Medical Interactive Recovery Assistant: a useful clinical tool in paediatric shoulder rehabilitation?

2021 ◽  
Vol 28 (9) ◽  
pp. 1-15
Author(s):  
Sophia SR Hashim ◽  
Nasreen Sau ◽  
Toni Trickett ◽  
Anju Jaggi ◽  
Deborah M Eastwood
Keyword(s):  
Shoulder Instability ◽  
Personal Contact ◽  
Free Text ◽  
Framework Analysis ◽  
Clinical Tool ◽  
Assessment Scores ◽  
Personal Interaction ◽  
Functional Assessments ◽  
Xbox Kinect ◽  
Therapy Programme

Background/aims Outpatient physical therapy is the mainstay of treatment in shoulder instability, but lack of motivation and intermittent monitoring of progress is associated with poor compliance. ‘Exergames’ (a combination of videogames and physical exercise) may provide an additional or alternative motivational factor. The aim of this study was to determine the applicability of the Medical Interactive Recovery Assistant Xbox Kinect gaming software in the management of adolescent atraumatic shoulder instability. Methods Patients completed six 30-minute sessions playing games using the Medical Interactive Recovery Assistant while participating in a therapy programme. Pain and fatigue questionnaires, functional assessments and a framework analysis of free-text comments were used. Results A total of 20 female patients (15 unilateral, five bilateral pathology, mean age 14.1 years) completed the sessions. An average session length was 10.8 mins (range 0–24 mins). After each session using the Medical Interactive Recovery Assistant, 80% were neither in pain, nor overly tired. At 2 weeks, the Stanmore Percentage of Normal Shoulder Assessment scores had improved by a mean 17.9% and 10 (50%) patients showed improvements in Oxford Shoulder Instability Scores. Overall, 15 participants (75%) liked the technology; however six (32%) preferred standard physiotherapy, because of software limitations and lack of personal interaction. Conclusions Medical Interactive Recovery Assistant gamification is applicable for this patient cohort and could be integrated into adolescent atraumatic shoulder instability rehabilitation programmes; however, results emphasise the importance of personal contact.

scholarly journals Barriers and Enablers of Weight Management After Breast Cancer: A Thematic Analysis of Free Text Survey Responses Using the COM-B Model

2021 ◽  
Author(s):  
Carolyn Ee ◽  
Freya MacMillan ◽  
John Boyages ◽  
Kate McBride
Keyword(s):  
Breast Cancer ◽  
Weight Management ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Social Impact ◽  
Metastatic Breast ◽  
Free Text ◽  
Framework Analysis ◽  
Model Framework ◽  
Lifestyle Behaviours

Abstract BackgroundWeight gain is common after breast cancer. The aim of this study was to identify and describe the barriers to and enablers of successful weight management for women with breast cancer. MethodsThis was a combined inductive and deductive framework analysis of free text responses to an anonymous cross-sectional survey on weight after breast cancer. Women were recruited mainly through the Breast Cancer Network Australia Review and Survey Group. We applied deductive thematic analysis to free text responses to questions on barriers, enablers, research priorities, and one open-ended question at the end of the survey using the Capability, Opportunity, Motivation and Behaviour (COM-B) model as a framework. Subthemes that arose from the inductive analysis were mapped onto the COM-B model framework. Findings were used to identify behaviour change intervention functions. Results133 women provided free text responses. Most women were of Caucasian origin and had been diagnosed with non-metastatic breast cancer, with a mean age of 59.1 years. Women's physical capability to adopt and sustain healthy lifestyle habits was significantly affected by treatment effects and physical illness, and some lacked psychological capability to self-regulate the face of stress and other triggers. Limited time and finances, and the social impact of undergoing cancer treatment affected the ability to control their diet. Frustration and futility around weight management were prominent. However, some women were confident in their abilities to self-regulate and self-monitor lifestyle behaviours, described support from friends and health professionals as enablers, and welcomed the physical and psychological benefits of being active in the context of embracing transformation and self-care after cancer. ConclusionWomen need specific advice and support from peers, friends and families and health professionals. There is a gap in provision of supportive care to empower women to adopt and sustain healthy lifestyles. Environmental restructuring (including financial support), incentivization (creating an expectation of looking and feeling better), persuasion and coercion (aiming to prevent recurrence), and equipping women with specific knowledge and skills, would also facilitate optimal lifestyle behaviours and weight management.

scholarly journals ‘Fix the issues at the coalface and mental wellbeing will be improved’: a framework analysis of frontline NHS staff experiences and use of health and wellbeing resources in a Scottish health board area during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine Clarissa ◽  
Sam Quinn ◽  
Rosie Stenhouse
Keyword(s):  
Health Board ◽  
Free Text ◽  
Framework Analysis ◽  
Frontline Staff ◽  
Behavioural Interventions ◽  
Cognitive Behavioural ◽  
Wide Range ◽  
Staff Wellbeing ◽  
Organisational Factors ◽  
Cognitive Behavioural Interventions

Abstract Background Frontline healthcare staff working in pandemics have been reported to experience mental health issues during the early and post-peak stages. To alleviate these problems, healthcare organisations have been providing support for their staff, including organisational, cognitive behavioural and physical and mental relaxation interventions. This paper reports the findings of a study commissioned by a Scottish NHS health board area during the initial outbreak of COVID-19. The study aimed to understand the experience of NHS staff relating to the provision of wellbeing interventions between March and August 2020. Methods Data were gathered from free-text comments of eight surveys completed by a wide range of staff across sites within one NHS health board in Scotland. We conducted a framework analysis of the data. Results Our findings show that despite the provision of relaxational and cognitive behavioural interventions to support staff wellbeing during the early months of the COVID-19 pandemic, there were barriers to access, including heavy workload, understaffing, inconvenient locations and the stigma of being judged. Organisational factors were the most frequently reported support need amongst frontline staff across sites. Conclusions While relaxational and cognitive behavioural interventions were well received by staff, barriers to accessing them still existed. Staff support in the context of organisational factors, such as engagement with managers was deemed as the most important for staff wellbeing. Managers play a key role in everyday organisational processes and therefore are in the right position to meet increasing frontline staff demands due to the pandemic and removing barriers to accessing wellbeing support. Healthcare managers should be aware of organisational factors that might increase job demands and protect organisational resources that can promote wellbeing for frontline staff.

Wales Interventions and Cancer Knowledge about Early Diagnosis (WICKED): findings of work package 2 of the WICKED research programme

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697433
Author(s):  
Sadia Nafees ◽  
Rebecca-Jane Law ◽  
Maggie Hendry ◽  
Julia Hiscock ◽  
Marian A Stanciu ◽  
...  
Keyword(s):  
Focus Groups ◽  
Cancer Diagnosis ◽  
Research Programme ◽  
Behavioural Intervention ◽  
Free Text ◽  
Cancer Knowledge ◽  
Cancer Outcomes ◽  
Framework Analysis ◽  
Cancer Symptoms ◽  
Early Cancer Diagnosis

BackgroundCancer outcomes in the UK are worse than many countries with similar health structures. GPs play a pivotal role in improving cancer outcomes through earlier diagnosis.AimTo develop and evaluate a behavioural intervention to enable GPs to expedite cancer diagnosis.MethodThis ongoing programme is divided into four inter-related Work Packages (WPs) using a mixed methods approach. WP 2 comprises an all-Wales online GP questionnaire, 20 GP telephone interviews, and 4 practice-team focus groups. The questionnaire examined GPs’ perceptions and attitudes towards cancer diagnosis, and influences on cancer referral-related behaviour change. GPs’ individual beliefs and behaviours were explored in interviews; practice systems and norms were investigated in focus groups. Quantitative data were analysed descriptively, with conventional content analysis for free-text responses, and Framework analysis was used for qualitative data-sets.ResultsEarly findings show that 269/1993 (13.5%) GPs completed the survey. Most agreed that ‘timelier diagnosis leads to better survival’, perceived themselves to be knowledgeable, confident and capable in managing cancer symptoms, reported recent changes in their cancer-related diagnostic activity, and believed in their ability to influence timely diagnosis. However, many thought that, if given the opportunity and support, there was still room to improve early cancer diagnosis. Preliminary analysis of six interviews revealed 5 themes including; ‘wanting referral behaviour to fit, ‘feeling untrusted by secondary care’, ‘practicing over-defensive medicine’, ‘support from colleagues, and ‘difficulty referring patients with vague symptoms’.ConclusionThese findings will inform the development (WP3), and evaluation (WP4) of a behavioural intervention to expedite referral and diagnosis.

scholarly journals A Fuller Picture: Evaluating an Art Therapy Programme in a Multi-disciplinary Mental Health Service

2017 ◽  
Vol 41 (S1) ◽  
pp. S612-S612
Author(s):  
H. Moss ◽  
C. Brady ◽  
B. Kelly
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Art Therapy ◽  
Qualitative Data ◽  
Small Sample ◽  
Free Text ◽  
Service Users ◽  
Long Term Effects ◽  
Therapy Programme

Art therapy has a long history in mental health care but requires an enhanced evidence based in order to better identify its precise role in contemporary services. This paper describes an evaluation of an art therapy programme in an acute adult psychiatry admission unit in Ireland. A mixed method research design was used. Quantitative data were collected through a survey of 35 staff members and 11 service-users. Qualitative data included free-text comments collected in the survey and individual feedback from service-users. Both methods aimed to assess the role of art therapy as part of a multidisciplinary mental health service. Thematic content analysis was employed to analyse qualitative data. Staff demonstrated overwhelming support for art therapy as one element within multidisciplinary services available to patients in the acute psychiatry setting, qualitative feedback associated art therapy with improvements in quality of life and individual support, and emphasised its role as a nonverbal intervention, especially useful for those who find talking therapy difficult. Creative self-expression is valued by staff and service-users as part of the recovery process. Recommendations arising from the research include continuing the art therapy service, expanding it to include rehabilitation patients, provision of information and education sessions to staff and further research to identify other potential long-term effects. The low response of staff and small sample in this study, however, must be noted as limitations to these findings.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Management of atraumatic shoulder instability in physiotherapy (MASIP): a survey of physiotherapy practice

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Caroline Coulthard ◽  
Mindy C Cairns ◽  
Deborah Williams ◽  
Ben Hughes ◽  
Anju Jaggi
Keyword(s):  
Shoulder Instability ◽  
Treatment Strategies ◽  
Management Approach ◽  
Free Text ◽  
National Guidelines ◽  
Cross Sectional ◽  
Physiotherapy Practice ◽  
Treatment Techniques ◽  
Wide Range ◽  
The Impact

Abstract Background The impact of atraumatic shoulder instability (ASI) on patients can be extensive, its management complex, with a biopsychosocial approach recommended. Currently how physiotherapists manage ASI is unknown or the extent to which current clinical practice aligns with existing evidence. At the time of this study no national guidelines or consensus to direct practice existed. Methods A cross-sectional electronic survey was distributed between July-September 2018, targeting UK-based physiotherapists managing shoulder pathology. Respondents were invited to describe their management of ASI, and rate their awareness and utilisation of various treatment techniques on a Likert-scale; median and interquartile ranges were calculated. Free text survey items were analysed using quantitative content analysis (QCA) to identify codes and categories. Means and percentages were calculated to summarise QCA and descriptive data. Results Valid survey responses were analysed (n = 135). Respondents had between 2 and 39 years of physiotherapy experience (mean = 13.9 years); the majority (71.1 %) reported that ASI made up < 10 % of their caseload. Only 22.9 % (n = 31/135) of respondents reported feeling ‘very confident’ in managing ASI; the majority feeling ‘somewhat confident’ (70.4 %, n = 95/135) or ‘not confident’ (6.7 %, n = 9/135). The majority of respondents (59.3 %) used an ASI classification system, > 90 % citing the Stanmore Classification. Physiotherapists adapted their management according to clinical presentation, responding to differing biopsychosocial needs of the patient scenario. Most respondents (> 80 %) did not use a protocol to guide their management. Exercise was the most utilised management approach for ASI, followed by education; novel treatment strategies, including cortical rehabilitation, were also reported. Conclusion Findings indicate physiotherapists utilise a wide range of treatment strategies and respond to biopsychosocial cues when managing patients with ASI. The majority reported not being very confident in managing this condition, however only a minority use rehabilitation protocols to support their management. Some interventions that respondents reported using lacked evidence to support their use in ASI management and further research regarding effectiveness is required. Guidelines have been published since this survey; the impact of these will need evaluating to determine their effectiveness in the future.

A framework analysis of free-text data from the neonatal survey 2014

2018 ◽  
Vol 24 (3) ◽  
pp. 163-168 ◽  
Author(s):  
Esther Ainley ◽  
Jenny King ◽  
Susanne Käsbauer ◽  
Robyn Cooper
Keyword(s):  
Free Text ◽  
Framework Analysis ◽  
Text Data

scholarly journals Patients’ Ability to Review Electronic Health Record Information to Identify Potential Errors: A Pilot Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Lisa Freise ◽  
Ana Luisa Neves ◽  
Kelsey Flott ◽  
Paul Harrison ◽  
John Kelly ◽  
...  
Keyword(s):  
Information Exchange ◽  
Online Survey ◽  
Personal Health Information ◽  
Free Text ◽  
Patient Portal ◽  
Medical Terminology ◽  
Framework Analysis ◽  
User Friendliness ◽  
Cross Sectional ◽  
Electronic Health

BACKGROUND Sharing personal health information positively impacts quality of care across several domains, and particularly safety and patient-centeredness. Patients when reading their electronic health records (EHRs) may identify and flag up inconsistencies, leading to improved information quality and patient safety. However, in order to identify potential errors, patients need to be able to understand the information contained in their electronic records. OBJECTIVE This study assesses patients’ ability to identify errors present in their EHRs. Specifically, it evaluates the degree to which patients comprehend the information in their EHRs, what barriers exist to their understanding, and what, if any, errors patients can identify when given access to their EHRs. METHODS A cross-sectional online survey was undertaken between March 2017 and September 2017. A total of 682 registered users of the Care Information Exchange patient portal, with at least one access during the time of the study, were invited to complete the survey containing both structured (multiple choice) and unstructured (free-text) questions. The survey contained questions on patients’ perceived ability to understand their EHR information and therefore to identify errors. Free-text questions allowed respondents to expand on the reasoning behind their structured responses and provide more detail about their perceptions of EHRs and identifying errors within them. Qualitative data was systematically reviewed by two independent researchers using the framework analysis method, in order to identify emerging themes. RESULTS A total of 160 participants completed the survey (response rate=23.5%). The majority of participants (68.7%) reported they understood the information. The main barriers identified were information-related (medical terminology and knowledge, and interpretation of test results) and technology-related (user-friendliness of the portal, information display). Participants identified inconsistencies relating to incomplete and incorrect information in 14% of their records. CONCLUSIONS While the majority of patients reportedly understand the information contained within their EHRs, both technology and information-based barriers persist. There is a potential to improve system design to better support opportunities for patients to identify errors. This is with the aim of improving the accuracy, quality and timeliness of the information held in the EHRs and also a mechanism to further engage patients in their heath and healthcare. CLINICALTRIAL Not applicable

scholarly journals Parent priorities for research and communication concerning childhood outcomes following preterm birth

2021 ◽  
Vol 6 ◽  
pp. 151
Author(s):  
Lorna Ginnell ◽  
James P. Boardman ◽  
Rebecca M. Reynolds ◽  
Sue Fletcher-Watson
Keyword(s):  
Online Survey ◽  
Rating Scale ◽  
Descriptive Analysis ◽  
Early Years ◽  
Research Centre ◽  
Free Text ◽  
Framework Analysis ◽  
Effective Interventions ◽  
Health Visitors ◽  
Educational Professionals

Background: Children born preterm (before 37 weeks of gestation) are at risk for several adverse childhood outcomes. Parent priorities for research into these outcomes, and preferences for receiving information about these risks, have not previously been established. Here we report the results of an online survey designed to understand parent priorities for research and their preferences for receiving information about childhood outcomes. Methods: An online survey was circulated through social media and was completed by 148 parents of preterm children between the ages of 0 and 12 years from around the United Kingdom (UK). Survey questions were in the form of rating scale, multiple choice, ranking or open-ended free text questions. Descriptive analysis was applied to the quantitative data. Illustrative quotes were extracted from the qualitative free text data and a subset of these questions were analysed using framework analysis. Results: Parent priorities for research centre around identification of factors which can protect against or improve adverse cognitive or developmental outcomes. The majority of parents would prefer for communication to begin within the first year of the child’s life. Parents reported a knowledge gap among health visitors, early years educators and schools. Conclusions: In order to align with parent preferences, research should prioritise identification of protective factors and the development of effective interventions to improve outcomes. Training for health visitors and educational professionals could improve the experiences of families and children.

scholarly journals Assessment of Patients’ Ability to Review Electronic Health Record Information to Identify Potential Errors: Cross-sectional Web-Based Survey

10.2196/19074 ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. e19074
Author(s):  
Lisa Freise ◽  
Ana Luisa Neves ◽  
Kelsey Flott ◽  
Paul Harrison ◽  
John Kelly ◽  
...  
Keyword(s):  
Information Exchange ◽  
Personal Health Information ◽  
Free Text ◽  
Patient Portal ◽  
Medical Terminology ◽  
Framework Analysis ◽  
Cross Sectional ◽  
Web Based ◽  
Patient Reported ◽  
Electronic Health

Background Sharing personal health information positively impacts quality of care across several domains, and particularly, safety and patient-centeredness. Patients may identify and flag up inconsistencies in their electronic health records (EHRs), leading to improved information quality and patient safety. However, in order to identify potential errors, patients need to be able to understand the information contained in their EHRs. Objective The aim of this study was to assess patients’ perceptions of their ability to understand the information contained in their EHRs and to analyze the main barriers to their understanding. Additionally, the main types of patient-reported errors were characterized. Methods A cross-sectional web-based survey was undertaken between March 2017 and September 2017. A total of 682 registered users of the Care Information Exchange, a patient portal, with at least one access during the time of the study were invited to complete the survey containing both structured (multiple choice) and unstructured (free text) questions. The survey contained questions on patients’ perceived ability to understand their EHR information and therefore, to identify errors. Free-text questions allowed respondents to expand on the reasoning for their structured responses and provide more detail about their perceptions of EHRs and identifying errors within them. Qualitative data were systematically reviewed by 2 independent researchers using the framework analysis method in order to identify emerging themes. Results A total of 210 responses were obtained. The majority of the responses (123/210, 58.6%) reported understanding of the information. The main barriers identified were information-related (medical terminology and knowledge and interpretation of test results) and technology-related (user-friendliness of the portal, information display). Inconsistencies relating to incomplete and incorrect information were reported in 12.4% (26/210) of the responses. Conclusions While the majority of the responses affirmed the understanding of the information contained within the EHRs, both technology and information-based barriers persist. There is a potential to improve the system design to better support opportunities for patients to identify errors. This is with the aim of improving the accuracy, quality, and timeliness of the information held in the EHRs and a mechanism to further engage patients in their health care.

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