scholarly journals Patient experiences of using skin self-monitoring apps with people at higher risk of melanoma: a qualitative study (Preprint)

2020 ◽  
Author(s):  
Emily Habgood ◽  
Christopher McCormack ◽  
Fiona M Walter ◽  
Jon D Emery
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Early Detection ◽  
Secondary Care ◽  
Mobile Apps ◽  
Healthcare Providers ◽  
Structured Interview ◽  
Self Monitoring ◽  
Increased Risk ◽  
Data Saturation

BACKGROUND Melanoma is the 4th most commonly diagnosed cancer in Australia. Up to 75% of melanomas are first detected by patients or their family/friends. Many mobile apps for melanoma exist, including apps to encourage skin self-monitoring (SSM) to improve the likelihood of early detection. Previous research in this area has focused on their development, diagnostic accuracy, or validation. Little is known about patients’ views and experiences of using these apps. OBJECTIVE This study aims to understand patients’ views and experiences of using commercially available melanoma SSM mobile apps for a period of three months. METHODS This qualitative study was conducted in two populations: primary care (where the MelatoolsQ tool was used to identify patients who were at increased risk of melanoma) and in secondary care (where patients had a previous diagnosis of melanoma, stages 0-3a). Participants downloaded two of four mobile apps for SSM (SkinVision, UMSkinCheck, Mole Monitor or MySkinPal) and were encouraged to use them for three months. After three months, a semi-structured interview was conducted with participants to discuss their experiences of using the SSM mobile apps. RESULTS Fifty-four participants were recruited into the study with 20 (37%) from primary care and 34 (62%) from secondary care. Interviews were conducted with 34 participants when data saturation was reached. Most participants didn’t use the apps at all (n=12) or tried them once but didn’t continue (n=14). Only eight participants used the apps to assist with SSM for the whole duration of the study. Patients discussed the apps in the context of the importance of early detection and their current SSM behaviours. A range of features of ‘perceived quality’ of each app affected engagement to support SSM. Participants described their SSM routines and potential mismatch with the app reminders. They also described technical and practical difficulties experienced using the apps for SSM. The app’s positioning within existing relationships with healthcare providers was crucial to understand use of the apps. CONCLUSIONS This study of patients at increased risk of melanoma highlights several barriers to engagement with apps to support SSM. The results highlight the wide ranging and dynamic influences on engagement with mobile apps, which extend beyond app design and relate to broader contextual factors about SSM routines and relationships with healthcare providers.

scholarly journals Professional resilience in GPs working in areas of socioeconomic deprivation: a qualitative study in primary care

2018 ◽  
Vol 68 (677) ◽  
pp. e819-e825 ◽  
Author(s):  
Eleanor Eley ◽  
Ben Jackson ◽  
Chris Burton ◽  
Elizabeth Walton
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Personal Characteristic ◽  
Socioeconomic Deprivation ◽  
Individual Level ◽  
Trade Offs ◽  
Increased Risk ◽  
Framework Approach ◽  
Data Saturation ◽  
The Individual

BackgroundGPs working in areas of high socioeconomic deprivation face particular challenges, and are at increased risk of professional burnout. Understanding how GPs working in such areas perceive professional resilience is important in order to recruit and retain a GP workforce in these areas.AimTo understand how GPs working in areas of high socioeconomic deprivation consider professional resilience.Design and settingA qualitative study of GPs practising in deprived areas within one primary care region of England.MethodIn total, 14 individual interviews and one focus group of eight participants were undertaken, with sampling to data saturation. A framework approach was used for data analysis.ResultsParticipants described three key themes relating to resilience. First, resilience was seen as involving flexibility and adaptability. This involved making trade-offs in order to keep going, even if this was imperfect. Second, resilience was enacted through teams rather than through individual strength. Third, resilience required the integration of personal and professional values rather than keeping the two separate. This dynamic adaptive view, with an emphasis on the importance of individuals within teams rather than in isolation, contrasts with the discourse of resilience as a personal characteristic, which should be strengthened at the individual level.ConclusionProfessional resilience is about more than individual strength. Policies to promote professional resilience, particularly in settings such as areas of high socioeconomic deprivation, must recognise the importance of flexibility, adaptability, working as teams, and successful integration between work and personal values.

scholarly journals Reducing risk of type 2 diabetes after gestational diabetes: a qualitative study to explore the potential of technology in primary care

2018 ◽  
Vol 68 (669) ◽  
pp. e260-e267 ◽  
Author(s):  
Brian McMillan ◽  
Katherine Easton ◽  
Elizabeth Goyder ◽  
Brigitte Delaney ◽  
Priya Madhuvrata ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
Secondary Care ◽  
Future Research ◽  
Increased Risk ◽  
Risk Of Progression

BackgroundDespite the seven-fold increased risk of type 2 diabetes mellitus (T2DM) among females previously diagnosed with gestational diabetes (GD), annual rates of follow-up in primary care are low. There is a need to consider how to reduce the incidence of progression to T2DM among this high-risk group.AimTo examine the views of females diagnosed with GD to ascertain how to improve primary care support postnatally, and the potential role of technology in reducing the risk of progression to T2DM.Design and settingA qualitative study of a purposive sample of 27 postnatal females leaving secondary care with a recent diagnosis of GD.MethodSemi-structured interviews were conducted with 27 females, who had been previously diagnosed with GD, at around 6–12 weeks postnatally. Interviews were audiotaped, transcribed, and analysed thematically.ResultsFacilitators and barriers to engaging in a healthy postnatal lifestyle were identified, the most dominant being competing demands on time. Although females were generally satisfied with the secondary care they received antenatally, they felt abandoned postnatally and were uncertain what to expect from their GP in terms of follow-up and support. Females felt postnatal care could be improved by greater clarity regarding this, and enhanced by peer support, multidisciplinary input, and subsidised facilities. Technology was seen as a potential adjunct by providing information, enabling flexible and personalised self-management, and facilitating social support.ConclusionA more tailored approach for females previously diagnosed with GD may help reduce the risk of progression to T2DM. A need for future research to test the efficacy of using technology as an adjunct to current care was identified.

scholarly journals White lie during patient care: A qualitative study of nurses’ perspectives

2020 ◽  
Author(s):  
Alireza Nikbakht nasrabadi ◽  
soodabeh joolaee ◽  
Elham Navab ◽  
Maryam esmaeilie ◽  
mahboobe shali
Keyword(s):  
Qualitative Study ◽  
Patient Care ◽  
Healthcare Providers ◽  
Cultural Knowledge ◽  
Hospital Nurses ◽  
Structured Interviews ◽  
Related Factors ◽  
Patient’S Rights ◽  
Wide Range ◽  
Data Saturation

Abstract Background: Keeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell “white lie” instead. This study aimed to explore the nurses’ experience of white lies during patient care. Methods: This qualitative study was conducted from June to December 2018. Eighteen hospital nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach. Results: The data analysis in this study resulted in four main categories and eleven subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competences. Conclusion: Results of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care.

scholarly journals The views of public and clinician stakeholders on risk assessment tools for post-stroke dementia: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025586 ◽  
Author(s):  
Eugene Tang ◽  
Catherine Exley ◽  
Christopher Price ◽  
Blossom Stephan ◽  
Louise Robinson
Keyword(s):  
Risk Assessment ◽  
Qualitative Study ◽  
Secondary Care ◽  
Assessment Tools ◽  
Stroke Patients ◽  
Post Stroke ◽  
North East ◽  
Increased Risk ◽  
Diagnosis Of Dementia

ObjectiveStroke-survivors are at increased risk of future dementia. Assessment to identify those at high risk of developing a disease using predictive scores has been utilised in different areas of medicine. A number of risk assessment scores for dementia have been developed but none has been recommended for use clinically. The aim of this qualitative study was to assess the acceptability and feasibility of using a risk assessment tool to predict post-stroke dementia.DesignQualitative semi-structured interviews were conducted and analysed thematically. The patients and carers were offered interviews at around 6 (baseline) and 12 (follow-up) months post-stroke; clinicians were interviewed once.SettingThe study was conducted in the North-East of England with stroke patients, family carers and healthcare professionals in primary and secondary care.ParticipantsThirty-nine interviews were conducted (17 clinicians and 15 stroke patients and their carers at baseline. Twelve stroke patients and their carers were interviewed at follow-up, some interviews were conducted in pairs).ResultsBarriers and facilitators to risk assessment were discussed. For the patients and carers the focus for facilitators were based on the outcomes of risk assessment for example assistance with preparation, diagnosis and for reassurance. For clinicians, facilitators were focused on the process that is, familiarity in primary care, resource availability in secondary care and collaborative care. For barriers, both groups focused on the outcome including for example, the anxiety generated from a potential diagnosis of dementia. For the patients/carers a further barrier included concerns about how it may affect their recovery. For clinicians there were concerns about limited interventions and how it would be different from standard care.ConclusionsRisk assessment for dementia post-stroke presents challenges given the ramifications of a potential diagnosis of dementia. Attention needs to be given to how information is communicated and strategies developed to support the patients and carers if risk assessment is used.

scholarly journals Dementia case-finding in hospitals: a qualitative study exploring the views of healthcare professionals in English primary care and secondary care

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020521 ◽  
Author(s):  
Anne-Marie Burn ◽  
Jane Fleming ◽  
Carol Brayne ◽  
Chris Fox ◽  
Frances Bunn
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Secondary Care ◽  
Healthcare Professionals ◽  
Hospital Staff ◽  
Case Finding ◽  
Care Staff ◽  
Dementia Case ◽  
Primary Care Staff ◽  
Views Of Healthcare Professionals

ObjectivesIn 2012–2013, the English National Health Service mandated hospitals to conduct systematic case-finding of people with dementia among older people with unplanned admissions. The method was not defined. The aim of this study was to understand current approaches to dementia case-finding in acute hospitals in England and explore the views of healthcare professionals on perceived benefits and challenges.DesignQualitative study involving interviews, focus groups and thematic content analysis.SettingPrimary care and secondary care across six counties in the East of England.ParticipantsHospital staff involved in dementia case-finding and primary care staff in the catchment areas of those hospitals.ResultsWe recruited 23 hospital staff and 36 primary care staff, including 30 general practitioners (GPs). Analysis resulted in three themes: (1) lack of consistent approaches in case-finding processes, (2) barriers between primary care and secondary care which impact on case-finding outcomes and (3) perceptions of rationale, aims and impacts of case-finding. The study shows that there were variations in how well hospitals recorded and reported outcomes to GPs. Barriers between primary care and secondary care, including GPs’ lack of access to hospital investigations and lack of clarity about roles and responsibilities, impacted case-finding outcomes. Staff in secondary care were more positive about the initiative than primary care staff, and there were conflicting priorities for primary care and secondary care regarding case-finding.ConclusionsThe study suggests a more evidence-based approach was needed to justify approaches to dementia case-finding. Information communicated to primary care from hospitals needs to be comprehensive, appropriate and consistent before GPs can effectively plan further investigation, treatment or care. Follow-up in primary care further requires access to options for postdiagnostic support. There is a need to evaluate the outcomes for patients and the economic impact on health and care services across settings.

scholarly journals Patient self-monitoring of blood pressure and self-titration of medication in primary care: the TASMINH2 trial qualitative study of health professionals’ experiences

2013 ◽  
Vol 63 (611) ◽  
pp. e378-e385 ◽  
Author(s):  
Miren I Jones ◽  
Sheila M Greenfield ◽  
Emma P Bray ◽  
FD Richard Hobbs ◽  
Roger Holder ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Qualitative Study ◽  
Health Professionals ◽  
Self Monitoring

scholarly journals Exploration of the Pregnant Women's Experiences During COVID-19 Disease Crisis: A Qualitative Study

2020 ◽  
Author(s):  
Fatemeh Bakouei ◽  
Maryam Nikpour ◽  
Hajar Adib Rad ◽  
zahra abadi marzoni
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Healthcare Providers ◽  
Pregnancy Care ◽  
Women’S Experiences ◽  
Individual Interviews ◽  
Women's Experiences ◽  
Data Saturation ◽  
North Of Iran ◽  
And Control

Abstract Background: Prevention and control of COVID-19 disease in pregnant women has become a major concern. Healthcare providers should be aware that restriction of the routine prenatal care may have adverse effects. A qualitative approach can be helpful in understanding the pregnant women's experience and perspective in crisis. The study was conducted to explain the pregnant women's experiences during COVID-19 disease crisis.Methods: The qualitative study was conducted with conventional content analysis. Pregnant women selected with purposive sampling from six urban health centers in Babol (North of Iran). The semi structured individual interviews were done by telephone from May 03 to June 10, 2020. The systematic thematic analysis was used to identify and organize themes into clusters and categories across interviews.Result: We recruited twelve pregnant women until data saturation. Three theme categories extracted from data analysis. The first was "unpleasant feelings during pregnancy", the pregnant women stated feelings in this crisis such as worry, fear, obsession, boredom, nervousness, discouragement, and the like, which led them to have no positive pregnancy experience. The second category was "adjusted lifestyle". They experienced changes in lifestyle with the aim of preventing COVID-19 disease. The third category was “safe pregnancy care”. The pregnant women, while paying attention to the importance of pregnancy care, were forced to limit, delay, or modify some cares in order to be safe. Conclusion: The pregnant women experienced unpleasant feelings in this crisis; therefore, they should receive the necessary consulting to maintain mental health. All pregnant women reported some changes in their lifestyle and pregnancy care in order to health considerations to prevent the disease. Regular training for all pregnant women is necessary to manage this important pregnancy period while maintaining the maternal and fetal health in crisis.

scholarly journals Peripheral arterial disease diagnosis and management in primary care: a qualitative study

BJGP Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. bjgpopen19X101659 ◽  
Author(s):  
Jan Lecouturier ◽  
Jason Scott ◽  
Nikki Rousseau ◽  
Gerard Stansby ◽  
Andrew Sims ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Disease Diagnosis ◽  
Diagnosis And Management ◽  
Increased Risk ◽  
Peripheral Arterial ◽  
The Impact

BackgroundPatients diagnosed with peripheral arterial disease (PAD) are at an increased risk of coronary heart disease, stroke, heart attack, and PAD progression. If diagnosed early, cardiovascular risk factors can be treated and the risk of other cardiovascular diseases can be reduced. There are clear guidelines on PAD diagnosis and management, but little is known about the issues faced in primary care with regards adherence to these, and about the impact of these issues on patients.AimTo identify the issues for primary care health professionals (HPs) and patients in PAD diagnosis and management, and to explore the impact of these on HPs and PAD patients.Design & settingQualitative study conducted in a primary care setting in the North East of England. Data was collected between December 2014 and July 2017.MethodSemi-structured interviews and focus groups were conducted with PAD register patients (n = 17), practice nurses ([PNs], n = 17), district nurses (DNs], n = 20), tissue viability nurses (n = 21), and GPs (n = 21).ResultsHPs’ attitudes to PAD, difficulty accessing tests, and patient delays impacted upon diagnosis. Some HPs had a reactive approach to PAD identification. Patients lacked understanding about PAD and some reported a delay consulting their GP after the onset of PAD symptoms. After diagnosis, few were attending for regular GP follow-up.ConclusionPatient education about PAD symptoms and risks, and questioning about exercise tolerance, could address the problem of under-reporting. Annual reviews could provide an opportunity to probe for PAD symptoms and highlight those requiring further investigation. Improved information when PAD is diagnosed and, considering the propensity for patients to tolerate worsening symptoms, the introduction of annual follow-up (at minimum) is warranted.

scholarly journals Do COVID-19 Apps Address Diabetes Mellitus and Health Equity Issues

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A379-A379
Author(s):  
Brian Nguyen ◽  
Chap-Kay Kendra Lau ◽  
Gloria Wu ◽  
Dwight Lubrin ◽  
Vincent Siu
Keyword(s):  
Risk Factors ◽  
Sexual Orientation ◽  
Hispanic Americans ◽  
Mobile Apps ◽  
Healthcare Providers ◽  
Search Term ◽  
Language Background ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Race 2

Abstract Purpose: To evaluate if COVID-19 apps address risk factors such as diabetes, hypertension, race, gender, sexual orientation, language. Background: In 2019, there were 204 Billion app downloads and 3.7 billion downloads of ehealth apps. COVID-19 affects ethnic minority patients with diabetes, hypertension, and other risk factors. Spanish is the second most commonly used language after English in the U.S.. African Americans, Hispanic Americans, and Asian Americans are at an increased risk of COVID-19. LGBTQ+ communities are also at higher risk for COVID due to historically poor access to healthcare. Methods: The search term, “COVID,” in Google Play store and Apple App store was used to find the most popular COVID-19 apps. App inclusion criteria: 1) Contains COVID-19 information and/or COVID symptom tracker, 2) Marketed and designed for the general public, 3) Free, 4) Android (DROID): 100,000+ Downloads; Apple (iOS): highest star ratings. Apple does not provide a number of downloads. App features: COVID-19 information, COVID-19 symptom questionnaire (QN), Diabetes, Hypertension, Cardiovascular disease, Languages (Spanish, Chinese), Race, Gender, and Sexual Orientation. Results: The top 10 DROID apps in descending order are: 1) GuideSafe, 2) CO Exposure Notifications, 3) Care19 Diary, 4) Care19 Alert, 5) Crush COVID RI, 6) MI COVID Alert, 7) DC CAN, 8) CombatCOVID MDC, 9) CombatCOVID PBC, 10) Stronger than C19. The top 10 iOS apps in descending order are: 1) SlowCOVIDNC, 2) COVIDWISE, 3) COVID Alert Pennsylvania, 4) COVID Alert DE, 5) COVID Alert NY, 6) Covid Watch Arizona, 7) Apple COVID-19, 8) COVID Alert NJ, 9) COVID Trace Nevada, 10) CDC. Of the 20 apps: COVID 19 information: 20/20; COVID-19 symptom QN: 8/20; DM: 2/20; HTN: 1/20; CardioVasc: 2/20; Spanish: 11/20 (2/11 of the Spanish apps have Chinese as well). Race: 5/20. Gender: 8/20; Sexual Orientation: 3/20; Age: 10/20. Conclusion: 1) Most apps do not ask about important risk factors such as DM, HTN, and Race. 2) Smartphone apps are not uniform in their health education features. 3) Healthcare providers should continue to play an important role in public education despite the ubiquity of mobile apps.

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