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Wild C, MacLean A, Nettleton S, Hunt K, Ziebland S. The double invisibility of Long Covid in children. Soc Sci Med 2024; 347:116770. [PMID: 38493682 DOI: 10.1016/j.socscimed.2024.116770] [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: 07/28/2023] [Revised: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
The Covid-19 pandemic has been dominated by discussions of mild and short-lasting cases or acutely serious or lethal forms of the disease; less attention has been paid to long-term Covid-19 symptoms ('Long Covid'), particularly in children. This analysis of the experiences of children and adolescents with Long Covid, and those of their parents/caregivers, argues that children with Long Covid encounter a 'double invisibility' due to the condition's limited social currency and their status as the youngest members of society. We draw on 39 narrative interviews about children's and adolescents' experiences, conducted in 2021-2022 in the United Kingdom. The occurrence of Long Covid in children challenges key aspects of a dominant pandemic narrative, some of which have persisted from the early stages of the pandemic into 2023. Analysis of our qualitative interviews demonstrates that participant experiences were shaped and undermined by the convergence of three elements of the dominant pandemic narrative: that Covid-19 is mild, and everyone recovers; that children are not badly affected by Covid-19; and that worst of the pandemic was essentially 'over' as early as 2021/2022. In the face of these characterisations of Covid-19 experience, young people and their families reported significant additional challenges in making the illness experiences of children and adolescents visible, and thus in gaining appropriate support from medical and educational professionals. We interpret this in relation to 'social currency' - the extent to which an illness elicits understanding and acceptance by wider society. Children and adolescents with Long Covid struggled to signal the severity of their condition and elicit care in the manner expected for other debilitating illnesses. This was exacerbated by assumptions and stereotypes about unwell children and adolescents, and their parents, and questioning of their candidacy as reliable, trustworthy patients.
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Affiliation(s)
- Cervantée Wild
- Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK.
| | - Alice MacLean
- Institute for Social Marketing and Health, University of Stirling, Scotland, FK9 4AL, UK.
| | | | - Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Scotland, FK9 4AL, UK.
| | - Sue Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK.
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Beeler D, Christensen V, Parker K, Cottrell E. "The place it puts us in emotionally and relationally with our child, it's damaging": understanding the real-world psychosocial needs of caregivers of childhood cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01461-7. [PMID: 37801177 DOI: 10.1007/s11764-023-01461-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Understanding the lived experiences of childhood cancer caregivers can guide the development of effective psychosocial models of care. We conducted this qualitative study to understand triggers that impact the mental health, quality of life, and mental health supportive care needs of caregivers. METHODS A maximum variation sampling strategy was used to recruit study participants for semi-structured interviews. Using a grounded theory approach, transcripts were independently dual-coded using inductive thematic analysis. We conducted a secondary thematic analysis emphasizing the impact of pediatric oncology on caregiver mental health. RESULTS Our findings highlight caregiver experiences connected to their child's appearance, quality of life, or change in behavior. Caregivers reported the need to transition between the role of nurturer and protector and simultaneously be part of the care team, which increased trauma for caregivers and their children. Caregivers noted that the hardest part of being a caregiver is witnessing, participating, and forcing the child to comply with cancer treatment. Caregivers were left wishing there had been more support for these situations. CONCLUSION Our findings reveal real-world experiences that caregivers view as among the most stressful during their child's cancer journey. These events provide insight into the nuanced and most difficult experiences from the caregiver perspective in which emotional support services would be most useful. These insights will inform a future model for mental healthcare. IMPLICATIONS FOR CANCER SURVIVORS Caregivers' treatment-related stress is associated with the quality of life of pediatric cancer patients. Supporting the mental health, quality of life, and mental health supportive care needs of childhood cancer caregivers through supportive care guidelines may positively impact the caregiver-child relationship long into survivorship. Children's and their caregivers' treatment-related stress are indelibly connected to the quality of life concerns throughout the cancer journey. Supporting the mental health, quality of life, and mental health supportive care needs of childhood cancer caregivers through supportive care guidelines will positively impact the caregiver-child relationship long into survivorship.
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Affiliation(s)
- Dori Beeler
- Levine Cancer Atrium Health, Charlotte, NC, USA.
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Parker K, Christensen V, Lindemulder S, Chan LHK, Saxton L, Cottrell E. Family perspectives on the transition from active treatment to survivorship for children with cancer. Pediatr Blood Cancer 2023; 70:e30490. [PMID: 37337303 PMCID: PMC10527349 DOI: 10.1002/pbc.30490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Completing therapy for childhood cancer is an exciting milestone. However, this adjustment can be extremely stressful for patients and their families as they transition from cancer patient to survivor. A better understanding of the patient and family experience and their needs during this transition is crucial for developing guidelines and leveraging support for future patients and families. PROCEDURE Participants were recruited from across the United States using a maximum variation sampling strategy. Families were eligible if they had a child diagnosed with cancer before age 15 and had completed treatment at least 1 year prior to their interview. Participants completed a 90-180-minute semi-structured interview either in person or virtually. Interviews focused on the experiences of getting a diagnosis, experiences with treatment, information seeking, impact of cancer on the family, social support, and transitions to survivorship. Inductive thematic analysis revealed a wide variety of themes. This paper examines the transition from active cancer therapy into survivorship. RESULTS Identified primary themes included (i) feelings about transitioning off therapy; (ii) coping with lingering effects; and (iii) experiences of transitioning off therapy and survivorship care. Subthemes highlighted the need for more support for both patients and families during this transition. CONCLUSION Patients and families desire more support during the transition off therapy. Suggestions included access to additional resources, earlier transition to receiving survivorship care, and more holistic survivorship care. Further research is needed to determine best models and feasibility of delivering this desired support to all patients and families.
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Affiliation(s)
- Kellee Parker
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Vivian Christensen
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon
| | - Susan Lindemulder
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
| | - Lai Hin Kimi Chan
- Department of Family Medicine, University of California Davis, Sacramento, California, USA
| | - Lauren Saxton
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon
| | - Erika Cottrell
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, Oregon
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Oluoch D, Molyneux S, Boga M, Maluni J, Murila F, Jones C, Ziebland S, English M, Hinton L. Not just surveys and indicators: narratives capture what really matters for health system strengthening. Lancet Glob Health 2023; 11:e1459-e1463. [PMID: 37591592 DOI: 10.1016/s2214-109x(23)00281-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/23/2023] [Accepted: 06/08/2023] [Indexed: 08/19/2023]
Abstract
Health system strengthening remains elusive and challenging. Health systems in many countries in sub-Saharan Africa are frequently characterised as weak, with inadequate management and accountability mechanisms, and poor human and financial resources. Putting patients and staff at the heart of health systems is an essential step towards strengthening them. As one of the three pillars of quality in health care, understanding patient experiences is key to moving towards people-centred care. Yet patient experiences are not a singular concept. Patient narratives can convey individual experiences of illness and health care, which complement and augment epidemiological and public health evidence. These narratives, gathered with rigorous, interview-based research and shared with digital tools (audio and video), can generate persuasive evidence. This evidence has important potential for influencing policy and practice, and for supporting people-centred care, but has not been tested systematically in low-income countries. In the Kenyan context of newborn health, work under way is generating evidence to show the transformative potential of patient narratives.
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Affiliation(s)
| | | | | | | | - Florence Murila
- Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | | | - Sue Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Lisa Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
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Dowrick A, Grob R, Sawada A, Thier A, Holmberg C, Sato RS. Navigating responsible bio-political citizenship: Cross-country comparison of stigma in Covid-19 illness narratives in Germany, Japan, the UK and the USA. SSM Qual Res Health 2023:100291. [PMID: 37361642 PMCID: PMC10257512 DOI: 10.1016/j.ssmqr.2023.100291] [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] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/20/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023]
Abstract
This paper aims to further understanding of discourses of responsible bio-political citizenship during the first year of the Covid-19 pandemic. This was an interview-based qualitative study comparing experiences of 103 people who were ill with Covid for the first time across 2020 in Japan, Germany, the USA and the UK. Comparative thematic analysis explored discussion of responsibility in relation to Covid illness, experiences of social fracture and stigma, and the strategies employed to resist or mitigate stigma. This comparative analysis highlighted significant similarities across countries. We identified three mysteries of Covid illness experiences that impacted the work of navigating biopolitical citizenship. First, the mystery of how people caught Covid. There was an inherent paradox of following guidance yet nonetheless falling ill. Disclosure of Covid to minimise onward transmission was held in tension with accusations of irresponsibility. Second, the mystery of onward transmission. Uncertainty about transmission placed participants in a liminal space of potentially having caused harm to others. Third, the mystery of how long illness should last. Uncertainty about ongoing infectiousness made social re-entry difficult, particularly in instances of persistent symptoms. We demonstrate the instability of certainty in the context of new and emerging forms of biopolitical citizenship. Guidance and emerging scientific evidence sought to demystify Covid through providing certainty that could guide responsible actions, but where citizens experienced paradoxes this had the potential to exacerbate stigma.
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Affiliation(s)
- Anna Dowrick
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachel Grob
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Anne Thier
- Institute of Social Medicine and Epidemiology, Medical School Brandenburg Theodor Fontane (MHB), Brandenburg an der Havel, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Medical School Brandenburg Theodor Fontane (MHB), Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the Brandenburg University of Technology Cottbus, Senftenberg, The University of Potsdam and the Brandenburg Medical School Theodor Fontane, Potsdam, Germany
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Maclean A, Hunt K, Brown A, Evered JA, Dowrick A, Fokkens A, Grob R, Law S, Locock L, Marcinow M, Smith L, Urbanowicz A, Verheij N, Wild C. Negotiation of collective and individual candidacy for long Covid healthcare in the early phases of the Covid-19 pandemic: Validated, diverted and rejected candidacy. SSM Qual Res Health 2023; 3:100207. [PMID: 36507117 PMCID: PMC9721377 DOI: 10.1016/j.ssmqr.2022.100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
This analysis of people's accounts of establishing their need and experiences of healthcare for long Covid (LC) symptoms draws on interview data from five countries (UK, US, Netherlands, Canada, Australia) during the first ∼18 months of the Covid-19 pandemic when LC was an emerging, sometimes contested, condition with scant scientific or lay knowledge to guide patients and professionals in their sense-making of often bewildering constellations of symptoms. We extend the construct of candidacy to explore positive and (more often) negative experiences that patients reported in their quest to understand their symptoms and seek appropriate care. Candidacy usually considers how individuals negotiate healthcare access. We argue a crucial step preceding individual claims to candidacy is recognition of their condition through generation of collective candidacy. "Vanguard patients" collectively identified, named and fought for recognition of long Covid in the context of limited scientific knowledge and no established treatment pathways. This process was technologically accelerated via social media use. Patients commonly experienced "rejected" candidacy (feeling disbelieved, discounted/uncounted and abandoned, and that their suffering was invisible to the medical gaze and society). Patients who felt their candidacy was "validated" had more positive experiences; they appreciated being believed and recognition of their changed lives/bodies and uncertain futures. More positive healthcare encounters were described as a process of "co-experting" through which patient and healthcare professional collaborated in a joint quest towards a pathway to recovery. The findings underpin the importance of believing and learning from patient experience, particularly vanguard patients with new and emerging illnesses.
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Affiliation(s)
- Alice Maclean
- Institute for Social Marketing and Health, University of Stirling, Scotland, FK9 4AL, UK
| | - Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Scotland, FK9 4AL, UK
| | - Ashley Brown
- Institute for Social Marketing and Health, University of Stirling, Scotland, FK9 4AL, UK
| | | | - Anna Dowrick
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - Andrea Fokkens
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Applied Health Research, the Netherlands
| | - Rachel Grob
- Department of Family Medicine and Community Health, University of Wisconsin, Madison, WI, USA
| | - Susan Law
- Institute of Health Policy, Management & Evaluation, University of Toronto, M5T 3M6, Canada
- Institute for Better Health, Trillium Health Partners, L5B 1B8, Canada
| | - Louise Locock
- University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Michelle Marcinow
- Institute for Better Health, Trillium Health Partners, L5B 1B8, Canada
| | - Lorraine Smith
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Australia
| | - Anna Urbanowicz
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, School of Health and Social Development, Faculty of Health, Deakin University, Australia
| | - Nientke Verheij
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Applied Health Research, the Netherlands
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Abstract
PURPOSE This study aimed to explore the experiences of civil rights of disabled children receiving physiotherapy in New Zealand. As yet there is limited attention given to this topic in rehabilitation literature. METHODS We conducted a qualitative study that drew on the fields of childhood studies and disability studies to address the study aim. Seven disabled children who used local physiotherapy services (aged between four and 14 years) were interviewed using child-centered methods. In addition, their parents were interviewed individually, and eight rehabilitation professionals and disability advocates took part in a focus group discussion. Interpretive thematic analysis was used to analyze findings. FINDINGS The participating disabled children all appreciated being informed about physiotherapy, but had individual preferences regarding involvement in decision making. They described positive and negative influences on their experiences, but indicated they may not have been asked by adults about these. Parents, professionals and advocates described that attempting to promote a positive experience for children is constrained by understandings regarding the purposes and practices of physiotherapy. CONCLUSIONS Our findings suggest it is important to get an understanding of individual children's views and preferences regarding physiotherapy in order to promote opportunities for choice, control and satisfaction. In this way physiotherapists can ensure disabled children's civil rights are realized in practice.
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Affiliation(s)
- Kate Waterworth
- School of Clinical Sciences, AUT University, Akoranga Campus, Auckland, New Zealand
| | - Michael Gaffney
- College of Education, University of Otago, Dunedin, New Zealand
| | - Nicola Taylor
- Children's Issues Centre, Faculty of Law, University of Otago, Dunedin, New Zealand
| | - Barbara E Gibson
- Department of Physiotherapy, University of Toronto, Toronto, ON, Canada.,Critical Disability and Rehabilitation Studies Unit, Bloorview Research Institute, Toronto, ON, Canada
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Spitale G, Glässel A, Tyebally-Fang M, Mouton Dorey C, Biller-Andorno N. Patient narratives - a still undervalued resource for healthcare improvement. Swiss Med Wkly 2023; 153:40022. [PMID: 36787439 DOI: 10.57187/smw.2023.40022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
In recent years, patient narratives have attracted increasing attention as a valuable source of insights into the subjective experience of healthcare. This paper outlines a best-practice approach to the collection, analysis, and use of patient narratives, based on current literature and on the experience of developing the Swiss Database of Individual Patient Experiences (DIPEx). The DIPEx project aims to provide a systematic and methodologically rigorous collection of patient narratives on various health situations and topics. This paper presents and details the DIPEx approach as a current standard in the field, offering a comprehensive overview and discussing the potential uses and benefits of patient narratives: improve healthcare practice, empower patients and caregivers, help structure better communication in healthcare, and contribute to medical teaching and learning.
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Affiliation(s)
- Giovanni Spitale
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland
| | - Andrea Glässel
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland.,ZHAW School of Health Sciences, Institute of Public Health (IPH), Winterthur, Switzerland
| | - Mirriam Tyebally-Fang
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland
| | - Corine Mouton Dorey
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland
| | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland
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CHRISTENSEN V, PARKER K, Kimi LH, SAXTON L, COTTRELL E. 'Never once was I thinking the c-word': Parent perspectives on the facilitators and barriers to getting a childhood cancer diagnosis. J Clin Nurs 2022:10.1111/jocn.16511. [PMID: 36059140 PMCID: PMC9984568 DOI: 10.1111/jocn.16511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To describe the facilitators and barriers of getting from 'something's not right' to a childhood cancer diagnosis from the perspective of parents living in the United States of America. BACKGROUND It is common for families to experience long trajectories from when they first notice symptoms to receiving a childhood cancer diagnosis. Understanding this trajectory within the social and cultural contexts of the United States healthcare system is the first step in developing strategies for reducing this timeframe and mitigating some of the psychosocial impact for parents in receiving a childhood cancer diagnosis. This study examines the interpretations and meanings parents attributed to their child's symptoms, their decisions regarding seeking medical care, interactions with healthcare providers and the time course of events. DESIGN An inductive qualitative inquiry. METHODS In-depth, semi-structured interviews with 55 participants representing 39 unique cases of childhood cancer were conducted. Data were analysed using an inductive thematic approach. COREQ guidelines were followed. RESULTS Participants described multiple barriers and facilitators in their path to receiving a childhood cancer diagnosis. Facilitators included noticing something 'wasn't right' and physician in agreement that symptoms were unusual; acute symptoms requiring action; advocating for a diagnosis; and obtaining a second opinion. Barriers included parents having to interpret symptoms in the context of daily life; physician dismissiveness even when symptoms persisted; and not feeling they could question their physician's assessment. CONCLUSION Families experience multiple facilitators and barriers in their trajectory to receiving a childhood cancer diagnosis. RELEVANCE TO CLINICAL PRACTICE Understanding the path to diagnosis from the parent perspective may increase opportunities for shared decision-making. Clinician educational modules that include family perspectives may improve patient/parent-provider relationships. PARTICIPANT CONTRIBUTION Participants described their family's cancer journey through narrative storytelling. Participants had the opportunity to review and make edits to their transcript.
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Affiliation(s)
- Vivian CHRISTENSEN
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098
| | - Kellee PARKER
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road. Mail Code: CDRCP
| | - Lai Hin Kimi
- Oregon Health and Science University, School of Medicine, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098
| | - Lauren SAXTON
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098
| | - Erika COTTRELL
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098,OCHIN, Inc. 1881 SW Naito Pkwy, Portland, OR 97201
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Davis S, Pandhi N, Warren B, Grevious N, Crowder M, Ingersoll H, Perry E, Sussman A, Grob R. Developing catalyst films of health experiences: an analysis of a robust multi-stakeholder involvement journey. Res Involv Engagem 2022; 8:34. [PMID: 35906697 PMCID: PMC9335457 DOI: 10.1186/s40900-022-00369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 07/14/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Those whose lives are most directly impacted by health care-patients, caregivers, and frontline staff-are ideally situated to improve patient health care services and care quality. Despite a proliferation of literature on both Patient and Public Involvement (PPI) and clinical quality improvement (QI), concrete strategies regarding how to involve patients remain elusive. AIM Research suggests catalyst films, comprised of rigorously-analyzed interview data from diverse patients about their experiences with health and health care ("catalyst films") are a promising way to bring actionable patient feedback to QI. To date, such films have been crafted primarily by researchers. This project aimed to inform the science of engagement through analyzing how deliberate PPI informed the process of creating catalyst films. METHODS PPI methods included: research team norming activities through a project charter and role delineation process; key informant interviews; participant-ambassador videotaped interviews; clinician and research focus groups; and inclusion of advisors on the research team. Content studied for the analysis presented here included team meeting notes, interview and focus group transcripts, and documentation from a facilitated discussion about team processes. These data were analyzed to determine the impact of our PPI process. Member checking verified themes and lessons learned. RESULTS PPI shaped team deliberations and final products in substantial ways, including: what material to include in catalyst films and the tone they should convey; multiple issues regarding representation; and our collective understanding of how catalyst films could be used in the United States. Specific discussions addressed: how to include the optimal mix of interview segments that describe experiences with those that more directly point towards care improvement strategies; and how to balance positive and negative feedback from patients about experiences with care. Team process issues included ensuring equity in involvement despite team members having differing and sometimes multiple roles that complicated power dynamics and processes. CONCLUSIONS Multiple forms and degrees of PPI resulted in significant influence on catalyst films and companion materials. Our project thus provides proof of concept for PPI in creation of video products for QI which have traditionally been crafted by researchers. The model we developed, and document in this paper, can be adapted by others creating research-derived video products. Our findings can also inform future research on how co-designing catalyst films enhances their value for QI and the application of co-designed catalyst film use in QI. Lastly, it can guide those engaged in QI and medical education in their selection of film products focused on patient experiences.
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Affiliation(s)
- Sarah Davis
- Center for Patient Partnerships, University of Wisconsin-Madison, 432 Lake St. Ste. 104, Madison, WI, 53706, USA.
- Primary Care Academics Transforming Healthcare (PATH), UW-Madison, Madison, USA.
| | - Nancy Pandhi
- Primary Care Academics Transforming Healthcare (PATH), UW-Madison, Madison, USA
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, USA
- Health Experiences Research Network ("HERN"), Madison, USA
| | - Barbara Warren
- Health Experiences Research Network ("HERN"), Madison, USA
- LGBT Programs and Policies in Mount Sinai's Office for Diversity and Inclusion, Mount Sinai Health System, New York City, USA
| | - Njeri Grevious
- Health Experiences Research Network ("HERN"), Madison, USA
- HERN National Patient Advisory Council, Madison, USA
| | | | | | - Elizabeth Perry
- Primary Care Academics Transforming Healthcare (PATH), UW-Madison, Madison, USA
- Department of Family and Community Medicine, University of Wisconsin-Madison, Madison, USA
| | - Andrew Sussman
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, USA
| | - Rachel Grob
- Center for Patient Partnerships, University of Wisconsin-Madison, 432 Lake St. Ste. 104, Madison, WI, 53706, USA
- Health Experiences Research Network ("HERN"), Madison, USA
- Department of Family and Community Medicine, University of Wisconsin-Madison, Madison, USA
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Schultze M, Breuning M, von der Heyde M, Kaiser M, Müller-Nordhorn J, Holmberg C. Presenting scientifically-derived illness experiences online - Evaluation of the use of the DIPEx Germany website. Patient Educ Couns 2022; 105:2328-2337. [PMID: 34823923 DOI: 10.1016/j.pec.2021.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the real-time usage of krankheitserfahrungen.de, a website providing scientifically collected and analyzed experiences of persons with various chronic illnesses. METHODS Web analytics of website use of www.krankheitserfahrungen.de in 2016. Qualitative content analysis of the 150 most and least opened video/audio clip titles in 2018-19. RESULTS In 2016, krankheitserfahrungen.de had 19,703 unique visits, of which 3925 were returning visits. Between new and returning visits, the latter were characterized by more actions and more time spent on the website. Thematic pages were clicked more often during new visits and person pages were more frequented during returning visits. In 2018-19, video/audio clip titles related to topics around uncertainties and/or decision making were most often clicked, whereas the least clicked clips dealt with topics like illness management, problem-solving, giving advice to others and emotionally difficult topics such as suffering, death and burden for the family. CONCLUSION A website with balanced, scientifically collected and analyzed patient experiences attracts a sufficient number of users and is used for further explorations. PRACTICE IMPLICATIONS Using multiple formats, broad topics and diverse personal experiences being accessible through themes or persons is necessary when a scientifically based website on patients' experiences is designed.
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Affiliation(s)
- Martin Schultze
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martina Breuning
- University of Education Freiburg, Department of Public Health and Health Education, Germany
| | | | - Maleen Kaiser
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jacqueline Müller-Nordhorn
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.
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Christensen V, Parker K, Cottrell E. Leveraging a qualitative data repository to integrate patient and caregiver perspectives into clinical research. J Clin Transl Sci 2021; 5:e155. [PMID: 34527294 PMCID: PMC8427548 DOI: 10.1017/cts.2021.822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/01/2021] [Accepted: 07/10/2021] [Indexed: 11/20/2022] Open
Abstract
Understanding patient and caregiver experiences is a critical component of the conception, design, and implementation of clinical research studies. The "Database of Individual Patient Experiences" (DIPEx) is an innovative, evidence-based approach for eliciting rich information about health experiences. We conducted a formative evaluation with 14 pediatric oncology researchers to assess the value of using data from a DIPEx study on patient and caregiver experiences with childhood cancer to inform patient-centered research in pediatric oncology. Participants identified barriers to incorporating patient perspectives and experiences into their research and how the DIPEx approach could be leveraged to facilitate this practice.
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Affiliation(s)
- Vivian Christensen
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health and Science University, Portland, OR, USA
| | - Kellee Parker
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, University of Utah, Salt Lake City, UT, USA
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Oregon Health and Science University
| | - Erika Cottrell
- Oregon Clinical and Translational Research Institute (OCTRI), Oregon Health and Science University, Portland, OR, USA
- OCHIN, Inc., Portland, OR, USA
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