scholarly journals A Shared Decison-Making Virtual Patient in Medical Education: A mixed methods evaluation (Preprint)

2020 ◽  
Author(s):  
Simon Jacklin ◽  
Neal Maskrey ◽  
Stephen Chapman
Keyword(s):  
Communication Skills ◽  
Structured Interviews ◽  
Post Intervention ◽  
Early Theory ◽  
Mixed Methods Evaluation ◽  
Informed Preferences ◽  
Or Practice ◽  
Observed Behaviour ◽  
Future Work ◽  
Real Patients

BACKGROUND Shared decision-making (SDM) is a process where clinicians and patients work together to select tests, treatments, management or support packages, based on clinical evidence and the patient’s informed preferences. Like any skill, SDM requires practice to improve. Virtual Patients (VPs) are simulations that allow one to practice their communication skills. VPs could be used to help professionals and students practice the communication skills required to engage in SDM, but this specific focus has not received much attention within the literature. OBJECTIVE To evaluate a VP workshop for medical students aimed at developing the communication skills required for SDM. METHODS A pre and post-intervention questionnaire followed by semi-structured interviews. RESULTS The interviews and questionnaires suggested that the VP was enjoyable and easy to use. When the participants were asked to rank their priorities in a consultation both pre and post-VP, there was a statistically significant change in the rank position of “respecting patient choices” (P = 0.038) with the median rank changing from 2nd to 1st. The VP allowed the participants to explore a consultation in a way that they could not with simulated or real patients; this may be part of the reason that the VP was suggested as a useful intervention for bridging from the early, theory focused years of the curriculum to the more patient focused ones later on. CONCLUSIONS The VP was well accepted by the participants. The multiple choice system of interaction was reported as both useful but also restrictive. Future work should look at further developing the mode of interaction and explore whether the VP results in any changes in observed behaviour or practice.

‘Are we on the same wavelength?’ International nurses and the process of confronting and adjusting to clinical communication in Australia

2017 ◽  
Vol 13 (3) ◽  
pp. 263-274 ◽  
Author(s):  
Tonia Crawford ◽  
Peter Roger ◽  
Sally Candlin
Keyword(s):  
Communication Skills ◽  
Thematic Analysis ◽  
Care Setting ◽  
Linguistically Diverse ◽  
The Other ◽  
Culturally And Linguistically Diverse ◽  
Central Theme ◽  
Structured Interviews ◽  
Clinical Communication ◽  
Professional Experiences

Effective communication skills are important in the health care setting in order to develop rapport and trust with patients, provide reassurance, assess patients effectively and provide education in a way that patients easily understand (Candlin and Candlin, 2003). However with many nurses from culturally and linguistically diverse (CALD) backgrounds being recruited to fill the workforce shortfall in Australia, communication across cultures with the potential for miscommunication and ensuing risks to patient safety has gained increasing focus in recent years (Shakya and Horsefall, 2000; Chiang and Crickmore, 2009). This paper reports on the first phase of a study that examines intercultural nurse patient communication from the perspective of four Registered Nurses from CALD backgrounds working in Australia. Five interrelating themes that were derived from thematic analysis of semi-structured interviews are discussed. The central theme of ‘adjustment’ was identified as fundamental to the experiences of the RNs and this theme interrelated with each of the other themes that emerged: professional experiences with communication, ways of showing respect, displaying empathy, and vulnerability.

scholarly journals QOLP-04. PILOT STUDY OF A VIDEOCONFERENCE-BASED PSYCHOLOGICAL INTERVENTION FOR FAMILY CAREGIVERS OF PATIENTS WITH MALIGNANT GLIOMAS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii175-ii175
Author(s):  
Deborah Forst ◽  
Michelle Mesa ◽  
Emilia Kaslow-Zieve ◽  
Areej El-Jawahri ◽  
Joseph Greer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Self Efficacy ◽  
Coping Skills ◽  
Malignant Gliomas ◽  
Anxiety Symptoms ◽  
Structured Interviews ◽  
Post Intervention ◽  
Clinically Significant ◽  
And Coping

Abstract BACKGROUND Caregivers of patients with malignant gliomas experience substantial anxiety symptoms while caring for someone with progressive neurological decline. Yet, interventions to reduce psychological distress and improve quality of life (QoL) in this caregiver population are lacking. METHODS We conducted an open pilot study evaluating feasibility and acceptability of a cognitive behavioral therapy-based intervention for caregivers of patients with malignant gliomas with clinically significant anxiety (Generalized Anxiety Disorder [GAD-7] score ≥ 5). Caregivers participated in six videoconference sessions with a mental health provider. We defined the intervention as feasible if ≥ 70% of eligible caregivers enrolled and ≥ 70% of those enrolled completed ≥ 50% of sessions. We evaluated intervention acceptability in semi-structured interviews. Caregivers completed baseline and post-intervention surveys assessing anxiety and depression symptoms (Hospital Anxiety and Depression Scale), QoL (Caregiver Oncology Quality of Life Questionnaire), caregiving burden (Caregiver Reaction Assessment), self-efficacy (Lewis Cancer Self-Efficacy Scale), and perceived coping skills (Measure of Current Status-Part A). We explored post-intervention changes using paired t-tests. RESULTS We obtained consent from 70.0% (21/30) of caregivers approached, of which 66.7% (14/21) had clinically significant anxiety and thus were eligible to participate (mean age=55.7 years, 64.3% female). Among enrolled caregivers, 71.4% (10/14) completed ≥ 50% of sessions. In semi-structured interviews, all participants found the intervention helpful and valued the ability to participate remotely via videoconference. Among caregivers who completed at least one session, 80.0% (8/10) completed all assessments and were included in analyses. Post-intervention, caregivers reported reduced anxiety symptoms (P=.02) and improved QoL (P=.03) and coping skills (P=.001). We found no significant change in depression, caregiving burden, or self-efficacy. CONCLUSION Our videoconference-based intervention is feasible and acceptable to caregivers. Participants reported significant improvements in anxiety symptoms, quality of life, and coping skills post-intervention, supporting further investigation of the intervention in a randomized controlled trial.

scholarly journals An evaluation of Cognitive Stimulation Therapy sessions for people with dementia and a concomitant support group for their carers

Dementia ◽  
2016 ◽  
Vol 16 (8) ◽  
pp. 985-1003 ◽  
Author(s):  
Jan Bailey ◽  
Paul Kingston ◽  
Simon Alford ◽  
Louise Taylor ◽  
Edward Tolhurst
Keyword(s):  
Support Groups ◽  
Support Group ◽  
Qualitative Data ◽  
Cognitive Stimulation ◽  
Structured Interviews ◽  
Post Intervention ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Quasi Experimental ◽  
The Impact

This research aimed to ascertain the impact of a pragmatic Cognitive Stimulation Therapy course of 10 sessions on the cognitive function of people living with dementia and whether attending a concomitant carers support group was beneficial to carers. A mixed method quasi-experimental approach was adopted; data were collected pre- and post-intervention. The quantitative arm utilised three validated questionnaires rated by the carers. Qualitative data were collected via semi-structured interviews with carers regarding their perceptions of the impact of Cognitive Stimulation Therapy and the carers support group. Quantitative data analysis found no statistically significant differences within or between groups. The qualitative data demonstrated that carers perceived Cognitive Stimulation Therapy had some benefits for the people living with dementia, especially social benefits. Carers also perceived that attending the carers support group was beneficial for them in terms of gaining a better understanding of dementia, developing coping skills and having peer support. The study was limited in scale and further research with a larger sample, using direct measures of the impact of Cognitive Stimulation Therapy with people living with dementia and supplementary research exploring which characteristic of carers support groups are effective would be worthwhile.

Linking disaster risk reduction, climate change and development

2016 ◽  
Vol 7 (2) ◽  
pp. 216-228 ◽  
Author(s):  
E. Lisa F. Schipper ◽  
Frank Thomalla ◽  
Gregor Vulturius ◽  
Marion Davis ◽  
Karlee Johnson
Keyword(s):  
Climate Change ◽  
Risk Reduction ◽  
Disaster Risk Reduction ◽  
Political Action ◽  
Disaster Risk ◽  
Content Type ◽  
Climate Risks ◽  
Emerging Risk ◽  
Or Practice ◽  
Future Work

Purpose The purpose of this paper is to advance the dialogue between the disaster risk reduction (DRR) and adaptation community by investigating their differences, similarities and potential synergies. The paper examines how DRR and adaptation can inform development to tackle the underlying drivers of disaster risk. Design/methodology/approach Based on a risk-based approach to the management of climate variability and change, the paper draws from a critical review of the literature on DRR and adaptation. The study finds that known and emerging risk from disasters continues to increase dramatically in many parts of the world, and that climate change is a key driver behind it. The authors also find that underlying causes of social vulnerability are still not adequately addressed in policy or practice. Linking DRR and adaptation is also complicated by different purposes and perspectives, fragmented knowledge, institutions and policy and poor stakeholder coordination. Findings The author’s analysis suggests that future work in DRR and adaptation should put a much greater emphasis on reducing vulnerability to environmental hazards, if there is truly a desire to tackle the underlying drivers of disaster and climate risks. Originality/value This will require coherent political action on DRR and adaptation aimed at addressing faulty development processes that are the main causes of growing vulnerability. The study concludes with a first look on the new Sendai Framework for Disaster Risk Reduction and how it aims to connect with adaptation and development.

A Retrospective Comparison of American Women’s Spontaneous Conceptions and Gestational Surrogate Pregnancies

2021 ◽  
Author(s):  
Jennifer Lahl ◽  
Kallie Fell ◽  
Kate Bassett ◽  
Frances Broghammer ◽  
Maggie Eastman ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Demographic Data ◽  
Health Issues ◽  
Structured Interviews ◽  
Survey Tool ◽  
Level Data ◽  
Retrospective Comparison ◽  
Caucasian Women ◽  
Future Work

Abstract Purpose: To evaluate the retrospective pregnancy experiences of American women by comparing spontaneous pregnancies with gestational surrogate pregnancies. Methods: Data were collected via structured interviews following an approved survey tool utilizing an online video platform. In total, 97 interviews were conducted. Results: Demographic data was collected on age, ethnicity, primary language, country of birth, education, and income level. Data revealed that a woman was more likely to have a pregnancy that was high-risk during a surrogate pregnancy than a non-surrogate pregnancy, independent of maternal age or gravidity (OR 7.22, p<0.001). A surrogate pregnancy had 4 times higher odds of resulting in a c-section (p<0.001) as well as delivering at an earlier gestational age (p<0.001). Further, women were more likely to experience adverse effects, including postpartum depression, following delivery of a surrogate child than their own biological child (p<0.001). Finally, the rate of new post-surrogacy chronic health issues for non-Caucasian women was significantly higher than for Caucasians (p<0.001). Women reported using the payment they received for their surrogacy for basic needs. Almost half of the women reported using the money to pay bills or get out of debt.Conclusions: These results are among the first of their kind. This study reveals that surrogate health disparities exist and that there may be long-term complications after a surrogate pregnancy. This raises important social, economic, and ethical issues related to surrogacy which must be further explored. Future work will build on this study and help elucidate the circumstances and consequences surrounding this complex issue.

scholarly journals Health-related quality of life among 13–14 year old adolescents with overweight - a mixed methods approach

2019 ◽  
Author(s):  
Turid Kristin Bigum Sundar ◽  
Kirsti Riiser ◽  
Milada Småstuen ◽  
Randi Opheim ◽  
Knut Løndal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Well Being ◽  
Reference Population ◽  
Health Related Quality ◽  
Structured Interviews ◽  
Post Intervention ◽  
Related Quality ◽  
Health Related

Abstract BackgroundOverweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study with the aim of increasing PA, reducing BMI and promoting HRQoL.Methods Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents’ HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13–14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52.ResultsHRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. ConclusionThe use of the KIDSCREEN 52 instrument gave important indications about the adolescents’ HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL, indicating better ways of providing help. More research using the benefits of mixed methods approaches is needed to further elucidate these findings.

scholarly journals Investigation of International Students’ Perception of ‘Community’ in a British Higher Education Institute

2015 ◽  
Vol 3 (3) ◽  
Author(s):  
Kathrine Angela Jackson ◽  
Fay Harris ◽  
Russell Crawford
Keyword(s):  
Higher Education ◽  
International Students ◽  
International Student ◽  
Global Community ◽  
Structured Interviews ◽  
Postgraduate Students ◽  
Student Community ◽  
Research Students ◽  
The Uk ◽  
Future Work

This paper investigates the perceptions of members of our international student community by giving them a voice and a platform to explore their feelings as part of a Higher Education institute in the UK and whether they consider that the university is a global environment. Our data is based on a series of structured interviews with twelve students from twelve different countries, inclusive of four postgraduate research students. Our findings reveal that our international students commonly feel part of multiple smaller communities but interestingly, they were less sure of their part within an institute-wide community. The postgraduate students’ perceptions of community were quite divergent when compared to the undergraduate perceptions, which we will continue to explore in our future work. Our data supports the perception from international students that their university is a global community, but there were distinct differences in how individuals defined it and some limitations to consider. Some defined it as students and staff of different nationalities being present at a university whilst other definitions relied on cultural characteristics within the institution as a whole. We reflect upon the implications of our research as these perceptions shape international student opinion of Higher Education institutes and what is understood by the term ‘global community’.

scholarly journals I’m Not Creative in That Way: Older Adults’ Differential Experiences of an Arts-Based Intervention

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 835-835
Author(s):  
Colette Brown ◽  
Andrea Chirino ◽  
Cristina Cortez ◽  
Cassandra Gearhart
Keyword(s):  
Older Adults ◽  
Conceptual Art ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Cognitively Normal ◽  
Cognitive Improvement ◽  
Adult Participants ◽  
Art Activities ◽  
Future Work ◽  
Community Dwelling Older Adults

Abstract A recent 12-week intervention study revealed that making conceptual art is linked to improved cognitive health among community-dwelling older adults (Brown et al., 2020). Unknown, however, is whether the intervention experience differed for participants who exhibited more versus less improvement. This pilot study examined 163 excerpts from semi-structured interviews with cognitively normal, older adult participants (N = 11, Mean age = 72.82). Using thematic analysis and data displays on Dedoose, key themes were distilled regarding intervention acceptability. Participants exhibiting less cognitive improvement more often mentioned personally connecting to topics of dementia and aging through art, but more often mentioned scheduling conflicts. Conversely, participants exhibiting greater cognitive improvement more often mentioned experiencing intellectual enrichment, but feeling insecure about their art capabilities. Novel art activities may be personally meaningful and cognitively stimulating for some participants, but emotionally frustrating for others. Future work should explore ways to optimize arts-based interventions for older participants.

scholarly journals Fulfilling the Demand for Workplace Communication Skills in the Civil Engineering Industry

2020 ◽  
Vol 28 (4) ◽  
Author(s):  
Masadliahani Masduki ◽  
Normah Zakaria
Keyword(s):  
Interpersonal Communication ◽  
Communication Skills ◽  
Civil Engineering ◽  
Oral Communication ◽  
Engineering Industry ◽  
Skilled Workers ◽  
Structured Interviews ◽  
Future Challenges ◽  
Communication Needs ◽  
Academic Qualifications

Human resources today must be nurtured with the skills needed at the workplace in preparation for future challenges. Many engineering graduates nowadays are facing difficulties in adapting themselves to the workplace. They are highly dependent on academic qualifications and underestimate the need for skilled workers who are not only technically proficient but have high competencies of soft skills, especially communication skills. The ability of graduates to communicate effectively can have a significant impact on their career development. Therefore, technical graduates need to equip themselves with knowledge of their future workplace’s communication needs. The objective of this study is to qualitatively explore the elements of communication skills demanded at the civil engineering workplace. Five participants consisting of experts from academia and industries were involved in semi-structured interviews. Data were hand-transcribed and analysed. Four themes emerged from the data and identified as oral communication, written communication, interpersonal communication, and visual communication. Thirty-four sub-themes appeared from the analysis and have been discussed accordingly.

Facilitators and barriers for promoting healthy eating among primary care patients: results of a qualitative study among practice nurses

2021 ◽  
Author(s):  
Geertruida J Groenendijk-van Woudenbergh ◽  
Marlies C van Hell-Cromwijk ◽  
Ytje J J van der Veen ◽  
Hylkje F Algra ◽  
Willemieke Kroeze
Keyword(s):  
Primary Care ◽  
Communication Skills ◽  
Healthy Eating ◽  
Patient Encounter ◽  
Structured Interviews ◽  
Good Communication ◽  
Practice Nurses ◽  
Professional Characteristics ◽  
Primary Care Patients ◽  
Facilitators And Barriers

Abstract Background Practice nurses have an important role in promoting healthy eating to prevent or delay long-term complications from chronic lifestyle-related diseases. Objective To identify the facilitators and barriers encountered by practice nurses at a professional level when promoting healthy eating among patients. Methods Face-to-face semi-structured interviews were conducted with 21 Dutch practice nurses. Data were recorded, transcribed and analysed using inductive thematic analysis. Results Two main themes were determined: professional characteristics and professional–patient encounter. Professional characteristics included good communication skills and experience facilitated the successful promotion of healthy eating, while a lack of communication skills and lack of knowledge about diet were perceived as barriers. The most frequently identified facilitators for professional–patient encounter included ensuring a personal connection with patients, creating food awareness, focussing on small changes, adopting a tailored approach, motivating and arranging extra consultations. Barriers included lack of skills to raise the topic, lack of persistence, inability to find a common understanding, lack of competence in handling patients’ own choices and underuse of existing educational materials. Conclusions Further research using the identified facilitators and barriers for promoting healthy eating in primary care patients with chronic diseases could assist in the development of future training programmes for practice nurses.

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