scholarly journals Midwifery-led care embedded within primary care: consumer satisfaction with a model in New Zealand

2014 ◽  
Vol 6 (4) ◽  
pp. 319
Author(s):  
Susan Pullon ◽  
Ben Gray ◽  
Monika Steinmetz ◽  
Claire Molineux
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Pilot Study ◽  
Focus Group ◽  
Focus Groups ◽  
Maternity Care ◽  
Consumer Satisfaction ◽  
Service Providers ◽  
Analytic Approach ◽  
Model Of Care

INTRODUCTION: Providing quality maternity care for high-needs, socially deprived women from ethnic minority groups is challenging. Consumer satisfaction with maternity services is an important aspect of service evaluation for this group. This pilot study aimed to investigate the feasibility of using focus groups and interviews to gauge consumer satisfaction of maternity care by high-needs women, and to explore their perceptions of the Newtown Union Health Service (NUHS) model of a midwifery-led service embedded in primary care in Wellington, New Zealand (NZ). METHODS: Following a previous audit of consumer satisfaction surveys collected over a six-year period, a qualitative pilot study using a thematic analytic approach was conducted at the NUHS in late 2011. The study assessed use of focus groups and interviews, interpreted where necessary, and considered the experiences reported by women about the model of care. FINDINGS: Interviews and focus groups were successfully conducted with 11 women: two NZ European (individual interviews), six Cambodian (five in a focus group, one interview), and three Samoan (focus group). Using a thematic analytic approach, key themes identified from the focus group and interviews were: issues with survey form-filling; importance of accessibility and information; and relationships and communication with the midwifery team. CONCLUSION: Interviews and focus groups were well received, and indicated positive endorsement of the model of care. They also revealed some hitherto unknown concerns. Good quality feedback about satisfaction with a range of maternal and child health services helps service providers to provide the best possible start in life for children in high-needs families. KEYWORDS: Interprofessional; maternity care; New Zealand; patient care team; primary health care

Information-seeking to Support Personal and Community Wellbeing: Report of a study of New Zealand Men Using Focus Groups

2016 ◽  
Author(s):  
Peta Wellstead
Keyword(s):  
New Zealand ◽  
Focus Groups ◽  
Support Services ◽  
Information Seeking ◽  
Service Providers ◽  
Structural Constraints ◽  
Health And Wellbeing ◽  
Study Results ◽  
Groupes De Discussion

This paper reports part of an ongoing study exploring the information behaviour of New Zealand men during periods of diminished health and wellbeing. Focus groups were used for this iteration of the study. Results indicate that New Zealand men face both personal and structural constraints to their information-seeking during periods when their health and wellbeing may be compromised. This study highlights that service providers need to develop more effective information delivery mechanisms and support services for men. These services need to be appealing to men and reflect men’s information seeking preferences. The role of LIS professionals in supporting this endeavour is discussed. Cet article présente une étude en cours explorant le comportement informationnel d’ hommes néo-zélandais durant des périodes où leur état de santé et de bien-être est amoindri. Des groupes de discussion ont été utilisés pour cette itération de l'étude. Les résultats indiquent que les hommes en Nouvelle-Zélande font face à des contraintes à la fois  personnelles et structurelles dans leur recherche d'information pendant les périodes où leur santé et leur bien-être peuvent être affaiblis. Cette étude met en évidence le besoin pour les fournisseurs de services de développer des mécanismes de diffusion de l'information plus efficaces et des services de soutien pour les hommes. Ces services doivent être attrayants et refléter les préférences des hommes dans leurs recherches d’information. Le rôle des professionnels de l'information dans le soutien à cette entreprise est discuté.

scholarly journals Perceptions of Malaysian medical students from different academic years on primary care: a qualitative research

2020 ◽  
Vol 8 (1) ◽  
pp. e000188
Author(s):  
Sook Ching Chan ◽  
Jaya Vinoshairine Ganeson ◽  
Jee Tat Ong ◽  
Sandheep Sugathan
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Focus Group ◽  
Focus Groups ◽  
Primary Care Practice ◽  
Care Practice ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Medical College ◽  
Career Pathway

ObjectiveTo explore the perception of medical students from a private medical college in Perak, Malaysia, on primary care practice and induce the factors influencing their perception and willingness to consider primary care as a career pathway.DesignQualitative study using focus group discussions. Participants’ responses were audio recorded, transcribed, grouped under various domains and listed out and analysed.SettingA private medical college in Perak state, Malaysia.ParticipantsForty-six medical students from years 2 to 5 were included. Eight focus groups were formed with two focus groups from each academic year (six students each in seven groups and four students in one group). Students were informed through their respective student leader of each year and received a participant information sheet and an informed consent form which were completed and returned if they decided to participate in the focus group discussions.ResultsThe participants had different levels of understanding of primary care depending on their level of exposure to primary care. Senior students with more exposure had a better understanding about primary care and its services. Attractive factors towards choosing primary care as a career included short working hours with a more balanced family and social life, being able to treat patients as a whole with continuity of care and closer relationship with patients. Unattractive factors included routine, unchallenging and boring practice, poor salary, work overload and administrative work in government clinics, being less recognised by other specialties; and the poor perception by other doctors that those pursuing primary care were not ‘brilliant enough’ for more ‘sophisticated disciplines like surgery or paediatrics’.ConclusionThis study showed that the medical students’ level of exposure to primary care played a crucial role in determining their understanding of primary care practice and their choice of career in primary care. Issues to be addressed include remuneration, workload and the prejudice against primary care as a career pathway. Suggestions included introducing early exposure to fun and challenging primary care postings in the medical curriculum and producing well trained, skilled and enthusiastic role models.

scholarly journals Evidence in Practice – A Pilot Study Leveraging Companion Animal and Equine Health Data from Primary Care Veterinary Clinics in New Zealand

2016 ◽  
Vol 3 ◽  
Author(s):  
Petra Muellner ◽  
Ulrich Muellner ◽  
M. Carolyn Gates ◽  
Trish Pearce ◽  
Christina Ahlstrom ◽  
...  
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Pilot Study ◽  
Companion Animal ◽  
Health Data

scholarly journals Exploring the Barriers and Levers to Hand Hygiene of Nursing and Medical Staff in Emergency Departments: A Mixed Methods Study

2021 ◽  
Author(s):  
◽  
Lorraine Rees
Keyword(s):  
Mixed Methods ◽  
New Zealand ◽  
Focus Group ◽  
Hand Hygiene ◽  
Focus Groups ◽  
Emergency Departments ◽  
Medical Staff ◽  
Healthcare Workers ◽  
Mixed Methods Study ◽  
Doctors And Nurses

<p>Background: Emergency Departments (ED) frequently host patients with undiagnosed infectious conditions and patients who are vulnerable to infection. Minimising the risk of exposure to infectious diseases is a priority in healthcare and is managed using a variety of strategies. Hand hygiene (HH) underpins these strategies, but ED have lagged behind improvement in HH compared to other units in New Zealand public hospitals. Given the consequences of healthcare associated infections (HAI), further investigation is warranted to identify barriers and levers to HH in the challenging environment of ED.  The aim of this explanatory sequential mixed methods study was to identify barriers and levers to HH practice in two ED in New Zealand.  Design: The mixed methods study was conducted in two phases. In Phase One, a questionnaire was used to survey nurses and doctors in the two ED sites. In Phase Two, follow-on focus groups were used to explore in-depth, specific aspects of the survey results.  Methods: In Phase One, doctors and nurses in the ED sites were surveyed to identify perceived barriers and levers of HH. A previously validated questionnaire from the United Kingdom was used. Following piloting, the questionnaire was circulated via email to all doctors and registered nurses. Results were analysed descriptively. Areas identified as strong barriers and levers to HH practice were identified, and used to inform development of a focus group interview guide.  In Phase Two, focus group participants were identified from a self-selected convenience sample of survey respondents. Focus groups were audio-recorded and data transcribed verbatim into NVivo Pro 11 before undergoing thematic analysis.  Results: The survey was distributed to doctors (n= 81) and nurses (n= 214). The response rate was low (11% for nurses, 12% for doctors). Two focus groups (n=6 & n=2) and one face to face interview (n=1) was held with nurses participating in each session. No medical staff participated in this phase of data collection. All respondents had worked in healthcare more than three years. Healthcare workers identified that professional role was the strongest lever for HH (93.1%, n=95), closely followed by knowledge and skills (84.3%, n=86). Healthcare workers demonstrated an awareness of benefits of HH including improving patient confidence and avoidance on infection for the patient and themselves (65.9%, n= 89). 45.6% (n=62) of responses identified a lack of encouragement or role modelling in this area of practice.  The physical environment in the ED was a major barrier (53.7%, n=73) although shorter stays in ED were not perceived as a barrier to HH (73.5%, n= 25). High patient turnover and acuity were also perceived as barriers to HH. HH initiatives were perceived to have a marginal effect (55.3%, n=57). Social influences and communication were further barriers to HH, with healthcare workers identifying discomfort when challenging others about HH.  Conclusion: Current barriers to HH including the environmental challenges, and social and cultural barriers to HH need to be addressed. Hand hygiene education that targets known challenges in, and misunderstandings about practice, need to be developed. Organisations must clearly articulate expectations of HH through policy and procedure, including a commitment to address non-compliance. Doctors and nurses should be supported in developing strategies to effectively communicate about, and challenge HH practices. With organisational support and a harnessing of the professional responsibilities that doctors and nurses hold, there is opportunity to strengthen barriers and mitigate barriers to HH.</p>

Using theories from group psychotherapy to understand group process in multicultural focus groups: A pilot study

2019 ◽  
Vol 53 (2) ◽  
pp. 210-233
Author(s):  
Kryst E. Cedeño ◽  
Samantha A. Diaz ◽  
Neil K. Aggarwal
Keyword(s):  
Pilot Study ◽  
Focus Group ◽  
Cultural Competence ◽  
Focus Groups ◽  
Group Psychotherapy ◽  
Practice Guidelines ◽  
Group Process ◽  
Group Processes ◽  
American Group

This study explores the applicability of the American Group Psychotherapy Association’s (AGPA) Practice Guidelines for Group Psychotherapy to analyse the construction of group processes in three focus groups with patients, clinicians, and administrators on cultural competence. Each focus group was recorded, transcribed, and analysed through codes developed from the AGPA’s Guidelines. Findings were compared and contrasted to discover thematic convergences and divergences. Our results show that certain processes such as catharsis, imparting information, and universality emerged commonly across all three focus groups, but with different frequencies. Group processes influenced how participants interacted and influenced each other in their responses, suggesting the value of analysing group processes in multicultural focus groups.

Māori and Tauiwi nurses’ perspectives of anti-racism praxis: findings from a qualitative pilot study

2020 ◽  
Vol 16 (4) ◽  
pp. 387-394
Author(s):  
Jacquie Kidd ◽  
Heather Came ◽  
Sarah Herbert ◽  
Tim McCreanor
Keyword(s):  
Professional Development ◽  
New Zealand ◽  
Pilot Study ◽  
Focus Groups ◽  
Indigenous Peoples ◽  
Broad Spectrum ◽  
Qualitative Design ◽  
Aotearoa New Zealand ◽  
Kaupapa Māori

This pilot study explored Māori (Indigenous peoples of Aotearoa (New Zealand)) and Tauiwi (non-Māori) nurses’ perspectives of anti-racism. A critical qualitative design was utilised, informed by kaupapa Māori (Māori philosophical approaches). Senior nurses with more than 7 years experience were recruited for focus groups. Two focus groups, one Māori ( n = 5) and one Tauiwi ( n = 4), were conducted September 2019 in Auckland. Data were analysed using the framework of a continuum of praxis which included themes of (a) problematic or racist, (b) variable and (c) proactive or anti-racism. Problematic praxis included examples of racism and White fragility. Variable praxis included Māori language and commitment to professional development. Proactive praxis included Māori workforce and reflexivity. These overarching themes illustrate a broad spectrum of anti-racism praxis within nursing. This continuum illustrated with examples is a potentially useful tool to assess and build proactive anti-racism praxis in nursing.

Cancer survivorship care in rural community: Provider perspective.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 50-50
Author(s):  
Katia Noyes ◽  
David Holub ◽  
Irfan Rizvi ◽  
Alex Swanger ◽  
Coty Reisdorf ◽  
...  
Keyword(s):  
Primary Care ◽  
Focus Group ◽  
Focus Groups ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Financial Incentives ◽  
Primary Care Physicians ◽  
Performance Metrics ◽  
Care Delivery ◽  
Successful Implementation

50 Background: Advances in oncologic sciences have resulted in successful treatments for many cancers with improved survival for millions of patients. Efficient delivery of cancer care now requires not only skills and professionalism of each provider but also well-orchestrated performances of multiple oncology, primary care and social services providers acting as one multidisciplinary team. It is unknown, however, whether providers are prepared for and accept their new roles in patient cancer care teams across region. This study assessed perspectives of providers involved in care for patients with cancer about their changing roles. Methods: We conducted a focus group with a diverse group of stakeholders involved in cancer care (2 primary care physicians, 1 rural surgeon, 2 rural oncologists, 2 oncology nurses, 2 cancer patients and a caregiver). The focus group was conducted using ThinkTank software, a collaborative tool that allows participants to communicate virtually in real time, screen share, express preferences and confidentially rank each other responses. We also conducted two traditional focus groups with rural care managers, nurses, social workers and public health providers. Results: The focus groups identified significant differences in attitudes and beliefs toward regional team-based cancer care between various providers. PCPs ranked oncology issues as less important to their practices compared to other chronic conditions associated with performance metrics and financial incentives. APPs ranked care coordination issues as more important compared to PCP rankings from the same practices. Rural providers identified limited staffing, outdated health IT systems, and lack of expertise as major barriers to multidisciplinary team care. Both patients and providers highlighted importance of trust and face-to-face communication in treatment adherence and choice of care setting. Conclusions: Current health information systems, performance metrics and payment models represent significant barriers to integrated care delivery in oncology and survivorship. Successful implementation of efficient and sustainable regional oncology program will require a multi-dimensional intervention to address each of these barriers.

scholarly journals POS0156-HPR ‘THE RIGHT ADVICE, IN THE RIGHT WAY AND AT THE RIGHT TIME’: AN INNOVATIVE MULTIDISCIPLINARY APPROACH TO ADDRESS CLIENT-IDENTIFIED PARTICIPATION NEEDS IN EARLY INFLAMMATORY ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 291.3-291
Author(s):  
Y. Codd ◽  
R. Mullan ◽  
D. Kane ◽  
A. Coe ◽  
T. Stapleton
Keyword(s):  
Focus Groups ◽  
Inflammatory Arthritis ◽  
Service Providers ◽  
Early Arthritis ◽  
Service Users ◽  
Model Of Care ◽  
Individual Interviews ◽  
Participation Restrictions ◽  
The Right ◽  
Life Roles

Background:Inflammatory arthritis (IA) is a complex life-long disease with negative consequences on occupational performance and significant impact on meaningful life roles. International guidelines for the clinical management of IA consistently recommend early intervention and a multidisciplinary (MDT) approach as the optimum method to address the medical, symptom and broader life impacts, however, barriers to timely access to the MDT is a common issue in clinical practice. Limited research has explored how clinical services support broader life impacts and participation restrictions associated with early disease as part of routine healthcare. Four rheumatology services in Ireland have recently reconfigured to provide an MDT-led early arthritis service which operates in parallel to traditional medical clinics. Staffed by nurses, occupational therapists, and physiotherapists this service provides assessment and management to clients with a new diagnosis of IA along a model of care within four to six weeks of diagnosis with mechanisms to follow the client over their first year of diagnosis.Objectives:To explore how a novel MDT-led early arthritis service addresses client-identified participation restrictions associated with early IA.Methods:A qualitative description (QD) study was used to explore the perspectives of service providers and service users of this MDT-led early arthritis service. Data were gathered using one-off focus groups with service providers, and individual interviews with service users.Results:All staff (n=15) currently working in these services participated in the focus groups. Forty-three service users with IA participated in individual interviews (males n=12: females n=31); diagnosis duration ranged from 5 to 24 months. QD principles and thematic analysis were used in data analysis.Extensive limitations in everyday activity and restriction in participation in meaningful, age-appropriate life roles in early IA were outlined by service users and service providers. Participants described how the MDT-led model provided automatic and immediate access to services focussed on identification and management of occupation-based participation restrictions early in the disease. Participants described how the model used a flexible approach that ensured; ease of early access to a full MDT, prolonged support from the MDT, and a person-centred approach incorporating social prescribing and self-management principles. Service users emphasised the strength of the MDT approach of providing ‘the right advice, in the right way and at the right time’ as the most influential feature that assisted them to address participation restrictions and support positive health outcomes. This was accomplished by the service providers acting in a coordinated and interdisciplinary manner with a clear remit to address participation restrictions alongside the traditional symptom management approach. Findings highlight the feasibility of the MDT-led early arthritis model as an approach to address participation-based restrictions as part of routine healthcare that delivers on the rheumatology guidelines and was positively regarded by both service users and service providers.Conclusion:Findings provide important insights into the role of an innovative early MDT intervention approach in addressing client-identified participation needs in early IA. This model maps onto the Irish rheumatology model of care (HSE, 2018), ‘right place, right time’ approach but importantly includes a ‘right way’ approach which is identified as influential in the effective delivery of client-focussed and client-centred care.References:[1]HSE. (2018). Model of care for rheumatology in Ireland. Retrieved 15/09/2019, https://www.hse.ie/eng/about/who/cspd/ncps/rheumatology/achievements/model-of-care-for-rheumatology-in-ireland.pdfAcknowledgements:The authors, thank you to the research sites who facilitated this study & the service providers and service users who partook in the research. Thank you to Kildare Branch of Arthritis Ireland who provided funding support for the researchDisclosure of Interests:None declared

scholarly journals Implementation of a Complex Health Services Intervention in Long-term Care Homes: A Process Evaluation Using Focus Groups

2020 ◽  
Author(s):  
Rieka von der Warth ◽  
Vanessa Kaiser ◽  
Christina Reese ◽  
Boris A. Brühmann ◽  
Erik Farin-Glattacker
Keyword(s):  
Primary Care ◽  
Nursing Homes ◽  
Focus Group ◽  
Focus Groups ◽  
Medical Care ◽  
Process Evaluation ◽  
The Elderly ◽  
Focus Group Interviews ◽  
Total N ◽  
Group Interviews

Abstract BackgroundWith increasing numbers of the elderly living in nursing homes in Germany, the need for on-site primary care increases. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. Therefore, project CoCare (“coordinated medical care”) implements a complex health intervention in nursing homes, using among others regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports the results of a process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.MethodsFocus group interviews were held between the fall of 2018 and the fall of 2019 with nursing staff, general practitioners and medical assistants working in or consulting a participating nursing home. A half-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis. ResultsIn total, N=11 focus group interviews with N= 74 participants were conducted. Ten main themes with seven subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to talk most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding CoCare had prevented unnecessary hospitalizations. Main barriers were understaffing and complexity of the program.ConclusionImplementation of CoCare in nursing homes is complex and holds some barriers. However, the overall acceptance was good and first positive results were reported by participants. Furthermore, the project provides a good structure to overcome potential barriers.Trial Registration: German Clinical Trial Register (DRKS00012703)

scholarly journals Implementation of a complex health services intervention in long-term care homes: a process evaluation using focus groups

2020 ◽  
Author(s):  
Rieka von der Warth ◽  
Vanessa Kaiser ◽  
Christina Reese ◽  
Boris A. Brühmann ◽  
Erik Farin-Glattacker
Keyword(s):  
Primary Care ◽  
Nursing Homes ◽  
Focus Group ◽  
Focus Groups ◽  
Medical Care ◽  
Process Evaluation ◽  
The Elderly ◽  
Focus Group Interviews ◽  
Total N ◽  
Group Interviews

Abstract BackgroundWith rising numbers of the elderly living in nursing homes in Germany, the need for on-site primary care is on the increase. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. The CoCare (“coordinated medical care”) project has therefore implemented a complex health intervention in nursing homes, using inter alia, regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports upon the results of the process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.MethodsFocus group interviews were held between the fall of 2018 and the fall of 2019 with nurses, general practitioners and GP´s assistants working in or consulting a participating nursing home. A semi-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis. ResultsIn total, N=11 focus group interviews with N=74 participants were conducted. Eleven main themes with four subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to speak most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding that CoCare had prevented unnecessary hospitalizations. The main barriers were understaffing and complexity of the program.ConclusionImplementation of CoCare in nursing homes is complex and presents some barriers. However, the overall acceptance was good and participants reported the first positive results. Furthermore, the project provides a good structure to overcome potential barriers. However, some adaptions to the implementation process should be made.

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