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Reijnierse EM, Geelen SJG, van der Schaaf M, Visser B, Wüst RCI, Pijnappels M, Meskers CGM. Towards a core-set of mobility measures in ageing research: The need to define mobility and its constructs. BMC Geriatr 2023; 23:220. [PMID: 37024827 PMCID: PMC10080758 DOI: 10.1186/s12877-023-03859-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 02/28/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Mobility is a key determinant and outcome of healthy ageing but its definition, conceptual framework and underlying constructs within the physical domain may need clarification for data comparison and sharing in ageing research. This study aimed to (1) review definitions and conceptual frameworks of mobility, (2) explore agreement on the definition of mobility, conceptual frameworks, constructs and measures of mobility, and (3) define, classify and identify constructs. METHODS A three-step approach was adopted: a literature review and two rounds of expert questionnaires (n = 64, n = 31, respectively). Agreement on statements was assessed using a five-point Likert scale; the answer options 'strongly agree' or 'agree' were combined. The percentage of respondents was subsequently used to classify agreements for each statement as: strong (≥ 80%), moderate (≥ 70% and < 80%) and low (< 70%). RESULTS A variety of definitions of mobility, conceptual frameworks and constructs were found in the literature and among respondents. Strong agreement was found on defining mobility as the ability to move, including the use of assistive devices. Multiple constructs and measures were identified, but low agreements and variability were found on definitions, classifications and identification of constructs. Strong agreements were found on defining physical capacity (what a person is maximally capable of, 'can do') and performance (what a person actually does in their daily life, 'do') as key constructs of mobility. CONCLUSION Agreements on definitions of mobility, physical capacity and performance were found, but constructs of mobility need to be further identified, defined and classified appropriately. Clear terminology and definitions are essential to facilitate communication and interpretation in operationalising the physical domain of mobility as a prerequisite for standardisation of mobility measures.
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Affiliation(s)
- Esmee M Reijnierse
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dokter Meurerlaan 8, Amsterdam, 1067 SM, The Netherlands
| | - Sven J G Geelen
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Marike van der Schaaf
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam Movement Sciences, Amsterdam University of Applied Sciences, Tafelbergweg 51, Amsterdam, 1105 BD, The Netherlands
| | - Bart Visser
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam Movement Sciences, Amsterdam University of Applied Sciences, Tafelbergweg 51, Amsterdam, 1105 BD, The Netherlands
| | - Rob C I Wüst
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Mirjam Pijnappels
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands.
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Eigeland JA, Jones L, Sheeran N, Moffitt RL. Critical physician behaviors in the formation of a good physician-patient relationship: Concept mapping the perspective of patients with chronic conditions. Patient Educ Couns 2022; 105:198-205. [PMID: 34023173 DOI: 10.1016/j.pec.2021.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE A robust physician-patient relationship has been linked to better health outcomes for a range of chronic conditions. Our study aimed to identify physician behaviors patients consider contribute to good physician-patient relationships. METHOD Fifty patients with a chronic condition and a self-reported good physician-patient relationship were interviewed using the Critical Incidents technique and asked to describe observable behaviors that contributed to their good physician-patient relationship. A sub-sample of 30 participants rated the importance of each behavior and sorted them into self-labelled, mutually exclusive, and conceptually homogenous categories. Multivariate concept mapping with hierarchal cluster analysis was performed. RESULTS Patients reported 65 behaviors, which were grouped into six overarching domains: valuing the whole person, investigation and future planning, collaboration and empowerment, validation and emotional support, politeness and courtesy, and professionalism. CONCLUSION Results indicate patients with chronic conditions have a broader conceptualization and identified additional behaviors that reflect components of the physician-patient relationship than has been identified in researcher and practitioner based models. PRACTICE IMPLICATIONS Practitioners could utilize these concrete behaviors when forming relationships with their patients. These behaviors could also be incorporated into a tool designed to teach and assess the physician-patient relationship.
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Affiliation(s)
| | - Liz Jones
- School of Applied Psychology, Griffith University, Brisbane, Australia.
| | - Nicola Sheeran
- School of Applied Psychology, Griffith University, Brisbane, Australia.
| | - Robyn L Moffitt
- Psychology, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.
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Meyer C, Waite M, Atkins J, Ekberg K, Scarinci N, Barr C, Cowan R, Hickson L. How Can eHealth Meet the Hearing and Communication Needs of Adults With Hearing Impairment and their Significant Others? A Group Concept Mapping Study. Ear Hear 2021; 43:335-346. [PMID: 34320524 DOI: 10.1097/aud.0000000000001097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To seek the perspectives of key stakeholders regarding: (1) how eHealth could help meet the hearing and communication needs of adults with hearing impairment and their significant others; and (2) how helpful each aspect of eHealth would be to key stakeholders personally. DESIGN Group concept mapping, a mixed-methods participatory research method, was used to seek the perspectives of key stakeholders: adults with hearing impairment (n = 39), significant others (n = 28), and hearing care professionals (n = 56). All participants completed a short online survey before completing one or more of the following activities: brainstorming, sorting, and rating. Brainstorming required participants to generate ideas in response to the focus prompt, "One way I would like to use information and communication technologies to address the hearing and communication needs of adults with hearing loss and their family and friends is to…." The sorting task required participants to sort all statements into groups that made sense to them. Finally, the rating task required participants to rate each of the statements according to "How helpful would this idea be to you?" using a 5-point Likert scale. Hierarchical cluster analysis was applied to the "sorting" data to develop a cluster map using the Concept Systems software. The "rating" data were subsequently analyzed at a cluster level and an individual-item level using descriptive statistics. Differences in cluster ratings between stakeholder groups were examined using Kruskal-Wallis tests. RESULTS Overall, 123 statements were generated by participants in response to the focus prompt and were included in subsequent analyses. Based on the "sorting" data and hierarchical cluster analysis, a seven-cluster map was deemed to be the best representation of the data. Three key themes emerged from the data, including using eHealth to (1) Educate and Involve Others; (2) Support Aural Rehabilitation; and (3) Educate About and Demonstrate the Impacts of Hearing Impairment and Benefits of Hearing Rehabilitation. Overall median rating scores for each cluster ranged from 3.97 (educate and involve significant others) to 3.44 (empower adults with hearing impairment to manage their hearing impairment from home). CONCLUSIONS These research findings demonstrate the broad range of clinical applications of eHealth that have the capacity to support the implementation of patient- and family-centered hearing care, with self-directed educational tools and resources typically being rated as most helpful. Therefore, eHealth appears to be a viable option for enabling a more biopsychosocial approach to hearing healthcare and educating and involving significant others in the hearing rehabilitation process without adding more pressure on clinical time. More research is needed to inform the subsequent development of eHealth interventions, and it is recommended that health behavior change theory be adhered to for such interventions.
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Affiliation(s)
- Carly Meyer
- HEARing CRC, Melbourne, VIC, Australia School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, VIC, Australia
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Keller AO. A Healthy Life for African American Women Caregivers: A Concept Mapping Study. Womens Health Issues 2021; 31:130-139. [PMID: 33380373 DOI: 10.1016/j.whi.2020.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 11/06/2020] [Accepted: 11/25/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE African American women experience a higher burden of caregiving, but they are often underrepresented in studies on caregiver health. This study used a participatory process to elucidate how African American women caring for older adults view health and factors that influence health. METHODS We invited African American women ages 24-64 years old who reported caring for an older adult for group concept mapping, a process consisting of five steps: 1) preparation, 2) idea generation, 3) sorting and rating, 4) creating maps, and 5) interpreting maps. Participants (n = 29) first completed idea generation by responding to the focus prompt "A healthy life for a caregiver includes _____." Participants then sorted ideas into clusters based on conceptual similarity and rated each idea on desirability and importance. Data were managed via The Concept System Global MAX Software. RESULTS Idea generation identified 512 ideas that reduced to 99 unique ideas. Using the 99 ideas, a cluster map with 12 outcome domains best fit the data. Identified clusters included spirituality, maintaining relationships, good character, taking action to cope, preserving oneself, support, personal empowerment, resources, striving for peace, handling emotions, wellness, and taking care of self and place. Forty-three ideas representing 10 of the 12 domains were rated high for desirability and importance. CONCLUSION A participatory research method was used to integrate the voices of African American women caregivers and provide a rich set of elements necessary for their health and well-being. We also identified potential focus areas for interventions aimed at promoting the health of these caregivers.
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Affiliation(s)
- Abiola O Keller
- Marquette University College of Nursing, Milwaukee, Wisconsin.
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Robinson LJ, Stephens NM, Wilson S, Graham L, Hackett KL. Conceptualizing the key components of rehabilitation following major musculoskeletal trauma: A mixed methods service evaluation. J Eval Clin Pract 2020; 26:1436-1447. [PMID: 31816667 DOI: 10.1111/jep.13331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/14/2019] [Accepted: 11/22/2019] [Indexed: 12/16/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The reorganization of acute major trauma pathways in England has increased survival following traumatic injury, resulting in an increased patient population with diverse and complex needs requiring specialist rehabilitation. However, national audit data indicate that only 5% of patients with traumatic injuries have access to specialist rehabilitation, and there are limited guidelines or standards to inform the delivery of rehabilitation interventions for individuals following major trauma. This group concept mapping project aimed to identify the clinical service needs of individuals accessing our major trauma rehabilitation service, prioritize these needs, determine whether each of these needs is currently being met, and plan targeted service enhancements. METHODS Participants contributed towards a statement generation exercise to identify the key components of rehabilitation following major trauma, and individually sorted these statements into themes. Each statement was rated based on importance and current success. Multi-dimensional scaling and hierarchical cluster analysis were applied to the sorted data to produce themed clusters of ideas within concept maps. Priority values were applied to these maps to identify key areas for targeted service enhancement. RESULTS Fifty-eight patients and health care professionals participated in the ideas generation activity, 34 in the sorting, and 49 in the rating activity. A 7-item cluster map was agreed upon, containing the following named clusters: Communication and Coordination; Emotional and psychological wellbeing; Rehabilitation environment; Early rehabilitation; Structured therapy input; Planning for home; and Long-term support. Areas for targeted service enhancement included access to timely and adequate information provision, collaborative goal setting, and specialist pain management across the rehabilitation pathway. CONCLUSION The conceptual framework presented in this article illustrates the importance of a continuum of rehabilitation provision across the injury trajectory, and provides a platform to track future service changes and facilitate the codesign of new rehabilitation interventions for individuals following major trauma.
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Affiliation(s)
- Lisa J Robinson
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nicola M Stephens
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stella Wilson
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Laura Graham
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Katie L Hackett
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Department of Social Work, Education and Community Wellbeing, Northumbria University, UK
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Anderson LA, Slonim A. Perspectives on the strategic uses of concept mapping to address public health challenges. Eval Program Plann 2017; 60:194-201. [PMID: 27591959 DOI: 10.1016/j.evalprogplan.2016.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/22/2016] [Indexed: 05/23/2023]
Abstract
We examine the adaptation of approaches used to plan and implement the steps of concept mapping to meet specialized needs and requirements in several public health projects. Seven published concept mapping projects are detailed to document how each of the phases were modified to meet the specific aims of each project. Concept mapping was found to be a useful tool to complement public health roles such as assessment, program development, and priority setting. The phases of concept mapping allow for a blending of diverse perspectives, which is critical to public health efforts. The adaptability of concept mapping permits the use of multiple modalities such as the addition of face-to-face brainstorming; use of qualitative methods, including structured interviews; and review and use of published literature and guidelines. Another positive aspect of concept mapping for public health practice is its ability to identify program elements, provide a visual map of generated ideas and their relationships to one another, and assist in identifying priorities. Our reflections on the adaptability should help inform another generation in designing concept mapping projects and related products that may benefit from unique adaptations and the rapidly expanding social media technology and platforms.
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Affiliation(s)
- Lynda A Anderson
- Director Healthy Aging Program, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop F-78, United States; Rollins School of Public Health, Emory University, Atlanta, GA, 30341, United States
| | - Amy Slonim
- CDC-AARP Liaison, Michigan Public Health Institute, Health Promotion and Disease Prevention Program, 2436 Woodlake Drive, Okemos, MI, 48864, United States; Robert Wood Johnson Foundation, United States.
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Hackett KL, Lambson RL, Strassheim V, Gotts Z, Deary V, Newton JL. A concept mapping study evaluating the UK's first NHS generic fatigue clinic. Health Expect 2015; 19:1138-49. [PMID: 26332418 PMCID: PMC5054859 DOI: 10.1111/hex.12405] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2015] [Indexed: 12/02/2022] Open
Abstract
Importance Fatigue is a significant and debilitating symptom affecting 25% of the population. It occurs in those with a range of chronic diseases, can be idiopathic and in 0.2–0.4% of the UK population occurs in combination with other symptoms that together constitute chronic fatigue syndrome (CFS). Until recently, NHS clinical services only focussed upon CFS and excluded the majority of fatigued patients who did not meet the CFS diagnostic criteria. The CRESTA Fatigue interdisciplinary clinic was established in 2013 in response to this unmet need. Objective To identify the service needs of the heterogeneous group of patients accessing the CRESTA Fatigue Clinic, to prioritize these needs, to determine whether each is being met and to plan targeted service enhancements. Design Using a group concept mapping approach, we objectively identified the shared understanding of service users accessing this novel clinic. Setting NHS Clinics for Research & Service in Themed Assessment (CRESTA) Fatigue Clinic, Newcastle Upon Tyne, UK. Participants Patients (n = 30) and referrers (n = 10) to the CRESTA Fatigue Clinic contributed towards a statement generation exercise to identify ways the clinic could support service users to improve their quality of life. Patients (n = 46) participated in the sorting and rating task where resulting statements were sorted into groups similar in meaning and rated for ‘importance’ and ‘current success’. Main outcome and measure We mapped the needs of patients attending the CRESTA Fatigue Clinic and identified which high‐priority needs were being successfully met and which were not. Results Multidimensional scaling and hierarchical cluster analysis depicted the following eight themed clusters from the data which related to various service‐user requirements: ‘clinic ethos’, ‘communication’, ‘support to self‐manage’, ‘peer support’, ‘allied health services’, ‘telemedicine’, ‘written information’ and ‘service operation’. Service improvement targets were identified within value bivariate plots of the statements. Conclusion and Relevance Service development concepts were grouped into thematic clusters and prioritized for both importance and current success. The resulting concept maps depict where the CRESTA Fatigue Clinic successfully addresses issues which matter to patients and highlights areas for service enhancement. Unmet needs of patients have been identified in a rigorous service evaluation, and these are currently being addressed in collaboration with a service‐user group.
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Affiliation(s)
- Katie L Hackett
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Rebecca L Lambson
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Victoria Strassheim
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Zoe Gotts
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Vincent Deary
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Julia L Newton
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. .,Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
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Affiliation(s)
- Lynda A Anderson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA Emory University, Atlanta, GA, USA
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