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Vanstone MG, Krewulak K, Taneja S, Swinton M, Fiest K, Burns KEA, Debigare S, Dionne JC, Guyatt G, Marshall JC, Muscedere JG, Deane AM, Finfer S, Myburgh JA, Gouskos A, Rochwerg B, Ball I, Mele T, Niven DJ, English SW, Verhovsek M, Cook DJ. Patient-important upper gastrointestinal bleeding in the ICU: A mixed-methods study of patient and family perspectives. J Crit Care 2024; 81:154761. [PMID: 38447306 DOI: 10.1016/j.jcrc.2024.154761] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION The objective of this study was to create a definition of patient-important upper gastrointestinal bleeding during critical illness as an outcome for a randomized trial. DESIGN This was a sequential mixed-methods qualitative-dominant multi-center study with an instrument-building aim. In semi-structured individual interviews or focus groups we elicited views from survivors of critical illness and family members of patients in the intensive care unit (ICU) regarding which features indicate important gastrointestinal bleeding. Quantitative demographic characteristics were collected. We analyzed qualitative data using inductive content analysis to develop a definition for patient-important upper gastrointestinal bleeding. SETTING Canada and the United States. PARTICIPANTS 51 ICU survivors and family members of ICU patients. RESULTS Participants considered gastrointestinal bleeding to be important if it resulted in death, disability, or prolonged hospitalization. The following also signaled patient-important upper gastrointestinal bleeding: blood transfusion, vasopressors, endoscopy, CT-angiography, or surgery. Whether an intervention evinced concern depended on its effectiveness, side-effects, invasiveness and accessibility; contextual influences included participant familiarity and knowledge of interventions and trust in the clinical team. CONCLUSIONS Survivors of critical illness and family members described patient-important upper gastrointestinal bleeding differently than current definitions of clinically-important upper gastrointestinal bleeding.
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Affiliation(s)
- Meredith G Vanstone
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Karla Krewulak
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shipra Taneja
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Marilyn Swinton
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kirsten Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karen E A Burns
- Interdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, Canada
| | - Sylvie Debigare
- Patient and Family Partnership Committee, Commission Scolaire Central Québec, Canadian Critical Care Trials Group, Canada
| | - Joanna C Dionne
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Department of Critical Care, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Gordon Guyatt
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - John C Marshall
- Interdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, Canada; Department of Surgery, Unity Health Toronto, University of Toronto, Canada
| | - John G Muscedere
- Department of Critical Care Medicine, Queens University, Kingston Health Sciences Center
| | - Adam M Deane
- Department of Critical Care, University of Melbourne, Melbourne Medical School, Victoria, Australia
| | - Simon Finfer
- Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health, School of Public Health, Imperial College London, London, England, United Kingdom
| | - John A Myburgh
- Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Audrey Gouskos
- Patient and Family Advisory Committee and Steering Committee representative, FAST-NAWC Trial, University of Toronto, Canada
| | - Bram Rochwerg
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Department of Critical Care, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Ian Ball
- Department of Medicine, Western University, London, Ontario, Canada.; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Tina Mele
- Department of Critical Care Medicine, Western University, London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada
| | - Daniel J Niven
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shane W English
- Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Madeleine Verhovsek
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Deborah J Cook
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Department of Critical Care, St. Joseph's Healthcare Hamilton.
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Xiang E, Rangel ML, Badr H. Social Connectedness and Perceived Stress Among Caregivers During the COVID-19 Pandemic: a Mixed-Methods Study. Int J Behav Med 2024; 31:380-392. [PMID: 37853272 DOI: 10.1007/s12529-023-10228-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The COVID-19 pandemic has created unprecedented stressors for caregivers due to social distancing requirements that simultaneously increased their responsibilities and reduced opportunities for social connection and support. This concurrent embedded mixed-methods study examined differences between caregivers and non-caregivers regarding the effects of social connectedness on perceived stress and explored challenges caregivers experienced related to social connectedness and perceived stress. METHOD A national online survey containing forced-choice and free-response questions was administered between April and June 2020. The survey was distributed via social media advertisements and a crowdsourcing platform to eligible adult residents in the United States (US) fluent in either English or Spanish. Multivariable regression and thematic analysis were used to analyze the quantitative and qualitative data. Mixed-methods integration occurred during the data analysis, interpretation, and reporting phases. RESULTS The study sample comprised 1540 US adults (1275 non-caregivers, 265 caregivers; 65% women; 36% racial/ethnic minorities). Relative to non-caregivers, caregivers had lower levels of social connectedness and higher levels of perceived stress. Social connectedness was also inversely related to perceived stress for non-caregivers (p < 0.001) and slightly but not significantly positively related to perceived stress for caregivers. Qualitative findings showed caregivers experienced a variety of stressors including fear of COVID-19 exposure to their care recipients, disruption to usual care routines, and difficulty accessing healthcare services that may have contributed to decrements in social connectedness and higher levels of perceived stress. CONCLUSION Findings suggest social connectedness may be beneficial for reducing perceived stress, but its impact can vary depending on individual circumstances. Overall, findings support the idea that caregivers are a particularly vulnerable sub-group of the population and may benefit from more targeted support and interventions.
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Affiliation(s)
- Ellen Xiang
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, USA
| | - Maria Lizette Rangel
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, USA
| | - Hoda Badr
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, USA.
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Köbler P, Vogel RT, Joraschky P, Söllner W. [Experiences of Burden and Coping Strategies and their Associations with Mental Health and Well-Being in COPD - a Mixed Methods Study]. Psychother Psychosom Med Psychol 2024; 74:183-191. [PMID: 38492567 DOI: 10.1055/a-2255-8695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
Understanding trigger and maintaining factors regarding psychiatric comorbidities in COPD is of great importance. In the presented mixed-methods study, qualitative interview data on burden experience and coping were related to psychiatric comorbidity (using PHQ-D) and quality of live (Positive Affect Negative Affect Schedulde, PANAS and Satisfaction with Life Scale, SWLS) and extended by the Freiburg Questionnaire on Coping with Illness (FKV-LIS). The two interview questions prompting narrative were 1.) "What is currently bothering you most?"; 2.) "How do you cope with your chronic disease in everyday life?" A total of 62 patients who were hospitalized due to COPD participated. The severity of physical impairment was assessed using GOLD stage and the Charlson Comorbidity Index (CCI). The interviews conducted were content analyzed and then quantified. The collected data were then compared between two groups with regard to mental distress. 13 themes of burden and 11 coping strategies were identified by content analysis. A total of 42 patients showed signs of mental distress, while 20 patients did not show signs of distress. There were no significant differences between the two groups in terms of sociodemographic characteristics and the severity of their physical symptoms. In the first interview question, the stressed group more frequently addressed issues related to death (35.7% versus 15.0%) and social stress (21.4% versus 0.0%). With respect to the second interview question, the nonstressed group was significantly more likely to mention strategies for consciously emphasizing positive emotions (70.0% versus 31.0%). In addition, higher scores on the FKV scales for depressive coping and trivialization and wishful thinking were evident in the stressed group. Quality of life and mental distress should be considered in clinical care for COPD. Interventions to influence illness perception and related coping styles are important, especially with regard to the development of a realistic and optimistic perspective on life and disease burden, as well as the inclusion of group and family therapeutic interventions.
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Affiliation(s)
- Paul Köbler
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Paracelsus Medizinische Privatuniversität - Nürnberg
| | - Ralf T Vogel
- Praxis für Psychotherapie und Supervision, Ingolstadt
| | | | - Wolfgang Söllner
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Paracelsus Medizinische Privatuniversität - Nürnberg
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Brunner K, Weisschuh L, Jobst S, Kugler C, Rebafka A. Defining Self-Management for Solid Organ Transplantation Recipients: A Mixed Method Study. Nurs Rep 2024; 14:961-987. [PMID: 38651485 PMCID: PMC11036239 DOI: 10.3390/nursrep14020073] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/15/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
Patients with Solid Organ Transplantations (SOTx) face long-term lifestyle adaptations, psychological and social adjustments, and complex self-care regimes to maintain health post-transplant. Self-management (SM) skills represent important aspects of nursing communication with SOTx patients; however, there is potential for SM to be defined narrowly in terms of medication adherence. The study presented here collated the existing definitions in a mixed method review in order to identify SM attributes for this group (including those unique to this population). Secondary analysis of a dataset and bibliographic analysis and an expert panel were used to develop a comprehensive working definition of SOTx patients. The analysis comprised critical interpretation of the evolving definition content, concepts, and contexts of application in current usages and over time. We identified eight definitions and 63 cited definition sources from bibliographic analysis. Findings identified limitations of the existing definitions. Population-specific attributes included optimisation of transplant outcomes, active engagement in healthy behaviours, control, structure, and discipline characteristics, and moderating factors of patient motivation, self-efficacy, and cognitive function. A critical appraisal of definitions indicated inadequately defined aspects such as setting, temporal dimension, concept interaction, interventions, and measurable outcomes. The bibliographic analysis highlighted the influence of broader chronic illness constructions of SM, underpinning the generalisable SM attributes in current definitions. Further research may advance the development of a definition in exploring the relevance of SOTx-specific attributes of the definition.
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Affiliation(s)
| | | | | | | | - Anne Rebafka
- Institute of Nursing Science, University Medical Centre, Albert-Ludwigs University Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany (S.J.); (C.K.)
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Sapag JC, Mancevski A, Perry A, Norman CD, Barnsley J, Ferris LE, Rush B. Developing and Testing an Evaluation Framework for Collaborative Mental Health Services in Primary Care Systems in Latin America. Community Ment Health J 2024; 60:426-437. [PMID: 37815700 DOI: 10.1007/s10597-023-01186-y] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/05/2023] [Indexed: 10/11/2023]
Abstract
To develop and pilot-test a feasible and meaningful evaluation framework to support the ongoing improvement and performance measurement of services and systems in Latin America regarding Collaborative Mental health Care (CMHC). This mixed methods study, guided by a developmental evaluation approach, included: (1) a critical review of the literature; (2) an environmental scan at three selected health networks in Mexico, Nicaragua and Chile; (3) a Delphi group with experts; (4) a final consultation in the three sites; and (5) a pilot-test of the framework. A comprehensive evaluation framework was developed and successfully piloted. It considers five levels, 28 dimensions and 40 domains, as well as examples of indicators and an implementation plan. This evaluation framework represents an important effort to foster accountability and quality regarding CMHC in Latin America. Recommendations to build upon current capacity and to effectively address the existing implementation challenges are further discussed.
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Affiliation(s)
- Jaime C Sapag
- Departments of Public Health and Family Medicine, Division of Public Health and Family Medicine, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Division of Public Health and Family Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362 (Second Floor), Piso 2 (Salud Pública)-Comuna de Santiago, 8330077, Santiago, Chile.
| | | | - Andrés Perry
- Departments of Public Health and Family Medicine, Division of Public Health and Family Medicine, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cameron D Norman
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Cense Ltd., Toronto, ON, Canada
| | - Jan Barnsley
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Lorraine E Ferris
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Brian Rush
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Mihevc M, Lukančič MM, Črt Z, Potočnik TV, Šter MP, Klemenc-Ketiš Z, Susič AP. Towards Integrated Care for the Elderly: Exploring the Acceptability of Telemonitoring for Hypertension and Type 2 Diabetes Management. Int J Integr Care 2024; 24:16. [PMID: 38765055 PMCID: PMC11100527 DOI: 10.5334/ijic.7621] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/07/2024] [Indexed: 05/21/2024] Open
Abstract
Introduction Telemonitoring has been proposed as an effective method to support integrated care for older people with hypertension and type 2 diabetes. This paper examines acceptability of telemontioring, its role in supporting integrated care, and identifies scale-up barriers. Methods A concurrent triangulation mixed-methods study, including in-depth interviews (n = 29) and quantitative acceptability tool (n = 55) was conducted among individuals who underwent a 12-month telemonitoring routine. The research was guided by the Theoretical Framework of Acceptability. Interviews were analysed using template content analysis (TCA). Results TCA identified seven domains of acceptability, with twenty-one subthemes influencing it positively or negatively. In the quantitative survey, acceptability was high across all seven domains with an overall score of 4.4 out of 5. Urban regions showed higher acceptability than rural regions (4.5 vs. 4.3), with rural participants perceiving initial training and participation effort as significantly more burdensome than their urban counterparts. Discussion Patients described several instances where telemonitoring supported self-management, education, treatment, and identification elements of the integrated care package. However, there were barriers that may limit its further scale-up. Conclusion For further scale-up, it is important to screen patients for monitoring eligibility, adapt telemonitoring devices to elderly needs, combine telemonitoring with health education, involve family members, and establish follow-up programmes.
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Affiliation(s)
- Matic Mihevc
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- Primary Healthcare Centre Trebnje, Goliev trg 3, SI-8210 Trebnje, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Majda Mori Lukančič
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
| | - Zavrnik Črt
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Tina Virtič Potočnik
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- Primary Healthcare Centre Slovenj Gradec, Partizanska pot 16, SI-2380 Slovenj Gradec, Slovenia
- University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska ulica 8, SI-2000 Maribor, Slovenia
| | - Marija Petek Šter
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Zalika Klemenc-Ketiš
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
- University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska ulica 8, SI-2000 Maribor, Slovenia
| | - Antonija Poplas Susič
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
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Sherborne V, Wood E, Mayland CR, Gardiner C, Lusted C, Bibby A, Tod A, Taylor B, Ejegi-Memeh S. The mental health and well-being implications of a mesothelioma diagnosis: A mixed methods study. Eur J Oncol Nurs 2024; 70:102545. [PMID: 38522172 DOI: 10.1016/j.ejon.2024.102545] [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: 10/31/2023] [Revised: 02/21/2024] [Accepted: 03/03/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE Mesothelioma is an incurable, asbestos-related cancer with a poor prognosis. There is scant evidence about the mental health and well-being impacts on patients and carers living with the illness. This study aimed to investigate mesothelioma's impact on mental health and well-being and the scale of mental health conditions in patients and informal carers. METHODS A mixed-methods design was used: a cross-sectional survey of mesothelioma patients and informal carers plus semi-structured interviews with patients and carers. The survey used validated scales collecting data on mental health aspects of mesothelioma: the EQ5D to assess health-related quality-of-life; the Hospital Anxiety and Depression scale; the PCL-5 to assess Posttraumatic Stress; and the Posttraumatic Growth Inventory. The datasets were integrated during analysis. RESULTS 96 useable survey responses were received. A clinical level of depression was reported by 29 participants (30.21%), of anxiety by 48 (50%), of posttraumatic distress disorder by 32 (33.33%), and of posttraumatic growth by 34 (35.42%). Carers had worse scores than patients. Three main themes were developed from interviews with 10 patients and 11 carers: 'Prognosis', 'Support from services', and 'Social connections and communication'. CONCLUSIONS Healthcare professionals delivering a mesothelioma diagnosis require regular training in communication skills plus updating in current treatment options, so they provide an appropriate mix of realism and hope. Better signposting to mental health support is needed for patients and carers. Our introduction of posttraumatic growth into the mesothelioma literature is novel. We recommend specialist nurses are trained to recognise, understand, and foster posttraumatic growth.
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Affiliation(s)
- Virginia Sherborne
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK.
| | - Emily Wood
- Division of Population Health, School of Medicine and Population Health, The University of Sheffield, UK
| | - Catriona R Mayland
- Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, UK
| | - Clare Gardiner
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Caitlin Lusted
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Anna Bibby
- Academic Respiratory Unit, University of Bristol and North Bristol NHS Trust, Bristol, UK
| | - Angela Tod
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Bethany Taylor
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Stephanie Ejegi-Memeh
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
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Archibald A, Spronk E, Potvin S, Kovacs Burns K, Moran M, Peng HJ, Raso J, Bahari H, Khan S, Cruz AM, Sia W. Perspectives on Communication Technology Use for Alleviating the Impact of COVID-19 on Hospitalized Patients' Well-Being and Transitions in Care. Can J Aging 2024:1-8. [PMID: 38372162 DOI: 10.1017/s0714980824000060] [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] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic created many challenges for in-patient care including patient isolation and limitations on hospital visitation. Although communication technology, such as video calling or texting, can reduce social isolation, there are challenges for implementation, particularly for older adults. OBJECTIVE/METHODS This study used a mixed methodology to understand the challenges faced by in-patients and to explore the perspectives of patients, family members, and health care providers (HCPs) regarding the use of communication technology. Surveys and focus groups were used. FINDINGS Patients who had access to communication technology perceived the COVID-19 pandemic to have more adverse impact on their well-beings but less on hospitalization outcomes, compared to those without. Most HCPs perceived that technology could improve programs offered, connectedness of patients to others, and access to transitions of care supports. Focus groups highlighted challenges with technology infrastructure in hospitals. DISCUSSION Our study findings may assist efforts in appropriately adopting communication technology to improve the quality of in-patient and transition care.
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Affiliation(s)
- Andrew Archibald
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Elena Spronk
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Sacha Potvin
- Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Katharina Kovacs Burns
- Clinical Quality Metrics, University of Alberta, Edmonton, AB, Canada
- Alberta Health Services, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Martin Moran
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Hongwei J Peng
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jim Raso
- Alberta Health Services, Edmonton, AB, Canada
- Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Hosein Bahari
- Alberta Health Services, Edmonton, AB, Canada
- Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Samina Khan
- Alberta Health Services, Edmonton, AB, Canada
| | - Antonio Miguel Cruz
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- GRRIT Hub Glenrose Rehabilitation Research, Innovation & Technology, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Winnie Sia
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Samost-Williams A, Rosen R, Cummins E, Sonnay Y, Nash G, Hannenberg A, Brindle M. Perspectives on Perioperative Team-Based Morbidity and Mortality Conferences: A Mixed Methods Study. Jt Comm J Qual Patient Saf 2024; 50:139-148. [PMID: 37953168 DOI: 10.1016/j.jcjq.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Morbidity and mortality conferences (MMCs) are quality improvement mechanisms during which adverse events are reviewed, often by physicians within a single discipline. There is a growing desire to include nonphysicians and physicians from other disciplines in team-based morbidity and mortality conferences (TBMMs). This mixed methods study investigates perioperative perspectives on MMCs generally and TBMMs specifically. METHODS A national survey of perioperative health care professionals, including surgeons, anesthesiologists, and nurses, was used to explore opinions about MMCs and TBMMs. Semistructured qualitative interviews and focus groups were conducted with health care professionals and leaders at a single study site. Quantitative data were compared using a Kruskal-Wallis test. Interview transcripts were inductively analyzed. Data were analyzed using a concurrent mixed methods approach, triangulating both sources of data. RESULTS Survey respondents (N = 1,466) were generally positive about both MMCs and TBMMs, agreeing that conferences were respectful, affected practice, and were educational. Nurses, compared to surgeons and anesthesiologists, were more likely to find conferences educational (p = 0.004) and were less comfortable speaking up in conferences (p < 0.001). Attendees who had more experience with TBMMs rated conferences as having significantly higher utility in achieving educational and safety goals. Qualitative data from 14 participants identified barriers and facilitators at the micro, meso, and macro level. Barriers include negative personal interactions, unsupportive leadership, and legal and regulatory issues. Facilitators include interpersonal relationships between professionals, buy-in from leadership, and external motivators. CONCLUSION Perceptions of TBMMs were overall positive, but significant barriers to implementation remain. Team members may be invited to the table, but more effort is needed to make the entire team feel included in the discussion and optimize the value of these conferences. Strategies for overcoming identified barriers remains an open area of research.
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Yin Z, Wang X, Lu X, Fu H. Hospital pharmacists' mental health during home isolation in the post-pandemic era of COVID-19: influencing factors, coping strategies, and the mediating effect of resilience. Front Public Health 2024; 12:1268638. [PMID: 38356948 PMCID: PMC10864583 DOI: 10.3389/fpubh.2024.1268638] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Objective There is a notable research gap on the mental health challenges faced by hospital pharmacists in the post-pandemic era. Therefore, the present study aims to explore mental health status, influencing factors, coping strategies, and the mediating effect of resilience of home quarantine hospital pharmacists (HQHPs). Methods An embedded mixed-method study was conducted in Zhengzhou, a megalopolis in central China, from 20 October to 3 November 2022. For the qualitative study, semi-structured interviews and focus group discussions were conducted among HQHPs to understand their mental health state,the factors that affect their mental health, and the alleviating strategies they used. For the quantitative study, the Generalized Anxiety Disorder Scale (GAD-7) and the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC-25) were used to explore the mental health level of HQHPs. Meanwhile, the mediating effect of resilience was explored and verified with the bootstrap method or the structural equation model. Results 20 HQHPs participated in the qualitative study. Two themes were identified in terms of the factors that influenced the HQHPs' mental health levels. The positive factors include optimism, family company, and connection with friends, while the negative factors include inadequate supplies, inadequate information, and other emergencies. 210 HQHPs participated in the quantitative study, with a median resilience score of 66 [55.75, 74] in the lowest score range and an anxiety score of 5 [2, 7] in the mild anxiety range. The correlation analysis showed that nine of the 10 influencing factors identified in qualitative research were positively correlated with CD-RISC-25 scores and negatively correlated with the GAD-7 score. The mediating effect of resilience on anxiety was significant (95% bootstrap CI [-1.818, -0.384], p<0.001; or 95% bootstrap CI [-1.174, -0.430], p<0.001). Conclusion Even in the post-epidemic era, hospital pharmacists face psychological challenges. They actively address these issues based on accumulated experience and a stabilized mindset. In this process, resilience plays a significant mediating role.
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Affiliation(s)
- Zhao Yin
- Institute for Hospital Management of Henan Province, Zhengzhou, China
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - XiangYu Wang
- Beijing Chaoyang Hospital, Party Committee Office, Beijing, China
| | - Xiaojing Lu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou, China
| | - Hang Fu
- Institute for Hospital Management of Henan Province, Zhengzhou, China
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11
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Hollier JM, Strickland TA, Fordis CM, Shulman RJ, Thompson D. Expert review of child and caregiver critiques of a therapeutic guided imagery therapy mobile application targeting disorders of gut-brain interaction in children. Digit Health 2024; 10:20552076241245376. [PMID: 38784053 PMCID: PMC11113049 DOI: 10.1177/20552076241245376] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 05/25/2024] Open
Abstract
Background A guided imagery therapy mobile application (GIT App) is a novel platform for treating children with disorders of gut-brain interaction (DGBI). Previous feedback from child/caregiver dyads suggested modifications for our App prototype. However, their feedback had the potential to affect the intervention's efficacy. Thus, we aimed to have their critiques vetted by relevant experts prior to further App refinement. Objective Compare expert reviews of the GIT App with end-users' (i.e., child/caregiver dyads') feedback. Methods This mixed-methods study with experts included a hands-on App evaluation, a survey assessing usability, and focus groups comparing their perspectives with those previously provided by end-users. Results Eight medical and technology experts were enrolled. Their average usability survey score of the GIT App was 69.0 ± 27.7, which was marginally above the 50th percentile. While the expert and end-user usability assessments were generally favorable, both groups agreed that the App's reminder notification feature location was not intuitive, detracting from its usability. Experts agreed with end-users that the App's aesthetics were acceptable and suggested increasing icon and font sizes. Like the end-users, the experts did not achieve consensus regarding the ideal session length or inclusion of background sounds and screen animations. Lastly, the experts agreed with end-users that gamification techniques (e.g., gift cards and virtual badges) would promote user engagement. Conclusion An expert review of our therapeutic App revealed findings consistent with end-users and provided insight for modifying the interface and GIT sessions. Based on this experience, we recommend expert vetting of end-user suggestions as a routine checkpoint when developing therapeutic Apps.
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Affiliation(s)
- John M Hollier
- Texas Children's Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | | | - C Michael Fordis
- Center for Collaborative and Interactive Technologies, Baylor College of Medicine, Houston, TX, USA
| | - Robert J Shulman
- Texas Children's Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Children's Nutrition Research Center, Agriculture Research Services, United States Department of Agriculture, Houston, TX, USA
| | - Debbe Thompson
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Children's Nutrition Research Center, Agriculture Research Services, United States Department of Agriculture, Houston, TX, USA
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12
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Sapag JC, Rush B. Evaluation of collaborative mental health services in Latin America: Theoretical and methodological basis. Int J Health Plann Manage 2024; 39:83-99. [PMID: 37865953 DOI: 10.1002/hpm.3719] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/17/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVES Approaches to collaborative mental health care (CMHC) have been implemented in many countries to strengthen the accessibility and delivery of mental health services in primary care. However, there are not well-defined frameworks to evaluate CMHC models. The purpose of this article is to identify, contextualize and discuss relevant health services research approaches, theory, and evaluation models for the development of an appropriate evaluation framework in order to foster effective CMHC in Latin America. METHODS A comprehensive literature review informed a critical analysis of relevant theories and alternative methods to be considered in the development of the framework. RESULTS Specific health services research frameworks are discussed in the context of evaluating CMHC. Two theoretical perspectives - collaboration theory and systems theory - and three evaluation models- realistic, developmental and collaborative - are analyzed in terms of their relevance. Methodological implications are identified. CONCLUSION An appropriate evaluation framework for CMHC in Latin America needs to reflect theoretical and contextual considerations and relevant evaluation approaches and methods, including key dimensions and attributes/variables, core indicators, and recommendations for implementation.
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Affiliation(s)
- Jaime C Sapag
- Departments of Public Health and Family Medicine, Division of Public Health and Family Medicine, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brian Rush
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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13
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Wentzel DL, Collins A, Brysiewicz P. An intervention to manage compassion fatigue in oncology nurses in Durban, South Africa. Health SA 2023; 28:2376. [PMID: 38223212 PMCID: PMC10784258 DOI: 10.4102/hsag.v28i0.2376] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/26/2023] [Indexed: 01/16/2024] Open
Abstract
Background Oncology nurses are involved through the often protracted and potentially traumatic continuum of diagnosis and treatment of their patients, which places them at high risk of developing compassion fatigue. Aim The aim of the study was to develop and implement an in-facility intervention to manage compassion fatigue among oncology nurses in Durban, South Africa. Setting The study was conducted with oncology nurses at state, private (private health insurance) and non-governmental oncology facilities (Hospice). Methods The Self-Care Intervention for Oncology Nurses was developed and implemented using action research with a mixed methods sequential explanatory design. It involved an integrative review, Professional Quality of Life (ProQOL) v 5 questionnaires (n = 83) and in-depth individual interviews (n = 8). Results Developed from the findings of the integrative review, quantitative and qualitative data, the Self-Care Intervention for Oncology Nurses comprised three components, namely psycho-education on risks (booklet), practices of remembrance (remembrance tree) and support structures (support group and follow-up family call). Overall, the participants enjoyed reading the booklet and engaging in the support group. There were varied responses to the remembrance tree and hesitancy to partaking in the follow-up phone call. Conclusion The developed intervention could encourage awareness of compassion fatigue amongst oncology nurses' engagement in self-care practices such as symbolic remembrance of patients and recognition of the value of support structures. Contribution The intervention may assist oncology nurses in the provision of compassionate caring for their patients and potentially minimise compassion fatigue.
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Affiliation(s)
- Dorien L Wentzel
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Anthony Collins
- Department of Social Inquiry, Faculty of Humanities and Social Sciences, La Trobe University, Melbourne, Australia
- Department of Psychology, Faculty of Arts, Rhodes University, Makhanda, South Africa
| | - Petra Brysiewicz
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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14
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Machado S, Karsiem S, Lavergne MR, Goldenberg S, Wiedmeyer ML. Respectful community engagement in health research with diverse im/migrant communities. BMJ Open 2023; 13:e077391. [PMID: 38097234 PMCID: PMC10729093 DOI: 10.1136/bmjopen-2023-077391] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Global migration and immigration are increasing, and migrants and immigrants (im/migrants) have specific health needs and healthcare experiences. Yet, im/migrant involvement in immigration and health research in Canada is inconsistent. Heretofore, involvement has primarily been in research planning, data collection and analysis, with little community involvement during knowledge exchange or through training and colearning opportunities. Community engagement has been especially uncommon in mixed-method and quantitative research in Canada. OBJECTIVE This article describes lessons learnt from the Evaluating Inequities in Refugee & Immigrants' Health Access (IRIS) project from 2018 to 2023, an ongoing mixed-method, community-based research project in British Columbia, Canada. Specifically, we share our core community engagement project structures, Commitments to Community and our Community Engagement Backbone, both collaboratively developed with im/migrant community memebers. PARTICIPANTS People with varied experiences of im/migration and connections to multiple, specific im/migrant communities participate in the project as participants, community researchers, community advisory board members, faculty members and students. Core research activities are supported in English, Farsi, Spanish and Tigrinya. We engage community members throughout the research process, from identifying research topics to knowledge exchange. CONCLUSION We found that these structures offer an accessible visual representation of the project's commitments to community engagement, and the ways these commitments are demonstrated through values and action. Our training opportunities, colearning activities and knowledge exchange efforts also confirmed the accuracy of interpretation, prompted additional analysis to clarify or add depth to findings, and helped us identify additional research topics. We hope these learnings can be used to expand engagement with diverse im/migrant communities in health and immigration research.
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Affiliation(s)
- Stefanie Machado
- Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Samira Karsiem
- Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada
| | - M Ruth Lavergne
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Centre for Applied Research in Mental Health and Addiction, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Shira Goldenberg
- Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada
- San Diego State University, San Diego, California, USA
| | - Mei-Ling Wiedmeyer
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Department of Family Practice, UBC, Vancouver, British Columbia, Canada
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15
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Wang Q, Xu C, He Z, Zou P, Yang J, Huang Y. An exploration of proactive health oriented symptom patterns in patients undergoing percutaneous coronary intervention with stent implantation: A mixed-methods study protocol. PLoS One 2023; 18:e0292285. [PMID: 37796788 PMCID: PMC10553226 DOI: 10.1371/journal.pone.0292285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/17/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Coronary Heart Disease (CHD) is one of the most prevalent chronic diseases worldwide. Currently, percutaneous coronary intervention (PCI) with stent implantation is the main clinical treatment for CHD, and patients can achieve better outcomes after stenting. However, adverse cardiovascular events continue to recur, ultimately failing to yield good results. Several symptoms exist after stenting and are associated with health outcomes. Little is known about the symptom patterns of patients during the different postoperative periods. Therefore, this study aims to explore the dynamics of symptoms and clarify the experiences of post-stenting in patients during different periods, which may help the delivery of more specific patient management and improve survival outcomes in the future. METHODS A mixed method (quantitative/qualitative) design will be adopted. Longitudinal research, including surveys regarding three different periods, will be sued to describe the symptom patterns of patients undergoing PCI with stent implantation, clarifying their focused symptom problems during different time periods or in populations with different features. Qualitative individual interviews aim to understand the feelings, experiences, opinions, and health conditions of patients post-stenting, which can explain and supplement quantitative data. Quantitative data will be analyzed using descriptive statistics, latent class analysis (LCA), and latent translation analysis (LTA). Qualitative data will be analyzed using content analysis. DISCUSSION This study is the first study to explore the symptom patterns and experiences of patients in various domains after stent implantation using a novel design including quantitative and qualitative methods, which will help the delivery of more specific patient management, reduce the recurrence of adverse cardiovascular events, and improve survival outcomes in the future. It is also meaningful to use PROMIS profile-57 to help patients to proactively focus on their health problems, promote health literacy, and incorporate active patient participation into health management, which is a successful transition from passive medical treatment to active management.
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Affiliation(s)
- Qi Wang
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Chaoyue Xu
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Zhiqing He
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ping Zou
- Nipissing University, Toronto, Ontario, Canada
| | - Jing Yang
- The Second Affiliated Hospital of University of South China, Hengyang, China
| | - Yanjin Huang
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
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16
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Grootjans SJM, Stijnen MMN, Hesdahl-DE Jong I, Kroese MEAL, Ruwaard D, Jansen MWJ. Implementation of an integrated community approach in deprived neighbourhoods: a theory-based process evaluation using the Consolidated Framework for Implementation Research (CFIR). Scand J Public Health 2023:14034948231199804. [PMID: 37726916 DOI: 10.1177/14034948231199804] [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] [Indexed: 09/21/2023]
Abstract
BACKGROUND We investigated the implementation process of an Integrated Community Approach (ICA) applied in four low socio-economic status neighbourhoods in Maastricht, the Netherlands. The ICA is a Population Health Management initiative and aims to improve population health, quality of care, professional's satisfaction and decrease costs of care. This study addresses the facilitators and barriers for implementing the ICA from a stakeholder perspective, including steering group members, professionals and citizens. METHODS We conducted a mixed-methods study using a triangulation of methods to investigate the implementation from 1 December 2016 to 31 December 2020. The Consolidated Framework for Implementation Research guided data collection and data-analysis for evaluating the implementation process. In total, 77 interviews, 97 observations, seven focus groups, 65 collected documents and two surveys with open-ended questions were conducted. RESULTS Facilitators for implementation were the use of citizen science to bring residents' needs into sharp focus, the integration of the ideology of Positive Health into the working routines of the professionals and leadership at the steering group level to overcome barriers in the ICA. The existing accounting and financial infrastructure obstructed combining budgets at neighbourhood level. CONCLUSIONS Engaging citizens and professionals at an early stage is an important facilitator for implementation. The use of a shared vision on health also worked as a facilitator since it created a shared language among professionals, which is important in Population Health Management initiatives where multiple professionals are expected to collaborate. TRIAL REGISTRATION NTR 6543; registration date, 25 July 2017.
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Affiliation(s)
- Sanneke J M Grootjans
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - M M N Stijnen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Academic Collaborative Centre for Public Health Limburg, Public Health Service South Limburg (GGD Zuid Limburg), Heerlen, the Netherlands
| | - I Hesdahl-DE Jong
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - M E A L Kroese
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - D Ruwaard
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - M W J Jansen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Academic Collaborative Centre for Public Health Limburg, Public Health Service South Limburg (GGD Zuid Limburg), Heerlen, the Netherlands
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McManamny T, Ortega M, Munro S, Jennings P, Whitley GA. A pre-hospital mixed methods systematic review protocol. Br Paramed J 2023; 8:38-43. [PMID: 37674915 PMCID: PMC10477821 DOI: 10.29045/14784726.2023.9.8.2.38] [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] [Indexed: 09/08/2023] Open
Abstract
Introduction Mixed methods research, a methodology entailing the integration of qualitative and quantitative data within a single study, offers researchers the ability to investigate complex processes and systems in health and healthcare. The collective strength gained through the data combination can provide an enhanced understanding of research problems, providing an ideal solution to understanding complex clinical issues in a range of settings. In pre-hospital practice, where often uncontrollable variables and environmental considerations increase healthcare complexity, mixed methods has emerged as a valuable approach to research. Aims Given the exponential growth of pre-hospital mixed methods research since the publication of our first systematic review in 2014, we aim to provide an update. Our review will explore how mixed methods is utilised in pre-hospital research and identify what standards of reporting are achieved. Methods This systematic review update will search MEDLINE, CINAHL Complete, Embase and Scopus bibliographic databases from 1 January 2012 to 15 March 2023, using an updated pre-hospital search strategy. Study screening will be performed in duplicate. Articles reported in English, explicitly stating the use of 'mixed methods' in the pre-hospital ambulance setting, including helicopter emergency medical services and community first-responder services, will be included. Data related to underpinning philosophy or theoretical framework, rationale for utilising mixed methods, background of the corresponding author, mode of data integration, model of publication and adherence to reporting standards, utilising the good reporting of a mixed methods study (GRAMMS) guidelines, will be extracted and analysed. All extracted data from study articles will be summarised in a table, allowing analysis of included studies against specified criteria.
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Affiliation(s)
- Tegwyn McManamny
- Ambulance Victoria; Monash University ORCID iD: https://orcid.org/0000-0001-6512-0191
| | - Marishona Ortega
- University of Lincoln ORCID iD: https://orcid.org/0000-0003-2647-264X
| | - Scott Munro
- South East Coast Ambulance Service NHS Foundation Trust; University of Surrey ORCID iD: https://orcid.org/0000-0002-0228-4102
| | - Paul Jennings
- Ambulance Victoria; Monash University ORCID iD: https://orcid.org/0000-0002-5605-7589
| | - Gregory Adam Whitley
- East Midlands Ambulance Service NHS Trust; University of Lincoln ORCID iD: https://orcid.org/0000-0003-2586-6815
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18
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Gopalan G, Lee KA, Pisciotta C, Hooley C, Stephens T, Acri M. Implementing a Child Mental Health Intervention in Child Welfare Services: Stakeholder Perspectives on Feasibility. J Emot Behav Disord 2023; 31:204-218. [PMID: 37635804 PMCID: PMC10454527 DOI: 10.1177/10634266221120532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
This pilot study integrated quantitative and qualitative data to examine the feasibility of implementing a modified version of a multiple family group behavioral parent training intervention (The 4Rs and 2Ss for Strengthening Families Program [4Rs and 2Ss]) in child welfare (CW) placement prevention services, from the perspectives of participating caregivers (n = 12) and CW staff (n = 12; i.e., 6 caseworkers, 4 supervisors, and 2 administrators). Quantitative surveys were administered to caregivers and CW staff followed by semi-structured interviews to examine the feasibility of implementing the modified 4Rs and 2Ss program, as well as factors impacting feasibility. Results indicated that quantitative benchmarks for high feasibility were met in all assessed areas (e.g., family recruitment, caseworker fidelity ratings, CW staff feasibility ratings) except for family attendance, which was markedly lower than desired. Factors facilitating feasibility included agency and research support, intervention ease-of-use, perceived benefits to existing CW practice, as well as logistical support (e.g., food, transportation, childcare) promoting attendance. Factors hindering feasibility included conflicts between research-based eligibility criteria and existing client population demographics, research-related processes resulting in delays, CW staff role conflicts, added workload burden, complex family issues, and power differentials inherent to CW services which complicated families' voluntary participation.
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Affiliation(s)
- Geetha Gopalan
- Hunter College – Silberman School of Social Work, 2180 Third Ave., New York, NY 10035
| | - Kerry A Lee
- Graduate School of Social Work and Social Research of Bryn Mawr College, Bryn Mawr, PA 19010
| | - Caterina Pisciotta
- The Graduate Center, City University of New York, 365 Fifth Ave., New York, NY 10016
| | - Cole Hooley
- School of Social Work, College of Family, Home and Social Sciences, Brigham Young University, Provo, UT 84602
| | - Tricia Stephens
- Hunter College – Silberman School of Social Work, 2180 Third Ave., New York, NY 10035
| | - Mary Acri
- McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, 41 East 11 St., New York, NY 10001
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Phillips WR, Gebauer S, Kueper JK, Martinez-Guijosa A, Felzien M, Olde Hartman TC, Westfall JM, DeVoe JE, Stewart M, Herbert CP, Green LA, Brown JB. Primary Care Research: Looking Back and Moving Forward With Reflections on NAPCRG's First 50 Years. Ann Fam Med 2023; 21:456-462. [PMID: 37748895 PMCID: PMC10519759 DOI: 10.1370/afm.3009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/18/2023] [Indexed: 09/27/2023] Open
Abstract
NAPCRG celebrated 50 years of leadership and service at its 2022 meeting. A varied team of primary care investigators, clinicians, learners, patients, and community members reflected on the organization's past, present, and future. Started in 1972 by a small group of general practice researchers in the United States, Canada, and the United Kingdom, NAPCRG has evolved into an international, interprofessional, interdisciplinary, and intergenerational group devoted to improving health and health care through primary care research. NAPCRG provides a nurturing home to researchers and teams working in partnership with individuals, families, and communities. The organization builds upon enduring values to create partnerships, advance research methods, and nurture a community of contributors. NAPCRG has made foundational contributions, including identifying the need for primary care research to inform primary care practice, practice-based research networks, qualitative and mixed-methods research, community-based participatory research, patient safety, practice transformation, and partnerships with patients and communities. Landmark documents have helped define classification systems for primary care, responsible research with communities, the central role of primary care in health care systems, opportunities to revitalize generalist practice, and shared strategies to build the future of family medicine. The future of health and health care depends upon strengthening primary care and primary care research with stronger support, infrastructure, training, and workforce. New technologies offer opportunities to advance research, enhance care, and improve outcomes. Stronger partnerships can empower primary care research with patients and communities and increase commitments to diversity and quality care for all. NAPCRG offers a home for all partners in this work.
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Affiliation(s)
- William R Phillips
- Department of Family Medicine, University of Washington, Seattle, Washington
| | - Sarah Gebauer
- Saint Louis University-School of Medicine, St Louis, Missouri
| | | | | | | | | | - John M Westfall
- Department of Family Medicine, University of Colorado School of Medicine, Denver, Colorado (Retired)
| | - Jennifer E DeVoe
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
| | | | - Carol P Herbert
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
| | - Larry A Green
- University of Colorado School of Medicine, Aurora, Colorado
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20
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Sun W. The impact of automatic speech recognition technology on second language pronunciation and speaking skills of EFL learners: a mixed methods investigation. Front Psychol 2023; 14:1210187. [PMID: 37663357 PMCID: PMC10469312 DOI: 10.3389/fpsyg.2023.1210187] [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: 04/21/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction This study employed an explanatory sequential design to examine the impact of utilizing automatic speech recognition technology (ASR) with peer correction on the improvement of second language (L2) pronunciation and speaking skills among English as a Foreign Language (EFL) learners. The aim was to assess whether this approach could be an effective tool for enhancing L2 pronunciation and speaking abilities in comparison to traditional teacher-led feedback and instruction. Methods A total of 61 intermediate-level Chinese EFL learners were randomly assigned to either a control group (CG) or an experimental group (EG). The CG received conventional teacher-led feedback and instruction, while the EG used ASR technology with peer correction. Data collection involved read-aloud tasks, spontaneous conversations, and IELTS speaking tests to evaluate L2 pronunciation and speaking skills. Additionally, semi-structured interviews were conducted with a subset of the participants to explore their perceptions of the ASR technology and its impact on their language learning experience. Results The quantitative analysis of the collected data demonstrated that the EG outperformed the CG in all measures of L2 pronunciation, including accentedness and comprehensibility. Furthermore, the EG exhibited significant improvements in global speaking skill compared to the CG. The qualitative analysis of the interviews revealed that the majority of the participants in the EG found the ASR technology to be beneficial in enhancing their L2 pronunciation and speaking abilities. Discussion The results of this study suggest that the utilization of ASR technology with peer correction can be a potent approach in enhancing L2 pronunciation and speaking skills among EFL learners. The improved performance of the EG compared to the CG in pronunciation and speaking tasks demonstrates the potential of incorporating ASR technology into language learning environments. Additionally, the positive feedback from the participants in the EG underscores the value of using ASR technology as a supportive tool in language learning classrooms.
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Affiliation(s)
- Weina Sun
- School of Foreign Languages, Changchun Institute of Technology, Changchun, China
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Ahuja S, Phillips L, Smartt C, Khalid S, Coldham T, Fischer L, Rae S, Sevdalis N, Boaz A, Robinson S, Gaughran F, Lelliott Z, Jones P, Thornicroft G, Munshi JD, Drummond C, Perez J, Littlejohns P. What interventions should we implement in England's mental health services? The mental health implementation network (MHIN) mixed-methods approach to rapid prioritisation. Front Health Serv 2023; 3:1204207. [PMID: 37638343 PMCID: PMC10456870 DOI: 10.3389/frhs.2023.1204207] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/17/2023] [Indexed: 08/29/2023]
Abstract
Introduction Setting mental health priorities helps researchers, policy makers, and service funders improve mental health services. In the context of a national mental health implementation programme in England, this study aims to identify implementable evidence-based interventions in key priority areas to improve mental health service delivery. Methods A mixed-methods research design was used for a three step prioritisation approach involving systematic scoping reviews (additional manuscript under development), expert consultations and data triangulation. Groups with diverse expertise, including experts by experience, worked together to improve decision-making quality by promoting more inclusive and comprehensive discussions. A multi-criteria decision analysis (MCDA) model was used to combine participants' varied opinions, data and judgments about the data's relevance to the issues at hand during a decision conferencing workshop where the priorities were finalised. Results The study identified mental health interventions in three mental health priority areas: mental health inequalities, child and adolescent mental health, comorbidities with a focus on integration of mental and physical health services and mental health and substance misuse problems. Key interventions in all the priority areas are outlined. The programme is putting some of these evidence-based interventions into action nationwide in each of these three priority mental health priority areas. Conclusion We report an inclusive attempt to ensure that the list of mental health service priorities agrees with perceived needs on the ground and focuses on evidence-based interventions. Other fields of healthcare may also benefit from this methodological approach if they need to make rapid health-prioritisation decisions.
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Affiliation(s)
- Shalini Ahuja
- Methodologies Research Division, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Lawrence Phillips
- Department of Management, London School of Economics and Political Science, London, United Kingdom
| | - Caroline Smartt
- Department of Health Service & Population Research, School of Mental Health & Psychological Sciences, King's College London, London, United Kingdom
| | - Sundus Khalid
- Department of Health Service & Population Research, School of Mental Health & Psychological Sciences, King's College London, London, United Kingdom
| | - Tina Coldham
- Participation Involvement & Engagement Advisor at NIHR (National Institute for Health Research), London, United Kingdom
| | - Laura Fischer
- Department of Health Service & Population Research, School of Mental Health & Psychological Sciences, King's College London, London, United Kingdom
| | - Sarah Rae
- Independent Expert by Experience, and Patient Community Involvement and Engagement Participation (PCIEP) Lead, co-Lead Workstream 2 (Patient and Public Involvement), London, United Kingdom
| | - Nick Sevdalis
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Annette Boaz
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Sarah Robinson
- Eastern Academic Health Science Network, Cambridge, United Kingdom
| | - Fiona Gaughran
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Zoe Lelliott
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Peter Jones
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Graham Thornicroft
- Department of Health Service & Population Research, School of Mental Health & Psychological Sciences, King's College London, London, United Kingdom
| | - Jayati-Das Munshi
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Colin Drummond
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jesus Perez
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Peter Littlejohns
- Social and Psychiatric Epidemiology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Balbale SN, Schäfer WLA, Davis TL, Blake SC, Close S, Sullivan GA, Reiter AJ, Hu AJ, Smith CJ, Wilberding MJ, Johnson JK, Holl JL, Raval MV. A mixed-method approach to generate and deliver rapid-cycle evaluation feedback: lessons learned from a multicenter implementation trial in pediatric surgery. Implement Sci Commun 2023; 4:82. [PMID: 37464448 DOI: 10.1186/s43058-023-00463-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Rapid-cycle feedback loops provide timely information and actionable feedback to healthcare organizations to accelerate implementation of interventions. We aimed to (1) describe a mixed-method approach for generating and delivering rapid-cycle feedback and (2) explore key lessons learned while implementing an enhanced recovery protocol (ERP) across 18 pediatric surgery centers. METHODS All centers are members of the Pediatric Surgery Research Collaborative (PedSRC, www.pedsrc.org ), participating in the ENhanced Recovery In CHildren Undergoing Surgery (ENRICH-US) trial. To assess implementation efforts, we conducted a mixed-method sequential explanatory study, administering surveys and follow-up interviews with each center's implementation team 6 and 12 months following implementation. Along with detailed notetaking and iterative discussion within our team, we used these data to generate and deliver a center-specific implementation report card to each center. Report cards used a traffic light approach to quickly visualize implementation status (green = excellent; yellow = needs improvement; red = needs significant improvement) and summarized strengths and opportunities at each timepoint. RESULTS We identified several benefits, challenges, and practical considerations for assessing implementation and using rapid-cycle feedback among pediatric surgery centers. Regarding potential benefits, this approach enabled us to quickly understand variation in implementation and corresponding needs across centers. It allowed us to efficiently provide actionable feedback to centers about implementation. Engaging consistently with center-specific implementation teams also helped facilitate partnerships between centers and the research team. Regarding potential challenges, research teams must still allocate substantial resources to provide feedback rapidly. Additionally, discussions and consensus are needed across team members about the content of center-specific feedback. Practical considerations include carefully balancing timeliness and comprehensiveness when delivering rapid-cycle feedback. In pediatric surgery, moreover, it is essential to actively engage all key stakeholders (including physicians, nurses, patients, caregivers, etc.) and adopt an iterative, reflexive approach in providing feedback. CONCLUSION From a methodological perspective, we identified three key lessons: (1) using a rapid, mixed method evaluation approach is feasible in pediatric surgery and (2) can be beneficial, particularly in quickly understanding variation in implementation across centers; however, (3) there is a need to address several methodological challenges and considerations, particularly in balancing the timeliness and comprehensiveness of feedback. TRIAL REGISTRATION NIH National Library of Medicine Clinical Trials. CLINICALTRIALS gov Identifier: NCT04060303. Registered August 7, 2019, https://clinicaltrials.gov/ct2/show/NCT04060303.
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Affiliation(s)
- Salva N Balbale
- Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
- Center for Health Services and Outcomes Research, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Department of Surgery, Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES), Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Center of Innovation for Complex Chronic Healthcare, Health Services Research & Development, Jr. VA Hospital, Edward Hines, Hines, IL, 60141, USA.
| | - Willemijn L A Schäfer
- Center for Health Services and Outcomes Research, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Surgery, Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES), Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Teaniese L Davis
- Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA, USA
| | - Sarah C Blake
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sharron Close
- Department of Pediatric Advanced Practice Nursing, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Gwyneth A Sullivan
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Audra J Reiter
- Department of Surgery, Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES), Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Andrew J Hu
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Charesa J Smith
- Center for Health Services and Outcomes Research, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Surgery, Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES), Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maxwell J Wilberding
- Center for Health Services and Outcomes Research, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Julie K Johnson
- Center for Health Services and Outcomes Research, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Surgery, Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES), Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jane L Holl
- Department of Neurology, Biological Sciences Division and Center for Healthcare Delivery Science and Innovation, University of Chicago, Chicago, IL, USA
| | - Mehul V Raval
- Center for Health Services and Outcomes Research, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Surgery, Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES), Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Cook DJ, Swinton M, Krewulak KD, Fiest K, Dionne J, Debigare S, Guyatt G, Taneja S, Alhazzani W, Burns KEA, Marshall JC, Muscedere J, Gouskos A, Finfer S, Deane AM, Myburgh J, Rochwerg B, Ball I, Mele T, Niven D, English S, Verhovsek M, Vanstone M. What counts as patient-important upper gastrointestinal bleeding in the ICU? A mixed-methods study protocol of patient and family perspectives. BMJ Open 2023; 13:e070966. [PMID: 37208143 DOI: 10.1136/bmjopen-2022-070966] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 05/21/2023] Open
Abstract
INTRODUCTION Clinically important upper gastrointestinal bleeding is conventionally defined as bleeding accompanied by haemodynamic changes, requiring red blood cell transfusions or other invasive interventions. However, it is unclear if this clinical definition reflects patient values and preferences. This protocol describes a study to elicit views from patients and families regarding features, tests, and treatments for upper gastrointestinal bleeding that are important to them. METHODS AND ANALYSIS This is a sequential mixed-methods qualitative-dominant multi-centre study with an instrument-building aim. We developed orientation tools and educational materials in partnership with patients and family members, including a slide deck and executive summary. We will invite intensive care unit (ICU) survivors and family members of former ICU patients to participate. Following a virtual interactive presentation, participants will share their perspectives in an interview or focus group. Qualitative data will be analysed using inductive qualitative content analysis, wherein codes will be derived directly from the data rather than using preconceived categories. Concurrent data collection and analysis will occur. Quantitative data will include self-reported demographic characteristics. This study will synthesise the values and perspectives of patients and family members to create a new trial outcome for a randomised trial of stress ulcer prophylaxis. This study is planned for May 2022 to August 2023. The pilot work was completed in Spring 2021. ETHICS AND DISSEMINATION This study has ethics approval from McMaster University and the University of Calgary. Findings will be disseminated via manuscript and through incorporation as a secondary trial outcome on stress ulcer prophylaxis. TRIAL REGISTRATION NUMBER NCT05506150.
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Affiliation(s)
- Deborah J Cook
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Critical Care, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Marilyn Swinton
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Karla D Krewulak
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Kirsten Fiest
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Joanna Dionne
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Critical Care, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Sylvie Debigare
- Patient and Family Partnership Committee, Canadian Critical Care Trials Group, Montreal, Quebec, Canada
| | - Gordon Guyatt
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Shipra Taneja
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Waleed Alhazzani
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Critical Care, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John C Marshall
- Surgery and Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John Muscedere
- Critical Care Medicine, Kingston Health Sciences Center, Queens University, Kingston, Ontario, Canada
| | - Audrey Gouskos
- Patient and Family Advisory Committee and Steering Committee Representative, Toronto, Ontario, Canada
| | - Simon Finfer
- Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| | - Adam M Deane
- Critical Care, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - John Myburgh
- Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bram Rochwerg
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Critical Care, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Ian Ball
- Medicine and Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Tina Mele
- Surgery and Critical Care Medicine, Western University, London, Ontario, Canada
| | - Daniel Niven
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Shane English
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Ofori R, Takyi SA, Amponsah O, Gagakuma D. Mining-induced displacement and resettlement in Ghana: an assessment of the prospects and challenges in selected mining communities. Soc Netw Anal Min 2023. [DOI: 10.1007/s13278-023-01075-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Freytes IM, Schmitzberger MK, Rivera-Rivera N, Lopez J, Motta-Valencia K, Wu SS, Orozco T, Hale-Gallardo J, Eliazar-Macke N, LeLaurin JH, Uphold CR. Study protocol of a telephone problem-solving intervention for Spanish-speaking caregivers of veterans post-stroke: an 8-session investigator-blinded, two-arm parallel (intervention vs usual care), randomized clinical trial. BMC Prim Care 2023; 24:73. [PMID: 36932321 PMCID: PMC10022053 DOI: 10.1186/s12875-022-01929-y] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/25/2022] [Indexed: 03/18/2023]
Abstract
BACKGROUND Stroke is one of the leading causes of death and the main cause of long-term disability in the United States. The significant risk factors of stroke among Hispanics are well-documented. The majority of stroke survivors return home following a stroke and are cared for by family caregivers. Due to the abrupt nature of strokes, caregivers experience unexpected changes and demands that oftentimes lead to caregiver burden and depression. Given the significant risk factors for stroke in Hispanics and the influence of culture in family norms and family management, we developed a telephone and online problem-solving intervention for Spanish-speaking stroke caregivers. This study tests the impact of a telephone and online problem-solving intervention for Spanish-speaking stroke caregivers on caregiver outcomes. METHODS The design is a two-arm parallel randomized clinical trial with repeated measures. We will enroll 290 caregivers from 3 Veterans Affairs (VA) medical centers. Participants randomized into the intervention arm receive a problem-solving intervention that uses telephone and online education and care management tools on the previously developed and nationally available RESCUE en Español Caregiver website. In the usual care group, participants receive the information and/or support caregivers of veterans with stroke normally receive through existing VA resources (e.g., stroke-related information and support). The primary outcome is change in caregiver's depressive symptoms at 1- and 12-weeks post-intervention. Secondary outcomes include changes in stroke caregivers' burden, self-efficacy, problem-solving, and health-related quality of life (HRQOL) and veterans' functional abilities. We will also determine the budgetary impact, the acceptability of the intervention and participation barriers and facilitators for Spanish-speaking stroke caregivers. DISCUSSION This is an ongoing study. It is the first known randomized controlled trial testing the effect of a telephone and online problem-solving intervention in Spanish for caregivers of veterans post-stroke. If successful, findings will support an evidence-based model that can be transported into clinical practice to improve the quality of caregiving post-stroke. TRIAL REGISTRATION ClinicalTrials.gov: NCT03142841- Spanish Intervention for Caregivers of Veterans with Stroke (RESCUE Español). Registered on February 23, 2018. Protocol version 8. 08.11.2022.
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Affiliation(s)
- I Magaly Freytes
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA.
- Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA.
| | - Magda K Schmitzberger
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Naiomi Rivera-Rivera
- Research Service, VA Caribbean Healthcare System, 10 Casia St, San Juan, PR, 00921, USA
| | - Janet Lopez
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Keryl Motta-Valencia
- Physical Medicine and Rehabilitation Service, VA Caribbean Healthcare System, 10 Casia St, San Juan, PR, 00921, USA
| | - Samuel S Wu
- College of Medicine, Department of Biostatistics, University of Florida, CTRB Room 5243, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Tatiana Orozco
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Jennifer Hale-Gallardo
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Nathaniel Eliazar-Macke
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Jennifer H LeLaurin
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Constance R Uphold
- Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
- College of Medicine, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32603, USA
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Xuecong Fan, Junyu Lu, Miaoxi Qiu, Xiao Xiao. Changes in travel behaviors and intentions during the COVID-19 pandemic and recovery period: A case study of China. Journal of Outdoor Recreation and Tourism 2023; 41. [PMID: 37521263 PMCID: PMC9046066 DOI: 10.1016/j.jort.2022.100522] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic severely hit the tourism industry in China and worldwide. Chinese government adopted extensive nonpharmaceutical interventions (NPIs) to control it. COVID-19 has been well under control since April 2020 and China entered into a unique recovering period. The aim of this study is to examine how the COVID-19 pandemic changed residents' travel behaviors and intentions and investigate the theoretical factors associated with these changes during the pandemic and the recovery period. This study used a mixed-methods approach by combining quantitative surveys (N = 1,423) and qualitative interviews (N = 34). We extended the theory of planned behavior (TPB) to include other emerging factors in the context of the COVID-19 pandemic, such as risk perception, tourist trust, and charitable attitude. Our findings show that COVID-19 changed respondents' travel preferences in different ways, for example, tend to choose natural/outdoor/uncrowded attractions over cultural/indoor/crowded attractions. Second, respondents' domestic travel behaviors and intentions were positively associated with constructs in TPB, charitable attitude to contribute to the recovery of the tourism industry, tourists' trust in domestic COVID-19 control, and awareness of destinations' promotion strategies, while domestic travel intentions were negatively associated with risk perception. Third, concerns about the international COVID-19 control and travel restrictions were the two major factors affecting residents' intentions to travel abroad. Finally, we highlighted the management implications including implementing strict preventive measures while improving the effectiveness, increasing tourists’ trust, and adopting diverse marketing and promotion strategies.
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Kaewchandee C, Hnuthong U, Thinkan S, Rahman MS, Sangpoom S, Suwanbamrung C. The experiences of district public health officers during the COVID-19 crisis and its management in the upper southern region of Thailand: A mixed methods approach. Heliyon 2023; 9:e12558. [PMID: 36573081 PMCID: PMC9771841 DOI: 10.1016/j.heliyon.2022.e12558] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/19/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
District public health officers (DPHO) are the major health care providers and vital resources for tackling the coronavirus disease 2019 (COVID-19) outbreak in Thailand. No studies have been published on their experiences of combating COVID-19 in Thailand. To guide and improve COVID-19 control efforts, we aimed to describe their experiences and analyze associated factors for tackling the outbreak. This mixed-methods design involved providing structured questionnaires to selected DPHOs across 52 districts of seven provinces in the upper southern region Thailand. We performed data analysis using descriptive and multivariate statistics. The quantitative approach used questionnaires that demonstrated the content validity and reliability. Data collection involved Google forms, analyzed by multivariate statistics. The qualitative approach comprised an online in-depth interview of 11 DPHOs and a thematic analysis. Results found of the 52 DPHOs, 41 were men (78.8%), and the mean age was 50.02 years (SD = 8.52 years). Their proactive experiences were significantly associated with sex (ORadj = 2.38, 95% CI = 1.11-3.30), age (ORadj = 1.73, 95% CI = 1.09-2.76), the length of experience in the current position (ORadj = 2.27, 95% CI = 1.43-3.63), and working time in the current position (ORadj = 2.27, 95% CI = 1.43-3.63). There was no significant association between marital status, knowledge, understanding, opinion, proactive practice, and participation experiences. These results were related to six themes of the qualitative approach as follows: High morbidity and mortality of COVID-19, COVID-19 concomitant with several problems, Reaching out to the community for better COVID-19 solutions, The importance of regular reports and feedback, Solution planning based on the situation, and Providing relief to all stakeholders from COVID-19 issue. Proactive experiences of district public health officers are important for sustainable COVID-19 solutions. Disseminating relevant equipment, guidelines, policy, and government regulations is necessary to promote preparedness and efficacy in the crisis management of COVID-19.
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Affiliation(s)
- Chuthamat Kaewchandee
- Department of Research and Medicine Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, 10300, Thailand
| | - Unchalee Hnuthong
- School of Public Health, Walailak University, Nakhon Si Thammarat, 80160, Thailand
| | - Sudarat Thinkan
- School of Public Health, Walailak University, Nakhon Si Thammarat, 80160, Thailand
| | - Md. Siddikur Rahman
- Department of Statistics, Begum Rokeya University, Rangpur, 5404, Bangladesh
| | - Suttida Sangpoom
- School of Science, Walailak University, Nakhon Si Thammarat, 80160, Thailand,Excellent Center for Dengue and Community Public Health: EC for DACH; MPH. and PhD. in Public Health Research Program, Walailak University, 80160, Thailand
| | - Charuai Suwanbamrung
- School of Public Health, Walailak University, Nakhon Si Thammarat, 80160, Thailand,Excellent Center for Dengue and Community Public Health: EC for DACH; MPH. and PhD. in Public Health Research Program, Walailak University, 80160, Thailand,Corresponding author
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Salami B, Tulli M, Alaazi DA, Juen J, Khasanova N, Foster J, Vallianatos H. Formal and informal support networks as sources of resilience and sources of oppression for temporary foreign workers in Canada. Migration Studies 2022. [DOI: 10.1093/migration/mnac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract
In this article, we explore temporary foreign workers’ (TFWs) access to and experiences with formal and informal supports in Canada. Our study utilized a participatory action research design and four overlapping phases of data collection: individual interviews with current and former TFWs, focus groups, individual interviews with settlement service agencies, and a cross-sectional survey with current and former TFWs. We used an intersectional theoretical framework to analyze these data and explore ways that TFWs interact with formal and informal sources of support for navigating their precarious immigration status and integration in Canada. Our findings show these supports have the potential to both benefit and harm TFWs, depending on their social positioning and availability of institutional resources. The benefits include information that aids settlement and integration processes in Canada, while the harms include misinformation that contributes to status loss. Future research and policy should recognize the complexity of informal and formal support networks available to TFWs. An absence of government support is apparent, as is the need for increased funding for settlement service agencies that serve these workers. In addition, Canada should better monitor employers, immigration consultants, and immigration lawyers to ensure these agents support rather than oppress TFWs.
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Affiliation(s)
- Bukola Salami
- Department of Nursing, University of Alberta , 116 Street and 85 Avenue , Edmonton, Alberta, Canada T6G 2R3
| | - Mia Tulli
- Department of Nursing, University of Alberta , 116 Street and 85 Avenue , Edmonton, Alberta, Canada T6G 2R3
| | - Dominic A Alaazi
- Department of Nursing, University of Alberta , 116 Street and 85 Avenue , Edmonton, Alberta, Canada T6G 2R3
| | - Jessica Juen
- Calgary Catholic Immigration Society , 1111-11 Avenue Southwest , Calgary, Alberta, Canada T2R 0G5
| | - Nariya Khasanova
- Department of Nursing, University of Alberta , 116 Street and 85 Avenue , Edmonton, Alberta, Canada T6G 2R3
| | - Jason Foster
- Department of Human Resources and Labour Relations, Athabasca University , 1 University Drive , Athabasca, Alberta, Canada T9S 3A3
| | - Helen Vallianatos
- Department of Nursing, University of Alberta , 116 Street and 85 Avenue , Edmonton, Alberta, Canada T6G 2R3
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Bruno G, Bell RC, Parlee B, Lightning P, Bull I, Cutknife B, Oster RT. Mâmawihitowin (bringing the camps together): Perinatal healthcare provider and staff participation in an Indigenous-led experiential intervention for enhancing culturally informed care—a mixed methods study. Int J Equity Health 2022; 21:164. [PMCID: PMC9667858 DOI: 10.1186/s12939-022-01764-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
In partnership with a Nehiyawak (Plains Cree) community of Maskwacîs,central Alberta (Canada), we implemented an Indigenous-led intervention to provide experiential learning opportunities for perinatal health care providers (HCPs) and staff. Our objective was to capture the impact of participating in cultural safety learning opportunities on perceived self-awareness for HCPs and staff to provide enhanced culturally informed care.
Methods
Perinatal HCPs and staff who work regularly with Indigenous women from our partnering community took part in a series of experiential learning activities designed by a Community Advisory Committee. We used an explanatory sequential mixed methods approach informed by community-based participatory research. We compared Cultural Intelligence Scale (CQS) and Maskwacîs-Specific Cultural Scale (MSCS) scores pre- and post-intervention using non-parametrical statistical analysis (Wilcoxon signed rank test). Post-intervention, we conducted a qualitative description study using semi-structured interviews. Qualitative data was analyzed using thematic analysis.
Results
A total of 17 participants completed pre- and post-intervention questionnaires. Responses indicated a shift in perceived cultural and community knowledge and comfort levels, with positive gains in overall mean scores for both the CQS (p = 0.01) and MSCS (p = 0.01). Nine participants completed qualitative interviews. Overall, participants felt better equipped to provide more culturally informed care to their patients post-intervention.
Conclusion
An Indigenous-led experiential learning intervention was effective in enhancing overall perceived cultural awareness and preparedness to provide culturally informed care for perinatal HCPs and staff. This study provides evidence for fostering relationships between Indigenous communities and health systems toward enhanced perinatal care.
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Glavinovic K, Eggleton K, Davis R, Gosman K, Macmillan A. Understanding and experience of climate change in rural general practice in Aotearoa-New Zealand. Fam Pract 2022; 40:442-448. [PMID: 36170172 DOI: 10.1093/fampra/cmac107] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Climate change is already affecting Aotearoa New Zealand (Aotearoa-NZ). The public health effects are varied and complex, and rural primary care staff will be at the front line of effects and responses. However, little is known about their understanding and experience. OBJECTIVES To determine understanding, experiences and preparedness of rural general practice staff in Aotearoa-NZ about climate change and health equity. METHODS A mixed-methods national cross-sectional survey of rural general practice staff was undertaken that included Likert-style and free-text responses. Quantitative data were analysed with simple descriptive analysis and qualitative data were thematically analysed using a deductive framework based on Te Whare Tapa Whā. RESULTS A proportion of survey respondents remained unsure about climate science and health links, although many others already reported a range of negative climate change health impacts on their communities, and expected these to worsen. Twenty to thirty percent of respondents lacked confidence in their health service's capability to provide support following extreme weather. Themes included acknowledgement that the health effects of climate change are highly varied and complex, that the health risks for rural communities combine climate change and wider environmental degradation and that climate change will exacerbate existing health inequities. CONCLUSIONS The study adds to sparse information on climate change effects on health in rural primary care. We suggest that tailored professional education on climate change science and rural health equity is still needed, while urgent resourcing and training for interagency disaster response within rural and remote communities is needed.
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Affiliation(s)
- Krystyna Glavinovic
- General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand
| | - Kyle Eggleton
- General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand
| | - Rhoena Davis
- Te Rōpu Ārahi, Hauora Taiwhenua (Rural Health Network), Wellington, New Zealand
| | - Kim Gosman
- Te Rōpu Ārahi, Hauora Taiwhenua (Rural Health Network), Wellington, New Zealand
| | - Alexandra Macmillan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Hollier JM, Strickland TA, Fordis CM, van Tilburg MA, Shulman RJ, Thompson D. Children and Caregiver Review of a Guided Imagery Therapy Mobile Application Designed to Treat Children with Functional Abdominal Pain Disorders: Leveraging a Mixed-Methods Approach with User-Centered Design (Preprint). JMIR Form Res 2022; 7:e41321. [PMID: 37074773 PMCID: PMC10157463 DOI: 10.2196/41321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Functional abdominal pain disorders (FAPDs) are highly prevalent and associated with substantial morbidity. Guided imagery therapy (GIT) is efficacious; however, barriers often impede patient access. Therefore, we developed a GIT mobile app as a novel delivery platform. OBJECTIVE Guided by user-centered design, this study captured the critiques of our GIT app from children with FAPDs and their caregivers. METHODS Children aged 7 to 12 years with Rome IV-defined FAPDs and their caregivers were enrolled. The participants completed a software evaluation, which assessed how well they executed specific app tasks: opening the app, logging in, initiating a session, setting the reminder notification time, and exiting the app. Difficulties in completing these tasks were tallied. After this evaluation, the participants independently completed a System Usability Scale survey. Finally, the children and caregivers were separately interviewed to capture their thoughts about the app. Using a hybrid thematic analysis approach, 2 independent coders coded the interview transcripts using a shared codebook. Data integration occurred after the qualitative and quantitative data were analyzed, and the collective results were summarized. RESULTS We enrolled 16 child-caregiver dyads. The average age of the children was 9.0 (SD 1.6) years, and 69% (11/16) were female. The System Usability Scale average scores were above average at 78.2 (SD 12.6) and 78.0 (SD 13.5) for the children and caregivers, respectively. The software evaluation revealed favorable usability for most tasks, but 75% (12/16) of children and 69% (11/16) of caregivers had difficulty setting the reminder notification. The children's interviews confirmed the app's usability as favorable but noted difficulty in locating the reminder notification. The children recommended adding exciting scenery and animations to the session screen. Their preferred topics were animals, beaches, swimming, and forests. They also recommended adding soft sounds related to the session topic. Finally, they suggested that adding app gamification enhancements using tangible and intangible rewards for listening to the sessions would promote regular use. The caregivers also assessed the app's usability as favorable but verified the difficulty in locating the reminder notification. They preferred a beach setting, and theme-related music and nature sounds were recommended to augment the session narration. App interface suggestions included increasing the font and image sizes. They also thought that the app's ability to relieve gastrointestinal symptoms and gamification enhancements using tangible and intangible incentives would positively influence the children's motivation to use the app regularly. Data integration revealed that the GIT app had above-average usability. Usability challenges included locating the reminder notification feature and esthetics affecting navigation. CONCLUSIONS Children and caregivers rated our GIT app's usability favorably, offered suggestions to improve its appearance and session content, and recommended rewards to promote its regular use. Their feedback will inform future app refinements.
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Affiliation(s)
- John M Hollier
- Texas Children's Hospital, Houston, TX, United States
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Tiantá A Strickland
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - C Michael Fordis
- The Center for Collaborative & Interactive Technologies, Baylor College of Medicine, Houston, TX, United States
| | - Miranda Al van Tilburg
- Department of Internal Medicine, Marshall University, Huntington, WV, United States
- School of Social Work, University of Washington, Seattle, WA, United States
- Department of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, United States
- Graduate Medical Education, Cape Fear Valley Hospital, Fayetteville, NC, United States
| | - Robert J Shulman
- Texas Children's Hospital, Houston, TX, United States
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Children's Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Houston, TX, United States
| | - Debbe Thompson
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Children's Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Houston, TX, United States
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Jo J, Tran TT, Beyda ND, Simmons D, Hendrickson JA, Almutairi MS, Alnezary FS, Gonzales-Luna AJ, Septimus EJ, Garey KW. Development of the invasive candidiasis discharge [I Can discharge] model: a mixed methods analysis. Eur J Clin Microbiol Infect Dis 2022; 41:1207-1213. [PMID: 36002777 PMCID: PMC9489576 DOI: 10.1007/s10096-022-04473-w] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Abstract
Patients with invasive candidiasis (IC) have complex medical and infectious disease problems that often require continued care after discharge. This study aimed to assess echinocandin use at hospital discharge and develop a transition of care (TOC) model to facilitate discharge for patients with IC. This was a mixed method study design that used epidemiologic assessment to better understand echinocandin use at hospital discharge TOC. Using grounded theory methodology focused on patients given echinocandins during their last day of hospitalization, a TOC model for patients with IC, the invasive candidiasis [I Can] discharge model was developed to better understand discharge barriers. A total of 33% (1405/4211) echinocandin courses were continued until the last day of hospitalization. Of 536 patients chosen for in-depth review, 220 (41%) were discharged home, 109 (20%) were transferred, and 207 (39%) died prior to discharge. Almost half (46%, 151/329) of patients discharged alive received outpatient echinocandin therapy. Independent predictors for outpatient echinocandin use were osteomyelitis (OR, 4.1; 95% CI, 1.1-15.7; p = 0.04), other deep-seated infection (OR, 4.4; 95% CI, 1.7-12.0; p = 0.003), and non-home discharge location (OR, 3.9, 95% CI, 2.0-7.7; p < 0.001). The I Can discharge model was developed encompassing four distinct themes which was used to identify potential barriers to discharge. Significant echinocadin use occurs at hospital discharge TOC. The I Can discharge model may help clinical, policy, and research decision-making processes to facilitate smoother and earlier hospital discharges.
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Affiliation(s)
- Jinhee Jo
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA
| | - Truc T Tran
- University of Texas Health Science Center, Houston, TX, USA
| | - Nicholas D Beyda
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA
| | - Debora Simmons
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, USA
| | | | - Masaad Saeed Almutairi
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA.,Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Faris S Alnezary
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA.,Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Medinah, Saudi Arabia
| | - Anne J Gonzales-Luna
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA
| | - Edward J Septimus
- Department of Population Medicine Harvard Medical School, Boston, MA, USA.,Texas A&M College of Medicine, Houston, TX, USA
| | - Kevin W Garey
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA.
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Pang H, Pan Z, Adams R, Duncan E, Chi C, Kong X, Adab P, Cheng KK, Cooper BG, Correia-de-Sousa J, Dickens AP, Enocson A, Farley A, Gale N, Jolly K, Jowett S, Maglakelidze M, Maghlakelidze T, Martins S, Sitch A, Stavrik K, Stelmach R, Turner A, Williams S, Jordan RE. Community lung health service design for COPD patients in China by the Breathe Well group. NPJ Prim Care Respir Med 2022; 32:27. [PMID: 35985992 PMCID: PMC9388970 DOI: 10.1038/s41533-022-00286-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
COPD is increasingly common in China but is poorly understood by patients, medications are not used as prescribed and there is no access to recommended non-pharmacological treatment. We explored COPD patients’ and general practitioners’ (GPs) knowledge of COPD, views on its management and the acceptability of a flexible lung health service (LHS) offering health education, exercise, self-management, smoking cessation and mental health support. Using a convergent mixed methods design, data were collected from patients and GPs using focus groups (FGs) in four Chinese cities, questionnaires were also used to collect data from patients. FGs were audio-recorded and transcribed. Quantitative data were analysed descriptively, thematic framework analysis was used for the qualitative data. Two-hundred fifty-one patients completed the questionnaire; 39 patients and 30 GPs participated in ten separate FGs. Three overarching themes were identified: patients’ lack of knowledge/understanding of COPD, current management of COPD not meeting patients’ needs and LHS design, which was well received by patients and GPs. Participants wanted COPD education, TaiChi, psychological support and WeChat for social support. 39% of survey responders did not know what to do when their breathing worsened and 24% did not know how to use their inhalers. 36% of survey respondents requested guided relaxation. Overall, participants did not fully understand the implications of COPD and current treatment was sub-optimal. There was support for developing a culturally appropriate intervention meeting Chinese patients’ needs, health beliefs, and local healthcare delivery. Further research should explore the feasibility of such a service.
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Vasudevan L, Bruening R, Hung A, Woolson S, Brown A, Hastings SN, Linton T, Embree G, Hostler CJ, Mahanna E, Okeke NL, Bosworth H, Sperber NR. COVID-19 vaccination intention and activation among health care system employees: A mixed methods study. Vaccine 2022; 40:5141-5152. [PMID: 35902277 PMCID: PMC9276645 DOI: 10.1016/j.vaccine.2022.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Achieving high COVID-19 vaccination rates among employees is necessary to prevent outbreaks in health care settings. The goal of the study was to produce actionable and timely evidence about factors underlying the intention and decisions to obtain the COVID-19 vaccine by employees. METHODS The study was conducted from December 2020 - May 2021 with employees from a VA health care system in Southeastern US. The study used a convergent mixed methods design comprising two main activities: a cross-sectional survey conducted prior to COVID-19 vaccine distribution, and semi-structured interviews conducted 4-6 months after vaccine distribution. Data were collected about participant characteristics, vaccination intention prior to distribution, vaccination decision post-distribution, determinants of vaccination intention and decision, activating factors, sources of information and intervention needs. Data from the survey and interviews were analyzed separately and integrated narratively in the discussion. RESULTS Prior to vaccine distribution, 77% of employees wanted to be vaccinated. Post vaccine distribution, we identified 5 distinct decision-making groups: 1) vaccine believers who actively sought vaccination and included those sometimes described as "immunization advocates", 2) go along to get along (GATGA) individuals who got vaccinated but did not actively seek it, 3) cautious acceptors who got the COVID-19 vaccine after some delay, 4) fence sitters who remained uncertain about getting vaccinated, and 5) vaccine refusers who actively rejected the COVID-19 vaccine. Participants identifying with Black or multiple races were more likely to express hesitancy in their vaccination intention. CONCLUSION The findings of our study highlight distinct decision-making profiles associated with COVID-19 vaccination among employees of a VA health care system, and provide tailored recommendations to reduce vaccine hesitancy in this population.
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Affiliation(s)
- Lavanya Vasudevan
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA; Duke Human Vaccine Institute, Durham, NC, USA.
| | - Rebecca Bruening
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA
| | - Anna Hung
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Sandra Woolson
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA
| | - Adrian Brown
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA
| | - Susan N Hastings
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA; Geriatrics Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Tammy Linton
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Office of Public Health and Epidemiology, Durham VA Health Care System, Durham, NC, USA
| | - Genevieve Embree
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Office of Public Health and Epidemiology, Durham VA Health Care System, Durham, NC, USA
| | - Christopher J Hostler
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Office of Public Health and Epidemiology, Durham VA Health Care System, Durham, NC, USA
| | - Elizabeth Mahanna
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA
| | - Nwora Lance Okeke
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Hayden Bosworth
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA; Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| | - Nina R Sperber
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Duke-Margolis Center for Health Policy, Durham, NC, USA
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Averbeck H, Litaker D, Fischer JE. Expanding the role of non-physician medical staff in primary care in Germany: protocol for a mixed-methods study exploring the perspectives of physicians in rural practices. BMJ Open 2022; 12:e064081. [PMID: 35882465 PMCID: PMC9330334 DOI: 10.1136/bmjopen-2022-064081] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Primary care faces substantial challenges worldwide through an increasing mismatch in supply and demand, particularly in rural areas. One option to address this mismatch might be increasing efficiency by delegation of tasks to non-physician medical staff. Possible influencing factors, motives and beliefs regarding delegation to non-physician medical staff and the potential of an expanded role, as perceived by primary care physicians, however, remain unclear. The aim of this study is to assess these factors to guide development of potential interventions for expanding the role of non-physician medical staff in delivering primary care services in rural Germany. METHODS AND ANALYSIS This mixed-methods study based on the theoretical domains framework (TDF) consists of survey and interviews conducted sequentially. The survey, to be sent to all primary care physicians active in rural Baden-Wuerttemberg (estimated n=1250), includes 37 items: 15 assessing personal and practice characteristics, 15 matching TDF domains and 7 assessing opportunities for delegation. The interview, to be performed in a subsample (estimated n=12-20), will be informed by results of the survey. The initial interview guide consists of 11 questions covering additional TDF domains. Perspectives towards delegation will be maximised by comparing data emerging in either part of the study, seeking confirmation, disagreement or further details. ETHICS AND DISSEMINATION The Ethics Committee of Heidelberg University approved this study (approval number: 2021-530). Written informed consent will be obtained before each interview; consent for participation in the survey will be assumed when the survey has been returned. Results will be disseminated via publications in peer-reviewed journals and talks at conferences. By combining quantitative and qualitative methods, our results will support future research for crafting potential interventions to expand the role of non-physician medical staff in rural primary care.
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Affiliation(s)
- Heiner Averbeck
- Division of General Medicine, Center for Preventive Medicine and Digital Health (CPD), Heidelberg University, Mannheim, Germany
| | - David Litaker
- Division of General Medicine, Center for Preventive Medicine and Digital Health (CPD), Heidelberg University, Mannheim, Germany
| | - Joachim E Fischer
- Division of General Medicine, Center for Preventive Medicine and Digital Health (CPD), Heidelberg University, Mannheim, Germany
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Zeng T, Yang Y, Man S. How Does Family Intergenerational Relationships Affect the Life Satisfaction of Middle-Aged and Elderly Parents in Urban Only-Child Families in Chengdu, China. Int J Environ Res Public Health 2022; 19:8704. [PMID: 35886556 DOI: 10.3390/ijerph19148704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022]
Abstract
Over the past 40 years, the implementation of the family planning policy in China has led to the creation of many only-child families. In the process of modernization and urbanization, it is critical to focus on the intergenerational relationships in only-child families and their associational mechanism on the life satisfaction of middle-aged and elderly parents, which has crucial implications for them staying active and healthy aging. Using the survey data from Chengdu, China, this study analyzed the characteristics of only-child parents' life satisfaction and family intergenerational relationships, and explored the associational mechanism of family intergenerational relationships on only-child parents' life satisfaction in urban families, as well as the possible moderating role of gender. The results indicate that there are gender differences in the life satisfaction of only-child parents in urban families, and men are more satisfied than women. Moreover, parents of sons and daughters differ in life satisfaction from the dual-gender perspective. Parents of daughters are likely to have higher life satisfaction, especially mothers. The only-child families have not moved toward nucleation in urban families, and intergenerational members maintain close contact and provide frequent mutual support to achieve individual and family development. There are significant gender differences in structural, associational, affectual, and functional solidarity among only-child. This study confirms that there are differences in the associational mechanism of family intergenerational relationships on life satisfaction in different dimensions. Affectual solidarity is the most influential factor of life satisfaction. In terms of normative and consensual solidarity, gender plays a moderating role. For men, normative and consensual solidarity is beneficial for improving life satisfaction, but it has an insignificant effect on women. The effects of structural solidarity, association solidarity, and functional solidarity are not significant.
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Tawash E. Career guidance for nursing education: a mixed-method study in high schools. British Journal of Guidance & Counselling 2022. [DOI: 10.1080/03069885.2022.2079612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Eman Tawash
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland-Bahrain, Muharraq, Bahrain
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Kristo I, Mowll J. Voicing the perspectives of stroke survivors with aphasia: A rapid evidence review of post-stroke mental health, screening practices and lived experiences. Health Soc Care Community 2022; 30:e898-e908. [PMID: 34951068 DOI: 10.1111/hsc.13694] [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: 06/29/2021] [Revised: 10/26/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
A rapid evidence review (RER) of empirical literature was conducted to explore aphasic stroke survivors' mental health outcomes and lived experiences, as well as the screening instruments for this cohort. The RER was informed by a critical disability theory approach and synthesised qualitative and quantitative evidence within and across 29 studies, published between 2000 and 2021, from a systematic search of three databases. Understanding the relationship between post-stroke aphasia and mental health outcomes is essential for developing comprehensive treatment strategies and designing appropriate long-term care. Available screening instruments currently only detect depression and anxiety, which are then used to detect further mental health issues. The RER revealed that the current screening instruments demonstrate reliability; however, research remains limited regarding their validity. Furthermore, limited studies include aphasic patients as participants and decision-makers in stroke research. Methodological limitations across studies include comparators and small sample sizes. Importantly, across the studies, there is a lack of representation of culturally diverse and minority participants. Overall, the RER results found a high prevalence of aphasic stroke survivors experiencing depression and other mental health outcomes, indicating that implementing mood screening in a timely manner is essential. In addition, the results support that psychological care pathways must be developed and evaluated in consultation with aphasic patients' and carers' lived experiences to identify stepped levels of care and establish appropriate screening instruments. Furthermore, the health system requires consistency, which would ideally be achieved by establishing staff roles and responsibilities regarding mood screening and supportive care in these psychological care pathways. Including mental health specialists such as social workers and establishing specialist training in the multidisciplinary team would support this endeavour. There is a need for further research regarding mood screening instruments, a diversity of aphasic stroke survivors' lived experiences and the clinical expertise of those providing psychological support.
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Affiliation(s)
- Isabella Kristo
- Royal Prince Alfred Hospital, New South Wales, Sydney, New South Wales, Australia
| | - Jane Mowll
- School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
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Karkou V, Omylinska‐Thurston J, Parsons A, Nair K, Starkey J, Haslam S, Thurston S, Marshall LD. Bringing creative psychotherapies to primary
NHS
Mental Health Services in the
UK
: A feasibility study on patient and staff experiences of arts for the blues workshops delivered at Improving Access to Psychological Therapies (
IAPT
) services. Couns and Psychother Res 2022. [DOI: 10.1002/capr.12544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Vicky Karkou
- Research Centre for Arts and Wellbeing Edge Hill University Ormskirk UK
| | | | - Ailsa Parsons
- Department of Psychology University of Salford Salford UK
| | - Kerry Nair
- Greater Manchester Mental Health NHS Foundation Trust Manchester UK
| | - Jennifer Starkey
- Research Centre for Arts and Wellbeing Edge Hill University Ormskirk UK
| | | | - Scott Thurston
- School of Arts and Media University of Salford Salford UK
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Mahmoudi R, Moitie T, Dorent R, Guillemin F, Couchoud C. Implementation of patient‐reported outcome measures in a heart transplant recipient registry: first step toward a patient‐centered approach. Clin Transplant 2022; 36:e14708. [DOI: 10.1111/ctr.14708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Redouane Mahmoudi
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
| | - Tiphaine Moitie
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
| | - Richard Dorent
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
- Département de cardiologie Hôpital Bichat – Claude‐Bernard Assistance Publique Hôpitaux de Paris Paris France
| | | | - Cécile Couchoud
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
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Pantha S, Aguinaldo MJ, Hasan-ul-bari SM, Chowdhury S, Dendup U, Gupta RD, Sutradhar I, Bari R, Sarker M. Facilitators and Barriers to Implementation of a Childhood Tuberculosis Control Program in Bangladesh: A Mixed-Methods Study from BRAC Urban DOTS Centres in Dhaka. Nursing Reports 2022; 12:371-86. [PMID: 35645362 PMCID: PMC9149828 DOI: 10.3390/nursrep12020036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/17/2022] [Accepted: 05/06/2022] [Indexed: 11/23/2022] Open
Abstract
The case detection rate of childhood tuberculosis in Bangladesh is 4%, far below the World Health Organization predicted rate of 10–15% for a country with a high burden of tuberculosis. A concurrent triangulation mixed-methods study was carried out in eight urban DOTS (Directly Observed Treatment, Short-course) centres to investigate the factors contributing to the diagnosis and treatment of childhood tuberculosis. Front-line health care workers (Shasthya Shebika) (n = 111) were surveyed to understand knowledge, attitude, and practice (KAP) of the diagnosis and treatment of childhood tuberculosis. In-depth interviews were conducted with field workers (n = 32) and mothers of TB cases (n = 4). Stakeholders involved in implementing the tuberculosis program (n = 9) participated in the key informant interviews. Knowledge of Shasthya Shebika was associated with the components addressed during refresher training (p = 0.02). Government stewardship, presence of specific guidelines, knowledge and capacity building of front-line health workers were identified as the key facilitators. Frequent turnover of key managerial positions in the government, stigma, delays in seeking care, lack of diagnostic facilities, and poor engagement of private practitioners were identified as major constraints. It was identified that the government should focus on improving diagnostic capacities, conduct research on childhood tuberculosis, and produce awareness materials.
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Kalantari E, Montazer G, Ghazinoory S. Modeling the characteristics of collaborative science and technology policy network. Technology Analysis & Strategic Management 2022. [DOI: 10.1080/09537325.2021.1908537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Esmaeel Kalantari
- Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran
| | - Gholamali Montazer
- Faculty of Industrial and Systems Engineering, Tarbiat Modares University, Tehran, Iran
| | - Sepehr Ghazinoory
- Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran
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Savory N, Sanders J, Hannigan B. Midwives’ experiences of supporting women's mental health: a mixed-method study. Midwifery 2022. [DOI: 10.1016/j.midw.2022.103368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/07/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022]
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Abstract
During the COVID-19 pandemic, urban green spaces (UGS) have gained relevance as a resilience tool that can sustain or increase well-being and public health in cities. However, several cities in Latin America have seen a decrease in their UGS use rates during the health emergency, particularly among vulnerable groups such as women. Using Mexico City as a case study, this research examines the main barriers affecting women’s access to UGS during the COVID-19 pandemic in Latin America. We applied a sequential mixed-methods approach in which the results of a survey distributed via social media in June 2020 to women aged 18 and older were used to develop semi-structured interviews with 12 women during October 2020. One year later, in November 2021, the continuity of the themes was evaluated through focus groups with the same group of women who participated in the interviews. Our results suggest that (1) prohibiting access to some UGS during the first months of the pandemic negatively impacted UGS access for women in marginalized neighborhoods; (2) for women, the concept of UGS quality and safety are intertwined, including the security level of the surrounding streets; and (3) women who live in socially cohesive neighborhoods indicated using UGS to a greater extent. Our findings highlight that while design interventions can affect women’s willingness to use UGS by improving their perceived safety and comfort, they remain insufficient to fully achieve equity in access to UGS.
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LeBlanc A, Baron M, Blouin P, Tarabulsy G, Routhier F, Mercier C, Despres JP, Hébert M, De Koninck Y, Cellard C, Collin-Vézina D, Côté N, Dionne É, Fleet R, Gagné MH, Isabelle M, Lessard L, Menear M, Merette C, Ouellet MC, Roy MA, Saint-Jacques MC, Savard C. For a structured response to the psychosocial consequences of the restrictive measures imposed by the global COVID-19 health pandemic: the MAVIPAN longitudinal prospective cohort study protocol. BMJ Open 2022; 12:e048749. [PMID: 35379610 PMCID: PMC8980732 DOI: 10.1136/bmjopen-2021-048749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic and associated restrictive measures have caused important disruptions in economies and labour markets, changed the way we work and socialise, forced schools to close and healthcare and social services to reorganise. This unprecedented crisis forces individuals to make considerable efforts to adapt and will have psychological and social consequences, mainly on vulnerable individuals, that will remain once the pandemic is contained and will most likely exacerbate existing social and gender health inequalities. This crisis also puts a toll on the capacity of our healthcare and social services structures to provide timely and adequate care. The MAVIPAN (Ma vie et la pandémie/ My Life and the Pandemic) study aims to document how individuals, families, healthcare workers and health organisations are affected by the pandemic and how they adapt. METHODS AND ANALYSIS MAVIPAN is a 5-year longitudinal prospective cohort study launched in April 2020 across the province of Quebec (Canada). Quantitative data will be collected through online questionnaires (4-6 times/year) according to the evolution of the pandemic. Qualitative data will be collected with individual and group interviews and will seek to deepen our understanding of coping strategies. Analysis will be conducted under a mixed-method umbrella, with both sequential and simultaneous analyses of quantitative and qualitative data. ETHICS AND DISSEMINATION MAVIPAN aims to support the healthcare and social services system response by providing high-quality, real-time information needed to identify those who are most affected by the pandemic and by guiding public health authorities' decision making regarding intervention and resource allocation to mitigate these impacts. MAVIPAN was approved by the Ethics Committees of the Primary Care and Population Health Research Sector of CIUSSS de la Capitale-Nationale (Committee of record) and of the additional participating institutions. TRIAL REGISTRATION NUMBER NCT04575571.
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Affiliation(s)
- Annie LeBlanc
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- VITAM Research Center on Sustainable Health, Quebec, Quebec, Canada
| | - Marie Baron
- VITAM Research Center on Sustainable Health, Quebec, Quebec, Canada
| | - Patrick Blouin
- VITAM Research Center on Sustainable Health, Quebec, Quebec, Canada
| | - George Tarabulsy
- University Center for Research on Youth and Families (CRUJeF), Québec, Québec, Canada
- Faculty of Social Sciences, Université Laval, Québec, Quebec, Canada
| | - Francois Routhier
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Quebec, Canada
| | - Catherine Mercier
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Quebec, Canada
| | - Jean-Pierre Despres
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- VITAM Research Center on Sustainable Health, Quebec, Quebec, Canada
| | - Marc Hébert
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- CERVO Brain Research Center, Québec, Québec, Canada
| | - Yves De Koninck
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- CERVO Brain Research Center, Québec, Québec, Canada
| | - Caroline Cellard
- Faculty of Social Sciences, Université Laval, Québec, Quebec, Canada
- CERVO Brain Research Center, Québec, Québec, Canada
| | - Delphine Collin-Vézina
- University Center for Research on Youth and Families (CRUJeF), Québec, Québec, Canada
- McGill University Faculty of Arts, Montreal, Québec, Canada
| | - Nancy Côté
- VITAM Research Center on Sustainable Health, Quebec, Quebec, Canada
- Faculty of Social Sciences, Université Laval, Québec, Quebec, Canada
| | - Émilie Dionne
- VITAM Research Center on Sustainable Health, Quebec, Quebec, Canada
| | - Richard Fleet
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- Integrated Research Center for a Learning System in Healthcare and Social Services-SASSS, Québec, Québec, Canada
| | - Marie-Hélène Gagné
- University Center for Research on Youth and Families (CRUJeF), Québec, Québec, Canada
- School of Psychology, Université Laval Faculté des sciences sociales, Quebec, Québec, Canada
| | - Maripier Isabelle
- Faculty of Social Sciences, Université Laval, Québec, Quebec, Canada
- CERVO Brain Research Center, Québec, Québec, Canada
| | - Lily Lessard
- Integrated Research Center for a Learning System in Healthcare and Social Services-SASSS, Québec, Québec, Canada
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, Québec, Canada
| | - Matthew Menear
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- VITAM Research Center on Sustainable Health, Quebec, Quebec, Canada
| | - Chantal Merette
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- CERVO Brain Research Center, Québec, Québec, Canada
| | - Marie-Christine Ouellet
- Faculty of Social Sciences, Université Laval, Québec, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Quebec, Canada
| | - Marc-André Roy
- Faculty of Medecine, Université Laval, Québec, Québec, Canada
- CERVO Brain Research Center, Québec, Québec, Canada
| | - Marie-Christine Saint-Jacques
- University Center for Research on Youth and Families (CRUJeF), Québec, Québec, Canada
- Faculty of Social Sciences, Université Laval, Québec, Quebec, Canada
| | - Claudia Savard
- CERVO Brain Research Center, Québec, Québec, Canada
- Faculty of Education, Université Laval, Québec, Québec, Canada
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Makamu-Beteck SJ, Moss SJ, Watson FG, Cameron M. Exercise Intervention Changes the Perceptions and Knowledge of Non-Communicable Disease Risk Factors among Women from a Low-Resourced Setting. Int J Environ Res Public Health 2022; 19. [PMID: 35329156 DOI: 10.3390/ijerph19063474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 12/04/2022]
Abstract
We employed the Health Belief Model (HBM) as a theoretical lens to explore the influence of an exercise intervention on the perceptions and knowledge of modifiable risk factors for non-communicable diseases (NCDs) among women from a low-resource setting in South Africa. We used a mixed-methods design, gathering qualitative and quantitative data at baseline (n = 95) and again after 12 weeks (n = 55) and 24 weeks (n = 44) of an exercise intervention. Qualitative data consisted of focus group discussions exploring the knowledge and perceptions of modifiable risk factors for NCDs at the three time points. We collected quantitative measurements of modifiable risk factors for NCDs (waist-to-hip ratio, body mass index, blood pressure, peripheral blood glucose, and cholesterol) as well as objective physical activity (PA) data over seven consecutive days. Surveys on coronary heart disease and PA knowledge were conducted at all three time points. Qualitative findings indicated that health exposures and cultural traditions influenced the participant’s perceptions about PA and NCDs. Waist circumference significantly decreased at 12 weeks compared to baseline MD = 4.16, p < 0.001. There was significant improvement at 12 weeks, compared to baseline, MD = 0.59, p = 0.009 for PA knowledge, and MD = 0.68, p = 0.003 for heart disease knowledge. There were reductions from baseline to 24 weeks in diastolic blood pressure (MD = 4.97, p = 0.045), waist circumference (MD = 2.85, p = 0.023) and BMI (MD = 0.82, p = 0.004). Significant heart disease knowledge improvements were found at 24 weeks compared to baseline (MD = 0.75, p < 0.001). Supervised exercise positively influenced Black African females′ health behaviours by understanding cultural perceptions of modifiable risk factors for NCDs.
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Shiyanbola OO, Maurer MA, Virrueta N, Walbrandt Pigarelli DL, Huang YM, Unni EJ, Smith PD. Feasibility of a Randomized Controlled Mixed Methods Trial to Address Health Literacy, Beliefs, Medication Adherence, and Self-Efficacy (ADHERE) in a Clinical Pharmacist-Led Clinic. Patient Prefer Adherence 2022; 16:679-696. [PMID: 35300357 PMCID: PMC8922467 DOI: 10.2147/ppa.s349258] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/12/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To assess the feasibility and acceptability of a health literacy-psychosocial support intervention - ADHERE and explore changes in glycemic values and medication adherence. PATIENTS AND METHODS Thirty-one participants with hemoglobin A1c (HbA1c) ≥ 8% were randomly allocated to control (usual care) or intervention groups (receiving usual care plus a 6-session pharmacist-led intervention focusing on the modifiable psychosocial factors that may influence medication adherence). Feasibility metrics evaluated recruitment, retention, and intervention adherence. Questionnaires were administered to collect psychosocial factors and self-reported medication adherence at baseline, the end of the intervention, 3 months, and 6 months post intervention. HbA1c values were extracted from electronic medical records. Repeated measures analysis of variance was used to compare differences in mean outcomes between the control and intervention groups. To assess intervention acceptability, eleven individuals participated in semi-structured interviews about their intervention experiences. Qualitative content analysis was used for analyzing the interviews. RESULTS Thirty participants completed the study. Overall, the findings support the feasibility of the intervention. There were significant differences in HbA1c values. Participants in the intervention group had lower A1C (8.3 ± 1.4) than in the control group (9.2 ± 1.3) at the time of 6-month follow-up (p = 0.003). In addition, the participants in the intervention group showed improved HbA1c at 6-month follow-up (8.3 ± 1.4), compared to baseline (9.4 ± 1.5, p = 0.011) and after 6-session intervention (8.9 ± 1.6, p = 0.046). However, there were no significant differences in medication adherence between groups over time. Qualitative themes suggest participants liked the intervention and perceived the additional support from the pharmacist as beneficial. CONCLUSION A pharmacist-led intervention to provide additional health literacy-psychosocial support may contribute to long-term improvements in HbA1c. Equipping pharmacists with patient-specific diabetes medication adherence information and building in additional follow-up support for patients may improve patient health outcomes.
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Affiliation(s)
- Olayinka O Shiyanbola
- Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin- Madison, Madison, WI, USA
- Correspondence: Olayinka O Shiyanbola, Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI, 53705, USA, Tel +1 608 890 2091, Email
| | - Martha A Maurer
- Sonderegger Research Center, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Natasha Virrueta
- Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin- Madison, Madison, WI, USA
| | | | - Yen-Ming Huang
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Elizabeth J Unni
- Department of Social, Behavioral, and Administrative Sciences, Touro College of Pharmacy, New York, NY, USA
| | - Paul D Smith
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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Wang EY, Breyer BN, Lee AW, Rios N, Oni-Orisan A, Steinman MA, Sim I, Kenfield SA, Bauer SR. Perceptions of Older Men Using a Mobile Health App to Monitor Lower Urinary Tract Symptoms and Tamsulosin Side Effects: Mixed Methods Study. JMIR Hum Factors 2021; 8:e30767. [PMID: 34951599 PMCID: PMC8742207 DOI: 10.2196/30767] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background Mobile health (mHealth) apps may provide an efficient way for patients with lower urinary tract symptoms (LUTS) to log and communicate symptoms and medication side effects with their clinicians. Objective The aim of this study was to explore the perceptions of older men with LUTS after using an mHealth app to track their symptoms and tamsulosin side effects. Methods Structured phone interviews were conducted after a 2-week study piloting the daily use of a mobile app to track the severity of patient-selected LUTS and tamsulosin side effects. Quantitative and qualitative data were considered. Results All 19 (100%) pilot study participants completed the poststudy interviews. Most of the men (n=13, 68%) reported that the daily questionnaires were the right length, with 32% (n=6) reporting that the questionnaires were too short. Men with more severe symptoms were less likely to report changes in perception of health or changes in self-management; 47% (n=9) of the men reported improved awareness of symptoms and 5% (n=1) adjusted fluid intake based on the questionnaire. All of the men were willing to share app data with their clinicians. Thematic analysis of qualitative data yielded eight themes: (1) orientation (setting up app, format, symptom selection, and side-effect selection), (2) triggers (routine or habit and symptom timing), (3) daily questionnaire (reporting symptoms, reporting side effects, and tailoring), (4) technology literacy, (5) perceptions (awareness, causation or relevance, data quality, convenience, usefulness, and other apps), (6) self-management, (7) clinician engagement (communication and efficiency), and (8) improvement (reference materials, flexibility, language, management recommendations, and optimize clinician engagement). Conclusions We assessed the perceptions of men using an mHealth app to monitor and improve management of LUTS and medication side effects. LUTS management may be further optimized by tailoring the mobile app experience to meet patients’ individual needs, such as tracking a greater number of symptoms and integrating the app with clinicians’ visits. mHealth apps are likely a scalable modality to monitor symptoms and improve care of older men with LUTS. Further study is required to determine the best ways to tailor the mobile app and to communicate data to clinicians or incorporate data into the electronical medical record meaningfully.
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Affiliation(s)
- Elizabeth Y Wang
- Columbia Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Benjamin N Breyer
- University of California San Francisco, San Francisco, CA, United States
| | - Austin W Lee
- University of California San Francisco, San Francisco, CA, United States
| | - Natalie Rios
- University of California San Francisco, San Francisco, CA, United States
| | | | - Michael A Steinman
- University of California San Francisco, San Francisco, CA, United States
| | - Ida Sim
- University of California San Francisco, San Francisco, CA, United States
| | - Stacey A Kenfield
- University of California San Francisco, San Francisco, CA, United States
| | - Scott R Bauer
- University of California San Francisco, San Francisco, CA, United States
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Eysenbach G, Ginossar T, Sulskis J, Zheleva E, Berger-Wolf T. Content and Dynamics of Websites Shared Over Vaccine-Related Tweets in COVID-19 Conversations: Computational Analysis. J Med Internet Res 2021; 23:e29127. [PMID: 34665760 PMCID: PMC8647974 DOI: 10.2196/29127] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/11/2021] [Accepted: 10/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The onset of the COVID-19 pandemic and the consequent "infodemic" increased concerns about Twitter's role in advancing antivaccination messages, even before a vaccine became available to the public. New computational methods allow for analysis of cross-platform use by tracking links to websites shared over Twitter, which, in turn, can uncover some of the content and dynamics of information sources and agenda-setting processes. Such understanding can advance theory and efforts to reduce misinformation. OBJECTIVE Informed by agenda-setting theory, this study aimed to identify the content and temporal patterns of websites shared in vaccine-related tweets posted to COVID-19 conversations on Twitter between February and June 2020. METHODS We used triangulation of data analysis methods. Data mining consisted of the screening of around 5 million tweets posted to COVID-19 conversations to identify tweets that related to vaccination and including links to websites shared within these tweets. We further analyzed the content the 20 most-shared external websites using a mixed methods approach. RESULTS Of 841,896 vaccination-related tweets identified, 185,994 (22.1%) contained links to specific websites. A wide range of websites were shared, with the 20 most-tweeted websites constituting 14.5% (27,060/185,994) of the shared websites and typically being shared for only 2 to 3 days. Traditional media constituted the majority of these 20 websites, along with other social media and governmental sources. We identified markers of inauthentic propagation for some of these links. CONCLUSIONS The topic of vaccination was prevalent in tweets about COVID-19 early in the pandemic. Sharing websites was a common communication strategy, and its "bursty" pattern and inauthentic propagation strategies pose challenges for health promotion efforts. Future studies should consider cross-platform use in dissemination of health information and in counteracting misinformation.
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Affiliation(s)
| | - Tamar Ginossar
- Department of Communication and Journalism, University of New Mexico, Albuquerque, NM, United States
| | - Jason Sulskis
- Department of Computer Science, The University of Illinois at Chicago, Chicago, IL, United States
| | - Elena Zheleva
- Department of Computer Science, The University of Illinois at Chicago, Chicago, IL, United States
| | - Tanya Berger-Wolf
- Department of Computer Science, The University of Illinois at Chicago, Chicago, IL, United States.,Translational Data Analytics Institute, The Ohio State University, Colombus, OH, United States
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Haines S, Evans K, Timmons S, Cutler E. A service improvement project of a legacy nurse programme to improve the retention of late career nurses. J Res Nurs 2021; 26:648-681. [PMID: 35669147 PMCID: PMC9163764 DOI: 10.1177/17449871211036172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND A Nottingham Legacy Nurse Programme was developed in response to the reducing supply of new nursing registrants and an ageing workforce. The programme comprised components of focussed mentorship, knowledge transition, support and development of new learners in practice. AIMS The work-based development programme aimed to improve the retention and experience of late career registered nurses. METHODS The programme was informed by the evidence base and co-produced with late career registered nurses (aged 55 years or over, approaching retirement). A small pilot programme (n = 6) was evaluated through a mixed-methods approach. Refinements and recommendations were proposed in response to findings of a scoping search of the literature, feedback from participants and stakeholder groups across the NHS Midlands and East regions (n = 238). RESULTS A Legacy Nurse programme has potential to address nurses' individual career development needs, valuing and retaining them in the workforce, enabling them to share professional knowledge and skills within clinical teams and offers a cost-effective solution to improving retention of late career nurses. CONCLUSIONS Addressing the needs of late career registered nurses is required to improve retention, job satisfaction, quality-of-care provision and facilitate knowledge transfer. The programme requires evaluation in other care settings and should be considered as part of an integrated approach to nurse retention, inclusive talent management and workforce planning, alongside financial and careers advice.
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Affiliation(s)
- Sue Haines
- Assistant Director of Nursing, Institute of Care Excellence, Nottingham University Hospitals, NHS Trust, Nottingham, UK
| | - Kerry Evans
- HEE / NIHR Midwife Clinical Lecturer, Institute of Care Excellence, Nottingham University Hospitals, NHS Trust, Nottingham, UK
| | - Stephen Timmons
- Professor of Health Services Management, Nottingham University Business School, Centre for Health Innovation, Leadership and Learning, Nottingham, UK
| | - Ellen Cutler
- Senior Nurse for Speciality Education and Accreditation, Nottingham University Hospitals, NHS Trust, Nottingham, UK
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