scholarly journals The SELFIE project: Results from 8 focus groups amongst persons with multi-morbidity on how to define good health and a good care process

2017 ◽  
Vol 17 (5) ◽  
pp. 87
Author(s):  
Fenna Leijten ◽  
Melinde Boland ◽  
Verena Struckmann ◽  
Markus Kraus ◽  
Jonathan Stokes ◽  
...  
Keyword(s):  
Focus Groups ◽  
Good Health ◽  
Care Process ◽  
Good Care

scholarly journals Defining good health and care from the perspective of persons with multimorbidity: results from a qualitative study of focus groups in eight European countries

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021072 ◽  
Author(s):  
Fenna R M Leijten ◽  
Maaike Hoedemakers ◽  
Verena Struckmann ◽  
Markus Kraus ◽  
Sudeh Cheraghi-Sohi ◽  
...  
Keyword(s):  
Focus Groups ◽  
Integrated Care ◽  
Group Discussion ◽  
Well Being ◽  
Good Health ◽  
European Countries ◽  
Care Process ◽  
Good Care ◽  
Total N ◽  
Health And Social Care

ObjectivesThe prevalence of multimorbidity is increasing in many Western countries. Persons with multimorbidity often experience a lack of alignment in the care that multiple health and social care organisations provide. As a response, integrated care programmes are appearing. It is a challenge to evaluate these and to choose appropriate outcome measures. Focus groups were held with persons with multimorbidity in eight European countries to better understand what good health and a good care process mean to them and to identify what they find most important in each.MethodsIn 2016, eight focus groups were organised with persons with multimorbidity in: Austria, Croatia, Germany, Hungary, the Netherlands, Norway, Spain and the UK (total n=58). Each focus group followed the same two-part procedure: (1) defining (A) good health and well-being and (B) a good care process, and (2) group discussion on prioritising the most important concepts derived from part one and from a list extracted from the literature. Inductive and deductive analyses were done.ResultsOverall, the participants in all focus groups concentrated more on the care process than on health. Persons with multimorbidity defined good health as being able to conduct and plan normal daily activities, having meaningful social relationships and accepting the current situation. Absence of shame, fear and/or stigma, being able to enjoy life and overall psychological well-being were also important facets of good health. Being approached holistically by care professionals was said to be vital to a good care process. Continuity of care and trusting professionals were also described as important. Across countries, little variation in health definitions were found, but variation in defining a good care process was seen.ConclusionA variety of health outcomes that entail well-being, social and psychological facets and especially experience with care outcomes should be included when evaluating integrated care programmes for persons with multimorbidity.

scholarly journals Ruolo ed attività di un Comitato di Bioetica in un Centro di cure palliative: l’esperienza di Antea

2013 ◽  
Vol 62 (1) ◽  
Author(s):  
M.T. Iannone ◽  
F. Bordin ◽  
C. Magnani ◽  
C. Mastroianni ◽  
G. Casale ◽  
...  
Keyword(s):  
Human Person ◽  
Ethics Consultation ◽  
Good Health ◽  
Care Process ◽  
Research Centre ◽  
Research Projects ◽  
Staff Support ◽  
Non Profit ◽  
Linee Guida ◽  
Principles And Standards

L’articolo esamina l’attività del Comitato di Bioetica di Antea (CB-Antea), Associazione onlus dedicata all’assistenza gratuita a domicilio ai pazienti in fase avanzata di malattia, istituito nel 2008. Il CB-Antea si propone di proteggere e promuovere i valori della persona umana in tutte le attività assistenziali e scientifiche che si svolgono all’interno dell’Associazione. Tale attività si estrinseca attraverso la formulazione di linee-guida comportamentali per problemi clinico-assistenziali, l’espressione di pareri per rispondere a quesiti specifici su temi di bioetica, l’attenta valutazione dei princìpi e dei canoni che sottendono ad una buona relazione operatore-paziente, anche attraverso l’informazione e il consenso agli atti medici che vi si svolgono. Questo organismo si è proposto, sin dall’inizio, come il luogo di condivisione dell’attività assistenziale, in cui esperti di varie discipline potessero contribuire a supportare tanto il personale sanitario, motivandolo ad assumere uno stile etico condiviso e individuando percorsi di sensibilizzazione alle problematiche di etica e di bioetica di fine vita, quanto i pazienti ed i familiari per riflettere ed affrontare al meglio tutte le questioni potenzialmente conflittuali. Il CB-Antea, organizzato ai sensi della normativa italiana vigente, è organo consultivo per la direzione sanitaria, l’amministrazione, il personale – sanitario e non – di Antea, ed eventualmente di enti diversi ed altre persone interessate che ne facciano richiesta. I principali ambiti di attività del Comitato di Bioetica del Centro Antea sono: formazione e sensibilizzazione bioetica; analisi etica di casi clinici; ideazione, approvazione, coordinamento e attuazione di progetti di ricerca in ambito farmacologico, clinico non farmacologico, assistenziale, sociale, psicologico e formativo; formulazione di linee guida comportamentali e raccomandazioni per problemi clinico-assistenziali interni ad Antea. Dalla sua istituzione ad oggi, il CB-Antea si è dedicato ad alcuni temi importanti, quali la Carta dei Valori Antea; la promozione e riconoscimento di Antea come Centro di Ricerca; la produzione di protocolli, procedure operative e materiale facilmente fruibile per il personale della struttura; supporto alla stesura dei progetti di ricerca; rivalutazione dei processi informativi e di consenso. ---------- The article deals with the activities of the “Antea” Ethics Committee (CB-Antea), a non-profit association dedicated to providing free care for advanced/ terminal patients. CB-Antea was established in 2008, aimed to protect and promote the values of the human person in all scientific and charitable activities that take place within the Association. This activity is expressed through the formulation of behavioral guidelines and the expression of advices for addressing issues in palliative medicine and care; the careful evaluation of the principles and standards that underlie a good health professional – patient relationship, through information and consent to medical procedures that take place in Antea. This body has been proposed, from the outset, as the place for sharing the care process, in which experts from different disciplines could help support both the medical staff to assume a shared ethical professional style and the patients and their families to better address all potentially conflicting issues. The CB-Antea has an advisory role for the Antea healthcare work and administration. The main activities are: training in bioethics; clinical ethics consultation; support for designing and conducting of Antea clinical-sociale research projects; development of internal behavioral guidelines and recommendations. From 2008, CB-Antea is devoted to some important issues, such as the drafting of Antea Charter of Values; the promotion of Antea as Research Centre; the production of protocols, operating procedures and material easily accessible for clinical staff; support for the preparation of research projects; revaluation of information processes and consent

scholarly journals How should realism and hope be combined in physician–patient communication at the end of life? An online focus-group study among participants with and without a Muslim background

2016 ◽  
Vol 15 (3) ◽  
pp. 359-368 ◽  
Author(s):  
Mariska G. Oosterveld-Vlug ◽  
Anneke L. Francke ◽  
H. Roeline W. Pasman ◽  
Bregje D. Onwuteaka-Philipsen
Keyword(s):  
Focus Groups ◽  
End Of Life ◽  
Skills Training ◽  
Care Process ◽  
Focus Group Study ◽  
Incurable Illness ◽  
Realistic Information ◽  
Physician Patient ◽  
To Receive ◽  
End Of Life Communication

ABSTRACTObjective:Maintaining false hope may result in prolonged curative aggressive treatments until the very last stage of life. In this study, we sought to explore how people think that realistic and hopeful information should best be combined in physician–patient communications at the end of life.Method:During a period of 15 days, participants of five online focus groups (OFGs) could log in onto a closed discussion site and offer responses to several topics. A variety of people participated: patients, older people, relatives, and healthcare professionals with and without a Muslim background. Participants with a Muslim background constituted a separate group, because previous research indicated that they might have distinct views on good end-of-life care and communication. Transcripts were analyzed following the principles of thematic analysis.Results:Participants from all focus groups preferred that physicians provide realistic information in an empathic way, stating that the patient would never be left on his own and that withholding curative treatment was not equal to withholding care, explicitly asking how the patient could be helped during the time remaining, and involving other professionals in the care process and communications. As such, physicians could support patients' transition from “hope for a cure” to “hope for a good death.” Muslims specified the way they wished to receive realistic information: first from a relative, and not by using the term “incurable illness,” but rather by informing the patient that they had no remaining curative treatments available.Significance of results:Realism and hope are not necessarily mutually exclusive and can be combined when providing realistic information in a delicate and culturally sensitive way. This study provides suggestions on how physicians can do so. Communication skills training as well as anchoring knowledge of the diversity of cultural and religious views into physicians' education could improve end-of-life communication.

The impact of a weight-centred treatment approach on women's health and health-seeking behaviours

2012 ◽  
Vol 1 (2) ◽  
pp. 3-12
Author(s):  
Lucy Aphramor
Keyword(s):  
Focus Groups ◽  
Interpersonal Relationships ◽  
Disease Risk ◽  
Good Health ◽  
Size Discrimination ◽  
Structured Interviews ◽  
Health Seeking ◽  
Attitudes And Practices ◽  
The Impact ◽  
Experiences Of Women

Background Dietetics relies on a conventional weight-centred paradigm that attributes disease risk to fatness and encourages weight loss. This research examines the impact that this weight-centred paradigm has on the health, health-seeking behaviours, and everyday experiences of women who self-identify as large. Methods This was a qualitative, community-based study using semi-structured interviews and focus groups. The participants were 18 women who self-identified as being large, either previously or currently, where large was understood among participants as an appropriate descriptor for fatness. Interviews and focus groups were recorded and transcribed verbatim and data were manually sorted. Coding categories were developed and participants' quotes were assigned to these using thematic analysis. The study had ethics approval. Results Participants described that health professionals’ assumptions and recommendations about their weight negatively affected psychosocial variables and behaviours known to impact on health, such as depression, self-esteem, eating/exercise habits and interpersonal relationships. The assumptions of a weight-centred paradigm underpinned experiences of size discrimination outside the clinic. Conclusions The conventional position towards weight results in attitudes and practices that negatively impact on health and health-seeking behaviour through a range of interlinked pathways. A professional commitment to reappraising the weight-centred paradigm is required to promote good health and avoid overt and inadvertent size discrimination.

scholarly journals College Students’ Views on Functional, Interactive and Critical Nutrition Literacy: A Qualitative Study

2021 ◽  
Vol 18 (3) ◽  
pp. 1124 ◽  
Author(s):  
Jade McNamara ◽  
Noereem Z. Mena ◽  
Leigh Neptune ◽  
Kayla Parsons
Keyword(s):  
College Students ◽  
Qualitative Study ◽  
Focus Groups ◽  
Food Environment ◽  
Critical Appraisal ◽  
Good Health ◽  
Food Choices ◽  
Nutrition Information ◽  
Theory Approach ◽  
Grounded Theory Approach

This research aimed to uncover how the nutrition literacy domains (functional, interactive, critical) influence the dietary decisions of young adults in college. For this qualitative study, undergraduate college students aged 18–24 years old (n = 24) were recruited to participate in focus groups. The focus group transcripts were independently coded for primary and secondary themes using a grounded theory approach and a basic thematic analysis. Four focus groups with 5–7 participants per group were conducted. The three domains of nutrition literacy emerged in the focus groups with two themes per domain. Themes within functional nutrition literacy included ‘food enhances or inhibits good health’ and ‘components of a healthy diet’; themes within interactive nutrition literacy included ‘navigating the college food environment’ and ‘awareness of food marketing on dietary behavior’; themes within critical nutrition literacy included ‘critical appraisal of nutrition information’ and ‘awareness of societal barriers to good health’. Understanding how the different nutrition literacy domains relate to college students’ food choices can inform future researchers on how to appropriately assess nutrition literacy and design programs aimed at improving dietary behaviors of college students.

scholarly journals Equitable Care for Indigenous People: every health service can do it

2016 ◽  
Vol 11 (3) ◽  
pp. 11-17 ◽  
Author(s):  
Judith Dwyer ◽  
Kim O'Donnell ◽  
Eileen Willis ◽  
Janet Kelly
Keyword(s):  
Indigenous Peoples ◽  
Healthcare Providers ◽  
Complex Mixture ◽  
Good Health ◽  
Demographic Variables ◽  
Good Care ◽  
Aboriginal Community ◽  
Official Policy ◽  
Important Barrier ◽  
Access And Quality

Problem and its context: Indigenous peoples in many countries suffer poorer health and poorer access to good healthcare than their non-Indigenous counterparts. In Australia, enduring barriers to good health and good healthcare remain, in spite of long-standing policy priorities. These barriers include the ongoing reality of colonisation, and silence about its implications. People working in and using the health system need to relate across cultures, but they approach this endeavour witha complex mixture of goodwill, defensiveness, guilt and anxiety. Methods: We analysed what is known in Australia about differentials in access to good care, and the underlying factors that entrench them, as well as strategies for developing mainstream competence in care for Aboriginal and Torres Strait Islander patients and communities. Analysis and Conclusions: The available evidence of differentials in access and quality that are not explained by clinical or demographic variables is unequivocal. Official policy needs to be implemented at the system and organisation level through operational policies, programs and protocols, and through relationships with Aboriginal healthcare providers and community organisations. The concept of racism anxiety provides a way of making one important barrier visible, and moving beyond it can enable people of goodwill to ‘see’ where change is needed, and to see themselves as part of the solution. It is time to get beyond the barriers and attend to practical improvements in care, focused on the care system, not simply on the skills and knowledge of individuals within it. Abbreviations: ACCHO – Aboriginal Community Controlled Health Organisation; CC – Cultural Competence.

scholarly journals Identifying exceptional cystic fibrosis care services: combining statistical process control with focus groups

2019 ◽  
Vol 7 (6) ◽  
pp. 1-158
Author(s):  
Stephanie J MacNeill ◽  
Livia Pierotti ◽  
Mohammed A Mohammed ◽  
Martin Wildman ◽  
Jonathan Boote ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Socioeconomic Status ◽  
Focus Groups ◽  
Case Mix ◽  
Good Care ◽  
Statistical Process ◽  
Care Services ◽  
The Mean ◽  
The Uk ◽  
Future Work

Background The Cystic Fibrosis (CF) Registry collects clinical data on all patients attending specialist CF centres in the UK. These data have been used to make comparisons between centres on key outcomes such as forced expiratory volume in 1 second (FEV1) using simple rankings, which promote the assumption that those with the highest measures provide ‘better’ care. Objectives To explore whether or not using statistical ‘process control’ charts that move away from league tables and adjusting for case mix (age, where appropriate; sex; CF genotype; pancreatic sufficiency; and socioeconomic status) could identify exceptional CF care services in terms of clinically meaningful outcomes. Then, using insight from patients and clinicians on what structures, processes and policies are necessary for delivering good CF care, to explore whether or not care is associated with observed differences in outcomes. Design Cross-sectional analyses. Setting Specialist CF centres in the UK. Participants Patients aged ≥ 6 years attending specialist CF centres and clinicians at these centres. Main outcome measures FEV1% predicted. Data sources Annual reviews taken from the UK CF Registry (2007–15). Results We studied FEV1 in many different ways and in different periods. In our analyses of both adult and paediatric centres, we observed that some centres showed repeated evidence of ‘special-cause variation’, with mean FEV1 being greater than the mean in some cases and lower than the mean in others. Some of these differences were explained by statistical adjustment for different measures of case mix, such as age, socioeconomic status, genotype and pancreatic sufficiency. After adjustment, there was some remaining evidence of special-cause variation for some centres. Our data at these centres suggest that there may be an association with the use of intravenous antibiotics. Workshops and focus groups with clinicians at paediatric and adult centres identified a number of structures, processes and policies that were felt to be associated with good care. From these, questionnaires for CF centre directors were developed and disseminated. However, the response rate was low, limiting the questionnaires’ use. Focus groups with patients to gain their insights into what is necessary for the delivery of good care identified themes similar to those identified by clinicians, and a patient questionnaire was developed based on these insights. Limitations Our data analyses suggest that differences in intravenous antibiotic usage may be associated with centre-level outcomes; this needs to be explored further in partnership with the centres. Our survey of centre directors yielded a low response, making it difficult to gain useful knowledge to inform further discussions with sites. Conclusions Our findings confirm that the CF Registry can be used to identify differences in clinical outcomes between centres and that case mix might explain some of these differences. As such, adjustment for case mix is essential when trying to understand how and why centres differ from the mean. Future work Future work will involve exploring with clinicians how care is delivered so that we can understand associations between care and outcomes. Patients will also be asked for their perspectives on the care they receive. Funding The National Institute for Health Research Health Services and Delivery Research programme.

Health Communication: Implications for Diverse Populations

2011 ◽  
Vol 18 (1) ◽  
pp. 12-19
Author(s):  
Amy Hasselkus
Keyword(s):  
Health Care ◽  
Health Communication ◽  
Negative Impact ◽  
Linguistically Diverse ◽  
Good Health ◽  
The United States ◽  
Poor Health ◽  
Health Care Decisions ◽  
Diverse Backgrounds ◽  
Health Related

The need for improved communication about health-related topics is evident in statistics about the health literacy of adults living in the United States. The negative impact of poor health communication is huge, resulting in poor health outcomes, health disparities, and high health care costs. The importance of good health communication is relevant to all patient populations, including those from culturally and linguistically diverse backgrounds. Efforts are underway at all levels, from individual professionals to the federal government, to improve the information patients receive so that they can make appropriate health care decisions. This article describes these efforts and discusses how speech-language pathologists and audiologists may be impacted.

Handlungsleitende Orientierungen frühpädagogischer Fachkräfte in der Zusammenarbeit mit Eltern

2017 ◽  
Vol 6 (1) ◽  
pp. 10-15
Author(s):  
Beate Vomhof
Keyword(s):  
Focus Groups ◽  
Sich Eine

Zusammenfassung. Die Zusammenarbeit mit Eltern wird in Bildungsplänen und Kompetenzbeschreibungen als professionelle Aufgabe frühpädagogischer Fachkräfte definiert. Um einen Paradigmenwechsel anzuzeigen, verwenden zahlreiche Autoren inzwischen nicht mehr den Begriff Elternarbeit, sondern sprechen von Bildungs- und Erziehungspartnerschaft. Doch wird die Kooperation tatsächlich partnerschaftlich umgesetzt? Um der Forschungsfrage nachzugehen, welche handlungsleitenden Orientierungen frühpädagogische Fachkräfte in der Zusammenarbeit mit Eltern im Kontext kompensatorischer Sprachfördermaßnahmen haben, werden neun Fälle (die aus sechs Interviews und zwei Focus Groups generiert wurden) anhand der Dokumentarischen Methode interpretiert. Es zeigt sich, dass die Förderkräfte auf der Ebene der Einstellung die normativen Setzungen um Partnerschaftlichkeit teilen. Die Rekonstruktion der impliziten Wissensbestände offenbart jedoch, dass die Kooperation hierarchisch und teilweise als Machtbeziehung konstruiert wird. Es lässt sich eine grundlegende Diskrepanz zwischen den expliziten und den impliziten Orientierungen rekonstruieren, die sich als Differenz zwischen Norm und Habitus zeigt.

Validity of the Elderly Behavior Assessment for Relatives (EBAR)

2000 ◽  
Vol 16 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Lina Pezzuti ◽  
Caterina Laicardi ◽  
Marco Lauriola
Keyword(s):  
Cognitive Functioning ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Good Health ◽  
The Elderly ◽  
Behavior Assessment ◽  
Elderly Persons ◽  
Behavior Rating Scale ◽  
Components Analysis ◽  
State Examination

Summary: An Elderly Behavior Assessment for Relatives (EBAR), updating the GERRI ( Schwartz, 1983 ), was administered to relatives (or significant others) of 349 elderly persons, from 60 to over 80 years of age, living at home, in good health and without cognitive impairment. A trained psychologist administered subjects the Life Satisfaction for Elderly Scale (LSES), the Instrumental Activity of Daily Living (IADL), the Mini Mental State Examination (MMSE), and personally answered to an overall elderly behavior rating scale (RA). EBAR items were first examined. The more attractive and less discriminative statements were excluded. A principal components analysis was carried out on the remaining EBAR items. Three factors were extracted. After varimax rotation they were tentatively labeled: Everyday Cognitive Functioning, Depression, and Hostility. Factor-driven EBAR subscales were designed, taking into account simpler items in the factor matrix. Results provide evidence for EBAR construct validity. Everyday Cognitive Functioning is connected to the IADL and the RA scores; Depression is very highly related to the LSES; Hostility is weakly related to RA, IADL, and MMSE, indicating that the scale needs further investigation.

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