scholarly journals Negotiating Goals: Exploring the Dialogue Between Professionals and Patients in Team-Meetings

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bjørg Christiansen ◽  
Mirela Slomic
Keyword(s):  
Health Care ◽  
Discourse Analysis ◽  
Goal Setting ◽  
Professional Practice ◽  
Health Care Professionals ◽  
Qualitative Method ◽  
Rehabilitation Services ◽  
Everyday Language ◽  
Team Meetings ◽  
Language Constructs

The aim of this study is to explore the negotiation of goals in team meetings with patients within a specialized rehabilitation context: What characterizes the dialogue between professionals and patients in goal meetings? Despite agreement in the literature that the patients’ perspectives and participation are significant in goal setting processes, there seem to be few studies on characteristics of the dialogue in such meetings with patients. The data derived from audio-recorded observations of three team meetings with various health care professionals and patients within rehabilitation services. The method can be characterized as a theme-oriented discourse analysis, which is a qualitative method for analyzing how language constructs professional practice. The analysis identifies two main themes: 1. Reviewing goals: from standardized readings to everyday language. 2. Setting meaningful goals. The article discusses characteristics of the patients´ participation in the dialogue, and how professionals de-emphasize inherent power inequalities in the negotiation of goals.

scholarly journals In-Home Telerehabilitation for Post-Knee Arthroplasty: A Pilot Study

2009 ◽  
Vol 1 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Michel Tousignant ◽  
Patrick Boissy ◽  
Hélène Corriveau ◽  
Hélène Moffet ◽  
François Cabana
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Acute Care ◽  
Knee Arthroplasty ◽  
Health Care Professionals ◽  
Acute Care Hospital ◽  
Rehabilitation Services ◽  
Control Group ◽  
Care Hospital ◽  
Post Discharge

The purpose of this study was to investigate the efficacy of in-home telerehabilitation as an alternative to conventional rehabilitation services following knee arthroplasty. Five community-living elders who had knee arthroplasty were recruited prior to discharge from an acute care hospital. A pre/post-test design without a control group was used for this pilot study. Telerehabilitation sessions (16) were conducted by two trained physiotherapists from a service center to the patient’s home using H264 videoconference CODECs (Tandberg 550 MXP) connected at 512 Kb\s. Disability (range of motion, balance and lower body strength) and function (locomotor performance in walking and functional autonomy) were measured in face-to-face evaluations prior to and at the end of the treatments by a neutral evaluator. The satisfaction of the health care professional and patient was measured by questionnaire. Results are as follows. One participant was lost during follow-up. Clinical outcomes improved for all subjects and improvements were sustained two months post-discharge from in-home telerehabilitation. The satisfaction of the participants with in-home telerehabilitation services was very high. The satisfaction of the health care professionals with the technology and the communication experience during the therapy sessions was similar or slightly lower. In conclusion, telerehabilitation for post-knee arthroplasty is a realistic alternative for dispensing rehabilitation services for patients discharged from an acute care hospital.Keywords: Telerehabilitation, Physical Therapy, Total Knee Arthroplasty, Videoconferencing

scholarly journals Anesthesia Geriatric Evaluation (AGE): A Care-Ethical Perspective of a Multi-Disciplinary Approach for Tailored Preoperative Interventions

2019 ◽  
Vol 5 ◽  
pp. 233372141987612 ◽  
Author(s):  
E. L. Pel ◽  
E. van Wijngaarden ◽  
E. P. A. van Dongen ◽  
P. G. Noordzij
Keyword(s):  
Health Care ◽  
Multidisciplinary Team ◽  
Health Care Professionals ◽  
Screening Tool ◽  
Care Process ◽  
Ethical Perspective ◽  
Team Meetings ◽  
Geriatric Evaluation ◽  
Sharing Responsibility ◽  
Multidisciplinary Team Meetings

Background: Frailty is considered to be an important risk factor for mortality in hospitalized patients. This study evaluates a preoperative frailty-screening tool called Anesthesia Geriatric Evaluation (AGE). Research into the concept of frailty, with a focus on multidisciplinary team meetings, may provide further insight for health care professionals in the understanding of frailty in everyday care situations. Methods: The research method chosen for this research is QUAGOL: Qualitative Analysis Guide of Leuven, which aims to reconstruct the story of the participants on a theoretical level and analyze the concepts found. Results: The following themes illustrate the analyzed concepts found: competence, resilience, sharing responsibility, broad frame of reference, obligation, and significance. Conclusion: AGE seems to create more awareness among health care professionals about frailty and tries to involve patients in their care process by making them aware of their abilities, motivation, and involving them in decisions to be made. This study shows that a shared decision-making process for surgical patients is often difficult to accomplish since AGE is still a paternalistic process of a multidisciplinary team with a medical perspective.

Professional Practice and Patient Care: Multidisciplinary Teamwork in Geriatric Wards

1982 ◽  
Vol 2 (1) ◽  
pp. 57-75 ◽  
Author(s):  
Helen Evers
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Professional Practice ◽  
Health Care Professionals ◽  
Geriatric Patient ◽  
Geriatric Patients ◽  
The Elderly ◽  
Policy And Practice ◽  
Professional Literature ◽  
Multidisciplinary Teamwork

ABSTRACTThis paper aims to examine aspects of the nature of multidisciplinary teamwork in geriatric care. First, some of the medical profession's current views of teamwork in geriatrics will be summarized. Second, case studies from a research project on care of geriatric patients in hospital will be used to illustrate some of the strengths and limitations of the adoption of a teamwork approach by health care professionals. Evidence from research suggests that under only a few circumstances does care of the geriatric patient match the images of teamwork as portrayed in the professional literature. This finding in part reflects piecemeal developments in interprofessional responsibilities and relationships in policy and practice of care of the elderly.

scholarly journals Exploring the Specific Needs of Persons with Multiple Sclerosis for mHealth Solutions for Physical Activity: Mixed-Methods Study (Preprint)

2017 ◽  
Author(s):  
Guido Giunti ◽  
Jan Kool ◽  
Octavio Rivera Romero ◽  
Enrique Dorronzoro Zubiete
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Health Care ◽  
Mixed Methods ◽  
Goal Setting ◽  
Health Care Professionals ◽  
Mobile Technologies ◽  
Satisfaction With Life Scale ◽  
Care Providers ◽  
Mhealth Apps

BACKGROUND Multiple sclerosis (MS) is one of the world’s most common neurologic disorders, with symptoms such as fatigue, cognitive problems, and issues with mobility. Evidence suggests that physical activity (PA) helps people with MS reduce fatigue and improve quality of life. The use of mobile technologies for health has grown in recent years with little involvement from relevant stakeholders. User-centered design (UCD) is a design philosophy with the goal of creating solutions specific to the needs and tasks of the intended users. UCD involves stakeholders early and often in the design process. In a preliminary study, we assessed the landscape of commercially available MS mobile health (mHealth) apps; to our knowledge, no study has explored what persons with MS and their formal care providers think of mHealth solutions for PA. OBJECTIVE The aim of this study was to (1) explore MS-specific needs for MS mHealth solutions for PA, (2) detect perceived obstacles and facilitators for mHealth solutions from persons with MS and health care professionals, and (3) understand the motivational aspects behind adoption of mHealth solutions for MS. METHODS A mixed-methods design study was conducted in Kliniken Valens, Switzerland, a clinic specializing in neurological rehabilitation. We explored persons with MS and health care professionals who work with them separately. The study had a qualitative part comprising focus groups and interviews, and a quantitative part with standardized tools such as satisfaction with life scale and electronic health (eHealth) literacy. RESULTS A total of 12 persons with relapsing-remitting MS and 12 health care professionals from different backgrounds participated in the study. Participants were well-educated with an even distribution between genders. Themes identified during analysis were MS-related barriers and facilitators, mHealth design considerations, and general motivational aspects. The insights generated were used to create MS personas for design purposes. Desired mHealth features were as follows: (1) activity tracking, (2) incentives for completing tasks and objectives, (3) customizable goal setting, (4) optional sociability, and (5) game-like attitude among others. Potential barriers to mHealth apps adoption were as follows: (1) rough on-boarding experiences, (2) lack of clear use benefits, and (3) disruption of the health care provider-patient relationship. Potential facilitators were identified: (1) endorsements from experts, (2) playfulness, and (3) tailored to specific persons with MS needs. A total of 4 MS personas were developed to provide designers and computer scientists means to help in the creation of future mHealth solutions for MS. CONCLUSIONS mHealth solutions for increasing PA in persons with MS hold promise. Allowing for realistic goal setting and positive feedback, while minimizing usability burdens, seems to be critical for the adoption of such apps. Fatigue management is especially important in this population; more attention should be brought to this area.

Sharing the Vision of NICU Nursing Practice

1999 ◽  
Vol 18 (4) ◽  
pp. 71-72
Author(s):  
Denise Maguire
Keyword(s):  
Health Care ◽  
Professional Practice ◽  
Health Care Professionals ◽  
Nursing Practice ◽  
Shared Vision ◽  
Staff Nurses ◽  
Neonatal Nursing ◽  
Ideal World ◽  
Significant Difference ◽  
The Future

NURSES WHO READILY AND consistently describe their vision of professional practice help to move nursing toward the future. A vision is a philosophy that determines how we conduct the business of neonatal nursing in our NICU. It is how we hope nursing practice will evolve; it helps to direct our efforts toward our goals. Personal vision is a powerful motivator, fueling commitment and energy toward great achievements. Creators of the vision assume an ideal world, where nurses are fully prepared to engage in collegial relationships with physicians and other health care professionals to make a significant difference in the lives of patients and their families. Keepers of the vision are often managers, but staff nurses have vision also. The key to success is developing a shared vision that all members of the staff embrace.

scholarly journals Developing an interprofessional transition course to improve team-based HIV care for Sub-Saharan Africa

2020 ◽  
Author(s):  
Elsie Kiguli-Malwadde ◽  
Jehan Z Budak ◽  
Evelyn Chilemba ◽  
Fred Semitala ◽  
Deborah Von Zinkernagel ◽  
...  
Keyword(s):  
Health Care ◽  
Curriculum Development ◽  
Professional Practice ◽  
Health Care Professionals ◽  
Health Professions ◽  
Sub Saharan Africa ◽  
Training Package ◽  
Service Training ◽  
Training Institutions ◽  
Sub Saharan

Abstract BackgroundWith funding from the United States Health Resources Service Administration (HRSA), a consortium of health professional training institutions from Africa developed HIV-specific, interprofessional, team-based educational resources to better support trainees during the transition period between pre-service training and professional practice.MethodsTen faculty members representing nine medical and nursing schools in sub-Saharan Africa (SSA) developed a training package of modules focused on core clinical, public health, interprofessional education (IPE), and quality improvement (QI) domains related to HIV service delivery. Curriculum development was informed by a rapid needs assessment of existing tools and future needs for HIV education across 27 SSA health professions training institutions. A total of 17 modules were developed, targeted at newly qualified health care professionals to be taught in a series of two-day workshops meant to complement existing institution specific HIV-curricula. ResultsBetween April and July 2019, a comprehensive case-based HIV training package was developed to support trainees in transition from pre-service training to independent professional practice. Each module, addressing different elements of interprofessional practice, was intended to be delivered in an interprofessional format. Thus far, 70 health professions training institutions in 14 countries have implemented the program; 547 educators facilitated STRIPE workshops, with a total of 5,027 learners trained between September 2019 and September 2020.ConclusionsTo our knowledge this is the first IPE HIV-specific curriculum explicitly focused on enhancing the quality of training provided to graduating health care professionals working in SSA. The collaborative, cross-institutional, interprofessional approach to curriculum development provides a benchmark for how best-practice approaches to education can be disseminated in SSA.

scholarly journals Developing an inter-professional transition course to improve team-based HIV care for Sub-Saharan Africa

2020 ◽  
Author(s):  
Elsie Kiguli-Malwadde ◽  
Jehan Z Budak ◽  
Evelyn Chilemba ◽  
Fred Semitala ◽  
Deborah Von Zinkernagel ◽  
...  
Keyword(s):  
Health Care ◽  
Curriculum Development ◽  
Professional Practice ◽  
Health Care Professionals ◽  
Health Professions ◽  
Sub Saharan Africa ◽  
Training Package ◽  
Service Training ◽  
Training Institutions ◽  
Sub Saharan

Abstract Background With funding from the United States Health Resources Service Administration (HRSA), a consortium of health professional training institutions from Africa developed HIV-specific, interprofessional, team-based educational resources to better support trainees during the transition period between pre-service training and professional practice.Methods Ten faculty members representing nine medical and nursing schools in sub-Saharan Africa (SSA) developed a training package of modules focused on core clinical, public health, interprofessional education (IPE), and quality improvement (QI) domains related to HIV service delivery. Curriculum development was informed by a rapid needs assessment of existing tools and future needs for HIV education across 27 SSA health professions training institutions. A total of 17 modules were developed, targeted at newly qualified health care professionals to be taught in a series of two-day workshops meant to complement existing institution specific HIV-curricula. Results Between April and July 2019, a comprehensive case-based HIV training package was developed to support trainees in transition from pre-service training to independent professional practice. Each module, addressing different elements of interprofessional practice, was intended to be delivered in an interprofessional format. Thus far, 70 health professions training institutions in 14 countries have implemented the program; 547 educators facilitated STRIPE workshops, with a total of 5,027 learners trained between September 2019 and September 2020.Conclusions To our knowledge this is the first IPE HIV-specific curriculum explicitly focused on enhancing the quality of training provided to graduating health care professionals working in SSA. The collaborative, cross-institutional, interprofessional approach to curriculum development provides a benchmark for how best-practice approaches to education can be disseminated in SSA.

scholarly journals Real time location systems: Is it big brother or a big opportunity for professional practice?

2020 ◽  
Vol 10 (11) ◽  
pp. 67
Author(s):  
Jacqueline Limoges ◽  
Sara Lankshear ◽  
Joseph Church
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Real Time ◽  
Professional Practice ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Location Systems

Purpose: Real Time Location Systems (RTLS) is an emerging health care technology with the potential to capture data that can be used to improve professional practice and patient outcomes. However, there is a paucity of literature in this area to guide health professionals and leaders in both the implementation and use of RTLS data. To address this gap in the literature, this qualitative study was designed to explore how staff perceive and experience RTLS, and how health care providers anticipate using RTLS data for professional practice and clinical decision making.Results: Interviews and focus groups were conducted with 31 health care professionals who work in a community hospital in Canada. There was variation between the participants in terms of the experience of being monitored, the intensity of emotions related to RTLS and being monitored, the degree to which RTLS influenced clinical decision making and reflection, and the perceptions of usefulness of RTLS data for  professional practice. Three key themes emerged from the data: (1) the experience of being monitored, (2) anticipating using the data and (3) claiming the data for professional practice.Conclusions: Supports are vital to the successful adoption of RTLS and to enable health care professionals to claim and use RTLS data for professional practice and clinical decision making. During the implementation and use of RTLS data, it is crucial to recognize that RTLS data only represent the time spent in a location, and not the professional or knowledge-based practice of health professionals. Further research is required to understand the leadership strategies to guide the use of RTLS data.

scholarly journals Acceptability and Usability of the Mobile Digital Health App NoObesity for Families and Health Care Professionals: Protocol for a Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Edward Meinert ◽  
Em Rahman ◽  
Alison Potter ◽  
Wendy Lawrence ◽  
Michelle Van Velthoven
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Health Education ◽  
Goal Setting ◽  
Feasibility Study ◽  
Health Care Professionals ◽  
Technology Use ◽  
Self Efficacy ◽  
Future Studies ◽  
Study Recruitment

BACKGROUND Almost a quarter or more than a fifth of children in the United Kingdom are overweight or obese by the time they start school. The UK Department of Health and Social Care’s national policy for combating childhood obesity has critical outcomes centered on sugar and caloric consumption reduction. Health Education England has developed two digital apps for families with children up to 15 years and for their associated health care professionals to provide a digital learning resource and tool aimed at encouraging healthy lifestyles to prevent obesity. OBJECTIVE This feasibility study assesses the usability and acceptability of Health Education England’s NoObesity app for undertaking activities to improve families’ diet and physical activity. The purpose of the study is to evaluate the app’s influence on self-efficacy and goal setting and to determine what can be learnt to improve its design for future studies, if there is evidence of adoption and sustainability. METHODS The study population will include 20 to 40 families and their linked health care professionals. Considering issues related to digital access associated with socioeconomic status and the impact on information technology use, study recruitment will be regionally focused in a low socioeconomic status area. The study will last for 9 months (3-month intervention period and 6-month follow-up). The evaluations of feasibility, acceptability, and usability will be conducted using the following scales and theoretical frameworks: (1) system usability scale; (2) Reach Effectiveness Adoption Implementation Maintenance framework; (3) Bandura model of health promotion; and (4) Nonadoption, Abandonment, and Challenges to the Scale-up, Spread, and Suitability framework. App use will be captured and quantitatively analyzed for net use patterns (eg, number of screens viewed, number of logins, cumulative minutes using the app, number of plans made, and number of times goals met) and to triangulate qualitative feedback from study participants. RESULTS This study was funded in March 2019 by Health Education England and received University of Oxford Medical Sciences Interdivisional Research Ethics Committee approval on January 31, 2020 (R62092/RE001). At manuscript submission, study recruitment is pending, and expected results will be published in 2021. CONCLUSIONS This study will provide evidence on the NoObesity app’s influence on self-efficacy and goal-setting and determine what can be learnt to improve its design for future studies, if there is evidence of adoption and sustainability. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/18068

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