The Danish Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: Design and Pilot Study in Collaboration with Patients and Their Relatives (Preprint)

BACKGROUND Atrial fibrillation is the most common cardiac arrhythmia and is predicted to more than double in prevalence over the next 20 years. Tailored patient education is recommended as an important aspect of atrial fibrillation care. Current guidelines emphasize measures enabling patients to become more active participants in the management of their own disease, yet there are no rehabilitation programs for AF patients in the Danish healthcare system. OBJECTIVE The aims of this pilot study were to identify the challenges facing patients with atrial fibrillation and their relatives and based upon this, to design and pilot test a telerehabilitation program. METHODS A participatory design process was divided into a phase 0 and a phase 1, and took place from December 2018 to March 2020. Phase 0 consisted of interviews, cultural probes, and workshops with the aim of identifying and prioritizing challenges of living with atrial fibrillation in everyday life as they affect atrial fibrillation patients and their relatives, as well as to design scenarios for telerehabilitation programs for patients with atrial fibrillation. Phase 1 was conducted as a pilot study with the aim to evaluate and compare the feasibility of two scenarios of telerehabilitation programs for atrial fibrillation patients. RESULTS The main results of iterations 1 and 2 were the following challenges listed in a prioritized order: Lack of knowledge of everyday stresses, psychological influence, physical limitations, insecurity about being diagnosed and living with atrial fibrillation, and uncertainty about the role of the relative. In iteration 3, two scenarios of telerehabilitation programs, A and B, were designed, and a web-based interactive HeartPortal for patients with atrial fibrillation was created. In iteration 4, a pilot study of the two telerehabilitation programs was tested and evaluated. CONCLUSIONS Patients with atrial fibrillation and their relatives were positive about a telerehabilitation program. Patients with atrial fibrillation and their relatives found the telerehabilitation program useful, especially because it created an increased sense of security, knowledge about mastering their symptoms and a community of practice linking patients with atrial fibrillation and their relatives and healthcare personnel. CLINICALTRIAL ClinicalTrials.gov NCT04493437; https://clinicaltrials.gov/ct2/show/NCT04493437

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Faculty Opinions recommendation of Does sodium nitroprusside decrease the incidence of atrial fibrillation after myocardial revascularization?: a pilot study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1118767.574844 ◽

2008 ◽

Author(s):

John Augoustides

Keyword(s):

Atrial Fibrillation ◽

Pilot Study ◽

Sodium Nitroprusside ◽

Myocardial Revascularization

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Patient and Provider Perspectives Regarding Criteria for Patient Prioritization in Rehabilitation Programs (Preprint)

10.2196/preprints.14495 ◽

2019 ◽

Author(s):

Julien Déry ◽

Angel Ruiz ◽

François Routhier ◽

Marie-Pierre Gagnon ◽

André Côté ◽

...

Keyword(s):

Service Providers ◽

Quebec City ◽

Web Based ◽

Rehabilitation Programs ◽

Provider Perspectives ◽

Patient Prioritization ◽

Services Sociaux ◽

Multiple Case ◽

Patient And Provider Perspectives

BACKGROUND Queueing patients on waiting lists is a common practice to manage access to rehabilitation services. To increase fairness and equity in access, a strategy emerging from the literature is patient prioritization. The goal is for patients with the greatest needs to be treated first and for patient wait times to be determined objectively on the basis of explicit criteria. Selecting criteria, however, is a complex task because it is important to simultaneously consider the objectives of all stakeholders. OBJECTIVE The aim of this study was to compare service users’ and service providers’ perspectives regarding patient prioritization criteria in two rehabilitation programs. METHODS We conducted a multiple case study in two rehabilitation programs at the Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale in Quebec City (Canada), i.e. a driving evaluation program (DEP) and a compression garment manufacturing program (CGMP). We sent a web-based survey asking two groups (patients and providers) of informed stakeholders to individually produce a set of criteria. We then conducted an inductive thematic analysis where each group’s individual answers were coded and combined in a single set of criteria. RESULTS Stakeholders from the DEP identified a total of 22 criteria to prioritize patients while those from the CGMP listed 27 criteria. Providers shared 76% of the criteria mentioned by patients. Some criteria, such as age, occupation, functional level, pain, absence of caregiver, and time since referral, were considered important by both stakeholders in both programs. CONCLUSIONS Patients and providers tended to have similar opinions about a majority of the criteria to prioritize patients in waitlists. Nonetheless, our study confirms that patients and providers base their choices on different types of knowledge and values, which explains some of the differences observed. Taking into consideration the opinions of all stakeholders concerning prioritization criteria is an important part of the decision-making process, based on a multiple constituency approach.

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How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study

BMJ Open ◽

10.1136/bmjopen-2020-041743 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041743

Author(s):

Christina Østervang ◽

Annmarie Touborg Lassen ◽

Charlotte Myhre Jensen ◽

Elisabeth Coyne ◽

Karin Brochstedt Dieperink

Keyword(s):

Patient Outcomes ◽

Participatory Design ◽

Hospital Admissions ◽

Phase 1 ◽

Family Needs ◽

Focus Group Interviews ◽

Phase 3 ◽

Ace Study ◽

Group Interviews ◽

Improve Patient

IntroductionThe development of acute symptoms or changes in diseases led to feelings of fear and vulnerability and the need for health professional support. Therefore, the care provided in the acute medical and surgical areas of the emergency department (ED) is highly important as it influences the confidence of patients and families in managing everyday life after discharge. There is an increase in short-episode (<24 hours) hospital admissions, related to demographic changes and a focus on outpatient care. Clear discharge information and inclusion in treatment decisions increase the patient’s and family’s ability to understand and manage health needs after discharge, reduces the risk of readmission. This study aims to identify the needs for ED care and develop a solution to improve outcomes of patients discharged within 24 hours of admission.Methods and analysisThe study comprises the three phases of a participatory design (PD). Phase 1 aims to understand and identify patient and family needs when discharged within 24 hours of admission. A qualitative observational study will be conducted in two different EDs, followed by 20 joint interviews with patients and their families. Four focus group interviews with healthcare professionals will provide understanding of the short pathways. Findings from phase 1 will inform phase 2, which aims to develop a solution to improve patient outcomes. Three workshops gathering relevant stakeholders are arranged in the design plus development of a solution with specific outcomes. The solution will be implemented and tested in phase 3. Here we report the study protocol of phase 1 and 2.Ethics and disseminationThe study is registered with the Danish Data Protection Agency (19/22672). Approval of the project has been granted by the Regional Committees on Health Research Ethics for Southern Denmark (S-20192000–111). Findings will be published in suitable international journals and disseminated through conferences.

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Adapting an Evidence-Based Early Childhood Tier 2 Social-Emotional Learning Intervention for Web-Based Delivery

Journal of Educational Technology Systems ◽

10.1177/00472395211016051 ◽

2021 ◽

pp. 004723952110160

Author(s):

Kristen L. Granger ◽

Maureen A. Conroy ◽

Kevin S. Sutherland ◽

Edward G. Feil ◽

Jessica Wright ◽

...

Keyword(s):

Early Childhood ◽

Intervention Program ◽

Phase 1 ◽

Lessons Learned ◽

Study Phase ◽

Evidence Based ◽

Tier 2 ◽

Web Based ◽

Testing Phase ◽

Panel Review

The purpose of this article is to describe the adaptation process of an evidence-based early childhood Tier-2 intervention program, BEST in CLASS-Prekindergarten, from a face-to-face format to a web-based delivery format called BEST in CLASS-Web. We describe the three-phase iterative development process used to adapt the parent program for delivery via the web. Activities in these phases included focus groups, interviews, an expert panel review, alpha and beta testing (Phase 1), feasibility testing (Phase 2), and a pilot promise study (Phase 3). Each phase included a series of refinements and improvements to materials based on data and stakeholder feedback. Lessons learned and implications for developing and implementing professional development services via online platforms are discussed.

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