scholarly journals Beliefs about prescribed medication among older patients with polypharmacy: a mixed methods study in primary care

2017 ◽  
Vol 67 (660) ◽  
pp. e507-e518 ◽  
Author(s):  
Barbara Clyne ◽  
Janine A Cooper ◽  
Fiona Boland ◽  
Carmel M Hughes ◽  
Tom Fahey ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Older Patients ◽  
Qualitative Data ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Inappropriate Prescribing ◽  
Adverse Outcomes ◽  
Mixed Methods Study ◽  
Negative Attitudes

BackgroundPolypharmacy (≥5 medications) is common in older patients and is associated with adverse outcomes. Patients’ beliefs about medication can influence their expectations for medication, adherence, and willingness to deprescribe. Few studies have examined beliefs about prescribed medication among older patients with polypharmacy in primary care.AimTo explore medication-related beliefs in older patients with polypharmacy and factors that might influence beliefs.Design and settingA mixed methods study utilising data from a randomised controlled trial aiming to decrease potentially inappropriate prescribing in older patients (≥70 years) in Ireland.MethodBeliefs were assessed quantitatively and qualitatively. Participants completed the Beliefs about Medicines Questionnaire by indicating their degree of agreement with individual statements about medicines on a 5-point Likert scale. Semi-structured qualitative interviews were conducted with a purposive sample of participants. Interviews were transcribed verbatim and a thematic analysis conducted. Quantitative and qualitative data were analysed separately and triangulated during the interpretation stage.ResultsIn total, 196 patients were included (mean age 76.7 years, SD 4.9, 54% male), with a mean of 9.5 (SD 4.1) medications per patient. The majority (96.3%) believed strongly in the necessity of their medication, while 33.9% reported strong concerns. Qualitative data confirmed these coexisting positive and negative attitudes to medications and suggested the importance of patients’ trust in GPs in establishing positive beliefs and potential willingness to deprescribe.ConclusionParticipants reported strong beliefs in medications with coexisting positive and negative attitudes. The doctor–patient relationship may have influenced beliefs and attitudes towards medicines, highlighting the importance of strong doctor–patient relationships, which need to be considered in the context of deprescribing.

scholarly journals The PUPPY Study - Protocol for a Longitudinal Mixed Methods Study Exploring Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year

2021 ◽  
Author(s):  
Emily Gard Marshall ◽  
Mylaine Breton ◽  
Benoit Cossette ◽  
Jennifer Isenor ◽  
Maria Mathews ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Nurse Practitioners ◽  
Qualitative Interviews ◽  
Mixed Methods Study ◽  
Specialist Care ◽  
Policy And Practice ◽  
Care Systems ◽  
Multi Stakeholder ◽  
The Impact

Background: The COVID-19 pandemic significantly disrupted primary care in Canada, with many walk-in clinics and family practices initially closing or being perceived as inaccessible, pharmacies remaining open with restrictions on patient interactions, rapid uptake of virtual care, and reduced referrals for lab tests, diagnostics, and specialist care. The PUPPY Study seeks to understand the impact of COVID-19 across the quadruple aim of primary care, with particular focus on the impacts on patients without attachment to a regular provider and those with chronic health conditions. Methods: The PUPPY study builds on an existing research program exploring patient access and attachment to primary care, pivoted to adapt to the emerging COVID-19 context. We will undertake a longitudinal mixed methods study to understand critical gaps in primary care access and coordination, comparing data pre- and post-pandemic in three Canadian provinces (Quebec, Ontario, and Nova Scotia). Multiple data sources will be used including: a policy review; qualitative interviews with primary care policymakers, providers (i.e., family physicians, nurse practitioners, and pharmacists), and patients (N=120); and medication prescribing and healthcare billings. The findings will inform the strengthening of primary care during and beyond the COVID-19 pandemic. Interpretation: This is the first study of its kind exploring the impacts of COVID-19 on primary care systems, with particular focus on the issues of patient's attachment and access to primary care. Our multi-stakeholder, cross-jurisdictional team will collaborate to rapidly disseminate findings and share implications for future policy and practice.

scholarly journals Mixed methods and survey research in family medicine and community health

2019 ◽  
Vol 7 (2) ◽  
pp. e000086 ◽  
Author(s):  
John W Creswell ◽  
Mariko Hirose
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Family Medicine ◽  
Data Collection ◽  
Community Health ◽  
Survey Research ◽  
Research Methodology ◽  
Qualitative Data ◽  
Mixed Methods Study ◽  
Integrate Survey

Many family medicine and community health researchers use surveys as an original research methodology. Our purpose is to illustrate how survey research provides an important form of quantitative research that can be effectively combined with qualitative data to form a mixed methods study. We first provide an overview of the key principles in survey research and in mixed methods research. We review the various ways that survey can be used in mixed methods studies, citing options such as beginning a study with a survey, using a survey as the second form of data collection, or combining a survey and a form of qualitative data in a single data collection procedure. Finally, we illustrate in a specific example six steps in conducting a mixed methods study using survey research. In a mixed methods study using a survey, primary care researchers should consider six steps. Step 1. Articulate the rationale for mixed methods study. Step 2. Detail quantitative and qualitative databases. Step 3. Identify a mixed methods design. Step 4. Analyse and report the results of the quantitative and qualitative databases. Step 5. Present and show integration. Step 6. Explicate the value of using mixed methods. The ability to combine and integrate survey research into a mixed methods study provides a more rigorous approach to research than conducting only a survey or conducting just a qualitative interview. While requiring skills beyond traditional survey approaches, surveys in primary care offers an opportunity for a high level of sophistication in research methodology.

Uncertainty about cellulitis and unmet patient information needs: a mixed methods study

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697349
Author(s):  
Anna Lalonde ◽  
Emma Teasdale ◽  
Ingrid Muller ◽  
Joanne Chalmers ◽  
Peter Smart ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Information Needs ◽  
Qualitative Data ◽  
Information Provision ◽  
Mixed Methods Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Face To Face ◽  
Patient Information Needs ◽  
History Of

BackgroundCellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis and their information needs.MethodMixed methods study comprising semi-structured, face-to-face interviews and cross-sectional survey, recruiting through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.ResultsThirty interviews were conducted between August 2016 and July 2017. Qualitative data revealed low prior awareness of cellulitis, uncertainty around diagnosis, concern/surprise at the severity of cellulitis, and perceived insufficient information provision. People were surprised they had never heard of the condition and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this bewildering. Two hundred and forty surveys were completed (response rate 17%). These showed that, while most people received information on the treatment of cellulitis (60.0%, n = 144), they reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need for provision of basic information for people with cellulitis, particularly being informed of the name of their condition, how to manage acute episodes, and how to reduce risk of recurrence.

Habits-GDM mobile application in managing gestational diabetes in Singapore: A mixed-methods study (Preprint)

2020 ◽  
Author(s):  
Shilpa Surendran ◽  
Chang Siang Lim ◽  
Gerald Choon Huat Koh ◽  
Tong Wei Yew ◽  
E Shyong Tai ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Randomised Controlled Trial ◽  
Gestational Diabetes ◽  
Healthcare Professionals ◽  
Controlled Trial ◽  
Perceived Usefulness ◽  
Mixed Methods Study ◽  
Automatic Data ◽  
Glucose Testing ◽  
Randomised Controlled

BACKGROUND The prevalence of gestational diabetes mellitus (GDM) is increasing in Singapore and the cost of providing traditional care for GDM is high. Mobile health (mHealth) applications may act as useful tools in the management of GDM. OBJECTIVE The objective of this mixed-methods study was to measure the usage behaviour and explore users’ perceived usefulness of the Habits-GDM application when managing GDM in a randomised controlled trial. METHODS We conducted a quantitative analysis of the application usage behaviour in 170 Habits-GDM application users and 14 semi-structured interviews with users from a randomised controlled trial. RESULTS The convenience of automatic data transfer of weight values to the Habits-GDM application helped users (116/170, 68%) log their weight at least once a week. However, when the application had usability challenges, users avoided using that feature, i.e. users logged only an average of less than one meal/week out of the recommended six meals/week. Of the usability challenges, many users (12/14, 85.7%) mentioned food items not worded in the commonly known way and limited ethnic food database as the primary barriers. Only half of the users (84/170, 49.4%) accessed the educational lessons, but many (9/14, 64%) identified the provision of always available, valuable health-related information as an advantage of the educational lessons. ‘Healthy eating’ and ‘Why exercise’ were the most (56/84, 66.67%) and least (38/84, 45.24%) frequently accessed educational lessons, respectively. Users (10/14, 71.4%) reported sending messages to the coach via the chat interface only when they faced logistic issues and 86.45% of all the coach messages were replies typed by the research coordinator in response to the logistics issues (i.e. a request for blood glucose testing strips and appointment confirmation) raised by the users. Healthcare professionals lack of access to the coach’s dashboard discouraged users from asking queries related to GDM via the e-coaching feature. CONCLUSIONS The findings suggest that mHealth application acts as a useful tool in managing GDM. Culturally sensitive mHealth applications with a provision for women to interact with healthcare professionals should be developed in cooperation with the users. CLINICALTRIAL Not applicable.

scholarly journals An Exploratory Mixed Methods Study of Experiences of Interprofessional Teams Who Received Coaching to Simultaneously Redesign Primary Care Education and Clinical Practice

2021 ◽  
Vol 12 ◽  
pp. 215013272110237
Author(s):  
Patricia A. Carney ◽  
W. Perry Dickinson ◽  
Jay Fetter ◽  
Eric J. Warm ◽  
Brenda Zierler ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Local Context ◽  
Primary Care Residency ◽  
Interprofessional Teams ◽  
Coaching Relationship ◽  
Team Coaching ◽  
Primary Care Education ◽  
Health Coaches

Introduction/Objectives: Coaching is emerging as a form of facilitation in health professions education. Most studies focus on one-on-one coaching rather than team coaching. We assessed the experiences of interprofessional teams coached to simultaneously improve primary care residency training and interprofessional practice. Methods: This three-year exploratory mixed methods study included transformational assistance from 9 interprofessional coaches, one assigned to each of 9 interprofessional primary care teams that included family medicine, internal medicine, pediatrics, nursing, pharmacy and behavioral health. Coaches interacted with teams during 2 in-person training sessions, an in-person site visit, and then as requested by their teams. Surveys administered at 1 year and end study assessed the coaching relationship and process. Results: The majority of participants (82% at end of Year 1 and 76.6% at end study) agreed or strongly agreed that their coach developed a positive working relationship with their team. Participants indicated coaches helped them: (1) develop as teams, (2) stay on task, and (3) respond to local context issues, with between 54.3% and 69.2% agreeing or strongly agreeing that their coaches were helpful in these areas. Cronbach’s alpha for the 15 coaching survey items was 0.965. Challenges included aligning the coach’s expertise with the team’s needs. Conclusions: While team coaching was well received by interprofessional teams of primary care professionals undertaking educational and clinical redesign, the 3 primary care disciplines have much to learn from each other regarding how to improve inter- and intra-professional collaborative practice among clinicians and staff as well as with interprofessional learners rotating through their outpatient clinics.

scholarly journals Engaging primary care providers in managing pediatric eating disorders: a mixed methods study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jocelyn Lebow ◽  
Cassandra Narr ◽  
Angela Mattke ◽  
Janna R. Gewirtz O’Brien ◽  
Marcie Billings ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Mixed Methods ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Care Providers ◽  
Evidence Based Treatment

Abstract Background The primary care setting offers an attractive opportunity for, not only the identification of pediatric eating disorders, but also the delivery of evidence-based treatment. However, constraints of this setting pose barriers for implementing treatment. For interventions to be successful, they need to take into consideration the perspectives of stakeholders. As such, the purpose of this study was to examine in-depth primary care providers’ perspective of challenges to identifying and managing eating disorders in the primary care setting. Methods This mixed methods study surveyed 60 Pediatric and Family Medicine providers across 6 primary care practices. Sixteen of these providers were further interviewed using a qualitative, semi-structured interview. Results Providers (n = 60, response rate of 45%) acknowledged the potential of primary care as a point of contact for early identification and treatment of pediatric eating disorders. They also expressed that this was an area of need in their practices. They identified numerous barriers to successful implementation of evidence-based treatment in this setting including scarcity of time, knowledge, and resources. Conclusions Investigations seeking to build capacities in primary care settings to address eating disorders must address these barriers.

Analyzing trends in the aural decoding errors of Japanese EFL learners

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kriss Lange ◽  
Joshua Matthews
Keyword(s):  
Mixed Methods ◽  
Qualitative Data ◽  
Mixed Methods Study ◽  
First Year ◽  
Formulaic Language ◽  
Decoding Skills ◽  
Efl Learners ◽  
Japanese University ◽  
Syntactic Knowledge ◽  
L2 Listening

Abstract Japanese EFL learners’ difficulty with accurately decoding connected English speech motivated this mixed methods study. The aural decoding capacities of 63 first-year Japanese university students, with low to intermediate level English proficiency, were first measured with a battery of paused transcription tests (PTT). The transcriptions were clusters of three-words that each possessed attributes typical of co-articulated speech. In addition, after each test, a subgroup of 10 participants individually listened to the same PTT and recounted introspective self-observations of their perceived difficulties with the aural decoding tasks in their L1. These quantitative and qualitative data were used to identify four trends in decoding errors which were categorized as follows: limited collocation familiarity, syntactic knowledge constraints, difficulties utilizing co-text, and L1 phonological influence. This study investigates some of the difficulties associated with aural decoding, highlights the challenges of identifying the origins of decoding errors and suggests that more focus is needed on developing decoding skills as well as knowledge of formulaic language in L2 listening education.

scholarly journals Students’ and Instructors’ Understandings, Attitudes and Beliefs about Educational Theories: Results of a Mixed-Methods Study

2021 ◽  
Vol 11 (5) ◽  
pp. 197
Author(s):  
Stefan T. Siegel ◽  
Martin Daumiller
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Study ◽  
Attitudes And Beliefs ◽  
Abstract Concepts ◽  
Negative Attitudes ◽  
Self Reflection ◽  
Educational Theories ◽  
Practical Implications ◽  
Constitutive Element ◽  
Educational Studies

(1) Background: Educational theories are a constitutive element of educational studies. Despite their theoretical relevance, little is still known about students’ and instructors’ understandings of educational theories and their theory-related attitudes and beliefs. (2) Methods: To elucidate these constructs and to test their relevance, we conducted a mixed-methods study with 32 students and 12 instructors of educational studies at a German university. (3) Results: We found that both groups perceived educational theories as rather abstract concepts. Students reported rather negative attitudes and naive beliefs. For both groups, we found that attitudes and beliefs were strongly tied to motivational and affective aspects when dealing with educational theories, which stresses their relevance for educational studies. (4) Conclusions: We suggest a systematic theoretical clarification of the term educational theories. Furthermore, consideration of students’ and instructors’ theory-related attitudes and beliefs can give rise to meaningful practical implications (e.g., through self-reflection).

Sign in / Sign up

Export Citation Format

Share Document