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Mahomed A, Pretorius C. Giving voice to the voiceless: Understanding the perceived needs of dementia family carers in Soweto, a South African township. Dementia (London) 2024; 23:622-642. [PMID: 38354041 PMCID: PMC11059838 DOI: 10.1177/14713012241234155] [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: 05/01/2024]
Abstract
This qualitative study aimed to provide family caregivers with an independent platform to reflect on and identify their needs in the role of dementia caregiver. Thirty caregivers were interviewed using a semi-structured approach, and data analysis followed a reflective thematic analysis method. The study revealed that Black African caregivers in townships require sufficient information and orientation to dementia-specific services, psychoeducation on dementia as a disease and its behavioural manifestations, as well as practical skills to manage the disease process. Caregivers expressed the need for in-depth, accessible education to boost their confidence and resilience in handling the challenges of dementia caregiving. They also proposed community initiatives to raise awareness, promote knowledge, and facilitate early detection and diagnosis of dementia. Additional needs included informational and educational workshops, resources like transportation services and helplines, day care facilities, media campaigns, and collaboration with the government for funding and policy change. New caregivers were advised to seek comprehensive education, support, and services while preserving the dignity of their family members with dementia. Remarkably, the identified needs and community initiatives aligned with the priority areas outlined by ADI for a National Dementia Plan, which South Africa currently lacks. The study highlights the importance of developing a National Dementia Plan in South Africa through collaboration among stakeholders, including communities, policy-makers, and multidisciplinary healthcare teams, while ensuring that individuals and families affected by dementia have a voice.
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Affiliation(s)
- Aqeela Mahomed
- Department of Psychology, Stellenbosch University, South Africa
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Duboisdindien G. The analysis of gestural and verbal pragmatic markers produced by Mild Cognitive Impaired participants during longitudinal and autobiographical interviews. Clin Linguist Phon 2024; 38:116-137. [PMID: 36755395 DOI: 10.1080/02699206.2023.2174450] [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: 06/06/2022] [Revised: 12/15/2022] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
CONTEXT This corpus-based study presents a multimodal analysis of verbal pragmatic markers and non-verbal pragmatic markers in elderly people with Mild Cognitive Impairment aged over 75 years. METHODS The corpus collection and analysis methodology has been described in the Belgian CorpAGEst transversal study and the French VintAGE longitudinal and transversal oriented pilot studies. The protocols are available online in both English and French. RESULTS & CONCLUSION Our general findings indicate that with ageing, verbal pragmatic markers acquire an interactive function that allows people with MCI to maintain intersubjective relationships with their interlocutor. Furthermore, at the non-verbal level, gestural manifestations are increasingly used over time with a preference for non-verbal pragmatic markers with a referential function and an adaptive function. We aim to show the benefits of linguistic and interactional scientific investigation methods through cognitive impaired ageing for clinicians and family caregivers.
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Webber J, Finlayson M, Norman KE, Trothen TJ. How Community-Based Health and Social Care Professionals Support Unpaid Caregivers: Experiences From One Health Authority in Ontario, Canada. Qual Health Res 2024:10497323241231425. [PMID: 38419528 DOI: 10.1177/10497323241231425] [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] [Indexed: 03/02/2024]
Abstract
In Ontario, Canada, rising rates of caregiver distress have been the 'canary in the coal mine' for a health system out of balance with the needs of an ageing population. Community-based health and social care professionals are well placed to play an important role in the caregiver support process; however, a gap has remained in the understanding of if and how caregiver support strategies are operationalized or experienced by community service providers (CSPs). The goal of this study was to describe how CSPs interpreted policy and how those interpretations may enable their work in supporting unpaid caregivers. Using a qualitative constructionist design, we interviewed 24 participants and reviewed 92 publicly available documents. Braun and Clarke's method of thematic analysis was used for analysis strategy. Four overarching themes were identified: (1) community care as a priority, (2) sidewalk accountability, (3) creative care planning through partnerships, and (4) challenges to care delivery. We found that the importance of caregivers to the health system was reflected in organizational policy and strategy. There is an opportunity to improve health outcome for caregivers and the population alike through strong leadership and a clear shared vision. Our findings also suggested that social capital was a significant factor in enabling providers in their work, leveraging long-standing relationships, and accumulated local knowledge to implement highly creative care plans.
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Affiliation(s)
- Jodi Webber
- School of Social Work, Algoma University, Sault Ste. Marie, ON, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Kathleen E Norman
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Tracy J Trothen
- School of Rehabilitation Therapy and The School of Religion, Queen's University, Kingston, ON, Canada
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Paravathaneni M, Safa H, Joshi V, Tamil MK, Adashek JJ, Ionescu F, Shah S, Chadha JS, Gilbert S, Manley B, Semaan A, Jim HS, Kalos D, Kim Y, Spiess PE, Chahoud J. 15 years of patient-reported outcomes in clinical trials leading to GU cancer drug approvals: a systematic review on the quality of data reporting and analysis. EClinicalMedicine 2024; 68:102413. [PMID: 38273886 PMCID: PMC10809115 DOI: 10.1016/j.eclinm.2023.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024] Open
Abstract
Background Standardized, high-quality PRO data reporting is crucial for patient centered care in the field of oncology, especially in clinical trials that establish standard of care. This study evaluated PRO endpoint design, conduct and reporting methods in FDA approved drugs for GU malignancies. Methods A systematic review of the FDA archives identified GU cancer drug approvals from Feb 2007 to July 2022. ClinicalTrials.gov and PubMed were used to retrieve relevant data. PRO data was screened, and analytic tools, interpretation methods in the published papers and study protocols were reviewed. Compliance with PRO reporting standards were assessed using PRO Endpoint Analysis Score (PROEAS), a 24-point scoring scale from Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data Consortium (SISAQOL). Findings We assessed 40 trial protocols with 27,011 participants, resulting in 14 renal cell cancer (RCC), 16 prostate cancer (PC), and 10 urothelial cancer (UC) approvals. PRO data was published for 27 trials, with 23 PRO publications (85%) focusing solely on PRO data, while 4 (15%) included PRO data in the original paper. Median time between primary clinical and secondary paper with PRO data was 10.5 months (range: 9-25 months). PROs were not planned as primary endpoints for any study but 14 (52%) reported them as secondary, 10 (37%) as exploratory outcomes, and 3 (11%) lacked any clarity on PRO data as endpoint. Mean PROEAS score of all GU cancers was 11.10 (range: 6-15), RCC (11.86, range: 6-15), UC (11.50, range: 9-14), and PC (10.56, range: 6-15). None met all the SISAQOL recommendations. Interpretation Low overall PROEAS score and delays in PRO data publication in GU cancer drug trials conducted in the past decade emphasize the need for improvement in quality of design and conduct of PRO endpoint in future trials and accelerated publication of PRO endpoints, using standardized analysis, and prespecified hypothesis driven endpoint. These improvements are essential for facilitating interpretation and application of PRO study findings to define patient care. Funding None.
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Affiliation(s)
- Mahati Paravathaneni
- Department of Hematology and Oncology, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Houssein Safa
- Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, 10467, USA
| | - Vidhu Joshi
- Participant Research, Villanova University Charles Widger School of Law, Villanova, PA, 19085, USA
| | - Monica K. Tamil
- Department of Hematology and Oncology, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Jacob J. Adashek
- Department of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - Filip Ionescu
- Department of Hematology and Oncology, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Savan Shah
- Department of Hematology and Oncology, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Juskaran S. Chadha
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Scott Gilbert
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Brandon Manley
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Adele Semaan
- Participant Research, Interventions, and Measurements Core, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Denise Kalos
- Department of Biostatistics, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Youngchul Kim
- Department of Biostatistics, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Philippe E. Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
| | - Jad Chahoud
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, and Research Institute, Tampa, FL, 33612, USA
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Chudyk AM, Stoddard R, McCleary N, Duhamel TA, Shimmin C, Hickes S, Schultz ASH. Exploring patient and caregiver perceptions of the meaning of the patient partner role: a qualitative study. Res Involv Engagem 2023; 9:106. [PMID: 38017570 PMCID: PMC10683322 DOI: 10.1186/s40900-023-00511-9] [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: 05/30/2023] [Accepted: 10/26/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The re-conceptualization of patients' and caregivers' roles in research from study participants to co-researchers ("patient partners") has led to growing pains within and outside the research community, such as how to effectively engage patients in research and as part of interdisciplinary teams. To support the growth of more successful research partnerships by developing a shared understanding of how patient partners conceptualize and contribute to their role, this study aimed to explore patient partners' motivations for engagement and understanding of their role. METHODS We conducted semi-structured interviews with participants (n = 13) of an online survey of activities and impacts of patient engagement in Strategy for Patient-Oriented Research projects. Eligibility criteria included being a patient partner that indicated interest in interview participation upon survey completion, the ability to read/write in English and provide informed consent. Data were analyzed thematically using an inductive, codebook thematic analysis. RESULTS Illuminating the lived/living patient and caregiver experience was central to how most patient partners conceptualized the role in terms of its definition, purpose, value, and responsibilities. Participants also identified four additional categories of motivations for becoming a patient partner and contributions that patient partners make to research that build upon and are in addition to sharing their lived/living experiences. Lastly, participants highlighted important connotations of the term patient partner, including temporal and context-specific considerations for the term "patient" and what "partner" may imply about the nature of the research relationship. CONCLUSIONS At the onset of partnership, academic researchers and patient partners must create the space necessary to discuss and understand each other's underlying motivations for partnering and their perspectives on the purpose, value, and responsibilities of the patient partner role. These early conversations should help unearth what research partners hope to get out of and feel that they are able to contribute to engaging, and in such contribute to the development of reciprocal relationships that work towards shared and valued goals. Trial registration Not applicable.
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Affiliation(s)
- Anna Maria Chudyk
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, CR3024 - 369 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
| | - Roger Stoddard
- Horizon Health Network, 80 Woodbridge Street, Fredericton, New Brunswick, E3B 4R3, Canada
| | - Nicola McCleary
- Ottawa Hospital Research Institute - Clinical Epidemiology Program, Room L1202, Box 711 - 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Todd A Duhamel
- Faculty of Kinesiology and Recreation Management, 212 Active Living Centre, Winnipeg, MB, R3T 2N2, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Albrechtsen Research Centre, R4012 - 351 Tache Ave, Winnipeg, MB, R2H 2A6, Canada
| | - Carolyn Shimmin
- George and Fay Yee Centre for Healthcare Innovation, 3rd floor - 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada
| | - Serena Hickes
- Translating Emergency Knowledge for Kids (TREKK) Parent Advisory Group, Children's Hospital Research Institute of Manitoba, 512E - 715 McDermot Avenue, Winnipeg, MB, R3E 3P4, Canada
| | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, CR3022, 369 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada
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La Vallee L, Johnson JL, Shade K. Improving Dementia-Specific Referrals From the Acute Care Setting: A Quality Improvement Project. Prof Case Manag 2023; 28:224-234. [PMID: 36630223 DOI: 10.1097/ncm.0000000000000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE OF STUDY The purpose of this quality improvement project was to design and implement an education and referral protocol for care coordination staff to use when working with hospitalized patients with dementia and their families. The goal was to increase delivery of dementia resource education and dementia-specific referrals during the discharge planning process. PRIMARY PRACTICE SETTING The practice setting for this project was an acute care hospital in Northern California. The care coordination department collaborated with the Northern California Chapter of the Alzheimer's Association to improve the delivery of referrals and follow-up with patients and families who were interested in additional information and support related to dementia. METHODOLOGY AND SAMPLE Twenty-one members of the care coordination department received education on the dementia disease process as well as community resources available to the patient population. The registered nurse care coordinators (RNCCs) and social workers (SWs) within the department then implemented a referral protocol to connect patients with dementia and their families to the Alzheimer's Association. Referral volume was captured over a 60-day preimplementation period, a 60-day implementation period, and a 60-day postimplementation period. The Northern California Chapter of the Alzheimer's Association tracked referral volume. A paired-sample t test was used to examine pre/postimplementation Dementia Knowledge Assessment Scale (DKAS) scores to evaluate the impact of the education intervention. Care coordination staff completed a pre/postimplementation survey on knowledge of community resources for dementia and confidence in connecting patients to these resources. They also completed a postimplementation survey about the benefit of the project to their care coordination practice. RESULTS There was a modest, yet positive increase in referral volume over the 60-day implementation period ( n = 6) compared with the preimplementation period ( n = 1). An increase was sustained during the 60-day postimplementation period ( n = 4). Pre/posttimplementation DKAS scores significantly improved for care coordination staff postimplementation ( p < .001) by an average of 7 points. Fifty-three percent of RNCC and SW staff responded to the postimplementation survey, and results indicated they thought the project was beneficial ( n = 8) or somewhat beneficial ( n = 1) to practice. In addition, RNCC and SW staff reported an increase in awareness of available community resources and confidence in connecting patients and families to these resources. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE Case management professionals have an important role in providing education and support to patients and families across the continuum of care. The complexity and trajectory of illness, shortage of qualified providers, and gaps in provider knowledge about resources place patients with dementia and their families in an increasingly vulnerable position within the health care system. This quality improvement project demonstrates that care coordination staff can improve referrals to resources when in contact with patients and families in the acute care setting. Case managers can ensure patients with dementia and their families have access to the resources in the community that may prevent return to the emergency department or rehospitalization.
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Affiliation(s)
- Lisamarie La Vallee
- Lisamarie La Vallee, DNP-C, MSN, RN, ACM, is an assistant professor at Samuel Merritt University, Sacramento, CA. She has experience in acute care case management, education, and consulting. Her clinical and research interests include improving transitions of care and health equity for diverse populations
- Jonni Johnson, PhD, is a senior research scientist for the California Department of Public Health/Center for Health Statistics and Informatics. She received her doctoral degree from UC Davis in Developmental Psychology. Her main areas of study include memory development, atypical memory functioning, and quantitative psychology
- Kate Shade, PhD, RN, is an assistant professor at Cal State East Bay and an adjunct associate professor at Samuel Merritt University, Sacramento, CA. Dr. Shade has experience in public health case management and program evaluation. She has conducted research with youth involved in the juvenile justice system
| | - Jonni L Johnson
- Lisamarie La Vallee, DNP-C, MSN, RN, ACM, is an assistant professor at Samuel Merritt University, Sacramento, CA. She has experience in acute care case management, education, and consulting. Her clinical and research interests include improving transitions of care and health equity for diverse populations
- Jonni Johnson, PhD, is a senior research scientist for the California Department of Public Health/Center for Health Statistics and Informatics. She received her doctoral degree from UC Davis in Developmental Psychology. Her main areas of study include memory development, atypical memory functioning, and quantitative psychology
- Kate Shade, PhD, RN, is an assistant professor at Cal State East Bay and an adjunct associate professor at Samuel Merritt University, Sacramento, CA. Dr. Shade has experience in public health case management and program evaluation. She has conducted research with youth involved in the juvenile justice system
| | - Kate Shade
- Lisamarie La Vallee, DNP-C, MSN, RN, ACM, is an assistant professor at Samuel Merritt University, Sacramento, CA. She has experience in acute care case management, education, and consulting. Her clinical and research interests include improving transitions of care and health equity for diverse populations
- Jonni Johnson, PhD, is a senior research scientist for the California Department of Public Health/Center for Health Statistics and Informatics. She received her doctoral degree from UC Davis in Developmental Psychology. Her main areas of study include memory development, atypical memory functioning, and quantitative psychology
- Kate Shade, PhD, RN, is an assistant professor at Cal State East Bay and an adjunct associate professor at Samuel Merritt University, Sacramento, CA. Dr. Shade has experience in public health case management and program evaluation. She has conducted research with youth involved in the juvenile justice system
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Kokoszka L. Weathering the Storm of Caregiving for Persons with Alzheimer's Disease. Home Healthc Now 2023; 41:272-276. [PMID: 37682741 DOI: 10.1097/nhh.0000000000001195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Alzheimer's disease (AD) is a progressive incurable disease affecting an individual's cognitive, behavioral, and physical systems. As individuals become more impaired, assistance is required and care may be provided by spouses, family members, or other close companions who serve as informal caregivers. To examine the perceptions and meaning of caring for a person with AD an interpretive descriptive study was used. Semistructured interviews were conducted with 13 informal caregivers. Data analysis revealed two themes: Grappling with the Responsibilities of Invisible Care and Weathering the Storm of Visible Care. Both themes relate to the stress and struggle of the visible and invisible roles of caregivers. The results of the study strengthen the need for home care clinicians to support caregivers who provide both visible and invisible care for persons with AD.
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Affiliation(s)
- Lori Kokoszka
- Lori Kokoszka, PhD, RN, is an Assistant Professor, Widener University, One University Place, Chester, Pennsylvania
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Gillibrand S, Hine P, Conyers R, Gravestock J, Walsh C, McAvoy A, Sanders C. "Take a walk in someone else's shoes": the role of participatory arts for health research development and training. Res Involv Engagem 2023; 9:40. [PMID: 37291659 DOI: 10.1186/s40900-023-00441-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/26/2023] [Indexed: 06/10/2023]
Abstract
Participatory arts are increasingly recognised as a valuable and accessible mechanism for giving a voice to the experiences of individuals' health and healthcare. In recent years, there has been a move towards embedding participatory arts-based models into public engagement processes. Here, we contribute to the existing literature on the use of participatory arts-based approaches and their role in health research and healthcare practise, focusing on two interlinked approaches, the creation of personas and storytelling. We draw on two recent projects which have utilised these approaches to inform subsequent healthcare research and as a professional training tool to improve patient experience in a healthcare setting. We add to emerging literature to outline the benefits of these approaches in supporting research and training in healthcare settings, with a focus towards the co-produced foundations of these approaches. We demonstrate how such approaches can be utilised to capture different forms of voices, experiences and perspectives to help inform healthcare research and training, rooted in the lived experience of individuals who are directly involved in the creative process of developing personas via storytelling. These approaches challenge the listener to "walk in someone else's shoes", using their own homes and lives as a theatrical set in which to envisage someone else's story, involving the listener in the creative process through (re)imagining the stories and experiences of the characters. Greater use of immersive, co-produced participatory art-based approaches should be used in PPIE to inform research and training in healthcare settings as a means of centring those with lived experience through co-production. Involving those with lived experience, particularly from groups who are traditionally excluded from research, via a process which is based on co-creation and co-production, reorientates the researcher-participant dynamic to fully centre those involved in the research at the heart of the tools used to guide health and healthcare research. In this way, it may also aid in trust and relationship building between institutions and communities in a way which is focused around positive, creative methods to aid health research and healthcare processes. Such approaches may help to break down barriers between academic institutions, healthcare sites and communities.
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Affiliation(s)
| | | | - Rob Conyers
- Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Jason Gravestock
- Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Cole Walsh
- Independent (Public Contributor), Greater Manchester, UK
| | - Aneela McAvoy
- Applied Research Collaboration for Greater Manchester, Manchester, UK
| | - Caroline Sanders
- University of Manchester, Manchester, UK
- Applied Research Collaboration for Greater Manchester, Manchester, UK
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Frost J, Hall A, Taylor E, Lines S, Mandizha J, Pope C. How do patients and other members of the public engage with the orphan drug development? A narrative qualitative synthesis. Orphanet J Rare Dis 2023; 18:84. [PMID: 37069597 PMCID: PMC10108537 DOI: 10.1186/s13023-023-02682-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 04/02/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The diversity of patient experiences of orphan drug development has until recently been overlooked, with the existing literature reporting the experience of some patients and not others. The current evidence base (the best available current research) is dominated by quantitative surveys and patient reported outcome measures defined by researchers. Where research that uses qualitative methods of data collection and analysis has been conducted, patient experiences have been studied using content analysis and automatic textual analysis, rather than in-depth qualitative analytical methods. Systematic reviews of patient engagement in orphan drug development have also excluded qualitative studies. The aim of this paper is to review qualitative literature about how patients and other members of the public engage with orphan drug development. METHODS We conducted a systematic search of qualitative papers describing a range of patient engagement practices and experiences were identified and screened. Included papers were appraised using a validated tool (CASP), supplemented by reporting guidance (COREQ), by two independent researchers. RESULTS 262 papers were identified. Thirteen papers reported a range of methods of qualitative data collection. Many conflated patient and public involvement and engagement (PPIE) with qualitative research. Patients were typically recruited via their physician or patient organisations. We identified an absence of overarching philosophical or methodological frameworks, limited details of informed consent processes, and an absence of recognisable methods of data analysis. Our narrative synthesis suggests that patients and caregivers need to be involved in all aspects of trial design, including the selection of clinical endpoints that capture a wider range of outcomes, the identification of means to widen access to trial participation, the development of patient facing materials to optimise their decision making, and patients included in the dissemination of trial results. CONCLUSIONS This narrative qualitative synthesis identified the explicit need for methodological rigour in research with patients with rare diseases (e.g. appropriate and innovative use of qualitative methods or PPIE, rather than their conflation); strenuous efforts to capture the perspectives of under-served, under-researched or seldom listened to communities with experience of rare diseases (e.g. creative recruitment and wider adoption of post-colonial practices); and a re-alignment of the research agenda (e.g. the use of co-design to enable patients to set the agenda, rather than respond to what they are being offered).
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Affiliation(s)
- Julia Frost
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK.
| | - Abi Hall
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK
| | - Emily Taylor
- College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK
| | - Sarah Lines
- South West Peninsular ILD Service, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Jessica Mandizha
- South West Peninsular ILD Service, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Catherine Pope
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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Marcu A, McGregor F, Egan B, Hill K, Cook T, Arber A. Developing sustainable patient and public involvement in mesothelioma research: multi-method exploration with researchers, patients, carers, and patient organisations. Res Involv Engagem 2023; 9:15. [PMID: 36966347 PMCID: PMC10039679 DOI: 10.1186/s40900-023-00426-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Rare diseases where prognosis is poor provide limited scope for patient and public involvement (PPI). One such disease is mesothelioma, a cancer of the lung pleura or of the peritoneum caused by exposure to asbestos, where PPI is poorly documented. We undertook to explore how PPI could be facilitated in mesothelioma research. METHODS An online survey with mesothelioma researchers (n = 23) assessed the perceived benefits and challenges of PPI in mesothelioma. Six online workshops and thirteen in-depth interviews with patients and the public explored their views on how PPI could be increased in mesothelioma and their motivations to become PPI representatives in the future. The survey data were analysed using descriptive statistics and the interviews, using Thematic Analysis. RESULTS In the survey, 26% (n = 6) of the researchers did not include PPI in their research, while 74% (n = 17) did, finding it most beneficial at the stages of applying for funding and dissemination. The main perceived benefits of PPI were clarifying the research question and outcome measures, making research more credible and relevant to patients' needs, and increasing its impact. The main perceived challenges to PPI were the general poor prognosis in mesothelioma, and funding timescales which hindered timely recruitment of PPI representatives. The analysis of the interviews with the patients and public revealed three main themes: "Motivations to become a PPI representative in the future", "Understanding the nature of PPI during the project", and "Perceived challenges to PPI in mesothelioma". Altruism and the need for hope were the main reasons to wish to become involved in PPI in the future. For many participants, the project proved to be a journey of understanding the nature of PPI, a concept that was not easy to grasp from the start. The participants perceived certain barriers to PPI such as high symptom burden in mesothelioma, the abstract concept of PPI, and the use of scientific language. CONCLUSIONS The present research provides a detailed picture of the benefits and challenges of PPI in mesothelioma. We recommend long-term engagement with mesothelioma support groups so that researchers achieve meaningful and sustainable PPI in mesothelioma research.
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Affiliation(s)
- Afrodita Marcu
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK.
| | - Fiona McGregor
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK
| | - Bernadette Egan
- School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Kate Hill
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | - Anne Arber
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK
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McVey L, Frost T, Issa B, Davison E, Abdulkader J, Randell R, Alvarado N, Zaman H, Hardiker N, Cheong VL, Woodcock D. Working together: reflections on how to make public involvement in research work. Res Involv Engagem 2023; 9:14. [PMID: 36966339 PMCID: PMC10039333 DOI: 10.1186/s40900-023-00427-4] [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] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/16/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND The importance of involving members of the public in the development, implementation and dissemination of research is increasingly recognised. There have been calls to share examples of how this can be done, and this paper responds by reporting how professional and lay researchers collaborated on a research study about falls prevention among older patients in English acute hospitals. It focuses on how they worked together in ways that valued all contributions, as envisaged in the UK standards for public involvement for better health and social care research. METHODS The paper is itself an example of working together, having been written by a team of lay and professional researchers. It draws on empirical evidence from evaluations they carried out about the extent to which the study took patient and public perspectives into account, as well as reflective statements they produced as co-authors, which, in turn, contributed to the end-of-project evaluation. RESULTS Lay contributors' deep involvement in the research had a positive effect on the project and the individuals involved, but there were also difficulties. Positive impacts included lay contributors focusing the project on areas that matter most to patients and their families, improving the quality and relevance of outcomes by contributing to data analysis, and feeling they were 'honouring' their personal experience of the subject of study. Negative impacts included the potential for lay people to feel overwhelmed by the challenges involved in achieving the societal or organisational changes necessary to address research issues, which can cause them to question their rationale for public involvement. CONCLUSIONS The paper concludes with practical recommendations for working together effectively in research. These cover the need to discuss the potential emotional impacts of such work with lay candidates during recruitment and induction and to support lay people with these impacts throughout projects; finding ways to address power imbalances and practical challenges; and tips on facilitating processes within lay groups, especially relational processes like the development of mutual trust.
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Affiliation(s)
- Lynn McVey
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Tina Frost
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Basma Issa
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Eva Davison
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Jamil Abdulkader
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Rebecca Randell
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Natasha Alvarado
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Hadar Zaman
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | | | - V.-Lin Cheong
- Pharmacist Elderly and Interfaces of Care, Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust and School of Healthcare, University of Leeds, Leeds, UK
| | - David Woodcock
- Pharmacist Elderly and Interfaces of Care, Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust and School of Healthcare, University of Leeds, Leeds, UK
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Olvera CE, Levin ME, Fleisher JE. Community-based neuropalliative care. Handb Clin Neurol 2023; 191:49-66. [PMID: 36599515 DOI: 10.1016/b978-0-12-824535-4.00001-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Community-based palliative care is defined as palliative care delivered outside of the hospital and outpatient clinics. These settings include the home, nursing homes, day programs, volunteer organizations, and support groups. There is strong evidence outside of the neuropalliative context that community-based palliative care can reduce hospital costs and admissions at the end of life. Research that focuses on specialized community-based palliative care for neurologic disease have similar findings, although with significant variability across conditions and geographic locations. Several of these studies have investigated home-based care for neurologic conditions including dementia, Parkinson's disease, multiple sclerosis, brain tumors, and motor neuron disease. Other work has focused on incorporating palliative care models into the treatment of patients with neurologic diseases within nursing home settings. Similar to nonneurologic community-based palliative care, little has been published on patient and caregiver quality-of-life outcomes in such models of care, although the emerging data are generally positive. Future studies should explore how best to provide comprehensive, cost-effective, scalable, and replicable models of community-based neuropalliative care, patient and caregiver outcomes in such models, and how care can be adapted between and within specific patient populations and healthcare systems.
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Affiliation(s)
- Caroline E Olvera
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States; Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, United States
| | - Melissa E Levin
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States; Chicago Medical School-Rosalind Franklin University, North Chicago, IL, United States
| | - Jori E Fleisher
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States.
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Yous ML, Ploeg J, Kaasalainen S, McAiney C. Experiences of caregivers of community-dwelling older persons with moderate to advanced dementia in adapting the Namaste Care program: a qualitative descriptive study. Res Involv Engagem 2022; 8:61. [PMID: 36371288 PMCID: PMC9655803 DOI: 10.1186/s40900-022-00401-6] [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: 02/16/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Globally many older persons with dementia are living at home to maintain independence within the community. As older persons with dementia transition from early to moderate or advanced stages of dementia they require more support from family members and friends to complete their daily activities. Family and friend caregivers, however, often report a lack of preparation for their caregiving role. There are few psychosocial programs that can be delivered by caregivers of community-dwelling older persons with moderate to advanced dementia. Namaste Care is a psychosocial intervention, predominantly used in long-term care, to improve the quality of life of persons with advanced dementia. Namaste Care provides multisensory stimulation for persons with dementia through meaningful activities such as music, massage, aromatherapy, and nutrition. There have been limited attempts at adapting Namaste Care for use by caregivers in the community.There is a need to involve caregivers in adapting programs and understanding their experiences in research involvement so that strategies can be put in place for a positive experience. The purpose of this study is to explore the experiences of caregivers who participated in workshop sessions to adapt Namaste Care for community-dwelling older persons with moderate to advanced dementia. METHODS A qualitative descriptive design was used. Six caregivers residing in Ontario, Canada attended virtual workshop sessions (i.e., by phone or videoconference) that were guided by the Strategy for Patient-Oriented Research (SPOR) Patient Engagement Framework. Caregivers completed individual post-workshop interviews. Experiential thematic analysis was used to analyze interviews and post-interview researcher notes. RESULTS Key findings were that caregivers had a positive experience in adapting Namaste Care by learning how to improve their caregiving skills and being supported to engage in research through multiple facilitators such as flexible scheduling and an inclusive and respectful environment. Having designated time for discussions between caregivers was perceived as important to forming partnerships within the group to support co-creation of knowledge. CONCLUSION Findings support the need to improve caregiver research engagement processes by ensuring that caregivers can benefit through learning opportunities and discussions and empowering caregivers to value their contributions in adapting interventions.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Sharon Kaasalainen
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Carrie McAiney
- Schlegel-UW Research Institute for Aging, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
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Chudyk AM, Stoddard R, McCleary N, Duhamel TA, Shimmin C, Hickes S, Schultz ASH. Activities and impacts of patient engagement in CIHR SPOR funded research: a cross-sectional survey of academic researcher and patient partner experiences. Res Involv Engagem 2022; 8:44. [PMID: 36038887 PMCID: PMC9423700 DOI: 10.1186/s40900-022-00376-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/09/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUND Knowledge about the specific engagement activities pursued and associated impacts of patient engagement in research in Canada remains nascent. This study aimed to describe engagement activities and perceived impacts of projects funded by the Strategy for Patient-Oriented Research (SPOR). METHODS This was a cross-sectional online survey of academic researchers and patient partners engaging in projects funded through 13 SPOR funding calls (2014-2019). Patient engagement activities and impacts were measured using a self-developed survey. Thematic analysis was used to describe engagement activities and impacts. RESULTS 66 of 511 academic researchers and 20 of 28 patient partners contacted completed the survey and were included in analyses. Respondents reported that patient partners were engaged in seven types of activities across the research cycle: (a) sharing experiences/giving advice, (b) identifying the research focus/methods, (c) developing/revising aspects of the project, (d) conducting research activities, (e) study participation, (f) presenting on behalf of the project, and (g) other grant development or knowledge translation activities. Engagement was associated with six different types of impacts related to knowledge, outputs, or directions being (a) created, (b) moulded, (c) confirmed, or (d) chosen/prioritized, (e) perceived success of the research, and (f) minimal/negative impacts on the research. CONCLUSIONS This study presents information on different ways that patient partners were engaged in SPOR-funded research and the potential impacts of these activities. This knowledge base is imperative to the future of patient engagement in research, including the planning and evaluation of future studies that engage patients as active shapers of research.
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Affiliation(s)
- Anna Maria Chudyk
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, CR3024 - 369 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
| | - Roger Stoddard
- Horizon Health Network, 80 Woodbridge Street, Fredericton New Brunswick, E3B 4R3, Canada
| | - Nicola McCleary
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Room L1202, 501 Smyth Road, Box 711, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Todd A Duhamel
- Faculty of Kinesiology and Recreation Management, 212 Active Living Centre, Winnipeg, MB, R3T 2N2, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Albrechtsen Research Centre, Winnipeg, Canada
| | - Carolyn Shimmin
- George and Fay Yee Centre for Healthcare Innovation, 3rd floor - 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada
| | - Serena Hickes
- Translating Emergency Knowledge for Kids (TREKK) Parent Advisory Group, Children's Hospital Research Institute of Manitoba, 512E - 715 McDermot Avenue, Winnipeg, MB, R3E 3P4, Canada
| | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, CR3022 - 369 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada
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Bressan V, Snijder A, Hansen H, Koldby K, Andersen KD, Allegretti N, Porcu F, Marsillas S, García A, Palese A. Supporting the Community to Embrace Individuals with Dementia and to Be More Inclusive: Findings of a Conceptual Framework Development Study. Int J Environ Res Public Health 2022; 19:10335. [PMID: 36011964 PMCID: PMC9407991 DOI: 10.3390/ijerph191610335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
The number of community-dwelling people with dementia (PwD) is rising, and the role of their relatives is crucial in addressing and mitigating the implications of dementia on health care systems and on society. We developed a new conceptual framework to promote the collaboration of the community in supporting relatives who are caring for a PwD as well as a range of stakeholders in embracing dementia. A qualitatively driven, multi-method study divided into three phases was performed from 2019 to 2021. A qualitative descriptive study, a mixed-method systematic review and three consensus workshops were conducted, and their results were triangulated. The final version of the Community Collaboration Concept Framework is composed of three main domains based upon seven components: (1) embracing dementia; (2) creating empowerment and a sense of community; (3) collaborating through cocreation and design thinking. The new framework is based on the literature, the synthesis of empirical data and the consensus of a panel of international experts, supporting the global goal of improving community inclusiveness and collaboration. Further studies are needed to confirm its validity, how it should be implemented in practice in various settings and to propose improvements when designing projects based upon it.
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Affiliation(s)
- Valentina Bressan
- Department of Medicine, University of Udine, Viale Ungheria 20, 33100 Udine, Italy
| | - Allette Snijder
- Healthy Ageing Network Northern Netherlands, Peizerweg 140H, 9727 AP Groningen, The Netherlands
| | - Henriette Hansen
- South Denmark European Office, Av. Palmerston 18, 1000 Bruxelles, Belgium
| | - Kim Koldby
- Department for Further Education, University College Lillebaelt, Niels Bohrs Allé 1, 5230 Odense, Denmark
| | - Knud Damgaard Andersen
- Odense Kommune, Department for the Elderly and Persons with Disabilities (ÆHF), Flakhaven 2, 5000 Odense, Denmark
| | - Natalia Allegretti
- Connected Health Alliance CIC, 13A Ballyhoy Avenue, D05 K068 Dublin, Ireland
| | - Federica Porcu
- Connected Health Alliance CIC, 13A Ballyhoy Avenue, D05 K068 Dublin, Ireland
| | - Sara Marsillas
- Matia Gerontological Institute, Pinu Bidea, 35, 20018 Donostia-San Sebastián, Spain
| | - Alvaro García
- Matia Gerontological Institute, Pinu Bidea, 35, 20018 Donostia-San Sebastián, Spain
| | - Alvisa Palese
- Department of Medicine, University of Udine, Viale Ungheria 20, 33100 Udine, Italy
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Lake JK, Volpe T, St. John L, Thakur A, Steel L, Baskin A, Durbin A, Chacra MA, Lunsky Y. Mental health and COVID-19: The impact of a virtual course for family caregivers of adults with intellectual and developmental disabilities. J Intellect Disabil Res 2022; 66:677-689. [PMID: 35915874 PMCID: PMC9539047 DOI: 10.1111/jir.12965] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/06/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted family caregivers of adults with intellectual and developmental disabilities (IDD). This study evaluated a virtual course for family caregivers from across Canada, focused on supporting the mental health and well-being of adults with IDD and their families. The evaluation examined the feasibility and acceptability of the course, as well as the impact of the intervention on participants' overall health and well-being. METHODS The 6-week virtual course, informed by a parallel Extension for Community Healthcare Outcomes (ECHO) course for service providers, combined didactic instruction with applied activities. A total of 126 family caregiver course participants consented to be part of the research evaluation delivered over three cycles between October 2020 and April 2021. Attendance was measured at each weekly session. Satisfaction was assessed weekly and post-program. Learning, self-efficacy, and well-being were assessed pre- and post-course, and again at follow-up (8 weeks post-course). Mixed-effects models assessed changes between and within individuals across time. RESULTS Participants had consistent attendance, low-dropout rates, and reported high satisfaction, with 93% of participants reporting that their expectations for the course were met. Compared with pre-course, participants reported improved self-efficacy and well-being post-course, which were maintained at follow-up. CONCLUSIONS An interactive and applied virtual education course delivered to a large group of family caregivers of adults with IDD was both feasible and acceptable. It positively impacted participants' well-being by offering much needed mental health support and creating a peer-led community of practice.
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Affiliation(s)
- J. K. Lake
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
| | - T. Volpe
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - L. St. John
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Thakur
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
- Surrey PlaceTorontoCanada
| | - L. Steel
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Baskin
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Durbin
- Li Ka Shing Knowledge Institute, St. Michael's HospitalTorontoCanada
| | - M. A. Chacra
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - Y. Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
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Lotfi MS, Shahboulaghi FM, Jablonski RA, Ebadi A, Fadayevatan R, Foroughan M. Facilitators and barriers for families caring for adults living with Alzheimer's dementia: A qualitative study. Geriatr Nurs 2022; 47:61-70. [PMID: 35850033 DOI: 10.1016/j.gerinurse.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/22/2022]
Abstract
This study investigates the barriers and promoters of caring for older adults living with Alzheimer's Dementia (AD) in families. This was a qualitative study through content analysis (based on the Granheim and Lundman method), and the participants were selected using purposive sampling from the families of older adults living with AD who were receiving care in the community. We used semi-structured interviews to collect data from 32 family members. The validity and reliability of the data were assessed using the Lincoln and Guba criteria. In this study, 70.58% of primary caregivers were women. Caregiving facilitators included "Efficient family," "Capable caregiver," and "Motivated caregiver." Caregiving barriers included "Lacking awareness and knowledge," "Vulnerable family," "Older person with complex/multiple needs," and "Lack of care infrastructures." Training families and caregivers and developing care infrastructures for older adults with AD can help reduce caring barriers in older adults.
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van Ham CR, Burgers VWG, Sleeman SHE, Dickhout A, Harthoorn NCGL, Manten-Horst E, van Eenbergen MC, Husson O. A qualitative study on the involvement of adolescents and young adults (AYAs) with cancer during multiple research phases: "plan, structure, and discuss". Res Involv Engagem 2022; 8:30. [PMID: 35804443 PMCID: PMC9264747 DOI: 10.1186/s40900-022-00362-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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Including the lived experience of patients in research is important to improve the quality and outcomes of cancer studies. It is challenging to include adolescents and young adults (AYAs) cancer patients in studies and this accounts even more for AYAs with an uncertain and/or poor prognosis (UPCP). Little is known about involving these AYAs in scientific research. However, by including their lived experiences during multiple phases of research, the quality of the study improves and therefore also the healthcare and quality of life of this unique patient group. We first aimed to document experiences of AYAs and researchers with AYA involvement initiatives using the Involvement Matrix and the nine phases of the research cycle. Second, we aimed to map the (expected) challenges and recommendations, according to patients and researchers, for AYA involvement in each research phase. METHODS Thirteen semi-structured qualitative interviews were conducted with AYAs and researchers from February 2020 to May 2020. A thematic analysis codebook with a critical realistic framework was used to analyze the data. RESULTS AYAs and researchers were predominantly positive about AYA involvement within six of the nine phases of research: identify and prioritize topics, develop study design, disseminate information, implement, and evaluate findings. Not all respondents were positive about AYA involvement in the following three phases: formulate research questions, conduct research, and analysis and interpretation. However, few respondents had experience with AYA-researcher collaborations in multiple phases of the research cycle. Last, the results indicate the importance of adding a role (practical support) and two phases (grant application and recruitment) to the Involvement Matrix. CONCLUSION Our results show the added value of AYA (with a UPCP) involvement within scientific research projects. We recommend researchers to actively think about the level and phase of collaboration prior to each research project, by involving and brainstorming with AYAs at the conception and throughout research projects. Besides, to enhance fruitful participation, we suggest thoroughly discussing the pros and cons of collaboration for each phase together with AYAs via the proposed Involvement Matrix to support transparency. We recommend to report experiences, choices, and results of AYA involvement.
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Affiliation(s)
- Camila Rosalinde van Ham
- Department of Communication, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Vivian Wilhelmina Gerarda Burgers
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | | | - Annemiek Dickhout
- Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | - Mies Christina van Eenbergen
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
- Division of Clinical Studies, Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, London, UK.
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Khemai C, Meijers JM, Mujezinovic I, Bolt SR, Pieters S, Moser A, Schols JMGA, Janssen DJA. Interprofessional collaboration in palliative dementia care through the eyes of informal caregivers. Dementia (London) 2022; 21:1890-1913. [PMID: 35535552 PMCID: PMC9301172 DOI: 10.1177/14713012221098259] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A qualitative study was conducted to examine the experiences of informal caregivers of persons with dementia pertaining interprofessional collaboration with and among healthcare professionals in home care (HC), nursing homes and during home to nursing home transitions in palliative care. Semi-structured interviews were performed with bereaved informal caregivers. Data were analysed using a critical realist approach. The two main themes that emerged were: (1) Informal caregivers' roles in interprofessional collaboration with healthcare professionals and (2) Informal caregivers' perception of interprofessional collaboration among healthcare professionals. Informal caregivers' roles were identified in three collaboration processes: information exchange, care process and shared decision-making. Interprofessional collaboration among healthcare professionals was more perceptible on the collaboration outcome level (e.g. being up to date with the health status of the person with dementia; acting proactive, being adequate and consistent in the care process; and giving a warm welcome) than on the collaboration processes level (e.g. communicating and being involved in team processes). Our study revealed that intrinsic and extrinsic factors and interprofessional collaboration among healthcare professionals affected informal caregivers' collaborative roles. In summary, our study showed that informal caregivers have important roles as team members in the continuity and quality of palliative care for persons with dementia.
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Affiliation(s)
- Chandni Khemai
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, 5211Maastricht University, Maastricht, Limburg, Netherlands
| | - Judith M Meijers
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, 5211Maastricht University, Maastricht, Limburg, Netherlands; Zuyderland Care, 159205Zuyderland Medical Center, Sittard-Geleen, Limburg, Netherlands
| | - Irma Mujezinovic
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, 5211Maastricht University, Maastricht, Limburg, Netherlands
| | - Sascha R Bolt
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, 5211Maastricht University, Maastricht, Limburg, Netherlands
| | - Sabine Pieters
- 5216Zuyd University of Applied Sciences, Heerlen, Limburg, Netherlands
| | - Albine Moser
- Department Family Medicine, 5211Maastricht University, Maastricht, Limburg, Netherlands
| | - Jos M G A Schols
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, 5211Maastricht University, Maastricht, Limburg, Netherlands
| | - Daisy J A Janssen
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, 5211Maastricht University, Maastricht, Limburg, Netherlands; Department of Research and Education, CIRO, Horn, Hornerheide, Netherlands
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Ford MK, Roberts SD, Andrade BF, Desrocher M, Wade SL, Kohut SA, Williams TS. Building I-INTERACT-North: Participatory Action Research Design of an Online Transdiagnostic Parent-Child Interaction Therapy Program to Optimize Congenital and Neurodevelopmental Risk. J Clin Psychol Med Settings 2022. [PMID: 35505202 DOI: 10.1007/s10880-022-09875-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 11/16/2022]
Abstract
To adapt an existing virtual family-based mental health intervention learning platform (I-InTERACT-North), using participatory action research design, to meet the needs of parents and children with congenital, neonatal, and neurodevelopmental conditions that impact development. A purposive sample of parent knowledge users recruited from a large pediatric hospital (n = 21) and clinician stakeholders (n = 16) participated in one interview. An iterative process was adopted to implement feedback in the adaption of the learning platform. Qualitative thematic analysis was used to examine themes across participant feedback. Initial satisfaction with the adapted website was high. Qualitative results revealed four themes: acceptability, usability, recommendations, and dissatisfaction. Addressed with iterations, technical difficulties, wanting more information on content, resources, and intended audience were areas of dissatisfaction. This study reflects the importance of participatory action research methods in informing virtual mental health interventions. Future directions to improve the learning platform are discussed.
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Salehinejad S, Jannati N, Azami M, Mirzaee M, Bahaadinbeigy K. A web-based information intervention for family caregivers of patients with Dementia: A randomized controlled trial. J Inf Sci 2022. [DOI: 10.1177/01655515221081353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to evaluate the efficacy of a web-based health information intervention on knowledge, care burden and attitudes of family caregivers of patients with dementia. This study is a unblinded randomised controlled trial. The study population consisted of family caregivers of patients with dementia ( n = 50) which were randomly allocated to the intervention group (access to the web-based health information) or control group (access to information as usual). The participants completed knowledge, care burden and attitude questionnaire at baseline and at two months follow-up. A total of 50 caregivers participated in this study. Before the intervention, there was no statistically significant difference between the knowledge, care burden and attitude score between the two groups ( p > 0.001). In comparison to the control group after the intervention, participants in the intervention group showed significant improvements in all outcomes ( p < 0.001). These findings provide further evidence that web-based information interventions helped caregivers feel more confident, empathetic and concerned about dementia care with less care burden.
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Affiliation(s)
- Simin Salehinejad
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nazanin Jannati
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon Canada
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Azami
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Moghaddameh Mirzaee
- Department of Epidemiology and Biostatistics, Kerman University of Medical Sciences, Kerman, Iran
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Prado P, Norman RS, Vasquez L, Glassner A, Osuoha P, Meyer K, Brackett JR, White CL. An Interprofessional Skills Workshop to Teach Family Caregivers of People Living with Dementia to Provide Complex Care. J Interprof Educ Pract 2022; 26:100481. [PMID: 34977361 PMCID: PMC8716014 DOI: 10.1016/j.xjep.2021.100481] [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] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to evaluate the acceptability of and satisfaction with an interprofessional educational workshop to teach family caregivers of persons living with dementia to provide complex care. The workshop was developed by a team that included nursing, occupational therapy, speech-language pathology, nutrition and dental hygiene. Caregivers who attended the workshop completed an evaluation to describe their satisfaction and acceptability using a Likert-type scale, as well as open ended comments about their learning needs and feedback about the workshop. Semi-structured interviews were conducted with family caregivers and members of the interprofessional team to analyze and evaluate how the workshop may have improved their confidence in performing complex tasks and to obtain their perspectives on offering this program as a virtual workshop in the future. Family caregivers (n=171) reported high satisfaction with the workshop and strongly agreed that the workshop provided them with useful information to support their caregiving roles. Themes identified from the content of the interviews were: i) building understanding; ii) mastering new skills; and iii) learning skills together. Our results suggest and emphasize the importance and the benefits of an interprofessional team approach to support family caregivers and build confidence with complex care.
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Affiliation(s)
- Patty Prado
- Department of Occupational Therapy, School of Health Professions, UT Health San Antonio, San Antonio, Texas
| | - Rocio S Norman
- Department of Communication Sciences and Disorders, School of Health Professions, UT Health San Antonio, San Antonio, Texas
| | - Liset Vasquez
- Assistant Professor in Practice, The University of Texas at San Antonio, San Antonio, Texas
| | - Ashley Glassner
- School of Nursing, UT Health San Antonio, San Antonio, Texas
| | - Precious Osuoha
- Department of Occupational Therapy, School of Health Professions, UT Health San Antonio, San Antonio, Texas
| | - Kylie Meyer
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas
| | - Jennifer R Brackett
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, Texas
| | - Carole L White
- School of Nursing, Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases, UT Heath, San Antonio, Antonio, San Antonio, Texas
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Goodridge D, Reis N, Neiser J, Haubrich T, Westberg B, Erickson-Lumb L, Storozinski J, Gonzales C, Michael J, Cammer A, Osgood N. An App-Based Mindfulness-Based Self-compassion Program to Support Caregivers of People With Dementia: Participatory Feasibility Study. JMIR Aging 2021; 4:e28652. [PMID: 34842530 PMCID: PMC8665388 DOI: 10.2196/28652] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/13/2021] [Accepted: 07/31/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The number of persons with dementia is steadily growing, as is the number of individuals supporting persons with dementia. Primary caregivers of persons with dementia are most often family members or spouses of the persons with dementia, and they are more likely to experience increased stress and other negative effects than individuals who are not primary caregivers. Although in-person support groups have been shown to help buffer the negative impacts of caregiving, some caregivers live in isolated or rural communities and are unable to make the burdensome commitment of traveling to cities. Using an interdisciplinary approach, we developed a mobile smartphone support app designed for primary caregivers of persons with dementia, with the goal of reducing caregiver burden and easing stress. The app features a 12-week intervention, largely rooted in mindfulness-based self-compassion (MBSC), because MBSC has been linked to minimizing stress, depression, and anxiety. OBJECTIVE The primary objectives of our program are twofold: to explore the feasibility of a 12-week mobile support program and to conduct an initial efficacy evaluation of changes in perceived caregiver burden, coping styles, and emotional well-being of caregivers before and after the program. METHODS Our feasibility study used a 2-phase participatory pretest and posttest design, focusing on acceptability, demand, practicality, implementation, and efficacy. At phase I, we recruited 57 primary caregivers of persons with dementia (mean age 76.3, SD 12.9 years), comprising spouses (21/57, 37%), children (21/57, 37%), and friends or relatives (15/57, 26%) of persons with dementia, of whom 29 (51%) completed all measures at both pre- and postprogram. The content of the program featured a series of MBSC podcasts. Our primary outcome measure was caregiver burden, with secondary outcome measures including coping styles and emotional well-being. Daily ecological momentary assessments enabled us to ask participants, "How are you feeling today?" Phase II of our study involved semistructured follow-up interviews with most participants (n=21) who completed phase I. RESULTS Our findings suggest that our app or program meets the feasibility criteria examined. Notably, participants generally accepted the program and believed it could be a useful resource. Emotional well-being increased significantly (P=.04), and emotion-based coping significantly decreased (P=.01). Participants generally considered the app or program to be a helpful resource. CONCLUSIONS Although there were no significant changes in caregiver burden, we were encouraged by the increased emotional well-being of our participants following the completion of our program. We also conclude that our app or program demonstrated feasibility (ie, acceptability, practicality, implementation, and efficacy) and can provide a much-needed resource for primary caregivers of persons with dementia. In the subsequent version of the program, we will respond to participant feedback by incorporating web-based weekly sessions and incorporating an outcome measure of self-compassion.
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Affiliation(s)
- Donna Goodridge
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nathan Reis
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jenna Neiser
- Department of Computer Science, College of Arts and Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - Tim Haubrich
- Saskatchewan Centre for Patient-Oriented Research, Saskatoon, SK, Canada
| | - Bev Westberg
- Saskatchewan Centre for Patient-Oriented Research, Saskatoon, SK, Canada
| | | | | | | | | | - Allison Cammer
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nathaniel Osgood
- Department of Computer Science, Faculty of Arts and Science, University of Saskatchewan, Saskatoon, SK, Canada
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Stefánsdóttir OÁ, Munkejord MC, Sveinbjarnardóttir EK. Maintaining or letting go of couplehood: Perspectives of older male spousal dementia caregivers. Scand J Caring Sci 2021; 36:742-751. [PMID: 34569074 DOI: 10.1111/scs.13035] [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: 05/04/2021] [Revised: 09/01/2021] [Accepted: 09/12/2021] [Indexed: 11/30/2022]
Abstract
Despite the negative implications for their own health, spouses continue to support each other and maintain their couplehood for as long as possible, including when one of them develops a severe illness. However, with some exceptions, the experiences of older male spousal caregivers have been largely overlooked, and our knowledge of the relational aspects of spousal dementia care is scarce. To respond to this knowledge gap, this article explores the following research questions: How do older male spousal caregivers of wives with dementia talk about changes in their couplehood? What transitions or phases in the relationship can be identified as the caring process evolves and the wife's health continues to deteriorate? To answer these questions, we analyse in-depth interviews with eight purposefully selected men aged 67-92 years old from Iceland and Norway. Our findings reveal that the participants felt that they were gradually losing their couplehood in the sense that they lost their shared everyday life routines, intimacy, joint activities, meaningful communication, and dreams and hopes for the future. Four phases of the dementia caring process were identified: the denial phase, the battle phase, the new reality phase and the redefinition phase. We hope that our findings spur more research on relational challenges as experienced by spouses caring for partners with cognitive decline. In conclusion, we argue that interdisciplinary clinical guidelines for a couple-centred approach in elder care should be developed to urge professional care providers to pay attention to the various changes and challenges that dementia couples undergo to meet not only the health and care needs of dementia patients but also those of their spouses.
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Affiliation(s)
| | - Mai Camilla Munkejord
- Dept of Business Administration, Western Norway University of Applied Sciences, Bergen, Norway.,NORCE, Bergen, Norway.,Centre for Care Research West, Western Norway of Applied Sciences, Bergen, Norway
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Poon IO, Skelton F, Bean LR, Guinn D, Jemerson TL, Mbue ND, Charles CV, Ndefo UA. Building Community-Engaged Multidisciplinary Partnerships to Improve Medication Management in Elderly Patients With Multiple Chronic Conditions. J Patient Cent Res Rev 2021; 8:113-120. [PMID: 33898643 PMCID: PMC8060036] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
PURPOSE Many studies in preventing adverse drug events have been researcher-driven, yet few have engaged patients in the development of a project. This project aims to engage minority elderly patients with multiple chronic conditions in the development of research questions and strategies to improve medication safety. METHODS Elderly patients (≥65 years old) who were prescribed 7 or more chronic medications were recruited through a university-based aging resource network in a historically African American community in Houston, Texas. Patients and a caregiver participated in a multidisciplinary workgroup comprised of a physician, pharmacists, a nurse, health educators, and a social worker. Patients were engaged by utilizing the 4 patient-centered outcomes research engagement principles. The workgroup created a strategic plan, completed an environmental scan, identified research problems, and reviewed current evidence-based approaches in the literature. Workgroup findings were presented to a broader audience within a community town hall setting, and input was collected from a community-wide survey. RESULTS From April 2018 to July 2018, 3 patients and 1 caregiver participated in 5 multidisciplinary workgroup meetings. A total of 74 seniors attended the town hall meeting, and 69 completed the surveys. The most common drug-related problems among survey participants were doubts about drug advertisements (79%) and drug interactions (70%). Most participants (88%) were more comfortable in receiving face-to-face counseling compared to an app or virtual visits. Findings aided in developing 3 grant proposals. CONCLUSIONS This narrative provides a roadmap for conducting multidisciplinary, patient-centered participatory research to refine research strategies in minimizing drug-related problems.
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Affiliation(s)
- Ivy O. Poon
- Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX
| | - Felicia Skelton
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
| | - Lena R. Bean
- Division of Student Services, Texas Southern University, Houston, TX
| | - Dominique Guinn
- Department of Health Kinesiology and Sports Studies, College of Education, Texas Southern University, Houston, TX
| | | | | | - Creaque V. Charles
- Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX
| | - Uche Anadu Ndefo
- Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX
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Lavorgna L, Brigo F, Esposito S, Abbadessa G, Sparaco M, Lanzillo R, Moccia M, Inglese M, Bonfanti L, Trojsi F, Spina E, Russo A, De Micco P, Clerico M, Tedeschi G, Bonavita S. Public Engagement and Neurology: An Update. Brain Sci 2021; 11:429. [PMID: 33800571 PMCID: PMC8065487 DOI: 10.3390/brainsci11040429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/11/2021] [Accepted: 03/24/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Public engagement (PE) is defined as the involvement of "specialists who listen, develop their understanding, and interact with non-specialists in non-profit activities of educational, cultural, and social nature to engage the public in science-related matters". The public health relevance of PE consists in building up a scientifically literate society, able to participate in and support scientific and technological developments and their implications for educational settings. Neurological disorders account for 35% of all diseases. PE could have a positive impact on the lives of people affected by neurological diseases. METHOD This review evaluates the role of PE in dementia, stroke, epilepsy, multiple sclerosis, Parkinson's disease, migraine, neurogenetics, and amyotrophic lateral sclerosis. RESULTS AND CONCLUSIONS PE can provide accessible information, support research activities and prevention through appropriate lifestyles, and increase knowledge and awareness of neurological disorders, improving their diagnosis and treatment.
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Affiliation(s)
- Luigi Lavorgna
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, AOU—University of Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Naples, Italy; (L.L.); (S.E.); (G.A.); (M.S.); (A.R.); (G.T.); (S.B.)
| | - Francesco Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), 39012 Merano, Italy;
| | - Sabrina Esposito
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, AOU—University of Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Naples, Italy; (L.L.); (S.E.); (G.A.); (M.S.); (A.R.); (G.T.); (S.B.)
| | - Gianmarco Abbadessa
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, AOU—University of Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Naples, Italy; (L.L.); (S.E.); (G.A.); (M.S.); (A.R.); (G.T.); (S.B.)
| | - Maddalena Sparaco
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, AOU—University of Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Naples, Italy; (L.L.); (S.E.); (G.A.); (M.S.); (A.R.); (G.T.); (S.B.)
| | - Roberta Lanzillo
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, 80138 Naples, Italy; (R.L.); (M.M.); (E.S.)
| | - Marcello Moccia
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, 80138 Naples, Italy; (R.L.); (M.M.); (E.S.)
| | - Matilde Inglese
- Italy—OSPEDALE San Martino, IRCCS, University of Genova, 16132 Genoa, Italy;
| | - Luca Bonfanti
- Neuroscience Institute Cavalieri Ottolenghi (NICO), 10043 Orbassano, Italy;
- Department of Veterinary Sciences, University of Turin, 10095 Torino, Italy
| | - Francesca Trojsi
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, AOU—University of Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Naples, Italy; (L.L.); (S.E.); (G.A.); (M.S.); (A.R.); (G.T.); (S.B.)
| | - Emanuele Spina
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, 80138 Naples, Italy; (R.L.); (M.M.); (E.S.)
| | - Antonio Russo
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, AOU—University of Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Naples, Italy; (L.L.); (S.E.); (G.A.); (M.S.); (A.R.); (G.T.); (S.B.)
| | | | - Marinella Clerico
- Clinical and Biological Sciences Department, University of Torino, 10124 Turin, Italy;
| | - Gioacchino Tedeschi
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, AOU—University of Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Naples, Italy; (L.L.); (S.E.); (G.A.); (M.S.); (A.R.); (G.T.); (S.B.)
| | - Simona Bonavita
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, AOU—University of Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Naples, Italy; (L.L.); (S.E.); (G.A.); (M.S.); (A.R.); (G.T.); (S.B.)
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van Wyk NC. Care for carers: A concept analysis of support for carers of ill relatives. Nurs Forum 2020; 56:202-207. [PMID: 33125730 DOI: 10.1111/nuf.12520] [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: 07/16/2020] [Revised: 09/04/2020] [Accepted: 10/09/2020] [Indexed: 11/28/2022]
Abstract
The aim of the study is to clarify the concept "care for carers," and enhance our understanding of caring for carers of ill relatives. Healthcare professionals often refer to "care for carers" when discussing methods to support the carers of ill family relatives. These carers do not always receive the support they need. A literature search of electronic databases and search engines, using the keywords carer, caregiver, caring for the carer, caring for the caregiver was done. Peer-reviewed research articles published between 2014 and 2019 and written in the English language were analyzed. Following retrieval, research articles were analyzed to describe the uses, attributes, antecedents, consequences, and empirical referents of the concept "care for carers." Research articles describing borderline, related, contrary, and illegitimate examples were included. "Care for carers" addresses the unique support needs of those taking care of ill family members. Carers may derive a sense of empowerment from receiving individualized and proactively rendered support. Carers should be supported to develop control over their circumstances, to find meaning in their caring, to become resilient when experiencing challenges, and to confirm their identity as carers of their ill relatives.
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Affiliation(s)
- Neltjie C van Wyk
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
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Gulestø R, Halvorsrud L, Bjørge H, Lillekroken D. 'The desire for a harmonious interaction': A qualitative study of how healthcare professionals in community-based dementia teams perceive their role in reaching and supporting family caregivers from minority ethnic backgrounds. J Clin Nurs 2020; 31:1850-1863. [PMID: 33010066 DOI: 10.1111/jocn.15518] [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] [Received: 07/02/2020] [Revised: 08/28/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To explore how healthcare professionals in community-based dementia teams perceive their role in reaching and supporting family caregivers from minority ethnic backgrounds when caring for a family member suffering from dementia or cognitive impairment. BACKGROUND Despite increased focus on barriers to accessing the dementia healthcare service for family caregivers from minority ethnic backgrounds, the lack of knowledge on how to address these barriers in order to reach and support this group is evident. DESIGN The study has a qualitative, explorative design. The principles of consolidated criteria for reporting qualitative research (COREQ) were applied for reporting methods and findings. METHODS Based on data from semi-structured interviews (n = 9) conducted in two large Norwegian municipalities, a thematic analysis influenced by Braun and Clarke was used. The analytical findings draw on Pierre Bourdieu's theoretical concepts of field, habitus and capital. FINDINGS 'The desire for a harmonious interaction' was identified as an overarching theme. However, while desirable, the analysis shows that healthcare professionals in community-based dementia teams do not always succeed in reaching and supporting family caregivers from minority ethnic backgrounds. The study reveals that the dementia healthcare service is a complex, normative and sometimes rigid system that requires a number of distinct attributes to navigate. CONCLUSIONS The different social structures within the dementia healthcare service can both create and retain barriers that prevent family caregivers from minority ethnic backgrounds from receiving support on their own terms. RELEVANCE TO CLINICAL PRACTICE A practical implication of allowing critical reflection on the dementia healthcare service is that it provides opportunities for discussion. Healthcare professionals in community-based dementia teams need to reflect on how normative ideals and 'taken-for-granted' mindsets can affect their ability to reach and support family caregivers from minority ethnic backgrounds.
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Affiliation(s)
- Ragnhild Gulestø
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Liv Halvorsrud
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Heidi Bjørge
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Daniela Lillekroken
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Ritchie L, Jack-Waugh A, Sanatombi Devi E, V B, George A, Henry J, Martis CS, Gangopadhyay D, Tolson D. Understanding family carer experiences of advanced dementia caregiving in India: towards a vision for integrated practice. JICA 2020. [DOI: 10.1108/jica-02-2020-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeMany individual and family hardships are associated with poorly understood palliative care needs arising from advanced dementia within India. The purpose of this paper is to explore the experiences of people in India affected by advanced dementia and to shape educational approaches for practitioners and the local community.Design/methodology/approachThree focus groups with family carers of people (n = 27) with advanced dementia were undertaken with local communities in South India. One focus group was carried out in English and two in the local language (Kannada) and translated to English.FindingsThe findings of the focus groups are presented in four themes, conditions of caring, intersecting vulnerabilities, desperate acts of care and awareness of education and training needs. These themes highlight the challenges faced by family carers of people with advanced dementia and describe the potential harm, abuse and poor mental well-being facing both the person with dementia and the family carer as a result of their situation.Research limitations/implicationsThere is a need to explore ways to ensure inclusivity and sensitivity in the research process and enable equal participation from all participants.Practical implicationsThe findings highlight a lack of support for family carers of people with advanced dementia and demonstrate the need for dementia-specific integrated and palliative care approaches in India.Originality/valueThis paper provides insight into the experiences and challenges facing family caregivers of people living with advanced dementia in India to shape practitioner education in a way that will underpin effective dementia-specific palliation and integrated services.
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Mattos EBT, Oliveira JP, Novelli MMPC. As demandas de cuidado e autocuidado na perspectiva do cuidador familiar da pessoa idosa com demência. Rev bras geriatr gerontol 2020. [DOI: 10.1590/1981-22562020023.200189] [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: 11/21/2022] Open
Abstract
Resumo Objetivo Conhecer as demandas de cuidado e autocuidado de cuidadores familiares de pessoas idosas com demência, a partir de rodas de conversa. Método Em 2017, foram realizados dois grupos com seis rodas de conversa cada, com as seguintes questões norteadoras: 1º)“Quem sou eu? De quem eu cuido?”; 2º) “O que é demência para mim?”; 3º)“Qual o meu papel diante das atividades de cuidado diário?”; 4º)“Quais os meus pensamentos ou emoções desencadeados pelo cuidar?” 5º) “Eu consigo ver algo de positivo nessa experiência de cuidar?”; e por último 6º) “Como eu cuido ou posso cuidar de mim?”. Os critérios de inclusão foram: ser cuidador familiar de idoso com demência, exercer esse papel no mínimo há 6 meses e ter disponibilidade para participar dos encontros. As rodas ocorreram quinzenalmente, com 1 hora e meia de duração, tendo uma terapeuta ocupacional como facilitadora. Todas foram gravadas, transcritas e posteriormente analisadas por meio da análise de conteúdo temática. Resultados No total, participaram 15 cuidadores familiares. A partir da análise, emergiram 09 categorias de demandas de cuidado e autocuidado: autopercepção de comprometimento físico e emocional; a busca por suporte; sobrecarga e estresse do cuidador; o que eu aprendi com essa experiência; a mistura de sentimentos; as perdas; valorização dos aspectos simples do cotidiano; já cuido de mim; e eu preciso cuidar de mim. Conclusão A identificação dessas demandas de cuidado e de autocuidado de cuidadores familiares de pessoas idosas com demência pode sensibilizar e conscientizar os profissionais de saúde sobre a importância de considerar esses aspectos na proposição de intervenções com foco nos cuidadores.
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Barello S, Castiglioni C, Bonanomi A, Graffigna G. The Caregiving Health Engagement Scale (CHE-s): development and initial validation of a new questionnaire for measuring family caregiver engagement in healthcare. BMC Public Health 2019; 19:1562. [PMID: 31771546 PMCID: PMC6880352 DOI: 10.1186/s12889-019-7743-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 01/10/2019] [Accepted: 10/03/2019] [Indexed: 11/23/2022] Open
Abstract
Background This study was aimed to preliminary validate a cross-disease psychometric measure to assess the psycho-social experience of family caregiver engagement in healthcare (Caregiving Health Engagement Scale, CHE-s), which refers to the caregiver’s psychological attitude to be an active, skilled and motivated player in the care process of their loved ones. Method The study consisted of a mixed methods, multi-stage research. First, a preliminary qualitative stage was aimed at investigating – in the caregivers’ perspective - the engagement process in providing care to a ill relative (stage 1). The second stage of the research was aimed at developing a psychometric scale to assess this concept (i.e. the Caregiving Health Engagement Scale – CHE-s) and to preliminary test its psychometric properties (stage 2). Results Overall, 230 caregivers (32 in stage 1, and 198 in stage 2) participated to the study. The first qualitative stage, conducted by qualitative interviews on 32 family caregivers, highlighted four main experiential positions of caregiver engagement (namely, denial, hyper-activation, drawing, and balance), showing that “full engagement” occurs when caregivers become able to reach balance between their caring tasks and their broad life goals. In the second quantitative stage, we used the qualitative evidences emerged from stage one as a basis for developing the items of the Caregiving Health Engagement scale (CHE-s). We preliminary tested its psychometric properties through a cross-sectional study on 198 caregivers, which demonstrated CHE-s to be a reliable measure to capture the dynamic nature of caregiver engagement. The CATPCA results, together with the ordinal alpha of 0.88, suggests a mono-dimensional latent structure and a very good internal consistency and CFA showed adequate goodness of fit indices. (CFI = 0.96, RMR = 0.03, RMSEA = 0.05). Conclusions Health care systems that prioritize person-led care may benefit from using the Caregiving Health Engagement Model and the CHE scale (CHE-s) to assess the engagement level of family caregivers in order to better tailor the supportive and educational intervention addressing them.
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Affiliation(s)
- Serena Barello
- EngageMinds Hub - Consumer & Health Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123, Milan, Italy.
| | - Cinzia Castiglioni
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Andrea Bonanomi
- Department of Statistical Science, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Guendalina Graffigna
- EngageMinds Hub - Consumer & Health Research Center, Department of Psychology Faculty of Agricultural, Nutrition and Environmental Sciences -Università Cattolica del Sacro Cuore, Milan, Italy
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Phoenix M, Nguyen T, Gentles SJ, VanderKaay S, Cross A, Nguyen L. Using qualitative research perspectives to inform patient engagement in research. Res Involv Engagem 2018; 4:20. [PMID: 30002874 PMCID: PMC6034277 DOI: 10.1186/s40900-018-0107-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/02/2018] [Indexed: 05/15/2023]
Abstract
PLAIN ENGLISH SUMMARY In Canada, and internationally, there is an increased demand for patient engagement in health care research. Patients are being involved throughout the research process in a variety of roles that extend beyond the traditional passive participant role. These practices, referred to collectively as 'patient engagement', have raised questions about how to engage patients in the research process. Specifically, researchers have noted a lack of theory underpinning patient engagement and are looking for guidance on how to select patients and engage patients throughout the research process. In this commentary, we draw on qualitative research perspectives to generate theoretical and methodological ideas that novice or experienced researchers can apply to facilitate patient engagement in research. ABSTRACT Despite the recent advancements in patient engagement in health care research, there is limited research evidence regarding the best strategies for developing and supporting research partnerships with patients and caregivers. Three particular outstanding concerns that have been reported in the literature and that we will explore in this commentary are: (i) the lack of theoretical underpinning to inform the practice of patient engagement in research; (ii) the lack of knowledge regarding how to select patients to engage in research; and (iii) the lack of clear guidance about the best methods for engaging patients in research. We draw on qualitative research perspectives to reflect on these three areas of concern and propose insights into the theory and methods that we believe are useful for engaging patients in research.
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Affiliation(s)
- Michelle Phoenix
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8 Canada
- CanChild, Institute for Applied Health Sciences, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON L8S 1C7 Canada
- School of Rehabilitation Science, Institute for Applied Health Science, McMaster University, 1400 Main Street West, Room 403, Hamilton, ON L8S 1C7 Canada
| | - Tram Nguyen
- CanChild, Institute for Applied Health Sciences, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON L8S 1C7 Canada
- School of Epidemiology, Public Health, and Preventative Medicine, Alta Vista Campus, 600 peter Morand Crescent, Ottawa, ON K1G 5Z3 Canada
| | - Stephen J. Gentles
- Offord Centre For Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W., Hamilton, ON M1P 201A Canada
| | - Sandra VanderKaay
- School of Rehabilitation Science, Institute for Applied Health Science, McMaster University, 1400 Main Street West, Room 403, Hamilton, ON L8S 1C7 Canada
| | - Andrea Cross
- CanChild, Institute for Applied Health Sciences, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON L8S 1C7 Canada
- School of Rehabilitation Science, Institute for Applied Health Science, McMaster University, 1400 Main Street West, Room 403, Hamilton, ON L8S 1C7 Canada
| | - Linda Nguyen
- CanChild, Institute for Applied Health Sciences, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON L8S 1C7 Canada
- School of Rehabilitation Science, Institute for Applied Health Science, McMaster University, 1400 Main Street West, Room 403, Hamilton, ON L8S 1C7 Canada
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