Teacher‐as‐actor: investigating the barriers and facilitators of patient education among hospitalised patients in a cardiology clinical unit

Author(s):  
Mary Boyde ◽  
Anthony Tuckett ◽  
Jerry Ty
2019 ◽  
Author(s):  
Randi Hessellund Knudsen ◽  
Janus Laust Thomsen ◽  
Camilla Aakjaer Andersen ◽  
Tamana Afzali ◽  
Allan Riis

Abstract Background Low back pain (LBP) is the leading cause of disability worldwide. Patient education and self-management have the potential to improve the care of patients. However, high workload and little available time for consultations are argued to challenge the delivery of optimal care in general practice. Involving clinical staff members in the management of diabetes and of patients with hypertension has shown to be feasible. Consequently, involving clinical staff members in providing education and information to patients may improve the delivery of patient information and education. However, this require a shift in the division of tasks and general practitioners’ (GPs’) barriers and facilitators for this is currently unknown. The aim is to explore GPs’ barriers and facilitators to involve clinical staff members in the treatment of LBP in general practice. Methods This is a qualitative, semi-structured interview study. We used the phenomenological approach to study experiences and attitudes towards changing the management of patients with LBP from the GPs’ perspectives. Analysis was conducted using inductive descriptive methods. Results We conducted five 60-minute interviews with Danish GPs. All GPs had experience with task delegation, but it varied which tasks the GPs delegated and to which types of clinical staff members. The following barriers towards clinical staff member involvement were identified: Patients with LBP is a heterogeneous group with a variety of treatment needs, the examination and treatment can be considered as one coherent process, and it would require external support.
Involving clinical staff members can release GP time. Another facilitator was the possibility for improving the uptake of clinical guidelines and involvement of practice nurses was considered to improve the provision of patient education and lead to greater patient self-management. Conclusion While some GPs currently consider delegation to clinical staff members a good idea in the treatment of LBP, others prefer the existing treatment strategy without clinical staff member involvement. Consequently, healthcare providers need to address existing barriers and facilitators for involving clinical staff members when advocating for a future multi professional treatment strategy of LBP in general practice.


2014 ◽  
Vol 14 (5) ◽  
pp. 551-556 ◽  
Author(s):  
Raheb Ghorbani ◽  
Mohsen Soleimani ◽  
Mohammad-Reza Zeinali ◽  
Mohammad Davaji

2016 ◽  
Vol 15 (3) ◽  
pp. 471-476 ◽  
Author(s):  
Zohreh Badiyepeymaie Jahromi

Objective: Patient education is the process of enhancing patients’ knowledge and skills in order to encourage the required attitude and behaviors for maintaining or improving their health. This study aims to explore the barriers and facilitators of patient education in clinical environments from the viewpoint of nursing students.Materials and Method: 78 senior and junior nursing students at Jahrom University of Medical Sciences formed the participants of this descriptive-cross-sectional study. The participants were selected based on the census method. The questionnaire used to collect data included questions about students’ demography, barriers (10 questions), and facilitators (10 questions) in patient education.Results: The most important barriers to patient education were lack of appropriate educational facilities (4.34±0.99), time limitation (4.31±1.10), and nurses’ inadequate knowledge and skills (4.29±0.59). The most important facilitators were enhancing the knowledge and skills of educator (4.49±0.50), raising the interest of the educator (4.44±0.74), and implementing of the education step-by-step (4.40±0.49).Conclusion: Patient education is an important part of patient care thus nursing teachers should be encouraged to incorporate patient education in the curriculum as part of the introduction of diseases, and stress such issues as evaluation of patients’ health literacy, familiarity with educational tools, and methods of enabling patients.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.471-476


2021 ◽  
pp. 1722-1729
Author(s):  
Prisca C. Diala ◽  
Magdalene Randa ◽  
Jackline Odhiambo ◽  
Gregory Ganda ◽  
Craig R. Cohen ◽  
...  

PURPOSE Nearly half of Kenyan women with breast cancer present with advanced disease—owing partially to limited patient education and screening limitations in low- and middle-income countries. With increasing access to nurse-led cervical cancer screening (CCS) in government clinics in Kenya, we investigated provider-perceived barriers and facilitators to integrating clinical breast examinations (CBEs) with ongoing CCS programs in Kisumu County, Kenya. METHODS CCS providers within the Ministry of Health Clinics in Kisumu County, Kenya, were recruited to participate in a two-phase, sequential, mixed methods study. Knowledge of CBE guidelines was assessed with a questionnaire. Providers with significant CCS and CBE experience then completed a one-on-one interview discussing barriers and facilitators to integration. RESULTS Sixty-nine providers from 20 randomly selected facilities participated in the survey. Providers all agreed that breast cancer screening was very important. Although 93% said that they routinely offered CBEs, only 22% of these providers screened at least eight of their last 10 patients. Forty-four percent identified four or more of five signs and symptoms of breast cancer, and 33% identified four to five risk factors. Although providers showed enthusiasm for integration of CBEs into their practices, barriers were identified and grouped into four themes: (1) fragmentation of services, (2) staffing shortage and inadequate on-the-job training, (3) limited space and referral system challenges, and (4) limited patient awareness on need for cancer screening. CONCLUSION Addressing providers' concerns by providing routine on-the-job clinical training, improving staffing shortages, strengthening the diagnostic and treatment referral pathway, and increasing patient education are some of the first steps in facilitating integration of CBEs with CCS services in primary care clinics in Kenya.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1268.3-1269
Author(s):  
H. Akgül ◽  
N. Sermenlİ Aydin ◽  
Z. Sari ◽  
M. Bİrtane ◽  
E. Tonga

Background:Home exercise programs are widely used in the treatment of knee osteoarthritis (OA). However, adherence to these exercises decreases in the long term due to different factors. In recent years, new approaches are being developed to increase exercise adherence (EA) for patients with OA. Although it is known that EA is low in Turkish patients, there is no study that examines the barriers of adherence to home exercise programs in patients with OA by qualitative research methods.Objectives:Aim of our study was to investigate the barriers and facilitators for adherence of home-based exercises for knee osteoarthritis management from the perspective of physiotherapists and patients.Methods:A Qualitative study by using focus groups discussions and semi-structured interviews were designed to investigate the barriers and facilitators to home-based exercise program adherence for OA. Two researchers facilitated focus group interview. Participants of focus group members were eight physiotherapists (PT) working with OA with different experience levels. Third researcher conduct the interviews which lasted 30-60 minutes with patients (patients with knee OA, n=5 ages>50). Data were audio recorded, transcribed verbatim and thematically analyzed with NVIVO 12 software. Three researchers conducted the thematic analysis to ensure the validity.Results:In total, 25 main themes from the focus group discussions and interviews were determined. Major barrier themes from focus group were (a) beliefs to exercise benefits (b) patient education and (c)fear avoidance beliefs on exercise; from the interviews were (a)negligence of self-management (b)fatigue and (c)patient education. Patients and therapists all agreed for patient education is one of the most important factors for home EA. Patients wanted to get education on arthritis management. A patient said:“Actually, the clinicians should give information more deeply. I don’t know which is correct for me after therapy, resting or moving?”Major facilitator themes from the focus group were (a)motivation from PT (b)client-centred exercise (c)digital technology; from interviews were (a) motivational approaches of therapists (wats-up messages) (b) having pain and (c)patient education for disease management. Therapists agreed on that personalized exercise is the most important facilitator. A therapist commented,“If the personalized exercise given the patient with correct intensity and repetitions, I don’t think that patients would not do their home exercises.”Conclusion:This is the first qualitative study about exercise adherence in knee osteoarthritis in Turkey. It has been determined that the lack of education and motivation are the most important barriers. More studies are needed to examine the factors affecting EA for patients with OA. In future studies, implementations to increase home EA on Turkish patients with OA should be investigated by qualitative research methods.References:[1]MacKay C. Qualitative study exploring the factors influencing physical therapy management of early knee osteoarthritis in Canada. BMJ 2018 open.[2]Carmona-Terés, Understanding knee osteoarthritis from the patients’ perspective: a qualitative study.” BMC musculoskeletal disorders 18.1 (2017): 225.[3]Marlene F.Exercise for osteoarthritis of the knee: a Cochrane systematic review. British journal of sports medicine 2015 49(24).Disclosure of Interests:None declared


Author(s):  
Marian C Brennan ◽  
Janie A Brown ◽  
Nikos Ntoumanis ◽  
Gavin D Leslie

To identify and map barriers and facilitators of physical activity (PA) in adults living with type 1 diabetes (T1D) in any care setting or environment. A scoping review was conducted in accordance with the PRISMA-ScR guidelines to address the aim of this review. Exclusion / inclusion criteria were determined a priori. Articles captured in the search were subject to title and abstract screening before full text articles were assessed for eligibility against the exclusion / inclusion criteria. Included articles underwent critical appraisal before being charted, mapped, and discussed. Forty-six articles were included in the final synthesis. Most commonly, articles reported cross-sectional survey studies (46%), then qualitative designs (17%), and opinion or text (17%). Experimental studies accounted for 13% of included articles. Fear of hypoglycaemia / hypoglycaemia was the most commonly reported barrier and patient education the most commonly discussed facilitator. Quality appraisal revealed methodological issues among included articles. Higher quality research with theoretically sound behaviour change interventions combined with targeted patient education is needed to address fear of hypoglycaemia / hypoglycaemia as a barrier to PA. Novelty bullets • Hypoglycaemia and fear of hypoglycaemia were the most commonly reported barriers to physical activity in adults with T1D • Powered RCTs are required to establish efficacy of behaviour change interventions targeting these barriers to physical activity


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