scholarly journals Comparing the Experiences of Birth Experiences Women With Remifentanil Analgesia and Elective Cesarean Section and Providing Improver Strategies: A Sequential Explanatory Mixed Method Study

2020 ◽  
Author(s):  
rana dousti ◽  
sevil Hakimi ◽  
Hojjat Pourfathi ◽  
Roghayeh Nourizadeh ◽  
Niloufar Sattarzadeh Jahdi
Keyword(s):  
Mixed Method ◽  
Mixed Methods Research ◽  
Nominal Group Technique ◽  
Target Population ◽  
Nominal Group ◽  
Elective Cesarean Section ◽  
Care Providers ◽  
Private Hospitals ◽  
Sequential Explanatory ◽  
Tabriz City

Abstract BackgroundIdentifying methods that are effective and safe while also compatible with maternal needs and improving the delivery experience is important. Since pharmacological interventions provide better pain alleviation for women during labor when compared to nonpharmacological interventions, in case the former also improves women satisfaction with the labor experience, care providers can propose this method for mitigating the women's pain during labor. The aim of this study is to compare the experience of parturient women between remifentanil analgesia and elective C-section, as well as proposing ameliorating strategies in Tabriz city, Iran.MethodThe present research is of mixed methods research type with a sequential explanatory approach. The first stage is quantitative and longitudinal. The target population consists of parturient women receiving elective C-section and vaginal labor through remifentanil analgesia in the private hospitals of Tabriz city. The sampling will be performed from all private hospitals of Tabriz city as available sampling. They will be chosen from each hospital based on specific rations in relation to the eligible women according to the inclusion criteria, and then assigned into two groups (elective C-section and parturient women receiving remifentanil). Demographic characteristics as well as Edinburgh's depression test during pregnancy questionnaires plus labor agentry scale (LAS) as well as the checklist of maternal and neonatal outcomes within 24 hours postdelivery will be completed by the researcher. The subjects will be followed up for up to 30 days postdelivery in order to complete the Edinburgh depression questionnaire. The second stage of study is qualitative performed to interpret parturient women's perception about elective C-section and Remifentanil anesthesia regarding different aspects and the factors associated with delivery experience. The sampling will continue until data saturation, i.e. no new information or code is received. Based on the results of the total mean score of delivery experience, which will be obtained in the quantitative section, the extreme cases will be chosen. For this purpose, at both ends of the total score spectrum of the delivery experience, the women acquiring the 10% upper and lower extreme total score of delivery experience will be chosen as the extreme cases. Purposeful sampling will be done on mothers belonging to extreme cases and who are willing as well as able to express their experiences. In the third stage, in order to provide ameliorating strategies for delivery experience, after combining the quantitative and qualitative studies, a review of the literature and then nominal group technique will be used.DiscussionBy comparing the experience of parturient women receiving Remifentanil analgesia and elective C-section, evidence-based improving strategies using a culturally sensitive approach can be provided. Presentation of the results obtained from this study using the mixed method may help in better understanding the issue. Also, the obtained results can be used to enhance the quality of midwifery care to be examined by health policymakers and planners.Ethical codeIR.TBZMED.REC.1399. 521

Comparing the Experiences of Parturient Women With Remifentanil Analgesia and Elective Cesarean Section and Providing Improver Strategies: A Sequential Explanatory Mixed Method Study

2021 ◽  
Author(s):  
rana dousti ◽  
Sevil Hakimi ◽  
Hojjat Pourfathi ◽  
Roghayeh Nourizadeh ◽  
Niloufar sattarzadeh jahdi
Keyword(s):  
Cesarean Section ◽  
Mixed Method ◽  
Elective Cesarean Section ◽  
Mixed Method Study ◽  
Quality Of Data ◽  
Sequential Approach ◽  
Private Hospitals ◽  
Elective Cesarean ◽  
The City

Abstract Background Identifying methods that can effectively and safely improve the childbirth experience and are tailored to mothers' needs are of crucial importance. The current study aimed to compare experiences of parturient women with remifentanil analgesia and elective cesarean section and providing improver strategies for women living in the city of Tabriz, Iran.MethodsThis is a mixed-method study with an explanatory sequential approach. The first stage is quantitative and longitudinal. The study population is all parturient women who will give birth by elective C-section or vaginal painless delivery using remifentanil in private hospitals of the city of Tabriz in 2020-2021. All mothers are free to choose either method. Participants will be selected from all private hospitals using the convenience sampling technique proportioned to the number of eligible women in each hospital. Participants will be followed up to 30 days after delivery to complete the Edinburgh Postpartum Depression questionnaire. The second stage is a qualitative study aimed at exploring the perceptions of parturient women who had either elective C-section or painless delivery (using remifentanil), including factors related to labor experiences. Data will be collected by semi structured interviews with new mothers and important others (if needed).In the third stage, a mixed study will be performed to provide strategies for improving labor experiences. we will use an explanatory Sequential approach in order to increase the accuracy and quality of data and to use the findings to evaluate different methods of delivery.DiscussionBy comparing the experience of parturient women receiving Remifentanil analgesia and elective C-section, evidence-based improving strategies using a culturally sensitive approach can be provided. Presentation of the results obtained from this study using the mixed method may help in better understanding the issue. Also, the obtained results can be used to enhance the quality of midwifery care to be examined by health policymakers and planners.Trial registrationThis study is approved by the ethics committee of the Tabriz University of Medical Sciences (code: IR.TBZMED.REC.1399. 521). Besides, it's evaluated by relevant refers.

scholarly journals Constructing a measure of balance recovery confidence for older persons: content themes from different stakeholders

2021 ◽  
Vol 11 (1) ◽  
pp. 1-19
Author(s):  
Shawn Leng-Hsien Soh ◽  
◽  
Fiona Gilmour ◽  
Judith Lane ◽  
Shalini Asokan ◽  
...  
Keyword(s):  
Older Persons ◽  
Nominal Group Technique ◽  
Target Population ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Community Dwelling ◽  
Nominal Group ◽  
Balance Recovery ◽  
Patient Reported ◽  
Practice Development

Background: The absence of patient-reported outcome measures (PROMs) for a specific construct or target population suggests a need for such measures to be developed. A case in point is the domain of falls efficacy; a PROM for balance recovery confidence was proposed to improve older persons ’agency to arrest a fall. Appropriate participation in its development by relevant stakeholders was identified as essential to maximise the utility of the PROM and its potential to enhance patient care. There is a gap in the practice development literature in terms of PROMs for older persons. This article aims to encourage researchers to use the principles of practice development to address this gap by involving relevant stakeholders to gain greater insight. Methods: The nominal group technique and the Delphi technique were used to generate and refine the content of the measure, and content analysis was applied to assess and summarise the data. Findings: Unique themes emerged, such as ‘agency of older people in the prevention of falls ’from the community-dwelling older adults in Singapore, and ‘clinical specificity ’from an international panel of healthcare professionals. Common themes including ‘relevance to the target population’, ‘comprehensibility ’and ‘cultural and contextual sensitivity ’were found in both groups. Conclusion: A collaborative, inclusive and participatory approach involving different stakeholders, underpinned by practice development methodology, can offer rich insights for PROM developers. Implications for practice: Meaningful perspectives are generated from a diversity of views shared by representatives from all stakeholder groups involved in caregiving Participation of different stakeholders, such as physiotherapists, occupational therapists, nurses, doctors, podiatrists and older persons, provides a more robust and authentic approach to developing a PROM for older persons

What makes a high-quality electronic consultation (eConsult)? A nominal group study

2019 ◽  
Vol 26 (4) ◽  
pp. 239-247 ◽  
Author(s):  
Christopher Tran ◽  
Douglas Archibald ◽  
Susan Humphrey-Murto ◽  
Clare Liddy ◽  
Erin Keely
Keyword(s):  
Nurse Practitioners ◽  
Assessment Tool ◽  
Group Discussion ◽  
Nominal Group Technique ◽  
Primary Care Providers ◽  
Nominal Group ◽  
Consensus Methods ◽  
Care Providers ◽  
High Quality ◽  
Electronic Consultation

Introduction Poor communication between health professionals can compromise patient safety, yet specialists rarely receive feedback on their written communication. Although worldwide implementation of electronic consultation (eConsult) services is rising rapidly, little is known about the features of effective communication when specialists provide online advice to primary care providers (PCP). To inform efforts to ensure and maintain high-quality communication via eConsult, we aim to identify features of high-quality eConsult advice to incorporate into an assessment tool that can provide specialists with feedback on their correspondence. Methods Initial items for the tool were generated by PCPs and specialists using the nominal group technique (NGT). Invited PCPs were above-median eConsult users between July 2016 and June 2017. Specialists were purposively recruited to represent the range of available specialties. Participants individually wrote down items they felt should be included in the tool. A moderator with consensus group expertise then led a round-robin discussion for each item. Items were ranked anonymously and included if highly-ranked by over 70% of participants. Results Eight PCPs (six family physicians, two nurse practitioners) and three specialists (dermatology, hematology, pediatric orthopedics) produced 49 items that were refined to 14 after group discussion and two rounds of ranking. Highly-ranked items encompassed specific, up-to-date, patient-individualized, and practical advice that the PCP could implement. Discussion Features of high-quality eConsult correspondence derived from consensus methods highlight similarities and differences between face-to-face consultation letters and eConsult. Our findings could be used to inform feedback and education for eConsult specialists on their advice to PCPs.

scholarly journals What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne M. Finucane ◽  
Connie Swenson ◽  
John I. MacArtney ◽  
Rachel Perry ◽  
Hazel Lamberton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Psychological Needs ◽  
Care Providers ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Complex Needs ◽  
Sequential Explanatory ◽  
Palliative Care Needs

Abstract Background Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service. Methods Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices. Results Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly. Conclusions Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input.

scholarly journals Barriers to implementing motivational interviewing in addiction treatment: A nominal group technique process evaluation

2021 ◽  
Vol 2 ◽  
pp. 263348952110184
Author(s):  
Melissa R Hatch ◽  
Kristine Carandang ◽  
Joanna C Moullin ◽  
Mark G Ehrhart ◽  
Gregory A Aarons
Keyword(s):  
Motivational Interviewing ◽  
Process Evaluation ◽  
Nominal Group Technique ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Nominal Group ◽  
Management Level ◽  
Implementation Program ◽  
Ebp Implementation ◽  
Staff Level

Background: The successful implementation of evidence-based practices (EBPs) in real-world settings requires an adaptive approach and ongoing process evaluation and tailoring. Although conducting a needs assessment during the preparation phase of implementation is beneficial, it is challenging to predict all barriers to EBP implementation that may arise over the course of implementation and sustainment. This article describes a process evaluation that identified emergent and persistent barriers that impacted the implementation of an EBP across multiple behavioral health organizations and clinics. Methods: This study was conducted during the first cohort of a cluster randomized controlled trial testing the effectiveness of the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI) in substance use disorder treatment agencies and clinics. We used a modified nominal group technique (NGT) in which clinic leaders identified barriers faced during the implementation process. Barriers were categorized, then ranked and rated according to leaders’ perceptions of each barrier’s influence on implementation. The barriers were then contextualized through individual qualitative interviews. Results: Fifteen barriers were identified, grouped into staff-level barriers, management-level barriers, and implementation program barriers. Time and resistance to MI were rated as the most influential staff-level barriers. Among management-level barriers, time was also rated highest, followed by turnover and external contractual constraints. The most influential implementation barrier was client apprehension of recording for fidelity assessment and feedback. Individual interviews supported these findings and provided suggested adaptations for future implementation efforts. Conclusion: EBP implementation is an ongoing process whereby implementation strategies must be proactively and strategically tailored to address emergent barriers. This research described a process evaluation that was used to identify 15 emergent and/or persistent barriers related to staff, management, and the implementation program. Using implementation strategies that can be tailored and/or adapted to such emergent barriers is critical to implementation effectiveness. Plain Language Summary Unforeseen barriers often arise during the course of implementation. Conducting evaluations during implementation allows for tailoring the implementation strategy. As part of a larger study using the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI), we collected data from the first cohort of LOCI clinic leaders to identify barriers to MI implementation that persisted despite advanced planning and to understand unanticipated barriers that arose during implementation. Leaders identified 15 barriers faced during the implementation process that fell into three categories: staff-level barriers, management-level barriers, and implementation program barriers. The leaders ranked time as the most influential barrier at both the staff and management levels. Staff apprehension, resistance to MI implementation, and staff turnover were also of significant concern to leaders. Future implementation efforts may benefit from conducting a similar process evaluation during the implementation phase.

scholarly journals Photograph Based Evaluation of Consumer Expectation on Healthiness, Fullness, and Acceptance of Sandwiches as Convenience Food

Foods ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 1102
Author(s):  
Purificación García-Segovia ◽  
Mª Jesús Pagán-Moreno ◽  
Amparo Tárrega ◽  
Javier Martínez-Monzó
Keyword(s):  
Interaction Effect ◽  
Online Survey ◽  
Age Groups ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Visual Appearance ◽  
Consumer Expectation ◽  
Preference Mapping ◽  
Consumer Experiences ◽  
And Cluster Analysis

Sandwiches are the most common “casual-food” consumed by all age groups in Spain. Due to the importance of visual appearance to promote unplanned or impulse buying, foodservice and hospitality companies focus on improving the visual impression of their food menus to create an expectation that satisfies both sensory and hedonic consumer experiences. To provide a list of attributes about the visual appearance of sandwiches, 25 students were recruited from a university and were invited to participate in two nominal group technique (NGT) sessions. To understand whether a sandwiches’ appearance can influence the expectation of consumers, 259 participants completed an online survey specially designed from the results of the NGT sessions. Data were analyzed using conjoint, internal preference mapping and cluster analysis; the interaction effect by gender was also studied. The conjoint results indicate that visual perception about the filling (vegetal or pork based) plays the most key role overall in consumer expectation. When consumers choose vegetables as the filling, the consumers’ perceived sandwiches as healthier, but the pork filling was perceived as more attractive and satiating. Interaction effect by gender was observed in filling when females perceived pork filling as less healthy than vegetable. By acceptance, consumers were segmented into three groups. The first cluster (n = 80) selected the pork filling. The smaller group (cluster 3, n = 36) prioritized the vegetal filling, and the most numerous cluster 2 (n = 140) liked sandwiches with multigrain bread. These results may help companies to build tailor-made marketing strategies to satisfy consumer segments.

scholarly journals Parent engagement in co-design of clinical trials: the PARENT trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Leigh M. Vanderloo ◽  
Shelley M. Vanderhout ◽  
Erika Tavares ◽  
Jonathon Maguire ◽  
Sharon Straus ◽  
...  
Keyword(s):  
Focus Group ◽  
Patient Engagement ◽  
Parent Engagement ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Future Research ◽  
Potential Barriers ◽  
Patient Engagement In Research ◽  
Diverse Individual ◽  
Parent Trial

AbstractEvidence generated from partnering with parents to design and conduct research together may be used to refine, adjust, and modify future research approaches. This study aimed to describe the initial approaches to parent engagement in the design of the PARENT trial as well as understand parent perspectives on the acceptability and relevance of the PARENT trial and potential barriers and facilitators to participation.Parents participating in the TARGet Kids! cohort were invited to participate in a focus group, called the PARENT panel, to co-design the PARENT trial. This focus group was conducted to capture diverse individual and collective parents’ experiences. Overall methodological approaches for the PARENT panel were informed by the CIHR Strategy for Patient Oriented Research (SPOR) guiding principles (mutual respect, co-building, inclusiveness, and support) for patient engagement in research, and facilitated through the Knowledge Translation Program in the Li Ka Shing Knowledge Institute at Unity Health Toronto. Using a Nominal Group Technique, the PARENT panel provided feedback on the feasibility, relevance, and acceptability of the proposed intervention. Findings from this work will be used to further refine, adjust, and modify the next iteration of the PARENT trial, which will also serve as an opportunity to discuss the efforts made by researchers to incorporate parent suggestions and what additional steps are required for improved patient engagement.

scholarly journals Prioritization Of Research Under National Aids Control Programme In India Using Nominal Group Technique

1970 ◽  
Vol 8 (1) ◽  
pp. 20-30
Author(s):  
R Sogarwal ◽  
D Bachani
Keyword(s):  
Nominal Group Technique ◽  
Research Priorities ◽  
Control Programme ◽  
Pediatric Hiv ◽  
Nominal Group ◽  
Phase Iii ◽  
Hiv Care ◽  
Policy Makers ◽  
Research Questions ◽  
Group Technique

Introduction: During the fi rst 2 years of the fi ve year plan of India’s National AIDS Control Programme Phase-III (NACP-III; 2007-12), various interactive consultative workshops were organized in collaboration with development partners with the objective of identifying priority areas for operational research and further development of research protocols adopting mentorship approach. Methodology: This article is an attempt to present the Nominal Group Technique (NGT) which was used to identify a set of fundable and practically feasible research priorities under NACP-III specifi cally focusing on Prevention of Parent to Child Transmission (PPTCT) and Pediatric HIV Care in India. The activity was undertaken with support of UNICEF in the year 2010. A total of 110 persons participated in the consultation clustering into 37, 36 and 37 members in Group A, B and C, respectively. The participants refl ected the mix of policy makers / decision makers (8), programme managers (12), implementers (36), subject experts / researchers (28), other stakeholders (16). Results: A total of nine highest priority research questions were identifi ed by all the groups in the assigned themes. The value of Kendall’s W coeffi cient of concordance was 0.68, which shows signifi cant agreement among raters on priority research questions (chi-square=16.35; p=0.03). Conclusion: Based on our experience, we can conclude that NGT was found to be an important tool for setting research priorities that is more democratic and transparent than the traditional methods. By applying various stages of the group sessions, participants can experience the rethinking process with reference information to enhance their judgment. The results of our experience may help programme managers / policy makers to plan similar and more improved method in other element of NACP as well as other health programmes. DOI: http://dx.doi.org/10.3126/saarctb.v8i1.5888 SAARCTB 2011; 8(1): 20-30

Psychographic segmentation of the self-employed: An exploratory study

2010 ◽  
Vol 13 (2) ◽  
pp. 47-56 ◽  
Author(s):  
Matthew G. Kenney ◽  
Art Weinstein
Keyword(s):  
Small Business ◽  
Personality Traits ◽  
Exploratory Study ◽  
Nominal Group Technique ◽  
The Self ◽  
Nominal Group ◽  
Academic Literature ◽  
Self Employment ◽  
Group Technique

Although it is well established in the academic literature that entrepreneurs share common traits, there has been limited research dedicated to evaluating psychographic profiles of the self-employed. Using the Nominal Group Technique, the authors gleaned insight from a panel of experts in an effort to segment the self-employed based on personality traits and the benefits they receive from an entrepreneurial career. The findings show that self-employed individuals can be classified into four distinct segments: Exemplars, Generals, Moms and Dads, and Altruists. Each group derives different benefits from self-employment. Understanding these benefits can greatly assist entrepreneurship educators and marketers of small business oriented products and services.

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