scholarly journals Maintaining face-to-face contact during the COVID-19 pandemic: a longitudinal qualitative investigation in UK primary care

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0036
Author(s):  
Andrew Turner ◽  
Anne Scott ◽  
Jeremy Horwood ◽  
Chris Salisbury ◽  
Rachel Denholm ◽  
...  
Keyword(s):  
Qualitative Interview ◽  
Infection Risk ◽  
Qualitative Investigation ◽  
Structured Interviews ◽  
Face To Face ◽  
Outdoor Spaces ◽  
National Guidance ◽  
Qualitative Interview Study ◽  
General Practices ◽  
Indoor And Outdoor

BackgroundIn March 2020 the COVID-19 pandemic required a rapid reconfiguration of UK general practice to minimise face-to-face contact with patients to reduce infection risk. However, some face-to-face contact remained necessary and practices needed to ensure such contact could continue safely.AimTo examine how practices determined when face-to-face contact was necessary and how face-to-face consultations were reconfigured to reduce COVID-19 infection risk.Design & settingQualitative interview study in general practices in Bristol, North Somerset and South Gloucestershire.MethodLongitudinal semi-structured interviews with clinical and managerial practice staff at four timepoints between May and July 2020.ResultsPractices worked flexibly within general national guidance to determine when face-to-face contact with patients was necessary, influenced by knowledge of the patient, experience, and practice resilience. For example, practices prioritised patients according to clinical need using face-to-face contact to resolve clinician uncertainty or provide adequate reassurance to patients. To make face-to-face contact as safe as possible and keep patients separated, practices introduced a heterogeneous range of measures that exploited features of their indoor and outdoor spaces and altered their appointment processes. As national restrictions eased in June and July, the number and proportion of patients seen face-to-face generally increased. However, the reconfiguration of buildings and processes reduced the available capacity and put increased pressure on practices.ConclusionPractices responded rapidly and creatively to the initial lockdown restrictions. The variety of ways practices organised face-to-face contact to minimise infection highlights the need for flexibility in guidance.

scholarly journals Maintaining face-to-face contact during the COVID-19 pandemic: a longitudinal qualitative investigation in UK primary care

2021 ◽  
Author(s):  
Andrew Turner ◽  
Anne Scott ◽  
Jeremy Horwood ◽  
Chris Salisbury ◽  
Rachel Denholm ◽  
...  
Keyword(s):  
Infection Risk ◽  
Qualitative Investigation ◽  
Structured Interviews ◽  
Practice Staff ◽  
Face To Face ◽  
Outdoor Spaces ◽  
National Guidance ◽  
General Practices ◽  
Increased Pressure ◽  
Indoor And Outdoor

Abstract BackgroundIn March 2020 the COVID-19 pandemic required a rapid reconfiguration of UK general practice to minimise face-to-face contact with patients to reduce infection risk. However, some face-to-face contact remained necessary and practices needed to ensure such contact could continue safely.AimTo examine how practices determined when face-to-face contact was necessary and how face-to-face consultations were reconfigured to reduce COVID-19 infection risk. Design and SettingQualitative interview study in general practices in Bristol, North Somerset and South Gloucestershire.MethodLongitudinal semi-structured interviews with clinical and managerial practice staff at four timepoints between May and July 2020.ResultsPractices worked flexibly within general national guidance to determine when face-to-face contact with patients was necessary, influenced by knowledge of the patient, experience, and practice resilience. For example, practices prioritised patients according to clinical need using face-to-face contact to resolve clinician uncertainty or provide adequate reassurance to patients. To make face-to-face contact as safe as possible and keep patients separated, practices introduced a heterogeneous range of measures that exploited features of their indoor and outdoor spaces and altered their appointment processes. As national restrictions eased in June and July, the number and proportion of patients seen face-to-face generally increased. However, the reconfiguration of buildings and processes reduced the available capacity and put increased pressure on practices.ConclusionPractices responded rapidly and creatively to the initial lockdown restrictions. The variety of ways practices organised face-to-face contact to minimise infection highlights the need for flexibility in guidance.

scholarly journals GPs’ and nurses’ perceptions of electronic cigarettes in England: a qualitative interview study

2018 ◽  
Vol 69 (678) ◽  
pp. e8-e14 ◽  
Author(s):  
Melissa Stepney ◽  
Paul Aveyard ◽  
Rachna Begh
Keyword(s):  
Electronic Cigarettes ◽  
Qualitative Interview ◽  
Interview Study ◽  
Structured Interviews ◽  
Face To Face ◽  
Perceptions And Attitudes ◽  
Qualitative Interview Study ◽  
Nurses Perceptions ◽  
Support Programmes ◽  
The Right

BackgroundReports from royal colleges and organisations such as Public Health England suggest that GPs and nurses should advise patients to switch to electronic cigarettes (e-cigarettes) if they do not want to stop smoking using licensed medication. However, there are no data on what practitioners think, feel, or do about e-cigarettes.AimTo explore practitioners’ perceptions and attitudes towards e-cigarettes, and their experiences of discussing e-cigarettes with patients.Design and settingA qualitative interview study was carried out with semi-structured interviews conducted with nurses and GPs across England in 2017.MethodParticipants were interviewed once either via telephone or face to face. Data were analysed using thematic analysis.ResultsInterviews were conducted with 23 practitioners (eight nurses and 15 GPs). There were three key themes: ambivalence and uncertainty; pragmatism; and responsibility. Many practitioners had uncertainties about the safety and long-term risks of e-cigarettes. Some had ambivalence about their own knowledge and ability to advise on their use, as well as uncertainty about whether to and what to advise patients. Despite this, many sought to provide honesty in consultations by acknowledging these uncertainties about e-cigarettes with patients and taking a pragmatic approach, believing that e-cigarettes were a ‘step in the right direction’. Practitioners wanted advice from healthcare regulators such as the National Institute for Health and Care Excellence to reassure them about the safety of e-cigarettes, practical tools to support the consultation, and to control their use by providing behavioural support programmes for reduction or cessation.ConclusionCurrent dissemination strategies for guidelines are not effective in reaching practitioners, who are offering more cautious advice about e-cigarettes than guidelines suggest is reasonable.

scholarly journals We Still Have Mutual Friends

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Sierra Burrier
Keyword(s):  
Sexual Abuse ◽  
Sexual Assault ◽  
Sexual Violence ◽  
Oral History ◽  
Qualitative Interview ◽  
Self Awareness ◽  
Holistic View ◽  
Face To Face ◽  
Qualitative Interview Study ◽  
The World

The project We Still Have Mutual Friends is a qualitative interview study into women’s experiences with sexualviolence. Through the interview process, mostly face-to-face recorded interviews, I have evaluated multiplefacets of sexual abuse/marginalization and their consequences on survivors. In total, I interviewed thirty-twowomen about their familial background, their adolescence, and depending on their age, their life experienceswith their sexuality. Some of the facets I have focused on are the disparity between a subject’s definition andtheir experience of sexual assault. I have also evaluated their self-awareness of this disparity, and why they thinkit occurs. I tried as much as I could, to ask questions in an order/way that did not create preferential answering.Because these interviews followed a standard oral history format of open-ended questions with follow-ups basedon the interviewee’s answers, instances of leading answers were possible. Seventeen out of thirty-two womenwere white, with the next largest group being Hispanic, and then Black. With ages ranging from eighteen upto fifty-eight, several generational voices are accounted for. While there were certain trends found within typesof assault, and who it was (trends not entirely new to us), one thing I discovered is a similar background everyperson shared with their family. All the women had at some point experienced some sort of “body policing.” Ihope this project has provided a more holistic view into the world of sexual violence that women face.

scholarly journals Parents and GPs’ understandings and beliefs about food allergy testing in children with eczema: qualitative interview study within the Trial of Eczema allergy Screening Tests (TEST) feasibility trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041229
Author(s):  
Clare Clement ◽  
Matthew J Ridd ◽  
Kirsty Roberts ◽  
Miriam Santer ◽  
Robert Boyle ◽  
...  
Keyword(s):  
Decision Making ◽  
Food Allergy ◽  
Qualitative Interview ◽  
Interview Study ◽  
Screening Tests ◽  
Feasibility Trial ◽  
Structured Interviews ◽  
Allergy Testing ◽  
Qualitative Interview Study ◽  
Severe Eczema

AimTo explore parent and general practitioner (GP) understanding and beliefs about food allergy testing for children with eczema.Design and settingQualitative interview study in UK primary care within the Trial of Eczema allergy Screening Tests feasibility trial.ParticipantsSemi-structured interviews with parents of children with eczema taking part in the feasibility study and GPs at practices hosting the study.Results21 parents and 11 GPs were interviewed. Parents discussed a range of potential causes for eczema, including a role for food allergy. They believed allergy testing to be beneficial as it could potentially identify a cure or help reduce symptoms and they found negative tests reassuring, suggesting to them that no dietary changes were needed. GPs reported limited experience and uncertainty regarding food allergy in children with eczema. While some GPs believed referral for allergy testing could be appropriate, most were unclear about its utility. They thought it should be reserved for children with severe eczema or complex problems but wanted more information to advise parents and help guide decision making.ConclusionsParents’ motivations for allergy testing are driven by the desire to improve their child’s condition and exclude food allergy as a possible cause of symptoms. GPs are uncertain about the role of allergy testing and want more information about its usefulness to support parents and help inform decision making.Trial registration numberISRCTN15397185.

scholarly journals Experiences of patients and physiotherapists with blended internet-based vestibular rehabilitation: a qualitative interview study

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101092
Author(s):  
Vincent A van Vugt ◽  
Anja JThCM de Kruif ◽  
Johannes C van der Wouden ◽  
Henriëtte E van der Horst ◽  
Otto R Maarsingh
Keyword(s):  
Controlled Trial ◽  
Randomised Trial ◽  
Qualitative Interview ◽  
Vestibular Rehabilitation ◽  
Interview Study ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Vestibular Symptoms ◽  
Randomised Controlled

BackgroundInternet-based vestibular rehabilitation (VR) with physiotherapy support, known as blended VR, was effective in reducing vestibular symptoms in a recent randomised controlled trial. Blended VR is a complex intervention comprised of physiotherapeutic visits, the vertigo training website, and VR exercises. Because of these interacting components, it is important to understand how blended VR works, for whom it works best, and how it should ideally be delivered.AimTo investigate the experiences of both patients and physiotherapists with blended internet-based VR.Design & settingA qualitative interview study was performed with patients who received blended internet-based VR with physiotherapy support, and physiotherapists who provided this support.MethodSemi-structured interviews were conducted with 14 patients and eight physiotherapists after the 6-month follow-up of the randomised trial. All interviews were audio-recorded, transcribed, and thematically analysed.ResultsAccording to both patients and physiotherapists, the physiotherapist visits were useful in providing personal attention, helping patients safely execute exercises, and improving patients’ adherence to therapy. Some patients said they did not need physiotherapist support and, according to physiotherapists, both the necessity and the optimal way to deliver guidance differed greatly between patients. The Vertigo Training website and exercises provided patients with a sense of control over their symptoms. Patients reported that the VR exercises were easy to perform and most patients continued to use them long after the trial ended.ConclusionIn blended VR, physiotherapeutic visits appear to offer benefits above the vertigo training website and VR exercises alone. Physiotherapy support may best be used when individually tailored.

scholarly journals Emotional distress and well-being among people with motor neurone disease (MND) and their family caregivers: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e044724
Author(s):  
Cathryn Pinto ◽  
Adam W A Geraghty ◽  
Lucy Yardley ◽  
Laura Dennison
Keyword(s):  
Emotional Distress ◽  
Well Being ◽  
Motor Neurone ◽  
Motor Neurone Disease ◽  
Psychological Interventions ◽  
Structured Interviews ◽  
Face To Face ◽  
Qualitative Interview Study ◽  
The Uk ◽  
Broad Understanding

ObjectiveWe aimed to get an in-depth understanding of the emotions experienced by people with motor neurone disease (MND) and their caregivers, and to explore what impacts emotional distress and well-being.DesignQualitative study using semi-structured interviews with people with MND and caregivers.SettingParticipants were recruited from across the UK and took part in interviews conducted either face to face, by telephone or email to accommodate for varying levels of disability.Participants25 people with MND and 10 caregivers took part. Participants were purposively sampled based on their MND diagnosis, symptoms and time since diagnosis.Data analysisData were analysed using inductive reflexive thematic analysis.ResultsEight broad themes were generated (20 subthemes). Participants described the emotional distress of losing physical function and having a threatened future because of poor prognosis. Keeping up with constant changes in symptoms and feeling unsupported by the healthcare system added to emotional distress. Finding hope and positivity, exerting some control, being kinder to oneself and experiencing support from others were helpful strategies for emotional well-being.ConclusionThe study provides a broad understanding of what impacts emotional distress and well-being and discusses implications for psychological interventions for people with MND and caregivers. Any communication and support provided for people with MND and their caregivers, needs to pay attention to concepts of hope, control and compassion.

Are Young Adults Talking about Their Family Health History? A Qualitative Investigation

2017 ◽  
Vol 32 (2) ◽  
Author(s):  
Lei Xu ◽  
Wura Jacobs ◽  
Mary Odum ◽  
Caitlin Melton ◽  
Lindsey Holland ◽  
...  
Keyword(s):  
Young Adults ◽  
Essential Role ◽  
Family Health ◽  
Family Health History ◽  
Qualitative Investigation ◽  
Structured Interviews ◽  
Face To Face ◽  
Health History ◽  
Culturally Tailored ◽  
Proactive Care

Family Health History (FHH) plays an essential role in risk assessment for a variety of hereditaryconditions. However, little is known about how young adults communicate with their family membersabout FHH. We conducted face-to-face, semi-structured interviews with 30 college students to gatherinformation about their FHH communications with family members. Our sample was diverse and halfof our participants were international young adults. Our findings indicated that none of the intervieweeshad initiated conversations about their FHH. Our findings highlight the need to provide culturally-tailored educational programs for young adults on the importance of collecting FHH for proactive care.

scholarly journals Improving GP communication in consultations on medically unexplained symptoms: a qualitative interview study with patients in primary care

2017 ◽  
Vol 67 (663) ◽  
pp. e716-e723 ◽  
Author(s):  
Juul Houwen ◽  
Peter LBJ Lucassen ◽  
Hugo W Stappers ◽  
Willem JJ Assendelft ◽  
Sandra van Dulmen ◽  
...  
Keyword(s):  
Symptom Management ◽  
Medically Unexplained Symptoms ◽  
Qualitative Interview ◽  
Structured Interview ◽  
Management Plan ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Specific Management

BackgroundMany GPs find the care of patients with medically unexplained symptoms (MUS) challenging. Patients themselves are often not satisfied with the care they receive.AimTo explore the problems patients with MUS experience in communication during consultations, with the aim of improving such consultationsDesign and settingA qualitative analysis of semi-structured interviews.MethodGP consultations were videorecorded and the GPs were asked immediately afterwards whether MUS were presented. Patients in these MUS consultations were asked to reflect on the consultation in a semi-structured interview while watching a recording of their own consultation.ResultsOf the 393 videorecorded consultations, 43 contained MUS. Patients who did identified six categories of problems. First, they reported a mismatch between the GP’s and their own agenda. Second, patients indicated that the GP evoked an uncomfortable feeling in them during the consultation. Third, they found that GPs did not provide a specific management plan for their symptoms. Fourth, patients indicated that the GP was not well prepared for the consultation. Fifth, they perceived prejudices in the GP during the consultation. Finally, one patient found that the GP did not acknowledge a limited understanding of the origin of the symptoms.ConclusionAccording to patients, GPs can improve their consultations on MUS by making genuine contact with their patients, by paying more attention to the patient’s agenda, and by avoiding evoking uncomfortable feelings and displaying prejudices. They should prepare their consultations and focus on the issues that matter to patients, for example, symptom management. GPs should be honest to patients when they do not understand the origin of symptoms.

scholarly journals Alternatives to the face-to-face consultation in general practice: focused ethnographic case study

2018 ◽  
Vol 68 (669) ◽  
pp. e293-e300 ◽  
Author(s):  
Helen Atherton ◽  
Heather Brant ◽  
Sue Ziebland ◽  
Annemieke Bikker ◽  
John Campbell ◽  
...  
Keyword(s):  
General Practice ◽  
Participant Observation ◽  
Health Issues ◽  
Ethnographic Case Study ◽  
Structured Interviews ◽  
Face To Face ◽  
The Face ◽  
General Practices ◽  
The One

BackgroundNHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives.AimTo understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice.Design and settingFocused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016.MethodNon-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report.ResultsCase study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal.ConclusionExperience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team.

scholarly journals Use of an electronic consultation system in primary care: a qualitative interview study

2017 ◽  
Vol 68 (666) ◽  
pp. e1-e8 ◽  
Author(s):  
Jon Banks ◽  
Michelle Farr ◽  
Chris Salisbury ◽  
Elly Bernard ◽  
Kate Northstone ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Decision Making ◽  
Qualitative Interview ◽  
Interview Study ◽  
Sufficient Information ◽  
Current Form ◽  
Financial Investment ◽  
Consultation System ◽  
Qualitative Interview Study ◽  
General Practices

BackgroundThe level of demand on primary care continues to increase. Electronic or e-consultations enable patients to consult their GP online and have been promoted as having potential to improve access and efficiency.AimTo evaluate whether an e-consultation system improves the ability of practice staff to manage workload and access.Design and settingA qualitative interview study in general practices in the West of England that piloted an e-consultation system for 15 months during 2015 and 2016.MethodPractices were purposefully sampled by location and level of e-consultation use. Clinical, administrative, and management staff were recruited at each practice. Interviews were transcribed and analysed thematically.ResultsTwenty-three interviews were carried out across six general practices. Routine e-consultations offered benefits for the practice because they could be completed without direct contact between GP and patient. However, most e-consultations resulted in GPs needing to follow up with a telephone or face-to-face appointment because the e-consultation did not contain sufficient information to inform clinical decision making. This was perceived as adding to the workload and providing some patients with an alternative route into the appointment system. Although this was seen as offering some patient benefit, there appeared to be fewer benefits for the practices.ConclusionThe experiences of the practices in this study demonstrate that the technology, in its current form, fell short of providing an effective platform for clinicians to consult with patients and did not justify their financial investment in the system. The study also highlights the challenges of remote consultations, which lack the facility for real time interactions.

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