scholarly journals Identifying Outcomes Important to Patients with Glomerular Disease and Their Caregivers

2020 ◽  
Vol 15 (5) ◽  
pp. 673-684 ◽  
Author(s):  
Simon A. Carter ◽  
Talia Gutman ◽  
Charlotte Logeman ◽  
Dan Cattran ◽  
Liz Lightstone ◽  
...  
Keyword(s):  
Focus Groups ◽  
Nominal Group Technique ◽  
The United States ◽  
Glomerular Disease ◽  
Nominal Group ◽  
Family Impact ◽  
Importance Score ◽  
Future Health ◽  
The United Kingdom ◽  
And Control

Background and objectivesShared decision making in patients with glomerular disease remains challenging because outcomes important to patients remain largely unknown. We aimed to identify and prioritize outcomes important to patients and caregivers and to describe reasons for their choices.Design, setting, participants, & measurementsWe purposively sampled adult patients with glomerular disease and their caregivers from Australia, Hong Kong, the United Kingdom, and the United States. Participants identified, discussed, and ranked outcomes in focus groups using the nominal group technique; a relative importance score (between zero and one) was calculated. Qualitative data were analyzed thematically.ResultsAcross 16 focus groups, 134 participants (range, 19–85 years old; 51% women), including 101 patients and 33 caregivers, identified 58 outcomes. The ten highest-ranked outcomes were kidney function (importance score of 0.42), mortality (0.29), need for dialysis or transplant (0.22), life participation (0.18), fatigue (0.17), anxiety (0.13), family impact (0.12), infection and immunity (0.12), ability to work (0.11), and BP (0.11). Three themes explained the reasons for these rankings: constraining day-to-day experience, impaired agency and control over health, and threats to future health and family.ConclusionsPatients with glomerular disease and their caregivers highly prioritize kidney health and survival, but they also prioritize life participation, fatigue, anxiety, and family impact.

scholarly journals Barriers to antigen detection and avoidance in chronic hypersensitivity pneumonitis in the United States

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kerri I. Aronson ◽  
Ronan O’Beirne ◽  
Fernando J. Martinez ◽  
Monika M. Safford
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Nominal Group Technique ◽  
The United States ◽  
Antigen Detection ◽  
Nominal Group ◽  
Clinical Knowledge ◽  
Financial Barriers ◽  
Chronic Hypersensitivity Pneumonitis ◽  
The Individual ◽  
Development And Validation

Abstract Background Chronic hypersensitivity pneumonitis (CHP) is an interstitial lung disease (ILD) caused by long term exposure to an offending antigen. Antigen avoidance is associated with improved outcomes. We are unable to identify the antigen source in approximately half of patients. When an antigen is successfully identified, patients have difficulty with avoidance. Methods We conducted three structured group discussions with US based ILD specialists utilizing the nominal group technique (NGT). Participants listed barriers to antigen detection and avoidance in CHP. Each participant ranked what they perceived to be the top three barriers in the list in terms of importance. The master list of barriers was consolidated across the three groups into themes that were prioritized based on receiving the highest rankings by participants. Results Twenty-five physicians participated; 56% had experience caring for CHP patients for ≥ 16 years. Sixty barriers to antigen detection were categorized into seven themes of which the top three were: 1. unclear significance of identified exposures; 2. gaps in clinical knowledge and testing capabilities; 3. there are many unknown and undiscovered antigens. Twenty-eight barriers to antigen avoidance were categorized into five themes of which the top three were: 1. patient limitations, financial barriers and lack of resources; 2. individual patient beliefs, emotions and attachments to the antigen source; and 3. gaps in clinical knowledge and testing capabilities. Conclusions This study uncovered challenges at the individual patient, organizational, and societal levels and ranked them in terms of level of importance. These findings provide information to guide development and validation of multidisciplinary support and interventions geared towards antigen identification and avoidance in CHP.

scholarly journals A Qualitative Exploration of Practitioners’ Understanding of and Response to Child-to-Parent Aggression

2020 ◽  
pp. 088626052096714
Author(s):  
Sarah E. O’Toole ◽  
Stella Tsermentseli ◽  
Athanasia Papastergiou ◽  
Claire P. Monks
Keyword(s):  
Risk Factors ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Youth Justice ◽  
The United Kingdom ◽  
Effective Policy ◽  
Qualitative Exploration ◽  
And Control ◽  
Detrimental Impact ◽  
Research And Policy

There has been limited research and policy directed toward defining and understanding child-to-parent aggression (CPA), resulting in inconsistent definitions, understandings, and responses, which has a detrimental impact on families. In particular, there have been limited qualitative studies of those working on the frontline of CPA, hindering the development of effective policy. The present qualitative study therefore aimed to explore practitioner perspectives of CPA. Twenty-five practitioners from diverse fields (e.g., youth justice, police, charities) participated in four focus groups relating to their experiences of working with CPA in the United Kingdom. Thematic analysis of focus groups revealed three key themes: definitions of CPA, understanding of CPA risk factors, and responding to CPA. Practitioners understood CPA to be a broad use of aggression to intimidate and control parents and highlighted a range of individual (e.g., mental health, substance abuse) and social (e.g., parenting, gangs) risk factors for CPA. Further, practitioners felt that current methods of reporting CPA were ineffective and may have a detrimental impact on families. The findings of this study have implications for CPA policy and support the need for a multiagency and coordinated strategy for responding to CPA.

scholarly journals The Nominal Group Technique (NGT) as a Tool for Facilitating Pan-Disability Focus Groups and as a New Method for Quantifying Changes in Qualitative Data

2019 ◽  
Vol 18 ◽  
pp. 160940691986604 ◽  
Author(s):  
Jason Olsen
Keyword(s):  
Focus Groups ◽  
Qualitative Data ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Disabled People ◽  
Full Inclusion ◽  
New Methods ◽  
Pertinent Data ◽  
Qualitative Focus Groups ◽  
Group Technique

This article reaffirms the value and flexibility of the nominal group technique (NGT) when conducting qualitative focus groups (QFGs). In the project that will be discussed, the methods used expanded the application of the NGT into the realm of pan-disability (i.e., individuals with differing impairments) research. It provides requirements and recommendations for the full inclusion and participation of disabled people into projects where the pertinent source of qualitative data is obtained from QFGs. Furthermore, this article describes innovative additional steps to the NGT that are beneficial to researchers. This includes a method of evaluating the data that is often lost between the NGTs’ stages of initial and final rankings. These new methods ensure pertinent data are not overlooked.

scholarly journals Consensus Recommendations on the Prehospital Care of the Injured Athlete With a Suspected Catastrophic Cervical Spine Injury

2020 ◽  
Vol 55 (6) ◽  
pp. 563-572
Author(s):  
Brianna M. Mills ◽  
Kelsey M. Conrick ◽  
Scott Anderson ◽  
Julian Bailes ◽  
Barry P. Boden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Prehospital Care ◽  
Athletic Trainers ◽  
Nominal Group Technique ◽  
The United States ◽  
Nominal Group ◽  
Spine Injury ◽  
Group Technique

Introduction Sports participation is among the leading causes of catastrophic cervical spine injury (CSI) in the United States. Appropriate prehospital care for athletes with suspected CSIs should be available at all levels of sport. The goal of this project was to develop a set of best-practice recommendations appropriate for athletic trainers, emergency responders, sports medicine and emergency physicians, and others engaged in caring for athletes with suspected CSIs. Methods A consensus-driven approach (RAND/UCLA method) in combination with a systematic review of the available literature was used to identify key research questions and develop conclusions and recommendations on the prehospital care of the spine-injured athlete. A diverse panel of experts, including members of the National Athletic Trainers' Association, the National Collegiate Athletic Association, and the Sports Institute at UW Medicine participated in 4 Delphi rounds and a 2-day nominal group technique meeting. The systematic review involved 2 independent reviewers and 4 rounds of blinded review. Results The Delphi process identified 8 key questions to be answered by the systematic review. The systematic review comprised 1544 studies, 49 of which were included in the final full-text review. Using the results of the systematic review as a shared evidence base, the nominal group technique meeting created and refined conclusions and recommendations until consensus was achieved. Conclusions These conclusions and recommendations represent a pragmatic approach, balancing expert experiences and the available scientific evidence.

scholarly journals Priorities of Unmet Needs for Those Affected by Colorectal Cancer: Considerations From a Series of Nominal Group Technique Sessions

2021 ◽  
Vol 19 (6) ◽  
pp. 693-699
Author(s):  
Sharyn F. Worrall ◽  
Andrea J. Dwyer ◽  
Reese M. Garcia ◽  
Keavy E. McAbee ◽  
Anjelica Q. Davis
Keyword(s):  
Colorectal Cancer ◽  
Adverse Effects ◽  
Unmet Needs ◽  
Nominal Group Technique ◽  
The United States ◽  
Nominal Group ◽  
Disease Stage ◽  
Caregiver Support ◽  
Race Ethnicity ◽  
Group Technique

Background: Colorectal cancer (CRC) is the third most common cancer among men and women in the United States. Patients and survivors experience a range of challenges, including anxiety, financial issues, long-term adverse effects, and more. The intent of this project was to assess the needs of the CRC community directly from survivors and their caregivers and to lay a foundation for ongoing support. Methods: Twelve nominal group technique sessions were facilitated. Participants were randomized and presented with the following questions: “What information do you wish you had at the time of diagnosis?” and “What information do you need now as a survivor?” After the nominal group technique process, each statement’s score was divided by the number of people in the session, providing the average to identify the top-ranked statements. Themes and subthemes were applied to statements. Results were compared between coders. Results: There was a total of 79 participants, 49 of whom self-identified as a patient with or survivor of cancer. Patient/survivor demographics were as follows: stage IV disease (n=20), stage III disease (n=22), stage II disease (n=5), stage I disease (n=2), caregiver/family member (n=30), male (n=16), female (n=63), White (n=50), Native Hawaiian/Pacific Islander (n=1), Hispanic/Latino (n=13), Black/African American (n=11), Asian (n=1), and more than one race/ethnicity (n=3). The most frequent themes among responses to the first question were communication and coordination with care team and access to CRC resources. The most frequent themes among responses to the second question were psychosocial support and family/caregiver support. Frequent themes among responses across both questions were understanding treatment options and adverse effects. Conclusions: These findings highlight gaps in support for individuals affected by CRC, and lay a foundation for ongoing assistance. Future studies exploring differences based on disease stage, race/ethnicity, age, gender identity, geographic location, and tumor location are needed to further tailor support for those experiencing CRC. Themes identified in this project require a multidisciplinary approach to ensure that the unmet needs of survivors are addressed.

The value of cancer treatments: Patient and clinician perspectives.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18320-e18320 ◽  
Author(s):  
Andrew Briggs ◽  
Camilla Baba ◽  
Anna Kaltenboeck ◽  
Allison Nicole Lipitz Snyderman ◽  
Emma McIntosh ◽  
...  
Keyword(s):  
Focus Groups ◽  
Contextual Factors ◽  
Treatment Options ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Efficacy And Safety ◽  
Cancer Treatments ◽  
Trade Offs ◽  
Clinician Perspectives

e18320 Background: A number of frameworks for assessing the value of cancer treatments such as the National Comprehensive Cancer Network’s evidence blocks, Memorial Sloan Kettering Cancer Center’s Drug Abacus and ASCO’s value framework have been developed to help address the rising cost of cancer treatments. Yet the methodological basis for the inclusion of differing attributes, how to incorporate other contextual considerations and understand stakeholder trade-offs is unclear. This qualitative study aimed to identify contextual factors prioritized by stakeholders for inclusion in oncology value frameworks. Methods: A scoping review identified attributes currently included in value frameworks. Nominal group technique methods were then used in 3 focus groups representing cancer patients, oncology nurses, and physicians across a range of cancer specialties. Each group was tasked with ‘identifying important treatment features’ based on their own experience. Following discussions, participants ranked attributes in order of importance and group consensus identified the ‘top 6’ factors. Results: Twenty-one attributes were identified by the patient (n = 9), nurse (n = 10) and physician (n = 6) focus groups. All identified efficacy and safety/toxicity. Long-term adverse effects, alternative treatment options, quality of evidence and reputation of the treating oncologist/center were prioritized by patients. Nurse preferences centered on mode of administration, quality of life, communication and treatment innovation. Physicians focused on the burden and inconvenience of treatments to patients, functional outcomes, financial toxicity to patients, and societal costs. Conclusions: Although efficacy and safety/toxicity were prioritized in all groups, the prioritization of contextual factors across stakeholders highlights the need to further understand the relative value of possible ‘other’ attributes currently not reflected in frameworks thus, possibly failing to reflect the preferences of stakeholders.

scholarly journals Assessing Living Donor Priorities Through Nominal Group Technique

2017 ◽  
Vol 28 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Lindsey M. Dorflinger ◽  
Sanjay Kulkarni ◽  
Carrie Thiessen ◽  
Sharon Klarman ◽  
Liana Fraenkel
Keyword(s):  
Living Donor ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Future Research ◽  
Living Donation ◽  
Future Health ◽  
Personal Benefit ◽  
Public Campaign ◽  
The Impact ◽  
Group Technique

The need for kidneys for transplantation continues to far surpass the number of donors. Although studies have shown that most people are aware of and support the idea of living donation, it remains unclear what motivates individuals who are aware, knowledgeable, and in support of donation to actually donate, or conversely, what deters them from donating. Utilizing nominal group technique, 30 individuals participated in 4 groups in which they brainstormed factors that would impact willingness to be a living donor and voted on which factors they deemed most important. Responses were analyzed and categorized into themes. Factors that influence the donation decision, from most to least important as rated by participants, were altruism, relationship to recipient, knowledge, personal risk/impact, convenience/access, cost, support, personal benefit, and religion. Participants reported a significant lack of information about donation as well as lack of knowledge about where and how to obtain information that would motivate them to donate or help make the decision to donate. Findings suggest that public campaign efforts seeking to increase rates of living donation should appeal to altruism and increase knowledge about the impact (or lack thereof) of donation on lifestyle factors and future health, and transplant programs should aim to maximize convenience and minimize donor burden. Future research should examine whether tailoring public campaigns to address factors perceived as most salient by potential donors reduces the significant gap in supply of and demand for kidneys.

scholarly journals Between security and convenience: Facial recognition technology in the eyes of citizens in China, Germany, the United Kingdom, and the United States

2021 ◽  
pp. 096366252110015
Author(s):  
Genia Kostka ◽  
Léa Steinacker ◽  
Miriam Meckel
Keyword(s):  
United States ◽  
United Kingdom ◽  
Technology Acceptance ◽  
Facial Recognition ◽  
The United States ◽  
The United Kingdom ◽  
State Surveillance ◽  
Socio Demographic Factors ◽  
Acceptance Model ◽  
And Control

How does the public perceive facial recognition technology and how much do they accept facial recognition technology in different political contexts? Based on online surveys resembling the Internet-connected population in China, Germany, the United Kingdom, and the United States, our study finds that facial recognition technology enjoys generally highest acceptance among respondents in China, while acceptance is lowest in Germany, and the United Kingdom and the United States are in between. A closer examination through the lens of an integrated technology acceptance model reveals interesting variations in the selected four countries based, among other factors, on socio-demographic factors as well as perceived consequences, usefulness, and reliability of facial recognition technology. While previous research has pointed out that facial recognition technology is an instrument for state surveillance and control, this study shows that surveillance and control are not foremost on the minds of citizens in China, Germany, the United Kingdom, and the United States, but rather notions of convenience and improved security.

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