scholarly journals Factors Influencing the Uptake of Canadian Research Findings into the Care of Children with Arthritis: A Healthcare Provider Perspective

2018 ◽  
Vol 46 (3) ◽  
pp. 294-300 ◽  
Author(s):  
Benjamin Rose-Davis ◽  
Janet Curran ◽  
Julia Wright ◽  
Tania Cellucci ◽  
Ciarån M. Duffy ◽  
...  
Keyword(s):  
Clinical Care ◽  
Healthcare Providers ◽  
Theoretical Domains Framework ◽  
Barriers And Facilitators ◽  
Primary Role ◽  
Comprehensive Overview ◽  
Allied Health Professionals ◽  
Translation Strategies ◽  
Telephone Interviews ◽  
Knowledge Translation Strategies

Objective.To determine barriers and facilitators to the uptake of findings from the Research in Arthritis in Canadian Children emphasizing Outcomes (ReACCh-Out) study into clinical care by pediatric rheumatologists (PR) and allied health professionals (AHP) caring for children with juvenile idiopathic arthritis (JIA) in Canada.Methods.PR and AHP participated in this qualitative study through telephone interviews. Interview guides were developed using the Theoretical Domains Framework and focused on the use of information from the ReACCh-Out study in the practice of counseling patients and families. A directed content analysis approach was used for coding.Results.Nineteen interviews (8 PR and 11 AHP) were completed. All PR had knowledge of the ReACCh-Out study. Three major themes were identified: (1) both groups are motivated to use information from research in clinical care; (2) volume and emotional effect of information on families are barriers; and (3) specific timepoints in care trigger providing this information. AHP had less knowledge of the ReACCh-Out study, did not feel it was their primary role to provide this information, and have a desire for more opportunity to participate in academic forums related to research.Conclusion.We have described a comprehensive overview of the barriers and facilitators perceived by healthcare providers in the translation of knowledge from JIA research into use in clinical practice. These findings provide a foundation for the development of knowledge translation strategies in the care of children with JIA and other rheumatic diseases.

Barriers and facilitators for the usage of a personal health record for medication reconciliation: a qualitative study among patients (Preprint)

2021 ◽  
Author(s):  
Denise van der Nat ◽  
Victor J B Huiskes ◽  
Margot Taks ◽  
Bart J F van den Bemt ◽  
Hein A W van Onzenoort
Keyword(s):  
Qualitative Study ◽  
Medication Reconciliation ◽  
Data Exchange ◽  
Personal Health Record ◽  
Healthcare Providers ◽  
Theoretical Domains Framework ◽  
Information Provision ◽  
Perceived Usefulness ◽  
Barriers And Facilitators ◽  
Personal Health

BACKGROUND Transitions in care are a risk factor for medication discrepancies, which can be identified and solved with medication reconciliation (MR). However, MR is a time consuming process, its effect on clinical outcomes is limited and a central role for patients is missing. As multiple organizations stimulate a more central role for patients in healthcare, personal health records (PHRs) are more often applied in medical care. However, patients’ adoption rate of using a PHR for MR is low. OBJECTIVE Therefore, the aim of this study was to provide insight into patients’ barriers and facilitators for the usage of a PHR for MR prior to an in- or outpatient visit. METHODS A qualitative study was conducted among PHR users and non-users who had a planned visit at the in- or outpatient clinic. About one week after the visit, patients were interviewed about barriers and facilitators for the use of a PHR for MR using a semi-structured interview guide based on the theoretical domains framework. Afterwards, data were analysed following thematic content analysis. RESULTS In total, 10 PHR users and 10 PHR non-users were interviewed. The barriers and facilitators were classified in four domains: 1) patient, consisting of the barriers: limited (health) literacy and/or computer skills, limited perceived usefulness and/or motivation, concerns about data safety, no computer/smartphone, and poor memory, and the facilitators: perceived importance/usefulness and place and time independent; 2) application, consisting of the barriers: practical and technical issues, poor usability and missing functionalities, and the facilitators: improve usability and add functionalities; 3) process, consisting of the barrier: ambiguity about who is responsible, the patient or the healthcare provider, and the facilitators: check by healthcare providers, more frequent update of medication list by healthcare providers and target patients who benefit most and/or have sufficient skills; 4) context, consisting of the barriers: lack of data exchange and connectivity between ICT applications, privacy concerns, healthcare professional do not use the requested data, insufficient information provision and bad (timing) of invitations and reminders, and the facilitators: integration of different applications, information provision by healthcare providers and support of professionals and/or family. CONCLUSIONS Patients reported barriers and facilitators for using a PHR to perform MR are identified at the patient, application, process and context level. Furthermore, patients indicated that they become more engagement in their own healthcare when they use a PHR. To improve the implementation of MR by using PHRs, the barriers and facilitators need to be addressed to effectively develop and implement PHRs in the MR process.

scholarly journals A Framework for Development of Useful Metabolomic Biomarkers and Their Effective Knowledge Translation

Metabolites ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. 59 ◽  
Author(s):  
Calena Marchand ◽  
Farshad Farshidfar ◽  
Jodi Rattner ◽  
Oliver Bathe
Keyword(s):  
Knowledge Translation ◽  
Patent Protection ◽  
Biomarker Discovery ◽  
Clinical Care ◽  
Interdisciplinary Teams ◽  
Natural Phenomenon ◽  
Translation Strategies ◽  
Patient Advocate ◽  
Metabolomic Data ◽  
Knowledge Translation Strategies

Despite the significant advantages of metabolomic biomarkers, no diagnostic tests based on metabolomics have been introduced to clinical use. There are many reasons for this, centered around substantial obstacles in developing clinically useful metabolomic biomarkers. Most significant is the need for interdisciplinary teams with expertise in metabolomics, analysis of complex clinical and metabolomic data, and clinical care. Importantly, the clinical need must precede biomarker discovery, and the experimental design for discovery and validation must reflect the purpose of the biomarker. Standard operating procedures for procuring and handling samples must be developed from the beginning, to ensure experimental integrity. Assay design is another challenge, as there is not much precedent informing this. Another obstacle is that it is not yet clear how to protect any intellectual property related to metabolomic biomarkers. Viewing a metabolomic biomarker as a natural phenomenon would inhibit patent protection and potentially stifle commercial interest. However, demonstrating that a metabolomic biomarker is actually a derivative of a natural phenomenon that requires innovation would enhance investment in this field. Finally, effective knowledge translation strategies must be implemented, which will require engagement with end users (clinicians and lab physicians), patient advocate groups, policy makers, and payer organizations. Addressing each of these issues comprises the framework for introducing a metabolomic biomarker to practice.

scholarly journals Healthcare Providers’ Knowledge of Disordered Sleep, Sleep Assessment Tools, and Nonpharmacological Sleep Interventions for Persons Living with Dementia: A National Survey

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Cary A. Brown ◽  
Patricia Wielandt ◽  
Donna Wilson ◽  
Allyson Jones ◽  
Katelyn Crick
Keyword(s):  
Healthcare Providers ◽  
Assessment Tools ◽  
Assessment Practices ◽  
Term Care ◽  
Translation Strategies ◽  
Sleep Diaries ◽  
Knowledge Translation Strategies ◽  
Sleep Assessment ◽  
The Relationship

A large proportion of persons with dementia will also experience disordered sleep. Disordered sleep in dementia is a common reason for institutionalization and affects cognition, fall risk, agitation, self-care ability, and overall health and quality of life. This report presents findings of a survey of healthcare providers’ awareness of sleep issues, assessment practices, and nonpharmacological sleep interventions for persons with dementia. There were 1846 participants, with the majority being from nursing and rehabilitation. One-third worked in long-term care settings and one-third in acute care. Few reported working in the community. Findings revealed that participants understated the incidence of sleep deficiencies in persons with dementia and generally lacked awareness of the relationship between disordered sleep and dementia. Their knowledge of sleep assessment tools was limited to caregiver reports, self-reports, and sleep diaries, with few using standardized tools or other assessment methods. The relationship between disordered sleep and comorbid conditions was not well understood. The three most common nonpharmacological sleep interventions participants identified using were a regular bedtime routine, increased daytime activity, and restricted caffeine. Awareness of other evidence-based interventions was low. These findings will guide evidence-informed research to develop and test more targeted and contextualized sleep and dementia knowledge translation strategies.

scholarly journals Using Theoretical Domains Framework to Identify Barriers and Enablers to Implementing a Virtual Tertiary-regional Telemedicine Rounding and Consultation (TRaC-K) Model for Kids: A Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Sumedh Bele ◽  
Christine Cassidy ◽  
Janet Curan ◽  
David W. Johnson ◽  
J A Michelle Bailey
Keyword(s):  
Rural Areas ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Theoretical Domains Framework ◽  
Perceived Barriers ◽  
Successful Implementation ◽  
Access To Health Services ◽  
Barriers And Enablers ◽  
Pediatric Hospitals ◽  
Regional Hospitals

BACKGROUND Inequities in access to health services is a global concern and a concern for Canadian populations living in rural areas. Rural children hospitalized at tertiary children’s hospitals have higher rates of medical complexity and experience more expensive hospitalizations and more frequent readmissions. The two tertiary pediatric hospitals in Alberta, Canada have already been operating over capacity, but the pediatric beds at regional hospitals are underutilized. Such imbalance could lead to poor patient safety, and increased readmission risk at tertiary pediatric hospitals and diminish the clinical exposure of regional pediatric healthcare providers, erode their confidence, and compel health systems to further reduce the capacity in regional sites. A “Telemedicine Rounding and Consultation for Kids” (TRaC-K) model was proposed to enable healthcare providers at the Alberta Children’s Hospital to partner with their counterparts in Medicine Hat Regional Hospital to provide inpatient clinical care for pediatric patients who would otherwise have to travel or be transferred to the tertiary site. OBJECTIVE The current study is aimed at identifying perceived barriers and enablers to implementing the TRaC-K model. METHODS This study was guided by the Theoretical Domain Framework (TDF) and utilized qualitative methods. We collected qualitative data from 42 participants from tertiary and regional hospitals through 31 semi-structured interviews and two focus groups. This data was thematically analysed to identify major sub-themes within each TDF domain. These sub-themes were further aggregated themes and categorized into as barriers or enablers to the TRaC-K model and were tabulated separately. RESULTS Our study identified 31 sub-themes in 14 TDF domains ranging from administrative issues to specific clinical conditions. We were able to merge these sub-themes into larger themes and categorize them into 4 barriers and 4 enablers. Our findings showed that barriers were lack of awareness of telemedicine, skills to provide virtual clinical care, and unclear processes and resources to support TRaC-K and concerns about clear roles and responsibilities. To the contrary, enablers were of healthcare providers’ motivation to provide care closer to home, supporting system resource stewardship, site and practice compatibility, and motivation to strengthen tertiary-regional relationships. CONCLUSIONS Systematic enquiry of perceived barriers and enablers to implementation of TRaC-K helped us gain insights from various healthcare providers and family member’s perspectives. We will use these findings to design interventions to overcome the identified barriers and harness the enablers to encourage successful implementation of TRaC-K. These findings will inform the implementation of telemedicine-based interventions in pediatric settings in other parts of Canada and beyond. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1186/s12913-018-3859-2

scholarly journals Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Caitlin McArthur ◽  
Yuxin Bai ◽  
Patricia Hewston ◽  
Lora Giangregorio ◽  
Sharon Straus ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Long Term Care ◽  
Barriers And Facilitators ◽  
Care Staff ◽  
Evidence Based ◽  
Term Care ◽  
Translation Strategies ◽  
Knowledge Translation Strategies ◽  
Evidence Based Guidelines

Abstract Background The long-term care setting poses unique challenges and opportunities for effective knowledge translation. The objectives of this review are to (1) synthesize barriers and facilitators to implementing evidence-based guidelines in long-term care, as defined as a home where residents require 24-h nursing care, and 50% of the population is over the age of 65 years; and (2) map barriers and facilitators to the Behaviour Change Wheel framework to inform theory-guided knowledge translation strategies. Methods Following the guidance of the Cochrane Qualitative and Implementation Methods Group Guidance Series and the ENTREQ reporting guidelines, we systematically reviewed the reported experiences of long-term care staff on implementing evidence-based guidelines into practice. MEDLINE Pubmed, EMBASE Ovid, and CINAHL were searched from the earliest date available until May 2021. Two independent reviewers selected primary studies for inclusion if they were conducted in long-term care and reported the perspective or experiences of long-term care staff with implementing an evidence-based practice guideline about health conditions. Appraisal of the included studies was conducted using the Critical Appraisal Skills Programme Checklist and confidence in the findings with the GRADE-CERQual approach. Findings After screening 2680 abstracts, we retrieved 115 full-text articles; 33 of these articles met the inclusion criteria. Barriers included time constraints and inadequate staffing, cost and lack of resources, and lack of teamwork and organizational support. Facilitators included leadership and champions, well-designed strategies, protocols, and resources, and adequate services, resources, and time. The most frequent Behaviour Change Wheel components were physical and social opportunity and psychological capability. We concluded moderate or high confidence in all but one of our review findings. Conclusions Future knowledge translation strategies to implement guidelines in long-term care should target physical and social opportunity and psychological capability, and include interventions such as environmental restructuring, training, and education.

scholarly journals Professional barriers and facilitators to using stratified care approaches for managing non-specific low back pain: a qualitative study with Canadian physiotherapists and chiropractors

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Fadi M. AL Zoubi ◽  
Simon D. French ◽  
Andrea M. Patey ◽  
Nancy E. Mayo ◽  
André E. Bussières
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Theoretical Domains Framework ◽  
Readiness For Change ◽  
Barriers And Facilitators ◽  
Low Back ◽  
Chronic Patients ◽  
Telephone Interviews ◽  
Stratified Care

Abstract Background Recent clinical practice guidelines for the management of non-specific low back pain (LBP) recommend using stratified care approaches. To date, no study has assessed barriers and facilitators for health professionals in using stratified care approaches for managing non-specific LBP in the Canadian primary care setting. This study aimed to identify and contrast barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors. Methods Individual telephone interviews, underpinned by the Theoretical Domains Framework (TDF), explored beliefs and attitudes about, and identified barriers and facilitators to the use of stratified care approaches for managing non-specific LBP in a purposive sample of 13 chiropractors and 14 physiotherapists between September 2015 and June 2016. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using directed content analysis. Results Three and seven TDF domains were identified as likely relevant for physiotherapists and chiropractors, respectively. Shared key beliefs (and relevant domains of the TDF) for both physiotherapists and chiropractors included: lack of time, cost, and expertise (Environmental Context and Resources); and consulting more experienced colleagues and chronic patients with important psychological overlay (Social Influences). Unique key domains were identified among physiotherapists: incompatibility with achieving other objectives (Goals), and chiropractors: confidence in using stratified care approaches (Beliefs about Capabilities); intention to use stratified care approaches (Intentions); awareness and agreement with stratified care approaches (Knowledge); assessment of readiness for change and intentional planning behaviour (Behavioural Regulation); and improving the management of non-specific LBP patients and the uptake of evidence-based practice (Beliefs about Consequences). Conclusions Several shared and unique barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors were identified. Findings may help inform the design of tailored theory-based knowledge translation interventions to increase the uptake of stratified care approaches in clinical practice.

Interventions to change clinician behaviour in relation to suicide prevention care in the emergency department: A scoping review protocol

2020 ◽  
Author(s):  
Hwayeon Danielle Shin ◽  
Christine Cassidy ◽  
Janet Curran ◽  
Lori Weeks ◽  
Leslie Anne Campbell ◽  
...  
Keyword(s):  
Emergency Department ◽  
Suicide Prevention ◽  
Behaviour Change ◽  
Clinical Care ◽  
Grey Literature ◽  
Allied Health Professionals ◽  
Wide Range ◽  
Knowledge And Attitude ◽  
Clinician Behaviour ◽  
Google Search

Objective: This review aims to explore, characterize, and map the literature on interventions implemented to change emergency department (ED) clinicians’ behaviour related to suicide prevention using the Behaviour Change Wheel (BCW) as a guiding theoretical framework. Introduction: An ED is a critical place for suicide prevention. Yet, many patients who present with suicide-related thoughts and behaviours are discharged without proper assessment or appropriate treatment. Supporting clinicians (who provide direct clinical care, including nurses, physicians, allied health professionals) to make the desired behaviour change following evidence-based suicide prevention care is an essential step toward improving patient outcomes. However, reviews to date have yet to take a theoretical approach to investigate interventions implemented to change clinicians’ behaviour. Inclusion criteria: This review will consider literature that includes interventions that target ED clinicians’ behaviour change related to suicide prevention. Behaviour change refers to observable practice changes as well as proxy measures of behaviour change including knowledge and attitude. There are many ways in which an intervention can change clinicians’ behaviour (e.g., education, altering service delivery). This review will include a wide range of interventions that target behaviour change regardless of the type but exclude interventions that exclusively target patients.Methods: Multiple databases will be searched: PubMed, PsycInfo, CINAHL and Embase. We will also include grey literature, including Google search, ProQuest Dissertations and Theses Global, and Scopus conference papers. Full text of included studies will be reviewed, critically appraised and extracted. Extracted data will be coded to identify intervention functions using the BCW. Findings will be summarized in tables accompanied by narrative reports.

Healing experience for family caregivers after an intensive care unit death

2019 ◽  
pp. bmjspcare-2018-001561 ◽  
Author(s):  
Susan DeSanto-Madeya ◽  
Dan Willis ◽  
Julie McLaughlin ◽  
Aristotle Boslet
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Caregivers ◽  
Phenomenological Study ◽  
Healthcare Providers ◽  
Loved One ◽  
Hermeneutic Phenomenological ◽  
Telephone Interviews ◽  
Hermeneutic Phenomenological Study ◽  
Purposive Sample

ObjectivesFamily caregivers suffer a high burden of emotional and psychological distress following the death of a loved one in the intensive care unit and often struggle to heal in the weeks following their loss. The purpose of this hermeneutic phenomenological study was to describe and interpret the experience of healing for family caregivers six weeks following the death of a loved one in the ICU.MethodsSemi-structured telephone interviews were conducted with a purposive sample of twenty-four family caregivers six weeks following the death of their loved ones in the ICU. Qualitative analysis techniques were used to identify common themes central to the experience of healing across all interviews.ResultsSeven themes were interpreted from the data: searching for clarity from a time of uncertainty; riding an emotional rollercoaster; seeking peace in one’s decisions; moving forward with each new day; taking comfort in the memories; valuing layers of support; and discovering life on one’s own.ConclusionBy identifying and gaining an understanding of healing following the death of a loved one in the ICU, nursing and other healthcare providers have an opportunity to promote healing and positively impact family caregiver’s bereavement.

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