scholarly journals Physicians' attitudes towards psycho‐oncology, perceived barriers, and psychosocial competencies: Indicators of successful implementation of adjunctive psycho‐oncological care?

2018 ◽  
Vol 28 (2) ◽  
pp. 415-422 ◽  
Author(s):  
Bianca Senf ◽  
Jens Fettel ◽  
Christina Demmerle ◽  
Paula Maiwurm
Keyword(s):  
Perceived Barriers ◽  
Successful Implementation ◽  
Oncological Care ◽  
Psychosocial Competencies

scholarly journals Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 2: Attitudes, Beliefs, Accessibility, and Barriers

2013 ◽  
Vol 48 (3) ◽  
pp. 405-415 ◽  
Author(s):  
Cailee W. McCarty ◽  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Eric J. Newton ◽  
Bonnie L. Van Lunen
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Trainers ◽  
Perceived Barriers ◽  
Successful Implementation ◽  
Evidence Based ◽  
Attitudes And Beliefs ◽  
Athletic Training Educators ◽  
Personal Skills

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students. Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training educators (n = 24) and postprofessional students (n = 71). Main Outcome Measure(s): Likert-scale items (1 = strongly disagree, 4 = strongly agree) assessed attitudes and beliefs and perceived barriers, whereas multipart questions assessed accessibility to resources. Kruskal-Wallis H tests (P ≤ .05) and Mann-Whitney U tests with a Bonferroni adjustment (P ≤ .01) were used to determine differences among groups. Results: Athletic trainers agreed (3.27 ± 0.39 out of 4.0) that EBP has various benefits to clinical practice and disagreed (2.23 ± 0.42 out of 4.0) that negative perceptions are associated with EBP. Benefits to practice scores (P = .002) and negative perception scores (P < .001) differed among groups. With respect to perceived barriers, athletic trainers disagreed that personal skills and attributes (2.29 ± 0.52 out of 4.0) as well as support and accessibility to resources (2.40 ± 0.40 out of 4.0) were barriers to EBP implementation. Differences were found among groups for personal skills and attributes scores (P < .001) and support and accessibility to resources scores (P < .001). Time (76.6%) and availability of EBP mentors (69.6%) were the 2 most prevalent barriers reported. Of the resources assessed, participants were most unfamiliar with clinical prediction rules (37.6%) and Cochrane databases (52.5%); direct access to these 2 resources varied among participants. Conclusions: Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.

scholarly journals Faculty Members' Attitude, Perceived Barriers, and Motivators toward Using E-Learning in University Education

2020 ◽  
Vol 2 (4) ◽  
pp. 12
Author(s):  
Wessam A. Elsayed ◽  
Shaimaa M. Nageeb ◽  
Walaa N. Othman
Keyword(s):  
Personal Characteristics ◽  
Faculty Members ◽  
Learning System ◽  
Perceived Barriers ◽  
University Education ◽  
Successful Implementation ◽  
Training Environment ◽  
Faculty Attitude ◽  
E Learning ◽  
Barriers And Motivators

Context: E-learning is an important trend for faculty members and students teaching and learning, which needs overcoming barriers and enhancing motivators for the successful implementation of educational programs. Aim: To explore the faculty members' attitudes, perceived barriers, and motivators toward using e-learning in university education. Methods: Descriptive correlational design was used to achieve the study's aim on 110 faculty members in Nursing Faculties at Mansoura, and Zagazig Universities, Egypt. They were chosen through a convenience sampling to participate in the study. One questionnaire was used to undertake the study and had four parts: Personal data, faculty attitude towards e-learning scale, possible barriers, and motivators. Results: 54.5% of the studied sample was from Mansoura University, 92.7% of them were females, 38.2% were lecturers, 31.8% of them aged from 31-35 years old, and 30% of them had 5-10 years of experience. More than 75% of studied faculty members have a positive attitude toward using e-learning in university education. Access to students was the top-most barrier as perceived by the faculty members (42.7%). Better internet bandwidth at the workplace is the top-most motivating factor and professional incentives to use e-learning. Both were mentioned by 30% of the studied faculty members. Conclusion: There is a highly significant positive correlation between faculty attitude and motivators and a significant negative correlation between perceived barriers and motivators. At the same time, there is no significant correlation between faculty attitude and perceived barriers. No significant correlation between personal characteristics of the studied sample and faculty members' attitudes, perceived barriers, and motivators toward using E-learning in Mansoura and Zagazig Universities except for gender and faculty barriers only in Mansura University. The study recommended enhancing the basics of e-learning within the plan for dealing with crises, improving infrastructure, and providing a training environment for faculty staff to enhance e-learning, activating interactive education by setting up discussion sessions on the course topics' sidelines—full activation of the e-learning system through assignments and short tests. Paying attention to student feedback and taking the necessary corrective measures are also recommended.             

scholarly journals Mixed method survey to assess the problems and propose solutions for implementation of CME/CPD in Sindh, Pakistan

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Nighat Ali Shah ◽  
Marium Soomro ◽  
Mehjabeen Musharraf ◽  
Shiraz Shaikh
Keyword(s):  
Mixed Method ◽  
Original Work ◽  
Career Progression ◽  
Perceived Barriers ◽  
Mixed Method Study ◽  
Successful Implementation ◽  
Creative Commons ◽  
Qualitative Component ◽  
Depth Interviews ◽  
Open Access Article

Objectives: To determine the type of CME/CPD sessions attended by doctors, identify the problems with implementation of CME/CPD program and propose possible solutions for successful implementation of CME/CPD Program. Methods: This was a concurrent triangulation mixed method study. Quantitative questionnaires were filled by faculty and physicians from different specialties. The qualitative component had both focus groups and in depth interviews conducted with different professional bodies (PMA), faculty JSMU, College of Family Physicians. This study was done in 2016-2017. Results: More than half of the participants (53.6%) reported that CPD/CME should be mandatory. Doctors who had graduated from outside Karachi were significantly less likely to report CPD/CME to be mandatory as compared to graduates from Karachi (p=0.004).Top three factors which influenced HCP’s to attend CPD/CME included career progression (65.1%), interest (54.7%) and knowledge gap (50.5%). The most common perceived barriers were lack of study leave, cost and work-life imbalance. The implementation issues expressed by different stakeholders included lack of doctor’s interest, busy clinical schedule and poor accessibility. Conclusion: Mostly medical practioners believe that CPD program is an important step toward enabling physicians to demonstrate their competency and professionalism to themselves and others. The PM&DC has to take practical steps to evaluate the cognitive, clinical, and humanistic attributes of certified doctors. How to cite this:Shah N, Soomro M, Musharraf M, Shaikh S. Mixed method survey to assess the problems and propose solutions for implementation of CME/CPD in Sindh, Pakistan. Pak J Med Sci. 2019;35(2):555-560.  doi: https://doi.org/10.12669/pjms.35.2.243 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Framework Development for an Immediate Postpartum Long-Acting Reversible Contraception Program

2020 ◽  
Vol 13 (1) ◽  
pp. 25-30
Author(s):  
Jessica Poulsen ◽  
Kylea Liese
Keyword(s):  
Critical Time ◽  
The United States ◽  
Perceived Barriers ◽  
Successful Implementation ◽  
Time Period ◽  
Complex Process ◽  
Maternal Morbidity And Mortality ◽  
Long Acting ◽  
Framework Development ◽  
E Mail

BackgroundWith the high rates of unintended pregnancy and associated maternal morbidity and mortality in the United States, particularly among poor and minority women, it is imperative that all individuals have information about and access to long-acting reversible contraception (LARC) methods in the immediate postpartum period.ObjectiveThe creation of a framework to provide guidance, address barriers, and dispel myths associated with the implementation of an immediate postpartum LARC program.MethodsA multistep approach to develop a framework to guide planning and implementation of an immediate postpartum LARC program. A literature review, telephone and e-mail interviews with clinical experts involved with successful implementation of immediate postpartum LARC programs, development of a list of interdisciplinary specialists, and steps required to initiate a change in current practice.ResultsThe provision of a framework to guide the planning and implementation of an immediate postpartum LARC program to streamline the process while addressing perceived barriers and myths.ConclusionsAddressing the lack of knowledge about LARCs, financial concerns, and absence of a standardized framework related to planning and implementation of this complex process will hopefully begin the process of making effective and reliable contraception available.Implications for NursingThe use of a standardized framework to guide the implementation of an immediate postpartum LARC program provides the potential for easier access to LARC methods in this critical time period.

scholarly journals Using Theoretical Domains Framework to Identify Barriers and Enablers to Implementing a Virtual Tertiary-regional Telemedicine Rounding and Consultation (TRaC-K) Model for Kids: A Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Sumedh Bele ◽  
Christine Cassidy ◽  
Janet Curan ◽  
David W. Johnson ◽  
J A Michelle Bailey
Keyword(s):  
Rural Areas ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Theoretical Domains Framework ◽  
Perceived Barriers ◽  
Successful Implementation ◽  
Access To Health Services ◽  
Barriers And Enablers ◽  
Pediatric Hospitals ◽  
Regional Hospitals

BACKGROUND Inequities in access to health services is a global concern and a concern for Canadian populations living in rural areas. Rural children hospitalized at tertiary children’s hospitals have higher rates of medical complexity and experience more expensive hospitalizations and more frequent readmissions. The two tertiary pediatric hospitals in Alberta, Canada have already been operating over capacity, but the pediatric beds at regional hospitals are underutilized. Such imbalance could lead to poor patient safety, and increased readmission risk at tertiary pediatric hospitals and diminish the clinical exposure of regional pediatric healthcare providers, erode their confidence, and compel health systems to further reduce the capacity in regional sites. A “Telemedicine Rounding and Consultation for Kids” (TRaC-K) model was proposed to enable healthcare providers at the Alberta Children’s Hospital to partner with their counterparts in Medicine Hat Regional Hospital to provide inpatient clinical care for pediatric patients who would otherwise have to travel or be transferred to the tertiary site. OBJECTIVE The current study is aimed at identifying perceived barriers and enablers to implementing the TRaC-K model. METHODS This study was guided by the Theoretical Domain Framework (TDF) and utilized qualitative methods. We collected qualitative data from 42 participants from tertiary and regional hospitals through 31 semi-structured interviews and two focus groups. This data was thematically analysed to identify major sub-themes within each TDF domain. These sub-themes were further aggregated themes and categorized into as barriers or enablers to the TRaC-K model and were tabulated separately. RESULTS Our study identified 31 sub-themes in 14 TDF domains ranging from administrative issues to specific clinical conditions. We were able to merge these sub-themes into larger themes and categorize them into 4 barriers and 4 enablers. Our findings showed that barriers were lack of awareness of telemedicine, skills to provide virtual clinical care, and unclear processes and resources to support TRaC-K and concerns about clear roles and responsibilities. To the contrary, enablers were of healthcare providers’ motivation to provide care closer to home, supporting system resource stewardship, site and practice compatibility, and motivation to strengthen tertiary-regional relationships. CONCLUSIONS Systematic enquiry of perceived barriers and enablers to implementation of TRaC-K helped us gain insights from various healthcare providers and family member’s perspectives. We will use these findings to design interventions to overcome the identified barriers and harness the enablers to encourage successful implementation of TRaC-K. These findings will inform the implementation of telemedicine-based interventions in pediatric settings in other parts of Canada and beyond. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1186/s12913-018-3859-2

scholarly journals Patient-reported outcome measures in oncology: a qualitative study of the healthcare professional’s perspective

2021 ◽  
Author(s):  
Caitlin Graupner ◽  
S. O. Breukink ◽  
S. Mul ◽  
D. Claessens ◽  
A. H. M. Slok ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Barriers And Facilitators ◽  
Local Context ◽  
Healthcare Organisation ◽  
Successful Implementation ◽  
Oncological Care ◽  
Patient Reported

Abstract Background In the last decades, the number of cancer survivors has increased significantly due to improved treatment and better detection of recurrence. This increased survival redirects the scope from survival towards optimising functional outcomes and improving health-related quality of life (HRQol). Functional and HRQoL outcomes can be assessed with patient-reported outcome measures (PROMs). However, the use of PROMs in daily oncological care is not common. This qualitative study investigates the barriers and facilitators of PROM use in an oncological setting, from the perspective of the healthcare professionals (HCPs). Methods Individual semi-structured interviews were conducted among Dutch oncological HCPs. Barriers and facilitators of PROM implementation were identified on various levels of the healthcare system (i.e. level of the patient, individual professional, medical team, and healthcare organisation). Interviews were audio recorded and transcribed verbatim. Transcripts were manually analysed by two independent reviewers using a thematic approach. Identified barriers and facilitators were categorised into Grol and Wensing’s framework for changing healthcare practice. Results Nineteen oncological HCPs working in academic and non-academic hospitals were interviewed. Barriers for PROM implementation were lack of good IT support, lack of knowledge on how to use PROMs, lack of time to complete and interpret PROMs, and a high administrative burden. PROM implementation can be facilitated by providing clear guidance regarding PROM interpretation, evidence that PROMs can save time, and stimulating multidisciplinary teamwork. Conclusion From a HCP point of view, adequately functioning IT technology, sufficient knowledge on PROMs, and dedicated time during the consultation are essential for successful implementation of PROMs in oncological care. Additional local context-specific factors need to be thoroughly addressed.

scholarly journals A Novel Emergency Telepsychiatry Program in a Canadian Urban Setting: Identifying and Addressing Perceived Barriers for Successful Implementation: Un nouveau programme de télépsychiatrie d’urgence en milieu urbain canadien: Identifier et aborder les obstacles perçus d’une mise en œuvre réussie

2020 ◽  
Vol 65 (8) ◽  
pp. 559-567
Author(s):  
Jennifer Hensel ◽  
Reid Graham ◽  
Corinne Isaak ◽  
Naweed Ahmed ◽  
Jitender Sareen ◽  
...  
Keyword(s):  
Implementation Strategies ◽  
Wait Time ◽  
Perceived Barriers ◽  
Urban Setting ◽  
Care Staff ◽  
First Year ◽  
Successful Implementation ◽  
Hub And Spoke ◽  
Patient Transfers ◽  
Milieu Urbain

Objectives: To report on the perceived barriers surrounding the use of telepsychiatry for emergency assessments and our approach to overcoming those barriers to achieve successful implementation of a program to increase access to emergency psychiatric assessment in a Canadian urban setting. Methods: We conducted a survey of emergency care staff to inform the implementation of an emergency telepsychiatry program in the urban setting of Winnipeg, Manitoba, where hospitals have variable on-site emergency psychiatric coverage. We analyzed survey responses for perceived barriers we would need to address in implementation. We employed implementation strategies for each barrier and scaled the program to three sites over the first year. Data from the first year were collected including number of telepsychiatry assessments, reasons for referral, wait time, and percentage of patient transfers avoided. Results: Survey respondents ( N = 111) had little prior exposure to telepsychiatry, but the majority were open to its use for emergency psychiatric assessments in the region. We identified three categories of perceived barriers: clinical, logistical/technical, and readiness barriers. Implementation planning addressed each barrier, and a hub-and-spoke program was launched. After the first year, the program had one hub serving three spokes, and 243 emergency telepsychiatry assessments had been completed. After 12 months, we were avoiding 65% of patient transfers. Conclusions: By conducting a user survey to identify perceived barriers, and addressing these during implementation, we successfully scaled our emergency telepsychiatry program across our region. Our report of this experience may benefit others attempting to implement a similar program.

scholarly journals Barriers and Facilitators When Implementing Web-Based Disease Monitoring and Management as a Substitution for Regular Outpatient Care in Pediatric Asthma: Qualitative Survey Study (Preprint)

2017 ◽  
Author(s):  
Lara S van den Wijngaart ◽  
Wytske W Geense ◽  
Annemie LM Boehmer ◽  
Marianne L Brouwer ◽  
Cindy AC Hugen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Outpatient Care ◽  
Organizational Context ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Survey Study ◽  
Disease Monitoring ◽  
Successful Implementation ◽  
Web Based

BACKGROUND Despite their potential benefits, many electronic health (eHealth) innovations evaluated in major studies fail to integrate into organizational routines, and the implementation of these innovations remains problematic. OBJECTIVE The purpose of this study was to describe health care professionals’ self-identified perceived barriers and facilitators for the implementation of a Web-based portal to monitor asthmatic children as a substitution for routine outpatient care. Also, we assessed patients’ (or their parents) satisfaction with this eHealth innovation. METHODS Between April and November 2015, we recruited 76 health care professionals (from 14 hospitals). During a period of 6 months, participants received 3 questionnaires to identify factors that facilitated or impeded the use of this eHealth innovation. Questionnaires for patients (or parents) were completed after the 6-month virtual asthma clinic (VAC) implementation period. RESULTS Major perceived barriers included concerns about the lack of structural financial reimbursement for Web-based monitoring, lack of integration of this eHealth innovation with electronic medical records, the burden of Web-based portal use on clinician workload, and altered patient-professional relationship (due to fewer face-to-face contacts). Major perceived facilitators included enthusiastic and active initiators, a positive attitude of professionals toward eHealth, the possibility to tailor care to individual patients (“personalized eHealth”), easily deliverable care according to current guidelines using the VAC, and long-term profit and efficiency. CONCLUSIONS The implementation of Web-based disease monitoring and management in children is complex and dynamic and is influenced by multiple factors at the levels of the innovation itself, individual professionals, patients, social context, organizational context, and economic and political context. Understanding and defining the barriers and facilitators that influence the context is crucial for the successful implementation and sustainability of eHealth innovations.

Perception and barriers to virtual medicine in Hispanics and underrepresented populations.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 169-169
Author(s):  
Alvaro G. Menendez ◽  
Katarina Bade ◽  
Emily Hsu ◽  
Jyoti Chhabra
Keyword(s):  
Behavioral Interventions ◽  
Multivariable Analysis ◽  
Healthcare Delivery ◽  
Perceived Barriers ◽  
Healthcare Outcomes ◽  
Chi Square ◽  
Oncological Care ◽  
Home Based ◽  
Significant Difference ◽  
Virtual Medicine

169 Background: Perceptions and barriers to virtual medicine (VM) in Hispanics and underrepresented population (H/UP) are unknown. We investigated these parameters in a multicenter oncology trial in hopes of improving quality of care and minimizing potentially negative healthcare outcomes related to this increasingly popular healthcare delivery (HD) technique. Methods: An IRB-approved, 14-item questionnaire was offered in English and Spanish to all pts. receiving care at participating cancer centers over a 6-month period. Examined variables included demographic information, preferences and perceived barriers regarding VM. Multivariable analysis was performed using Chi Square test to determine association between demographic variables and participants preferences and perceived barriers. Results: A total of 180 pts were enrolled. H/UP rely more on social media to receive health information (32.6% vs 23.9%) as opposed to face-to-face. Fewer H/UP have received oncological care through VM (27.9% vs 32.9%) despite comparable preferences regarding incorporation or exclusive use of VM in HD (23.2 % vs 24.6%). Similar levels of satisfaction with current HD methods were reported (83.7% vs 86%). No significant difference by age, level of education, marital status or Hispanic ethnicity was noted although Spanish as primary language was statistically significant (p = 0.001) in patient satisfaction and preferences regarding use of VM. H/UP involve family members more frequently through VM (48.8% vs 29.1). H/UP have more technical barriers to VM as they were up to 2.6 times more likely to not have a phone/ipad/similar or have access to broadband connectivity (23.3% vs 9%; and 16.3% vs 8.2% respectively). Conclusions: H/UP are equally interested and satisfied in receiving oncological care through VM. Given the shift towards outpatient and home-based care, an aging population, and cultural appropriations, VM excitedly allows re-incorporation of family/caregiver in medical engagement. However, fewer H/UP are currently utilizing VM which could be secondary to H/UP’s specific barriers or healthcare bias. Although behavioral interventions may be explored, H/UP barriers are predominantly technical and targetable with appropriate policies that take into consideration institutional and reimbursement programs.

scholarly journals Analysis of States' Barriers to and Progress Toward Implementation of Health and Safety Policies for Secondary School Athletics

2019 ◽  
Vol 54 (4) ◽  
pp. 361-373 ◽  
Author(s):  
Alicia M Pike ◽  
William M. Adams ◽  
Robert A. Huggins ◽  
Stephanie M. Mazerolle ◽  
Douglas J. Casa
Keyword(s):  
Secondary School ◽  
Policy Implementation ◽  
Heat Stroke ◽  
Sudden Cardiac Arrest ◽  
Health And Safety ◽  
Perceived Barriers ◽  
Successful Implementation ◽  
Safety Policy ◽  
Key Stakeholders

Context Implementation of health and safety best practices for the leading causes of sudden death and catastrophic injury has been shown to mitigate risk. However, to our knowledge, no authors have examined progress toward health and safety policy implementation at the state level. Objective To investigate the progress made by state secondary school leaders in developing and implementing health and safety policies (ie, exertional heat stroke, sudden cardiac arrest, concussion, emergency action plans) and to explore perceived barriers to and strategies for implementation. Design Mixed-methods study. Setting State high school athletics associations and sports medicine advisory committees. Patients or Other Participants Collaborative Solutions for Safety in Sport meeting attendees participated in this study. Thirty-five state leaders (current role experience = 8 ± 6 years) completed the survey. Ten of the 35 participated in follow-up interviews. Data Collection and Analysis A survey assessing progress on health and safety policy implementation was administered. Respondents indicated whether their state had implemented a policy, made progress without implementation, or made no progress. We conducted follow-up telephone interviews so they could expand on the survey responses. The data were analyzed using descriptive statistics and the general inductive approach. Results A total of 89% of respondents reported their states made progress on or implemented health and safety policies during the 2015–2016 academic year. Barriers to policy implementation included cost, a lack of understanding regarding policies versus recommendations, the content and value of policy change, and a false sense of security. Strategies for implementation included varying approaches to change, education of all constituents, and collaborative relationships among key stakeholders. Conclusions Although a majority of respondents reported progress in implementing health and safety policies in their states, perceived barriers pointed to the need for the continued education of state leaders in charge of developing and implementing health and safety policies. Despite these barriers, collaboration among key stakeholders is crucial to successful implementation of best-practice policies in secondary school athletics.

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