Identifying Quality Indicators Used by Patients to Choose Secondary Health Care Providers: A Mixed Methods Approach

BACKGROUND Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)–based simulation, MPathic-VR, was developed to train health care providers in empathic communication with patients and in interprofessional settings and evaluated through a randomized controlled trial. OBJECTIVE This mixed methods study aimed to investigate the differential effects of a VH-based simulation developed to train health care providers in empathic patient-provider and interprofessional communication. METHODS We employed a mixed methods intervention design, involving a comparison of 2 quantitative measures—MPathic-VR–calculated scores and the objective structured clinical exam (OSCE) scores—with qualitative reflections by medical students about their experiences. This paper is a secondary, focused analysis of intervention arm data from the larger trial. Students at 3 medical schools in the United States (n=206) received simulation to improve empathic communication skills. We conducted analysis of variance, thematic text analysis, and merging mixed methods analysis. RESULTS OSCE scores were significantly improved for learners in the intervention group (mean 0.806, SD 0.201) compared with the control group (mean 0.752, SD 0.198; <italic>F</italic>1,414=6.09; <italic>P</italic>=.01). Qualitative analysis revealed 3 major positive themes for the MPathic-VR group learners: gaining useful communication skills, learning awareness of nonverbal skills in addition to verbal skills, and feeling motivated to learn more about communication. Finally, the results of the mixed methods analysis indicated that most of the variation between high, middle, and lower performers was noted about nonverbal behaviors. Medium and high OSCE scorers most often commented on the importance of nonverbal communication. Themes of motivation to learn about communication were only present in middle and high scorers. CONCLUSIONS VHs are a promising strategy for improving empathic communication in health care. Higher performers seemed most engaged to learn, particularly nonverbal skills.

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Improving Patient-Centredness in Endometriosis Care: A Study Protocol for a Prospective Study with a Mixed-Methods Approach

Gynecologic and Obstetric Investigation ◽

10.1159/000520495 ◽

2021 ◽

pp. 1-7

Author(s):

Anneke M.F. Schreurs ◽

Charlotte I. van Schaijik ◽

Bianca De Bie ◽

Jacques W.M. Maas ◽

Cornelis Lambalk ◽

...

Keyword(s):

Health Care ◽

Focus Groups ◽

Health Care Providers ◽

Study Protocol ◽

Care Providers ◽

Mixed Methods Approach ◽

Improvement Plan ◽

A Prospective Study ◽

Improve Patient ◽

Patient Centredness

Objective: Endometriosis is a chronic gynaecologic disease, causing pain and infertility. As there is no definitive cure, patients are subjected to long-term care. This study aimed to improve patient-centred endometriosis care. Patient-centredness of endometriosis care can be evaluated using the validated ENDOCARE questionnaire (ECQ), resulting in centre-specific targets for improvement. To understand how to tackle the targets for improvement as found by the ECQ, focus groups can be organized. Design: This protocol presents a prospective study with a mixed-methods approach to improve patient-centredness of endometriosis care. The study consists of 5 steps: (1) evaluating current patient-centredness of endometriosis care by using the ECQ, (2) understanding targets for improvement, (3) drafting an improvement plan, (4) implementing improvements, and (5) evaluating the improved patient-centredness of endometriosis care. The final evaluation will be performed 1.5 years after implementing the improvement plan. Methods: Patient-centredness will be evaluated using the ECQ by inviting women with endometriosis to participate (steps 1 and 5). To investigate step 2, focus groups will be organized. For these focus groups, women with endometriosis are asked to participate until data saturation is achieved. During focus groups, participants are motivated to discuss the found targets for improvement and stimulated to find ways to improve them. The drafting and implementing of the improvement plan (steps 3 and 4) will be organized with the help of health-care providers in close collaboration with the patient organization. To assess whether the implementation of the improvement plan was successful in improving endometriosis care, the results from the ECQ in step 5 will be compared to the results from the ECQ in step 1. Ethical approval was granted by the local Institutional Review Board (Ref 2018.438). Setting: The study was conducted in the university hospital in the Netherlands. Limitations: Both patients and health-care providers will be involved in drafting the improvement plan. By making the health-care providers responsible for improving care, the chance of succeeding is optimized. Whether this improvement strategy is successful will be investigated after the implementation of the improvement plan. The improvement plan is clinic specific and can possibly not be extrapolated to other endometriosis clinics. In order to aim to improve patient-centred endometriosis care elsewhere, the complete study protocol should be performed. Conclusions: This study protocol aimed to investigate focus groups as a strategy to identify possible interventions to improve patient-centred endometriosis care by investigating the underlying causes for poor performance on patient-centred care. This study protocol could be used in more endometriosis care centres in the future and might also be useful for improving patient-centredness in other chronic diseases.

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Management of antithrombotic therapy after gastrointestinal bleeding: A mixed methods study of health‐care providers

Journal of Thrombosis and Haemostasis ◽

10.1111/jth.15111 ◽

2020 ◽

Vol 19 (1) ◽

pp. 153-160

Author(s):

Derek H. W. Little ◽

Tara Robertson ◽

James Douketis ◽

Joanna C. Dionne ◽

Anne Holbrook ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Gastrointestinal Bleeding ◽

Health Care Providers ◽

Antithrombotic Therapy ◽

Mixed Methods Study ◽

Care Providers

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The paradox of compassionate work: a mixed-methods study of satisfying and fatiguing experiences of animal health care providers

Anxiety Stress & Coping ◽

10.1080/10615806.2017.1392224 ◽

2017 ◽

Vol 31 (2) ◽

pp. 228-243 ◽

Cited By ~ 3

Author(s):

Alicia J. Polachek ◽

Jean E. Wallace

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Animal Health ◽

Mixed Methods Study ◽

Care Providers

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Uptake challenges of intermittent preventive malaria therapy among pregnant women and their health care providers in the Upper West Region of Ghana: A mixed-methods study

Parasite Epidemiology and Control ◽

10.1016/j.parepi.2021.e00222 ◽

2021 ◽

Vol 15 ◽

pp. e00222

Author(s):

Frederick Dun-Dery ◽

Peter Meissner ◽

Claudia Beiersmann ◽

Naasegnibe Kuunibe ◽

Volker Winkler ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Pregnant Women ◽

Health Care Providers ◽

Mixed Methods Study ◽

Care Providers ◽

Malaria Therapy ◽

West Region

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An Exploratory Mixed Methods Study of Diabetes self-management in Blind Americans

Western Journal of Nursing Research ◽

10.1177/01939459211019421 ◽

2021 ◽

pp. 019394592110194

Author(s):

Nazanin Heydarian ◽

Allyson S. Hughes ◽

Osvaldo F. Morera

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Mixed Methods Study ◽

Self Management ◽

Diabetes Distress ◽

Management Support ◽

Care Providers ◽

Health Significance ◽

Coverage Policy

This study used mixed methods to investigate the experiences of 33 participants who are blind (PWB) and have diabetes in managing their diabetes, support (or lack thereof) from their health care providers, and diabetes distress as PWB. Participants most frequently reported barriers to check blood glucose (55%), maintaining a healthy diet (45%), and distress due to their intersectional status of having blindness and diabetes. Those who mentioned intersectional distress of managing diabetes as a PWB tended to be Braille illiterate and less likely to use mobility tools that are symbolic of blindness (e.g., white cane, guide dog). These results illuminate heterogenous characteristics of PWB with diabetes, an understudied population of public health significance, to be considered when setting priorities for diabetes self-management support and health care coverage policy.

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