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Janssens N, Van Wilder L, Van Hecke A, Van Hoorenbeeck K, Vanden Wyngaert K, De Smedt D, Goossens E. COCCOS study: Developing a transition program for adolescents with chronic conditions using Experience-Based Co-Design. A study protocol. PLoS One 2024; 19:e0298571. [PMID: 38578769 PMCID: PMC10997087 DOI: 10.1371/journal.pone.0298571] [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: 08/16/2023] [Accepted: 01/25/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND During adolescence, adolescents and young adults (AYAs) are expected to transfer their care from the pediatric environment towards an adult-focused setting. To prevent an abrupt transfer of care, it is recommended to provide AYAs with chronic conditions an adequate transition program. The aim of this paper is to describe the study protocol for the development of a transition program for AYAs with common chronic conditions (COCCOS study), using the Experience-Based Co-Design (EBCD) methodology. METHODS AND ANALYSIS A qualitative, participatory study is conducted in Flanders (Belgium). Study participants are AYAs (n≥15, 14-25 years old, diagnosed with type 1 diabetes, asthma, or obesity), their families, and healthcare providers (n≥15). The study is composed of eight EBCD stages: clinical site observations, in-depth interviews, trigger film, healthcare providers' feedback event, AYAs' feedback event, joint event, co-design workshops, and a celebration event. Photovoice will take place as a starting point of EBCD. Data will be analyzed using thematic analysis. RESULTS Data collection has started in January 2023 and is expected to be completed in May 2024. As of August 2023, over 15 clinical site observations have been conducted. A total of 18 AYAs, two parents, six healthcare providers have been enrolled and a total of 20 interviews have been conducted. CONCLUSION Advancing transitional care is essential for tackling negative health outcomes. Applying the innovative participatory EBCD methodology will reveal key elements of transitional care for AYAs with common chronic conditions in the development of a person-centered transition program. PRACTICE IMPLICATIONS Study findings will apply key elements of transitional care of AYAs with chronic conditions in the development of an adequate transition program.
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Affiliation(s)
- Natwarin Janssens
- Department of Nursing and Midwifery, University of Antwerp, Antwerp, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Lisa Van Wilder
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Ghent University Hospital, Ghent, Belgium
| | - Kim Van Hoorenbeeck
- Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
| | | | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Eva Goossens
- Department of Nursing and Midwifery, University of Antwerp, Antwerp, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Patient Care, Antwerp University Hospital, Antwerp, Belgium
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Ohan JL, Jackson HM, Bett R, Farmer GM, Martini A. Experiences and needs of children and adolescents affected by a parent's acquired brain injury: a systematic review and thematic synthesis. Disabil Rehabil 2024; 46:1034-1044. [PMID: 36861777 DOI: 10.1080/09638288.2023.2179673] [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: 05/09/2021] [Revised: 12/21/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE To identify the experiences and needs of dependent children who have a parent with an acquired brain injury (ABI) using a systematic review and thematic synthesis. MATERIALS AND METHODS A systematic search of Medline, Embase, PsycINFO, CINAHL Plus, and Web of Science was conducted. The search included variants of: "children," "parents," "acquired brain injury," and "experiences" or "needs." Eligible articles reported on the experiences/needs of dependent children who have a parent with an ABI, from the child's perspective. Thematic analysis was used to identify themes. RESULTS A total of 4895 unique titles were assessed, and 9 studies met inclusion. Four themes were identified: (1) Sustained Emotional Toll (subthemes: (i) Initial Shock and Distress; (ii) Ongoing Loss and Grief; (iii) Present-Day Stress and Emotions), (2) Responsibilities Change and Children Help Out, (3) Using Coping Strategies (subtheme: Talking Can Help), and (4) Wanting Information about the Injury. CONCLUSION Themes highlighted significant disruption and challenges to children's wellbeing across development, with ongoing and considerable impacts many years after the parent's injury. The nature of the experiences shifted with time since the parent's injury. These children need ongoing support starting shortly after their parent's injury that is grounded in their particular experiences.IMPLICATIONS FOR REHABILITATIONWhen a parent has an acquired brain injury (ABI), dependent children and adolescents face emotional upheaval, significant stressors, increased responsibilities, and lack of information about their parent's injury that persist even many years after injury.The nature of these experiences and therefore their needs change based on the acute versus later stages of the parent's injury.Children often do not ask questions or tell others how they feel, which means that they need support that asks about, and listens and responds to their needs.Support for children needs to start soon after the parent's injury, be grounded in the lived experiences of this group, consider their parent's recovery stage, and be embedded as part of service provision rather than rely on children or families to make service contact.
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Affiliation(s)
- Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Hayley M Jackson
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Robyn Bett
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Glenda M Farmer
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
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Van de Velde E, Van Hecke A, Eeckloo K, Malfait S. Implementing bedside handovers in mental health care: Insights from an experience-based co-design. Patient Educ Couns 2024; 119:108051. [PMID: 37952401 DOI: 10.1016/j.pec.2023.108051] [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: 08/22/2023] [Revised: 10/15/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Bedside handovers have the potential to provide opportunities to increase patient involvement in mental health care. However, limited research has been conducted on this subject. METHODS In this study, we investigate the suitability of experience-based co-design as a method for designing bedside handover in mental health care. RESULTS The article discusses the goals of bedside handover, the preferred structure and content of the handover, its location and frequency, and the familiarization involved in it. CONCLUSIONS EBCD proved to be a suitable method of making recommendations for involving patients in nursing handover in a mental healthcare unit of a general hospital. PRACTICE IMPLICATIONS Nurses and mental health care patients agreed on the ISBARRT model to structure bedside handovers.
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Affiliation(s)
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium; Strategic Policy Cell, Ghent University Hospital, Belgium
| | - Simon Malfait
- Clinical Support Unit, Nursing Department, Ghent University Hospital, Belgium; Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium
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Pomey MP, Paquette J, Nelea MI, Vialaron C, Mourad R, Bouchard K, Normandin L, Côté MA, Desforges M, Pomey-Carpentier P, Fortin I, Ganache I, Régis C, Rosberger Z, Charpentier D, Vachon MF, Bélanger L, Dorval M, Ghadiri DP, Lavoie-Tremblay M, Boivin A, Pelletier JF, Fernandez N, Danino AM, de Guise M. Integrating accompanying patients into clinical oncology teams: limiting and facilitating factors. BMC Health Serv Res 2024; 24:150. [PMID: 38291443 PMCID: PMC10826234 DOI: 10.1186/s12913-024-10624-w] [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: 04/11/2023] [Accepted: 01/22/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES Since 2018, four establishments in Quebec have been instrumental in implementing the PAROLE-Onco program, which introduced accompanying patients (APs) into healthcare teams to improve cancer patients' experience. APs are patient advisors who have acquired specific experiential knowledge related to living with cancer, using services, and interacting with healthcare professionals. They are therefore in a unique and reliable position to be able to provide emotional, informational, cognitive and navigational support to patients who are dealing with cancer. We aimed to explore APs' perspectives regarding the limiting and facilitating factors in terms of how they are integrated into the clinical oncology teams. METHODS A qualitative study based on semi-structured interviews and focus groups was conducted with 20 APs at the beginning of their intervention (T1) and, two years later, during a second data collection (T2). Limiting and facilitating factors of APs' integration into clinical teams were analyzed in terms of governance, culture, resources and tools. RESULTS The limited factors raised by APs to be integrated into clinical teams include the following: confusion about the specific roles played by APs, lifting the egos of certain professionals who feel they are already doing what APs typically do, lack of identification of patient needs, absence of APs in project governance organizational boundaries, and team members' availability. Various communication challenges were also raised, resulting in the program being inadequately promoted among patients. Also mentioned as limiting factors were the lack of time, space and compensation. Creating opportunities for team members to meet with APs, building trust and teaching team members how APs' activities complement theirs were enhancing factors. Other facilitators include APs being involved in decision-making committees, being leaders in promoting the PAROLE-Onco program to patients and clinical team members and creating opportunities to communicate with team members to help enhance their work and provide feedback to improve patient services. Awareness of APs' added value for the team and patients is also a key facilitator. Regarding tools, offering accompanying services by telephone allows both patients and APs to benefit from the flexibility they need. CONCLUSION Over time, APs were able to identify optimal factors for successful implementation. Recommendations include APs and professionals working in co-construction on organization, leadership, resources and status factors. This could help catalyze a change in culture within health establishments and allow people dealing with cancer to benefit from the experiential knowledge of other patients within their clinical team.
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Affiliation(s)
- Marie-Pascale Pomey
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada.
- Centre d'excellence Sur Le Partenariat Avec Les Patients Et Le Public, Montréal, QC, Canada.
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montréal, Montréal, QC, CA, Canada.
| | - Jesseca Paquette
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Monica Iliescu Nelea
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Cécile Vialaron
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Rim Mourad
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Karine Bouchard
- Centre Hospitalier Universitaire- CHU de Québec-Université Laval, Québec, QC, Canada
| | - Louise Normandin
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Marie-Andrée Côté
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Mado Desforges
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | | | - Israël Fortin
- Centre Intégré, Universitaire de Santé Et Services Sociaux de L'Est-de-L'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, Montréal, QC, Canada
| | - Isabelle Ganache
- Institut National d'excellence en Santé Et Services Sociaux (INESSS), Montréal, QC, Canada
| | - Catherine Régis
- Université de Montréal - Faculté de droit, Montréal, QC, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, Lady Davis Institute for Medical Research, Jewish General Hospital &, McGill University, Montréal, QC, Canada
| | | | | | - Lynda Bélanger
- Centre Hospitalier Universitaire- CHU de Québec-Université Laval, Québec, QC, Canada
| | - Michel Dorval
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche du CISSS Chaudière Appalaches, Lévis, QC, Canada
| | | | - Mélanie Lavoie-Tremblay
- Faculté Des Sciences Infirmières, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Antoine Boivin
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
- Centre d'excellence Sur Le Partenariat Avec Les Patients Et Le Public, Montréal, QC, Canada
- Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Pelletier
- Centre Intégré de Santé Et de Services Sociaux de La Montérégie-Ouest, St-Hubert, QC, Canada
- Yale Program for Recovery & Community Health, New Haven, CT, USA
| | - Nicolas Fernandez
- Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Alain M Danino
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
- Centre Hospitalier Universitaire de Montréal (CHUM), Montréal, QC, Canada
| | - Michèle de Guise
- Institut National d'excellence en Santé Et Services Sociaux (INESSS), Montréal, QC, Canada
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Winter N, McKenzie K, Spence D, Lane K, Ugalde A. The experience of bereaved cancer carers in rural and regional areas: The impact of the COVID-19 pandemic and the potential of peer support. PLoS One 2023; 18:e0293724. [PMID: 37934771 PMCID: PMC10629652 DOI: 10.1371/journal.pone.0293724] [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: 11/09/2022] [Accepted: 10/18/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Caring for someone with cancer during end of life care can be a challenging and complex experience. Those living in rural and regional areas are less likely to have local healthcare services and may be physically isolated. Even where support services such as respite do exist, they may be less likely to be accessed due to the time burden in travelling to services. This was compounded by the COVID-19 pandemic. AIM To understand the potential benefits of peer support for bereaved carers of people with cancer from rural and regional locations during the COVID-19 period. METHODS Phone interviews were conducted with bereaved cancer carers living in rural and regional areas in Victoria. Semi-structured interviews were used, and participants were asked about their experience as a carer, bereavement and the potential for peer support. Interviews were audio recorded and transcribed verbatim; transcripts were coded and a thematic analysis was conducted. FINDINGS 12 interviews were conducted. Carers were mostly female (85%) and were on average 58 years of age (range 42-71). Interviews lasted an average of 58 minutes (range 53-91 minutes). Three themes were derived from the data; 1) Supportive care needs while caring and the impact of COVID-19; 2) Isolation during bereavement compounded by the COVID-19 pandemic; and 3) Peer support requires flexibility to meet diverse needs. CONCLUSION Peer support has potential to assist bereaved carers of people with cancer. A co-design approach may be beneficial for developing a flexible model for supporting and linking carers together.
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Affiliation(s)
- Natalie Winter
- School of Nursing & Midwifery and Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Kerry McKenzie
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Danielle Spence
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Katherine Lane
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Anna Ugalde
- School of Nursing & Midwifery and Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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Kessler D, McCutcheon T, Rajachandrakumar R, Lees J, Deyell T, Levy M, Liddy C. Understanding barriers to participation in group chronic disease self-management (CDSM) programs: A scoping review. Patient Educ Couns 2023; 115:107885. [PMID: 37473604 DOI: 10.1016/j.pec.2023.107885] [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: 05/17/2022] [Revised: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To identify factors that influence enrollment in and attendance of chronic disease self-management (CDSM) group programs. METHODS A scoping review of peer-reviewed publications that reported on factors of enrollment or attendance in group CDSM programs for adults with any type of chronic condition. Screening was completed by two reviewers and data extraction was checked for accuracy. Data were summarized and key themes were identified in collaboration with the study team. RESULTS Following screening, 52 of 2774 articles were included. Attendance rates that varied from 10.4-98.5% (mean =72.5%). There is considerable overlap between enrollment and attendance factors. These included Competing Commitments, Logistics, Personal characteristics, Perception of illness/health status, Health service provision, and Group dynamics. CONCLUSIONS Varied and individualized factors can facilitate or impede enrollment or attendance in group CDSM programs. Consideration of these factors and tailoring of programs is needed to facilitate patient ability to take part. Participatory co-design is a growing approach to ensure programs meet individual and community needs. More research is needed to identify the specific impact of using codesign on enrollment and attendance in group CDSM programs. PRACTICE IMPLICATIONS Including community members and service users in design and implementation may enhance CDSM program access.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada.
| | - Tess McCutcheon
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | | | - Jodie Lees
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Tracy Deyell
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada
| | - Marisa Levy
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
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Merner B, Schonfeld L, Virgona A, Lowe D, Walsh L, Wardrope C, Graham-Wisener L, Xafis V, Colombo C, Refahi N, Bryden P, Chmielewski R, Martin F, Messino NM, Mussared A, Smith L, Biggar S, Gill M, Menzies D, Gaulden CM, Earnshaw L, Arnott L, Poole N, Ryan RE, Hill S. Consumers' and health providers' views and perceptions of partnering to improve health services design, delivery and evaluation: a co-produced qualitative evidence synthesis. Cochrane Database Syst Rev 2023; 3:CD013274. [PMID: 36917094 PMCID: PMC10065807 DOI: 10.1002/14651858.cd013274.pub2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Partnering with consumers in the planning, delivery and evaluation of health services is an essential component of person-centred care. There are many ways to partner with consumers to improve health services, including formal group partnerships (such as committees, boards or steering groups). However, consumers' and health providers' views and experiences of formal group partnerships remain unclear. In this qualitative evidence synthesis (QES), we focus specifically on formal group partnerships where health providers and consumers share decision-making about planning, delivering and/or evaluating health services. Formal group partnerships were selected because they are widely used throughout the world to improve person-centred care. For the purposes of this QES, the term 'consumer' refers to a person who is a patient, carer or community member who brings their perspective to health service partnerships. 'Health provider' refers to a person with a health policy, management, administrative or clinical role who participates in formal partnerships in an advisory or representative capacity. This QES was co-produced with a Stakeholder Panel of consumers and health providers. The QES was undertaken concurrently with a Cochrane intervention review entitled Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. OBJECTIVES 1. To synthesise the views and experiences of consumers and health providers of formal partnership approaches that aimed to improve planning, delivery or evaluation of health services. 2. To identify best practice principles for formal partnership approaches in health services by understanding consumers' and health providers' views and experiences. SEARCH METHODS We searched MEDLINE, Embase, PsycINFO and CINAHL for studies published between January 2000 and October 2018. We also searched grey literature sources including websites of relevant research and policy organisations involved in promoting person-centred care. SELECTION CRITERIA We included qualitative studies that explored consumers' and health providers' perceptions and experiences of partnering in formal group formats to improve the planning, delivery or evaluation of health services. DATA COLLECTION AND ANALYSIS Following completion of abstract and full-text screening, we used purposive sampling to select a sample of eligible studies that covered a range of pre-defined criteria, including rich data, range of countries and country income level, settings, participants, and types of partnership activities. A Framework Synthesis approach was used to synthesise the findings of the sample. We appraised the quality of each study using the CASP (Critical Appraisal Skill Program) tool. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. The Stakeholder Panel was involved in each stage of the review from development of the protocol to development of the best practice principles. MAIN RESULTS We found 182 studies that were eligible for inclusion. From this group, we selected 33 studies to include in the final synthesis. These studies came from a wide range of countries including 28 from high-income countries and five from low- or middle-income countries (LMICs). Each of the studies included the experiences and views of consumers and/or health providers of partnering in formal group formats. The results were divided into the following categories. Contextual factors influencing partnerships: government policy, policy implementation processes and funding, as well as the organisational context of the health service, could facilitate or impede partnering (moderate level of confidence). Consumer recruitment: consumer recruitment occurred in different ways and consumers managed the recruitment process in a minority of studies only (high level of confidence). Recruiting a range of consumers who were reflective of the clinic's demographic population was considered desirable, particularly by health providers (high level of confidence). Some health providers perceived that individual consumers' experiences were not generalisable to the broader population whereas consumers perceived it could be problematic to aim to represent a broad range of community views (high level of confidence). Partnership dynamics and processes: positive interpersonal dynamics between health providers and consumers facilitated partnerships (high level of confidence). However, formal meeting formats and lack of clarity about the consumer role could constrain consumers' involvement (high level of confidence). Health providers' professional status, technical knowledge and use of jargon were intimidating for some consumers (high level of confidence) and consumers could feel their experiential knowledge was not valued (moderate level of confidence). Consumers could also become frustrated when health providers dominated the meeting agenda (moderate level of confidence) and when they experienced token involvement, such as a lack of decision-making power (high level of confidence) Perceived impacts on partnership participants: partnering could affect health provider and consumer participants in both positive and negative ways (high level of confidence). Perceived impacts on health service planning, delivery and evaluation: partnering was perceived to improve the person-centredness of health service culture (high level of confidence), improve the built environment of the health service (high level of confidence), improve health service design and delivery e.g. facilitate 'out of hours' services or treatment closer to home (high level of confidence), enhance community ownership of health services, particularly in LMICs (moderate level of confidence), and improve consumer involvement in strategic decision-making, under certain conditions (moderate level of confidence). There was limited evidence suggesting partnering may improve health service evaluation (very low level of confidence). Best practice principles for formal partnering to promote person-centred care were developed from these findings. The principles were developed collaboratively with the Stakeholder Panel and included leadership and health service culture; diversity; equity; mutual respect; shared vision and regular communication; shared agendas and decision-making; influence and sustainability. AUTHORS' CONCLUSIONS Successful formal group partnerships with consumers require health providers to continually reflect and address power imbalances that may constrain consumers' participation. Such imbalances may be particularly acute in recruitment procedures, meeting structure and content and decision-making processes. Formal group partnerships were perceived to improve the physical environment of health services, the person-centredness of health service culture and health service design and delivery. Implementing the best practice principles may help to address power imbalances, strengthen formal partnering, improve the experiences of consumers and health providers and positively affect partnership outcomes.
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Affiliation(s)
- Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Ariane Virgona
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Child and Family Evidence, Australian Institute of Family Studies, Melbourne, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Cheryl Wardrope
- Clinical Governance, Metro South Hospital and Health Service, Eight Mile Plains, Australia
| | | | - Vicki Xafis
- The Sydney Children's Hospitals Network, Sydney, Australia
| | - Cinzia Colombo
- Laboratory for medical research and consumer involvement, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Nora Refahi
- Consumer Representative, Melbourne, Australia
| | - Paul Bryden
- Consumer Representative, Caboolture, Australia
| | - Renee Chmielewski
- Planning and Patient Experience, The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | | | | | | | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Susan Biggar
- Consumer Representative, Melbourne, Australia
- Australian Health Practitioner Regulation Agency (AHPRA), Melbourne, Australia
| | - Marie Gill
- Gill and Wilcox Consultancy, Melbourne, Australia
| | - David Menzies
- Chronic Disease Programs, South Eastern Melbourne Primary Health Network, Heatherton, Australia
| | - Carolyn M Gaulden
- Detroit Wayne County Authority Health Residency Program, Michigan State University, Providence Hospital, Southfield, Michigan, USA
| | | | | | - Naomi Poole
- Strategy and Innovation, Australian Commission on Safety and Quality in Health Care, Sydney, Australia
| | - Rebecca E Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Sharp R, Xu Q, Corsini N, Turner L, Altschwager J, Marker J, Ullman A, Esterman A. Community-based Intravenous Treatment and Central Venous Access Devices: A Scoping Review of the Consumer and Caregiver Experience, Information Preferences, and Supportive Care Needs. J Community Health Nurs 2023; 40:28-51. [PMID: 36602775 DOI: 10.1080/07370016.2022.2081506] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Map existing research and describe the consumer/caregiver experience of community-based intravenous treatment, central venous access devices (CVADs), supportive care needs, and information preferences. DESIGN Scoping review. METHODS Five databases (Joanna Briggs Institute, Cochrane library, Emcare, Embase, and Medline) were searched. Screening and data extraction were performed independently by two reviewers. FINDINGS Forty-eight studies were included. CONCLUSIONS Although community-based intravenous treatment and CVADs have a significant impact on consumers and caregivers, there is scant research on their supportive care needs and information preferences. CLINICAL EVIDENCE Some consumers and caregivers may require additional support while undergoing community-based intravenous treatment.
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Affiliation(s)
- Rebecca Sharp
- Clinical & Health Sciences, University of South Australia, Adelaide, Australia.,Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, Australia
| | - Qunyan Xu
- Clinical & Health Sciences, University of South Australia, Adelaide, Australia
| | - Nadia Corsini
- Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, Australia
| | - Lisa Turner
- Clinical Operations, Silver Chain Group, Australia
| | | | - Julie Marker
- Cancer Voices South Australia, Adelaide, Australia
| | - Amanda Ullman
- Children's Health Queensland and Health Service/ School of Nursing, Midwifery and Social Work, The University of Queensland, Australia
| | - Adrian Esterman
- Clinical & Health Sciences, University of South Australia, Adelaide, Australia.,Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, Australia
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9
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Forman J, Murtagh E, Cheung J, Chakrabarti S, Macleod S, MacEwing C, Owens S, Alley H, Bangma K, Villeneuve M, Lauck S. Development of a patient and clinician co-led education program to promote living well with an implantable cardioverter defibrillator: Insights from a pilot project. PEC Innov 2022; 1:100104. [PMID: 37213750 PMCID: PMC10194333 DOI: 10.1016/j.pecinn.2022.100104] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 05/23/2023]
Abstract
Objective To evaluate a pilot education program designed to improve patients' experience of living well with an implantable cardioverter-defibrillator (ICD). Methods Patient Partners with previously implanted ICD and clinicians collaboratively performed monthly education sessions for potential and recent ICD recipients. Curriculum development was informed by current evidence of ICD patients' unique educational needs; delivery format transitioned to a virtual platform following the onset of COVID-19. Participants' experience was evaluated using a tailored questionnaire to explore preliminary insights. Results 126 participants (median age: 62 years; women: 30%) attended 24 sessions. In-person participants (n = 62, 49.2%) reported sessions as helpful (n = 56, 94%) with regards to format and Patient Partner interactions. Virtual participants 64 (50.8%) completed an electronic survey (n = 27, 45%); reporting sufficient information for most topics with the exception of potential psychological effects of ICD implantation. Patient Partners as collaborative session leaders was perceived to be very helpful (n = 22, 82%) or somewhat helpful (n = 5, 18%). Conclusion This novel educational partnership met the learning needs of patients at the vulnerable time of new cardiac device implantation of both in-person and virtual formats. Innovation The inclusion of Patient Partners in co-led cardiac education informs novel approach to care that may improve patients' experiences of living well with complex technology.
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Affiliation(s)
| | | | | | - Santabhanu Chakrabarti
- St. Paul’s Hospital, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | | | | | | | | | | | | | - Sandra Lauck
- St. Paul’s Hospital, Vancouver, Canada
- University of British Columbia School of Nursing, Vancouver, Canada
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10
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Kinnaer LM, Van de Vyver M, Kenis I, Decoene E, Foulon V, Van Hecke A. A qualitative evaluation of the process of creating and implementing an interprofessional care pathway for patients treated with oral anticancer drugs. Eur J Oncol Nurs 2022; 61:102218. [DOI: 10.1016/j.ejon.2022.102218] [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: 09/29/2021] [Revised: 08/24/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
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11
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Kasali A. Generating Plan Layouts: A Case Study on Visualization of Implicit Knowledge by "Doctor Architects". HERD 2022; 15:67-78. [PMID: 35345909 DOI: 10.1177/19375867221089707] [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: 11/17/2022]
Abstract
AIM This article presents an opportunistic case with particular focus on instances from an extended procurement operation in which medical professionals run a proactive process involving the generation of layouts through distinct modes of representational practices without any actual collaboration with designers. The questions of inquiry involve an analysis on how the visualizations came into being and a discussion into the content of drawings that was shaped by individuals without any formal design education. BACKGROUND Although the literature introduces examples of genuine participation, particularly in healthcare design practices, the instances in which nondesigners demonstrate accomplished skills in spatial reasoning and representation are limited. METHOD The research was formulated as a qualitative case study including a series of observations of the activities of the participants followed by interviews recorded at different locations. The investigation also focuses on the features of these authentic graphics which illustrate the intentions of the medical professionals concerning the function of spaces. RESULTS In this research, the participants went through a labor intensive and elaborate effort to produce "architectural representations" with the intention to convey their implicit professional expertise in the domain. The layouts were introduced to be the vital elements to visualize the implicit knowledge regarding the functioning of space. CONCLUSIONS The productive and creative engagement of clinicians within this research makes the case for a multidisciplinary approach that reframes the limits and potential contributions of participants alongside drawings, which are exclusively claimed by and strategically employed by architects as negotiation devices within participatory design processes.
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Affiliation(s)
- Altug Kasali
- Department of Architecture, Izmir Institute of Technology, Turkey.,Faculty of Architecture, Izmir Institute of Technology, Gulbahce Koyu, Urla, Turkey
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12
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Van de Velde E, Van Hecke A, Van Cleemput N, Eeckloo K, Malfait S. Nursing handover involving consumers on inpatient mental healthcare units: A qualitative exploration of the consumers' perspective. Int J Ment Health Nurs 2021; 30:1713-1725. [PMID: 34495574 DOI: 10.1111/inm.12930] [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] [Received: 06/08/2021] [Revised: 08/14/2021] [Accepted: 08/23/2021] [Indexed: 11/30/2022]
Abstract
Handovers between nurses are a significant cause of communication problems and possible consumer safety issues. A potential solution for both problems is the nursing handover involving consumers, in which the consumer is present at the time of handover. This practice invites consumers to be more involved in their care process and supports a recovery-oriented practice. Research into nursing handovers involving consumers on inpatient mental health units is however very limited. A qualitative, phenomenological study was conducted. Semi-structured interviews with 13 consumers staying on an inpatient mental health unit of a general hospital were used. The interviews were transcribed verbatim and thematically analysed. Data saturation was reached after 11 interviews when no new themes or codes emerged from the data. Three themes were generated from the interviews: (i) the first moments on the inpatient mental health unit; (ii) the nurse as an ally; and (iii) informing each other. The COREQ-checklist was used. According to consumers, nursing handover involving consumers initiated a change in the relationship between consumers and nurses. Consumers and nurses got to know each other better during handover and built a relationship of trust. The introduction of nursing handover involving consumers created an accessible opportunity for consumers to exchange information with nurses and ask questions concerning their admission. Consumers felt jointly responsible for the continuity of the information about their healthcare process. Due to the use of nursing handover involving consumers, consumers experienced the opportunity to take more control in their health process and ensured that information is correct and complete.
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Affiliation(s)
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Nursing Department, Ghent University Hospital, Ghent, Belgium
| | | | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Ghent, Belgium
| | - Simon Malfait
- Strategic Unit & Nursing Department, Ghent University Hospital, Gent, Belgium
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13
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Kirk JW, Nilsen P, Andersen O, Stefánsdóttir NT, Grønfeldt B, Brødsgaard R, Pedersen BS, Bandholm T, Tjørnhøj-Thomsen T, Pedersen MM. Adaptations and modifications to a co-designed intervention and its clinical implementation: a qualitative study in Denmark. BMC Health Serv Res 2021; 21:1108. [PMID: 34656126 PMCID: PMC8520628 DOI: 10.1186/s12913-021-07142-4] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a long-standing debate in implementation research on whether adaptations to evidence-based interventions (EBIs) are desirable in health care. If an intervention is adapted and not delivered as conceived and planned, it is said to have low fidelity. The WALK-Cph project was developed based on the assumption that involving stakeholders in co-design processes would facilitate the fidelity of an intervention to increase the mobility of acutely admitted older medical patients and its implementation in two hospitals in Denmark. The purpose of this study is to describe and analyse adaptations and modifications that were made to the co-designed WALK-Cph intervention and its implementation. METHODS This study used a qualitative design. An ethnographic field study was performed using participant observations, workshops and semi-structured interviews. Data were analysed twice using the Framework Method. The first analysis was based on the frameworks from Stirman, Moore and Proctor. The second analysis, a retrospective modifications analysis, was based on the Adaptation-Impact Framework. RESULTS Many different types of adaptations and modifications were made to the WALK-Cph intervention and its implementation plan. Most of the modifications were made on the contents of the intervention. In total, 44 adaptations and modifications were made, of which 21 were planned (adaptations) and 23 were made haphazardly (modifications). Most of the content and context adaptations and modifications made on the intervention had a mixed result regarding enhanced fidelity. The retrospective modifications analysis showed that modifications were ongoing and both situationally and contextually shaped. CONCLUSIONS Although an extensive co-design process was carried out to facilitate the fidelity of the WALK-Cph intervention, this study showed that many adaptations and modifications were still made to both the intervention and its implementation plan. It could indicate that the co-design process had a small effect or that adaptations and modifications are ongoing and both situationally and contextually shaped, which challenge the assumption and the desire to be able to plan and control changes.
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Affiliation(s)
- Jeanette Wassar Kirk
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Kettegaard alle 30, 2650, Hvidovre, Danmark. .,Department of Public Health, Nursing, Aarhus University, Nordre Ringgade 1, 8000, Aarhus, Denmark.
| | - Per Nilsen
- Department of Health, Medical and Caring Sciences, Linköping University, Sandbäcksgatan 7, 582 25, Linköping, Sweden
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Kettegaard alle 30, 2650, Hvidovre, Danmark
| | - Nina Thórný Stefánsdóttir
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Kettegaard alle 30, 2650, Hvidovre, Danmark
| | - Birk Grønfeldt
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Kettegaard alle 30, 2650, Hvidovre, Danmark
| | - Rasmus Brødsgaard
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Kettegaard alle 30, 2650, Hvidovre, Danmark
| | - Britt Stævnsbo Pedersen
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Kettegaard alle 30, 2650, Hvidovre, Danmark.,Copenhagen Neuromuscular Center, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen Ø, Denmark
| | - Thomas Bandholm
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Kettegaard alle 30, 2650, Hvidovre, Danmark.,Department of Orthopedic Surgery, and Department of Physical and Occupational Therapy, Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Copenhagen University Hospital, Amager and Hvidovre, Kettegaards alle 30, 2650, Hvidovre, Denmark
| | - Tine Tjørnhøj-Thomsen
- Department of Health and Social Context, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
| | - Mette Merete Pedersen
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Kettegaard alle 30, 2650, Hvidovre, Danmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
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14
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Cranley L, Sivakumaran G, Helfenbaum S, Galessiere D, Meyer R, Duggleby W, McGillis Hall L, McGilton KS. Development of communication tool for resident- and family-led care discussions in long-term care through patient and family engagement. Int J Older People Nurs 2021; 17:e12429. [PMID: 34618396 PMCID: PMC9285466 DOI: 10.1111/opn.12429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Effective communication between residents (older adults), families, and the healthcare team supports person-centred care. However, communication breakdowns can occur that can impact care and outcomes. The aim of this paper is to describe a feedback approach to developing a communication tool for residents and families to guide information sharing during care discussions with the healthcare team in long-term care. METHODS Development of the communication tool included consultation with key stakeholders for their feedback and input. Following initial development of the tool template by our research team, we invited feedback from our study collaborators. Next, individual interviews and a focus group were conducted with family members, followed by individual interviews with selected residents from two long-term care homes in Ontario, Canada. Participants were asked to provide input and feedback on the tool's content and usability and to share ideas for improving the tool. Content analysis was used to analyse the interview data. RESULTS Feedback from residents and family included suggestions to enhance the tool's content and use of plain language, and suggestions for potential application of the tool. CONCLUSION Feedback highlighted the value of engaging residents and family members in the development of a communication tool. The communication tool offers a structured format to support participation of residents and families in information sharing for care discussions with the healthcare team.
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Affiliation(s)
- Lisa Cranley
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gajan Sivakumaran
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Shoshana Helfenbaum
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Baycrest, Toronto, ON, Canada
| | - Daniel Galessiere
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Baycrest, Toronto, ON, Canada
| | - Raquel Meyer
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Baycrest, Toronto, ON, Canada
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Linda McGillis Hall
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Katherine S McGilton
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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15
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Scholtes B, Breinbauer M, Rinnenburger M, Voyen M, Nguyen-Thi PL, Ziegler O, Germain L, Böhme P, Baumann M, Le Bihan E, Repplinger JJ, Spitz E, Voz B, Ortiz-Halabi I, Dardenne N, Donneau AF, Guillaume M, Bragard I, Pétré B. Hospital practices for the implementation of patient partnership in a multi-national European region. Eur J Public Health 2021; 31:73-79. [PMID: 32968807 DOI: 10.1093/eurpub/ckaa153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The extent to which patients are involved in their care can be influenced by hospital policies and interventions. Nevertheless, the implementation of patient participation and involvement (PPI) at the organisational (meso) level has rarely been assessed systematically. The aim of this study was to assess the occurrence of PPI practises in hospitals in Belgium, France, Germany and Luxembourg and to analyze if, and to what extent, the hospital vision and the presence of a patient committee influence the implementation of PPI practises. METHODS A cross-sectional study was carried out using an online questionnaire in hospitals in the border regions of the four countries. The data were analyzed for differences between regions and the maturity of PPI development. RESULTS Full responses were obtained from 64 hospitals. A wide range of practices were observed, the degree of maturity was mixed. A majority of hospitals promoted patient partnership in the hospital's philosophy of care statement. However, the implementation of specific interventions for PPI was not found uniformly and differences could be observed between the countries. CONCLUSIONS Hospitals in the region seem to be motivated to include patients more fully, however, implementation of PPI interventions seems incomplete and only partially integrated into the general functioning of the hospitals. The implementation of the concept seems to be more mature in the francophone part of the region perhaps due, in part, to a more favourable political context.
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Affiliation(s)
- Beatrice Scholtes
- Department of Public Health Sciences, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Mareike Breinbauer
- Department of Sociology, Empirical Social Research and Methodology, Trier University, Trier, Germany
| | - Mirko Rinnenburger
- Department of Sociology, Empirical Social Research and Methodology, Trier University, Trier, Germany
| | - Madeline Voyen
- Department of Medical Evaluation and Information, University Hospital Centre, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Phi Linh Nguyen-Thi
- Department of Medical Evaluation and Information, University Hospital Centre, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Oliver Ziegler
- Department of Endocrinology, Diabetology, and Nutrition , Brabois Hospital, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Lucie Germain
- Department of Medical Evaluation and Information, University Hospital Centre, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Philip Böhme
- Department of Endocrinology, Diabetology, and Nutrition , Brabois Hospital, CHRU de Nancy, Vandoeuvre-lès-Nancy, France.,LORDIAMN Network, Faculty of Medicine, Vandoeuvre-lès-Nancy, France
| | - Michèle Baumann
- Institute for Research on Sociology and Economic Inequalities (IRSEI) MSH, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Etienne Le Bihan
- Institute for Research on Sociology and Economic Inequalities (IRSEI) MSH, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | | | - Elisabeth Spitz
- Department of Health Psychology, APEMAC Unit, Université de Lorraine, Ile du Saulcy, Metz
| | - Bernard Voz
- Department of Public Health Sciences, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Iness Ortiz-Halabi
- Department of Public Health Sciences, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Nadia Dardenne
- Unit of Biostatistics, Department of Public Health, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Anne-Françoise Donneau
- Unit of Biostatistics, Department of Public Health, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Michèle Guillaume
- Department of Public Health Sciences, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Isabelle Bragard
- Department of Public Health Sciences, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Benoit Pétré
- Department of Public Health Sciences, Faculty of Medicine, University of Liège, Liège, Belgium
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16
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Pakkanen P, Häggman-Laitila A, Kangasniemi M. Ethical issues identified in nurses´ interprofessional collaboration in clinical practice: a meta-synthesis. J Interprof Care 2021; 36:725-734. [PMID: 34120556 DOI: 10.1080/13561820.2021.1892612] [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: 10/21/2022]
Abstract
The aim of this study was to synthesize previous knowledge about ethics in nurses' interprofessional collaboration in clinical practice. Although healthcare professionals have common goals and shared values, ethical conflicts still arise during patient care. We carried out a meta-synthesis of peer-reviewed papers published in any language from 2013-2019, using both electronic searches, with the CINAHL, PubMed, Scopus, and SocINDEX databases, and manual searches. We identified 4,763 papers and selected six qualitative papers, and three theoretical papers, based on predetermined inclusion and exclusion criteria and quality appraisal. The studies came from the USA, Canada, Sweden, Australia, Botswana, and the Netherlands. We found that in ethics studies on nurses' interprofessional collaboration in clinical practice the focus has been on factors that affect how patients receive care. These factors were patients' wishes, whether they were told the truth about their condition, and how different professionals recognized and treated their pain. The focus in the papers we reviewed was on the roles of different professionals during the care process, including ethical conflicts with regard to their aims, commitment, and the balance of power among them and other professions. More research is needed to raise the visibility of how nurses and other professionals recognize, and evaluate, their professional and interprofessional ethics.
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Affiliation(s)
- Piiku Pakkanen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Arja Häggman-Laitila
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
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17
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Fylan B, Tomlinson J, Raynor DK, Silcock J. Using experience-based co-design with patients, carers and healthcare professionals to develop theory-based interventions for safer medicines use. Res Social Adm Pharm 2021; 17:2127-2135. [PMID: 34187746 DOI: 10.1016/j.sapharm.2021.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 11/20/2020] [Revised: 05/22/2021] [Accepted: 06/03/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Experience-Based Co-Design (EBCD) is a participatory design method which was originally developed and is still primarily used as a healthcare quality improvement tool. Traditionally, EBCD has been sited within single services or settings and has yielded improvements grounded in the experiences of those delivering and receiving care. METHOD In this article we present how EBCD can be adapted to develop complex interventions, underpinned by theory, to be tested more widely within the healthcare system as part of a multi-phase, multi-site research study. We begin with an outline of co-design and the stages of EBCD. We then provide an overview of how EBCD can be assimilated into an intervention development and evaluation study, giving examples of the adaptations and research tools and methods that can be deployed. We also suggest how to appraise the resulting intervention so it is realistic and tractable in multiple sites. We describe how EBCD can be combined with different behaviour change theories and methods for intervention development and finally, we make suggestions about the skills needed for successful intervention development using EBCD. CONCLUSION EBCD has been recognised as being a collaborative approach to improving healthcare services that puts patients and healthcare staff at the heart of initiatives and potential changes. We have demonstrated how EBCD can be integrated into a research project and how existing research approaches can be assimilated into EBCD stages. We have also suggested where behaviour change theories can be used to better understand intervention change mechanisms.
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Affiliation(s)
- Beth Fylan
- School of Pharmacy and Medical Sciences, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK; NIHR Yorkshire and Humber Patient Safety Translational Research Centre. Bradford Institute for Health Research, Temple Bank House, Bradford, BD9 6RJ, UK.
| | - Justine Tomlinson
- School of Pharmacy and Medical Sciences, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK; Medicines Management and Pharmacy Services, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, LS9 7TF, UK.
| | - David K Raynor
- School of Healthcare, University of Leeds, Leeds, LS2 9JT, UK.
| | - Jonathan Silcock
- School of Pharmacy and Medical Sciences, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
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18
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Cardinali F, Carzaniga S, Duranti G, Labella B, Lamanna A, Cerilli M, Caracci G, Carinci F. A nationwide participatory programme to measure person-centred hospital care in Italy: Results and implications for continuous improvement. Health Expect 2021; 24:1145-1157. [PMID: 34014021 PMCID: PMC8369125 DOI: 10.1111/hex.13231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/01/2021] [Accepted: 02/21/2021] [Indexed: 02/06/2023] Open
Abstract
Background Patient‐centredness has been targeted by the Italian government as a key theme for the future development of health services. Objective Measuring patient‐centred health services in partnership with citizens, health professionals and decision makers. Design National participatory survey in a large test set of hospitals at national level. Setting and participants A total of 387 hospital visits conducted in 16 Italian regions by over 1,500 citizens and health professionals during 2017‐2018. Main variables and outcome measures An ad hoc checklist was used to assess person‐centredness in hospital care through 243 items, grouped in 4 main areas, 12 sub‐areas and 29 person‐centred criteria (scored 0‐10). GEE linear multivariate regression was used to explore the relation between hospital characteristics and person‐centredness. Results Person‐centred scores were moderately high, with substantial variation overall (median score: 7.0, range: 3.2‐9.5) and by area (Care Processes: 6.8, 2.0‐9.8; Access: 7.4, 2.7‐9.7; Transparency: 6.7, 3.4‐9.5 and Relationship: 7.3, 0.8‐10.0). Multivariate regression found higher scores for increasing volumes of activity (quartile increase: +0.21; 95% CI: 0.13, 0.29) and lower scores in the south and islands (−1.03; −1.62,‐0.45). Discussion The checklist has been applied successfully by over 1,500 collaborators who assessed hospitals in 16 distinct Regions and Autonomous Provinces of Italy. Despite an overall positive mark, all scores were highly variable by location and hospital characteristics. Conclusion and patient or public contribution A national participatory programme to improve patient‐centredness in Italian hospitals highlighted critical areas with the direct input of citizens.
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Affiliation(s)
- Flavia Cardinali
- Italian National Agency for Regional Health Services (AGENAS), Roma, Italy
| | - Sara Carzaniga
- Italian National Agency for Regional Health Services (AGENAS), Roma, Italy
| | - Giorgia Duranti
- Italian National Agency for Regional Health Services (AGENAS), Roma, Italy
| | - Barbara Labella
- Italian National Agency for Regional Health Services (AGENAS), Roma, Italy
| | - Alessandro Lamanna
- Italian National Agency for Regional Health Services (AGENAS), Roma, Italy
| | - Micaela Cerilli
- Italian National Agency for Regional Health Services (AGENAS), Roma, Italy
| | - Giovanni Caracci
- Italian National Agency for Regional Health Services (AGENAS), Roma, Italy
| | - Fabrizio Carinci
- Italian National Agency for Regional Health Services (AGENAS), Roma, Italy.,University of Bologna, Bologna, Italy
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19
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Eldh AC, Holmefur M, Luhr K, Wenemark M. Assessing and reporting patient participation by means of patient preferences and experiences. BMC Health Serv Res 2020; 20:702. [PMID: 32727451 PMCID: PMC7391651 DOI: 10.1186/s12913-020-05574-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/23/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Although patient participation is strongly associated with high quality of healthcare, valid means to measure and report a comprehensive notion of patient participation are scarce. The Patient Preferences for Patient Participation (4Ps) is a new healthcare practice and research tool, comprising patients' preferences as well as experiences. The 4Ps employs 12 items for the patient to conceptualise patient participation. The aim of this paper is to describe how the two perspectives of patient participation, namely preferences and experiences, can be combined to visualise and report preference-based patient participation. METHODS With four response alternatives in each section, the 4Ps offers sixteen possible combinations of degree of match per item. Theoretical and clinical principles fostered a tentative order of six ranks and three levels of preference-based patient participation. To test the standard, statistical analyses for ordinal data were performed, using data from a randomised controlled trial evaluating an intervention aiming to improve patient participation. Further, structures for visualising the preference-based patient participation of individuals and groups were suggested. RESULTS Data from the 4Ps demonstrated the individuals' preference-based patient participation, indicating either a match or a mismatch for each item. Mismatches represented either the experience of participation surpassing the patient's preferences, or the patient's preferences for patient participation not being established. At group level, the suggested approach for visualising and reporting the 4Ps demonstrated that the intervention group had a significantly higher proportion of sufficient preference-based patient participation for certain items than the control group. These results had not been identified earlier, when using the preferences and experiences of patient participation as separate measures. CONCLUSIONS Ways to easily acquaint stakeholders with patients' preferences for patient participation are needed, in order for healthcare staff to better use resources to match the basic requirements of individuals and groups. While the 4Ps can guide professionals to patient participation as framed in legislations, concept analyses and by patients, a visualisation of the results is needed to capture preference-based patient participation. The proposed route to representing degree of match in preferences and experiences may also be relevant to other dimensions of quality of healthcare.
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Affiliation(s)
- Ann Catrine Eldh
- Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE751 22 Uppsala, Sweden
| | - Marie Holmefur
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, S701 82 Örebro, Sweden
| | - Kristina Luhr
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, S701 82 Örebro, Sweden
| | - Marika Wenemark
- Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
- Unit of Public Health and Statistics, Region Östergötland, S581 85 Linköping, Sweden
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Prior SJ, Mather C, Ford K, Bywaters D, Campbell S. Person-centred data collection methods to embed the authentic voice of people who experience health challenges. BMJ Open Qual 2020; 9:bmjoq-2020-000912. [PMID: 32699082 PMCID: PMC7375396 DOI: 10.1136/bmjoq-2020-000912] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Sarah Jane Prior
- Tasmanian School of Medicine, University of Tasmania, Cradle Coast Campus, Tasmania, Australia
| | - Carey Mather
- School of Nursing, University of Tasmania, Newnham Campus, Tasmania, Australia
| | - Karen Ford
- School of Nursing, University of Tasmania, Hobart, Tasmania, Australia
| | - Danielle Bywaters
- School of Nursing, University of Tasmania, Newnham Campus, Tasmania, Australia
| | - Steven Campbell
- School of Nursing, University of Tasmania, Newnham Campus, Tasmania, Australia
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Årestedt L, Martinsson C, Hjelm C, Uhlin F, Eldh AC. Context Factors Facilitating and Hindering Patient Participation in Dialysis Care: A Focus Group Study With Patients and Staff. Worldviews Evid Based Nurs 2020; 17:457-464. [DOI: 10.1111/wvn.12452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Liselott Årestedt
- Faculty of Health and Life Sciences Department of Health and Caring Sciences Linnaeus University Kalmar Sweden
| | - Caroline Martinsson
- Department of Medical and Health Sciences Division of Nursing Linköping University Linköping Sweden
| | - Carina Hjelm
- Department of Medical and Health Sciences Division of Nursing Linköping University Linköping Sweden
| | - Fredrik Uhlin
- Department of Nephrology and Department of Medical and Health Sciences Division of Drug Research Linköping University Linköping Sweden
| | - Ann Catrine Eldh
- Department of Medical and Health Sciences Division of Nursing Linköping University Linköping Sweden
- Department of Public Health and Caring Science Uppsala University Uppsala Sweden
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Kuluski K, Ho JW, Cadel L, Shearkhani S, Levy C, Marcinow M, Peckham A, Sandercock J, Willison DJ, Guilcher SJ. An alternate level of care plan: Co-designing components of an intervention with patients, caregivers and providers to address delayed hospital discharge challenges. Health Expect 2020; 23:1155-1165. [PMID: 32602628 PMCID: PMC7696114 DOI: 10.1111/hex.13094] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/13/2020] [Accepted: 06/07/2020] [Indexed: 01/09/2023] Open
Abstract
Objective To engage with patients, caregivers and care providers to co‐design components of an intervention that aims to improve delayed hospital discharge experiences. Design This is a qualitative study, which entailed working groups and co‐design sessions utilizing World Café and deliberative dialogue techniques to continually refine the intervention. Setting and Participants Our team engaged with 61 participants (patients, caregivers and care providers) in urban and rural communities across Ontario, Canada. A 7‐member Patient and Caregiver Advisory Council participated in all stages of the research. Results Key challenges experienced during a delayed discharge by patients, caregivers and care providers were poor communication and a lack of care services. Participants recommended a communication guide to support on‐going conversation between care providers, patients and caregivers. The guide included key topics to cover and questions to ask during initial and on‐going conversations to manage expectations and better understand the priorities and goals of patients and caregivers. Service recommendations included getting out of bed and dressed each day, addressing the psycho‐social needs of patients through tailored activities and having a storyboard at the bedside to facilitate on‐going engagement. Discussion and Conclusions Our findings outline ways to meaningfully engage patients and caregivers during a delayed hospital discharge. Combining this with a minimal basket of services can potentially facilitate a better care experience and outcomes for patients, their care providers and families.
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Affiliation(s)
- Kerry Kuluski
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Julia W Ho
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Lauren Cadel
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Sara Shearkhani
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Charissa Levy
- Rehabilitative Care Alliance / GTA Rehab Network / Toronto ABI Network, Toronto, ON, Canada
| | - Michelle Marcinow
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Allie Peckham
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, AZ, USA
| | - Jane Sandercock
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Donald J Willison
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Sara Jt Guilcher
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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Van Humbeeck L, Malfait S, Holvoet E, Vogelaers D, De Pauw M, Van Den Noortgate N, Van Biesen W. Value discrepancies between nurses and patients: A survey study. Nurs Ethics 2020; 27:1044-1055. [DOI: 10.1177/0969733020906595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Patient-centeredness, respect for patient autonomy, and shared decision-making have now made it to center stage in discussions on quality of care. Knowing what actually counts in care and how it should be accomplished from the patients’ and nurses’ perspective seems crucial. Aim To explore how patients and their nurses perceive the importance and enactment of values in their healthcare. Research design An observational, cross-sectional study using a self-developed questionnaire, consisting of 15 items related to seven values (e.g. uniqueness, autonomy, professionalism, compassion, responsiveness, partnership, and empowerment) as described in the taxonomy of Bastemeijer et al. Participants and research context The survey was completed by 384 patients and 81 nurses. Participants were recruited on eight internal medicine wards of a 1000-bed university hospital in Belgium. Ethical considerations This study was approved by the ethical committee of the Ghent University Hospital (B670201836799). Findings (1) Patients and nurses prioritize values of care differently; (2) nurses report not being able to enact the values they prioritize in actual practice as much as one would like to; and (3) there is a gap in experienced delivery of a comprehensible explanation of all treatment options, a conversation based on equality, making shared decisions, and being non-judgmental between nurses and patients. Discussion Our findings challenge nurses’ overemphasis on professional compassion and uniqueness while arguing for increased attention on authentic shared decision-making and empowerment. The first step to a patient-centered culture truly involving patients in their healthcare is communication and information provision, rather than focusing on tangible and normative constructs. Conclusion Our findings revealed differences in prioritization and actual enactment of values in care between patients and nurses. This was especially so for values related to communication, provision of complete unbiased information, and shared decision-making. Nurses should prioritize providing comprehensible information and using conversations based on equality to make decision together with patients.
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Turkmani S, Homer CSE, Dawson AJ. Understanding the Experiences and Needs of Migrant Women Affected by Female Genital Mutilation Using Maternity Services in Australia. Int J Environ Res Public Health 2020; 17:ijerph17051491. [PMID: 32110898 PMCID: PMC7084919 DOI: 10.3390/ijerph17051491] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 02/07/2023]
Abstract
Female genital mutilation (FGM) is a cultural practice defined as the partial or total removal of the external female genitalia for non-therapeutic reasons. Changing patterns of migration in Australia and other high-income countries has meant that maternity care providers and health systems are caring for more pregnant women affected by this practice. The aim of the study was to identify strategies to inform culturally safe and quality woman-centred maternity care for women affected by FGM who have migrated to Australia. An Appreciative Inquiry approach was used to engage women with FGM. We conducted 23 semi-structured interviews and three focus group discussions. There were four themes identified: (1) appreciating the best in their experiences; (2) achieving their dreams; (3) planning together; and (4) acting, modifying, improving and sustaining. Women could articulate their health and cultural needs, but they were not engaged in all aspects of their maternity care or considered active partners. Partnering and involving women in the design and delivery of their maternity care would improve quality care. A conceptual model, underpinned by women’s cultural values and physical, emotional needs, is presented as a framework to guide maternity services.
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Affiliation(s)
- Sabera Turkmani
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo NSW 2007, Australia;
- Correspondence:
| | - Caroline S. E. Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne VIC 3004, Australia;
| | - Angela J. Dawson
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo NSW 2007, Australia;
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Raynor DK, Ismail H, Blenkinsopp A, Fylan B, Armitage G, Silcock J. Experience-based co-design-Adapting the method for a researcher-initiated study in a multi-site setting. Health Expect 2020; 23:562-570. [PMID: 32045087 PMCID: PMC7321746 DOI: 10.1111/hex.13028] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 07/04/2019] [Revised: 12/04/2019] [Accepted: 12/31/2019] [Indexed: 12/18/2022] Open
Abstract
Background Experience‐based co‐design (EBCD) brings patients and staff together to co‐design services. It is normally conducted in one organization which initiates and implements the process. We used the traditional EBCD method with a number of adaptations as part of a larger research study in the British National Health Service. Methods The primary aim was to assess the feasibility and acceptability of conducting research‐initiated EBCD, to enhance intervention development prior to testing. As well as embedding the method in a research study, there were 3 further key adaptations: (a) working across primary and secondary care sectors, (b) working on multiple sites and (c) incorporating theory‐informed analysis. Results We recruited four sites (covering both primary and secondary care) and, on each site, conducted the initial traditional EBCD meetings, with separate staff and patient groups—followed by a single joint patient‐staff event, where four priority areas for co‐design were agreed. This event was driven by theory‐informed analysis, as well as the traditional trigger film of patient experiences. Each site worked on one priority area, and the four co‐design groups met over 2‐3 months to design prototype tools. A second joint event was held (not usually undertaken in single‐site EBCD) where they shared and compared outputs. The research team combined elements of these outputs to create an intervention, now being tested in a cluster randomized controlled trial. Conclusions EBCD can be successfully adapted for use across an entire patient pathway with multiple organizations and as part of a research process to identify an intervention for subsequent testing in a randomized trial. Our pragmatic approach used the patient experience to identify areas for improvement and co‐designed an intervention which directly reflected patient priorities.
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Abstract
Purpose
The purpose of this paper is to develop a research framework for exploring and improving patient empowerment through the analysis of the effects produced by a satisfying physician relationship on patient involvement in the healthcare process.
Design/methodology/approach
The authors begin with a literature review of patient empowerment in healthcare, useful to highlight the importance of relational aspects. Then, the authors tested the hypotheses of the research through the analysis of 450 questionnaires. The results are analyzed through covariance-based structural equation modeling.
Findings
This paper highlights how empowerment is a more complex phenomenon, needing many dimensions to be investigated. The hypotheses were tested, and correlations computed, highlighting a medium-strong positive correlation between physician relationship and patient involvement determining satisfying patient empowerment.
Research limitations/implications
The considerations conducted in the paper are restricted to physician relationship and needs further research aimed to analyze and evaluate the changes in the patient behaviors influenced by empowerment.
Practical implications
The research points offer new insight into patient empowerment and allow the healthcare provider to create new opportunities for promoting patient empowerment through the development of quality relationship for effective patient involvement.
Originality/value
The study developed contributes new insight about patient empowerment in the healthcare management literature, proving the key role of satisfying physician relationship useful for future researches.
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Theys S, Lust E, Heinen M, Verhaeghe S, Beeckman D, Eeckloo K, Malfait S, Van Hecke A. Barriers and enablers for the implementation of a hospital communication tool for patient participation: A qualitative study. J Clin Nurs 2019; 29:1945-1956. [DOI: 10.1111/jocn.15055] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Sofie Theys
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care – University Centre for Nursing and Midwifery Ghent University Ghent Belgium
| | - Elisa Lust
- Dienstverleningscentrum voor personen met verstandelijke beperkingen vzw Heilig Hart Deinze Belgium
| | - Maud Heinen
- Nursing Science and Allied Healthcare Radboud Institute for Health Sciences IQ Healthcare Radboud University Medical Center Nijmegen The Netherlands
| | - Sofie Verhaeghe
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care – University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Department Health Care VIVES University College Roeselare Belgium
| | - Dimitri Beeckman
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care – University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Skin Integrity Research Group (SKINT) Department of Public Health and Primary Care– University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- School of Health Sciences Örebro University Örebro Sweden
- School of Nursing and Midwifery Royal College of Surgeons in Ireland Dublin Ireland
| | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care Ghent University Hospital Ghent Belgium
| | | | - Ann Van Hecke
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care – University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Nursing Department Ghent University Hospital Ghent Belgium
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Castro EM, Gielen P, Van Wanseele C. [Self-help groups and patient participation: current results and projects in the Belgian region of Flanders]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:49-55. [PMID: 30446789 DOI: 10.1007/s00103-018-2848-2] [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] [Indexed: 11/25/2022]
Abstract
In 2018, around 1500 self-help groups existed in the Belgian region of Flanders, dealing with almost 200 different diseases or problems. Most have existed for 25 to 35 years, with new initiatives added annually. The first part of this article describes the development of self-help groups and patient participation in Flanders. The second part discusses the legal framework for the participation of patient associations at the micro-, meso-, and macrolevel. The third section describes two current practical examples of patient participation in the health system: the "self-help-friendly hospital" and "the integration of experts by experience in hospitals" with initial interim results. Finally, we discuss development and growth opportunities, as well as needs of self-help groups and patient associations and their support agencies and umbrella associations. More support for self-help groups and increased recognition of their achievements can promote structural forms of cooperation with the professional health system and boost patient participation.
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Affiliation(s)
- Eva Marie Castro
- Trefpunt Zelfhulp vzw, Fakultät Sozialwissenschaft, KU Leuven, Parkstraat 45 bus 3608, 3000, Leuven, Belgien
| | - Peter Gielen
- Trefpunt Zelfhulp vzw, Fakultät Sozialwissenschaft, KU Leuven, Parkstraat 45 bus 3608, 3000, Leuven, Belgien
| | - Carine Van Wanseele
- Trefpunt Zelfhulp vzw, Fakultät Sozialwissenschaft, KU Leuven, Parkstraat 45 bus 3608, 3000, Leuven, Belgien.
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Riviere M, Dufoort H, Van Hecke A, Vandecasteele T, Beeckman D, Verhaeghe S. Core elements of the interpersonal care relationship between nurses and older patients without cognitive impairment during their stay at the hospital: A mixed-methods systematic review. Int J Nurs Stud 2019; 92:154-172. [PMID: 30826498 DOI: 10.1016/j.ijnurstu.2019.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 07/17/2018] [Revised: 01/18/2019] [Accepted: 02/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The fundamental importance of establishing an interpersonal care relationship for quality nursing care has been highlighted. However specific elements of the interpersonal care relationship of importance to older patients in the hospital have not been identified. OBJECTIVES The aim of this review was to explore and synthesise research findings regarding the elements of the interpersonal care relationship concept from the perspectives of older patients. DESIGN A systematic mixed-methods review. DATA SOURCES An extensive search was conducted up until October 2018 for articles without any publication date time limit in PubMed, Web of Science, Cochrane Database of Systematic Reviews and CINAHL. REVIEW METHODS Primary studies were included if they concerned patients aged 65 years or older and their perspectives on the elements of the interpersonal care relationship with nurses. Inclusion was limited to patients without cognitive impairment who were admitted to an acute hospital setting. The methodological quality of each study was assessed using the Critical Appraisal Skills Programme for qualitative studies, the Quality Assessment Tool for Quantitative Studies and the Mixed-Methods Appraisal Tool. Thematic analysis was used to structure the results of the included studies. RESULTS Of the 7596 studies found, 24 were included in this review. Twenty articles had a qualitative, three a quantitative and one a mixed methods design. Older patients consider dignity and respect as core values that need to be met in the interpersonal care relationship. Five core elements of the interpersonal care relationship were identified to meet these core values: elements related to caring behaviour and attitude, person-centred care, patient participation, communication and situational aspects. These core elements were structured according to three categories, identified in the literature, that determine the quality of the interpersonal care relationship: nurse-, older-patient-related elements and situational aspects. CONCLUSIONS The elements identified in this review can guide efforts to define the interpersonal care relationship between older patients and nurses. Nurses should be supported and motivated by education and practice to adapt their behaviour, attitudes and communication to meet older patients' expectations. Hospital management can also encourage nurses to communicate well. Investment in the current organisation of care is needed to improve nurses' work overload and presence. Further research is needed to clarify the underlying processes influencing the experience of the interpersonal care relationship from the perspectives of older patients, nurses, informal caregivers and hospital management.
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Affiliation(s)
- M Riviere
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium; AZ Delta, General Hospital, Roeselare, Belgium.
| | - H Dufoort
- AZ Delta, General Hospital, Roeselare, Belgium.
| | - A Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
| | - T Vandecasteele
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
| | - D Beeckman
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium; School of Health Sciences, Örebro University, Sweden; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
| | - S Verhaeghe
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium.
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Castro EM, Van Regenmortel T, Sermeus W, Vanhaecht K. Patients’ experiential knowledge and expertise in health care: A hybrid concept analysis. Soc Theory Health 2019; 17:307-30. [DOI: 10.1057/s41285-018-0081-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Brands J, Garvey G, Anderson K, Cunningham J, Chynoweth J, Wallington I, Morris B, Knott V, Webster S, Kinsella L, Condon J, Zorbas H. Development of a National Aboriginal and Torres Strait Islander Cancer Framework: A Shared Process to Guide Effective Policy and Practice. Int J Environ Res Public Health 2018; 15:E942. [PMID: 29747405 DOI: 10.3390/ijerph15050942] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 04/26/2018] [Accepted: 04/30/2018] [Indexed: 11/16/2022]
Abstract
Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an initiative by Cancer Australia and Menzies School of Health Research (Menzies) to develop Australia’s first National Aboriginal and Torres Strait Islander Cancer Framework using a process of co-design with relevant stakeholders. The initiative was guided by three core principles: achieving policy-relevant evidence-based outcomes; engaging and maintaining trust with Indigenous Australians at every phase; and employing best-practice and appropriate research methods. Four components of research comprised the Framework development: evidence review; multifaceted stakeholder consultation and input; triangulation of findings; and direct stakeholder input in drafting and refining the Framework. The evidence review confirmed the increasing burden of cancer on Indigenous Australians, while stakeholder consultations facilitated comprehensive input from those with lived experience. The consultations revealed issues not identified in existing literature, and gave different emphases of priority, thus reinforcing the value of including stakeholder perspectives. This paper focuses primarily on documenting the methods used; findings are presented only in order to illustrate the results of the process. The published Framework is available at www.canceraustralia.gov.au; further description and analyses of findings from the consultations will be published elsewhere. The logistics inherent in large-scale consultation are considerable. However, the quality of data and the foundation for sustained partnership with stakeholders and knowledge translation vastly outweighed the challenges. The process of wide-ranging stakeholder consultation described in this paper offers a model for other areas of national and international Indigenous priority setting and policy and practice development that meets the needs of those most affected. The Framework, through the establishment of an agreed, shared and evidence-based agenda, provides guidance for jurisdictional cancer plans, optimal care pathways, and program and service planning for the multiple players across all levels of the health system.
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