scholarly journals The Nordic Maintenance Care Program: Patient Experience of Maintenance Care - A Qualitative Study

2021 ◽  
Author(s):  
Jesper Hjertstrand ◽  
Per J Palmgren ◽  
Iben Axén ◽  
Andreas Eklund
Keyword(s):  
Back Pain ◽  
Qualitative Study ◽  
Care Program ◽  
Care Plan ◽  
Maintenance Care ◽  
Structured Interviews ◽  
Patient Centered ◽  
Negative Experiences ◽  
The One ◽  
Patients Experience

Abstract Background:Low back pain is one of the major causes of disability world-wide. Most back pain sufferers experience pain that is recurrent or persistent, making management of this condition a priority. In a series of previous studies, chiropractic maintenance care has been found to be an effective way of reducing the number of days with pain, particularly for patients with a certain psychological profile. However, little is known about patients’ experience of this kind of management plan.This study aimed to explore patient experiences and preferences by looking at barriers to and facilitators of engaging in and maintaining a care plan, and to contrast the data using psychological sub-groups.Methods:In this qualitative study we performed semi-structured interviews with 24 patients who had previously participated in a Swedish trial evaluating maintenance care. They were purposefully selected to obtain richness, variation and breadth of data. The data were analyzed using inductive qualitative manifest and latent content analysis. We used the theory of planned behavior to deepen our understanding of the constructed themes. Results:The analysis resulted in two overarching dimensions: “when maintenance care is of high value” and “when maintenance care is of low value”. Four factors were jointly identified as obstacles to maintenance care by patients in all the psychological subgroups. These factors were: Cost demanding, A sense of low value, Perceived as unavailable and Fear of treatment. The one factor seen as facilitating maintenance care by patients in all the subgroups was Care that is patient-centered.Conclusions:The findings reveal a variance of both positive and negative experiences of MC in the psychological subgroups. These findings can deepen our understanding of how patients experience MC and can help clinicians to understand when patients might regard maintenance care as being of high value.

scholarly journals The nordic maintenance care program: patient experience of maintenance care—a qualitative study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Jesper Hjertstrand ◽  
Per J. Palmgren ◽  
Iben Axén ◽  
Andreas Eklund
Keyword(s):  
Back Pain ◽  
Qualitative Study ◽  
Care Program ◽  
Management Plan ◽  
Care Plan ◽  
Maintenance Care ◽  
Structured Interviews ◽  
Patient Centered ◽  
The One ◽  
Patients Experience

Abstract Background Low back pain is one of the major causes of disability world-wide. Most back pain sufferers experience pain that is recurrent or persistent, making management of this condition a priority. In a series of previous studies, chiropractic maintenance care has been found to be an effective way of reducing the number of days with pain, particularly for patients with a certain psychological profile. However, little is known about patients’ experience of this kind of management plan. This study aimed to explore patient experiences and preferences by looking at barriers to and facilitators of engaging in and maintaining a care plan, and to contrast the data using psychological sub-groups. Methods In this qualitative study we performed semi-structured interviews with 24 patients who had previously participated in a Swedish trial evaluating maintenance care. They were purposefully selected to obtain richness, variation and breadth of data. The data were analyzed using inductive qualitative manifest and latent content analysis. We used the theory of planned behavior to deepen our understanding of the constructed themes. Results The analysis resulted in two overarching dimensions: “when maintenance care is of high value” and “when maintenance care is of low value”. Four factors were jointly identified as obstacles to maintenance care by patients in all the psychological subgroups. These factors were: Cost demanding, A sense of low value, Perceived as unavailable and Fear of treatment. The one factor seen as facilitating maintenance care by patients in all the subgroups was Care that is patient-centered. Conclusions The findings reveal a variance of both positive and negative experiences of MC in the psychological subgroups. These findings can deepen our understanding of how patients experience MC and can help clinicians to understand when patients might regard maintenance care as being of high value.

Implementing Serious Illness Communication Processes in Primary Care: A Qualitative Study

2020 ◽  
pp. 104990912095109
Author(s):  
Joanna Paladino ◽  
Elise Brannen ◽  
Emily Benotti ◽  
Natalie Henrich ◽  
Christine Ritchie ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Program Implementation ◽  
Primary Care Physicians ◽  
Care Program ◽  
Routine Care ◽  
Structured Interviews ◽  
Patient Centered ◽  
Serious Illness ◽  
Primary Care Clinicians

Purpose: Primary care clinicians face barriers to engaging patients in conversations about prognosis, values, and goals (“serious illness conversations”). We introduced a structured, multi-component intervention, the Serious Illness Care Program (SICP), to facilitate conversations in the primary care setting. We present findings of a qualitative study to explore practical aspects of program implementation. Methods: We conducted semi-structured interviews of participating primary care physicians, nurse care coordinators, and social workers and coded transcripts to assess the activities used to integrate SICP into the workflow. Results: We conducted interviews with 14 of 46 clinicians from 6 primary care clinics, stopping with thematic saturation. Qualitative analysis revealed major themes around activities in the timing of the conversation (before, during, and after) and overarching insights about the program. Clinicians used a variety of strategies to adapt program components while preserving key program goals, including processes to generate accountability to ensure that conversations happen in busy clinical workflows. The interviews revealed changes to clinicians’ mindset and norms, such as the recognition of the need to start conversations earlier in the illness course and the use of more expansive models of prognostic communication that address function and quality of life. Data also revealed indicators of sustainable behavior change and the spread of communication practices to patients outside the intended program scope. Conclusion: SICP served as a framework for primary care clinicians to integrate serious illness communication into routine care. The shifts in processes employed by inter-professional clinicians revealed comprehensive models for prognostic communication and creative workflows to ensure that patients with complex illnesses had proactive, longitudinal, and patient-centered serious illness conversations and care planning.

scholarly journals The Nordic Maintenance Care Program: when do chiropractors recommend secondary and tertiary preventive care for low back pain?

2009 ◽  
Vol 17 (1) ◽  
Author(s):  
Iben Axén ◽  
Irene B Jensen ◽  
Andreas Eklund ◽  
Laszlo Halasz ◽  
Kristian Jørgensen ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Preventive Care ◽  
Care Program ◽  
Low Back ◽  
Maintenance Care

scholarly journals The anticipated and the lived experience of home and in-centre haemodialysis: Is there a disconnect?

2016 ◽  
Vol 22 (12) ◽  
pp. 1524-1533 ◽  
Author(s):  
Rabiya Majeed-Ariss ◽  
A Jayanti ◽  
T Schulz ◽  
A Wearden ◽  
S Mitra
Keyword(s):  
Qualitative Study ◽  
Lived Experience ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Patient Factors ◽  
Home Haemodialysis ◽  
Advantages And Disadvantages ◽  
Patients Experience

This qualitative study aimed to explore home haemodialysis and in-centre haemodialysis patients’ experience, to illuminate barriers and facilitators in the uptake and maintenance of home haemodialysis. Thirty-two semi-structured interviews with patients receiving home haemodialysis or in-centre haemodialysis were analysed using framework analysis. Four themes emerged: ‘perceptions of self’; ‘impact of haemodialysis on family’; ‘perceived advantages and disadvantages of home haemodialysis and in-centre haemodialysis’ and ‘practical issues and negotiating haemodialysis’. The lived experience of home haemodialysis was in contrast to the lived experience of in-centre haemodialysis and to the anticipated experience of home haemodialysis, highlighting patient factors that contributed to under-usage of home haemodialysis.

scholarly journals The Nordic maintenance care program – case management of chiropractic patients with low back pain: A survey of Swedish chiropractors

2008 ◽  
Vol 16 (1) ◽  
Author(s):  
Iben Axén ◽  
Annika Rosenbaum ◽  
Andreas Eklund ◽  
Laszlo Halasz ◽  
Kristian Jørgensen ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Management ◽  
Care Program ◽  
Low Back ◽  
Maintenance Care

scholarly journals 301 Older Farmers' Experiences of Musculoskeletal Disorders

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
John Cunningham ◽  
Austin Kerin ◽  
Rose Galvin ◽  
Katie Robinson
Keyword(s):  
Qualitative Study ◽  
Musculoskeletal Disorders ◽  
Future Research ◽  
Full Time ◽  
Structured Interviews ◽  
Patient Centered ◽  
Part Time ◽  
Health Promoting ◽  
Time Basis ◽  
Older Farmers

Abstract Background Almost a third (n=41,000) of all Irish farm holders are aged 65 years or older. Older farmers are vulnerable to Musculoskeletal Disorders (MSD’s) both by virtue of the nature of their work and their age. MSD’s are a known risk factor for workplace accidents and farming is the highest risk occupation in Ireland. This study aimed to explore older farmers’ experiences of living with and accessing healthcare for MSD’s. Methods A qualitative study design employing semi-structured interviews was employed. Nine Irish farmers aged 65 years and over with current or previous experience of MSD's were recruited. All participants continued to farm on either a full-time or part-time basis. Data were analysed using thematic analysis. Results Four themes describing older farmers' experiences of MSD’s and healthcare were identified; (1) acceptance of MSD’s as inevitable (2) biomechanical and biological beliefs about MSD’s (3) resilience and a commitment to continuing work in response to MSD’s (4) scepticism and avoidance of healthcare. Conclusion To the best of our knowledge this is the first qualitative study of older Irish farmers’ experiences of MSD’s. Findings reveal that older farmer’s experiences differ significantly from those reported by other occupational groups. Commitment to continue working permeated the findings of this study and shaped older farmers' experiences and responses to MSD's. Older farmers accept MSD’s and pain as inevitable consequences of farming, and they respond to MSD’s with stoicism. Lack of healthcare provider knowledge about farming culture and practices contributes to older farmers' negative healthcare experiences and avoidance of healthcare. Given the prevalence of MSD’s in this population future research should focus on developing and evaluating appropriate health promoting and patient-centered interventions to support continued safe farming for older Irish farmers.

Patient and clinician experiences of a computerised cognitive battery for use after concussion: a preliminary qualitative study

2020 ◽  
pp. 1-16
Author(s):  
C. Macleod ◽  
L. J. Surgenor ◽  
W. Levack ◽  
J. Hackney ◽  
A. Theadom ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cognitive Testing ◽  
Qualitative Description ◽  
Future Research ◽  
Structured Interviews ◽  
Neuropsychological Battery ◽  
Negative Experiences ◽  
Select Group ◽  
Clinician Experiences ◽  
Neurological Research

Abstract Objective: The Cognition Battery of the National Institute of Health (NIH) Toolbox for Assessment of Neurological and Behavioural Function is a computerised neuropsychological battery recommended for clinical practice, neurological research and clinical trials. We investigated the utility of the NIH Toolbox Cognition Battery (NIHTB-CB) for people with concussion. Methods: In this small qualitative study, semi-structured interviews were conducted with five adults with concussion who were participating in a larger study using the NIHTB-CB. Three clinician participants and two cultural advisors familiar with the tool were also interviewed. Interview transcripts were analysed using a general thematic approach and qualitative description. Results: Participants described both positive and negative experiences with the NIHTB-CB and using qualitative description, their experiences were organised into three broad themes: (1) using technology for cognitive testing made sense, (2) there were some cultural relevance questions and (3) cognitive testing after concussion could have challenges. They were positive about the computerised format and range of domains assessed for the concussion context but identified the contextual relevance of some content as having potential to impact on performances. Conclusion: This was a small study examining the experiences of a select group of participants, but nevertheless does suggest a need for future research validating the NIHTB-CB for use in different cultural and clinical contexts.

scholarly journals Patient perceptions of students in a longitudinal integrated clerkship in Taiwan: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yaw-Wen Chang ◽  
David A. Hirsh ◽  
Wen-Hui Fang ◽  
Honghe Li ◽  
Wen-Chii Tzeng ◽  
...  
Keyword(s):  
Identity Formation ◽  
Clinical Education ◽  
Family Members ◽  
Patient Centered Care ◽  
Structured Interviews ◽  
Patient Centered ◽  
Education Leaders ◽  
Centered Care ◽  
Longitudinal Integrated Clerkship ◽  
Patients Experience

Abstract Background Longitudinal integrated clerkships (LICs) are a model of clinical education growing rapidly in Western contexts. LICs use educational continuity to benefits students’ clinical learning and professional identity formation. Patient-centered care is a core component of medical professionalism in the West. To support patient-centered care, education leaders in Taiwan restructured clinical education and implemented the first longitudinal integrated clerkship in East Asia. We aimed to investigate patients’ perceptions of longitudinal relationships with the LIC students within Taiwan’s Confucian cultural and social context. Methods We invited patients or their family members who were cared for longitudinally by a LIC student to participate in the study. Participating patients or their family members undertook semi-structured interviews. We analyzed data qualitatively using a general inductive approach to identify themes in the patients’ descriptions of their experiences interacting with the LIC students. Results Twenty-five patients and family members participated in interviews: 16 patients and 9 family members. Qualitative analysis of interview transcripts identified three themes from patients’ experience receiving care from their LIC students: care facilitation, companionship, and empathy. To provide care facilitation, LIC students served as a bridge between the physicians and patients. Students served patients by reminding, consulting, tracking disease progression, and researching solutions for problems. To provide companionship, students accompanied patients interpersonally like a friend or confidant who listens and provides a presence for patients. To provide empathy, patients reported that students showed sincere concern for patients’ experience, feelings, and mood. Conclusion In our study, Taiwanese patients’ perspectives of LIC students suggested the value of care facilitation, companionship, and empathy. We discuss these themes within the context of Confucian culture and the Taiwanese context of care.

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