Technology supported rehabilitation for patients of critical illness caused by COVID-19: a protocol for a mixed-methods feasibility study

2020 ◽  
Vol 27 (10) ◽  
pp. 1-9 ◽  
Author(s):  
Ana-Carolina Gonçalves ◽  
Todd Leckie ◽  
Alexander Hunter ◽  
Daniel Fitzpatrick ◽  
Alan Richardson ◽  
...  

Background/Aims The COVID-19 pandemic has created the need for research on how to effectively rehabilitate patients who have been discharged from an intensive care unit. This study is a protocol for a mixed methods feasibility study addressing the research questions: 1) what are the needs of patients who have survived COVID-19? 2) is the use of technology feasible to support their recovery? Methods A multicentre, technology supported, rehabilitation intervention for survivors of critical illness caused by COVID-19 will be assessed. Survivors in the study population will be offered a smartwatch to monitor their activity levels and will have biopsychosocial outcome measures monitored at three time points: discharge from hospital, 2–3 months post discharge and 1 year post discharge. Semi-structured interviews will be conducted across eight hospital sites with survivors, their relatives and professionals to understand their recovery experiences. Conclusions Designed by frontline clinicians, this protocol outlines a feasibility study that will provide new knowledge on the process of recovery of critical illness caused by COVID-19.

2021 ◽  
Author(s):  
Claire M Ghetti ◽  
Bente Johanne Vederhus ◽  
Tora Söderström Gaden ◽  
Annette K Brenner ◽  
Łucja Bieleninik ◽  
...  

Abstract Premature infants and their parents experience significant stress during the perinatal period. Music therapy (MT) may support maternal–infant bonding during this critical period, but studies measuring impact across the infant’s first year are lacking. This nonrandomized feasibility study used quantitative and qualitative methods within a critical realist perspective to evaluate the feasibility, acceptability, and suitability of the treatment arm of the Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers (LongSTEP) (NCT03564184) trial with a Norwegian cohort (N = 3). Families were offered MT emphasizing parent-led infant-directed singing during neonatal intensive care unit (NICU) hospitalization and across 3 months post-discharge. We used inductive thematic analysis of semi-structured interviews with parents at discharge from NICU and at 3 months and analyzed quantitative variables descriptively. Findings indicate that: (1) parents of premature infants are willing to participate in MT research where parental voice is a main means of musical interaction; (2) parents are generally willing to engage in MT in NICU and post-discharge phases, finding it particularly interesting to note infant responsiveness and interaction over time; (3) parents seek information about the aims and specific processes involved in MT; (4) the selected self-reports are reasonable to complete; and (5) the Postpartum Bonding Questionnaire appears to be a suitable measure of impaired maternal–infant bonding. Parents reported that they were able to transfer resources honed during MT to parent–infant interactions outside MT and recognized parental voice as a central means of building relation with their infants. Results inform the implementation of a subsequent multinational trial that will address an important gap in knowledge.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016307 ◽  
Author(s):  
Natalia Calanzani ◽  
Debbie Cavers ◽  
Gabriele Vojt ◽  
Sheina Orbell ◽  
Robert J C Steele ◽  
...  

ObjectivesWe aimed to test whether a brief, opportunistic intervention in general practice was a feasible and acceptable way to engage with bowel screening non-responders.DesignThis was a feasibility study testing an intervention which comprised a brief conversation during routine consultation, provision of a patient leaflet and instructions to request a replacement faecal occult blood test kit. A mixed-methods approach to evaluation was adopted. Data were collected from proformas completed after each intervention, from the Bowel Screening Centre database and from questionnaires. Semi-structured interviews were carried out. We used descriptive statistics, content and framework analysis to determine intervention feasibility and acceptability.ParticipantsBowel screening non-responders (as defined by the Scottish Bowel Screening Centre) and primary care professionals working in five general practices in Lothian, Scotland.Primary and secondary outcome measuresSeveral predefined feasibility parameters were assessed, including numbers of patients engaging in conversation, requesting a replacement kit and returning it, and willingness of primary care professionals to deliver the intervention.ResultsThe intervention was offered to 258 patients in five general practices: 220 (87.0%) engaged with the intervention, 60 (23.3%) requested a new kit, 22 (8.5%) kits were completed and returned. Interviews and questionnaires suggest that the intervention was feasible, acceptable and consistent with an existing health prevention agenda. Reported challenges referred to work-related pressures, time constraints and practice priorities.ConclusionsThis intervention was acceptable and resulted in a modest increase in non-responders participating in bowel screening, although outlined challenges may affect sustained implementation. The strategy is also aligned with the increasing role of primary care in promoting bowel screening.


2021 ◽  
Vol 20 ◽  
pp. 160940692110184
Author(s):  
Anthony Summers ◽  
Daniel Wadsworth ◽  
Karryn Bratby ◽  
Eilish Hobbs ◽  
Denise Wood

Design: A mixed-methods design will be used to collect data for the study, with each stage being of equal importance. Stage one is an online survey and stage two is a series of semi-structured interviews. Context of study: To explore the experiences of healthcare students who have faced allegations of breaching academic integrity, to improve the support provided to these students. Objectives: The main objectives of this study are to explore and describe the experiences of these students to develop an understanding of the areas they need support while going through this process. Study population: Healthcare students studying at a regional university in Australia.


BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025098 ◽  
Author(s):  
Claire Hayes ◽  
Victoria J Palmer ◽  
Magenta Simmons ◽  
Bridget Hamilton ◽  
Christine Simons ◽  
...  

IntroductionImproving mental healthcare for adolescents is a global policy priority. Despite demands for community-based services, many adolescents require more intensive interventions, such as an inpatient admission. This is typically at a point of crisis, often accompanied by intense emotional dysregulation, impairment of coping function and impulsivity. However, limited evidence exists on how best to support this group while they are in inpatient care, aside from pharmacological treatments which have a limited role in adolescents. Little is known about the models of care (MoC) offered in inpatient units, whether adolescents perceive these as helpful and the perspectives of caregivers and clinicians. Here, we describe a protocol which aims to explore and evaluate an inpatient MoC.Methods and analysisWe designed a longitudinal, mixed-methods, case study. The population consists of adolescents, caregivers and clinicians at a single inpatient unit in Melbourne, Australia. Standardised outcome measures, including semi- structured interviews, will be administered to adolescents at three time-points, T1 (admission), T2 (discharge) and T3 (6 months post discharge). Caregivers will also be interviewed at T1, T2 and T3. Clinicians will be interviewed once. The measures include: Life Problems Inventory, Quick Inventory of Depressive Symptomatology, Kessler Psychological Distress Scale and the Youth Self-Report. Health of the Nation Outcome Scales for Children and Adolescents will be collected at T1 and T2. Quantitative analysis will include descriptive statistics and paired t-tests summarising adolescents admitted to the unit, clinical characteristics and longitudinal data on symptomatology. Qualitative data will be analysed using both thematic and trajectory analysis. Data collection began in May 2017 and will cease with T3 interviews by October 2018.Ethics and dissemination


2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i7-i11
Author(s):  
J Tomlinson ◽  
H Smith ◽  
J Silcock ◽  
K Karban ◽  
B Fylan

Abstract Introduction Older patients often experience medication-related problems following discharge from hospital. These can be categorised as issues with obtaining medication, taking medication, medication effects or problems with communication or care co-ordination (Nicosia et al., Journal of General Internal Medicine, 2019, https://doi.org/10.1007/s11606-019-05463-z). The aim of this study was to explore older adults’ experiences of post-discharge medicines management, including the strategies they use to safely manage their changed medicines. Methods Following ethical approval, patients aged 75 and above, with a change in their long term medicines, were recruited during admission to one of two hospitals in Yorkshire. Semi-structured interviews took place with the participants in their own homes, approximately two weeks after discharge. Interviews were audio recorded and transcribed. Data were analysed using the Framework method. Results Twenty-seven patients (mean age 85 years; 6 males) consented to be interviewed. They described multiple self-management and safety strategies used to support medicines management in the early post-discharge phase. The work done included adaptations (to routines, the home environment and action plans), scaffolding (where patients and their care-givers support the primary care system by providing additional documentation or prompts to ensure medicines were supplied on time and were correct) and error avoidance (seeking information, performing checks and balances). Conclusion Older patients experience gaps in their post-discharge medicines-related care which they had to bridge through implementing their own strategies or by enlisting support from others. This study shines a spotlight on to the invisible work that patients have to do in order to make post-discharge medicines management fit for purpose. Further work should consider those patients who are not able to carry out these tasks or who do not have any care-givers available for support and how this potential gap in care can be addressed.


2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.


Author(s):  
Roman A. Lewandowski ◽  
Jędrzej B. Lewandowski ◽  
Inger Ekman ◽  
Karl Swedberg ◽  
Jan Törnell ◽  
...  

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used to guide implementation of PCC for patients with moderate scoliosis. A multi-disciplinary team of professionals were trained in the PCC approach and the hospital Information Technology (IT) system was modified to enhance PCC data capture. Semi-structured interviews were conducted with the nine health care professionals involved in the pilot study and three patients/parents receiving care. Transcribed data were analyzed via content analysis. Results: 51 patients and their families were treated via a PCC approach. High proportions of new PCC data fields were completed by the professionals. The professionals were able to implement the three core PCC routines and perceived benefits using the PCC approach. Patients and their families also perceived improved quality care. The WE-CARE framework enablers facilitated PCC implementation in this setting. Conclusions: This feasibility pilot study indicates that the Gothenburg PCC approach can be successfully transferred to a rehabilitation hospital in Poland with favorable perceptions of implementation by both professionals and patients/their families.


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