syndrome ◽  
Healthcare Needs ◽  
Centered Care

Background People with chronic conditions have complex healthcare needs that lead to challenges for adequate healthcare provision. Current healthcare services do not always respond adequately to their needs. A modular perspective, in particular providing visualization of the modular service architecture, is promising for improving the responsiveness of healthcare services to the complex healthcare needs of people with chronic conditions. The modular service architecture provides a comprehensive representation of the components and modules of healthcare provision. In this study, we explore this further in a qualitative multiple case study on healthcare provision for children with Down syndrome in the Netherlands. Methods Data collection for four cases involved 53 semi-structured interviews with healthcare professionals and 21 semi-structured interviews with patients (the parents of children with Down syndrome as proxy). In addition, we gathered data by means of practice observations and analysis of relevant documents. The interviews were audio-recorded, transcribed verbatim and analyzed utilizing the Miles and Huberman approach. Results Our study shows that the perspectives on healthcare provision of professionals and patients differ substantially. The visualization of the modular service architecture that was based on the healthcare professionals’ perspective provided a complete representation of (para)medical outcomes relevant to the professionals’ own discipline. In contrast, the modular service architecture based on the patients’ perspective, which we define as a person-centered modular service architecture, provided a representation of the healthcare service that was primarily based on functional outcomes and the overall wellbeing of the patients. Conclusion Our study shows that visualization of the modular service architecture can be a useful tool to better address the complex needs and requirements of people with a chronic condition. We suggest that a person-centered modular service architecture that focuses on functional outcomes and overall wellbeing, enables increased responsiveness of healthcare services to people with complex healthcare needs and provision of truly person-centered care.

scholarly journals Implementation of Person-Centered Care: A Feasibility Study Using the WE-CARE Roadmap

2021 ◽  
Vol 18 (5) ◽  
pp. 2205
Author(s):  
Roman A. Lewandowski ◽  
Jędrzej B. Lewandowski ◽  
Inger Ekman ◽  
Karl Swedberg ◽  
Jan Törnell ◽  
...  
Keyword(s):  
Pilot Study ◽  
Feasibility Study ◽  
Health Care Professionals ◽  
Quality Care ◽  
Structured Interviews ◽  
Rehabilitation Hospital ◽  
Person Centered Care ◽  
Centered Care ◽  
Multi Disciplinary Team

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used to guide implementation of PCC for patients with moderate scoliosis. A multi-disciplinary team of professionals were trained in the PCC approach and the hospital Information Technology (IT) system was modified to enhance PCC data capture. Semi-structured interviews were conducted with the nine health care professionals involved in the pilot study and three patients/parents receiving care. Transcribed data were analyzed via content analysis. Results: 51 patients and their families were treated via a PCC approach. High proportions of new PCC data fields were completed by the professionals. The professionals were able to implement the three core PCC routines and perceived benefits using the PCC approach. Patients and their families also perceived improved quality care. The WE-CARE framework enablers facilitated PCC implementation in this setting. Conclusions: This feasibility pilot study indicates that the Gothenburg PCC approach can be successfully transferred to a rehabilitation hospital in Poland with favorable perceptions of implementation by both professionals and patients/their families.

scholarly journals What are the risk factors for avoidable transitions in the last year of life? A qualitative exploration of professionals’ perspectives for improving care in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alina Kasdorf ◽  
◽  
Gloria Dust ◽  
Vera Vennedey ◽  
Christian Rietz ◽  
...  
Keyword(s):  
Healthcare Professional ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Individual Interviews ◽  
Information Power ◽  
Care Services ◽  
Healthcare Settings ◽  
Nursing Services ◽  
Value Based Care ◽  
Qualitative Exploration

Abstract Background Little is known about the nature of patients’ transitions between healthcare settings in the last year of life (LYOL) in Germany. Patients often experience transitions between different healthcare settings, such as hospitals and long-term facilities including nursing homes and hospices. The perspective of healthcare professionals can therefore provide information on transitions in the LYOL that are avoidable from a medical perspective. This study aims to explore factors influencing avoidable transitions across healthcare settings in the LYOL and to disclose how these could be prevented. Methods Two focus groups (n = 11) and five individual interviews were conducted with healthcare professionals working in hospitals, hospices and nursing services from Cologne, Germany. They were asked to share their observations about avoidable transitions in the LYOL. The data collection continued until the point of information power was reached and were audio recorded and analysed using qualitative content analysis. Results Four factors for potentially avoidable transitions between care settings in the LYOL were identified: healthcare system, organization, healthcare professional, patient and relatives. According to the participants, the most relevant aspects that can aid in reducing unnecessary transitions include timely identification and communication of the LYOL; consideration of palliative care options; availability and accessibility of care services; and having a healthcare professional taking main responsibility for care planning. Conclusions Preventing avoidable transitions by considering the multicomponent factors related to them not only immediately before death but also in the LYOL could help to provide more value-based care for patients and improving their quality of life.

scholarly journals Perceptions of midwives on shortage and retention of staff at a public hospital in Tshwane District

Curationis ◽  
2019 ◽  
Vol 42 (1) ◽  
Author(s):  
Mosehle S. Matlala ◽  
Thanyani G. Lumadi
Keyword(s):  
Decision Making ◽  
Design Method ◽  
Quality Care ◽  
Sampling Technique ◽  
The Status ◽  
Generic Qualitative ◽  
Tertiary Hospitals ◽  
Decision Making Processes ◽  
Group Interviews ◽  
The Impact

Background: Midwifery is the backbone of women and child healthcare. The shortage of staff in maternity units is a crisis faced by many countries worldwide, including South Africa.Objectives: This study aims to explore the perceptions of midwives on the shortage and retention of staff at a public institution.Method: The study was conducted at one of the tertiary hospitals in Tshwane District, Gauteng Province. A total of 11 midwives were interviewed through face-to-face and focus group interviews. An explorative, descriptive generic qualitative design method was followed, and a non-probability, purposive sampling technique was used. Thematic coding analysis was followed for analysing data.Results: The impact of shortage of midwives was reported to be directly related to poor provision of quality care as a result of increased workload, leading to low morale and burnout. The compromised autonomy of midwives in the high obstetrics dependency units devalues the status of midwives.Conclusion: Midwives are passionate about their job, despite the hurdles related to their day-to-day work environment. They are demoralised by chronic shortage of staff and feel overworked. Staff involvement in decision-making processes is a motivational factor for midwives to stay in the profession. The midwives need to be in the centre of the decision-making processes related to their profession. The revision of the scope of practice and classification of midwifery profession away from general nursing complex by the South African Nursing Council (SANC) could place midwifery in its rightful status.

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