scholarly journals A Systematic Framework for Analyzing Patient-Generated Narrative Data: Protocol for a Content Analysis

10.2196/13914 ◽  
2019 ◽  
Vol 8 (8) ◽  
pp. 13914
Author(s):  
Maryam Zolnoori ◽  
Joyce E Balls-Berry ◽  
Tabetha A Brockman ◽  
Christi A Patten ◽  
Ming Huang ◽  
...  

Background Patient narrative data in online health care forums (communities) are receiving increasing attention from the scientific community for implementing patient-centered care. Natural language processing (NLP) methods are gaining more and more attention because of the enormous data volume. However, state-of-the-art NLP still cannot meet the need of high-resolution analysis of patients’ narratives. Manual qualitative analysis still plays a pivotal role in answering complicated research questions from analyzing patient narratives. Objective This study aimed to develop a systematic framework for qualitative analysis of patient-generated narratives in online health care forums. Methods Our systematic framework consists of 4 phases: (1) data collection, (2) data preparation, (3) content analysis, and (4) interpretation of the results. Data collection and data preparation phases are constructed based on text mining methods for identifying appropriate online health forums for data collection, differentiating posts of patients from other stakeholders, protecting patients’ privacy, sampling, and choosing the unit of analysis. Content analysis phase is built on the framework method, which facilitates and accelerates the identification of patterns and themes by an interdisciplinary research team. In the end, the focus of interpretation of the results phase is to measure the data quality and interpret the findings regarding the dimensions and aspects of patients’ experiences and concerns in their original contexts. Results We demonstrated the usability of the proposed systematic framework using 2 case studies: one on determining factors affecting patients’ attitudes toward antidepressants and another on identifying the disease management strategies in patient with diabetes facing financial difficulties. The framework provides a clear step-by-step process for systematic content analysis of patient narratives and produces high-quality structured results that can be used for describing patterns or regularities in patients’ experiences, generating and testing hypotheses, and identifying areas of improvement in the health care systems. Conclusions The systematic framework is a rigorous and standardized method for qualitative analysis of patient narratives. Findings obtained through such a process indicate authentic dimensions and aspects of patient experiences and shed light on patients’ concerns, needs, preferences, and values, which are the core of patient-centered care. International Registered Report Identifier (IRRID) RR1-10.2196/13914

2019 ◽  
Author(s):  
Maryam Zolnoori ◽  
Joyce E Balls-Berry ◽  
Tabetha A Brockman ◽  
Christi A Patten ◽  
Ming Huang ◽  
...  

BACKGROUND Patient narrative data in online health care forums (communities) are receiving increasing attention from the scientific community for implementing patient-centered care. Natural language processing (NLP) methods are gaining more and more attention because of the enormous data volume. However, state-of-the-art NLP still cannot meet the need of high-resolution analysis of patients’ narratives. Manual qualitative analysis still plays a pivotal role in answering complicated research questions from analyzing patient narratives. OBJECTIVE This study aimed to develop a systematic framework for qualitative analysis of patient-generated narratives in online health care forums. METHODS Our systematic framework consists of 4 phases: (1) data collection, (2) data preparation, (3) content analysis, and (4) interpretation of the results. Data collection and data preparation phases are constructed based on text mining methods for identifying appropriate online health forums for data collection, differentiating posts of patients from other stakeholders, protecting patients’ privacy, sampling, and choosing the unit of analysis. Content analysis phase is built on the framework method, which facilitates and accelerates the identification of patterns and themes by an interdisciplinary research team. In the end, the focus of interpretation of the results phase is to measure the data quality and interpret the findings regarding the dimensions and aspects of patients’ experiences and concerns in their original contexts. RESULTS We demonstrated the usability of the proposed systematic framework using 2 case studies: one on determining factors affecting patients’ attitudes toward antidepressants and another on identifying the disease management strategies in patient with diabetes facing financial difficulties. The framework provides a clear step-by-step process for systematic content analysis of patient narratives and produces high-quality structured results that can be used for describing patterns or regularities in patients’ experiences, generating and testing hypotheses, and identifying areas of improvement in the health care systems. CONCLUSIONS The systematic framework is a rigorous and standardized method for qualitative analysis of patient narratives. Findings obtained through such a process indicate authentic dimensions and aspects of patient experiences and shed light on patients’ concerns, needs, preferences, and values, which are the core of patient-centered care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/13914


2020 ◽  
Author(s):  
Ansley Smallen Redinger ◽  
Zachary K. Winkelmann ◽  
Lindsey E Eberman

Abstract Context: The core competencies of health care indicate that all medical professionals should provide patient-centered care (PCC), or care that is respectful and responsive to one's values and preferences, during each encounter. Objective: To identify collegiate student-athletes' definition of PCC and measure their perceived level of PCC from an athletic trainer (AT). Design: Cross-sectional study. Setting: Mixed-method survey. Patients or Participants: A total of 610 (age = 19 ± 1 year) NCAA student-athletes completed the survey. Main Outcome Measure(s): The survey consisted of one open-ended question prompting the participant to define PCC in their own words. The quantitative data was gathered through the Global Perceptions of Athletic Trainer PCC tool which explored the overall agreement about the ATs use of PCC constructs. Finally, those participants who had received care from an AT completed the validated Patient Perception of Patient-Centeredness (PPPC) instrument. Qualitative analysis was completed through Text IQ™ technology from Qualtrics® with a mean sentiment score (MSS) attributed to each of the coded statements. We performed descriptive statistics for all quantitative data. Results: The qualitative analysis revealed 13 topics in which the most used were individualized, priority, and best. Other topics were inconsistent with how the medical community has defined PCC. On the global agreement scale of PCC tool, the participants expressed a strong agreement (mode = 4) with 12 of the 15 statements. On the patient perception instrument, participants expressed that the AT was completely (mode = 4) patient-centered for all dimensions during their most recent encounter. However, the behaviors of PCC, defined by the medical community, may not be directly expressed from the viewpoint of a collegiate student-athlete. Conclusions: Student-athletes defined PCC as individualized and prioritized health care. Additionally, student-athletes perceived that ATs provided care that kept their best interest in mind and practiced PCC during their encounters.


2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Iwimbong Kum Ghabowen ◽  
Neeraj Bhandari

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, controlling for sociodemographic factors, health care access, and health care utilization of respondents. Compared to Medicare and privately insured enrollees, Medicaid enrollees reported much lower odds of seeing providers who treated them with respect (OR = 1.91, P < .001; OR = 1.62, P < .01) and who offered PCC (OR = 1.35, P < .05; OR = 1.35, P < .01), but similar odds of seeing concordant providers (OR = 0.78, P = .96; OR = 0.96, P = .72). Importantly, Medicaid enrollees reported higher odds of seeing providers who solicited their opinion/beliefs/preferences than their Medicare or privately insured counterparts (OR = 0.82, P < .05; OR = 0.87 P < .10). Medicaid enrollees report less patient-centered experiences in some important facets of their provider interaction than their Medicare or privately insured counterparts. Federal, state, and local policies and practices directed at improving these facets of patient–provider interaction are needed and should be aimed squarely at Medicaid providers, especially those working in geographic areas and settings with a disproportionate number of racial, gender, cultural, and linguistic minorities.


2020 ◽  
pp. 019459982095483
Author(s):  
Melissa Ghulam-Smith ◽  
Yeyoon Choi ◽  
Heather Edwards ◽  
Jessica R. Levi

The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.


2017 ◽  
Vol 25 (1) ◽  
pp. 94-95
Author(s):  
Melissa G. French

Abstract Health literacy and palliative care have been receiving more attention within health care organizations and systems in recent years. Both can offer a pathway to care that is better for patients and has the potential to be of high value. A health literate approach to palliative care provides patient-centered care that is better aligned with patient preferences and needs.


10.2196/22913 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22913
Author(s):  
Consuela Cheriece Yousef ◽  
Abin Thomas ◽  
Ahmed O Alenazi ◽  
Sumaya Elgadi ◽  
Laila Carolina Abu Esba ◽  
...  

Background As health care organizations strive to improve health care access, quality, and costs, they have implemented patient-facing eHealth technologies such as personal health records to better engage patients in the management of their health. In the Kingdom of Saudi Arabia, eHealth is also growing in accordance with Vision 2030 and its National Transformation Program framework, creating a roadmap for increased quality and efficiency of the health care system and supporting the goal of patient-centered care. Objective The aim of this study was to investigate the adoption of the personal health record of the Ministry of National Guard Health Affairs (MNGHA Care). Methods A cross-sectional survey was conducted in adults visiting outpatient clinics in hospitals at the Ministry of National Guard Health Affairs hospitals in Riyadh, Jeddah, Dammam, Madinah, and Al Ahsa, and primary health care clinics in Riyadh and Qassim. The main outcome measure was self-reported use of MNGHA Care. Results In the sample of 546 adult patients, 383 (70.1%) reported being users of MNGHA Care. MNGHA Care users were more likely to be younger (P<.001), high school or university educated (P<.001), employed (P<.001), have a chronic condition (P=.046), use the internet to search for health-related information (P<.001), and use health apps on their mobile phones (P<.001). Conclusions The results of this study show that there is substantial interest for the use of MNGHA Care personal health record with 70% of participants self-reporting use. To confirm these findings, objective data from the portal usage logs are needed. Maximizing the potential of MNGHA Care supports patient engagement and is aligned with the national eHealth initiative to encourage the use of technology for high-quality, accessible patient-centered care. Future research should include health care provider perspectives, incorporate objective data, employ a mixed-methods approach, and use a theoretical framework.


2021 ◽  
Author(s):  
Jean-Baptiste Gartner ◽  
Kassim Said Abasse ◽  
Ghita Ben Zagguou ◽  
Frédéric Bergeron ◽  
Paolo Landa ◽  
...  

Background: Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more qualitative and efficient ways to deliver care. This study is conducted to provide a clear definition of the patient-centered care pathway and its characteristics to meet the need for an international consensus. Methods: This qualitative systematic review aims to perform a systematic synthesis of published evidence concerning (1) the definition of the patient trajectory, patient pathway or patient journey and (2) their characteristics. With a consulting librarian, a comprehensive and systematic search in three databases was conducted (PUBMED, Embase, ABI/Inform), from 1995 to 2020 without language criteria. Eligibility criteria guiding data selection will follow the PICo mnemonic criteria consisting of (1) Population : all types of patients managed by health care delivery systems for an acute or chronic condition regardless of age or condition, (2) Phenomena : studies that contribute to the definition and conceptualization of the concepts of care trajectory, care pathway and patient journey resulting in a theoretical and conceptual contribution, and (3) Context : health care providers include all providers of primary, secondary, tertiary, and quaternary care in any geographic area. Two reviewers will independently screen, select, extract data and make a critical assessment of the methodology used with the JBI Qualitative Assessment and Review Instrument (JBI QARI).Discussion: This systematic review will provide much-needed knowledge regarding patient-centered pathways. The results will benefit clinicians, decision makers, and researchers by giving them a clear and integrated definition and understanding of the patient-centered care pathways and their characteristics to finally meet the need for an international consensus.


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