scholarly journals One-to-One and Group-Based Teleconferencing for Falls Rehabilitation: Usability, Acceptability, and Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Helen Hawley-Hague ◽  
Carlo Tacconi ◽  
Sabato Mellone ◽  
Ellen Martinez ◽  
Lorenzo Chiari ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Public Involvement ◽  
Patient And Public Involvement ◽  
Feasibility Testing ◽  
One To One

BACKGROUND Falls have implications for the health of older adults. Strength and balance interventions significantly reduce the risk of falls; however, patients seldom perform the dose of exercise that is required based on evidence. Health professionals play an important role in supporting older adults as they perform and progress in their exercises. Teleconferencing could enable health professionals to support patients more frequently, which is important in exercise behavior. OBJECTIVE This study aims to examine the overall concept and acceptability of teleconferencing for the delivery of falls rehabilitation with health care professionals and older adults and to examine the usability, acceptability, and feasibility of teleconferencing delivery with health care professionals and patients. METHODS There were 2 stages to the research: patient and public involvement workshops and usability and feasibility testing. A total of 2 workshops were conducted, one with 5 health care professionals and the other with 8 older adults from a community strength and balance exercise group. For usability and feasibility testing, we tested teleconferencing both one-to-one and in small groups on a smartphone with one falls service and their patients for 3 weeks. Semistructured interviews and focus groups were used to explore acceptability, usability, and feasibility. Focus groups were conducted with the service that used teleconferencing with patients and 2 other services that received only a demonstration of how teleconferencing works. Qualitative data were analyzed using the framework approach. RESULTS In the workshops, the health care professionals thought that teleconferencing provided an opportunity to save travel time. Older adults thought that it could enable increased support. Safety is of key importance, and delivery needs to be carefully considered. Both older adults and health care professionals felt that it was important that technology did not eliminate face-to-face contact. There were concerns from older adults about the intrusiveness of technology. For the usability and feasibility testing, 7 patients and 3 health care professionals participated, with interviews conducted with 6 patients and a focus group with the health care team. Two additional teams (8 health professionals) took part in a demonstration and focus group. Barriers and facilitators were identified, with 5 barriers around reliability due to poor connectivity, cost of connectivity, safety concerns linked to positioning of equipment and connectivity, intrusiveness of technology, and resistance to group teleconferencing. Two facilitators focused on the positive benefits of increased support and monitoring and positive solutions for future improvements. CONCLUSIONS Teleconferencing as a way of delivering fall prevention interventions can be acceptable to older adults, patients, and health care professionals if it works effectively. Connectivity, where there is no Wi-Fi provision, is one of the largest issues. Therefore, local infrastructure needs to be improved. A larger usability study is required to establish whether better equipment for delivery improves usability. CLINICALTRIAL

scholarly journals One-to-One and Group-Based Teleconferencing for Falls Rehabilitation: Usability, Acceptability, and Feasibility Study

10.2196/19690 ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e19690
Author(s):  
Helen Hawley-Hague ◽  
Carlo Tacconi ◽  
Sabato Mellone ◽  
Ellen Martinez ◽  
Lorenzo Chiari ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Public Involvement ◽  
Patient And Public Involvement ◽  
Feasibility Testing ◽  
One To One

Background Falls have implications for the health of older adults. Strength and balance interventions significantly reduce the risk of falls; however, patients seldom perform the dose of exercise that is required based on evidence. Health professionals play an important role in supporting older adults as they perform and progress in their exercises. Teleconferencing could enable health professionals to support patients more frequently, which is important in exercise behavior. Objective This study aims to examine the overall concept and acceptability of teleconferencing for the delivery of falls rehabilitation with health care professionals and older adults and to examine the usability, acceptability, and feasibility of teleconferencing delivery with health care professionals and patients. Methods There were 2 stages to the research: patient and public involvement workshops and usability and feasibility testing. A total of 2 workshops were conducted, one with 5 health care professionals and the other with 8 older adults from a community strength and balance exercise group. For usability and feasibility testing, we tested teleconferencing both one-to-one and in small groups on a smartphone with one falls service and their patients for 3 weeks. Semistructured interviews and focus groups were used to explore acceptability, usability, and feasibility. Focus groups were conducted with the service that used teleconferencing with patients and 2 other services that received only a demonstration of how teleconferencing works. Qualitative data were analyzed using the framework approach. Results In the workshops, the health care professionals thought that teleconferencing provided an opportunity to save travel time. Older adults thought that it could enable increased support. Safety is of key importance, and delivery needs to be carefully considered. Both older adults and health care professionals felt that it was important that technology did not eliminate face-to-face contact. There were concerns from older adults about the intrusiveness of technology. For the usability and feasibility testing, 7 patients and 3 health care professionals participated, with interviews conducted with 6 patients and a focus group with the health care team. Two additional teams (8 health professionals) took part in a demonstration and focus group. Barriers and facilitators were identified, with 5 barriers around reliability due to poor connectivity, cost of connectivity, safety concerns linked to positioning of equipment and connectivity, intrusiveness of technology, and resistance to group teleconferencing. Two facilitators focused on the positive benefits of increased support and monitoring and positive solutions for future improvements. Conclusions Teleconferencing as a way of delivering fall prevention interventions can be acceptable to older adults, patients, and health care professionals if it works effectively. Connectivity, where there is no Wi-Fi provision, is one of the largest issues. Therefore, local infrastructure needs to be improved. A larger usability study is required to establish whether better equipment for delivery improves usability.

scholarly journals Two Approaches to Focus Group Data Collection for Qualitative Health Research

2018 ◽  
Vol 17 (1) ◽  
pp. 160940691775078 ◽  
Author(s):  
Rachel Flynn ◽  
Lauren Albrecht ◽  
Shannon D. Scott
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Data Collection ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Health Research ◽  
Qualitative Health Research ◽  
Group Data ◽  
Focus Group Data ◽  
Qualitative Focus Groups

This article discusses four challenges to conducting qualitative focus groups: (1) maximizing research budgets through innovative methodological approaches, (2) recruiting health-care professionals for qualitative health research, (3) conducting focus groups with health-care professionals across geographically dispersed areas, and (4) taking into consideration data richness when using different focus group data collection methods. In light of these challenges, we propose two alternative approaches for collecting focus group data: (a) extended period of quantitative data collection that facilitated relationship building in the sites prior to qualitative focus groups and (b) focus groups by videoconference. We share our experiences on employing both of these approaches in two national research programs.

scholarly journals The Views and Needs of People With Parkinson Disease Regarding Wearable Devices for Disease Monitoring: Mixed Methods Exploration (Preprint)

2021 ◽  
Author(s):  
Lorna Kenny ◽  
Kevin Moore ◽  
Clíona O' Riordan ◽  
Siobhan Fox ◽  
John Barton ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Parkinson Disease ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Technology Use ◽  
Wearable Devices ◽  
Wearable Device ◽  
Disease Monitoring ◽  
Perceived Benefits

BACKGROUND Wearable devices can diagnose, monitor, and manage neurological disorders such as Parkinson disease. With a growing number of wearable devices, it is no longer a case of whether a wearable device can measure Parkinson disease motor symptoms, but rather which features suit the user. Concurrent with continued device development, it is important to generate insights on the nuanced needs of the user in the modern era of wearable device capabilities. OBJECTIVE This study aims to understand the views and needs of people with Parkinson disease regarding wearable devices for disease monitoring and management. METHODS This study used a mixed method parallel design, wherein survey and focus groups were concurrently conducted with people living with Parkinson disease in Munster, Ireland. Surveys and focus group schedules were developed with input from people with Parkinson disease. The survey included questions about technology use, wearable device knowledge, and Likert items about potential device features and capabilities. The focus group participants were purposively sampled for variation in age (all were aged >50 years) and sex. The discussions concerned user priorities, perceived benefits of wearable devices, and preferred features. Simple descriptive statistics represented the survey data. The focus groups analyzed common themes using a qualitative thematic approach. The survey and focus group analyses occurred separately, and results were evaluated using a narrative approach. RESULTS Overall, 32 surveys were completed by individuals with Parkinson disease. Four semistructured focus groups were held with 24 people with Parkinson disease. Overall, the participants were positive about wearable devices and their perceived benefits in the management of symptoms, especially those of motor dexterity. Wearable devices should demonstrate clinical usefulness and be user-friendly and comfortable. Participants tended to see wearable devices mainly in providing data for health care professionals rather than providing feedback for themselves, although this was also important. Barriers to use included poor hand function, average technology confidence, and potential costs. It was felt that wearable device design that considered the user would ensure better compliance and adoption. CONCLUSIONS Wearable devices that allow remote monitoring and assessment could improve health care access for patients living remotely or are unable to travel. COVID-19 has increased the use of remotely delivered health care; therefore, future integration of technology with health care will be crucial. Wearable device designers should be aware of the variability in Parkinson disease symptoms and the unique needs of users. Special consideration should be given to Parkinson disease–related health barriers and the users’ confidence with technology. In this context, a user-centered design approach that includes people with Parkinson disease in the design of technology will likely be rewarded with improved user engagement and the adoption of and compliance with wearable devices, potentially leading to more accurate disease management, including self-management.

scholarly journals The Views and Needs of People With Parkinson Disease Regarding Wearable Devices for Disease Monitoring: Mixed Methods Exploration

10.2196/27418 ◽  
2022 ◽  
Vol 6 (1) ◽  
pp. e27418
Author(s):  
Lorna Kenny ◽  
Kevin Moore ◽  
Clíona O' Riordan ◽  
Siobhan Fox ◽  
John Barton ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Parkinson Disease ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Technology Use ◽  
Wearable Devices ◽  
Wearable Device ◽  
Disease Monitoring ◽  
Perceived Benefits

Background Wearable devices can diagnose, monitor, and manage neurological disorders such as Parkinson disease. With a growing number of wearable devices, it is no longer a case of whether a wearable device can measure Parkinson disease motor symptoms, but rather which features suit the user. Concurrent with continued device development, it is important to generate insights on the nuanced needs of the user in the modern era of wearable device capabilities. Objective This study aims to understand the views and needs of people with Parkinson disease regarding wearable devices for disease monitoring and management. Methods This study used a mixed method parallel design, wherein survey and focus groups were concurrently conducted with people living with Parkinson disease in Munster, Ireland. Surveys and focus group schedules were developed with input from people with Parkinson disease. The survey included questions about technology use, wearable device knowledge, and Likert items about potential device features and capabilities. The focus group participants were purposively sampled for variation in age (all were aged >50 years) and sex. The discussions concerned user priorities, perceived benefits of wearable devices, and preferred features. Simple descriptive statistics represented the survey data. The focus groups analyzed common themes using a qualitative thematic approach. The survey and focus group analyses occurred separately, and results were evaluated using a narrative approach. Results Overall, 32 surveys were completed by individuals with Parkinson disease. Four semistructured focus groups were held with 24 people with Parkinson disease. Overall, the participants were positive about wearable devices and their perceived benefits in the management of symptoms, especially those of motor dexterity. Wearable devices should demonstrate clinical usefulness and be user-friendly and comfortable. Participants tended to see wearable devices mainly in providing data for health care professionals rather than providing feedback for themselves, although this was also important. Barriers to use included poor hand function, average technology confidence, and potential costs. It was felt that wearable device design that considered the user would ensure better compliance and adoption. Conclusions Wearable devices that allow remote monitoring and assessment could improve health care access for patients living remotely or are unable to travel. COVID-19 has increased the use of remotely delivered health care; therefore, future integration of technology with health care will be crucial. Wearable device designers should be aware of the variability in Parkinson disease symptoms and the unique needs of users. Special consideration should be given to Parkinson disease–related health barriers and the users’ confidence with technology. In this context, a user-centered design approach that includes people with Parkinson disease in the design of technology will likely be rewarded with improved user engagement and the adoption of and compliance with wearable devices, potentially leading to more accurate disease management, including self-management.

scholarly journals Why Do People Undergo THR and What Do They Expect to Gain—A Comparison of the Views of Patients and Health Care Professionals

2020 ◽  
Vol 7 (6) ◽  
pp. 1778-1787
Author(s):  
Shayan Bahadori ◽  
Sarah Collard ◽  
Jonathan Mark Williams ◽  
Ian Swain
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Public Involvement ◽  
Well Being ◽  
Patient And Public Involvement ◽  
Future Research ◽  
Activity Monitors ◽  
Dog Walking ◽  
Future Research Project

Little concerted effort has been made to understand why individuals undergo total hip replacement (THR) surgery and their rehabilitation goals. Similarly, insight of views and perspective of health care professionals’ (HCPs) regarding surgery and what objective measures help them with decision-making is lacking. This patient and public involvement report aimed to explore both patients’ and HCPs’ perspectives of THR surgery. Twenty patients, 10 pre-THR, 10 post-THR, 9 physiotherapists, and 6 surgeons took part. Results suggest a consensus among patients and HCPs on pain reduction being the main reason for undergoing THR. The inability to carry out simple daily activities such as dog walking and sleep deprivation had a significant effect on patients’ mental and physical well-being. This article is the first to explore the views of THR patients and HCPs on reasons behind THR surgery amalgamated into a single report. As walking is important, wearable activity monitors are suggested as a possible motivator to enhance patient compliance to self-care rehabilitation and increase quality of life. A future research project on the use of such wearable activity monitors in enhancing mobility post-THR is therefore planned.

Needs and Interest Analysis of Health Professional Clinical Skills Needed Address Patient Vaping/E-Cigarette Use Using Survey and Focus Groups (Preprint)

2021 ◽  
Author(s):  
Mary Metcalf ◽  
Karen Rossie ◽  
Katie Sokes ◽  
Bradley Tanner
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Professional ◽  
Health Effects ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Clinical Skills ◽  
Skills Training ◽  
Cigarette Use ◽  
Wide Range

BACKGROUND The growth of e-cigarette devices, after their initial promotion as safer alternatives to traditional cigarettes, brought about a disturbing trend of youth vaping. Vaping by youth increased recent years and peaking in 2019 with 27.5% of high school students vaping [1–3]. Daily vaping declined for youths the next year by 7 to 9%, but over 3.6 million youths still reported current vaping in a national survey(Miech et. Al, 2020). For adults, vaping devices were often used as treatment alternatives for smoking cessation instead of FDA-approved options[4]. Health professional training and skills development is needed to prevent and address patient vaping and e-cigarette use. OBJECTIVE Develop an understanding of training needs that would help a wide range of health professionals prevent and address vaping and e-cigarette use by their patients. The ultimate goal was to develop online training for health providers focused on vaping/e-cigarette cessation, in a continuing education/continuing medical education format. METHODS We conducted an extensive literature review focused on aspects of vaping/e-cigarette relevant to clinical care. Using the review and our experience as educators on substance abuse, we created an online survey about clinical skills needed in the area of vaping and e-cigarettes, which was completed by two groups of health professionals: 1)self-identified experts on vaping and 2)practicing health professionals who did not self-identify as having expertise. Additionally, we conducted a focus group of clinical staff at an in-patient psychiatric hospital. Finally, we solicited feedback from addiction cessation educators. RESULTS Health professional participants showed a strong interest in the training topics. The top 3 topics of interest were: • Recommended treatments for patients who vape or use e-cigarettes. • How to evaluate and treat health effects in patients who vape or use e-cigarettes. • How to provide brief interventions for patients who vape THC. Interestingly, area of expertise or medical specialty influenced opinion of topic importance. For example, self-identified experts more strongly supported the need for prevention strategies in comparison to other health care professionals. In contrast, health care professionals were far more interested in the “health effects of second-hand vaping” than were the experts. In addition, focus group of in-patient medical staff were more interested in the outcomes of EVALI and the pharmacology of THC than were the other groups. CONCLUSIONS The needs analysis results support interest in clinical skills training related to vaping cessation by health professionals, and provide specific guidance on which topics are most needed. Health professional education on vaping is needed, wanted, and area of practice impacts topic interest significantly.

P–503 Focus groups with health care professionals, patient advocates and patients to explore how the potential need for multiple cycles is managed during fertility treatment consultations

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Harrison ◽  
J Boivin ◽  
G Sofia
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Treatment Failure ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Framework Analysis ◽  
Single Cycle ◽  
Cycle Basis ◽  
Patient Advocates ◽  
Multiple Cycles

Abstract Study question How is possibility of failure and potential need for multiple cycles discussed with patients during the first or repeat IVF/ICSI treatment consultation? Summary answer Health Care Professionals plan treatment on a cycle-by-cycle basis because it is the normative way to plan treatment, but patients see advantages in multi-cycle planning. What is known already Many patients need more than one round of IVF/ICSI stimulation to achieve their parenthood goals. A recent study has found around 60% of patients to be willing to plan for multiple cycles of treatment. However, it is not clear how patients are informed fully about the high possibility of treatment failure and the subsequent need for multiple cycles during their treatment planning consultations. Study design, size, duration Qualitative focus groups with health care professionals (HCP) patient advocates (April 2020) and patients (July and August 2020, respectively). Patients were eligible if they had had a consultation to start a first/repeat stimulated IVF/ICSI cycle in the eight weeks prior to participation, were aged 18 or older (upper age limit of 42 years for women) and fluent in English. Eligible Health HCPs and patient advocates were those employed at a fertility clinic or charity, respectively. Participants/materials, setting, methods HCP, patient advocate and patient focus group topic guides started with general questions about fertility consultations and progressed to discuss if and how the possibility of treatment failure and need for multiple cycles was introduced and discussed, and then preferences regarding planning IVF/ICSI on a multi-cycle rather than a single cycle basis. Focus groups were recorded, transcribed and analysed using framework analysis which allowed examination of shared, unique and incongruent thematic content across participant groups. Main results and the role of chance Twelve HCPs, 2 patient advocates and 11 patients participated in seven semi-structured online focus group discussions. Framework analysis revealed 52 codes (e.g., possibility of failure tentatively introduced; discussion of multiple cycles dependent on clinical/patient benchmarks) abstracted into 17 higher-level categories (e.g., Failure is a sensitive topic to approach; IVF treatment failure is the norm). Synthesis of categories revealed four themes and one meta theme The meta theme showed planning treatment on a cycle-by-cycle basis was the norm. This meta-theme was supported by four themes: (1) ‘culture of communication’ that dictated benchmarks (e.g., clinic, national live birth rate) and definition of key concepts (’complete’ cycle) that underpinned divergence between clinics; (2) ‘HCP-patient dynamics’ indexing degree of shared decision-making, advance preparation and involvement of partners in planning; (3) ‘tempering optimism’ that described tailoring, balancing and emotion management in giving personal chances of success; and (4) ‘transitioning to multi-cycle planning’ which identified worries of multi-cycle planning (e.g., need to learn from failure). Limitations, reasons for caution The majority of patients were women from private fertility clinics with no previous treatment experience recruited from social media websites, mainly associated with patient support groups. Similarly, the majority of HCPs were women from private fertility clinics. Informative comparisons across treatment stage, gender and funding source were therefore not possible. Wider implications of the findings: HCPs are hesitant towards multi-cycle planning. However, patients show openness, suggesting a cultural shift from the single cycle norm of planning IVF/ICSI may be possible. If adopted by clinics, HCPs patients and fertility organisations, multi-cycle planning could encourage patients to create informed treatment expectations and plans prior to treatment engagemen. Trial registration number MS200059_001

scholarly journals The Perception of Health Care Professionals and Managers about Resource Allocation in Primary Health Care in Minas Gerais State Municipalities

2021 ◽  
Vol 28 (98) ◽  
pp. 519-548
Author(s):  
Lucas Maia dos Santos ◽  
Márcio Augusto Gonçalves
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Primary Health Care ◽  
Focus Groups ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Field Research ◽  
Minas Gerais ◽  
Primary Health ◽  
Minas Gerais State

Abstract This study aimed to examine and describe the perceptions of health professionals and managers about the main phenomena that influence resource allocation in primary health care. Adopting a qualitative approach, the field research was carried out in ten municipalities in Minas Gerais and involved eleven focus groups, six interviews and two semi-structured questionnaires in 2014 and 2015, and nine focus groups and five interviews in 2018, in which participated a total of 133 health professionals and managers. Other sources of evidence were also included, such as non-participating observations, photographs and documents from the Minas Gerais State Health Secretariat and the Ministry of Health. Based on the content analysis, eight categories of phenomena that influence resource allocation in PHC were obtained, derived from daily interactions between the population and health professionals and managers. Our findings show that primary health care is in a process of institutional change, dependent on the validity of actors and institutions, at different institutional levels. Among the determining factors affecting resource allocation in PHC, the main ones are the agency of the actors involved, the health service flow, the private sector, the medical corporatism, the influence of politicians, the municipal management capability, the infrastructure and groups of specific individuals.

scholarly journals Mobile Health Adoption in Mental Health: User Experience of a Mobile Health App for Patients With an Eating Disorder (Preprint)

2018 ◽  
Author(s):  
Dimitra Anastasiadou ◽  
Frans Folkvord ◽  
Eduardo Serrano-Troncoso ◽  
Francisco Lupiañez-Villanueva
Keyword(s):  
Health Care ◽  
Eating Disorder ◽  
Focus Group ◽  
Health Care Providers ◽  
Mobile Health ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Daily Practice ◽  
Care Providers ◽  
The Web

BACKGROUND Despite the worldwide growth in mobile health (mHealth) tools and the possible benefits for both patients and health care providers, the overall adoption levels of mHealth tools by health professionals remain relatively low. OBJECTIVE This study aimed (1) to investigate attitudes of health care providers and mHealth experts toward mHealth tools in the health context in general, and this study aimed (2) to test the acceptability and feasibility of a specific mHealth tool for patients with an eating disorder (ED), called TCApp, among patients and ED specialists. METHODS To this purpose, we conducted an explorative qualitative study with 4 in-depth group discussions with several groups of stakeholders: our first focus group was conducted with 11 experts on mHealth from the Catalan Association of Health Entities; the second focus group included 10 health care professionals from the Spanish College of Doctors of Barcelona; the third focus group involved 9 patients with an ED who had used the TCApp over a 12-week period, and the fourth and last focus group involved 8 ED specialists who had monitored such ED patients on the Web. RESULTS The focus groups showed that health care providers and mHealth experts reported barriers for mHealth adoption more often than facilitators, indicating that mHealth techniques are difficult to obtain and use. Most barriers were attributed to external factors relating to the human or organizational environment (ie, lack of time because of workload, lack of direct interest on a legislative or political level) rather than being attributed to internal factors relating to individual obstacles. The results of the mHealth intervention study indicate that the TCApp was considered as easy to use and useful, although patients and the ED specialists monitoring them on the Web reported different adoption problems, such as the inability to personalize the app, a lack of motivational and interactive components, or difficulties in adhering to the study protocol. CONCLUSIONS In general, this paper indicates that both health professionals and patients foresee difficulties that need to be addressed before comprehensive adoption and usage of mHealth techniques can be effectively implemented. Such findings are in line with previous studies, suggesting that although they acknowledge their possible benefits and cost-effectiveness, health care providers are quite resistant and conservative about integrating mHealth technologies in their daily practice.

P-503 Focus groups with health care professionals, patient advocates and patients to explore how the potential need for multiple cycles is managed during fertility treatment consultations

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Harrison ◽  
J Boivin ◽  
G Sofia
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Treatment Failure ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Framework Analysis ◽  
Single Cycle ◽  
Cycle Basis ◽  
Patient Advocates ◽  
Multiple Cycles

Abstract Study question How is possibility of failure and potential need for multiple cycles discussed with patients during the first or repeat IVF/ICSI treatment consultation? Summary answer Health Care Professionals plan treatment on a cycle-by-cycle basis because it is the normative way to plan treatment, but patients see advantages in multi-cycle planning What is known already Many patients need more than one round of IVF/ICSI stimulation to achieve their parenthood goals. A recent study has found around 60% of patients to be willing to plan for multiple cycles of treatment. However, it is not clear how patients are informed fully about the high possibility of treatment failure and the subsequent need for multiple cycles during their treatment planning consultations Study design, size, duration Qualitative focus groups with health care professionals (HCP) patient advocates (April 2020) and patients (July and August 2020, respectively). Patients were eligible if they had had a consultation to start a first/repeat stimulated IVF/ICSI cycle in the eight weeks prior to participation, were aged 18 or older (upper age limit of 42 years for women) and fluent in English. Eligible Health HCPs and patient advocates were those employed at a fertility clinic or charity, respectively Participants/materials, setting, methods HCP, patient advocate and patient focus group topic guides started with general questions about fertility consultations and progressed to discuss if and how the possibility of treatment failure and need for multiple cycles was introduced and discussed, and then preferences regarding planning IVF/ICSI on a multi-cycle rather than a single cycle basis. Focus groups were recorded, transcribed and analysed using framework analysis which allowed examination of shared, unique and incongruent thematic content across participant groups Main results and the role of chance Twelve HCPs, 2 patient advocates and 11 patients participated in seven semi-structured online focus group discussions. Framework analysis revealed 52 codes (e.g., possibility of failure tentatively introduced; discussion of multiple cycles dependent on clinical/patient benchmarks) abstracted into 17 higher-level categories (e.g., Failure is a sensitive topic to approach; IVF treatment failure is the norm). Synthesis of categories revealed four themes and one meta theme The meta theme showed planning treatment on a cycle-by-cycle basis was the norm. This meta-theme was supported by four themes: (1) ‘culture of communication’ that dictated benchmarks (e.g., clinic, national live birth rate) and definition of key concepts (‘complete’ cycle) that underpinned divergence between clinics; (2) ‘HCP-patient dynamics’ indexing degree of shared decision-making, advance preparation and involvement of partners in planning; (3) ‘tempering optimism’ that described tailoring, balancing and emotion management in giving personal chances of success; and (4) ‘transitioning to multi-cycle planning’ which identified worries of multi-cycle planning (e.g., need to learn from failure). Limitations, reasons for caution The majority of patients were women from private fertility clinics with no previous treatment experience recruited from social media websites, mainly associated with patient support groups. Similarly, the majority of HCPs were women from private fertility clinics. Informative comparisons across treatment stage, gender and funding source were therefore not possible Wider implications of the findings HCPs are hesitant towards multi-cycle planning. However, patients show openness, suggesting a cultural shift from the single cycle norm of planning IVF/ICSI may be possible. If adopted by clinics, HCPs patients and fertility organisations, multi-cycle planning could encourage patients to create informed treatment expectations and plans prior to treatment engagement Trial registration number MS200059_001

Sign in / Sign up

Export Citation Format

Share Document