scholarly journals Adherence to behaviours associated with the test, trace, and isolate system: An analysis using the Theoretical Domains Framework

2021 ◽  
Author(s):  
Rachael Thorneloe ◽  
Elaine Clarke ◽  
Madelynne Arden
Keyword(s):  
Focus Groups ◽  
Close Contact ◽  
Theoretical Domains Framework ◽  
Isolate System ◽  
Negative Consequences ◽  
Framework Analysis ◽  
Factors Affecting ◽  
Social Settings ◽  
Practical Support ◽  
The Impact

Background: The UK’s test, trace, and isolate system are key measures to reduce the impact and spread of the COVID-19. However, engagement with and adherence to guidance on testing, self-isolation, and providing details of contacts can be low and interventions are needed. This qualitative study aimed to identify the key factors affecting adherence to test, trace, and isolate behaviours using the Theoretical Domains Framework (TDF). Methods: We conducted six online focus groups between October 2020 and February 2021 with people living in Sheffield who came into close contact with others in work or social settings (N = 30). The focus groups explored capability, opportunity, and motivational barriers to adherence to test, trace, and isolate behaviours. Framework analysis was used to code the data into TDF domains. Results: There is a complex relationship between the factors affecting COVID-19 symptom identification, testing, and self-isolation. People who perceived significant barriers to testing and self-isolation were less likely to interpret potential symptoms as COVID-19, and perceiving barriers to self-isolation reduced the likelihood of requesting a test. Concerns about the negative consequences of self-isolation for themselves and others were common and also influenced willingness to pass on details of contacts. There was a lack of trust in the Test and Trace system, with people wanting further evidence of being at risk of infection. Conclusions: Communications and interventions to increase adherence to test, trace, and isolate strategies need to consider the interplay of these behaviours and their influences and target them collectively. Efforts to promote testing should focus on the range of barriers to self-isolation, especially increasing financial and practical support, and include new messaging to promote symptom identification.

scholarly journals Improving support for breastfeeding mothers: a qualitative study on the experiences of breastfeeding among mothers who reside in a deprived and culturally diverse community

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Erica Jane Cook ◽  
Faye Powell ◽  
Nasreen Ali ◽  
Catrin Penn-Jones ◽  
Bertha Ochieng ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Culturally Diverse ◽  
Local Community ◽  
Framework Analysis ◽  
Black African ◽  
Early Stages ◽  
Practical Support ◽  
Diverse Community

Abstract Background The United Kingdom has one of the lowest breastfeeding rates in Europe, with the initiation and continuation of breastfeeding shown to be closely related to the mothers’ age, ethnicity and social class. Whilst the barriers that influence a woman’s decision to breastfeed are well documented, less is known how these barriers vary by the UK’s diverse population. As such, this study aimed to explore mothers’ experiences of breastfeeding and accessing breastfeeding services offered locally amongst a deprived and culturally diverse community. Methods A qualitative interpretive study comprising of 63 mothers (white British n = 8, Pakistani n = 13, Bangladeshi n = 10, black African n = 15 and Polish n = 17) who took part in single-sex focus groups, conducted in local community centres across the most deprived and ethnically diverse wards in Luton, UK. The focus groups were audio-recorded, transcribed and analysed thematically using Framework Analysis. Results The most common barriers to breastfeeding irrespective of ethnicity were perceptions surrounding pain and lack of milk. Confidence and motivation were found to be crucial facilitators of breastfeeding; whereby mothers felt that interventions should seek to reassure and support mothers not only during the early stages but throughout the breastfeeding journey. Mothers particularly valued the practical support provided by health care professions particularly surrounding positioning and attachment techniques. However, many mothers felt that the support from health care professionals was not always followed through. Conclusions The findings presented inform important recommendations for the design and implementation of future programs and interventions targeted at reducing breastfeeding inequalities. Interventions should focus on providing mothers practical support and reassurance not only during the early stages but throughout their breastfeeding journey. The findings also highlight the need for tailoring services to support diverse communities which acknowledge different traditional and familial practices.

scholarly journals Qualitative study using interviews and focus groups to explore the current and potential for antimicrobial stewardship in community pharmacy informed by the Theoretical Domains Framework

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025101 ◽  
Author(s):  
Leah Ffion Jones ◽  
Rebecca Owens ◽  
Anna Sallis ◽  
Diane Ashiru-Oredope ◽  
Tracey Thornley ◽  
...  
Keyword(s):  
Focus Groups ◽  
Community Pharmacy ◽  
Antimicrobial Stewardship ◽  
Self Care ◽  
Intervention Development ◽  
Theoretical Domains Framework ◽  
Community Pharmacists ◽  
Pharmacy Staff ◽  
Barriers And Opportunities ◽  
The Impact

ObjectivesCommunity pharmacists and their staff have the potential to contribute to antimicrobial stewardship (AMS). However, their barriers and opportunities are not well understood. The aim was to investigate the experiences and perceptions of community pharmacists and their teams around AMS to inform intervention development.DesignInterviews and focus groups were used to explore the views of pharmacists, pharmacy staff, general practitioners (GPs), members of pharmacy organisations and commissioners. The questioning schedule was developed using the Theoretical Domains Framework which helped inform recommendations to facilitate AMS in community pharmacy.Results8 GPs, 28 pharmacists, 13 pharmacy staff, 6 representatives from pharmacy organisations in England and Wales, and 2 local stakeholders participated.Knowledge and skills both facilitated or hindered provision of self-care and compliance advice by different grades of pharmacy staff. Some staff were not aware of the impact of giving self-care and compliance advice to help control antimicrobial resistance (AMR). The pharmacy environment created barriers to AMS; this included lack of time of well-qualified staff leading to misinformation from underskilled staff to patients about the need for antibiotics or the need to visit the GP, this was exacerbated by lack of space. AMS activities were limited by absent diagnoses on antibiotic prescriptions.Several pharmacy staff felt that undertaking patient examinations, questioning the rationale for antibiotic prescriptions and performing audits would allow them to provide more tailored AMS advice.ConclusionsInterventions are required to overcome a lack of qualified staff, time and space to give patients AMS advice. Staff need to understand how self-care and antibiotic compliance advice can help control AMR. A multifaceted educational intervention including information for staff with feedback about the advice given may help. Indication for a prescription would enable pharmacists to provide more targeted antibiotic advice. Commissioners should consider the pharmacists’ role in examining patients, and giving advice about antibiotic prescriptions.

Influences on diet and physical activity choices of 11–13-year-olds in a school setting

2019 ◽  
Vol 78 (5) ◽  
pp. 545-556 ◽  
Author(s):  
Camilla A McHugh ◽  
Lindsey Anderson ◽  
Jenny Lloyd ◽  
Stuart Logan ◽  
Katrina Wyatt
Keyword(s):  
Physical Activity ◽  
Focus Groups ◽  
School Environment ◽  
Food Choices ◽  
Future Research ◽  
Framework Analysis ◽  
Future Health ◽  
Diet And Physical Activity ◽  
Activity Choices ◽  
The Impact

Objective: This paper uses a qualitative approach to explore the factors that influence diet and physical activity choices of 11–13-year-olds with a particular focus on the impact of the school environment. Design: Qualitative focus groups. Setting: Three purposively sampled secondary schools in Devon, UK. Method: A total of 53 students, aged 11–13, took part in six focus groups. Thematic, framework analysis was used to analyse the data. Result: Four overarching themes emerged: (1) health now and in the future; (2) the role of others; (3) provision, temptation and addiction; and (4) boundaries, strategies and support. Participants demonstrated good knowledge of what constitutes a healthy lifestyle and its importance for future health, although it was not necessarily seen as a priority at this stage of life. Key influences on their choices were their peers and family, although participants also identified that the school environment influences the food choices they make while there. Conclusion: In this study, 11–13-year-olds identified that schools could do more to support them to make healthier food choices. However, future research needs to understand the constraints schools face in terms of food provision in order to highlight possible opportunities for intervention.

scholarly journals Barriers and facilitators to the effective de-escalation of conflict behaviours in forensic high-secure settings: A qualitative study

2020 ◽  
Author(s):  
Helena Goodman ◽  
Cat Papastavrou Brooks ◽  
Owen Price ◽  
Elizabeth Alexandra Barley
Keyword(s):  
Focus Groups ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Barriers And Facilitators ◽  
Framework Analysis ◽  
Building Relationships ◽  
Staff Members ◽  
Individual Interviews ◽  
Mental Health Settings ◽  
Dynamic Relationships

Abstract Background: Violent and aggressive incidents are common within mental health settings and are often managed using high-risk physical interventions such as restraint and seclusion. De-escalation is a first-line technique to manage conflict behaviours and prevent violence and aggression. There is limited research into the use of de-escalation in high-secure settings. This study investigated staff, patient and carer perspectives on the barriers and facilitators to using de-escalation for conflict behaviours.Methods: Semi-structured individual interviews (n=12) and focus groups (n=3) were conducted with eight patients, four carers and twenty-five staff members in a high-secure hospital in England. Interviews and focus groups were informed by the theoretical domains framework and were digitally recorded, transcribed verbatim and analysed using framework analysis and the COM-B behaviour change model. Results: Four themes and 15 sub-themes (barrier and facilitators) were identified. Themes related to capabilities (building relationships: knowing the patient and knowing yourself), opportunities (filling the void: challenges within the high-security environment; dynamic relationships) and motivation (keeping everyone safe). Strong staff-patient therapeutic relationships underpinned by trust, fairness, consistency and an awareness of the trauma-aggression link were considered key to successful de-escalation. Specific psychological and interpersonal skills including empathy, respect, reassurance, sincerity, genuine concern and validation of the patient perspective are needed to achieve this. Barriers related to the physical environment; organisational resources, practices and systems; staff traumatisation; hierarchical and punitive attitudes towards patient care, and an insufficient understanding of psychiatric diagnoses, especially personality disorder. It was apparent across themes that fear, which was experienced by both staff and patients, was a driver for many behaviours. Conclusions: This work has identified organizational and behaviour change targets for interventions seeking to reduce violence and restrictive practices through the use of de-escalation in high-secure hospitals. The potential for, and occurrence of, violence in such settings is high and leads to fear in patients and staff. The different factors which promote fear in each group should be addressed in de-escalation training.

scholarly journals Exploring Specialist Palliative Care Practitioner Perspectives on the Face Validity of the Attitude to Health Change Scales in Assessing the Impact of Life-limiting Illness on Patients and Carers

2021 ◽  
pp. 082585972110640
Author(s):  
Linda Machin ◽  
Catherine Walshe ◽  
Lesley Dunleavy
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Online Survey ◽  
Face Validity ◽  
Attitude To Health ◽  
Specialist Palliative Care ◽  
Framework Analysis ◽  
Coping Responses ◽  
Focus Group Data ◽  
The Impact

Background: Identifying and assessing vulnerability and resilience through reflexive reactions and conscious coping responses to life-limiting illness is an important, but rarely assessed, component of care. The novel Attitude to Health Change scales can contribute to this, but require fuller development and testing. Objectives: Exploring face validity of the Attitude to Health Change Scales (patient and carer versions) from the perspective of specialist palliative care professionals. Design: A two-stage study: (i) focus groups to explore experiences of scale use and wording, (ii) online survey to gather preferences on possible scale modifications. Focus group data were analysed using framework analysis. A hermeneutic approach was used to modify the wording of the scales, ensuring adherence to the underpinning concepts used in the design of the scale, congruence with the palliative care context, and simplicity of language. Setting/Subjects: Specialist palliative care practitioners in UK hospice settings who had been involved in pilot use of the scales in clinical practice. Results: 21 practitioners participated in 3 focus groups across 3 UK hospice sites, 9 of those participants responded to the survey. Four themes are presented: the importance and distinctiveness of the scales; maintaining conceptual integrity; ensuring a palliative care focus; and ensuring linguistic clarity. New iterations of the patient and carer versions of the Attitude to Health Change scales were developed. Conclusion: The scales appear to reflect the intended theoretical constructs, and are worded in a way which is congruent with the experience of specialist palliative care practitioners.

Impact of the COVID-19 Pandemic on International Negotiations

2021 ◽  
Vol 27 (3) ◽  
pp. 216-226
Author(s):  
D. M. Plotnikov ◽  
E. S. Funikova
Keyword(s):  
Online Communication ◽  
Business Communication ◽  
International Negotiations ◽  
Strong Impact ◽  
Negative Consequences ◽  
Daily Lives ◽  
Factors Affecting ◽  
Current Economic Situation ◽  
The Impact ◽  
The Way

Aim. The presented study aims to analyze factors affecting the way international negotiations are organized and conducted in the context of the COVID-19 pandemic.Tasks. The authors determine the positive and negative consequences of the pandemic for international negotiations and predict further development of the situation in this area.Methods. This study uses general scientific methods of cognition to examine the problem of reorganization of business activity in various aspects and identify characteristic trends in the current economic situation.Results. The coronavirus pandemic has had a strong impact on the daily lives of people, their interactions, and business communication. COVID-19 has led to significant transformations in business communication, emergence and modernization of various services for online interaction, including for conducting business negotiations. It is against this background that the attention to cybersecurity issues as a threat in the transition to online communication has increased.Conclusions. Examination of the impact of the COVID-19 pandemic on the way international negotiations are organized and conducted makes it possible not only to identify factors affect ing the transformation of all activities, but also to assess the consequences of ongoing changes and developments in the field of business communication.

scholarly journals Patient perspectives of nuisance bleeding and adherence to dual antiplatelet therapy: a qualitative study

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001405
Author(s):  
Christalla Pithara ◽  
Maria Pufulete ◽  
Thomas W. Johnson ◽  
Sabi Redwood
Keyword(s):  
Focus Groups ◽  
Antiplatelet Therapy ◽  
Information Seeking ◽  
Dual Antiplatelet Therapy ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Framework Analysis ◽  
Coronary Syndrome ◽  
The Impact ◽  
Medication Counselling

ObjectiveTo understand the experiences of patients with dual antiplatelet therapy (DAPT) and nuisance bleeding, and their perspectives of the impact of nuisance bleeding on medication adherence and information seeking.MethodsWe conducted focus groups with patients who had undergone percutaneous coronary intervention, coronary artery bypass graft and conservatively managed acute coronary syndrome patients. Two focus groups were with patients at the early stages of treatment (0–3 months), and two with patients coming to the end of treatment (9–12 months). Group discussions were audio recorded, and recordings were transcribed verbatim, anonymised and analysed using framework analysis.FindingsNine patients taking DAPT for up to 3 months, and 12 taking DAPT between 9 and 12 months participated in the focus groups. We found that: (1) participants adhered to treatment when they believed DAPT was important to health outcomes; (2) those who experienced nuisance bleeding reported symptoms to be mild and manageable; (3) participants’ and their family’s understanding of DAPT risks and benefits, and their ability to manage symptoms, influenced perspectives of and experiences with adherence. Factors influencing DAPT knowledge included access to medication counselling, engaging with information communicated during medication counselling, and access to timely, relevant and expert information and advice after discharge from hospital.ConclusionsPositive attitudes towards adherence were facilitated by knowledge and understanding of DAPT and confidence in dealing with symptoms caused by DAPT, but hindered by lack of opportunities to access relevant, timely and appropriate medication counselling. Education interventions should aim to support medication literacy through family-centred approaches and involve patients and families at all stages of intervention design and evaluation.

scholarly journals Exploring the Human Factors Affecting Health Service Managers: A Qualitative Study

2019 ◽  
Vol 7 (12) ◽  
pp. 2017-2023
Author(s):  
Mansour Ranjbar ◽  
Masoumeh Neishabouri ◽  
Mohammad Ali Heidari Gorji
Keyword(s):  
Health Service ◽  
Qualitative Study ◽  
Human Factors ◽  
Management Practices ◽  
Close Contact ◽  
Social Needs ◽  
Factors Affecting ◽  
Multiple Challenges ◽  
The Impact ◽  
Service Managers

BACKGROUND: In recent decades, managing health-service systems has faced multiple challenges. Identifying and resolving these challenges promote the efficiency and effectiveness of hospital activities. AIM: The present study aimed to explore the human factors affecting health service managers.MATERIAL AND METHODS: In this qualitative study, in-depth unstructured interviews were conducted with 29 employees who were in close contact with the health service managers. All the interviews were transcribed verbatim. Data were collected using purposeful sampling and were analysed using conventional content analysis via MAXQDA software.RESULTS: A group of 29 participants were interviewed (male 65.5%, female 34.4%). "Managing managers" has been identified as the primary theme with four supporting secondary themes including the inappropriate appointment of managers, the impact of human and social needs of managers, influential employees, and disrupting organisational communications. These are the challenges faced by managers in managing human resources in health-service organisations.CONCLUSION: Results showed that employees manage their managers within the organisation so that they can prevent managers from concentrating on their management affairs and tasks resulting in the distortion of management practices. The results of this study can help the key policy makers and planners in health-service organisations to guide the organisation to pursue its goals through appointing appropriate managers and identifying influential employees.

scholarly journals Barriers and facilitators to the effective de-escalation of conflict behaviours in forensic high-secure settings: A qualitative study

2020 ◽  
Author(s):  
Helena Mary Goodman ◽  
Cat Papastavrou Brooks ◽  
Owen Price ◽  
Elizabeth Alexandra Barley
Keyword(s):  
Focus Groups ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Barriers And Facilitators ◽  
Framework Analysis ◽  
Building Relationships ◽  
Staff Members ◽  
Individual Interviews ◽  
Mental Health Settings ◽  
Dynamic Relationships

Abstract Background: Violent and aggressive incidents are common within mental health settings and are often managed using high-risk physical interventions such as restraint and seclusion. De-escalation is a first-line technique to manage conflict behaviours and prevent violence and aggression. There is limited research into the use of de-escalation in high-secure settings. This study investigated staff, patient and carer perspectives on the barriers and facilitators to using de-escalation for conflict behaviours. Methods: Semi-structured individual interviews (n=12) and focus groups (n=3) were conducted with eight patients, four carers and twenty-five staff members in a high-secure hospital in England. Interviews and focus groups were informed by the theoretical domains framework and were digitally recorded, transcribed verbatim and analysed using framework analysis and the COM-B behaviour change model. Results: Four themes and 15 sub-themes (barrier and facilitators) were identified. Themes related to capabilities (building relationships: knowing the patient and knowing yourself), opportunities (filling the void: challenges within the high-security environment; dynamic relationships) and motivation (keeping everyone safe). Strong staff-patient therapeutic relationships underpinned by trust, fairness, consistency and an awareness of the trauma-aggression link were considered key to successful de-escalation. Specific psychological and interpersonal skills including empathy, respect, reassurance, sincerity, genuine concern and validation of the patient perspective are needed to achieve this. Barriers related to the physical environment; organisational resources, practices and systems; staff traumatisation; hierarchical and punitive attitudes towards patient care, and an insufficient understanding of psychiatric diagnoses, especially personality disorder. It was apparent across themes that fear, which was experienced by both staff and patients, was a driver for many behaviours. Conclusions: This work has identified organizational and behaviour change targets for interventions seeking to reduce violence and restrictive practices through the use of de-escalation in high-secure hospitals. The potential for, and occurrence of, violence in such settings is high and leads to fear in patients and staff. The different factors which promote fear in each group should be addressed in de-escalation training.

scholarly journals Using focus groups to evaluate a multiyear consumer health outreach collaboration

2021 ◽  
Vol 109 (4) ◽  
Author(s):  
Tara Malone ◽  
Shari Clifton
Keyword(s):  
Focus Groups ◽  
Health Information ◽  
Information Needs ◽  
Public Libraries ◽  
Structured Interview ◽  
Consumer Health Information ◽  
Consumer Health ◽  
Framework Analysis ◽  
Personal Lives ◽  
The Impact

Objectives: Academic health sciences librarians sought to evaluate the efficacy and future of the Health Information Specialists Program, a five-year consumer health information outreach collaboration with public libraries across the state.Methods: Five focus groups were held with participants from all five years of the program. Thirty-four participants from the program attended. Facilitators used structured interview guides consisting of eleven questions regarding the impact of the collaboration on participants’ abilities to connect themselves or others to health information; the usefulness of materials or knowledge gained and its applications; any consumer health outreach projects that arose from the program; and suggestions for future topics, formats, or modifications. Data was hand-coded and analyzed using the framework analysis methodology for qualitative research.Results: Participants reported feeling improved confidence and comfort in providing health information services to their patrons. Numerous instances of knowledge transfer—in their personal lives, with their colleagues, and for their patrons—were described. Participants reported improved abilities to both find and evaluate consumer health information, and many adapted class materials for their own programming or teaching. Suggestions were provided for future class topics as well as a program website.Conclusion: Based on data from the five focus groups, the Health Information Specialists Program has positively impacted participants in a number of ways. Primary among these were self-reported improvement in both health information retrieval skills and the ability to evaluate the reliability of health information online, as well as in the confidence to help patrons with their health information needs.

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