Management of antithrombotic therapy after gastrointestinal bleeding: A mixed methods study of health‐care providers

2020 ◽  
Vol 19 (1) ◽  
pp. 153-160
Author(s):  
Derek H. W. Little ◽  
Tara Robertson ◽  
James Douketis ◽  
Joanna C. Dionne ◽  
Anne Holbrook ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Gastrointestinal Bleeding ◽  
Health Care Providers ◽  
Antithrombotic Therapy ◽  
Mixed Methods Study ◽  
Care Providers

scholarly journals Health Care Providers’ Knowledge of HPV Vaccination, Barriers, and Strategies in a State With Low HPV Vaccine Receipt: Mixed-Methods Study

JMIR Cancer ◽  
2017 ◽  
Vol 3 (2) ◽  
pp. e12 ◽  
Author(s):  
Echo L Warner ◽  
Qian Ding ◽  
Lisa Pappas ◽  
Julia Bodson ◽  
Brynn Fowler ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Mixed Methods Study ◽  
Care Providers ◽  
Vaccination Barriers

Violence Against Health Care Providers: A Mixed-Methods Study from Karachi, Pakistan

2018 ◽  
Vol 54 (4) ◽  
pp. 558-566.e2 ◽  
Author(s):  
Lubna Ansari Baig ◽  
Shiraz Shaikh ◽  
Maciej Polkowski ◽  
Syeda Kausar Ali ◽  
Seemin Jamali ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Mixed Methods Study ◽  
Care Providers

scholarly journals Medical Students’ Experiences and Outcomes Using a Virtual Human Simulation to Improve Communication Skills: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Timothy C Guetterman ◽  
Rae Sakakibara ◽  
Srikar Baireddy ◽  
Frederick W Kron ◽  
Mark W Scerbo ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Medical Students ◽  
Communication Skills ◽  
Health Care Providers ◽  
Mixed Methods Study ◽  
Virtual Human ◽  
Care Providers ◽  
Empathic Communication ◽  
Nonverbal Skills

BACKGROUND Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)–based simulation, MPathic-VR, was developed to train health care providers in empathic communication with patients and in interprofessional settings and evaluated through a randomized controlled trial. OBJECTIVE This mixed methods study aimed to investigate the differential effects of a VH-based simulation developed to train health care providers in empathic patient-provider and interprofessional communication. METHODS We employed a mixed methods intervention design, involving a comparison of 2 quantitative measures—MPathic-VR–calculated scores and the objective structured clinical exam (OSCE) scores—with qualitative reflections by medical students about their experiences. This paper is a secondary, focused analysis of intervention arm data from the larger trial. Students at 3 medical schools in the United States (n=206) received simulation to improve empathic communication skills. We conducted analysis of variance, thematic text analysis, and merging mixed methods analysis. RESULTS OSCE scores were significantly improved for learners in the intervention group (mean 0.806, SD 0.201) compared with the control group (mean 0.752, SD 0.198; <italic>F</italic><sub>1,414</sub>=6.09; <italic>P</italic>=.01). Qualitative analysis revealed 3 major positive themes for the MPathic-VR group learners: gaining useful communication skills, learning awareness of nonverbal skills in addition to verbal skills, and feeling motivated to learn more about communication. Finally, the results of the mixed methods analysis indicated that most of the variation between high, middle, and lower performers was noted about nonverbal behaviors. Medium and high OSCE scorers most often commented on the importance of nonverbal communication. Themes of motivation to learn about communication were only present in middle and high scorers. CONCLUSIONS VHs are a promising strategy for improving empathic communication in health care. Higher performers seemed most engaged to learn, particularly nonverbal skills.

scholarly journals Validation and Acceptability of a Cuffless Wrist-Worn Wearable Blood Pressure Monitoring Device Among Users and Health Care Professionals: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Susie Cartledge ◽  
Chandan Karmakar ◽  
Jonathan Charles Rawstorn ◽  
Steve F Fraser ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Mixed Methods Study ◽  
Care Providers ◽  
Long Term Monitoring ◽  
Term Monitoring

BACKGROUND Blood pressure (BP) is an important modifiable cardiovascular risk factor, yet its long-term monitoring remains problematic. Wearable cuffless devices enable the capture of multiple BP measures during everyday activities and could improve BP monitoring, but little is known about their validity or acceptability. OBJECTIVE This study aimed to validate a wrist-worn cuffless wearable BP device and assess its acceptability among users and health care professionals. METHODS A mixed methods study was conducted to examine the validity and comparability of a wearable cuffless BP device against ambulatory and home devices. BP was measured simultaneously over 24 hours using wearable and ambulatory devices and over 7 days using wearable and home devices. Pearson correlation coefficients compared the degree of association between the measures, and limits of agreement (LOA; Bland-Altman plots) were generated to assess measurement bias. Semistructured interviews were conducted with users and 10 health care professionals to assess acceptability, facilitators, and barriers to using the wearable device. Interviews were audio recorded, transcribed, and analyzed. RESULTS A total of 9090 BP measurements were collected from 20 healthy volunteers (mean 20.3 years, SD 5.4; N=10 females). Mean (SD) systolic BP (SBP)/diastolic BP (DBP) measured using the ambulatory (24 hours), home (7 days), and wearable (7 days) devices were 126 (SD 10)/75 (SD 6) mm Hg, 112 (SD 10)/71 (SD 9) mm Hg and 125 (SD 4)/77 (SD 3) mm Hg, respectively. Mean (LOA) biases and precision between the wearable and ambulatory devices over 24 hours were 0.5 (−10.1 to 11.1) mm Hg for SBP and 2.24 (−17.6 to 13.1) mm Hg for DBP. The mean biases (LOA) and precision between the wearable and home device over 7 days were −12.7 (−28.7 to 3.4) mm Hg for SBP and −5.6 (−20.5 to 9.2) mm Hg for DBP. The wearable BP device was well accepted by participants who found the device easy to wear and use. Both participants and health care providers agreed that the wearable cuffless devices were easy to use and that they could be used to improve BP monitoring. CONCLUSIONS Wearable BP measures compared well against a gold-standard ambulatory device, indicating potential for this user-friendly method to augment BP management, particularly by enabling long-term monitoring that could improve treatment titration and increase understanding of users’ BP response during daily activity and stressors.

An Exploratory Mixed Methods Study of Diabetes self-management in Blind Americans

2021 ◽  
pp. 019394592110194
Author(s):  
Nazanin Heydarian ◽  
Allyson S. Hughes ◽  
Osvaldo F. Morera
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Mixed Methods Study ◽  
Self Management ◽  
Diabetes Distress ◽  
Management Support ◽  
Care Providers ◽  
Health Significance ◽  
Coverage Policy

This study used mixed methods to investigate the experiences of 33 participants who are blind (PWB) and have diabetes in managing their diabetes, support (or lack thereof) from their health care providers, and diabetes distress as PWB. Participants most frequently reported barriers to check blood glucose (55%), maintaining a healthy diet (45%), and distress due to their intersectional status of having blindness and diabetes. Those who mentioned intersectional distress of managing diabetes as a PWB tended to be Braille illiterate and less likely to use mobility tools that are symbolic of blindness (e.g., white cane, guide dog). These results illuminate heterogenous characteristics of PWB with diabetes, an understudied population of public health significance, to be considered when setting priorities for diabetes self-management support and health care coverage policy.

scholarly journals Barriers to Gestational Diabetes Management and Preferred Interventions for Women With Gestational Diabetes in Singapore: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Sumali Hewage ◽  
Jananie Audimulam ◽  
Emily Sullivan ◽  
Claudia Chi ◽  
Tong Wei Yew ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Health Care Providers ◽  
Working Women ◽  
Mixed Methods Study ◽  
Blood Glucose Monitoring ◽  
Care Providers ◽  
Diet Control

BACKGROUND Gestational diabetes mellitus (GDM) is associated with risks for both the mother and child. The escalated prevalence of GDM because of obesity and changes in screening criteria demands for greater health care needs than before. OBJECTIVE This study aimed to understand the perception of patients and health care providers of the barriers to GDM management and preferred interventions to manage GDM in an Asian setting. METHODS This mixed methods study used a convergent parallel design. Survey data were collected from 216 women with GDM, and semistructured interviews were conducted with 15 women and with 8 health care providers treating patients with GDM. Participants were recruited from 2 specialized GDM clinics at the National University Hospital, Singapore. RESULTS The patients were predominantly Chinese (102/214, 47.6%), employed (201/272, 73.9%), with higher education (150/216, 69.4%) and prenatal attendance at a private clinic (138/214, 64.2%), already on diet control (210/214, 98.1%), and receiving support and information from the GDM clinic (194/215, 90.2%) and web-based sources (131/215, 60.9%). In particular, working women reported barriers to GDM management, including the lack of reminders for blood glucose monitoring, diet control, and insufficient time for exercise. Most women preferred getting such support directly from health care providers, whether at the GDM clinic (174/215, 80.9%) or elsewhere (116/215, 53.9%). Smartphone apps were the preferred means of additional intervention. Desirable intervention features identified by patients included more information on GDM, diet and exercise options, reminders for blood glucose testing, a platform to record blood glucose readings and illustrate or understand trends, and a means to communicate with care providers. CONCLUSIONS A GDM-focused smartphone app that is able to integrate testing, education, and communication may be a feasible and acceptable intervention to provide support to women with GDM, particularly for working women.

scholarly journals Health Care Providers’ Trusted Sources for Information About COVID-19 Vaccines: Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Eden Brauer ◽  
Kristen Choi ◽  
John Chang ◽  
Yi Luo ◽  
Bruno Lewin ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Information Sources ◽  
Mixed Methods Study ◽  
Government Agencies ◽  
Advanced Practice ◽  
Care Providers ◽  
Sources Of Information ◽  
Vaccine Information

BACKGROUND Information and opinions shared by health care providers can affect patient vaccination decisions, but little is known about who health care providers themselves trust for information in the context of new COVID-19 vaccines. OBJECTIVE The purpose of this study is to investigate which sources of information about COVID-19 vaccines are trusted by health care providers and how they communicate this information to patients. METHODS This mixed methods study involved a one-time, web-based survey of health care providers and qualitative interviews with a subset of survey respondents. Health care providers (physicians, advanced practice providers, pharmacists, nurses) were recruited from an integrated health system in Southern California using voluntary response sampling, with follow-up interviews with providers who either accepted or declined a COVID-19 vaccine. The outcome was the type of information sources that respondents reported trusting for information about COVID-19 vaccines. Bivariate tests were used to compare trusted information sources by provider type; thematic analysis was used to explore perspectives about vaccine information and communicating with patients about vaccines. RESULTS The survey was completed by 2948 providers, of whom 91% (n=2683) responded that they had received ≥1 dose of a COVID-19 vaccine. The most frequently trusted source of COVID-19 vaccine information was government agencies (n=2513, 84.2%); the least frequently trusted source was social media (n=691, 9.5%). More physicians trusted government agencies (n=1226, 93%) than nurses (n=927, 78%) or pharmacists (n=203, 78%; <i>P</i>&lt;.001), and more physicians trusted their employer (n=1115, 84%) than advanced practice providers (n=95, 67%) and nurses (n=759, 64%; <i>P</i>=.002). Qualitative themes (n=32 participants) about trusted sources of COVID-19 vaccine information were identified: processing new COVID-19 information in a health care work context likened to a “war zone” during the pandemic and communicating information to patients. Some providers were hesitant to recommend vaccines to pregnant people and groups they perceived to be at low risk for COVID-19. CONCLUSIONS Physicians have stronger trust in government sources and their employers for information about COVID-19 vaccines compared with nurses, pharmacists, and advanced practice providers. Strategies such as role modeling, tailored messaging, or talking points with standard language may help providers to communicate accurate COVID-19 vaccine information to patients, and these strategies may also be used with providers with lower levels of trust in reputable information sources.

scholarly journals Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from Myanmar

2019 ◽  
Vol 5 (1) ◽  
pp. 3
Author(s):  
Aye Mon Phyo ◽  
Ajay M. V. Kumar ◽  
Kyaw Thu Soe ◽  
Khine Wut Yee Kyaw ◽  
Aung Si Thu ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Multidrug Resistant ◽  
Mixed Methods Study ◽  
Care Providers ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Contact Investigation ◽  
Mdr Tb

There is no published evidence on contact investigation among multidrug-resistant tuberculosis (MDR-TB) patients from Myanmar. We describe the cascade of contact investigation conducted in 27 townships of Myanmar from January 2018 to June 2019 and its implementation challenges. This was a mixed-methods study involving quantitative (cohort analysis of programme data) and qualitative components (thematic analysis of interviews of 8 contacts and 13 health care providers). There were 556 MDR-TB patients and 1908 contacts, of whom 1134 (59%) reached the health centres for screening (chest radiography and symptoms). Of the latter, 344 (30%) had presumptive TB and of them, 186 (54%) were investigated (sputum microscopy or Xpert MTB/RIF®). A total of 27 TB patients were diagnosed (six bacteriologically-confirmed including five with rifampicin resistance). The key reasons for not reaching township TB centres included lack of knowledge and lack of risk perception owing to wrong beliefs among contacts, financial constraints related to loss of wages and transportation charges, and inconvenient clinic hours. The reasons for not being investigated included inability to produce sputum, health care providers being unaware of or not agreeing to the investigation protocol, fixed clinic days and times, and charges for investigation. The National Tuberculosis Programme needs to note these findings and take necessary action.

Sign in / Sign up

Export Citation Format

Share Document