Pharmacist-led cardiovascular risk prevention in Western Canada: a qualitative study

2020 ◽  
Author(s):  
Anita I Kapanen ◽  
Annalijn I Conklin ◽  
Barbara Gobis ◽  
Larry Leung ◽  
Jamie Yuen ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Workplace Health Promotion ◽  
Medication Management ◽  
Free Text ◽  
Cvd Risk ◽  
Enabling Factors ◽  
Risk Factor Management ◽  
External Resources ◽  
Participant Engagement ◽  
Risk Management Programme

Abstract Objectives Preventing cardiovascular diseases (CVD) is a public health and policy priority, including for employers. A novel CVD risk management programme that included medication management was delivered by pharmacists to employees of a Canadian university. This qualitative study describes the experiences and perceptions of participants who received individual health consultations in this programme. Methods A qualitative study design using free-text responses was adopted. Data (5658 words) came from evaluation surveys completed by 119 programme participants were iteratively coded and thematically analysed. Key findings We identified four themes characterising participant experiences of pharmacist-led CVD prevention. Theme one was labelled self-efficacy because personalised health information and advice on CVD risk factor management empowered participants to make improvements for their health. Participants expressed a range of positive responses about the longer consultations, supportive communication and safe setting of their pharmacist-led encounters; hence, Theme two is labelled pharmacists’ interpersonal skills. The wider context of the programme included a number of enabling factors (Theme three) that either supported or limited participant engagement in the programme. A number of changes to behaviour and health measures were identified and participant suggestions to expand and continue the programme further contributed to perceptions of positive programme impact (Theme four). Conclusions This study raises questions about how external resources and broader determinants might enable, or hinder, future programme success and sustainability. It also highlights the need for greater understanding and communication of the importance of primary prevention and the role of pharmacists in CVD risk reduction and workplace health promotion.

“I Can’t Go Far”: Perceptions and Experiences of Heart Failure Patients Regarding Physical Activity: A Qualitative Study Using Semistructured Face-to-Face Interviews

2021 ◽  
pp. 109019812110532
Author(s):  
Elodie Charuel ◽  
Martial Bernard ◽  
Hélène Vaillant Roussel ◽  
Benoit Cambon ◽  
Thibault Ménini ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
New York ◽  
General Practitioner ◽  
Qualitative Study ◽  
Heart Association ◽  
Enabling Factors ◽  
Face To Face ◽  
New York Heart Association

Background Participation in regular physical activity (RPA) is beneficial to the quality of life and life expectancy of patients with chronic heart failure (CHF). However, it is inadequate in many patients. Aims To determine the factors that influence the practice of RPA in patients with CHF managed in general practice. Method This was a qualitative study using semistructured, individual face-to-face interviews. Patients with CHF (New York Heart Association Stages 1–3) capable of participating in RPA were enrolled by their general practitioner. A longitudinal and transversal inductive thematic analysis was performed by two researchers. Results Five themes emerged from the 19 interviews that were conducted. Poor knowledge of the disease and the benefits of participating in RPA, as well as the lack of motivation or enjoyment, in particular due to the absence of previous participation, were considered significant obstacles. Fear associated with CHF or other comorbidities was also an obstacle. Attendance at a rehabilitation center, family and social circles, and having a pet all appeared to be beneficial. Family and friends were important for motivating the patient to participate in an activity but could also be an obstacle when they were overprotective. Conclusion This study helps highlight the difficulties for patients with CHF associated with participation in RPA. Despite the obstacles, there are enabling factors on which the general practitioner may rely to motivate their patients.

From the Frontlines: A Qualitative Study of Staff Experiences With Clinical Event Debriefing

2021 ◽  
Author(s):  
Meghan M. Galligan ◽  
Mary Haggerty ◽  
Heather A. Wolfe ◽  
Dawn Debrocco ◽  
Katherine Kellom ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Inductive Reasoning ◽  
Improve Patient Care ◽  
Barriers And Facilitators ◽  
Clinical Event ◽  
Frontline Staff ◽  
Factors Affecting ◽  
Participant Engagement ◽  
Practice Recommendations ◽  
Staff Experiences

OBJECTIVES Clinical event debriefing (CED) can improve patient care and outcomes, but little is known about CED across inpatient settings, and participant experiences have not been well described. In this qualitative study, we sought to characterize and compare staff experiences with CED in 2 hospital units, with a goal of generating recommendations for a hospital-wide debriefing program. METHODS We conducted 32 semistructured interviews with clinical staff who attended a CED in the previous week. We explored experiences with CED, with a focus on barriers and facilitators. We used content analysis with constant comparative coding to understand priorities identified by participants. We used inductive reasoning to develop a set of CED practice recommendations to match participant priorities. RESULTS Three primary themes emerged related to CED barriers and facilitators. (1) Factors affecting attendance: most respondents voiced a need for frontline staff inclusion in CED, but they also cited competing clinical duties and scheduling conflicts as barriers. (2) Factors affecting participant engagement: respondents described factors that influence participant engagement in reflective discussion. They described that the CED leader must cultivate a psychologically safe environment in which participants feel empowered to speak up, free from judgment. (3) Factors affecting learning and systems improvement: respondents emphasized that the CED group should generate a plan for improvement with accountable stakeholders. Collectively, these priorities propose several recommendations for CED practice, including frontline staff inclusion. CONCLUSIONS In this study, we propose recommendations for CED that are derived from first-hand participant experiences. Future study will explore implementation of CED practice recommendations.

scholarly journals Reasons for presenteeism in nurses working in geriatric settings: A qualitative study

2018 ◽  
Vol 7 (4) ◽  
pp. 9 ◽  
Author(s):  
Luke Anthony Fiorini ◽  
Amanda Griffiths ◽  
Jonathan Houdmont
Keyword(s):  
Qualitative Study ◽  
Illness Perceptions ◽  
Workplace Health Promotion ◽  
Chronic Illnesses ◽  
Healthcare Sector ◽  
Workplace Health ◽  
Structured Interviews ◽  
Lost Productivity ◽  
Medical Wards ◽  
Geriatric Settings

Objective: To explore the perceived causes of presenteeism in nurses on geriatric wards.Background: Presenteeism, defined as working when unwell, is associated with lost productivity and increased absenteeism. It is more commonly reported by employees in the healthcare sector than other sectors.Methods: An exploratory, qualitative study using semi-structured interviews, thematically analysed. Data collected via 18 recorded interviews with nurses working with patients on geriatric medical wards in Malta.Results: Four major themes emerged that related to nurses’ decisions to engage in presenteeism: illness perceptions, which included participants’ views and experiences of their own health complaints; attitudes to their employing organisation, co-workers and patients; organisational aspects such as culture and administrative arrangements; and personal reasons including illness behaviour preference and personal circumstances.Conclusions: Nurses’ decisions to attend work when unwell were reported as dependent upon four themes. Further studies are warranted to determine if findings are applicable to nurse populations other than those represented in this study.Implications: Workplace health promotion initiatives should target nurses’ management of their own health, particularly if they have chronic illnesses. Workplace policies and arrangements should be examined with a view to controlling presenteeism.

scholarly journals Cross-sectional analysis of women in neurosurgery: a Canadian perspective

2021 ◽  
Vol 50 (3) ◽  
pp. E13
Author(s):  
Catherine Veilleux ◽  
Nardin Samuel ◽  
Han Yan ◽  
Victoria Bass ◽  
Rabab Al-Shahrani ◽  
...  
Keyword(s):  
Career Success ◽  
Career Advancement ◽  
Fellowship Training ◽  
Steady Increase ◽  
Free Text ◽  
Enabling Factors ◽  
Related Factors ◽  
Cross Sectional ◽  
Quantitative Analyses ◽  
Survey Responses

OBJECTIVEAlthough the past decades have seen a steady increase of women in medicine in general, women continue to represent a minority of the physician-training staff and workforce in neurosurgery in Canada and worldwide. As such, the aim of this study was to analyze the experiences of women faculty practicing neurosurgery across Canada to better understand and address the factors contributing to this disparity.METHODSA historical, cross-sectional, and mixed-method analysis of survey responses was performed using survey results obtained from women attending neurosurgeons across Canada. A web-based survey platform was utilized to collect responses. Quantitative analyses were performed on the responses from the study questionnaire, including summary and comparative statistics. Qualitative analyses of free-text responses were performed using axial and open coding.RESULTSA total of 19 of 31 respondents (61.3%) completed the survey. Positive enabling factors for career success included supportive colleagues and work environment (52.6%); academic accomplishments, including publications and advanced degrees (36.8%); and advanced fellowship training (47.4%). Perceived barriers reported included inequalities with regard to career advancement opportunities (57.8%), conflicting professional and personal interests (57.8%), and lack of mentorship (36.8%). Quantitative analyses demonstrated emerging themes of an increased need for women mentors as well as support and recognition of the contributions to career advancement of personal and family-related factors.CONCLUSIONSThis study represents, to the authors’ knowledge, the first analysis of factors influencing career success and satisfaction in women neurosurgeons across Canada. This study highlights several key factors contributing to the low representation of women in neurosurgery and identifies specific actionable items that can be addressed by training programs and institutions. In particular, female mentorship, opportunities for career advancement, and increased recognition and integration of personal and professional roles were highlighted as areas for future intervention. These findings will provide a framework for addressing these factors and improving the recruitment and retention of females in this specialty.

scholarly journals Cardiovascular disease risk prediction in older people: a qualitative study

2021 ◽  
pp. BJGP.2020.1038
Author(s):  
Denise Ann Taylor ◽  
Katharine Wallis ◽  
Sione Feki ◽  
Sione Segili Moala ◽  
Manusiu He-Naua Esther Latu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Qualitative Study ◽  
Older People ◽  
Focus Groups ◽  
Risk Prediction ◽  
Heart Attack ◽  
Clinical Decision Making ◽  
Community Dwelling ◽  
Cvd Risk

Background: Despite cardiovascular disease (CVD) risk prediction equations becoming more widely available for people aged 75 years and over, views of older people on CVD risk assessment are unknown. Aim: To explore older people’s views on CVD risk prediction and its assessment. Design and Setting: Qualitative study of community dwelling older New Zealanders. Methods: We purposively recruited a diverse group of older people. Semi-structured interviews and focus groups were conducted, transcribed verbatim and thematically analysed. Results: Thirty-nine participants (mean age 74 years) of Māori, Pacific, South Asian and European ethnicities participated in one of 26 interviews or three focus groups. Three key themes emerged, (1) Poor knowledge and understanding of cardiovascular disease and its risk assessment, (2) Acceptability and perceived benefit of knowing and receiving advice on managing personal cardiovascular risk; and (3) Distinguishing between CVD outcomes; stroke and heart attack are not the same. Most participants did not understand CVD terms but were familiar with ‘heart attack,’ ‘stroke’ and understood lifestyle risk factors for these events. Participants valued CVD outcomes differently, fearing stroke and disability which might adversely affect independence and quality of life, but being less concerned about a heart attack, perceived as causing less disability and swifter death. These findings and preferences were similar across ethnic groups. Conclusion: Older people want to know their CVD risk and how to manage it, but distinguish between CVD outcomes. To inform clinical decision making for older people, risk prediction tools should provide separate event types rather than just composite outcomes.

scholarly journals Do Women with Diabetes Need More Intensive Action for Cardiovascular Reduction than Men with Diabetes?

2020 ◽  
Vol 20 (11) ◽  
Author(s):  
Jürgen Harreiter ◽  
Helena Fadl ◽  
Alexandra Kautzky-Willer ◽  
David Simmons
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Meta Analysis ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Risk Factor Management ◽  
High Risk Women ◽  
Background Population ◽  
Cvd Mortality

Abstract Purpose of Review This narrative review makes the case for greater efforts to reduce cardiovascular disease (CVD) risk in women with diabetes. Recent Findings In a recent meta-analysis including five CVOTs of diabetes medications with 46,606 subjects, women (vs men) with type 2 diabetes had a higher relative risk for stroke (RR 1.28; 95% CI 1.09, 1.50) and heart failure (1.30; 1.21, 1.40). Prior studies found higher “within-gender” RR for CVD mortality in women with diabetes although men have an absolute higher risk. Women with prior gestational diabetes mellitus (GDM) have a 2-fold higher CVD risk than the background population. Worse CVD and CVD risk factor management in women, as well as lower female therapy adherence, contribute further to these disparities. Summary The mechanism behind this excess risk includes biological, hormonal, socioeconomic, clinical, and behavioral factors that still require further investigation. The need for more intensive CVD reduction in women now includes more attention to screening for both incident diabetes and CVD risk factors among high-risk women.

scholarly journals Assessing the perceived impact of post Minamata amalgam phase down on oral health inequalities: a mixed-methods investigation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
V. R. Aggarwal ◽  
S. Pavitt ◽  
J. Wu ◽  
B. Nattress ◽  
P. Franklin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Oral Health ◽  
Qualitative Study ◽  
Health Services ◽  
Health Inequalities ◽  
Dental Amalgam ◽  
Free Text ◽  
Oral Health Services ◽  
Phase Out ◽  
The Impact

Abstract Background Data from countries that have implemented a complete phase out of dental amalgam following the Minamata agreement suggest increased costs and time related to the placement of alternatives with consumers absorbing the additional costs. This aim of this study was to investigate the impact of a complete phase out of dental amalgam on oral health inequalities in particular for countries dependent on state run oral health services. Methods A mixed methods component design quantitative and qualitative study in the United Kingdom. The quantitative study involved acquisition and analysis of datasets from NHS Scotland to compare trends in placement of dental amalgam and a survey of GDPs in Yorkshire, UK. The qualitative study involved analysis of the free text of the survey and a supplementary secondary analysis of semi-structured interviews and focus groups with GDPs (private and NHS), dental school teaching leads and NHS dental commissioners to understand the impact of amalgam phase down on oral health inequalities. Results Time-trends for amalgam placement showed that there was a significant (p < 0.05) reduction in amalgam use compared with composites and glass ionomers. However dental amalgam still represented a large proportion (42%) of the restorations (circa 1.8 million) placed in the 2016–2017 financial year. Survey respondents suggest that direct impacts of a phase down were related to increased costs and time to place alternative restorations and reduced quality of care. This in turn would lead to increased tooth extractions, reduced access to care and privatisation of dental services with the greatest impact on deprived populations. Conclusion Amalgam is still a widely placed material in state run oral health services. The complete phase down of dental amalgam poses a threat to such services and threatens to widen oral health inequalities. Our data suggest that a complete phase out is not currently feasible unless appropriate measures are in place to ensure cheaper, long-lasting and easy to use alternatives are available and can be readily adopted by primary care oral health providers.

scholarly journals Time and participation in workplace health promotion: Australian qualitative study

2016 ◽  
pp. daw078 ◽  
Author(s):  
Ginny M Sargent ◽  
Cathy Banwell ◽  
Lyndall Strazdins ◽  
Jane Dixon
Keyword(s):  
Health Promotion ◽  
Qualitative Study ◽  
Workplace Health Promotion ◽  
Workplace Health
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