Journal articles on the topic 'Qualitative patient interviews'
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Vennedey, Vera, Kira Isabel Hower, Hendrik Hillen, Lena Ansmann, Ludwig Kuntz, and Stephanie Stock. "Patients’ perspectives of facilitators and barriers to patient-centred care: insights from qualitative patient interviews." BMJ Open 10, no. 5 (May 2020): e033449. http://dx.doi.org/10.1136/bmjopen-2019-033449.
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ObjectivesPrevious studies on patient-centred care (PCC) and its facilitators and barriers usually considered specific patient groups, healthcare settings and aspects of PCC or focused on expert perspectives. The objective of this study was to analyse patients’ perspectives of facilitators and barriers towards implementing PCC.DesignWe conducted semistructured individual interviews with chronically ill patients. The interviewees were encouraged to share positive and negative experiences of care and the related facilitators and barriers in all settings including preventive, acute and chronic health issues. Interview data were analysed based on the concept of content analysis.SettingInterviews took place at the University Hospital Cologne, nursing homes, at participants’ homes or by telephone.ParticipantsAny person with at least one chronic illness living in the region of Cologne was eligible for participation. 25 persons with an average age of 60 years participated in the interviews. The participants suffered from various chronic conditions including mental health problems, oncological, metabolic, neurological diseases, but also shared experiences related to acute health issues.ResultsParticipants described facilitators and barriers of PCC on the microlevel (eg, patient–provider interaction), mesolevel (eg, health and social care organisation, HSCO) and macrolevel (eg, laws, financing). In addition to previous concepts, interviewees illustrated the importance of being an active patient by taking individual responsibility for health. Interviewees considered functioning teams and healthy staff members a facilitator of PCC as this can compensate stressful situations or lack of staff to some degree. A lack of transparency in financing and reimbursement was identified as barrier to PCC.ConclusionIndividual providers and HSCOs can address many facilitators and barriers of PCC as perceived by patients. Large-scale changes such as reduction of administrative barriers, the expansion of care networks or higher mandatory nurse to patient ratios require political action and incentives.Trial registration numberDRKS00011925
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Kharaba, Zelal, Rozina Kousar, Yassen Alfoteih, Saira Azhar, Shujaat Ali Khan, and Ghulam Murtaza. "Nurses perception of pharmaceutical care practice: A qualitative approach." Tropical Journal of Pharmaceutical Research 19, no. 4 (May 16, 2020): 87–892. http://dx.doi.org/10.4314/tjpr.v19i4.30.
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Purpose: To evaluate the perception of nurses regarding pharmaceutical care services in the healthcare system of Khyber Pakhtunkhwa (KPK) Province of Pakistan.Methods: This qualitative study was implemented by conducting semi-structured interviews. For data collection, interviews (face-to-face) were conducted after developing an interview guide. The interviewees were 18 nurses and were interviewed at their nursing stations in hospitals. Interviews were continued until the data reached a saturation point. The respondents signed a written consent form before the start of the interview.Results: From the thematic content analysis, five major themes were extracted as stated here: (a) incognizance of pharmaceutical care; (b) collaboration of nurses and pharmacists; (c) improper distribution system; (d) lack of provision of patient counseling; and (e) pharmacist’s role in reducing prescribing errors.Conclusion: Based to the findings, Pakistani nurses have poor knowledge of pharmaceutical care, thus highlighting the need for organizing pharmaceutical care awareness programs for nurses. On the other hand, nurses have a positive perception of pharmacists’ roles in the healthcare system and want to work with them.
Keywords: Perception, Pharmaceutical care, Qualitative study, Nurse, Patient care
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Acquaye, Alvina A., and Samuel S. Payén. "QLIF-18. PATIENT EXPERIENCE THROUGH QUALITATIVE INTERVIEWS." Neuro-Oncology 18, suppl_6 (November 1, 2016): vi159—vi160. http://dx.doi.org/10.1093/neuonc/now212.663.
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van Vliet, Relin, Marieke Bink, Julian Polman, Amaran Suntharan, Iris Grooten, Sandra E. Zwolsman, Tessa J. Roseboom, and Rebecca C. Painter. "Patient Preferences and Experiences in Hyperemesis Gravidarum Treatment: A Qualitative Study." Journal of Pregnancy 2018 (October 30, 2018): 1–8. http://dx.doi.org/10.1155/2018/5378502.
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Introduction. Hyperemesis gravidarum (HG) medical therapies are currently of limited effect, which creates a larger role for patient preferences in the way HG care is arranged. This is the first study using in-depth interviews to investigate patients’ preferences and experiences of HG treatment. Materials and Methods. We conducted individual in-depth interviews among women who had been hospitalized for HG in North Holland at least once in the past 4 years. We asked them about their experiences, preferences, and suggestions for improvement regarding the HG treatment they received. The sample size was determined by reaching data saturation. Themes were identified from analysis of the interview transcripts. Results and Discussion. 13 women were interviewed. Interviewees emphasized the importance of early recognition of the severity of HG, increasing caregivers’ knowledge on HG, early medical intervention, and nasogastric tube feeding. They valued a single room in hospital, discussion of treatment options, more possibilities of home-treatment, psychological support during HG and after childbirth, and more uniform information and policies regarding HG treatment. Conclusion. Further research is needed to establish whether the suggestions can lead to more (cost) effective care and improve the course of HG and outcomes for HG patients and their children.
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Meskó, Bertalan, Nóra Radó, and Zsuzsa Győrffy. "Opinion leader empowered patients about the era of digital health: a qualitative study." BMJ Open 9, no. 3 (March 2019): e025267. http://dx.doi.org/10.1136/bmjopen-2018-025267.
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ObjectivesWe aimed to explore the opinion leader empowered patients’ relationship with their medical professionals, their experiences and beliefs about technologies, and how they see the future. We also attempted to determine whether technologies, the access to it or patient empowerment are the main driving forces behind these changes.DesignA qualitative interview study analysed with interpretative phenomenological analysis.SettingAll interviews were conducted and recorded individually with the same trained interviewer via a Skype call.ParticipantsThe study is based on qualitative, semistructured interviews with 11 opinion leader empowered patients from six countries including UK, USA, Australia, Sweden, South Africa and Ireland.ResultsWe identified four superordinate themes emerging from e-patients’ experiences: (1) impact of technology, (2) the meaning of empowerment, (3) the changing physician–patient relationship and (4) expectations for the future. The relationship e-patients have with their physicians is based on efficient communication, proactivity, the desire for asking questions and the use of technologies. The interviews have shown that the rapid development of technology has fundamentally changed the lives of these e-patients, and technology eventually is transforming the physician–patient relationship into a partnership. Regarding the future of the physician–patient partnership, e-patients emphasised that change will rather be cultural than technological.ConclusionsThe interviews have shown that cooperation between technology and healthcare is not enough on its own: the most decisive factor is the return of the human touch and reciprocal communication. All of these suggest that technology is an important ally in the ‘renaissance of medicine’ that starts to treat patients as it should have always had.
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Duncan, Polly, Christie Cabral, Deborah McCahon, Bruce Guthrie, and Matthew J. Ridd. "Efficiency versus thoroughness in medication review: a qualitative interview study in UK primary care." British Journal of General Practice 69, no. 680 (February 11, 2019): e190-e198. http://dx.doi.org/10.3399/bjgp19x701321.
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BackgroundMedication reviews may improve the safety of prescribing and the National Institute for Health and Care Excellence (NICE) highlights the importance of involving patients in this process.AimTo explore GP and pharmacist perspectives on how medication reviews were conducted in general practice in the UK.Design and settingAnalysis of semi-structured interviews with GPs and pharmacists working in the South West of England, Northern England, and Scotland, sampled for heterogeneity. Interviews took place between January and October 2017.MethodInterviews focused on experience of medication review. Data saturation was achieved when no new insights arose from later interviews. Interviews were analysed thematically.ResultsIn total, 13 GPs and 10 pharmacists were interviewed. GPs and pharmacists perceived medication review as an opportunity to improve prescribing safety. Although interviewees thought patients should be involved in decisions about their medicines, high workload pressures meant that most medication reviews were conducted with limited or no patient input. For some GPs, a medication review was done ‘in the quickest way possible to say that it was done’. Pharmacists were perceived by both professions as being more thorough but less time efficient than GPs, and few pharmacists were routinely involved in medication reviews even in practices employing a pharmacist. Interviewees argued that it was easier to continue medicines than it was to stop them, particularly because stopping medicines required involving the patient and this generated extra work.ConclusionPractices tended to prioritise being efficient (getting the work done) rather than being thorough (doing it well), so that most medication reviews were carried out with little or no patient involvement, and medicines were rarely stopped or reduced. Time and resource constraints are an important barrier to implementing NICE guidance.
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Elers, Phoebe, and Frances Nelson. "Improving healthcare through digital connection? Findings from a qualitative study about patient portals in New Zealand." Australian Journal of Primary Health 24, no. 5 (2018): 404. http://dx.doi.org/10.1071/py17116.
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Research has shown that patient portals can improve patient–provider communication and patient satisfaction. Yet few studies have examined patient portals in New Zealand. In this study, GPs from nine primary care practices were interviewed using a semi-structured interview technique to ascertain how they thought patient portals influence the delivery of primary healthcare. The interviews were transcribed and thematically analysed. The three themes detected were: patient portal usage, health information seeking and the changing consultation. Although most of the participants indicated that patient portals are not being effectively utilised, they were optimistic about the role of information technology in primary healthcare for providing accurate information and to connect with patients in modern terms. Participants reported that some patients have become more informed and compliant with medical treatments and interventions after using patient portals. It seems that patient portals have the potential to enhance patient–provider relationships and help patients manage more aspects of their health care.
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Jolles, Emily P., Raj S. Padwal, Alexander M. Clark, and Branko Braam. "A Qualitative Study of Patient Perspectives about Hypertension." ISRN Hypertension 2013 (March 5, 2013): 1–10. http://dx.doi.org/10.5402/2013/671691.
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To understand hypertensive patients' perspectives regarding blood pressure and hypertension treatment, this qualitative study applied semistructured interviews of hypertensive patients. Participants were recruited from two hypertension clinics at the University of Alberta in Edmonton, Canada. To be eligible for inclusion, patients had to be aged 18 years or older, diagnosed with hypertension by a healthcare provider, and currently taking an antihypertensive medication. Participants were stratified in the analysis according to blood pressure control. Twenty-six patients (mean age 57; 62% female) were interviewed, of which 42% were on target and 58% were not. Three underlying themes emerged from the interviews: (a) knowledge of blood pressure relating to diagnosis and management and control of hypertension, (b) integration of hypertension management into daily routine, and (c) feelings and beliefs of wellness. None of the above themes were associated with better control. Knowledge gaps were found, which emphasize the need for further patient education and physician training. Feelings and beliefs of wellness, and not knowledge, were important factors in home assessment of blood pressure. The absence of connections between control of hypertension and the identified domains indicates that current approaches could benefit from the development of a more personalized approach for education and communication.
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Hill, N., L. D. Krebs, C. Villa-Roel, and B. H. Rowe. "MP37: Conceptualizing unnecessary care in emergency departments (ED): qualitative interviews with ED physicians and site chiefs." CJEM 20, S1 (May 2018): S54. http://dx.doi.org/10.1017/cem.2018.191.
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Introduction: Unnecessary care is an increasingly commonly used term in medicine. Previous survey research suggests that definitions of unnecessary care vary within and among professional and patient groups. This research explores how emergency physicians and administrators understand the term unnecessary care. Methods: Site chiefs and emergency physicians in an Alberta region were recruited through email and online surveys respectively for a qualitative study. One hour one-on-one in-depth interviews explored understandings of unnecessary care within the emergency department (ED) context. Interview transcripts underwent thematic analysis. Results: Five physicians and seven site chiefs completed interviews. Two key themes emerged. First, interviewees conceptualized unnecessary care as inappropriate or non-urgent presentations. This patient-centric view raised non-urgent ED presentations as a health system problem with complex components, including: lack of public knowledge of healthcare resources, shrinking comfort and scope of community providers and patient willingness to utilize other resources. Despite concerns over non-urgent visits, interviewees expressed that these patients still need to be seen, assessed and managed. The second conceptualization focused on over-investigation (and to lesser extent, treatment). This physician-centric conceptualization identified issues around: variation in physician risk tolerance, established decision rules with the allowable miss rates, patient expectation for testing or physician feeling that the patient was owed something or that patient would not accept their diagnosis/treatment without testing. Additionally, interviewees described patient characteristics that may initiate more aggressive investigation (e.g., patient reliability, follow-up care access, etc.). An overarching concern about the connection between unnecessary care and wasted resources was identified. Additionally, interviewees emphasized that patient conversations are outside the scope of unnecessary care despite their possible implications for limited time resources. Conclusion: A range of concepts surrounding unnecessary care in the ED were identified. Further exploring nuances of these conceptualizations may inform and improve the effectiveness of campaigns seeking to improve efficiency in practice and reduce inappropriate care. Additionally, this work provides an impetus for developing clearer concepts of care within the ED.
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Tolotti, Angela, Serena Barello, Camilla Vignaduzzo, Sarah Jayne Liptrott, Dario Valcarenghi, Tiziana Nania, Davide Sari, and Loris Bonetti. "Patient Engagement in Oncology Practice: A Qualitative Study on Patients’ and Nurses’ Perspectives." International Journal of Environmental Research and Public Health 19, no. 18 (September 15, 2022): 11644. http://dx.doi.org/10.3390/ijerph191811644.
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Patient engagement has gained increasing attention in cancer care as it is widely acknowledged as an essential element of high-quality care. There are limited data on how oncology nurses might apply techniques that encourage patient engagement. Therefore, this study aims to understand which nursing strategies can favour patient engagement in oncological care from patients’ and nurses’ perspectives. We conducted a qualitative study involving oncology patients and oncology nurses. Patients were interviewed, while nurses were involved in focus groups (FGs). Both interviews and FGs were analysed by the means of thematic analysis. We interviewed six patients and conducted two FGs, involving 17 nurses. Five themes were identified from patients’ interviews: effective information, having the opportunity to choose, being considered a person, trusted relationship with nurses, and receiving support and advice. Additionally, five themes were identified from the FGs: the nurse–patient relationship, personalisation of care, information style, engagement strategies, and the team. The participants highlighted the importance of comprehensive information in order for patients to feel more involved. Great importance was given to the nurse–patient relationship, which must be based on trust and mutual respect. Both nurses and patients emphasised the importance of person-centred care. A more systematic implementation of suggestions from the participants in this study is desirable for the future.
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Remaklus-Homan, Caitlin, Aardhra M. Venkatachalam, Kathrina B. Siaron, DaiWai M. Olson, and Sonja E. Stutzman. "Qualitative Study of the Impact of Patient Satisfaction Surveys on Nurses in Ambulatory Neurosurgery." International Journal of Critical Care 16, no. 3 (January 1, 2023): 17–27. http://dx.doi.org/10.29173/ijcc52.
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ABSTRACT
Background: Literature on the impact of patient-satisfaction metrics on nursing staff is scarce and limits nurses’ ability to understand the impact these metrics have on their daily practice.
Aim: The aim of this qualitative study is to explore nurses’ perceptions of patient satisfaction surveys on their daily practice when working with patients with acute neurological changes.
Method: A content analysis approach was used to analyze interviews with six neurosurgical nurses. The analysis was conducted throughout the interview and analysis process, and guided interviews and rigor processes.
Results: Among the surveyed nurses, there was unified agreement that the current tool for obtaining the metrics did not accurately reflect the performance of the registered nurse. Themes that emerged from interview analysis included “anxiety”, “frustration”, “uncertainty”, and “workarounds”. Interviews uncovered a disconnect between clinical nurses and leadership, as well as how feedback is presented to nurses by patients, which drove many of the themes listed above. The nurses felt that the metrics should not be linked to individual performance feedback.
Conclusion: Nurses report that patient satisfaction surveys do not represent an ideal metric for quality of nursing care and impact their daily practice negatively. These results could be applied to improving the registered nurse performance evaluation tools utilized in neurological units.
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Tanwir, Farzeen, Sarah Moideen, and Raiya Habib. "Interviews in Healthcare: A Phenomenological Approach A Qualitative Research Methodology." Journal of Public Health International 4, no. 2 (July 8, 2021): 10–15. http://dx.doi.org/10.14302/issn.2641-4538.jphi-21-3881.
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Phenomenology is a ritual of Qualitative research methodology. Interviews in healthcare enables researchers to recognise and understand data from lived experiences of the participants by using Phenomenological approach. The purpose of this article is to review the various face to face in depth interviews conducted using Husserl’s descriptive, Heidegger’s interpretive phenomenology or Hermeneutic phenomenological approach in healthcare. The in-depth interview will help to understand the health issues and ethical issues faced by participants. Methodology Four articles were selected based on phenomenological approach. Article.1 was based on Hermeneutic Phenomenology approach. In this study thirteen women were taken as sample. Sampling was done by snowball method. The women were asked to share their rural maternity experience. Data was analyzed without any influence of the researcher. Article.2 was based on Transcendental phenomenology. There were 15 students from 4 different cultural background belonging to different health professional programmes like nursing, medicine, pharmacy, dentistry, and physical therapy. Triangulation methods were used and semi structured interviews were conducted, recorded and transcribed. Health professional students shared their lived experience with patients. Article.3 was based on a study conducted using both Transcendental phenomenology for patients interviews and Hermeneutic phenomenology for healthcare professionals’ interviews. The semi structured interview of patient was taken to understand and record their lived experience with the medication without any bias or interpretation and data received was bracketed. The healthcare professionals’ interviews were conducted on Hermeneutic strategy regarding the medications they prescribe for life threatening illnesses. Article 4 was based on Hermeneutic phenomenological approach. There were nine patients selected and in depth semi-structured interviews were conducted. The patients shared their experience of living with a life limiting illness.
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Matza, Louis S., Katherine Kim, Glenn Phillips, Kelsey Zorn, Kitty S. Chan, Katherine C. Smith, and Ellen M. Mowry. "Multiple sclerosis relapse: Qualitative findings from clinician and patient interviews." Multiple Sclerosis and Related Disorders 27 (January 2019): 139–46. http://dx.doi.org/10.1016/j.msard.2018.09.029.
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Glover, Crystal M., and Yanina A. Purim-Shem-Tov. "Qualitative patient interviews conducted within the ED: purpose and problems." American Journal of Emergency Medicine 34, no. 6 (June 2016): 1169–70. http://dx.doi.org/10.1016/j.ajem.2016.03.031.
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Bywall, Karin Schölin, Jennifer Viberg Johansson, Inger Erlandsson, Marie Heidenvall, Marta Lason, and Bente Appel Esbensen. "Making space for patients’ preferences in precision medicine: a qualitative study exploring perspectives of patients with rheumatoid arthritis." BMJ Open 12, no. 6 (June 2022): e058303. http://dx.doi.org/10.1136/bmjopen-2021-058303.
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ObjectivePrecision medicine in rheumatoid arthritis (RA) creates new opportunities to involve patients in early identification of accurate indicators of health trajectories. The aim of this study was to explore patient perspectives on patient-centredness in precision medicine for RA treatment.DesignSemistructured interviews were conducted to explore patients’ perspectives on a new personalised approach to RA treatment. The interview guide was developed together with patient research partners and health care professionals.SettingAn invitation to the interviews was sent through a mobile application. The interviews were one-on-one, using an interview guide with open-ended questions. Interviews were conducted digitally (October 2020–February 2021) via Zoom or telephone, depending on each participant’s preferences.ParticipantsPatients with RA (N=12) were purposively recruited. Patients were eligible if they had an RA diagnosis, were aged 18–80 years, and understood and expressed themselves in Swedish. Participants and researchers did not know each other prior to the interviews.ResultsParticipants expressed desires and needs for patients to have an active role in precision medicine by making shared treatment decisions together with a healthcare professional. In order for that to work, patients need information on potential treatment options, an ability to express their preferences, an individual treatment plan and identification of personal treatment goals. Patients also identified two requirements of healthcare professional in precision medicine: a safe environment to express personal matters and two-way communication with healthcare professionals.ConclusionCommunication between patients and healthcare professionals needs to be more focused on patients’ individual treatment preferences and expressed needs, in order to increase patient-centredness in treatment decisions, so shared decision-making can become a reality. More research is needed to design multifaceted implementation strategies to support patients and healthcare professionals to increase patient-centredness throughout treatment personalisation.
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Matthews, Allison, Surbhi Sidana, Lauren Seymour, Nancy Pick, James Pringnitz, David Argue, Gina Lange, et al. "QIM19-136: Developing an Ideal CAR-T Cell Therapy Patient Experience Through Human-Centered Design and Innovation." Journal of the National Comprehensive Cancer Network 17, no. 3.5 (March 8, 2019): QIM19–136. http://dx.doi.org/10.6004/jnccn.2018.7187.
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Background: The patient/caregiver experience during CAR-T therapy is stressful, overwhelming, terrifying, and often a patient’s last treatment option. The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Innovation and Design team has worked with the CAR-T therapy clinical team to develop a patient experience that provides patients with a sense of caring, supportive environment, timely knowledge, and realistic expectations. Using a human-centered design approach, the Innovation and Design team worked with patients and caregivers to understand latent and unspoken needs in order to develop an ideal CAR-T therapy patient journey. Methods: With qualitative interviewing techniques, patient observation, and low fidelity experimentation, 21 patients/caregiver pairs were interviewed throughout their CAR-T therapy experience in 2018. Patients were interviewed at several touch points as well as encouraged to reach out to the Innovation and Design team at any point with reflections on their experiences. Patients were recruited as they began their evaluation phase for CAR-T therapy. The interviews were unscripted to allow for a breadth of discovery by not constraining the conversations to previously developed themes. As themes emerged from patient/caregiver interviews, artifacts and interventions were designed to alleviate pain points and improve the patient/caregiver experience. These artifacts and interventions were integrated into the clinical processes in real time and patient/caregivers were interviewed to understand the impact of these activities. Results: Several themes emerged from qualitative interviews with patients and caregivers. From the themes, interventions were developed. We were able to demonstrate a qualitative improvement in patient/caregiver experience through these interventions (Figure 1). Conclusions: Patients/caregivers undergoing CAR-T therapy have unique issues surrounding the logistics of care, emotional burden, and physical effects of treatment. We implemented processes to address these issues and observed a qualitative improvement via patient interviews/feedback. Ongoing work includes optimizing remote monitoring, digital platforms for patient education, and a quantitative study looking at patient reported outcomes (PROs) in such patients. To our knowledge, this is the first report for care delivery optimization in real-world practice for this new therapy.
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Mikkelsen, Thomas R., Camilla B. Breer, Kari K. Nissen, and Karin Christiansen. "Understanding genetics in nursing care – A qualitative interview study." Journal of Nursing Education and Practice 12, no. 11 (June 29, 2022): 9. http://dx.doi.org/10.5430/jnep.v12n11p9.
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Objective: The aim of the present study was to investigate the use of genetics/genomics (G/G) knowledge and competencies in a Danish nursing context.Methods: Using a qualitative approach, thirteen Danish nurses representing different parts of the Danish health care system were interviewed about their experiences with G/G in daily practice. One focus group interview was conducted face to face, and nine individual semi-structured interviews were conducted partly face to face, partly online due to Covid-19 restrictions. Data were analyzed through systematic text condensation using the NVIVO13 tool (QSR International).Results: We identified five themes: 1) The nature of genetics; 2) Knowledge about genetics; 3) The roles of the nurse; 4) Nurses’ engagement with patients and relatives; 5) Patient pathways. Ethics was a recurrent theme in all five themes.Conclusions: The Danish nurses interviewed generally hold a narrow understanding of genetics i.e. defining it as heredity. They are involved in G/G aspects of care, although the extent and nature of this involvement varies considerably between different care settings. Hence, it seems unlikely that all nurses will require the same G/G knowledge and competencies. Nevertheless, the nurses share the belief that they should possess some basic knowledge about G/G to perform adequate nursing care. Their current knowledge about G/G is typically informed by practice and to a very small degree by their formal education. They agree that G/G literacy will be a general requirement in future nursing. Some of the nurses consider personalized medicine to be the golden road to better patient treatment and care. Some request more knowledge about G/G topics and a vocabulary to communicate adequately with doctors, patients and relatives on these issues. The importance of ethics is emphasized throughout the interviews.
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Burnett, E., K. Lee, R. Rushmer, M. Ellis, M. Noble, and P. Davey. "Healthcare-associated infection and the patient experience: a qualitative study using patient interviews." Journal of Hospital Infection 74, no. 1 (January 2010): 42–47. http://dx.doi.org/10.1016/j.jhin.2009.07.027.
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Mao, Jinjiao, Yun Dai, Lijuan Wang, Shucheng Pan, Wei Wang, and Hongwei Yu. "‘Is it painful’? A qualitative study on experiences of patients before prostate needle biopsy." BMJ Open 12, no. 9 (September 2022): e056619. http://dx.doi.org/10.1136/bmjopen-2021-056619.
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ObjectiveTo assess the experiences and emotional reactions of men prior to receiving a prostate needle biopsy (PNB).DesignThis was a qualitative study involving (1) material research and filter, (2) interviewer training, (3) cognitive semistructured interviews with open-ended questions, (4) data analysis, including translation and back translation and (5) group discussions to determine common themes in the data. All interviews were digitally audio-recorded. The thematic analysis was conducted by repeatedly reading the data manuscript and engaging in group discussion.Setting and participantsA total of 30 participants with suspected prostate cancer (PC) who were scheduled to receive a PNB were interviewed. Eligible participants were Chinese native men aged 51–77 years, and the study was conducted in China between September and December 2020. All participants were informed about the purpose of the study and provided written informed consent.ResultsFour main themes were identified based on the interview content: (1) fear (of pain, adverse effects and bad results), (2) impact of lower urinary tract symptoms (on emotional impact, work and sleeping), (3) inner struggles (relating to hesitation, regret and embarrassment) and (4) lifestyle change (including diet, exercise and receipt of traditional Chinese medicine).ConclusionsThis patient cohort had a low level of knowledge about PC and PNB. Providing additional education about these topics would help to reduce patient fear and anxiety and improve experiences of the procedure.
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Miesbach, Wolfgang, and Robert Klamroth. "The Patient Experience of Gene Therapy for Hemophilia: Qualitative Interviews with Trial Patients." Patient Preference and Adherence Volume 14 (April 2020): 767–70. http://dx.doi.org/10.2147/ppa.s239810.
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Patel, Manali I., David Moore, and Tumaini R. Coker. "End-of-Life Cancer Care Redesign: Patient and Caregiver Experiences in a Lay Health Worker–Led Intervention." American Journal of Hospice and Palliative Medicine® 36, no. 12 (May 2, 2019): 1081–88. http://dx.doi.org/10.1177/1049909119847967.
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Importance: The Engagement of Patients with Advanced Cancer (EPAC), comprised of a lay health worker (LHW) who assists patients with advance care planning, is an effective intervention for improving patient experiences and reducing acute care use and total health-care costs. The objective of this study was to assess patients’ and caregivers’ experiences with the intervention. Methods: We invited all patients enrolled in EPAC and their caregivers to complete an 8-item survey at the end of the intervention and a random 35% sample to participate in a qualitative interview to assess their experiences. At 15-month follow-up, we invited all caregivers of patients who died during the study to participate in a qualitative interview. We analyzed survey responses using bivariate methods and recorded, transcribed, and analyzed interviews using qualitative content analysis. Results: Sixty-nine patients were alive at completion of the intervention and all 30 identified caregivers completed the survey. All viewed the intervention as a critical part of cancer care and recommended the intervention for other patients. In qualitative interviews, among 30 patients, all reported improved comfort in discussing their end-of-life care preferences. In qualitative interviews with 24 bereaved caregivers, all viewed the intervention as critical in ensuring that their loved ones’ wishes were adhered to at the end of life. Conclusions and Relevance: Incorporating an LHW into end-of-life cancer care is an approach supported and viewed as highly effective in improving care by patients and caregivers. The LHW-led EPAC intervention is one solution that can significantly impact patient and caregiver experiences.
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Mishra, Manish K., Catherine H. Saunders, Hector P. Rodriguez, Stephen M. Shortell, Elliott Fisher, and Glyn Elwyn. "How do healthcare professionals working in accountable care organisations understand patient activation and engagement? Qualitative interviews across two time points." BMJ Open 8, no. 10 (October 2018): e023068. http://dx.doi.org/10.1136/bmjopen-2018-023068.
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ObjectiveIf patient engagement is the new ‘blockbuster drug’ why are we not seeing spectacular effects? Studies have shown that activated patients have improved health outcomes, and patient engagement has become an integral component of value-based payment and delivery models, including accountable care organisations (ACO). Yet the extent to which clinicians and managers at ACOs understand and reliably execute patient engagement in clinical encounters remains unknown. We assessed the use and understanding of patient engagement approaches among frontline clinicians and managers at ACO-affiliated practices.DesignQualitative study; 103 in-depth, semi-structured interviews.ParticipantsSixty clinicians and eight managers were interviewed at two established ACOs.ApproachWe interviewed healthcare professionals about their awareness, attitudes, understanding and experiences of implementing three key approaches to patient engagement and activation: 1) goal-setting, 2) motivational interviewing and 3) shared decision making. Of the 60 clinicians, 33 were interviewed twice leading to 93 clinician interviews. Of the 8 managers, 2 were interviewed twice leading to 10 manager interviews. We used a thematic analysis approach to the data.Key resultsInterviewees recognised the term ‘patient activation and engagement’ and had favourable attitudes about the utility of the associated skills. However, in-depth probing revealed that although interviewees reported that they used these patient activation and engagement approaches, they have limited understanding of these approaches.ConclusionsWithout understanding the concept of patient activation and the associated approaches of shared decision making and motivational interviewing, effective implementation in routine care seems like a distant goal. Clinical teams in the ACO model would benefit from specificity defining key terms pertaining to the principles of patient activation and engagement. Measuring the degree of understanding with reward that are better-aligned for behaviour change will minimise the notion that these techniques are already being used and help fulfil the potential of patient-centred care.
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Johnson, Matthew, Peter Allmark, and Angela Tod. "Living beyond expectations: a qualitative study into the experience of long-term survivors with pleural mesothelioma and their carers." BMJ Open Respiratory Research 9, no. 1 (May 2022): e001252. http://dx.doi.org/10.1136/bmjresp-2022-001252.
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BackgroundMalignant pleural mesothelioma (MPM) is characterised by poor prognosis and limited treatment options. However, a minority of patients can survive well beyond these bleak estimates. Little is known about the specific experiences and needs of long-term survivors and families.Study purposeThe study aimed to gain in-depth understanding of the experiences of patients diagnosed with MPM 3 or more years, along with their main carer, and to determine the care and support needs of this group.Participants and settingPeople diagnosed with MPM 3 or more years were recruited via asbestos and mesothelioma social media and support groups. Potential participants were asked to identify someone who acted as their main carer.MethodThe study employed a cross-sectional qualitative interview design. A topic guide aided a conversational interview style, conducted remotely and recorded. Patient and carer pairs were interviewed jointly when possible, but were given an option for separate interviews if preferred. Fifteen patients, with 14 identifying a main carer, consented to participation.AnalysisRecorded interviews were transcribed verbatim, and then anonymised by the interviewer. Framework analysis was used to analyse the data iteratively and to develop final themes.FindingsThree themes were developed. Participants ‘Living beyond expectations’ remained acutely aware that MPM was incurable, but developed a range of coping strategies. Periods of disease stability were punctuated with crises of progression or treatment ending, straining coping. ‘Accessing treatment’ was important for patients and carers, despite the associated challenges. They were aware options were limited, and actively sought new treatments and clinical trials. ‘Support needs’ were met by healthcare professionals, voluntary groups and social media networks.ConclusionsManaging patients via regional MPM multidisciplinary teams, facilitating equal access to treatment and trials, could reduce patient and carer burden. Greater awareness and support around crisis points for this group could improve care.
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Najafi Kalyani, Majid, Raziyeh Illon Kashkooli, Zahra Molazem, and Nahid Jamshidi. "Qualitative Inquiry into the Patients' Expectations regarding Nurses and Nursing Care." Advances in Nursing 2014 (April 3, 2014): 1–6. http://dx.doi.org/10.1155/2014/647653.
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Background and Objectives. Awareness about the patients’ needs and expectations is quite important in improving the quality of the services they are provided with. Since meeting the needs and expectations of the patients is one of the basic issues in patient care, the present study aimed to investigate the patients’ expectations from nurses and nursing care. Methods. In this qualitative study, 20 hospitalized patients were interviewed. The data were gathered through deep, semistructured interviews. Then, all the recorded interviews were transcribed, reviewed for several times, and analyzed using qualitative content analysis approach. Results. By analyzing of data, three main categories were extracted. The main categories of the patients’ expectations from nurses and nursing care were comprehensive care, ethical performance, and having proper individual characteristics. Discussion and Conclusion. The study results revealed that the patients expected comprehensive care from the nurses. In addition, the nurses were required to apply the ethical principles in what they do as their duties. The findings of the study can be helpful in improving the patient care.
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Sayma, Meelad, Dina Saleh, Doa’a Kerwat, Shiraz Jamshaid, Aaniya Ahmed, Folashade Oyewole, Abdul Samad Wahid, Claire Perry, and Benita Cox. "A qualitative inquiry into the barriers and facilitators to achieving home death." BMJ Supportive & Palliative Care 10, no. 2 (July 31, 2017): e18-e18. http://dx.doi.org/10.1136/bmjspcare-2016-001260.
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ObjectivesTo explore the barriers and facilitators to patients achieving death at home.MethodsIn-depth, semistructured interviews with end-of-life care experts were conducted to develop an insight into the barriers and facilitators to achieving death at home. Thirty-three interviews were conducted compromising of a mixture of face-to-face and tele interviews. Experts included healthcare professionals working in the community, hospital and policy/academic settings. Thematic analysis was undertaken on interview transcripts.ResultsThree overarching themes, further divided into a total of 12 subthemes were identified. The three themes were ‘managing people’, ‘education' and ‘planning’. The ‘managing people’ theme included subthemes of patient preferences and family influences; the ‘education’ theme encompassed knowledge and training, perceptions of death and communication and the ‘planning’ theme contained seven subthemes including ‘coordination’, ‘resources’ and ‘cost’.ConclusionsMultiple barriers and facilitators to achieving death at home were identified in this study. Of particular significance was the identification of the fear and stigma associated with death among doctors, patients and their families serving as a barrier to home death, not previously identified in the literature. Additionally, the importance of social networks and resource provision were highlighted as key in influencing patient death at home.
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Ogdie, Alexis, Kaleb Michaud, Miroslawa Nowak, Rachel Bruce, Sarah Cantor, Carlijn Hintzen, and Philip J. Mease. "Patient’s experience of psoriatic arthritis: a conceptual model based on qualitative interviews." RMD Open 6, no. 3 (October 2020): e001321. http://dx.doi.org/10.1136/rmdopen-2020-001321.
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IntroductionPsoriatic arthritis (PsA) is a heterogeneous chronic inflammatory musculoskeletal disorder that manifests as peripheral arthritis, dactylitis, enthesitis and spondylitis. PsA results in significant burden that impacts quality of life of patients. We examined the signs, symptoms and impacts reported by patients with PsA, to characterise the patient experience of PsA and develop a conceptual model representing this patient experience.MethodsSemi-structured interviews were conducted with patients with PsA recruited through the FORWARD databank. Spontaneous and probed signs, symptoms and impacts of PsA were assessed. Patients rated the disturbance of these concepts on their lives using a scale from 0 (‘does not disturb’) to 10 (‘greatly disturbs’). Signs, symptoms and impacts reported by >80% of patients with a disturbance rating of ≥5 were defined as salient concepts. Recruitment continued until concept saturation was achieved.Results19 patients with PsA were interviewed. The interviews elicited 42 symptoms of which 8 had not been identified in a previous literature review encompassing 15 relevant articles. The most salient signs and symptoms elicited in the interviews were joint pain, skin symptoms, stiffness, swollen/inflamed joints and fatigue all with moderate to high disturbance ratings (range: 5.5–7.8). The most salient impacts were sleep disturbance, physical disability, effects on daily activities and feelings of frustration with also moderate to high disturbance ratings (range: 6.1–7.4).ConclusionsThe interviews highlighted the adverse impact PsA has on the patient’s life and may inform on outcome variables or areas suitable to be assessed in PsA studies.
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Kassem, Lamyaa M., Bushra Alhabib, Khaledah Alzunaydi, and Maryam Farooqui. "Understanding Patient Needs Regarding Adverse Drug Reaction Reporting Smartphone Applications: A Qualitative Insight from Saudi Arabia." International Journal of Environmental Research and Public Health 18, no. 8 (April 7, 2021): 3862. http://dx.doi.org/10.3390/ijerph18083862.
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Background: A pragmatic shift in the healthcare sector characterized by moving from curative to preventive approaches highlights the role of pharmacovigilance in patient safety. There have been few published studies on patient reporting of adverse drug reactions (ADRs) in Saudi Arabia. This qualitative study aims to explore the community opinions and the need for patient-friendly smartphone applications (SPAs) to enhance their participation in ADR reporting. Methods: Purposeful sampling was followed to recruit study participants, a semi-structured interview guide was used to conduct interviews, and the saturation was reached after the 13th interviewer; no new information was obtained after two subsequent interviews. All the interviews were audio-recorded, transcribed verbatim, and analyzed by means of a standard content analysis framework. Results: As per the WHO guidelines, eleven participants were aware of the term “ADR”. All the participants denied receiving any prior education and attending events about ADRs and were unaware of the Saudi FDA-ADR reporting systems. The use of technologies such as SPAs has been widely accepted with a high level of concern for data confidentiality and privacy. Conclusions: These findings point out the need to build patient-oriented educational programs to increase their awareness of ADR reporting and to prioritize the use of artificial intelligence (AI) to be integrated in the Saudi healthcare system to develop future SPAs for improving both patient safety and signal detection of ADRs.
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Okoro, Tony, Vanja Sikirica, Linda Casillas, Triza Brion, Jacob Devine, Vivien Ong, and Kellee Howard. "Elicitation of disease concepts in patients with diabetic foot ulcers: a qualitative study." Journal of Wound Care 29, Sup5a (May 1, 2020): S38—S45. http://dx.doi.org/10.12968/jowc.2020.29.sup5a.s38.
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Objective: To identify in-depth information directly from patients with diabetic foot ulcers (DFU) on DFU symptoms, impacts on functioning and effects on health-related quality of life (HRQoL). Method: Semi-structured, qualitative concept elicitation interviews were conducted with patients with DFUs (Wagner grade 1 or 2) until saturation was reached. Qualitative analysis (using MAXQDA, VERBI GmbH, Germany) of interview transcripts was conducted to identify concepts relevant to patients with DFUs, based on the frequency of mentions, and elucidate themes regarding impacts on HRQoL. Results: Of the 18 participants, most were male (n=14; 78%) and 10 (56%) presented with a Wagner grade of 1. Frequently reported symptoms were pain/discomfort (n=15; 83%), weeping/discharge (n=10; 56%), bleeding (n=10; 56%) and swelling (n=8; 44%). Overall, patients reported more impacts than symptoms—wound care/treatment burden (n=14; 78%), limitations on exercise/physical activity (n=13; 72%), mobility limitations (n=12; 67%), and offloading (n=12; 67%) were the most frequently mentioned. Based on findings from the patient interviews, a draft conceptual model was developed outlining interrelationships between DFU symptoms, impacts, and HRQoL from the patient perspective. Conclusion: Qualitative interviews captured the breadth of disease-related concepts of direct importance to patients. The draft conceptual model developed from the analysis can help identify measures or instruments for use in assessing patient-reported symptoms or HRQoL in clinical practice and may have wider research applicability, including evaluation of treatment benefits in patients with DFUs.
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Samuel, Nardin, Mohammed F. Shamji, and Mark Bernstein. "Neurosurgical patients’ perceptions of the “surgeon+”: a qualitative study." Journal of Neurosurgery 124, no. 3 (March 2016): 849–53. http://dx.doi.org/10.3171/2015.4.jns15113.
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OBJECT Neurosurgical patients bear a varying degree of anxiety when confronted with having to undergo surgery or even visit with a neurosurgeon in consultation. Previous studies have suggested that patient perceptions can heavily influence the patient-physician encounter. Accordingly, a better understanding of these perceptions can marshal our knowledge regarding strategies for improving patient-physician interactions during such an apprehensive time. The aim of the present study was to qualitatively examine patient values and preferences for a neurosurgeon who participates in extraclinical activities (i.e., a “neurosurgeon+”) and understand the factors that influence these perceptions. METHODS Semistructured face-to-face interviews with 47 neurosurgical patients were conducted. Patients were recruited from the Toronto Western Hospital neurosurgery clinics for cranial and spinal conditions. Descriptive summary statistics were used to characterize the study participants. Family members were encouraged to contribute to the interviews. Interviews were audio-recorded, transcribed, and subjected to thematic analysis by using open and axial coding. RESULTS Patients generally indicated that they want to feel confident in their neurosurgeon. A number of factors contribute to this confidence, including a strong positive referral from another physician. Patients are inclined to search for information pertaining to the qualifications of neurosurgeons online, and a perception of the neurosurgeon’s adeptness given his or her qualifications is important for patients. Although there were some differences in patient values between those in the cranial and spinal groups, overall, neurosurgical patients tend to positively view their neurosurgeon’s involvement in extraclinical duties. CONCLUSIONS This study details the first comprehensive clinical qualitative study of patient perceptions of neurosurgeons and provides a descriptive framework for understanding patient values in this clinical domain.
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Herwig, Anna, Dorothea Dehnen, and Birgitta Weltermann. "Patient factors driving overuse of cardiac catheterisation: a qualitative study with 25 participants from two German teaching practices." BMJ Open 9, no. 4 (April 2019): e024600. http://dx.doi.org/10.1136/bmjopen-2018-024600.
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ObjectivesPercutaneous coronary interventions do not provide a benefit over medical therapy for stable patients. However, an overuse of cardiac catheterisation (CC) for stable coronary artery disease (CAD) is documented in Germany and other countries. In this study, we aim to understand patient factors that foster this overuse.DesignOur study is an exploratory qualitative interview study with narrative, structured interviews. The interviews were analysed using qualitative content analysis by Mayring.SettingThe interviews were conducted in two German teaching practices.Participants24 interviews with 25 patients were conducted; 17 (68%) patients were male, the average age was 73.9 years (range 53–88 years). All patients suffered from CAD and had undergone at least one CC. Patients with known anxiety disorders were excluded from the study.ResultsThe analysis identified six patient factors which contributed to or prevented the overuse of CC: (1) unquestioned acceptance of prescheduled appointments for procedures/convenience; (2) disinterest in and/or lack of disease-specific knowledge; (3) helplessness in situations with varying opinions on the required care; (4) fear of another cardiac event, (5) patient–physician relationship and (6) the patient’s experience that repeat interventions did not result in a change of health status or care.ConclusionsConducted in a country with documented overuse of CC, we showed that most patients trusted their physicians’ recommendations for repeat coronary angiographies even if they were asymptomatic. Strategies to align physician adherence with guidelines and corresponding patient information are needed to prevent overuse.
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Leonard, Chelsea, George Sayre, Sienna Williams, Alison Henderson, Daniel Norvell, Aaron P. Turner, and Joseph Czerniecki. "Understanding the experience of veterans who require lower limb amputation in the veterans health administration." PLOS ONE 17, no. 3 (March 18, 2022): e0265620. http://dx.doi.org/10.1371/journal.pone.0265620.
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Purpose There is limited qualitative research on the experience of patients undergoing lower limb amputation due to chronic limb threatening ischemia (CLTI) and their participation in amputation-level decisions. This study was performed to understand patient lived experiences related to amputation and patient involvement in shared decision making. Materials and methods Phenomenological interviews were conducted with Veterans 6–12 months post transtibial or transmetatarsal amputation due to CLTI. Interviews were read and summarized by two analysts who discussed the contents of each interview and relationships between interviews to identify emergent, cross-cutting elements of patient experience. Results Twelve patients were interviewed between March and August 2019. Three cross cutting elements of patient lived experience and participation in shared decision making were identified: 1) Lacking a sense of decision making; 2) Actively working towards recovery as response to a perceived loss of independence; and 3) Experiencing amputation as a Veteran. Conclusions Patients did not report a high level of involvement in shared decision making about their amputation or amputation level. Understanding patient experiences and priorities is crucial to supporting shared decision making for Veterans with amputation due to CLTI.
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Náfrádi, Lilla, Zlatina Kostova, Kent Nakamoto, and Peter J. Schulz. "The doctor–patient relationship and patient resilience in chronic pain: A qualitative approach to patients’ perspectives." Chronic Illness 14, no. 4 (November 2, 2017): 256–70. http://dx.doi.org/10.1177/1742395317739961.
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Objectives To study patients’ perspectives about the role of the doctor–patient relationship in promoting the resilience process. Methods We conducted in-depth interviews with 20 chronic pain patients. Using open-ended questions, the interviews explored aspects of the doctor–patient relationship that impacted the patients’ perceptions of their resilience. Thematic analysis built on an inductive, adaptive approach to data coding was employed to organize a representation of key factors affecting resilience. Results The themes emerging from the interviews inform us about how the different aspects of the doctor–patient relationship can promote patient resilience in chronic pain. Three main themes emerged: the doctor providing psychological support, promoting patients’ health literacy related to chronic pain and its treatment, and empowering the patients to cooperate in finding the right treatment. This fosters patients’ direct outcomes (feeling validated, health literate, and empowered), which, in turn, lead to adaptive coping responses and day-to-day disease management. These direct outcomes are crucial for patients to maintain socially and personally meaningful activities and their functional (physical) capacity. Discussion A doctor–patient relationship following the precepts of the patient-centered care is a significant resource that can lead to increased patient resilience. Thus, future interventions promoting patient resilience might consider addressing the doctor–patient relationship.
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El-Haddad, Carlos, Iman Hegazi, and Wendy Hu. "Understanding Patient Expectations of Health Care: A Qualitative Study." Journal of Patient Experience 7, no. 6 (April 28, 2020): 1724–31. http://dx.doi.org/10.1177/2374373520921692.
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Understanding and measuring patient expectations of health care is central to improving patient satisfaction and delivering patient-centered care. However, most empiric research in this field has focused on measuring patient expectations for specific diseases only. Patient expectations common to a variety of settings and clinical contexts need to be better understood to design measures with wider utility. We aimed to understand how patients express and conceptualize their expectations of health care across a range of clinical contexts and conditions. Semi-structured interviews were conducted with patients presenting to a major metropolitan hospital, informed by interpretive phenomenological analysis. Sampling continued until thematic saturation. Interview topics explored the illness experience, interactions with clinicians, how patients communicated and conceptualized their expectations of health care, and the nature of these expectations. The 26 participants conceptualized and described their expectations in 3 distinct domains: (1) health outcomes, (2) individual clinicians, and (3) the health-care system. Importantly, these domains were consistent across a variety of clinical contexts, participant demographics, and medical conditions. Despite variation in expectations due to individual patient circumstances, we identified 3 conceptual domains within which expectations consistently lie. When designing measurement tools for patient expectations, we suggest incorporating questions specifically addressing the 3 domains we have identified. With such measures, clinicians and health-care providers can be empowered to provide and monitor patient-centered care with outcomes tailored to what patients desire.
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Becker, Brandon, Laurie Eliason, Kenneth W. Culver, Rob Arbuckle, Anya Francis, and Shibani Pokras. "Qualitative patient interviews on symptoms and impacts in metastatic synovial sarcoma (mSS)." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e23576-e23576. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e23576.
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e23576 Background: Synovial sarcoma (SS), a soft tissue sarcoma, is a rare and aggressive malignancy, with significant morbidity and mortality associated with mSS. There are currently no patient-reported outcome (PRO) instruments specific to mSS patients and little qualitative research to understand impacts on mSS patients’ health-related quality of life (QoL). The objective of this study was to characterize the symptoms and impacts experienced by mSS patients to inform the selection of content-valid PRO instruments for use in investigational trials in mSS patients. Methods: This was a non-interventional, qualitative interview study of adult participants in the United States (US) with physician-confirmed mSS. Participants were consented from a large private practice in the US. Six semistructured concept elicitation interviews (60–90m by telephone) were conducted by trained interviewers. Participants were asked to describe their mSS symptoms and their impact on functioning in an open-ended fashion with follow-up probes. Verbatim transcripts were analyzed using thematic analysis methods and Atlas.Ti software. Socio-demographics and clinical characteristics were collected by the site. The study received Institutional Review Board (IRB) approval from Western IRB. Results: Among the 6 participants, average age was 45y (range 21–61y) and 2 were female. All 6 participants had pulmonary metastasis, 1 participant had a liver metastasis, and 1 participant had a mediastinal mass. The most common symptoms participants spontaneously identified were pain (n = 6), fatigue (n = 6), coughing (n = 5, with 2 upon probing), shortness of breath (n = 4), phlegm/mucus in the lungs (n = 3), coughing up blood (n = 2), and gastrointestinal complications (n = 2). Nerve/shooting/burning pain (n = 5) was mentioned upon probing. Participants also reported impacts of their disease on sleep (quantity and quality) (n = 6), physical activity (n = 6), social life (n = 6), daily activities (n = 5), emotions (n = 5), loss of appetite (n = 3), and finances (n = 1). Although not spontaneously reported, global ratings of overall health and QoL were considered relevant by all participants. Conclusions: This is the first study to identify patient-relevant symptoms and impacts associated with mSS. Further interviews with additional participants are ongoing, and we will analyze these data to identify appropriate PRO instruments for use in investigational trials in mSS patients. Funding: GlaxoSmithKline (209386).
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Kam, Seonju, and Youngsun Yoo. "Patient Clothing as a Healing Environment: A Qualitative Interview Study." International Journal of Environmental Research and Public Health 18, no. 10 (May 18, 2021): 5357. http://dx.doi.org/10.3390/ijerph18105357.
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Patients’ emotional responses to the hospital environment can be considered as important as medical technology and equipment. Therefore, this study investigated their experiences to determine whether the pattern using hospital identity (HI) elements, a widely used design method for patient clothing in university hospitals, can affect their emotional response and contribute to healing. It aimed to identify whether controlling the motif characteristics, arrangement, and spacing in this pattern design, and the direction between motifs, could be a method to design patient clothing for healing. To investigate patients’ emotional response and suggestions for patient clothing design, an interview-based qualitative approach was used. In-depth interviews were conducted with 12 patients discharged from Kyung Hee University Hospital Medical Center (KHUMC), Seoul. The interview questions consisted of two parts. One part featured questions about participants’ emotional responses to the medical environment and their latest patient clothing experience, and the other featured questions about their emotional response to, and suggestions for, the healing expression of pattern design using HI. The results confirmed that the motif characteristics, arrangement, and spacing, and the direction between motifs, influenced patients’ positive emotions and contributed to the healing effect. Therefore, when the HI elements of a medical institution are applied in the design of patient clothing with the characteristics of a healing design, patients perceive this as providing stability and comfort. The design of patient clothing becomes a medium that not only builds the brand image of medical institutions, but also enhances the quality of medical services centered on patient healing.
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van Seben, Rosanne, Susanne M. Smorenburg, and Bianca M. Buurman. "A qualitative study of patient-centered goal-setting in geriatric rehabilitation: patient and professional perspectives." Clinical Rehabilitation 33, no. 1 (August 14, 2018): 128–40. http://dx.doi.org/10.1177/0269215518791663.
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Objective: To characterize how rehabilitation goals of older patients change over time and to explore professionals’ attitudes toward patient-centered goal-setting and their perspectives on rehabilitation goals. Design: Qualitative interview study. Setting: Three geriatric rehabilitation centers. Subjects: Ten patients (aged ⩾ 80), who had recently received inpatient geriatric rehabilitation, and seven professionals were purposively recruited. Methods: Semi-structured interviews. Patients were interviewed in the third or fourth week after discharge from inpatient rehabilitation, to reflect on their inpatient goals and to investigate long-term goals now that they were at home. A thematic analysis was performed. Results: During inpatient rehabilitation, participants’ main goals were regaining independence in self-care activities and going home. Post-discharge, patients were not at their baseline functioning level. Rehabilitation goals appeared to shift over time, and once at home, patients formulated more ambitious rehabilitation goals that were related to regaining full independence and being able to perform activities. Although professionals thought goal-setting together with the patient is important, they also stated that older individuals often are either unable to formulate goals or they set unrealistic ones. In addition, professionals indicated that goals have to be related to discharge criteria, such as performing basic self-care activities, and rehabilitation revolves around getting patients ready for discharge. Conclusion: During inpatient rehabilitation, patient goals are related to going home. After discharge, patients have ambitious goals, related to their premorbid functioning level. Rehabilitation services should distinguish between goals that are important while patients are inpatient and goals that are important after discharge.
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Wong, Erin T., Carol Dunham, and Demetris Patsios. "Qualitative Assessment of Pain Management in Patients Undergoing Computed Tomography-Guided Transthoracic Lung Biopsy." Pain Research and Management 19, no. 3 (2014): 149–52. http://dx.doi.org/10.1155/2014/194519.
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BACKGROUND: Unpublished questionnaire data collected by the authors’ institution (Toronto General Hospital, Toronto, Ontario) indicates that patients often experience significant pain while undergoing lung biopsy, yet receive only a fraction of the maximum allowable dosage of analgesic.OBJECTIVES: To qualitatively assess current pain management practices from the patient perspective. Patient education and patient satisfaction were also evaluated.METHODS: From March through June 2012, participants were contacted via telephone within one week of their procedure until data saturation was reached. The semistructured interviews were based on a study-specific interview template. Thematic analysis of qualitative study data was used to identify recurring interview topics.RESULTS: A consecutive sample of 16 outpatients who had undergone image-guided transthoracic lung biopsy at the authors’ institution were interviewed. None of the study participants reported noteworthy pain associated with the insertion of lung biopsy needles. The most significant pain was caused by positioning within the computed tomography scanner, particularly among participants who were in the prone position. All participants reported high satisfaction with the amount of analgesic received. Potential complications and recovery period details were identified as areas for improved patient education.CONCLUSIONS: At the authors’ institution, pain associated with lung biopsy needle insertion was well controlled. Positional pain is common for patients required to be in the prone position. Potential solutions include increasing awareness of positional pain and instituting additional supportive equipment.
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Mahmoud, Dalia, Stacie Hudgens, Fiona Taylor, Farrah Pompilus, Steve Hwang, and C. L. Beach. "Quality of Life and Productivity Impact of Myelodysplastic Syndromes (MDS): The Patient Perspective." Blood 120, no. 21 (November 16, 2012): 4705. http://dx.doi.org/10.1182/blood.v120.21.4705.4705.
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Abstract Abstract 4705 Background: One of the most important clinical features of myelodysplastic syndromes (MDS) is the presence of chronic anemia which is directly related to fatigue. Patients' experiences of fatigue associated with chronic anemia are well-documented in the literature; however, consensus on measurement of fatigue is lacking. To understand the effect that fatigue has on the health-related quality of life (HRQL) of MDS patients, and the economic burden of the disease, a qualitative interview study was completed. Methods: Following a targeted review of the existing literature, 60-minute face-to-face in-depth qualitative interviews were conducted with MDS patients (n=17) in the US. All patients interviewed had a documented diagnosis of MDS according to the World Health Organization (WHO) 2008 classification. Interviewer questions were open-ended and focused on patients' HRQL and indirect costs associated with the disease. The 12-item Short-Form Health Survey (SF-12v2®) was administered after the interview to gain further insight into the impact on patients' HRQL. Qualitative data was analyzed using a grounded theory approach that combined semi-quantitative and qualitative methods. Results: The mean age of patients interviewed was 70.8 years; 59% of patients were male. The sample included patients of each WHO 2008 classification; the most common diagnosis was refractory cytopenia with multilineage dysplasia (47%). Based on the International Prognostic Scoring System (IPSS), 59% and 41% of patients were diagnosed with low and high risk MDS, respectively, with 76% of patients currently taking treatment for their MDS. Current treatments included erythroid growth factor support (53%; not approved for MDS in the US), hypomethylating agents (18%), and lenalidomide (6%). One patient reported transfusion-dependence (≥2 transactions in the past eight weeks) – however the number of patients receiving occasional transfusions was not recoded. This qualitative study found that MDS is associated with a considerable financial impact to patients. Based on the qualitative interviews with patients, the indirect financial costs reported (i.e., decreased work activities) were equally as burdensome to patients as their direct medical cost for treatment. Seven patients (41%) discussed the impact of MDS on their ability to work, either as a result of fatigue or their constant need for treatment. Patients reported being unable to complete work activities, taking time out of work for medical appointments, and reduced productivity during working hours. Patients also reported financial impacts associated with travel to medical appointments (n=11, 65%), and caregiver assistance with daily activities that patients had difficulty completing as a result of their disease (n=5, 29%). A total of 30 HRQL concepts within 11 domains (Table 1) were spontaneously reported by patients during the interviews, with the largest HRQL impairment being physical activity (n=16, 94%) directly related to patients' fatigue. These results are consistent with findings from the SF-12v2® questionnaire, on which patients scored a mean Physical Functioning domain score of 37.5 (SD 30.28) on a scale from 0–100 where a higher score indicates a better health status. MDS patients also frequently reported the social (n=12, 71%), sleep (n=11, 65%), functional (n=10, 59%), and emotional (n=9, 53%) impacts of the disease. Conclusions: These qualitative findings provide additional insight on the HRQL and financial impact of MDS which has been considered yet not fully articulated in the literature for these patients. Specifically, in addition to decline in HRQL, fatigue and the constant need for treatment in MDS appear to impact patients' work activities as well as their productivity within society. Disclosures: Mahmoud: celgene: Employment. Hudgens:Celgene: Consultancy. Taylor:Celgene: Consultancy. Pompilus:Celgene: Consultancy. Hwang:Celgene: Consultancy. Beach:Celgene: Employment.
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Etkind, Simon Noah, Katherine Bristowe, Katharine Bailey, Lucy Ellen Selman, and Fliss EM Murtagh. "How does uncertainty shape patient experience in advanced illness? A secondary analysis of qualitative data." Palliative Medicine 31, no. 2 (July 10, 2016): 171–80. http://dx.doi.org/10.1177/0269216316647610.
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Background: Uncertainty is common in advanced illness but is infrequently studied in this context. If poorly addressed, uncertainty can lead to adverse patient outcomes. Aim: We aimed to understand patient experiences of uncertainty in advanced illness and develop a typology of patients’ responses and preferences to inform practice. Design: Secondary analysis of qualitative interview transcripts. Studies were assessed for inclusion and interviews were sampled using maximum-variation sampling. Analysis used a thematic approach with 10% of coding cross-checked to enhance reliability. Setting/participants: Qualitative interviews from six studies including patients with heart failure, chronic obstructive pulmonary disease, renal disease, cancer and liver failure. Results: A total of 30 transcripts were analysed. Median age was 75 (range, 43–95), 12 patients were women. The impact of uncertainty was frequently discussed: the main related themes were engagement with illness, information needs, patient priorities and the period of time that patients mainly focused their attention on (temporal focus). A typology of patient responses to uncertainty was developed from these themes. Conclusion: Uncertainty influences patient experience in advanced illness through affecting patients’ information needs, preferences and future priorities for care. Our typology aids understanding of how patients with advanced illness respond to uncertainty. Assessment of these three factors may be a useful starting point to guide clinical assessment and shared decision making.
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Yan, Daisy, Danielle Zamalin, Srita Chakka, Rebecca Krain, Josef Concha, Rui Feng, Sarah Ahmed, Joyce Okawa, and Victoria P. Werth. "Cutaneous lupus concerns from the patient perspective: a qualitative study." Lupus Science & Medicine 8, no. 1 (August 2021): e000444. http://dx.doi.org/10.1136/lupus-2020-000444.
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ObjectiveThere is a need to identify concerns unique to patients with cutaneous lupus erythematosus (CLE), which may not be captured by current common-practice dermatological quality-of-life tools. This study formally characterises what bothers patients with CLE about their disease by conducting semistructured, qualitative interviews.MethodsSixteen patients with CLE were interviewed about how their cutaneous findings impact their daily life. Each interview was transcribed, coded and categorised for recurrent themes. Current CLE activity and damage were also assessed by the Cutaneous Lupus Activity and Severity Index tool.ResultsResponses were categorised into six themes, including Fear of Disease Progression, Unwanted Attention, Self-Consciousness, Physical Signs/Symptoms, Emotional Symptoms and Functional Decline. The most commonly reported themes were Self-Consciousness, mentioned by 13 of 16 (81.3%) patients, Physical Symptoms, mentioned by 12 of 16 (75%), and then Fear of Disease Progression, by 11 of 16 (68.8%). Frequently mentioned physical signs/symptoms included erythema, itch, dyspigmentation, scar and alopecia. The physical signs/symptoms were categorised as activity signs/symptoms, damage signs and other. For activity signs, erythema was mentioned most frequently (5 of 16), then scale (2 of 16). For activity symptoms, itch was mentioned most frequently (6 of 16), then pain (5 of 16). For damage signs, dyspigmentation was mentioned most frequently (4 of 16), followed by scarring (3 of 16). Patients less than 60 years old were more likely to report emotional symptoms than older patients (p<0.05), but there was no significant variation in frequency of reported themes between race, sex or subtype of CLE.ConclusionsThese patient experiences and resultant themes elucidated by this study are worth noting in future standardised estimations of the quality of life of patients with CLE. Additionally, the concerns shown by these interviews are important topics for providers to discuss when evaluating patient disease progression.
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Stuckey, Heather. "Three types of interviews: Qualitative research methods in social health." Journal of Social Health and Diabetes 01, no. 02 (December 2013): 056–59. http://dx.doi.org/10.4103/2321-0656.115294.
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AbstractInterviewing is a primary way of collecting data in qualitative research to direct the participant in responding to a specific research question. In diabetes, this may include “what are the reasons that have contributed to your success in diabetes self-management” or “how do you believe stress impacts your blood glucose?” Three types of interviews are common in social health: (1) Structured; (2) semi-structured; and (3) narrative interview. These range in a format including specified sets of questions to the telling of patient stories in an organic way. This paper describes the differences between these types of interviews and examples of each related to diabetes research.
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Salwan, Aaron, Megan Maroney, and Lisa Tremayne. "Patient-reported perceptions of brexanolone in the treatment of postpartum depression: A qualitative analysis." Mental Health Clinician 12, no. 6 (December 1, 2022): 342–49. http://dx.doi.org/10.9740/mhc.2022.12.342.
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Abstract Introduction Brexanolone demonstrates short-term efficacy for the treatment of postpartum depression (PPD). Postpartum depression is linked to infanticide and maternal suicide, and current treatment often fails to adequately control depressive symptoms. The purpose of this analysis is to further understand the experience(s) of women who have received brexanolone for the treatment of PPD. Methods Semistructured interviews modeled after the theory of planned behavior (TPB) were conducted to assess women's perceptions of treatment for PPD with brexanolone. Women who received treatment with brexanolone at this inpatient facility were eligible to participate in this study. The TPB is often used to predict intention to perform health-related behaviors. Semistructured interviews were recorded and transcribed, and thematic analysis was conducted to identify common ideas across all interviews. Follow-up assessment of depressive and anxious symptoms was also conducted using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Results Five of the 10 women who received treatment with brexanolone at this facility were interviewed, and common themes related to the TPB were analyzed. Attitudes toward brexanolone were favorable, and having a strong support system was a motivating factor in receiving treatment for PPD. Insurance approval, need for childcare, and poor understanding of symptoms of PPD were barriers to receiving treatment with brexanolone. Symptoms of depression and anxiety were rated as low at the time of the follow-up interview as measured by the PHQ-9 (mean 1.6, range 1 to 3) and GAD-7 (mean 2.8, range 2 to 4), respectively. Discussion Brexanolone rapidly and sustainably reduced symptoms of PPD and was well-received by patients. Despite significant barriers to use, women who received treatment with brexanolone advocated for its availability as well as increased awareness of PPD.
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Milosevic, Sarah, Heather Strange, Melanie Morgan, Graeme K. Ambler, David C. Bosanquet, Cherry-Ann Waldron, Emma Thomas-Jones, Debbie Harris, Christopher P. Twine, and Lucy Brookes-Howell. "Exploring patients’ experiences of analgesia after major lower limb amputation: a qualitative study." BMJ Open 11, no. 12 (November 2021): e054618. http://dx.doi.org/10.1136/bmjopen-2021-054618.
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ObjectivesTo explore patient experiences, understanding and perceptions of analgesia following major lower limb amputation.DesignQualitative interview study, conducted as part of a randomised controlled feasibility trial.SettingParticipants were recruited from two general hospitals in South Wales.ParticipantsInterview participants were patients enrolled in PLACEMENT (Perineural Local Anaesthetic Catheter aftEr Major lowEr limb amputatioN Trial): a randomised controlled feasibility trial comparing the use of perineural catheter (PNC) versus standard care for postoperative pain relief following major lower limb amputation. PLACEMENT participants who completed 5-day postoperative follow-up, were able and willing to participate in a face-to-face interview, and had consented to be contacted, were eligible to take part in the qualitative study. A total of 20 interviews were conducted with 14 participants: 10 male and 4 female.MethodsSemi-structured, face-to-face interviews were conducted with participants over two time points: (1) up to 1 month and (2) at least 6 months following amputation. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach.ResultsInterviews revealed unanticipated benefits of PNC usage for postoperative pain relief. Participants valued the localised and continuous nature of this mode of analgesia in comparison to opioids. Concerns about opioid dependence and side effects of pain relief medication were raised by participants in both treatment groups, with some reporting trying to limit their intake of analgesics.ConclusionsFindings suggest routine placement of a PNC following major lower limb amputation could reduce postoperative pain, particularly for patient groups at risk of postoperative delirium. This method of analgesic delivery also has the potential to reduce preoperative anxiety, alleviate the burden of pain management and minimise opioid use. Future research could further examine the comparison between patient-controlled analgesia and continuous analgesia in relation to patient anxiety and satisfaction with pain management.Trial registration numberISRCTN: 85710690; EudraCT: 2016-003544-37.
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Katzberg, Hans D., Vera Bril, Sarah Riaz, and Carolina Barnett. "Qualitative, Patient-Centered Assessment of Muscle Cramp Impact and Severity." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, no. 6 (August 27, 2019): 735–41. http://dx.doi.org/10.1017/cjn.2019.286.
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ABSTRACT:Background:There is an urgent need for new therapeutic options to treat muscle cramps; however, no patient-reported measures exist that capture the entire cramp experience. We conducted a qualitative study to assess the experience of patients suffering muscle cramps, aiming to understand what factors determine the impact cramps have in patients’ lives to guide the development of a patient-centered outcome measure of cramp severity and impact.Methods:We enrolled patients with cramps due to several etiologies, including motor neuron disease, pregnancy-induced cramps, cirrhosis and hemodialysis, and idiopathic and exercise-induced cramps. Patients participated in semistructured interviews about their experiences with muscle cramps and their responses were recorded and transcribed. Data were analyzed with content analysis using data saturation to determine the sample size. We subsequently developed a conceptual framework of cramp severity and overall cramp impact.Results:Ten patients were interviewed when data saturation was reached. The cramp experience was similar across disease and physiological states known to cause muscle cramps. The main themes that compose the overall cramp impact are cramp characteristics, sleep interference, daytime activities interference, and the effect on mental health.Conclusions:This framework will be used to develop a patient-reported outcome of cramp severity and impact.
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Gehrke-Beck, Sabine, Mareike Bänfer, Nina Schilling, Konrad Schmidt, Jochen Gensichen, and Christoph Heintze. "The specific needs of patients following sepsis: a nested qualitative interview study." BJGP Open 1, no. 1 (January 16, 2017): bjgpopen17X100725. http://dx.doi.org/10.3399/bjgpopen17x100725.
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BackgroundSurvivors of sepsis suffer from multiple critical disease sequelae when discharged to primary care. There is a lack of structured aftercare programmes and case managers may be helpful in caring for patients with chronic critical disease.AimTo gain insight into the functioning of a structured aftercare programme for post-sepsis patients in general practice.Design & settingA qualitative study using semi-structured interviews with patients and GPs across Germany who participated in an randomised controlled trial of a structured aftercare programme for post-sepsis patients, which included patient education and case manager monitoring.MethodQualitative interviews with 19 patients and 13 GPs were audiorecorded, transcribed verbatim, and analysed using qualitative content analysis.ResultsPatients appreciated the information given in the patient education session, but some disliked it because it reminded them of their serious illness. GPs appreciated patient education because well-informed patients are more likely to participate in follow-up. Patients appreciated the case monitoring because it made them feel safer and more cared for and helped them reflect on their health issues. However, some patients felt uncomfortable with the regular questioning. GPs appreciated the case management programme because they received regular clinical information. However some GPs were wary of the clinical relevance of the information, the delegation of the patient to the nurse, and efficiency of time. Both patients and GPs requested more clinical support, such as easier access to psychotherapists.ConclusionIn general, both patients and their GPs appreciated patient education and monitoring following sepsis. Patients’ retrospections and worries about their serious illness need to be considered.
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O’Loughlin, Kristen, Hannah M. Shadowen, Amber D. Haley, Jennifer Gilbert, Paulette Lail Kashiri, Ben Webel, Amy G. Huebschmann, and Alex H. Krist. "Patient Preferences for Discussing and Acting on Health-Related Needs in Primary Care." Journal of Primary Care & Community Health 13 (January 2022): 215013192211159. http://dx.doi.org/10.1177/21501319221115946.
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Background: Addressing social needs, health behaviors, and mental health may help patients more than traditional medical care. However, these root causes of poor health are difficult to address and the role of primary care is unclear. This qualitative study assesses patient’s willingness and motivations to discuss and accept assistance for these needs from their primary care team. Methods: In July and August of 2020, semi-structured virtual interviews were conducted with family medicine patients (n = 6) and residents of low resource neighborhoods (n = 11) in Richmond, Virginia. Interviews were conducted over Zoom. We conducted a qualitative analysis of patient and resident interview transcripts. A rapid qualitative analysis approach and immersion-crystallization processes were used to identify themes and categories. Results: Interviewees reported varying degrees of comfort discussing topics with their health care team. They were less comfortable discussing needs they considered outside the realm of “traditional primary care” including finances, transportation, and housing, but interviewees expressed willingness to discuss these needs under certain conditions. Important factors were a strong patient-clinician relationship to create a trusted and safe space for discussion, adequate time for discussion during visits, communication of practices’ ability to provide resources to help patients, and ensuring appropriate high quality referrals. Conclusions: Primary care provides opportunity for identifying and addressing needs that adversely impact health. Some needs are more sensitive for patients to work with their care team on, though, there was willingness to work on any need when a strong provider relationship and clinic structure for providing support were in place. This study highlights critical care delivery factors which may be used to enhance patient comfort accepting support for their needs and ultimately improve clinical care and chronic disease management.
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White, Louise, Nicola R. Heneghan, Navin Furtado, Annabel Masson, and Alison B. Rushton. "Patient journey following lumbar discectomy surgery: protocol for a single-centre qualitative analysis of the patient rehabilitation experience (DiscJourn)." BMJ Open 9, no. 8 (August 2019): e025814. http://dx.doi.org/10.1136/bmjopen-2018-025814.
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IntroductionLumbar discectomy is a widely used surgical procedure internationally with the majority of patients experiencing significant benefit. However, approximately 20% of patients report suboptimal functional recovery and quality of life. The impact and meaning of the surgical experience from the patients’ perspective are not fully understood. Furthermore, there is limited evidence guiding postoperative management with significant clinical practice variation and it is unclear if current postoperative support is valued, beneficial or meets patients’ needs and expectations. This study aims to address the evidence gap by moving beyond current knowledge to gain insight into the lived experiences relating to patients’ lumbar discectomy surgery journey. Results will inform more meaningful and specific care, thus, enhance rehabilitation and outcomes.Methods and analysisA qualitative investigation using interpretative phenomenology analysis (IPA) will provide a flexible inductive research approach. A purposive sample (n=20) of patients undergoing primary discectomy will be recruited from one UK NHS secondary care centre. Semi-structured interviews will be conducted postsurgery discharge. A topic guide, developed from the literature and our previous work with input from two patient co-investigators, will guide interviews with the flexibility to explore interesting or patient-specific points raised. Providing longitudinal data, patients will keep weekly diaries capturing experiences and change over time throughout 12 months following surgery. A second interview will be completed 1 year postsurgery with its topic guide informed by initial findings. This combination of patient interviews and diaries will capture patients’ attitudes and beliefs regarding surgery and recovery, facilitators and barriers to progress, experiences regarding return to activities/function and interactions with healthcare professionals. The rich density of data will be thematically analysed in accordance with IPA, supported by NVivo software.Ethics and disseminationEthical approval has been granted by the London-Bloomsbury Research Ethics Committee (18/LO/0459; IRAS 241345). Conclusions will be disseminated through conferences and peer-reviewed journals.
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Sheehan, Lusi, Sheldon Dias, Michael Joseph, Sahil Mungroo, Jake Pantinople, and Kenneth Lee. "Primary Care Wound Clinics: A Qualitative Descriptive Study of Patient Experiences in Community Pharmacies." Pharmacy 10, no. 4 (August 17, 2022): 99. http://dx.doi.org/10.3390/pharmacy10040099.
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The expansion of primary care wound services serves to alleviate secondary and tertiary care utilization. However, patient satisfaction is required to ensure service uptake. In recent years, various community pharmacies in Australia have begun to offer dedicated wound clinics; however, evaluations of patient experiences have yet to be conducted. Thus, the present study seeks to explore: (1) the experiences and satisfaction of patients who have received wound care consultations for their acute wounds in a community pharmacy setting; and (2) how current pharmacy-based wound services can be improved. Semi-structured individual interviews were conducted with patients across five pharmacy-based wound care clinics in Western Australia. Interviews were audio-recorded, transcribed verbatim, and imported into QSR NVivo 12 Plus. Interview transcripts were coded and thematically analyzed using the framework method. Twelve interviews were required to reach data saturation. Five key themes emerged: the accessibility of wound services, the comprehensiveness of wound care services, confidence in wound care consultants, the awareness and promotion of wound services, and the expansion of wound care services. Overall, participants were satisfied with the accessibility and comprehensiveness of pharmacy-based wound service delivery, trusted the health care providers, and wanted the service to be expanded. The reported patient satisfaction, confidence in the health care provider, and desire to expand the service suggests there is potential for the service to grow in Australia. Due to the growing costs of wound care globally, there is scope to further evaluate and expand wound care services in the primary care setting on an international level.
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Van der Voorden, Michael, Kees Ahaus, and Arie Franx. "Explaining the negative effects of patient participation in patient safety: an exploratory qualitative study in an academic tertiary healthcare centre in the Netherlands." BMJ Open 13, no. 1 (January 2023): e063175. http://dx.doi.org/10.1136/bmjopen-2022-063175.
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ObjectiveAlthough previous studies largely emphasize the positive effects of patient participation in patient safety, negative effects have also been observed. This study focuses on bringing together the separate negative effects that have been previously reported in the literature. This study set out to uncover how these negative effects manifest themselves in practice within an obstetrics department.DesignAn exploratory qualitative interview study with 16 in-depth semistructured interviews. The information contained in the interviews was deductively analysed.SettingThe study was conducted in one tertiary academic healthcare centre in the Netherlands.ParticipantsPatients (N=8) and professionals (N=8) from an obstetrics department.ResultsThe results of this study indicate that patient participation in patient safety comes in five different forms. Linked to these different forms, four negative effects of patient participation in patient safety were identified. These can be summarised as follows: patients’ confidence decreases, the patient–professional relationship can be negatively affected, more responsibility can be demanded of the patient than they wish to accept and the professional has to spend additional time on a patient.ConclusionThis study identifies and brings together four negative effects of patient participation in patient safety that have previously been individually identified elsewhere. In our interviews, there was a consensus among patients and professionals on five different forms of participation that would allow patients to positively participate in patient safety. Further studies should investigate ways to prevent and to mitigate the potential negative effects of patient participation.
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Merker, Vanessa, Liesel Von Imhof, Elyse Park, Dusica Babovic-Vuksanovic, PhiOanh [Leia] NghiemPhu, Kaleb Yohay, and Scott Plotkin. "CLRM-16 PATIENT-FOCUSED DRUG DEVELOPMENT IN NEURO-ONCOLOGY: A PILOT STUDY OF QUALITATIVE PATIENT INTERVIEWS EMBEDDED WITHIN A NEUROFIBROMATOSIS 2 CLINICAL TRIAL." Neuro-Oncology Advances 4, Supplement_1 (August 1, 2022): i9. http://dx.doi.org/10.1093/noajnl/vdac078.036.
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Abstract BACKGROUND The Food and Drug Administration recently issued guidance on conducting qualitative research to support patient-focused drug development. In prior FDA submissions, qualitative data has been critical to demonstrate the content validity of and meaningfulness of change in quantitative trial endpoints. Qualitative patient interviews embedded within neuro-oncology trials can supplement traditional quantitative measures by providing nuanced information on patients’ treatment priorities, benefit/risk assessments, and quality of life. METHODS We interviewed people with neurofibromatosis 2 (NF2) in stage one of the brigatinib arm of a multicenter, phase II, adaptive platform-basket trial for progressive NF2-related tumors (NCT04374305). Transcripts were coded by two analysts using a hybrid inductive/deductive framework; cross-cutting themes were generated using the Framework Method. RESULTS 16/20 trial enrollees participated in interviews May 2021-March 2022. The radiographic response rate (volume shrinkage ≥20% from baseline) at 6 months for target and non-target tumors was 5% and 22%, respectively. However, most participants rated their change in overall status as minimally (10/16) or much (3/16) improved. Several participants acknowledged their tumor size had not changed significantly but felt tumor stability was an improvement over previously accelerated growth rates; this importantly allowed them to avoid or postpone future surgery. Participants also valued prevention of symptomatic decline, minimal impact of side effects on social roles and activities, the convenience of oral medication, and the sense of hope and agency gained from participating in a trial. CONCLUSIONS Virtual, in-depth qualitative interviews were feasible across multiple sites and provided unique information on NF2 patients’ conceptualization of clinical benefit. Qualitative interviews embedded within neuro-oncology trials can reveal 1) whether trial design and choice of outcome measures align with patient priorities; 2) whether and how new treatments improve patients’ quality of life; and 3) what degree of change in quantitative measures such as radiographic progression are clinically meaningful.