scholarly journals A Small-Scale Qualitative Study of Early Comprehensive Patient Engagement in Acute Clinical Settings: Is It Feasible?

2020 ◽  
Author(s):  
Andrea Nedergaard Jensen ◽  
Ove Andersen ◽  
Hejdi Gamst-Jensen ◽  
Maria Kristiansen
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Patient Engagement ◽  
Participant Observation ◽  
Patient Flow ◽  
Time Constraints ◽  
Small Scale ◽  
User Engagement ◽  
Structured Interviews ◽  
Care Needs

Abstract Background: Patient-centered care (PCC) based on systematic and comprehensive patient engagement is important for patient satisfaction. However, ensuring PCC is difficult in emergency departments (ED) characterized by a high patient flow and a substantial proportion of older adults with multimorbidity and complex care needs. This small-scale qualitative study aimed to identify potentials and barriers for providing early PCC for older adults in Danish EDs using a novel user-engagement conversation tool.Methods: Participant observation, focus group interviews and individual semi-structured interviews with ED nurses and geriatric nurses were conducted between September and December 2019 in an ED at a hospital in the Capital Region of Denmark. Thematic network analysis with a focus on potentials and barriers for patient engagement was conducted.Results: Two key subthemes related to potentials emerged: 1) a positive attitude towards patient engagement in the context of PCC, and; 2) perceived benefits of PCC overall and the engagement tool in particular. Additionally, two key subthemes related to barriers emerged: 1) time constraints and; 2) concerns related to the importance of cross-sectoral care coordination.Conclusion: This study contributes to mounting evidence in support of policies and practices that encourage PCC as a driver of unpacking patients’ needs and values leading to targeted follow-up care. However, barriers such as time constraints, and lack of cross-sectoral care collaboration should be acknowledged if the potentials of PCC is to be fulfilled in ED settings.

scholarly journals NICU and postpartum nurse perspectives on involving fathers in newborn care: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Katharine W. Buek ◽  
Dagoberto Cortez ◽  
Dorothy J. Mandell
Keyword(s):  
Qualitative Study ◽  
Father Involvement ◽  
Perinatal Care ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Small Scale ◽  
Structured Interviews ◽  
Provider Attitudes ◽  
Attitudes And Practices ◽  
Sense Of Efficacy

Abstract Background Perinatal care nurses are well positioned to provide the education and support new fathers need to navigate the transition to fatherhood and to encourage positive father involvement from the earliest hours of a child’s life. To effectively serve fathers in perinatal settings, it is important to understand the attitudes, beliefs, and behaviors of healthcare providers that may encourage and engage them, or alternatively alienate and discourage them. Methods This qualitative study involved structured interviews with ten NICU and postpartum nurses from hospitals in two large Texas cities. The interview protocol was designed to elicit descriptive information about nurses’ attitudes and beliefs, sense of efficacy and intention for working with fathers, as well as their father-directed behaviors. Nurses were recruited for the study using a purposive sampling approach. Interviews were conducted by telephone and lasted approximately 25 to 35 min. Data were analyzed using a qualitative descriptive approach. Results Overall, study participants held very positive subjective attitudes toward fathers and father involvement. Nevertheless, many of the nurses signaled normative beliefs based on race/ethnicity, gender, and culture that may moderate their intention to engage with fathers. Participants also indicated that their education as well as the culture of perinatal healthcare are focused almost entirely on the mother-baby dyad. In line with this focus on mothers, participants comments reflected a normative belief that fathers are secondary caregivers to their newborns, there to help when the mother is unavailable. Conclusions Nurse attitudes and practices that place mothers in the role of primary caregiver may be interpreted by fathers as excluding or disregarding them. Further research is needed to validate the results of this small-scale study, and to assess whether and how provider attitudes impact their practices in educating and engaging fathers in newborn care.

scholarly journals The complexity of caregiving for community-living older adults with multiple chronic conditions: A qualitative study

2020 ◽  
Vol 10 ◽  
pp. 2235042X2098119
Author(s):  
Jenny Ploeg ◽  
Anna Garnett ◽  
Kimberly D Fraser ◽  
Lisa Garland Baird ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Chronic Conditions ◽  
Social Inclusion ◽  
Secondary Analysis ◽  
Community Support ◽  
Care Recipient ◽  
Community Living ◽  
Multiple Chronic Conditions ◽  
Structured Interviews

Background: Older adults with multiple chronic conditions (MCC) rely heavily on caregivers for assistance with care. However, we know little about their psychosocial experiences and their needs for support in managing MCC. The purpose of this study was to explore the experiences of caregivers of older adults living in the community with MCC. Methods: This qualitative study was a secondary analysis of previously collected data from caregivers in Ontario and Alberta, Canada. Participants included caregivers of older adults (65 years and older) with three or more chronic conditions. Data were collected through in-depth, semi-structured interviews. Interview transcripts were coded and analyzed using Thorne’s interpretive description approach. Results: Most of the 47 caregiver participants were female (76.6%), aged 65 years of age or older (61.7%), married (87.2%) and were spouses to the care recipient (68.1%). Caregivers’ experiences of caring for community-living older adults with MCC were complex and included: (a) dealing with the demands of caregiving; (b) prioritizing chronic conditions; (c) living with my own health limitations; (d) feeling socially isolated and constrained; (e) remaining committed to caring; and (f) reaping the rewards of caregiving. Conclusions: Healthcare providers can play key roles in supporting caregivers of older adults with MCC by providing education and support on managing MCC, actively engaging them in goal setting and care planning, and linking them to appropriate community health and social support services. Communities can create environments that support caregivers in areas such as social participation, social inclusion, and community support and health services.

scholarly journals COMPREHENSIVE MEDICATION MANAGEMENT SERVICES IN A BRAZILIAN SPECIALITY PHARMACY: A QUALITATIVE ASSESSMENT

2017 ◽  
Vol 9 (3) ◽  
pp. 227 ◽  
Author(s):  
Kirla Barbosa Detoni ◽  
Mariana Martins Gonzaga Do Nascimento ◽  
Isabela Viana Oliveira ◽  
Mateus Rodrigues Alves ◽  
Manoel Machuca GonzÁles ◽  
...  
Keyword(s):  
Participant Observation ◽  
Patient Flow ◽  
Medication Management ◽  
Implementation Process ◽  
Ethnographic Study ◽  
Qualitative Assessment ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Eligibility Criteria ◽  
Manager Support

Objective: To understand and describe the implementation process of a comprehensive medication management (CMM) service in a public speciality pharmacy in Brazil.Methods: Ethnographic study conducted over 17 mo (September 2014 to February 2016) in a public speciality pharmacy. Semi-structured interviews were conducted with twelve participants. Notes on field journals, resulting from participant observation conducted by the two pharmacists directly responsible for the service implementation, were also used as a source of data.Results: Ten important conditions to improve the success of CMM service implementation were identified: manager support; evaluation of physical and material resources; evaluation of human resources practitioners’ characteristics and knowledge about the theoretical framework of CMM services; time dedicated to CMM services; redefining the work process; defining patient eligibility criteria to CMM service; defining patient flow to CMM service; communication with healthcare team; integration with the staff; and marketing the service internally.Conclusion: The results unveiled by this article can be used by pharmacists and managers as a tool to optimize the implementation of CMM services in different healthcare settings. These conditions do not consist the only aspects necessary to ensure the success of the service; however, they can contribute to optimize the implementation process of the practice

Needs and views on healthy lifestyles for the prevention of dementia through mobile health (mHealth) interventions in China: a qualitative study. (Preprint)

2021 ◽  
Author(s):  
Jinxia Zhang ◽  
Esmé Eggink ◽  
Xiaoyu Zhang ◽  
Xingming Li ◽  
Bin Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Qualitative Study ◽  
Mobile Health ◽  
Healthy Lifestyle ◽  
Healthy Lifestyles ◽  
Structured Interviews ◽  
Living Situation ◽  
Chinese Older Adults ◽  
People With Dementia

BACKGROUND China is expected to face among the largest increase of people with dementia worldwide in the coming decades, seriously challenging the Chinese healthcare system. Approximately 40% of all dementia cases might be attributable to potentially modifiable risk factors, suggesting the potential to delay or prevent dementia when targeting these risk factors. Mobile health (mHealth) may improve the accessibility of such dementia prevention strategies in China, given the wide and increasing use of smartphones by the entire Chinese population, including older adults. OBJECTIVE The aim of this qualitative study is to explore the needs and views of Chinese older adults regarding healthy lifestyles to prevent cardiovascular disease (CVD) and dementia through mHealth, facilitating development and cultural adaptation of a coach-supported mHealth platform for the Prevention of Dementia using Mobile Phone Applications (PRODEMOS) study. METHODS We performed semi-structured interviews with older adults, aged 55 and over, from Beijing and Tai’an, China, with an increased dementia risk without a diagnosis of dementia, who possess a smartphone. Participants were recruited through seven hospitals that participate in the PRODEMOS study, and were purposively sampled on age, sex, living situation, and history of CVD and diabetes. Data were analysed using thematic analysis. RESULTS Between February and December 2019 we performed 26 interviews with participants aged 55-86 years. Three main themes were identified: valuing a healthy lifestyle, sociocultural expectations, and need for guidance. First, following a healthy lifestyle was generally deemed important. In addition to generic healthy behaviours, participants regarded certain specific Chinese behaviours as important to prevent disease. Second, the sociocultural context played a crucial role, as an important motive to avoid disease was to limit the burden put on family members. However, time-consuming family and other social obligations could also impede healthy behaviours, such as regular physical activity and a healthy diet. Finally, there seemed to be a need for reliable and personalised lifestyle advice and for guidance from a health professional. CONCLUSIONS In spite of their clear appreciation of healthy lifestyles, Chinese older adults express a need for personalised lifestyle support in order to adopt healthy behaviours. Potentially, the PRODEMOS mHealth intervention can meet these needs through blended lifestyle support to improve risk factors for CVD and dementia.

scholarly journals PET VISITATION AS NARRATIVE CARE FOR OLDER ADULTS IN THERAPEUTIC SETTINGS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S867-S867
Author(s):  
Jill Yamasaki ◽  
Kelley Murfin
Keyword(s):  
Older Adults ◽  
Los Angeles ◽  
Participant Observation ◽  
Ways Of Knowing ◽  
Well Being ◽  
Structured Interviews ◽  
Term Care ◽  
Personalized Care ◽  
Healing Relationships ◽  
Therapeutic Settings

Abstract A growing body of research highlights the physiological and psychosocial benefits of pet visitation programs in therapeutic settings. These programs utilize the profound connection between humans and animals to promote holistic healing, foster greater quality of life, and influence meaningful communication between patients and providers. For older adults in hospitals or long-term care, these benefits are often correlated with moments of pleasure, comfort, relaxation, and entertainment. The current study builds on this prior knowledge by examining pet visitation programs as a novel form of narrative care that can also help preserve biographical continuity and promote the sharing of lived stories. We worked with two volunteer pet visitation programs in Houston and one in Los Angeles. Our research included a variety of ethnographic methods, including participant observation; informal interviews with providers, patients (or residents, depending on the context), and their families; semi-structured interviews with volunteers; and discourse review of organizational materials. We employed a method of constant comparison to identify and thematically analyze recurrent patterns of behavior and overarching meanings across the data. Three primary themes emerged from the data: (a) compassion, (b) connection, and (c) response. Collectively, the presence of pets prompted stories and behaviors that foster healing relationships characterized by empathy and mutual understanding between patients (or residents), family members, and providers. Pet visitation programs facilitate storied conversations, increased autonomy, and alternative ways of knowing that promote greater understandings of the patient’s (or resident’s) psychosocial context and biographical history, leading to more personalized care and improved well-being.

scholarly journals Contribution of the Newborn Behavioral Observations (NBO) for the maternal care of preterm neonates

2017 ◽  
Vol 27 (3) ◽  
pp. 262
Author(s):  
Erika Silva Dittz ◽  
Claudia Regina Lindgren Alves ◽  
Elysângela Dittz Duarte ◽  
Lívia De Castro Magalhães
Keyword(s):  
Content Analysis ◽  
Qualitative Study ◽  
Maternal Care ◽  
Participant Observation ◽  
Preterm Neonates ◽  
Preterm Newborn ◽  
Structured Interviews ◽  
Daily Care ◽  
Behavioral Observations ◽  
Preterm Newborns

Introduction: In the care of preterm newborn, practices that favor the participation of mothers in care are recommended. The use of appropriate instruments by professionals can contribute to strengthen maternal participation.Objective: To analyse the contributions of the use of the Newborn Behavioral Observations (NBO) for the maternal care of preterm neonates.Methods: Descriptive qualitative study, using participant observation and semi-structured interviews with 14 mothers of preterm newborns who underwent NBO. Data was submitted to content analysis, assinted by the software MAXQda 12.Results: It was found that the mothers' prior perceptions of the newborn´s capacities or how they react to environmental stimuli do not differ from what was observed and reported by them after NBO. However, it was verified that NBO confirms this perception and broadens the mothers' understanding of the meaning of the newborn's behavior. Participating in the NBO helped the mothers to identify strategies to find the needs of the newborn, qualifying the care already performed by them and opening new possibilities for maternal care.Conclusions: The NBO is an instrument that favors the mother's learning about the behavior of the newborn and contributes to the construction of practices with potential to be used by them within daily care. This allows us to consider it as a tool that favors the mother-baby relationship, contributes to the mother's participation in the care, and supports the mother in the construction of her autonomy for the continuity of the newborn's care after hospital discharge.

scholarly journals Geriatric care: ways and means of providing comfort

2017 ◽  
Vol 70 (4) ◽  
pp. 830-837 ◽  
Author(s):  
Patricia Cruz Pontifice Sousa Valente Ribeiro ◽  
Rita Margarida Dourado Marques ◽  
Marta Pontifice Ribeiro
Keyword(s):  
Older Adults ◽  
Participant Observation ◽  
Geriatric Care ◽  
Ethnographic Study ◽  
Personal Hygiene ◽  
Structured Interviews ◽  
Positive Interaction ◽  
The Family ◽  
The Moment ◽  
First Contact

ABSTRACT Objective: To know the ways and means of comfort perceived by the older adults hospitalized in a medical service. Method: Ethnographic study with a qualitative approach. We conducted semi-structured interviews with 22 older adults and participant observation of care situations. Results: The ways and means of providing comfort are centered on strategies for promoting care mobilized by nurses and recognized by patients(clarifying/informing, positive interaction/communication, music therapy, touch, smile, unconditional presence, empathy/proximity relationship, integrating the older adult or the family as partner in the care, relief of discomfort through massage/mobilization/therapy) and on particular moments of comfort (the first contact, the moment of personal hygiene, and the visit of the family), which constitute the foundation of care/comfort. Final considerations: Geriatric care is built on the relationship that is established and complete with meaning, and is based on the meeting/interaction between the actors under the influence of the context in which they are inserted. The different ways and means of providing comfort aim to facilitate/increase care, relieve discomfort and/or invest in potential comfort.

scholarly journals Street Clinic Nursing for coping with vulnerabilities

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e67967
Author(s):  
Giulia Romano Bombonatti ◽  
Débora de Souza Santos ◽  
Dalvani Marques ◽  
Fernanda Mota Rocha
Keyword(s):  
Qualitative Study ◽  
Nursing Care ◽  
Nursing Staff ◽  
Participant Observation ◽  
Collaborative Work ◽  
Health Inequities ◽  
Homeless Population ◽  
Structured Interviews ◽  
Nursing Team

Objective: to unveil the perceptions of the Street Clinic nursing staff about coping with vulnerabilities. Methods: qualitative study, carried out by means of participant observation of the team’s activities, recording in a field diary and semi-structured interviews with the nursing team, totaling 17 participants. Results: situations experienced by people living on the streets that deepen health inequities by violating rights were revealed. Among the nursing work tools, the potential of collaborative work, listening, and welcoming technologies stand out as mediators of a more humanized care. There is a need for specific strategies to guide nursing care on the streets. Conclusion: nursing has great potential for addressing the vulnerabilities of the homeless population using soft and soft-hard technologies.

scholarly journals ProACT - A Digital Platform to Support Self-Management of Multiple Chronic Conditions: Findings in Relation to Engagement during a one-year Proof-of-Concept Trial (Preprint)

2020 ◽  
Author(s):  
Julie Doyle ◽  
Emma Murphy ◽  
Shane Gavin ◽  
Alessandra Pascale ◽  
Stephane Deparis ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Digital Health ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
User Engagement ◽  
Proof Of Concept ◽  
Structured Interviews ◽  
Health Technologies ◽  
Care Approach

BACKGROUND Self-management, a core activity for older adults living with multiple chronic conditions (multimorbidity), is challenging, requiring the person to engage in multiple tasks such as symptom monitoring, recognition of exacerbations, medication adherence and inter-stakeholder communication. A digital, integrated care approach is a critical part of the solution, however, there is a dearth of literature on this topic. Furthermore, there is little research on older adults’ acceptability, usage and experiences of engaging with digital health technologies, particularly over long periods of time. OBJECTIVE The objectives were to (1) co-design and develop a digital health platform, called ProACT, to facilitate older adults self-managing multimorbidity, with support from their care network (CN); (2) evaluate end user engagement and experiences with the platform through a 12-month trial. METHODS The ProACT digital health platfrom is presented. The platform was evaluated in a year-long proof-of-concept (PoC) action research trial with 120 older persons with multimorbidity (PwMs) in Ireland and Belgium. Alongside the technology, participants had access to a clinical triage service responding to symptom alerts, and a technical helpdesk. Interactions with the platform during the PoC trial were logged to determine engagement, semi-structured interviews were conducted with participants and analysed using inductive thematic analysis methods, while usability and user burden were examined using validated questionnaires. RESULTS This article presents the ProACT platform and its components, along with findings on engagement with the platform and its usability. Of the 120 participants who took part, 24 withdrew before the end of the study while three passed away. The remaining 93 participants actively used the platform until the end of the trial, on average taking two or three health readings daily over the course of the trial, in Ireland and Belgium respectively. Participants reported ProACT to be usable and of low burden. Findings from interviews outline that participants experienced multiple benefits as a result of using ProACT, including improved self-management, improved health and wellbeing and support from the triage service. For those who withdrew, barriers to engagement were poor health and frustration when technology didn’t work as expected. CONCLUSIONS This is the first study to present findings from a longitudinal study of older adults using digital health technology to self-manage multiple chronic conditions. Our findings show that older adults sustained engagement with the technology and found it usable. Potential reasons for this include a strong focus on user-centred design and engagement throughout the project lifecycle, resulting in a platform that met user needs, as well as the integration of behavior change techniques and personal analytics into the platform. The provision of triage and technical support services alongside the platform during the trial were also important facilitators of engagement. INTERNATIONAL REGISTERED REPORT RR2-10.2196/preprints.22125

scholarly journals Age-Friendly as Tranquilo Ambiente: How Socio-Cultural Perspectives Shape Older Latinos’ Lived Environment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 237-238
Author(s):  
Melanie Plasencia
Keyword(s):  
Older Adults ◽  
New York ◽  
Social Connectedness ◽  
Participant Observation ◽  
Methodological Approach ◽  
Well Being ◽  
Cultural Significance ◽  
Structured Interviews ◽  
Latino Older Adults

Abstract Researchers have increasingly considered the importance of age-friendly communities to improve the health and well-being of older adults. Studies have primarily focused on the built environment, such as community infrastructure, older adult behavior, and environmental expectations. Less attention, however, has been given to the role of cultural characteristics in shaping perceptions of age-friendly environments for Latinos. Using an ethnographic methodological approach, including participant observation in a Latino community near New York City and 72 semi-structured interviews, this study provides empirical insights into how older Latinos characterize age-friendly communities. Latino older adults described their community as age-friendly using Tranquilo Ambiente (TA), which translates to a calm or peaceful environment. According to older adults, a TA possesses the following: 1) a sense of personal safety, including protection of their body, 2) ethnic, social connectedness, including networks with other Latinos and important social and cultural events; and 3) a comparative understanding of their communities treatment of seniors versus other geographical and spatial locations. While much has been written on the role of the built and social environment in developing and implementing age-friendly communities, more research on the cultural significance and understanding of place among marginalized older adults is necessary. TA and its characteristics demonstrate that cultivating an age-friendly setting requires adapting structures and services to promote Latino older adults' social and cultural support and engagement.

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