scholarly journals Nursing homes: engaging patients and staff in healing garden design through focus group interviews

Author(s):  
Giulio Senes ◽  
Natalia Fumagalli ◽  
Rosella Crippa ◽  
Francesca Bolchini

Patient-specific gardens can provide general benefits related to the restorative effects of nature and respond to the specific needs of a particular patient population. These needs are to be considered in the design of outdoor space for healthcare. Our goal was to design a patient-specific garden for elderly people who live in Nursing Homes and Adult Day Services (RSA Famagosta, Milano). A participatory design process was used through the organization of focus groups. A focus group is a form of qualitative research in which a group of people are asked about a topic. Focus groups allowed us to study residents and staff in a more natural setting than a one-to-one interview. With this approach, users work closely together to create a program that has been implemented by landscape architects to design a patient-specific garden. The participatory process involving designers and clinical staff and residents has been appreciated because the users felt involved in the decision process. Focus group approach has proved to be useful to provide information ohealing garden user needs: the findings were useful to draw design guidelines that has been incorporated into the “garden design”.

Author(s):  
Kalle Jegers ◽  
Carlotte Wiberg

This chapter reports on the initial results of a study conducted in the project FunTain. The main purpose was to identify general guidelines/implications for edutainment games, in order to guide designers of such games as they often lack in design guidelines. Usability evaluations were conducted on an edutainment game in order to find usability problems. These findings were analyzed and used as input in focus group meetings, held with joint teams of game designers and HCI experts. The outcome of the focus groups was a proposal of a list of ten general design guidelines. Findings indicate that users had problems in understanding the underlying model for the game as well as identifying the knowledge related content. Experts, further, gave comments about feedback problems and different types of consistencies. Some of the implications from the findings are guidelines for earning and loosing points, scoring and performance feedback and game object characteristics.


2020 ◽  
Author(s):  
Rieka von der Warth ◽  
Vanessa Kaiser ◽  
Christina Reese ◽  
Boris A. Brühmann ◽  
Erik Farin-Glattacker

Abstract BackgroundWith increasing numbers of the elderly living in nursing homes in Germany, the need for on-site primary care increases. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. Therefore, project CoCare (“coordinated medical care”) implements a complex health intervention in nursing homes, using among others regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports the results of a process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.MethodsFocus group interviews were held between the fall of 2018 and the fall of 2019 with nursing staff, general practitioners and medical assistants working in or consulting a participating nursing home. A half-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis. ResultsIn total, N=11 focus group interviews with N= 74 participants were conducted. Ten main themes with seven subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to talk most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding CoCare had prevented unnecessary hospitalizations. Main barriers were understaffing and complexity of the program.ConclusionImplementation of CoCare in nursing homes is complex and holds some barriers. However, the overall acceptance was good and first positive results were reported by participants. Furthermore, the project provides a good structure to overcome potential barriers.Trial Registration: German Clinical Trial Register (DRKS00012703)


Author(s):  
Stéphane Sanchez ◽  
Fiona Ecarnot ◽  
Dimitri Voilmy ◽  
Biné Mariam Ndiongue ◽  
Clément Cormi ◽  
...  

Abstract Introduction Nursing homes (NHs) are an ideal environment in which to implement interventions aimed at reducing inappropriate prescriptions. Quality indicators (QIs) may be useful to standardize practices, but it is unclear how they mediate change. In the framework of a quantitative study aimed at reducing the prescription of anticholinergic drugs among NH residents using QIs, we performed a qualitative study to describe the investigators’ perception of the utility of QIs. Methods Qualitative study using focus group methodology. Focus groups were recorded and transcribed, and analyzed by thematic analysis. Participants were purposefully recruited from among the medical directors of the NHs in the quantitative study. Results Five medical directors participated in two focus group meetings. The main themes to emerge were: (1) communication is key to introducing new practices and achieving lasting uptake; (2) improved coordination and communication provided useful information to help interpret the quantitative results observed: e.g., participants reported that they were able to obtain contextual and patient-specific information that explained why some prescribers had consistently, but justifiably “poor” performance on the quantitative indicators; (3) negative aspects reported included reluctance to change among prescribers and the tendency to shirk responsibility. Conclusion From the point of view of medical directors of NHs participating in an interventional program to reduce inappropriate prescriptions of anticholinergic drugs, the main factor driving the success of the program was communication, which is key to achieving adherence. Improved communication provides useful insights into the reasons why no quantitative reduction is observed in objective quality indicators.


2020 ◽  
Author(s):  
Rieka von der Warth ◽  
Vanessa Kaiser ◽  
Christina Reese ◽  
Boris A. Brühmann ◽  
Erik Farin-Glattacker

Abstract BackgroundWith rising numbers of the elderly living in nursing homes in Germany, the need for on-site primary care is on the increase. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. The CoCare (“coordinated medical care”) project has therefore implemented a complex health intervention in nursing homes, using inter alia, regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports upon the results of the process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.MethodsFocus group interviews were held between the fall of 2018 and the fall of 2019 with nurses, general practitioners and GP´s assistants working in or consulting a participating nursing home. A semi-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis. ResultsIn total, N=11 focus group interviews with N=74 participants were conducted. Eleven main themes with four subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to speak most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding that CoCare had prevented unnecessary hospitalizations. The main barriers were understaffing and complexity of the program.ConclusionImplementation of CoCare in nursing homes is complex and presents some barriers. However, the overall acceptance was good and participants reported the first positive results. Furthermore, the project provides a good structure to overcome potential barriers. However, some adaptions to the implementation process should be made.


2005 ◽  
pp. 122-138
Author(s):  
Kalle Jegers ◽  
Charlotte Wiberg

This chapter reports on the initial results of a study conducted in the project FunTain. The main purpose was to identify general guidelines/implications for edutainment games, in order to guide designers of such games as they often lack in design guidelines. Usability evaluations were conducted on an edutainment game in order to find usability problems. These findings were analyzed and used as input in focus group meetings, held with joint teams of game designers and HCI experts. The outcome of the focus groups was a proposal of a list of ten general design guidelines. Findings indicate that users had problems in understanding the underlying model for the game as well as identifying the knowledge related content. Experts, further, gave comments about feedback problems and different types of consistencies. Some of the implications from the findings are guidelines for earning and loosing points, scoring and performance feedback and game object characteristics.


2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
S. Malhotra ◽  
R. Hatala ◽  
C.-A. Courneya

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.


2021 ◽  
Vol 20 ◽  
pp. 160940692110151
Author(s):  
Sarah C. Hunt ◽  
Nancy L. Young

The primary objective of this systematic review was to investigate how Western focus groups and Indigenous sharing circles have been blended for the study of Indigenous children’s health. The secondary objective of this study was to propose recommendations for adapting focus groups to include elements of sharing circles. This systematic review was conducted using a systematic search of original research articles published between 2009 and 2020 that (a) focused on North American Indigenous children’s health and (b) used group-based qualitative methods including focus groups and sharing circles. Each of the articles was screened for relevance and quality. The methods sections were reviewed, subjected to qualitative content analysis, and codes were analyzed to identify common themes and synthesize results. We identified 29 articles, most of which followed a community-based participatory research approach. In these publications, most included a community advisory board, ethics approval was obtained, and in some cases, community members were included as research assistants. There was evidence that sharing circles and focus group methods had been blended in the recent Indigenous children’s health literature. This was particularly apparent in the authors’ approaches to recruitment, location, facilitation techniques, question format and reimbursement. Several groups have published results that describe approaches that successfully incorporated aspects of Indigenous sharing circles into Western focus groups, thus establishing a research method that is culturally safe and appropriate for the study of Indigenous children’s health.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Zastrow ◽  
K Neher ◽  
H Hassel

Abstract Background Healthy aging is one of the major challenges currently faced by an aging population. Food literacy (FL) refers to the ability to apply knowledge and practical skills regarding healthy and sustainable nutrition into everyday life. The project “GUSTO” is sponsored by the Bavarian State Ministry of Health and Care and aims to contribute to enjoyable aging by developing the nutritional skills of people aged 65 and over. This community-based program comprises independent working groups of older adults guided by peer moderators. The FL intervention is developed in cooperation with the target group. Methods The nutritional situation of older adults was first established through a literature research. The results of this research were compared to the “self-perceived food literacy scale” by Poelman et al. (2018) and the “nutritional framework for literacy courses” by Johannsen et al. (2019). The resulting data provided a basis for focus group discussions carried out in six municipalities, supported by local practice partners. In six guided focus group discussions, a number of recurring themes were identified and summarized. Results The focus groups consisted of a total of 44 people between 62 and 88 years of age (average age: 73.1 ± 6.1 years). 22.7 % were men. The group discussions revealed resources used and barriers encountered in terms of FL and interests of older adults. It was evident that, due to the high density of information available, the participants found it difficult to identify reliable information and to implement it in their everyday life. At the request of the focus groups, topics such as the best before date and the use of food waste were added to the intervention. Conclusions Older adults find it challenging to identify reliable nutritional information and implement it in their everyday life. With the help of the participatory approach outlined in this study, target group-related issues can be identified and taken into account in the intervention. Key messages Older adults can be involved in the development of an FL intervention. A participatory approach allows target group-related issues and specific needs to be taken into account in the intervention.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S198-S198
Author(s):  
Wendy Stead ◽  
Jennifer Manne-Goehler ◽  
Jasmine R Marcelin ◽  
Carlos Del Rio ◽  
Douglas Krakower

Abstract Background Large and persistent inequities in academic advancement exist between men and women faculty in academic Infectious Diseases (ID). To identify and characterize beliefs about why these inequities persist in ID, we asked ID faculty members to share their thoughts and experiences with the advancement process. Characteristics of Focus Group Participants Summary of Main Emergent Themes from Focus Group Analysis Methods We conducted four 60-minute focus groups with ID faculty members during IDWeek 2019. We enrolled women that were diverse geographically and in academic rank (i.e., Instructor/Assistant, Associate, Full Professor). We assigned women to focus groups by rank to minimize social desirability bias across rank. Our fourth focus group included only men who were Full Professors, to capture additional perspectives about barriers to advancement and solutions. (Table 1) We analyzed focus group discussion transcripts using content analysis. Results We identified nine main themes regarding inequities in academic advancement of women in ID. (Table 2) In all 4 focus groups, gender bias as a barrier to academic advancement was a major theme. Women Full Professors emphasized explicit gender bias such as sexual harassment and “predatory mentoring,” whereas women Instructors/Assistant Professors more frequently cited barriers related to implicit bias, such as obscure maternity leave policies and divisional meetings scheduled during childcare hours. Women Associate Professors cited implicit and explicit gender bias, while men Full Professors focused primarily on implicit bias. Women Instructors/Assistant Professors experienced the greatest difficulty in balancing demands of family with career, though this was a prominent theme in all groups. The perception that women less often utilize negotiation to advance themselves was a dominant theme for women Associate Professors, though all groups raised examples of this theme. Conclusion Gender bias, both implicit and explicit, is an important and ongoing barrier to equitable academic advancement of women in ID. Difficulty balancing demands of family with career and gender differences in professional negotiation are also perceived barriers that can be targeted by innovative programs and interventions to address gender disparities in academic advancement. Disclosures All Authors: No reported disclosures


Author(s):  
Ellen J. Bass ◽  
Andrew J. Abbate ◽  
Yaman Noaiseh ◽  
Rose Ann DiMaria-Ghalili

There is a need to support patients with monitoring liquid intake. This work addresses development of requirements for real-time and historical displays and reports with respect to fluid consumption as well as alerts based on critical clinical thresholds. We conducted focus groups with registered nurses and registered dietitians in order to identify the information needs and alerting criteria to support fluid consumption measurement. This paper presents results of the focus group data analysis and the related requirements resulting from the analysis.


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