scholarly journals Most important factors for deciding rehabilitation provision for severe stroke survivors post hospital discharge: A study protocol for Best-Worst Scaling experiment (Preprint)

2020 ◽  
Author(s):  
Sushmita Mohapatra ◽  
Kei Long Cheung ◽  
Mickael Hiligsmann ◽  
Nana Anokye
Keyword(s):  
Decision Making ◽  
Hospital Discharge ◽  
Relative Weight ◽  
Hierarchical Bayes ◽  
Bayes Estimation ◽  
Stroke Survivors ◽  
Incentive Payment ◽  
Severe Stroke ◽  
Best Worst Scaling ◽  
Multidisciplinary Staff

UNSTRUCTURED Introduction: Objective decision-making is crucial to ensure adequate rehabilitation after stroke with optimal use of healthcare resources. Establishing the factors associated with making decisions concerning rehabilitation is important to guide clinical staff for making person-centred decisions for rehabilitation after severe stroke. In order to further validate the factors that impact decision-making, this study aims to identify the most important factors and their relative weight for decision making for rehabilitation concerning severe stroke survivors, post hospital discharge Methods and analysis: In this study, we will conduct a best-worst scaling (BWS) experiment, specifically a BWS object case. Fractional, efficient designs will be applied regards the survey design. Key multidisciplinary staff regularly involved in making decisions for rehabilitation in a stroke unit will be recruited to participate in an online BWS survey. Hierarchical Bayes estimation will be used as the main analysis method, with the best-worst count analysis as a secondary analysis. Ethics and dissemination Ethical approval for the study will be obtained from the College Research Ethics Committee (CREC) at Brunel University London. All participants will be provided with a participant information sheet with online consent before undertaking the survey, and there will be no incentive payment of any form to participants. Participants will remain anonymous throughout. No funding has been received for this study. Findings of the study will be presented in local, national and international platforms and published in peer reviewed journals. Published results will also be shared though various clinical forums for multidisciplinary staff, such as CAPHR and NIHR-CLHARC.

scholarly journals Most Important Factors for Deciding Rehabilitation Provision for Severe Stroke Survivors Post Hospital Discharge: A Study Protocol for a Best–Worst Scaling Experiment

2021 ◽  
Vol 4 (2) ◽  
pp. 27
Author(s):  
Sushmita Mohapatra ◽  
Kei-Long Cheung ◽  
Mickaël Hiligsmann ◽  
Nana Anokye
Keyword(s):  
Decision Making ◽  
Hospital Discharge ◽  
Clinical Decision Making ◽  
Survey Design ◽  
Secondary Analysis ◽  
Relative Weight ◽  
Hierarchical Bayes ◽  
Bayes Estimation ◽  
Severe Stroke ◽  
Best Worst Scaling

Efficient decision-making is crucial to ensure adequate rehabilitation with optimal use of healthcare resources. Establishing the factors associated with making decisions concerning rehabilitation provision is important to guide clinical staff towards person-centred decisions for rehabilitation after severe stroke. In this study we conduct a best–worst scaling (BWS) experiment to identify the most important factors and their relative weight of importance for deciding the type of ongoing rehabilitation services a person with severe stroke might receive post hospital discharge. Fractional, efficient designs are applied regarding the survey design. Key multidisciplinary staff regularly involved in making decisions for rehabilitation in a stroke unit will be recruited to participate in an online BWS survey. Hierarchical Bayes estimation will be used as the main analysis method, with the best–worst count analysis as a secondary analysis. The survey is currently being piloted prior to commencing the process of data collection. Results are expected by the end of September 2021. The research will add to the current literature on clinical decision-making in stroke rehabilitation. Findings will quantify the preferences of factors among key multi-disciplinary clinicians working in stroke units in the UK, involved in decision-making concerning rehabilitation after stroke.

MOST IMPORTANT BARRIERS AND FACILITATORS REGARDING THE USE OF HEALTH TECHNOLOGY ASSESSMENT

2017 ◽  
Vol 33 (2) ◽  
pp. 183-191 ◽  
Author(s):  
Kei Long Cheung ◽  
Silvia M.A.A. Evers ◽  
Hein de Vries ◽  
Mickaël Hiligsmann
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
National Level ◽  
Relative Weight ◽  
Health Technology ◽  
Hierarchical Bayes ◽  
Barriers And Facilitators ◽  
Policy Makers ◽  
Important Barrier

Objectives: Several studies have reported multiple barriers to and facilitators for the uptake of health technology assessment (HTA) information by policy makers. This study elicited, using best-worst scaling (BWS), the most important barriers and facilitators and their relative weight in the use of HTA by policy makers.Methods: Two BWS object case surveys (one for barriers, one for facilitators) were conducted among sixteen policy makers and thirty-three HTA experts in the Netherlands. A list of twenty-two barriers and nineteen facilitators was included. In each choice task, participants were asked to choose the most important and the least important barrier/facilitator from a set of five. We used Hierarchical Bayes modeling to generate the mean relative importance score (RIS) for each factor and a subgroup analysis was conducted to assess differences between policy makers and HTA experts.Results: The five most important barriers (RIS > 6.00) were “no explicit framework for decision-making process,” “insufficient support by stakeholders,” “lack of support,” “limited generalizability,” and “absence of appropriate incentives.” The six most important facilitators were: “availability of explicit framework for decision making,” “sufficient support by stakeholders,” “appropriate incentives,” “sufficient quality,” “sufficient awareness,” and “sufficient support within the organization.” Overall, perceptions did not differ markedly between policy makers and HTA experts.Conclusions: Our study suggests that barriers and facilitators related to “policy characteristics” and “organization and resources” were particularly important. It is important to stimulate a pulse at the national level to create an explicit framework for including HTA in the decision-making context.

Robust hierarchical Bayes estimation of exchangeable means

1991 ◽  
Vol 19 (1) ◽  
pp. 39-56 ◽  
Author(s):  
Jean-François Angers ◽  
James O. Berger
Keyword(s):  
Hierarchical Bayes ◽  
Bayes Estimation

Changes and predictors of psychological stress among elderly stroke survivors 6 months after hospital discharge

2017 ◽  
Vol 34 (3) ◽  
pp. 359-366 ◽  
Author(s):  
Emanuella Barros dos Santos ◽  
Rosalina Aparecida Partezani Rodrigues ◽  
Jack Roberto Silva Fhon ◽  
Vanderlei José Haas
Keyword(s):  
Hospital Discharge ◽  
Psychological Stress ◽  
Stroke Survivors

scholarly journals Impact of financial statements for financial decision-making

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Saddeq Abdulshakour
Keyword(s):  
Decision Making ◽  
Relative Weight ◽  
Financial Statements ◽  
Decision Makers ◽  
Financial Statement ◽  
Financial Decisions ◽  
Financial Decision Making ◽  
Vision 2030 ◽  
Study Population ◽  
Financial Decision

The study aimed to know the effects of analysis of financial statements on financial decisions, and the degree of benefit from them, and to identify what financial statements, what is its importance for the institutions within the framework of the Kingdom's Vision 2030 of ideas and trends, and to identify the contribution of financial statement analysis to financial decision-making. The study was based on the descriptive and analytical approach, and the study population consisted of all financial decision makers. The study was based on a simple random method (70) of financial decision makers. The study was based on the questionnaire and consisted of the following axes (financial statements in companies, financial decision-making, the effects of analysis of financial statements on financial decision-making). The study came out with a number of results, the most important of which are: There is approval by the respondents to all paragraphs of the first axis "financial statements in companies", with a relative weight of 82.8%. There is an agreement by the respondents on all paragraphs of the second axis "making financial decisions in companies", with a relative weight of 81.3%. There is strong approval by the respondents on all paragraphs of the third axis "the effects of analysis of financial statements on financial decision-making", with a relative weight of 86.4%. The financial statements are a key tool to know the financial position of the company, so they must be accurate and reliable before being published by management. The lack of credibility in the financial statements leads to mistrust in the company by investors, and does not give them the possibility to diagnose and make sound decisions. In light of the previous results, the study recommended the following: • Organizing several forums, conferences and forums to clarify the mechanism of preparing the financial statements and how to analyze them, and the need to raise awareness of financial decision makers about the importance of financial statements in the financial decision-making process.

Domiciliary Care Service: Factors Influencing Improvement in Activities of Daily Living Among Stroke Survivors

2019 ◽  
Vol 32 (1) ◽  
pp. 45-52
Author(s):  
Nur Raihan Ismail ◽  
Anees Abdul Hamid ◽  
Noor Aman Hamid
Keyword(s):  
Ischemic Stroke ◽  
Odds Ratio ◽  
Daily Living ◽  
Care Service ◽  
Stroke Survivors ◽  
Severe Stroke ◽  
Domiciliary Care ◽  
Factors Influencing ◽  
Home Based ◽  
Stroke Type

Stroke is a debilitating disease, adding to morbidity and mortality. Home-based rehabilitation has an influence on functional recovery among stroke survivors. This study aimed to determine factors influencing the improvement in activities of daily living (ADL) among stroke survivors after domiciliary care service. A state-wide record-review study using Domiciliary Care Record from health clinics with comprehensive domiciliary care was conducted. A logistic regression (LR) model was performed to assess factors influencing ADL improvement. Improved ADL was defined as obtaining at least 30% improvement on the Modified Barthel Index at the end of the program. From the records review, 72.2% of the participants had improved ADL following domiciliary care service. The mean age of the sample was 68.21 years ( SD = 11.99). The majority were ischemic stroke survivors (81.2%). In the single LR model, the influencing factors of ADL improvement were younger age (odds ratio [OR] = 2.76; p = .004), married (OR = 2.04; p = .018), ischemic stroke type (OR = 6.35; p < .001), less severe stroke (OR = 4.18; p < .001), no previous stroke (OR = 4.24; p < .001), and 9 to 12 home visits (OR = 2.79; p < .006). The multiple LR model showed ischemic stroke type (adjusted odds ratio [Adj. OR] = 5.30; p < .001), less severe stroke (Modified Rankin Scale score = 4; Adj. OR = 3.70; p < .001), and no previous stroke (Adj. OR = 3.51; p = .001) as significant factors when adjusted for other variables. Recognition of these factors associated with the improvement in stroke recovery is beneficial to intensify an optimal stroke care and home-based rehabilitation services.

scholarly journals Between Choice, Necessity, and Comfort: Deciding on Tube Feeding in the Acute Phase After a Severe Stroke

2020 ◽  
Vol 30 (7) ◽  
pp. 1114-1124
Author(s):  
Isabel Frey ◽  
Marike E. De Boer ◽  
Leonie Dronkert ◽  
A. Jeannette Pols ◽  
Marieke C. Visser ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Acute Phase ◽  
Participant Observation ◽  
Tube Feeding ◽  
Ethnographic Study ◽  
Sources Of Information ◽  
Severe Stroke ◽  
Stroke Units ◽  
Life Sustaining Treatment

This is an ethnographic study of decision-making concerning tube feeding in the acute phase after a severe stroke. It is based on 6 months of ethnographic research in three stroke units in the Netherlands, where the decision-making on life-sustaining treatment was studied in 16 cases of severe stroke patients. Data were collected through participant observation and interviews. For this article, the analysis was narrowed down to the decision whether or not the patient should receive tube feeding. The data on tube feeding were assembled and coded according to different modes of dealing with this decision in clinical practice, which we refer to as “repertoires.” We discerned three different repertoires: choice, necessity, and comfort. Each repertoire structures clinical practice differently: It implies distinctive ethical imperatives, central concerns, sources of information, and temporalities. We hope our findings can improve decision-making by uncovering its underlying logics in clinical practice.

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