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Waterland JL, Beer C, Forbes Shepherd R, Forrest LE. Exploring Consumers' Motivations and Experiences of Engaging as Partners in Cancer Research. THE PATIENT 2024:10.1007/s40271-023-00667-2. [PMID: 38401039 DOI: 10.1007/s40271-023-00667-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Consumer engagement improves research quality and relevance but can be difficult to implement. This study aimed to explore the motivations and understand the barriers, if any, experienced by consumers before and when partnering with cancer research teams. METHODS Semi-structured interviews were conducted with consumers and the results analysed thematically. Two groups were recruited: consumers who were members of the consumer registry and patients who did not have previous experience of being a consumer in a researcher partnership. RESULTS Twenty-one interviews were conducted with a total of 22 participants aged between 26 and 74 years. Consumers motivation was driven by altruism to help others and personal benefits. Barriers to beginning and maintaining consumer engagement included consumers' perceptions of being appreciated by researchers and meaningful communication between researchers and consumers. CONCLUSIONS Australian policy has made important steps towards consumer engagement in research. This study showed that demonstrating an appreciation for consumers and effective communication are key areas to consider when designing implementation strategies of these policies in the cancer research space in the future.
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Affiliation(s)
- Jamie L Waterland
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Cassandra Beer
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Rowan Forbes Shepherd
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Laura E Forrest
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
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Clay-Williams R, Hibbert P, Loy G, Braithwaite J. Innovative Models of Care for Hospitals of the Future. Int J Health Policy Manag 2024; 13:7861. [PMID: 38618834 PMCID: PMC11016280 DOI: 10.34172/ijhpm.2024.7861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/23/2024] [Indexed: 04/16/2024] Open
Abstract
New ways of providing acute care outside of traditional hospital building complexes, such as virtual care or hospital in the home, are becoming more common. Despite this, many hospitals are still conceived as "bricks and mortar" centralised constructions, and few health service infrastructure organisations meet intensively with consumers or clinicians prior to conceptualising hospital design. Our study sought to understand the needs and expectation of community members and healthcare providers, and co-design innovative models of acute care to inform development of a new metropolitan hospital in Australia. Our study used a three-step approach, consisting of academic and grey literature reviews; a demographic analysis of the hospital catchment population; and a series of 20 workshops and 6 supplementary interviews with community members and local healthcare providers. We found that care should be tailored to the healthcare needs and expectations of each consumer, with consumers cared for in the community where possible and safe. We propose an innovative model of care for hospitals of the future, consisting of fully integrated acute care underpinned by appropriate digital architecture to deliver care that is community focussed. It is vital that new hospitals build in sufficient adaptability to leverage future innovation and meet the needs of growing and changing communities.
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Affiliation(s)
- Robyn Clay-Williams
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Peter Hibbert
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Graeme Loy
- Western Sydney Local Health District, Sydney, NSW, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Chapman K, Dixon A, Kendall E, Clanchy K. Defining dignity at the intersection of disability: a scoping review. Disabil Rehabil 2024:1-11. [PMID: 38265032 DOI: 10.1080/09638288.2024.2302582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE This scoping literature review aimed to determine the definition of dignity in relation to disability. It also examined the extent to which inclusive research methods have been used to develop working definitions. MATERIALS AND METHODS A comprehensive search was conducted in five electronic databases, using a modified framework by Arksey and O'Malley. Narrative synthesis and qualitative content analysis were employed to examine definitions of dignity and the use of inclusive research methods. RESULTS 22 peer-reviewed studies were included. The majority of the studies were qualitative (72.72%) and examined various disability populations in diverse settings. Although 19 studies offered a definition of dignity, there was no clear consensus. Dignity was frequently defined from a utilitarian perspective, emphasising affordances and barriers. However, engagement with theoretical constructs was superficial and limited. Further, no studies mentioned the use of inclusive research methods. CONCLUSIONS The absence of inclusive research methods hinders the development of a comprehensive definition of dignity that is accepted by and relevant to people with disability. Engaging with both theoretical and empirical perspectives of dignity is crucial to develop a meaningful and inclusive definition, which can inform interventions and policies that enhance dignity for people with disability across diverse settings and contexts.
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Affiliation(s)
- Kelsey Chapman
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
| | - Angel Dixon
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
| | - Elizabeth Kendall
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
| | - Kelly Clanchy
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
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Scholz B, Kirk L, Warner T, O'Brien L, Kecskes Z, Mitchell I. From a Single Voice to Diversity: Reframing 'Representation' in Patient Engagement. QUALITATIVE HEALTH RESEARCH 2024:10497323231221674. [PMID: 38229426 DOI: 10.1177/10497323231221674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
There has been a growing emphasis on consumer representation in the development of health policy, services, research, and education. Existing literature has critiqued how discourses of representativeness can disempower consumers working in health systems. The context of the current study is consumer engagement in the development of COVID-19 triage policy and practice in a local health service. Consumer engagement has often been an afterthought in the COVID response, with few examples of consumers in agenda-setting or decision-making roles. In the Australian Capital Territory, 26 consumer, carer, and community groups worked together with academics and clinicians to develop these principles. Interviews were conducted with stakeholders (including consumers, clinicians, and other health professionals) to evaluate the development of triage principles. A discursive psychological approach to analysis was used to explore participants' understandings about and constructions of consumers being representative (or not) and how this may reproduce power imbalances against consumers. The results explore two distinct ways in which participants talked about consumer representativeness: the first drawing on rhetoric about consumers as lay members of the public (as distinct from being professionally engaged in the health sector), and the second in terms of consumer representatives being diverse and having intersectional identities and experiences. Expectations about consumers to be representative of the general population may reproduce traditional power imbalances and silence lived experience expertise. These power imbalances may be challenged by a shift in the way representativeness is conceptualised to requiring health services to seek out diverse and intersectionally marginalised consumers.
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Affiliation(s)
- Brett Scholz
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Lucy Kirk
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Terri Warner
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Lauren O'Brien
- ACT Disability, Aged and Carer Advocacy Service, Canberra, ACT, Australia
| | - Zsuzsoka Kecskes
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Imogen Mitchell
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Canberra Health Services, Canberra, ACT, Australia
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Abstract
OBJECTIVES To engage critical care end-users (survivors and caregivers) to describe their emotions and experiences across their recovery trajectory, and elicit their ideas and solutions for health service improvements to improve the ICU recovery experience. DESIGN End-user engagement as part of a qualitative design using the Framework Analysis method. SETTING The Society of Critical Care Medicine's THRIVE international collaborative sites (follow-up clinics and peer support groups). SUBJECTS Patients and caregivers following critical illness and identified through the collaboratives. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Eighty-six interviews were conducted. The following themes were identified: 1) Emotions and experiences of patients-"Loss of former self; Experiences of disability and adaptation"; 2) Emotions and experiences of caregivers-"Emotional impacts, adopting new roles, and caregiver burden; Influence of gender roles; Adaptation, adjustment, recalibration"; and 3) Patient and caregiver-generated solutions to improve recovery across the arc of care-"Family-targeted education; Expectation management; Rehabilitation for patients and caregivers; Peer support groups; Reconnecting with ICU post-discharge; Access to community-based supports post-discharge; Psychological support; Education of issues of ICU survivorship for health professionals; Support across recovery trajectory." Themes were mapped to a previously published recovery framework (Timing It Right) that captures patient and caregiver experiences and their support needs across the phases of care from the event/diagnosis to adaptation post-discharge home. CONCLUSIONS Patients and caregivers reported a range of emotions and experiences across the recovery trajectory from ICU to home. Through end-user engagement strategies many potential solutions were identified that could be implemented by health services and tested to support the delivery of higher-quality care for ICU survivors and their caregivers that extend from tertiary to primary care settings.
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Chapman K, Dixon A, Cocks K, Ehrlich C, Kendall E. The Dignity Project Framework: An extreme citizen science framework in occupational therapy and rehabilitation research. Aust Occup Ther J 2022; 69:742-752. [PMID: 36369985 PMCID: PMC10100520 DOI: 10.1111/1440-1630.12847] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Engaging citizens and patients as research partners is receiving increasing emphasis across disciplines, because citizens are untapped resources for solving complex problems. Occupational therapists are engaging in inclusive research, but not always in equitable partnership. Moving beyond inclusive research to a dignified framework for research prioritises lived experience and human rights in health research. METHODS Using nominal group technique over a series of three working group meetings, eight experts, including three with lived experience of disability and research, prioritised principles and steps for conducting dignified rehabilitation research in partnership with citizens with disability. FINDINGS Embedding transparency, accessibility and inclusion, dignified language, and authenticity throughout research were integral to maintaining dignity and safety for citizens with disability engaged in research. The Dignity Project Framework encompasses five phases, namely, (1) vision, (2) uncover, (3) discuss, (4) critical reflection, and (5) change, which address the prominent criticisms of the disability community about research and embed the principles of importance into research practice. CONCLUSION The framework builds on inclusive research frameworks to a human rights-based, dignified framework for extreme citizen science. Grounding disability in contemporary conceptualisations and providing a method for democratising knowledge production provide occupational therapists with a method for dignified partnership with citizens with disability.
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Affiliation(s)
- Kelsey Chapman
- Hopkins Centre Griffith University Nathan Queensland Australia
- Griffith University Southport Queensland Australia
| | - Angel Dixon
- Griffith University Southport Queensland Australia
| | - Kevin Cocks
- Hopkins Centre Griffith University Nathan Queensland Australia
| | - Carolyn Ehrlich
- Hopkins Centre Griffith University Nathan Queensland Australia
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Vidgen ME, Cutler K, Bean J, Bunker D, Fowles LF, Healy L, Hondow G, Istiko SN, McInerney-Leo AM, Pratt G, Robins D, Waddell N, Evans E. Community input in a genomic health implementation program: Perspectives of a community advisory group. Front Genet 2022; 13:892475. [PMID: 35938017 PMCID: PMC9355292 DOI: 10.3389/fgene.2022.892475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Consumer and community engagement (CCE) in the implementation of genomics into health services and associated research is needed to ensure that changes benefit the affected patients. Queensland Genomics was a program to implement genomics into a public health service. We describe its Community Advisory Group’s (CAG) structure and function and provide recommendations based on the CAG members’ perspectives. The CAG provided advice to the Queensland Genomics program and its projects in an advisory capacity. The CAG was also resourced to develop and lead community-focused activities. Key enablers for CAG included; diversity of CAG members’ skills and experience, adequate resourcing, and the CAG’s ability to self-determine their direction. The CAG experienced limitations due to a lack of mechanisms to implement CCE in the Program’s projects. Here, we provide insights and commentary on this CAG, which will be useful for other initiatives seeking to undertake CCE in genomic research and health care.
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Affiliation(s)
- Miranda E. Vidgen
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Correspondence: Miranda E. Vidgen, ; Nicola Waddell,
| | - Katrina Cutler
- Queensland Genomics, Herston, QLD, Australia
- Health Translation Queensland, Herston, QLD, Australia
| | - Jessica Bean
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - David Bunker
- Queensland Genomics, Herston, QLD, Australia
- Health Translation Queensland, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Lindsay F. Fowles
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Genetic Health Queensland, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Louise Healy
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Gary Hondow
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | | | - Aideen M. McInerney-Leo
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Dermatology Research Centre, University of Queensland Diamantina Institute, University of Queensland, Brisbane, QLD, Australia
| | - Gregory Pratt
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Deborah Robins
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Nicola Waddell
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Correspondence: Miranda E. Vidgen, ; Nicola Waddell,
| | - Erin Evans
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Health Consumers Queensland, Brisbane, QLD, Australia
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Shih P, Hallam L, Clay-Williams R, Carter SM, Brown A. Reimagining consumer involvement: Resilient system indicators in the COVID-19 pandemic response in New South Wales, Australia. Health Expect 2022; 25:1988-2001. [PMID: 35789158 PMCID: PMC9327835 DOI: 10.1111/hex.13556] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/02/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022] Open
Abstract
Background Reflections on the response to the COVID‐19 pandemic often evoke the concept of ‘resilience’ to describe the way health systems adjusted and adapted their functions to withstand the disturbance of a crisis, and in some cases, improve and transform in its wake. Drawing from this, this study focuses on the role of consumer representatives in healthcare services in initiating changes to the way they participated in the pandemic response in the state of New South Wales in Australia. Methods In‐depth interviews were conducted with two cohorts of consumer representatives. Cohort A included experienced and self‐identified consumer leaders, who worked together in a COVID‐19 Consumer Leaders Taskforce; Cohort B included participants outside of this group, and purposively included consumer representatives from rural and regional areas, and culturally and linguistically diverse communities. Results The pause in consumer engagement to support health service decision‐making in responding to the pandemic forced consumer representatives to consider alternative approaches to participate. Some initiated networking with each other, forming new collaborations to produce consumer‐led research and guidelines on pandemic‐related patient care. Others mobilized support from community and politicians to lobby for specific healthcare issues in their local areas. Conclusion The response to the COVID‐19 pandemic made visible the brittle nature of previous engagement processes of involving consumers in organizational design and governance. However, the momentum for proactive self‐organization in an unexpected crisis created space for consumer representatives to reset and reimagine their role as active partners in health services. Their ability to adapt and adjust ways of working are key assets for a resilient health system. Patient or Public Contribution This project is a collaborative study between academic researchers and health consumer (patient and public) representatives. It followed the principles of codesign and coresearch, whereby both consumer representatives and academic researchers contributed equally to all stages of the project. The study was cofunded by both academic institutions and consumer representative organizations.
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Affiliation(s)
- Patti Shih
- Australian Centre for Health Engagement Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Laila Hallam
- Sydney Local Health District, Sydney, New South Wales, Australia.,Centre for Disability Research and Policy (CDRP), The University of Sydney, Sydney, New South Wales, Australia
| | - Robyn Clay-Williams
- Centre for Healthcare Resilience and Implementation Science (CHRIS), Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Stacy M Carter
- Australian Centre for Health Engagement Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anthony Brown
- Australian Centre for Health Engagement Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia.,Health Consumers, Sydney, New South Wales, Australia
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