A nursing intervention aimed at reducing symptom burden during chemotherapy (CHEMO-SUPPORT): A mixed-methods study of the patient experience

2018 ◽  
Vol 34 ◽  
pp. 35-41 ◽  
Author(s):  
Annemarie Coolbrandt ◽  
Koen Milisen ◽  
Hans Wildiers ◽  
Bert Aertgeerts ◽  
Theo van Achterberg ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Patient Experience ◽  
Symptom Burden ◽  
Nursing Intervention ◽  
Mixed Methods Study

scholarly journals Comparing ERAS-Outpatient Versus Standard-Inpatient Hip and Knee Replacements: A Mixed Methods Study Exploring the Experience of Patients Who Underwent Both

2021 ◽  
Author(s):  
Alexandre Hardy ◽  
Jonathan Gervais-Hupé ◽  
François Desmeules ◽  
Anne Hudon ◽  
Kadija Perreault ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Pain Management ◽  
Clinical Outcomes ◽  
Patient Experience ◽  
Mixed Methods Study ◽  
P Value ◽  
Outpatient Program ◽  
Operative Care ◽  
Patients Experience ◽  
Outpatient Programs

Abstract BACKGROUND Optimizing patients’ total joint arthroplasty (TJA) experience is as crucial for providing high quality care as improving safety and clinical effectiveness. Yet, little evidence is available on patient experience in standard-inpatient and enhanced recovery after surgery (ERAS)-outpatient programs. Therefore, this study aimed to gain a more in-depth understanding of the patient experience by exploring the patient experience of ERAS-outpatient programs compared to standard-inpatient programs, identifying elements that could optimize patients’ experience and determining how it is associated with patient characteristics, clinical outcomes and care components satisfaction. METHODS We conducted a convergent mixed methods study of 48 consecutive patients who experienced both standard-inpatient and ERAS-outpatient TJA contralaterally. A reflective thematic analysis was conducted based on data collected via a questionnaire. Bivariate correlations between the patient experience and patients’ characteristics, clinical outcomes and care components satisfaction were performed. Then, the quantitative and qualitative data were integrated together. RESULTS The theme Support makes the difference—for better and for worse was identified in both programs and throughout the entire TJA care episode. Patients identified 3 main themes distinguishing the ERAS-outpatient program from their standard-inpatient experience: 1) Minimizing inconvenience, 2) Home sweet home and 3) Returning to normal function and activities. Providing more preoperative information and postoperative rehabilitation sessions (if needed) and ensuring better coherence of care between orthopaedic and homecare teams could further optimize the patient experience. Weak to moderate positive and statistically significant correlations were found between patients’ TJA experience and satisfaction with pain management, hospital stay, postoperative recovery, homecare and overall results (rs = + [0.36–0.66], p-value < 0.01) CONCLUSION Whatever the perioperative program, the key to improving patients’ TJA experience lies in improving support throughout the care episode. Compared to standard-inpatient care, the ERAS-outpatient program improves patients’ experience by providing dedicated support in post-operative care, reducing postoperative inconvenience, optimizing pain management, returning home sooner, and recovering and regaining function sooner. Patients’ TJA experience could further be enhanced by optimizing the information provided to the patient, the rehabilitation program and the coherence between care teams.

The patient experience of musculoskeletal imaging tests for investigation of inflammatory arthritis: a mixed-methods study

2017 ◽  
Vol 37 (8) ◽  
pp. 2261-2268 ◽  
Author(s):  
Sandra Bourke ◽  
William J. Taylor ◽  
Anthony J. Doyle ◽  
Merryn Gott ◽  
Nicola Dalbeth
Keyword(s):  
Mixed Methods ◽  
Patient Experience ◽  
Inflammatory Arthritis ◽  
Mixed Methods Study ◽  
Musculoskeletal Imaging

Feasibility of a nursing intervention to prepare frail older patients for cardiac surgery: A mixed-methods study

2014 ◽  
Vol 14 (4) ◽  
pp. 342-351 ◽  
Author(s):  
Roelof Ettema ◽  
Marieke J Schuurmans ◽  
Bernadette Schutijser ◽  
Mark van Baar ◽  
Nicole Kamphof ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mixed Methods ◽  
Older Patients ◽  
Nursing Intervention ◽  
Mixed Methods Study

What Matters Most? A Mixed Methods Study of Critical Aspects of a Home-Based Palliative Program

2017 ◽  
Vol 35 (2) ◽  
pp. 236-243 ◽  
Author(s):  
Claire K. Ankuda ◽  
Kaileen Kersting ◽  
Timothy C. Guetterman ◽  
Jessica Haefner ◽  
Evan Fonger ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Social Services ◽  
Functional Disability ◽  
Symptom Burden ◽  
Mixed Methods Study ◽  
Spiritual Support ◽  
Medical Monitoring ◽  
Home Based ◽  
The Impact

Background: Home-based palliative care programs have shown value in improving quality of care and lowering costs for seriously ill patients. It is unknown what specific elements of these programs matter most to patients and caregivers. Aim: To identify what services are critical and why they matter to patients in a home-based palliative program. Setting/Participants: A mixed methods study of 18 participants in the At Home Support (AHS) program in Southeast Michigan. Measurements: Two semistructured interviews were conducted for each participant, one while enrolled in AHS and another 3 months after the program ended to elicit the impact of AHS on their care. Qualitative theme data were merged with quantitative data on demographics, social and financial resources, symptoms, medical conditions, functional status, and utilization of health care while in AHS. Results: Four major themes of critical services reported by distinct populations of participants were described—medical support, endorsed by nearly every participant; emotional and spiritual support, endorsed by those with serious illness and symptom burden; practical assistance, endorsed by those with functional disability and isolation; and social services, endorsed by those in poverty. Medical monitoring was also described as critical but only by healthier participants. Conclusion: This study presents a conceptual model of the critical services in home-based palliative care and why these services are important to high-risk patients. This model may be used to guide further research and evaluation work on the benefits of home-based palliative care.

scholarly journals User Experience of Mobile Personal Health Records for the Emergency Department: Mixed Methods Study

10.2196/24326 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e24326
Author(s):  
Su Min Kim ◽  
Taerim Kim ◽  
Won Chul Cha ◽  
Jae-Ho Lee ◽  
In Ho Kwon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mixed Methods ◽  
User Experience ◽  
Patient Experience ◽  
Medical Information ◽  
Personal Health Records ◽  
Mixed Methods Study ◽  
Health Conditions ◽  
Personal Health ◽  
Health Records

Background Personal health records (PHRs) can be useful in the emergency department, as they provide patient information in an accurate and timely manner and enable it to be used actively. This has an effect on patients’ health outcomes and patient experience. Despite the importance of PHRs in emergencies, there are only a few studies related to PHRs in emergencies that evaluate patient experience. Objective This study aims to introduce the novel mobile PHR (mPHR) platform to emergency environments and assess user experience. Methods The study was conducted from October 2019 to November 2019. In total, 1000 patients or carers in the emergency departments of 3 hospitals were provided an application-based service called FirstER, which was developed to collect and utilize medical information for patients in the emergency department. This study was performed as a mixed methods study. After using FirstER, we investigated its usability and conducted a survey on the experience of obtaining medical information with a legacy system and with FirstER. Additionally, we interviewed 24 patients to gain insight into their experiences regarding medical information using FirstER. For the quantitative analysis, the survey results were analyzed using descriptive statistics (mean and standard deviation). For the qualitative analysis, we determined the keywords and their frequencies from each survey question and interview question. Results In total, 1000 participants, consisting of both patients and carers, were recruited in this study. Their mean age was 41.4 (SD 13.3) years. We ascertained participants’ satisfaction with FirstER and their mPHR needs through a survey and an in-depth interview. With the current system, participants were not well aware of their health conditions and medical information, and they were passive in the use of their medical information and treatment. However, they wanted their medical information for several reasons, such as information sharing and managing their health conditions. FirstER provided participants with their needed information and an easy way to access it. The mean System Usability Scale (SUS) value was 67.1 (SD 13.8), which was considered very near to acceptable. Conclusions This study is the first to implement mPHRs in the emergency department of large tertiary hospitals in the Republic of Korea. FirstER was found to enhance user experience in emergencies, as it provided necessary medical information and proper user experience. Moreover, the average SUS was 67.1, which means that participants found FirstER to be very near to acceptable. This is very encouraging in that FirstER was developed within a very short time, and it was a pilot study. Trial Registration Clinicaltrials.gov NCT04180618; https://clinicaltrials.gov/ct2/show/NCT04180618

scholarly journals The Impact of Non-Pharmacological Interventions on Patient Experience, Opioid Use, and Healthcare Utilization in Adult Cardiac Surgery Patients: Protocol for a Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Alexander A. Brescia ◽  
Julie R. Piazza ◽  
Jessica N. Jenkins ◽  
Lindsay K. Heering ◽  
Alexander J. Ivacko ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mixed Methods ◽  
Healthcare Utilization ◽  
Patient Experience ◽  
Mixed Methods Study ◽  
Opioid Use ◽  
Pharmacological Interventions ◽  
The Impact ◽  
Adult Cardiac Surgery

BACKGROUND Despite pharmacological treatments, patients undergoing cardiac surgery experience severe anxiety and pain which adversely impact outcomes. Prior work examining pediatric and non-surgical adult patients has documented the effectiveness of inexpensive non-pharmacological techniques to reduce anxiety and pain, as well as healthcare costs and length of hospitalization. However, the impact of non-pharmacological interventions administered by a dedicated “comfort coach” has not been evaluated in an adult surgical setting. OBJECTIVE The objective of this trial is to assess whether non-pharmacological interventions administered by a trained comfort coach impact patient experience, opioid use, and healthcare utilization compared to usual care in adult cardiac surgery patients. This study has three specific aims: (1) assess the effect of a comfort coach on patient experience, (2) measure differences in inpatient and outpatient opioid use and postoperative healthcare utilization, and (3) qualitatively evaluate the comfort coach intervention. METHODS To address these aims, we will perform a prospective, randomized controlled trial of 154 adult cardiac surgery patients at Michigan Medicine. Opioid-naive patients undergoing first-time, elective cardiac surgery via sternotomy will be randomized to undergo targeted interventions from a comfort coach (intervention) versus usual care (control). The individualized comfort coach interventions will be administered at six points: (1) preoperative outpatient clinic, (2) preoperative care unit on the day of surgery, (3) extubation, (4) chest tube removal, (5) hospital discharge, and (6) at 30-day clinic follow-up. To address aim 1, we will examine the effect of a comfort coach on perioperative anxiety, self-reported pain, functional status, and patient satisfaction through validated surveys administered at (1) preoperative outpatient clinic, (2) discharge, (3) 30-day follow-up, and (4) 90-day follow-up. For aim 2, we will record inpatient opioid use and collect post-discharge opioid use and pain-related outcomes through an 11-item questionnaire administered at 30-day follow-up. Hospital length of stay, readmission, number of days in an extended care facility, emergency room, urgent care, and at an unplanned doctor’s office visit will be recorded as the primary composite endpoint defined as total days spent at home within the first 30 after surgery. For aim 3, we will perform semi-structured interviews with patients in the intervention arm to understand the comfort coach intervention through a thematic analysis. RESULTS This trial, funded by Blue Cross Blue Shield Foundation of Michigan in 2019, is presently enrolling patients with anticipated manuscript submissions Data generated from this mixed methods study will highlight effective non-pharmacological techniques and support a multidisciplinary approach to perioperative care during the adult cardiac surgery patient experience. Findings from this study may serve as the foundation for a subsequent multicenter trial and broader dissemination of these techniques to other types of surgery.from our primary aims targeted for the end of 2020. CONCLUSIONS Data generated from this mixed methods study will highlight effective non-pharmacological techniques and support a multidisciplinary approach to perioperative care during the adult cardiac surgery patient experience. Findings from this study may serve as the foundation for a subsequent multicenter trial and broader dissemination of these techniques to other types of surgery. CLINICALTRIAL ClinicalTrials.gov NCT04051021; https://clinicaltrials.gov/ct2/show/NCT04051021.

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