scholarly journals Exploring Nurse and Patient Experiences of Developing Rapport During Oncology Ambulatory Care Videoconferencing Visits: Protocol for Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Paula Koppel ◽  
Jennie C De Gagne
Keyword(s):  
Qualitative Methodology ◽  
Research Team ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Final Analysis ◽  
Analysis Data ◽  
Personal Connection ◽  
Patients With Cancer ◽  
Patient Relationships ◽  
The Impact

BACKGROUND Telehealth videoconferencing has largely been embraced by healthcare providers and patients during the COVID-19 pandemic; however, little is known about specific techniques for building rapport and provider-patient relationships in this care environment. Although research suggests videoconferencing is feasible and can be effective for some types of care, concerns about the impact of technology on provider-patient relationships are evident across health disciplines. Suggestions for adapting some in-person rapport techniques, such as the use of small talk, eye contact, body language, and touch to facilitate trust, personal connection, and communication during videoconferencing encounters, have been discussed in the popular press and clinical commentaries. Notably, the evidence is lacking regarding the effects of these strategies on rapport and clinical care outcomes. Understanding how to establish rapport in videoconferencing visits is especially important in oncology nursing, where rapport with patients enables nurses to become a source of emotional support, helping patients adapt and navigate the cancer journey. OBJECTIVE This study will investigate the nature of nurse-patient rapport in ambulatory cancer care videoconferencing visits. Objectives include exploring (1) how patients with cancer and nurses describe experiences of rapport and strategies for cultivating rapport in videoconferencing visits and (2) similarities and differences identified by patients with cancer and nurses between rapport in videoconferencing and in-person visits. METHODS Semi-structured narrative interviews of patients with cancer and nurses will be conducted to understand the experience of rapport-building in videoconferencing visits. Nurses and patients will be interviewed separately to facilitate understanding the perspectives of both types of participants. Interviews will be conducted on a secure videoconferencing platform. This qualitative descriptive study will describe participant experiences in a manner that, while not without interpretation, is as close to the data as possible. The research team will meet regularly to discuss, define, and document codes, categories, and themes, keeping a detailed audit trail of analytical decisions. In addition, member checking will enhance the study’s rigor. Nurse and patient interviews will be analyzed separately using identical procedures and may be explored side-by-side in the final analysis to provide comparative analysis. Data management and analysis will be performed using NVivo 12. RESULTS Data collection will begin during April 2021 with results from data analysis anticipated by July 2021. A research team trained in qualitative methodology will use conventional content analysis to analyze the data using first- and second-level codes derived directly from the transcribed text data. CONCLUSIONS This study aims to determine what behaviors, communication techniques, and relational practices need to be adapted, setting the foundation for future development of interventions and evidence-based practice guidelines for relationship building during videoconferencing telehealth visits.

scholarly journals Understanding the Impact of Patients’ Disease Types on Caregiving Time and Caregiver Burden: An Analysis of the Health Information National Trends Survey

2020 ◽  
Author(s):  
Zhaohui Su ◽  
Zi Zhou ◽  
Jonathan Gelfond
Keyword(s):  
Psychological Distress ◽  
Health Information ◽  
Caregiver Burden ◽  
Final Analysis ◽  
Analysis Data ◽  
Burden Of Care ◽  
Patients With Cancer ◽  
Self Rated Health ◽  
National Trends ◽  
The Impact

Abstract Background: Patients with different medical conditions often have distinctive caregiving needs that could result in varying levels of caregiver burden. However, despite empirical advances in this area, little is known about how patients’ disease types interact with caregiving time and caregiver burden. To bridge this gap, we examined the impact of patients’ disease types on caregiving time and burden. Methods: Data were analyzed from the 2018 Health Information National Trends Survey 5 Cycle 2. Only participants self-identified as caregivers were included in the final analysis. Data on patients’ disease types, caregiving time (i.e., caregiving duration and caregiving hours spent per week), and caregiver burden (i.e., caregivers’ self-rated health, body mass index, and psychological distress) were examined using logistic regression analysis.Results: Patients’ disease types impacted caregiving time and burden. Caregivers of patients with neurological disease spent the greatest amount of time. For caregiver burden, caregivers of patients with cancer or aging related disease experienced worst self-rated health, caregivers of patients with orthopedic disease have the greatest likelihood to be overweight or obese, while cancer caregivers experienced greatest levels of psychological distress. Conclusions: Patients’ disease types had highly varied effects on caregiving time and burden. This study underscores the need for healthcare researchers to adopt a nuanced approach in acknowledging and addressing the burden of care experienced by caregivers, such as tailoring interventions based on both patients and caregivers’ characteristics and preferences.

Development of a Novel Clinician Decision Support Tool for the Management of Acute Diarrhea in Bangladesh: Formative Qualitative Research (Preprint)

2021 ◽  
Author(s):  
Rochelle K Rosen ◽  
Stephanie C Garbern ◽  
Monique Gainey ◽  
Ryan Lantini ◽  
Sabiha Nasrin ◽  
...  
Keyword(s):  
Decision Support ◽  
Focus Group ◽  
Acute Diarrhea ◽  
Clinical Utility ◽  
Qualitative Data ◽  
Care Delivery ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Final Analysis ◽  
Support Tool

BACKGROUND The availability of mobile clinical decision-support (CDS) tools has grown substantially with the increased prevalence of smartphone devices and applications (apps). Though healthcare providers express interest in integrating mobile health (mHealth) technologies into their clinical settings, concerns raised include perceived disagreements between information provided by mobile CDS tools and standard guidelines. Despite their potential to transform health care delivery, there remains limited literature on the provider’s perspective of the clinical utility of mobile CDS tools for improving patient outcomes, especially in low- and middle- income countries. OBJECTIVE The aim of this study is to describe providers’ perceptions about the utility of a mobile CDS tool accessed via a smartphone app for diarrhea management in Bangladesh. In addition, feedback was collected on preliminary components of the mobile CDS tool to address clinicians’ concerns and incorporate their preferences. METHODS From November to December 2020, qualitative data were gathered through eight virtual focus group discussions with physicians and nurses from three Bangladeshi hospitals. Each discussion was conducted in the local language, Bangla, and audio recorded for transcription and translation by the local research team. Transcripts and codes were entered into NVivo12 and applied thematic analysis was used to identify themes that explore the clinical utility of a mHealth app to assess dehydration severity in patients with acute diarrhea. Summaries of concepts and themes were generated from reviews of the aggregated coded data, and thematic memos were written and used for the final analysis. RESULTS Of the 27 focus group participants, 14 were nurses and 13 doctors; 15 worked at a diarrhea specialty hospital and 12 worked in government district or subdistrict hospitals. The participants’ experience in their current position ranged from 2 to 14 years, with an average of 10.3 years. Key themes from the qualitative data analysis, including: current experience with CDS, overall perception of the app utility and its potential role in clinical care, barriers and facilitators to app use, considerations of overtreatment and undertreatment, and guidelines for the app’s clinical recommendations. CONCLUSIONS Participants were positive about the mHealth app and its potential to inform diarrhea management. They provided detailed feedback, which developers used to further the design and programming. Participants felt that the tool would initially take time to use, but once learned could be useful during epidemic cholera. Some felt that clinical experience remains an important part of treatment that can be supplemented, but not replaced, by a CDS tool. Additionally, diagnostic information, including mid-upper arm circumference and blood pressure, might not be available to directly inform programming decisions. These formative qualitative data provided timely and relevant feedback to improve the utility of a CDS tool for diarrhea treatment in Bangladesh.

Depressive symptoms with cognitive dysfunction increase the risk of cognitive impairment: analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006–2018

2020 ◽  
pp. 1-11
Author(s):  
Minyoung Shin
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Longitudinal Study ◽  
Cognitive Dysfunction ◽  
Healthcare Providers ◽  
Final Analysis ◽  
Community Dwelling ◽  
The Impact ◽  
Community Dwelling Older Adults

ABSTRACT Objectives: Geriatric depression complicates cognitive health in older adults. This study aims to investigate the impact of depressive symptoms on cognitive impairment in community-dwelling older adults, depending on whether cognitive dysfunction accompanied. Design: A community-based longitudinal cohort study. Setting: This study analyzed data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2018. Participants: Among 10,254 individuals who were registered in the KLoSA study, a total of 9119 subjects met the criteria, and 4547 subjects were included in the final analysis. The subjects were grouped into 4 categories based on depressive symptoms and cognitive dysfunction at baseline assessment: “normal control” (NC, n = 3341), “depression only” (Dep-only, n = 652), “cognitive dysfunction only” (CD-only, n = 393), and “depression with cognitive dysfunction” (Dep-CD, n = 161). Measurements: Cognitive impairment 10 years later was defined as K-MMSE scores below two percentile on demographically adjusted norms. Results: Ten-year survival, that is, not experiencing cognitive impairment, was 80 $$ \pm \,$$ 1% in NC group, 72 $$ \pm $$ 2% in Dep-only group, 52 $$ \pm $$ 3% in CD-only group, and 44 $$ \pm $$ 5% in Dep-CD group. The hazard ratio (HR) of the Dep-only group (HR = 1.18, 95% CI, 0.97–1.43, n.s.) did not differ from that of the NC group, but the HR of the Dep-CD group was significantly higher (HR = 2.85, 95% CI, 2.23–3.66, p < 0.001) than the NC group. When the Dep-CD group was compared to the CD-only group, the HR was 1.13 (95% CI, 0.85–1.49, n.s.), which indicates that it did not significantly differ from the CD-only group. Conclusions: Our findings suggest that depressive symptoms with cognitive dysfunction are associated with a higher risk of cognitive impairment. Furthermore, cognitive dysfunction occurring with depressive symptoms is as much a risk for cognitive impairment as is pure cognitive dysfunction. Thus, healthcare providers should pay close attention to the community-dwelling elderly when depressive symptoms occur with cognitive dysfunction.

scholarly journals OS7.7 Educational program for caregivers of patients with brain tumors: AGAPE

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii15-iii15
Author(s):  
H Bourien ◽  
C Larible-Lefort ◽  
E Pelotte ◽  
F Le Brun ◽  
E Vauleon
Keyword(s):  
Quality Of Life ◽  
Brain Tumors ◽  
Educational Program ◽  
Medical Information ◽  
Healthcare Providers ◽  
Final Analysis ◽  
Educational Programs ◽  
Life Questionnaire ◽  
The Impact

Abstract BACKGROUND Patients with brain tumors suffer from physical, neurocognitive, and psychological decline. Among the potential evolutions of the disease, patients become dependent on caregivers. Nearly half suffer from anxiety or depression, which can significatively impact their quality of life. Better medical information and more effective integration of the caregivers are positively received. Patients and caregivers need more information on supportive care and the specificities of brain tumors. Educational programs may help them better support this new caregiving role and give them more information on the disease. MATERIALS AND METHODS At the Comprehensive Cancer Centre in Rennes, we have created an educational program for caregivers of patients with brain tumor, called AGAPE. The aim of AGAPE is to explain more precisely the medical aspects of brain tumors, describe resources that are available to caregivers, and allow a moment of exchange between caregivers. A medical oncologist and a nurse specialized in neuro-oncology organize the program divided into three workshops. During the first workshop, neurocognitive symptoms that may be presented by the patients as well as therapeutics are discussed. The second workshop aims to provide information on instrumental and human resources available, as well as on psychometrics, nutrition, and palliative care units. The last workshop gives each caregiver the opportunity to share their difficulties. In order to objectively evaluate the impact of AGAPE, caregivers are asked to complete a quality of life questionnaire after each workshop: CargoQoL (Caregiver Oncology Quality of Life). We retrospectively analyzed CargoQoL scores for each caregiver during their participation in AGAPE in order to evaluate the impact of AGAPE on the caregiver’s quality of life. RESULTS From February 2015 to February 2018, 9 three-month sessions were organized, allowing 45 caregivers to participate. Data for the years 2018 and 2019 are currently being updated. Each group of 3 to 4 caregivers met once a month for a period of 3 months. Final analysis of CargoQoL was based on 21 caregivers (responses with excessive missing data and the experience of caregivers who assisted to only one of the workshops organized every 3 months were not taken into account). For the 9 items of CargoQoL, there was no decrease in quality of life between the first and the last workshop. Even though these findings are not significant, caregivers seem to have a better relationship with healthcare providers and better self-esteem after attending the AGAPE workshops. CONCLUSION Diagnosis of brain tumors impacts the quality of life of both patients and caregivers. The assessment of the caregivers’ needs is essential in order to support them in caring for their loved ones and to include them in the healthcare process. AGAPE educational programs help caregivers maintain their quality of life.

scholarly journals A Mixed-method Analysis of Community-Engaged Theatre Illuminates Black Women’s Experiences of Racism and Addresses Healthcare Inequities by Targeting Provider Bias

2020 ◽  
Vol 57 ◽  
pp. 004695802097625
Author(s):  
Sally Wasmuth ◽  
Kevin Pritchard ◽  
Cierra Milton ◽  
Emily Smith
Keyword(s):  
Black Women ◽  
Thematic Analysis ◽  
Healthcare Providers ◽  
Analysis Data ◽  
Narrative Interviews ◽  
Convenience Sample ◽  
Post Test ◽  
Strongly Agree ◽  
Provider Bias ◽  
The Impact

Theatre has been a powerful means of eliciting social change. This paper describes methods and outcomes of a theatre project to reduce healthcare inequities experienced by Black women. We conducted narrative interviews with a convenience sample of Black women and conducted thematic analysis of interview transcripts to learn about their experiences of healthcare and to inform development of a professional theatrical production. To assess the impact of the performance on the audience, we used a single post-test concurrent mixed-methods design using a self-created Likert-type survey that included space for open-ended responses. Ten Black women completed narrative interviews. Thematic analysis revealed 5 main themes: being ignored, being accused, being talked-down to, fearing harm, and being hurt. Narratives were used to create a script that centered on these themes, and that was professionally produced and performed. Audience members (n = 113, 25% healthcare providers) produced a mean total post-test score of 19.28 (agree/strongly agree) on a 25-point survey with 2 items scoring in the 2 to 3 range (disagree/not sure). Thematic analysis data revealed the extent to which Black women experienced discrimination in multiple settings. Quantitative survey data suggested audience members conceptually understood and were aware of inequity, but open-ended responses revealed this information was new for some, and prior knowledge for others. The audience reported planning to change personal behaviors that may contribute to inequity. Participants were unsure if they had contributed to inequity in the past. The performance stimulated conversation about implicit bias and discrimination and encouraged audience members to examine their contributions to the problem. Future pre-post studies are needed to better assess the impact of the performance. Theatre has the potential to illuminate the extent and nature of discrimination in healthcare and society, and to foster conversations that allow audience members to consider their own potential contributions to discrimination.

scholarly journals Assimilation of GPS Radio Occultation Data for Tropical Cyclogenesis: A Case Study in the Eastern Atlantic

2018 ◽  
Vol 12 (1) ◽  
pp. 33-47
Author(s):  
Keren Rosado ◽  
Sen Chiao
Keyword(s):  
Radio Occultation ◽  
Final Analysis ◽  
Analysis Data ◽  
Time Frame ◽  
Saharan Dust ◽  
Tropical Cyclogenesis ◽  
Arw Model ◽  
Noteworthy Feature ◽  
Occultation Data ◽  
The Impact

Aim:This study aimed to investigate the impact of using Global Positioning System Radio Occultation (GPS RO) sounding data (i.e., Constellation Observing System for Meteorology, Ionosphere, and Climate; COSMIC) for Tropical Cyclogenesis (TC-genesis) research.Methods:The Weather Research and Forecasting (WRF-ARW) model and the WRF data assimilation system (i.e., WRF 3DVAR) were employed to simulate Tropical Depression- 8 (TD8) 2006. A noteworthy feature about TD8-genesis was that Saharan dust outbreak was also observed during this period, which made this event more sophisticated. The time frame to be focused on was from 1200 UTC September 09 to 1200 UTC September 12, 2006. The level 2 wetPrf COSMIC data was adopted in this research. A 72-hour integration wasperformed with initial and time-dependent lateral boundary conditions derived from the NCEP final analysis data (FNL). A 2-domain nested simulation was configured with 30 km, and10 km horizontal resolutions, respectively.Results:Simulation results from all the experiments performed with different RO soundings combination showed that the RO sounding 8 has the greatest significant impact on TD8 simulation.Conclusion:Elevation, time, and location are the parameters that made RO sounding 8 the most treasured sounding to analyze TD8.

scholarly journals Bringing a genomic perspective to the safety of drug treatment in oncology

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 385 ◽  
Author(s):  
Federico Innocenti
Keyword(s):  
Adverse Events ◽  
Patient Perspective ◽  
Clinical Care ◽  
Genomic Research ◽  
Financial Toxicity ◽  
Patients With Cancer ◽  
Anti Cancer ◽  
The Impact ◽  
Efficacy Of Treatment

This article describes the clinical relevance of toxicity of therapies administered to patients with cancer, putting the patient, rather than disease, at the center of the evaluation of safety of anti-cancer therapy. Hence, the implications of adverse events are described from the patient perspective, focusing on the impact of patient safety on quality of life and efficacy of treatment. Issues revolving around other types of safety, such as financial toxicity, are also discussed. The role played by genetics in the assessment of a patient’s risk of adverse events is also discussed, both in relation to the potential of genomic research and in the context of current tools of fruition in clinical care.

Abstract CT133: The impact of gene panel sequencing on clinical care in patients with cancer

2015 ◽  
Author(s):  
David Neil Hayes ◽  
Juneko E. Grilley-Olson ◽  
David A. Eberhard ◽  
Nirali M. Patel ◽  
Joel S. Parker ◽  
...  
Keyword(s):  
Clinical Care ◽  
Gene Panel ◽  
Patients With Cancer ◽  
The Impact ◽  
Gene Panel Sequencing ◽  
Panel Sequencing

The Impact of Internal Work Environment on the Retention of Healthcare Providers at Turaif General Hospital

2019 ◽  
Vol 10 (12) ◽  
pp. 1183-1199
Author(s):  
Mohammed Alrouili ◽  
Keyword(s):  
Work Environment ◽  
General Hospital ◽  
Professional Growth ◽  
Healthcare Providers ◽  
Entire Study ◽  
Internal Work ◽  
Research Findings ◽  
Study Population ◽  
The Right ◽  
The Impact

This study attempted to identify the impact of internal work environment on the retention of healthcare providers at Turaif General Hospital in the Kingdom of Saudi Arabia. In particular, the study aimed to identify the dimensions of work circumstances, compensation, and relationship with colleagues, professional growth, and the level of healthcare providers’ retention. In order to achieve the study goals, the researcher used the descriptive analytical approach. The researcher used the questionnaire as the study tool. The study population comprised all the healthcare providers at Turaif General Hospital. Questionnaires were distributed to the entire study sample that consisted of 220 individuals. The number of questionnaires valid for study was 183 questionnaires. The research findings were as follows: the participants’ estimate of the work circumstances dimension was high (3.64), the participants’ estimate of the compensation dimension was moderate (3.32), the participants’ estimate of the relationship with colleagues dimension was high (3.62), the participants’ estimate of the professional growth dimension was weak (2.39), and the participants’ estimate of healthcare providers’ retention level was intermediate (2.75). Accordingly, the researcher’s major recommendations are: the need to create the right atmosphere for personnel in hospitals, the interest of the hospital to provide the appropriate conditions for the staff in terms of the physical and moral aspects for building the work adjustment in the staff, and conducting training courses and educational lectures for personnel in hospitals on how to cope with the work pressures.

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