I like it but I don’t have time to tell patients’ families: Exploring barriers and facilitators of pain and dementia knowledge flow between healthcare providers and family caregivers

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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A75 IMPLEMENTING A CIRRHOSIS ORDER SET: A QUALITATIVE ANALYSIS OF PROVIDER-IDENTIFIED BARRIERS AND FACILITATORS

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.073 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 41-42

Author(s):

E Johnson ◽

M Carbonneau ◽

D Campbell-Scherer ◽

P Tandon ◽

A Hyde

Keyword(s):

Focus Groups ◽

Gastrointestinal Disease ◽

Pragmatic Trial ◽

Healthcare Providers ◽

Structured Interview ◽

Barriers And Facilitators ◽

Care Utilization ◽

Implementation Barriers ◽

Mortality And Morbidity ◽

Order Set

Abstract Background Cirrhosis is the leading cause of mortality and morbidity in individuals with gastrointestinal disease. Multiple care gaps exist for hospitalized patients with cirrhosis, resulting in high rates of re-hospitalization (e.g. 44% at 90 days in Alberta). The Cirrhosis Care Alberta (CCAB) is a 4-year multi-component pragmatic trial with an aim to reduce acute-care utilization by implementing an electronic order set and supporting education across eight hospital sites in Alberta. Aims As part of the pre-implementation evaluation, this qualitative study analyzed data from provider focus groups to identify barriers and facilitators to implementation. Methods We conducted focus groups at eight hospital sites with a total of 54 healthcare providers (3–12 per site). A semi-structured interview guide based upon constructs of the Consolidated Framework for Implementation Research (CFIR) and Normalization Process Theory (NPT) frameworks was used to guide the focus groups. Focus groups were recorded and transcribed verbatim. Data was analyzed thematically and inductively. Results Five major themes emerged across all eight sites: (i) understanding past implementation experiences, (ii) resource challenges, (iii) competing priorities among healthcare providers, (iv) system challenges, and (v) urban versus rural differences. Site-specific barriers included perceived lack of patient flow, time restraints, and concerns about the quality and quantity of past implementation interventions. Facilitators included passionate project champions, and an ample feedback process. Conclusions Focus groups were useful for identifying pre-implementation barriers and facilitators of an electronic orders set. Findings from this study are being refined to address the influence of COVID-19, and the data will be used to inform the intervention roll-out at each of the sites. Funding Agencies Alberta Innovates

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407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

International Psychogeriatrics ◽

10.1017/s1041610220002604 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 123-123

Author(s):

Ken Schwartz ◽

Robert Madan ◽

Anna Berall ◽

Marsha Natadira ◽

Anna Santiago

Keyword(s):

Family Caregivers ◽

Health Care Providers ◽

Healthcare Providers ◽

Well Being ◽

Moderate Degree ◽

Quick Response ◽

Care Providers ◽

High Level ◽

Person With Dementia ◽

The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

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Family Physician’s and Primary Care Team’s Perspectives on Supporting Family Caregivers in Primary Care Networks

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063293 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3293

Author(s):

Jasneet Parmar ◽

Sharon Anderson ◽

Marjan Abbasi ◽

Saeed Ahmadinejad ◽

Karenn Chan ◽

...

Keyword(s):

Primary Care ◽

Family Caregivers ◽

Healthcare Providers ◽

Family Physicians ◽

Care Team ◽

Primary Care Team ◽

Caregiver Support ◽

Team Members ◽

Primary Care Teams ◽

Support Family

Background. Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. Methods. We adopted an interpretive description design to explore family physicians and primary care team members’ perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. Results. Ten physicians and 42 team members participated. We identified three major themes. “Family physicians and primary care teams can be a valuable source of support for family caregivers” highlighted these primary care team members’ broad recognition of the need to support family caregiver’s health. “What stands in the way” spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, “A structured approach may be a way forward.” Conclusion. A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.

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HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

Innovation in Aging ◽

10.1093/geroni/igz038.1160 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S317-S318

Author(s):

Jenny Ploeg ◽

Marie-Lee Yous ◽

Kimberly Fraser ◽

Sinéad Dufour ◽

Sharon Kaasalainen ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Home Care ◽

Family Caregivers ◽

Chronic Conditions ◽

Care Delivery ◽

Healthcare Providers ◽

Multiple Chronic Conditions ◽

Team Approach ◽

Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

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Protective preparation: a process central to family caregivers of persons with mild cognitive impairment

International Psychogeriatrics ◽

10.1017/s1041610217001764 ◽

2017 ◽

Vol 30 (3) ◽

pp. 375-384 ◽

Cited By ~ 3

Author(s):

Ching-Lin Wang ◽

Li-Min Kuo ◽

Yi-Chen Chiu ◽

Hsiu-Li Huang ◽

Huei-Ling Huang ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Family Caregivers ◽

Caregiver Burden ◽

Family Caregiving ◽

Healthcare Providers ◽

Theory Approach ◽

Face To Face ◽

The Family ◽

The Impact

ABSTRACTBackground:To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.Methods:A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.Results:One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.Conclusions:Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.

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Barriers and Facilitators to COVID-19 screening at Jaipur International Airport, India.

10.21203/rs.3.rs-307039/v1 ◽

2021 ◽

Author(s):

Neha Mantri ◽

Nitin Kumar Joshi ◽

Pankaj Bhardwaj ◽

Akhil Dhanesh Goel ◽

Manoj Kumar Gupta ◽

...

Keyword(s):

Disease Transmission ◽

Healthcare Providers ◽

Health Department ◽

International Travel ◽

Barriers And Facilitators ◽

Organization Behavior ◽

Travel History ◽

International Airport ◽

Key Stakeholders ◽

The Mean

Abstract Background:Airports pose a possible threat in facilitating global disease transmission within the community which may be prevented by rigorous systematic entry-exit screening. With the aim to capture the perception of stakeholders associated with COVID-19 on barriers and facilitators of airport screening at Jaipur International Airport. Also, to assess key outcomes viz. total passengers screened, suspected cases, & confirmed cases.Methods:An inductive-deductive mix-method thematic analysis was conducted to capture qualitative data of key stakeholders. Additionally, quantitative data was obtained from the Rajasthan Medical & Health Department team deployed for COVID-19 airport screening.Results:Jaipur International Airport screened 4565 passengers (Males=4073 and Females=492) with 23 suspected cases during an outlined period of declaration of Pandemic to Lockdown in India (11th to 24th March 2020). Total 65 passengers had travel history from China (3 from Wuhan). The mean average age of passengers was 40.95 ± 7.8 years. The average screening time per passenger was 2-3 minutes with a load of 25-90 passengers per team per flight. Fishbone analysis of screening challenges revealed poor cooperation of passengers, masking symptoms, apprehension, and stigma related to quarantine. Moreover, inadequate human resources and changing guidelines overburdened healthcare providers. But, perception of risk, and social responsibility of travelers together with supportive organization behavior act as facilitators. Overall, groundwork on airport screening was insightful to propose key action areas for screening.Conclusions:Globally, COVID-19 has an impact on health infrastructure and international travel. International coordination with streamlined screening will go a LONG way in virus containment.

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International barriers and facilitators for cervical cancer screening among young people: a systematic review

10.22541/au.159620944.40309212/v2 ◽

2021 ◽

Author(s):

Abirami Kirubarajan ◽

Shannon Leung ◽

Xinglin Li ◽

Matthew Yau ◽

Mara Sobel

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Cancer Screening ◽

Young People ◽

Cervical Cancer Screening ◽

Low Income ◽

Healthcare Providers ◽

Barriers And Facilitators ◽

Low Income Countries ◽

Age Group

Background Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines and in many countries, screening rates for this age-group have even dropped. Objectives The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening among young people globally. Search Strategy We conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Selection Criteria We only examined original, peer-reviewed literature. Databases were examined from inception until the date of our literature searches (12/03/2020). Articles were excluded if they did not specifically discuss cervical cancer screening, were not specific to young people, or did not report outcomes or evaluation. Data Collection and Analysis All screening and extraction was completed in duplicate with two independent reviewers. Main Results Of the 2177 original database citations, we included 36 studies that met inclusion criteria. Our systematic review found that there are three large categories of barriers for young people: lack of knowledge/awareness, negative perceptions of the test, and practical barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. Conclusions Health systems worldwide should address the barriers and facilitators to increase cervical cancer screening rates in young people. Further research is required to understand this age group.

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How to Integrate Palliative Care Within Primary Healthcare- Perspectives of People Living With Serious Illnesses, Their Family Caregivers and Primary Healthcare Professionals in Nigeria

10.21203/rs.3.rs-1086435/v1 ◽

2021 ◽

Author(s):

Oladayo A Afolabi ◽

Kennedy Nkhoma ◽

Olaitan Soyannwo ◽

Akinyemi Aje ◽

Adesola Ogunniyi ◽

...

Keyword(s):

Palliative Care ◽

Family Caregivers ◽

Primary Healthcare ◽

Healthcare Providers ◽

Health Coverage ◽

Middle Income ◽

Healthcare Facilities ◽

Care Integration ◽

Qualitative Interview Study ◽

Building Information

Abstract Background Palliative care should be integrated into primary healthcare systems within low- and middle-income countries to achieve Universal Health Coverage goals. We aimed to identify preferences and expectations for primary healthcare support among people living with serious illness and their families in Nigeria, and to determine feasible steps palliative care integration within the health system. Methods Qualitative interview study with 48 participants including people living with serious illnesses (n=21) and their family caregivers (n=15) recruited from specialist clinics at a Teaching hospital in Nigeria; and healthcare providers (n=12) recruited from three primary healthcare facilities in Nigeria. Data were analysed using thematic analysis. Results Three major themes were identified. 1) Balancing patients and families’ expectations and preferences for easily accessible service and opportunities for social interaction and adequate communication with available human resource. 2) Engaging patients requires existing trust and bonds from their current use of primary healthcare and support to develop patients’ agency. 3) Development of healthcare providers is needed to ensure an appropriate clinical response, manage interprofessional trust and ensure clear role delineation. Conclusions Palliative care integration within primary healthcare in Nigeria can be achieved through building information and communication skills of healthcare providers, engaging and empowering patients to exercise their agency in care decisions, and adequately delineating healthcare providers’ roles to ensure staff work within their competencies and training.

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