scholarly journals Evaluation of a Case Management to Support Families With Children Diagnosed With Spinal Muscular Atrophy—Protocol of a Controlled Mixed-Methods Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Jana Willems ◽  
Erik Farin-Glattacker ◽  
Thorsten Langer
Keyword(s):  
Mixed Methods ◽  
Case Management ◽  
Muscular Atrophy ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Mixed Methods Approach ◽  
Management Intervention ◽  
Care Integration ◽  
Case Management Intervention

Background: Spinal muscular atrophy (SMA) is a rare neuromuscular disease characterized by degeneration of the anterior horn cells in the spinal cord, resulting in muscle atrophy, and proximal muscle weakness. SMA presents with a wide range of symptoms requiring multiple clinical specialists and therapists. Integrating care between disciplines can be challenging due to the dynamic course of the disease, and great distances between specialist centers and local providers. Insufficient care integration can lead to suboptimal quality of care and more difficulties for patients and families. This study aims to improve care integration through a Case Management intervention, and taking a mixed-methods approach, to evaluate its impact.Methods: An exploratory, controlled, two-armed study with baseline, post- and follow-up measurement and process evaluation is conducted to evaluate our intervention compared to usual care. Through a multi-perspective state analysis, we investigate the experiences of caregivers and healthcare providers concerning the actual healthcare quality of patients with SMA I and II. Semi-structured interviews and care diaries are used. We apply that data to conceive a tailored Case Management intervention supplemented by a digital platform. The intervention's effect is examined in comparison to a control group taking a mixed-methods approach. As primary endpoints, we investigate the caregivers' health-related quality of life and the quality of care integration. Secondary endpoints are the use of healthcare services (patients and caregivers) and costs. We assess the process quality from the perspectives of caregivers and healthcare providers through semi-structured interviews.Discussion: This is an exploratory, controlled study to assess the impact of a tailored Case Management intervention to improve the care of patients with SMA I and II. After the evaluation, results on feasibility, expected effect sizes, and process quality will be available. On this basis, future randomized controlled trials can be planned. If demonstrated beneficial, the experience gained within this study may also be valuable for care strategies in other regions and other (non-pediatric) patient groups with rare diseases and/or chronic, complex conditions.Clinical Trial registration:https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00018778, identifier: DRKS00018778.

scholarly journals Healthcare Providers and Caregivers’ Perspectives on the Quality of Child Health Services in Urban Indonesia: A Mixed-Methods Study

2021 ◽  
Vol 18 (15) ◽  
pp. 8047
Author(s):  
Agus Setiawan ◽  
Poppy Fitriyani ◽  
Rizkiyani Istifada ◽  
Shefaly Shorey
Keyword(s):  
Mixed Methods ◽  
Child Health ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Mixed Methods Study ◽  
Child Health Services ◽  
Structured Interviews ◽  
Mortality And Morbidity ◽  
Factors Affecting

Although Indonesia’s child mortality rate has decreased in tandem with the global trend, healthcare services can be further improved for children. This study aims to explore the perceptions of healthcare providers and caregivers of children aged below five years to improve child health in urban Indonesia. A mixed-methods study design was adopted. Quantitative data were collected via questionnaires from the caregivers. Qualitative data were collected via semi-structured interviews from the healthcare providers. Analysis of 540 caregiver questionnaires regarding the care provided to their child revealed that the majority of them were very satisfied (46.1%) and satisfied (52.2%) with the care received. Analysis of 12 interviews with healthcare providers derived three major themes: (1) importance of one’s role as a healthcare provider; (2) factors affecting the delivery of healthcare; and (3) the way forward in caring for young children. Although caregivers were very satisfied with the care received for their children, the perception of healthcare providers regarding their responsibility in delivering care to children under five years old provides insights into improving the quality of services for children in Indonesia. Our findings suggest that mortality and morbidity of children aged below five years can be best reduced by optimizing primary and secondary preventive measures.

Randomized controlled trial of technology-assisted case management in low-income adults with type 2 diabetes: Effect on quality of life and blood pressure

2021 ◽  
pp. 1357633X2110284
Author(s):  
Leonard E Egede ◽  
Aprill Z Dawson ◽  
Rebekah J Walker ◽  
Emma Garraci ◽  
Rebecca G Knapp
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Case Management ◽  
Low Income ◽  
Controlled Trial ◽  
Control Group ◽  
Management Intervention ◽  
Randomized Controlled ◽  
Case Management Intervention

Introduction A novel randomized controlled trial tested the efficacy of a technology-assisted case management program in a low income, rural population previously where nurses titrated medication over the phone instead of in a clinic. The primary analysis showed significant improvement in glycemic control at 6 months post-randomization decreasing hemoglobin A1c by 1%. This study aimed to test if the intervention was also effective at decreasing blood pressure without compromising quality of life. Methods A total of 113 adults with poorly controlled diabetes (hemoglobin A1c ≥ 8%) were randomly assigned to the technology-assisted case management intervention or usual care. Participants received a 2-in-1 telehealth system to monitor glycemic and blood pressure control, which was uploaded daily to a central server. A nurse case manager was trained to titrate medication under physician supervision every 2 weeks based on the readings. Outcomes were blood pressure and quality of life (12-item Short-Form Health Survey) at 6 months. Baseline adjusted mixed models using a random intercept were used to evaluate change at 6 months for the technology-assisted case management intervention group compared to usual care. Results There were no statistically significant differences in systolic blood pressure, physical component of quality of life, or mental component of quality of life between the technology-assisted case management and control group. However, there was a significant change in diastolic blood pressure over time, with the technology-assisted case management group decreasing at 6 months ( p = .05), whereas the control group remained stable. Conclusions Technology-assisted case management by a nurse with medication titration under physician supervision was efficacious in improving diastolic blood pressure without compromising quality of life in low-income rural adults with diabetes.

Risk perception on the labour ward: A mixed methods study

2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue
Keyword(s):  
Mixed Methods ◽  
Lived Experience ◽  
Healthcare Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Daily Basis ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Staff Support ◽  
Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

Exploring the association of learning participation with the quality of life of older Chinese adults: A mixed methods approach

2018 ◽  
Vol 44 (5-6) ◽  
pp. 378-390 ◽  
Author(s):  
Renfeng Wang ◽  
Liesbeth De Donder ◽  
Free De Backer ◽  
Karen Triquet ◽  
Li Shihua ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Chinese Adults ◽  
Mixed Methods Approach ◽  
Older Chinese ◽  
Older Chinese Adults

scholarly journals Health-related quality of life among 13–14 year old adolescents with overweight - a mixed methods approach

2019 ◽  
Author(s):  
Turid Kristin Bigum Sundar ◽  
Kirsti Riiser ◽  
Milada Småstuen ◽  
Randi Opheim ◽  
Knut Løndal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Well Being ◽  
Reference Population ◽  
Health Related Quality ◽  
Structured Interviews ◽  
Post Intervention ◽  
Related Quality ◽  
Health Related

Abstract BackgroundOverweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study with the aim of increasing PA, reducing BMI and promoting HRQoL.Methods Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents’ HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13–14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52.ResultsHRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. ConclusionThe use of the KIDSCREEN 52 instrument gave important indications about the adolescents’ HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL, indicating better ways of providing help. More research using the benefits of mixed methods approaches is needed to further elucidate these findings.

Short-Term Response to Counseling and Case Management Intervention in a Domestic Violence Shelter

1997 ◽  
Vol 81 (3_suppl) ◽  
pp. 1243-1251 ◽  
Author(s):  
John R. McNamara ◽  
Melissa A. Ertl ◽  
Sue Marsh ◽  
Suzanne Walker
Keyword(s):  
Domestic Violence ◽  
Case Management ◽  
Drop Out ◽  
Short Term ◽  
Domestic Violence Shelter ◽  
Management Intervention ◽  
Case Management Intervention ◽  
Skill Deficits ◽  
Shelter Services

81 women who accessed counseling and case management services at a domestic violence shelter after three sessions reported that abuse decreased, life satisfaction increased, perceived coping ability improved, as did their satisfaction with the services. Shelter users, however, also displayed significant skill deficits in the inability to apprise or respond appropriately to abusive situations. Limitations on understanding how shelter services affect longer-term outcomes were ascribed to high drop out rates and the absence of follow-up measures. Researchers need to address the causes of drop-out and what specific interventions can meet the needs of short-term shelter users.

Who Creates Microtransactions : The Production Context of Video Game Monetization

2021 ◽  
Author(s):  
Lies van Roessel ◽  
Jan Švelch
Keyword(s):  
Content Analysis ◽  
Mixed Methods ◽  
Data Analysis ◽  
Frequency Analysis ◽  
Video Game ◽  
Job Descriptions ◽  
Structured Interviews ◽  
Game Development ◽  
Mixed Methods Approach ◽  
Roles And Responsibilities

Despite a growing academic interest in in-game monetization, much less attention has been paid to the production context of microtransactions. With this chapter, we aim to address this gap by focusing on the roles and responsibilities related to video game monetization. We answer the titular question of this chapter using a mixed methods approach, combining semi-structured interviews, content analysis of job descriptions, and frequency analysis of in-game credits. Results suggest that monetization responsibilities are both being integrated into various existing roles, including game designers or product managers, but also spawn new dedicated roles of monetization specialists. Monetization as a game development task is closely related to data analysis and only inconsistently appears in in-game credits.

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