Dose Administration Aid Service in Community Pharmacies: Characterization and Impact Assessment

Adherence to therapies is a primary determinant of treatment success. Lack of medication adherence is often associated with medical and psychosocial issues due to complications from underlying conditions and is an enormous waste of medical resources. Dose Administration Aid Service (DAAS) can be seen as part of the solution, allowing individual medicine doses to be organized according to the dosing schedule determined by the patient’s prescriber. The most recent systematic reviews admit the possibility of a positive impact of this service. In line with this background, the study reported in this paper aimed to characterize DAAS implementation in Portugal and understand the perceptions of pharmacists and owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution. The study was guided by qualitative description methodology and reported using the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were collected through semi-structured interviews with 18 pharmacists and/or owners of community pharmacies. Using qualitative content analysis, we identified categories that revealed that automated weekly methodology is the preferred methodology, because of its easiness of use and lower cost of preparation. However, the investment cost was felt to be too high by the participants considering the number of potential users for implementation in practice. Participants were also unanimous in recognizing that DAAS has a very positive impact in terms of safety and medication adherence, and the majority agreed that it also helped reduce medication waste. Implications of these findings for medication adherence are discussed.

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P076: Assessment of a newly integrated and standardized approach for pediatric concussions aimed to improve the concussion recovery process

CJEM ◽

10.1017/cem.2020.282 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S91-S92

Author(s):

J. St.Onge ◽

E. Karreman ◽

M. McCarron ◽

L. Harasen ◽

C. Ames

Keyword(s):

Positive Impact ◽

Qualitative Content Analysis ◽

Recovery Process ◽

Return To School ◽

Structured Interviews ◽

Discharge Data ◽

Written Information ◽

Return To Learn ◽

Concussion Recovery ◽

The Impact

Introduction: Children with concussions presenting to emergency departments often receive very different recommendations for how to recover. In addition, there are no instructions for teachers to how children should return to learn and play after a concussion. Therefore, some children take too long to return to learn and play at school while others return too soon, thereby risking long-term problems because their brain injury is not fully healed. The purpose of this project is to determine the impact of a new integrated, standardized approach aimed to help a concussed child recover faster and whether the recovery experience for all involved has improved. Methods: Structured interviews were conducted with 11 parents of children treated for concussion at the Emergency Department of Pasqua Hospital in Regina, SK, four of whom received care after a change in practice whereby parents were provided with a return-to-school protocol form prior to discharge. Data were analyzed using an inductive qualitative content analysis approach using NVivo 12 software. Results: Three main categories were noted in the data: Parental response to the child's concussion, satisfaction with health services, and the communication amongst parents, physicians, and teachers. It was with regard to the last theme in particular that the impact of the return to school protocol was noted, helping to at least indirectly address the issue of the parent as the “middleman” in the communication triad. Most parents whose children received care prior to the introduction of the protocol suggested that providing written information at discharge to guide parents through the concussion recovery process would be helpful. Conclusion: Our initial results show a positive impact in regards to the process of children returning to learn and play after a concussion. Specifically, the increased communication between physician, teacher, and parent seems to benefit and improve the child's recovery process.

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Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03842-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kirsten Austad ◽

Michel Juarez ◽

Hannah Shryer ◽

Patricia L. Hibberd ◽

Mari-Lynn Drainoni ◽

...

Keyword(s):

Health Workers ◽

Positive Impact ◽

Qualitative Evaluation ◽

Obstetric Care ◽

Hospital Staff ◽

Public Hospitals ◽

Future Research ◽

Care Seeking ◽

Structured Interviews ◽

The Impact

Abstract Background Global disparities in maternal mortality could be reduced by universal facility delivery. Yet, deficiencies in the quality of care prevent some mothers from seeking facility-based obstetric care. Obstetric care navigators (OCNs) are a new form of lay health workers that combine elements of continuous labor support and care navigation to promote obstetric referrals. Here we report qualitative results from the pilot OCN project implemented in Indigenous villages in the Guatemalan central highlands. Methods We conducted semi-structured interviews with 17 mothers who received OCN accompaniment and 13 staff—namely physicians, nurses, and social workers—of the main public hospital in the pilot’s catchment area (Chimaltenango). Interviews queried OCN’s impact on patient and hospital staff experience and understanding of intended OCN roles. Audiorecorded interviews were transcribed, coded, and underwent content analysis. Results Maternal fear of surgical intervention, disrespectful and abusive treatment, and linguistic barriers were principal deterrents of care seeking. Physicians and nurses reported cultural barriers, opposition from family, and inadequate hospital resources as challenges to providing care to Indigenous mothers. Patient and hospital staff identified four valuable services offered by OCNs: emotional support, patient advocacy, facilitation of patient-provider communication, and care coordination. While patients and most physicians felt that OCNs had an overwhelmingly positive impact, nurses felt their effort would be better directed toward traditional nursing tasks. Conclusions Many barriers to maternity care exist for Indigenous mothers in Guatemala. OCNs can improve mothers’ experiences in public hospitals and reduce limitations faced by providers. However, broader buy-in from hospital staff—especially nurses—appears critical to program success. Future research should focus on measuring the impact of obstetric care navigation on key clinical outcomes (cesarean delivery) and mothers’ future care seeking behavior.

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Public libraries digital services and sustainability issues

The Bottom Line Managing Library Finances ◽

10.1108/bl-12-2014-0034 ◽

2015 ◽

Vol 28 (1/2) ◽

pp. 34-43 ◽

Cited By ~ 5

Author(s):

Katarina Michnik

Keyword(s):

Public Libraries ◽

Qualitative Content Analysis ◽

Public Library ◽

Structured Interviews ◽

Content Type ◽

The Sustainable Development ◽

Digital Services ◽

Local Politicians ◽

Physical Spaces ◽

The Impact

Purpose – The purpose of this paper is to study how Swedish local politicians perceive the impact of public library digital services on public libraries and to discuss how this can affect the sustainable development of public libraries. Design/methodology/approach – Empirical data were collected through semi-structured interviews with local politicians from 19 different Swedish municipalities. Data were treated to qualitative content analysis and discussed based on the concept of sustainable organization. Findings – According to local politicians, public library digital services may affect public libraries through changes to libraries’ physical spaces, librarians’ tasks and competencies and libraries’ economic situations. Based on these findings, public library digital services can both strengthen and weaken public library sustainability through, for example, increased access and expenditures, the latter of which may threaten public library sustainability. Research limitations/implications – Interviews did not focus specifically on the politicians’ views on public library digital services but dealt generally with their views on public libraries. To identify reasons for variations in views on this topic, follow-up interviews should be done. Data on views from public library managers would also be of use to determine the degree to which they are shared with local politicians. Originality/value – When sustainability and public libraries are discussed, the focus is generally on the library’s contribution to a sustainable society. Here, the focus is instead on the sustainability of the public library itself.

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CARING FOR THE CAREGIVER: EXPLORING THE EXPERIENCE OF CAREGIVING FOR A CHID WITH MEDICAL COMPLEXITY

Paediatrics & Child Health ◽

10.1093/pch/pxy054.139 ◽

2018 ◽

Vol 23 (suppl_1) ◽

pp. e55-e56

Author(s):

Jessica Teicher ◽

Natalie Weiser ◽

Danielle Arje ◽

Julia Orkin

Keyword(s):

Health Status ◽

Social Inequalities ◽

Qualitative Content Analysis ◽

Qualitative Description ◽

Medical Educator ◽

Holistic View ◽

The Family ◽

Medical Complexity ◽

The Impact ◽

Caregiver Burnout

Abstract BACKGROUND Children with medical complexity (CMC) represent a growing population in the paediatric healthcare system. CMCs’ multiple health needs, illness severity, and fragility lead to a high degree of caregiver burnout, parental employment loss, and other social and financial consequences. Healthcare providers must consider a holistic view of the family, including consideration of social determinants of health [SDOH]: socio-economic status, employment, quality of housing, availability of social support, and access to healthcare services. This study addresses a gap in current research by exploring how caring for a CMC exacerbates social inequalities, and how these challenges may be mitigated. OBJECTIVES 1. What are the SDOH impacting CMC and their families? 2. How do families report the impact of their child’s medical complexity on their social circumstances? DESIGN/METHODS A qualitative description approach was used to enable rich data collection through semi-structured interviews until thematic saturation was reached. Nine interviews were conducted with CMC caregivers who were chosen by purposeful sampling. The interview guide was developed by expert consultation and iteratively refined. Ethics approval and written consent were obtained. Interviews were recorded and transcribed verbatim. Three team members independently coded the interviews for recurrent themes to inform qualitative content analysis. RESULTS Caregiving for a CMC is all-consuming, requiring parents to take on roles including planner, medical professional, medical educator, and advocate. Parents of CMC report three major areas negatively impacted by caregiving: 1) physical and mental health; 2) personal relationships; and 3) finances. Additionally, three themes emerged describing enablers for resiliency: 1) the CMC’s health status when well or stable in hospital; 2) acceptance of one’s limitations as a caregiver and of the family’s ‘new normal’; and 3) broad supports including medical, personal, financial, and educational. CONCLUSION The wellbeing of CMC families is impacted by medical and social factors. An interdisciplinary model of care may offset some of the caregiver’s advocacy and medical educator responsibilities. Paediatricians can support families of CMC by providing comprehensive care for all components of the child’s health status, and by including routine assessment of the family’s SDOH. Finally, explicit discussion about parental expectations and caregiver burnout helps foster a positive therapeutic relationship with the family.

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Is it Worth Flipping? The Impact of Flipped Classroom on EFL Students’ Grammar

English Language Teaching ◽

10.5539/elt.v13n6p144 ◽

2020 ◽

Vol 13 (6) ◽

pp. 144 ◽

Cited By ~ 1

Author(s):

Ishaq Salim Al-Naabi

Keyword(s):

Flipped Classroom ◽

Positive Impact ◽

Future Research ◽

Flipped Learning ◽

Structured Interviews ◽

Intact Group ◽

English Grammar ◽

Post Test ◽

Quasi Experimental ◽

The Impact

In light of contemporary pedagogical methods, the flipped classroom has been recognised as an effective pedagogy in English as a Foreign Language (EFL). This study employed a quasi-experimental one-group research design to investigate the impact of flipped learning on Omani EFL learners’ grammar and to examine students’ perceptions on the flipped classroom. An intact group of students (n=28) enrolled at the foundation programme in Arab Open University-Oman was randomly selected. Seven videos on English grammar were developed and shared with the students prior to the class. A varaiety of activities were conducted in the class following task-based language teaching. Students met for 8 lessons over the period of 8 weeks. Pre-test, post-test and semi-structured interviews were used in the study. The findings indicated that flipped learning had a positive impact on students’ understanding and usage of English grammar. Students’ perceptions on the flipped approach were positive. The study also provided pedagogical insights for the flipped classroom and recommendations for future research. 

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20 Adolescent and caregiver perspectives on living with a limb fracture: A qualitative study

Paediatrics & Child Health ◽

10.1093/pch/pxab061.014 ◽

2021 ◽

Vol 26 (Supplement_1) ◽

pp. e12-e13

Author(s):

Manisha Bharadia ◽

Stevi Golden-Plotnik ◽

Michael van Manen ◽

Mithra Sivakumar ◽

Amy Drendel ◽

...

Keyword(s):

Social Dynamics ◽

Qualitative Content Analysis ◽

Functional Limitations ◽

Pediatric Emergency ◽

Family Impact ◽

Structured Interviews ◽

Discharge Instructions ◽

Caregiver Support ◽

Fracture Function ◽

The Impact

Abstract Primary Subject area Emergency Medicine - Paediatric Background Fractures occur in up to half of children by age 16 years. After initial emergency care for a fracture, function is universally impaired in children, and impacts extend to the immediate family. Knowledge of expected functional limitations is key to providing proper discharge instructions and anticipatory guidance to families. Objectives Our study objectives were to understand: 1) how adolescents (12-17 years) describe the functional impact of fractures on their lives; 2) how adolescents’ reports of their experiences compare to those of their caregivers; and 3) the impact of the fracture on the family unit. Design/Methods We conducted individual, semi-structured interviews from June 2019 to November 2020 with adolescents and their caregivers, 7-14 days following their initial visit to a pediatric emergency department. We utilized qualitative content analysis methodology. Recruitment proceeded until thematic saturation was achieved. Coding and analysis were concurrent with recruitment and interviews. A secondary coder reviewed 40% of the transcripts, and the coding team met regularly to discuss the coding framework and key themes. The interview script was modified in an iterative process, to reflect emerging themes. Results We completed a total of 29 interviews. The most commonly affected functions were: a) showering and hygiene (which required the most caregiver support); b) sleep variability (due to pain and cast-related discomfort); and c) exclusion from sports/activities. Many adolescents experienced disruptions to social activities and gatherings. Adolescents valued independence and often chose to take more time to complete a task to preserve this, regardless of inconvenience. Both adolescents and caregivers reported feelings of frustration as a result of day-to-day impacts imposed by the injury. Generally, caregivers’ perspectives were in keeping with the experiences that adolescents described for themselves. Notable family impacts included what we described as ‘sibling burden’ or conflicts that arose when a sibling had to take on extra chores/tasks. Conclusion These themes highlight an opportunity to better tailor discharge instructions for adolescents with fractures. Key messages include: 1) expect pain and impaired sleep, especially in the first few days; 2) allow extra time to complete tasks independently, especially for grooming and hygiene; 3) consider family impact, especially sibling burden; 4) prepare for changes in activities and social dynamics; and 5) frustration is normal, for both adolescents and caregivers. Future work can focus on developing a novel, family-informed tool to assess functional outcomes following injury.

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“It’s My Time”: Older Adults’ Experiences and Perceived Benefits of Participation in an Intergenerational Rock Band

Music Therapy Perspectives ◽

10.1093/mtp/miz021 ◽

2019 ◽

Vol 38 (2) ◽

pp. 187-194

Author(s):

Natalie Wlodarczyk

Keyword(s):

Older Adults ◽

Older Adult ◽

Positive Impact ◽

Qualitative Content Analysis ◽

Perceived Benefits ◽

Structured Interviews ◽

Rock Band ◽

Ability Levels ◽

Free Environment ◽

First Time

Abstract The purpose of this qualitative content analysis was to explore the experiences and perceived benefits for older adult members who participated in an intergenerational rock band (IGRB) pairing older adults with college students. Participants (n = 29) were first-time older adult IGRB members who completed semi-structured interviews over the course of 5 years. Interviews were completed within 1 week of the conclusion of the semester-long participation in the IGRB. Each interview was digitally recorded, manually transcribed, and analyzed using an iterative approach to thematic analysis. Experiences and perceived benefits associated with participation in the IGRB for these older adults were encompassed by four themes: Staying Active, Wanting to Try Something New, Feeling Connected, and Seeking Positive Experiences. Findings indicate that an IGRB is an innovative, collaborative, and inclusive intergenerational music-making experience that leaves a multifaceted and overall positive impact on its older adult members. Themes suggest that older adults with musical backgrounds may enjoy an experience like an IGRB because it brings a level of familiarity coupled with the opportunity to try something new and different from their previous experiences with music. A key contribution of this study is the importance of promoting a judgment-free environment for singing that is inclusive of all ability levels. Developing a better understanding of older adults’ motivations for participating in an IGRB may help us to plan future music experiences for older adults and broaden our reach to the older adult community.

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‘Physical appearance and well-being in adults with incurable cancer: a thematic analysis’

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002632 ◽

2020 ◽

pp. bmjspcare-2020-002632

Author(s):

Philippa Tollow ◽

Jane Ogden ◽

Candida S McCabe ◽

Diana Harcourt

Keyword(s):

Thematic Analysis ◽

Psychosocial Support ◽

Positive Impact ◽

Well Being ◽

Emotional Impact ◽

Structured Interviews ◽

Incurable Cancer ◽

The Impact ◽

Appearance Changes

ObjectivesExisting research has established the importance of appearance concerns for individuals with cancer and identified appearance as an important factor in dying with dignity. No research, however, has explored in depth the role of appearance in the experiences of individuals who have incurable cancer. This research aims to explore patients’ experiences and perspectives in relation to the role of appearance issues in adults with incurable cancer.MethodsSemi-structured interviews were conducted with 24 adults with incurable cancer (20 women, 4 men; mean age 54.5, SD 11.32).ResultsThematic analysis generated three themes: ‘Identity: Embodying Cancer’, ‘Communication: Wearing your illness’ and ‘Support: Holistic Care’. Appearance was felt to be an important element of identity, which was often dominated by cancer, leading to feelings of separation from the participant’s previous self. Appearance changes also influenced the way in which individuals communicated with their external world, forcing discussion of their diagnosis, and increasing focus on their cancer, with participants having to manage the emotional impact of this on loved ones, as well as the impact on their legacy. Finally, participants highlighted the positive impact of appearance-related support in their well-being and identified peer connections and refocusing on the self as key elements of such support.ConclusionsAppearance changes play an important role in the experiences of individuals with incurable cancer with regards to both identity and communication and challenged participants’ ability to maintain normalcy. Further psychosocial support relating to appearance concerns was considered necessary to promote dignity and provide truly holistic patient care.

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Implementing Portfolio-Based Learning (PoBL) for L2 Training: Vietnamese EFL Learners’ Motivational Orientations and Listening Achievement

TESL Canada Journal ◽

10.18806/tesl.v37i3.1342 ◽

2020 ◽

Vol 37 (3) ◽

Author(s):

Ngo Cong-Lem

Keyword(s):

Language Learners ◽

Positive Impact ◽

Qualitative Content Analysis ◽

Value Theory ◽

Control Beliefs ◽

Structured Interviews ◽

Motivational Orientations ◽

Efl Learners ◽

Foreign Language Learners ◽

Langue Seconde

Whilst previous researchers commonly report on the effect of portfolio-based instruction on L2/EFL (second language/English as a foreign language) learners’ language performance, very few studies examine its impact on their learning motivation. Drawing on expectancy-value theory, the current study examines how the implementation of a portfolio-based listening course may affect language learners’ L2 motivation and skill development. This study adopted a mixed method approach with Vietnamese EFL learners in higher education as its participants who were administered a motivation questionnaire, listening comprehension tests, and semi-structured interviews. Both quantitative statistics and qualitative content analysis were applied for data analysis purposes. The results indicated that the portfolio-based program in this study had a significant positive impact on the participants’ motivational orientations, especially their expectancy components (i.e., their self-efficacy and learning control beliefs) and their L2 listening accomplishment but not on the value aspects. Pedagogical implications are discussed. Alors que les chercheurs précédents font des rapports fréquents à propos des incidences sur la performance langagière des apprenants de L2/ALE (langue seconde/anglais langue étrangère) qu’a l’instruction basée sur le portfolio, très peu d’études examinent son impact sur leur motivation d’apprentissage. En s’inspirant de la théorie de l’expectancy-value, la présente étude examine comment la mise en place d’un cours d’écoute basé sur le portfolio peut affecter la motivation et le développement des compétences des apprenants de langue seconde. Cette étude a adopté une démarche à plusieurs méthodes auprès d’apprenants universitaires d’anglais langue étrangère vietnamiens à qui on a administré un questionnaire de motivation, des tests de compréhension orale et des entrevues semi-structurées. On a appliqué à la fois des statistiques quantitatives et une analyse qualitative du contenu à des fins d’analyse des données. Les résultats ont indiqué que le programme de cette étude, basé sur le portfolio, avait un impact positif significatif sur les orientations motivationnelles des participants, particulièrement sur les composantes de leurs attentes (c’est-à-dire leur efficacité personnelle et leurs croyances dans le contrôle de l’apprentissage) et leurs résultats d’écoute, mais pas sur les aspects de valeur. On discute des implications pédagogiques.

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Do Community Free-Medication Service Policy Improve Patient Medication Adherence? A Cross-Sectional Study of Patients With Severe Mental Disorders in Beijing Community

Frontiers in Public Health ◽

10.3389/fpubh.2021.714374 ◽

2021 ◽

Vol 9 ◽

Author(s):

Junli Zhu ◽

Qingzhi Huang ◽

Wei Lu ◽

Yun Chen ◽

Bin Li ◽

...

Keyword(s):

Mental Health ◽

Medication Adherence ◽

Mental Health Problems ◽

Positive Impact ◽

Cross Sectional Study ◽

Cross Sectional ◽

Patient Medication ◽

Multi Stage ◽

Service Policy ◽

The Impact

Background: Nowadays, mental health problems have become a major concern affecting economic and social development, with severe mental health disorders being the top priority. In 2013, Beijing began to implement the Community Free-Medication Service policy (CFMS). This article aims to evaluate the effect of the policy on medication adherence.Methods: In this study, multi-stage sampling was used to select representative patients as samples. Some of the baseline data were obtained by consulting the archives, and information about patient medication adherence measured by Brooks Medication Adherence Scale was obtained through face-to-face interviews. Logistic regression was used to examine the impact of the policy.Results: Policy participation had a significant positive impact on medication adherence (OR = 1.557). The effect of policy participation on medication adherence in the Medication-only mode and Subsidy-only mode were highly significant, but it was not significant in the Mixed mode.Conclusion: This study found that the CFMS in Beijing as an intervention is effective in improving the medication adherence of community patients. However, the impact of the policy is not consistent among service modes. Reinforcement magnitude and frequency should be considered when designing reinforcement interventions.

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