A Mobile App With Multimodality Prehabilitation Programs for Patients Awaiting Elective Surgery: Development and Usability Study

Background Complying with a prehabilitation program is difficult for patients who will undergo surgery, owing to transportation challenges and a limited intervention time window. Mobile health (mHealth) using smartphone apps has the potential to remove barriers and improve the effectiveness of prehabilitation. Objective This study aimed to develop a mobile app as a tool for facilitating a multidisciplinary prehabilitation protocol involving blood flow restriction training and sport nutrition supplementation. Methods The app was developed using “Appy Pie,” a noncoding app development platform. The development process included three stages: (1) determination of principles and requirements of the app through prehabilitation research team meetings; (2) app prototype design using the Appy Pie platform; and (3) app evaluation by clinicians and exercise and fitness specialists, technical professionals from Appy Pie, and non–team-member users. Results We developed a prototype of the app with the core focus on a multidisciplinary prehabilitation program with accessory features to improve engagement and adherence to the mHealth intervention as well as research-focused features to evaluate the effects of the program on frailty status, health-related quality of life, and anxiety level among patients awaiting elective surgery. Evaluations by research members and random users (n=8) were consistently positive. Conclusions This mobile app has great potential for improving and evaluating the effectiveness of the multidisciplinary prehabilitation intervention in the format of mHealth in future.

Impact of the First Wave of the COVID-19 Pandemic on the Lyon University Hospital Cancer Institute (IC-HCL)

This article presents the protective measures put in place at the “Institut de Cancérologie des Hospices de Lyon” (IC-HCL) during the first wave of the COVID-19 pandemic in France (spring 2020) and how they impacted IC-HCL clinical activity. Spring 2020 activities were compared to winter 2019–2020. Results showed a decrease of activity of 9% for treatment dispensations, 17% for multidisciplinary team meetings, 20% for head and neck and thoracic surgeries, and 58% for new patient enrolment in clinical trials. Characteristics of patients treated for solid cancer and hospitalized for COVID-19 during spring 2020 were collected in a retrospective study. Mortality was attributed to COVID-19 for half of the cases, 82% being patients above 70 and 73% being stage IV. This is in concordance with current findings concluding that the risk of developing severe or critical symptoms of COVID-19 is correlated with factors co-occurring in cancer patients and not to the cancer condition per se. While a number of routines and treatment regimens were changed, there was no major decline in numbers of treatments conducted at the IC-HCL during the first wave of the COVID-19 pandemic that hit France between March and May 2020, except for clinical trials and some surgery activities.

A Conceptual Framework of How Meeting Mindsets Shape and Are Shaped by Leader–Follower Interactions in Meetings

In this conceptual paper, we define a person's meeting mindset as the individual belief that meetings represent opportunities to realize goals falling into one of three categories: personal, relational, and collective. We propose that in alignment with their respective meeting mindsets, managers use specific leadership claiming behaviors in team meetings and express these behaviors in alignment with the meeting setting (virtual or face-to-face) and their prior experiences with their employees. Employees’ responses, however, are also influenced by their meeting mindsets, the meeting setting, and prior experiences with their managers. The interplay between managers’ leadership claiming behavior and their employees’ responses shapes leader–follower relations. Embedded in the team context, the emerging leader–follower relations impact the meaning of meetings. We outline match/mismatch combinations of manager–employee meeting mindsets and discuss the influence that a manager and employee can have on each other's meeting mindset through their behavior in a meeting. Plain Language Summary Have you ever had the experience of entering a team meeting and quickly realizing that your idea of how the meeting conversation should be approached did not align with your boss's understanding of the meeting purpose? This is indeed a common experience in meetings between managers and their employees. While we understand much about the communication dynamics that occur in meetings, we know less about what motivates people to communicate in certain ways in meetings. In this conceptual paper, we classify people's understanding of meetings as being driven by one of three purposes: [1] to strategically position and promote themselves (which reflects a personal meeting mindset), [2] to shape collaborations and to ensure reciprocation (which reflects a relational meeting mindset), or [3] to strengthen the team identity and increase the willingness to go the extra mile for the team (which reflects a collective meeting mindset). Meeting mindsets shape how people enact their leader or follower role in meetings—that is, how a manager exhibits leadership and how employees react. However, managers’ and employees’ meeting mindsets may not necessarily match, which can trigger tensions and may ultimately change the way in which managers or employees define the meaning of meetings. Our research helps managers to comprehend the reasoning behind their own and other people's meeting behavior and may promote reflection on one's leadership approach, particularly in a team meeting context. It can also help employees to grasp the power they can have in terms of actively shaping their managers’ meeting mindsets.

Testing the Usefulness of the Evidence Integration Triangle for Implementation of EIT-4-BPSD

The effectiveness of evidence-based practices, such as use of behavioral interventions, can be improved when delivered under conditions of an implementation framework. This pragmatic trial used the Evidence Integration Triangle (EIT) which is a parsimonious, community-engaged participatory framework that brings evidence and facility stakeholders together. Active engagement empowers key stakeholders to integrate evidence into practice using a simple three-pronged framework: (1) A participatory implementation process which was done via monthly meetings and weekly emails between stakeholders and a clinical expert as they worked on facility based goals; (2) Implementation of the four steps delineated in the EIT-4-BPSD; and (3) evaluation using practical progress measures. There was some evidence of implementation of the EIT-4-BPSD based on participation in Stakeholder team meetings, settings working towards goal achievement, and increased use of behavioral interventions among staff. The EIT approach is a useful implementation framework to help change staff behavior in long term care.

Transitional Care Management from Emergency Services to Communities: An Action Research Study

In recent years, nurses have developed projects in the area of hospital to community transition. The objective of the present study was to analyze the transitional care offered to elderly people after they used emergency services and were discharged to return to the community. The action research method was chosen. The participants were nurses, elderly people 70 years old or older, and their caregivers. The study was carried out from October 2018 to August 2019. The data were collected by means of semi-structured interviews with the nurses, analysis of medical records, participatory observation, phone calls to the elderly people and caregivers, and team meetings. The qualitative data were submitted to Bardin’s content analysis. Statistical treatment was carried out by applying SPSS version 23.0. The institution’s research ethics committee approved the research. Only 31.4% of the sample experienced care continuity after discharge, and the rate of readmission to emergency services during the first 30 days after discharge was 33.4%. The referral letters lacked data on information provided to patients or caregivers, and nurses mentioned difficulties in communication between care levels, as well as obstacles to teamwork; they also mentioned that the lack of health policies and clinical rules to formalize transitional care between the hospital and the community perpetuated non-coordination of care between the two contexts. The low level of literacy of patients and their relatives are mentioned as a cause for not understanding the information regarding seeking primary health care services and handing the discharge letter. It was concluded that there is an urgent need to mobilize health teams toward action in the patients’ process of returning home, and this factor must be taken into account in care planning.

The Application of Stakeholder Networking Theory for Strategic Planning in the New Zealand Public Sector

<p>The New Zealand public sector is facing an increasingly pluralistic stakeholder landscape due to a range of political, economic, social, and technological factors, all of which require public sector organisations to develop new ways of understanding and responding to diverse and complex stakeholder needs. The purpose of this thesis is to investigate whether the theory of stakeholder networking can contribute to strategic planning in the public sector, to assist organisations in planning to meet strategic goals and ultimately move toward their strategic direction. A qualitative research approach, known as participatory action research, was adopted. This required strong involvement with the two sample organisations, contributing to the development and application of the stakeholder networking process and also to the findings. Information gathering occurred through a variety of methods including focus groups, team meetings, interviews, document analysis and workshops. A Stakeholder Networking Framework is proposed as an approach for public sector organisations to apply stakeholder networking theory in practice, which takes into account the key issues participants raised during application. Three primary uses of stakeholder networking theory for strategic planning were found, including a means for providing greater clarity to the stakeholder context surrounding strategic issues, identification of potential relationship strategies to meet strategic goals, and assisting with the prioritisation of stakeholders. The Stakeholder Networking Framework has purposefully been developed in a way that is non-prescriptive and flexible, enabling it to be adapted by managers to suit the context specific needs of their organisation during application. Managers can then use the stakeholder network maps as outputs of the process to inform relationship management activities and strategic decision making. This thesis fills a gap in the literature that provides practical research to public sector organisations and managers on how to integrate a stakeholder networking perspective into their strategic planning processes. It addresses common concerns that arise when trying to deliver such objectives in practice, drawing on the practical considerations of organisations' day-to-day realities.</p>

The Application of Stakeholder Networking Theory for Strategic Planning in the New Zealand Public Sector

<p>The New Zealand public sector is facing an increasingly pluralistic stakeholder landscape due to a range of political, economic, social, and technological factors, all of which require public sector organisations to develop new ways of understanding and responding to diverse and complex stakeholder needs. The purpose of this thesis is to investigate whether the theory of stakeholder networking can contribute to strategic planning in the public sector, to assist organisations in planning to meet strategic goals and ultimately move toward their strategic direction. A qualitative research approach, known as participatory action research, was adopted. This required strong involvement with the two sample organisations, contributing to the development and application of the stakeholder networking process and also to the findings. Information gathering occurred through a variety of methods including focus groups, team meetings, interviews, document analysis and workshops. A Stakeholder Networking Framework is proposed as an approach for public sector organisations to apply stakeholder networking theory in practice, which takes into account the key issues participants raised during application. Three primary uses of stakeholder networking theory for strategic planning were found, including a means for providing greater clarity to the stakeholder context surrounding strategic issues, identification of potential relationship strategies to meet strategic goals, and assisting with the prioritisation of stakeholders. The Stakeholder Networking Framework has purposefully been developed in a way that is non-prescriptive and flexible, enabling it to be adapted by managers to suit the context specific needs of their organisation during application. Managers can then use the stakeholder network maps as outputs of the process to inform relationship management activities and strategic decision making. This thesis fills a gap in the literature that provides practical research to public sector organisations and managers on how to integrate a stakeholder networking perspective into their strategic planning processes. It addresses common concerns that arise when trying to deliver such objectives in practice, drawing on the practical considerations of organisations' day-to-day realities.</p>