6 results
Search Results
2. What does an e-mail address add? - Doing health and technology at home
- Author
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Andreassen, Hege K.
- Subjects
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CHRONIC disease treatment , *ATTITUDE (Psychology) , *COMMUNICATION , *DERMATOLOGY , *HEALTH services accessibility , *HOME care services , *HOSPITALS , *INTERVIEWING , *RESEARCH methodology , *MEDICAL practice , *PATIENT education , *PATIENTS , *PHYSICIAN-patient relations , *RESEARCH , *EMAIL , *QUALITATIVE research - Abstract
Abstract: There is increasing interest in using electronic mail and other electronic health technologies (e-health technologies) in patient follow-ups. This study sheds light on patients’ reception of provider-initiated e-health in their everyday environments. In a research project carried out in Norway (2005–2007), an electronic address for a hospital dermatology ward was offered to 50 patient families for improved access to expert advice from the patients’ homes. Drawing on semi-structured interviews with 12 families, this paper explores how the electronic address was integrated into everyday health practice. The research illuminates how the electronic address did not only represent changes related to treatment procedures and frequency or nature of expert contact; it was also important to other practices in the everyday lives of the families of patients with chronic illness. Once in place on the patients’ computers, the electronic address was ascribed at least four different roles: it was used as the intended riverbed for a flow of information, but also as a safety alarm, as a shield to the medical gaze and as a token of competence in care and parenting. The multiplicity in use and reception of an electronic address in patient settings illustrates the need to include patients’ everyday practices in current professional and political discussions of e-mail and other e-health technologies. Thus this paper argues that there is a need for research on electronic patient–provider communication that moves beyond frequency of use and questions on how technology will affect medical encounters. Social science equally needs to investigate how provider-initiated e-health technologies gets involved in patients’ moral and social performance of health and illness in everyday life. [Copyright &y& Elsevier]
- Published
- 2011
- Full Text
- View/download PDF
3. "I just need to know they are going to do what they say they're going to do with my mom." Understanding hospice expectations from the patient, caregiver and admission nurse perspective.
- Author
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Candrian, Carey, Tsantes, Alexandra, Matlock, Dan D., Tate, Channing, and Kutner, Jean S.
- Subjects
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CAREGIVERS , *HOSPITAL admission & discharge , *PATIENT education , *MEDICAL decision making , *NURSING care facilities - Abstract
Objective: The objective of this paper is to understand patient, caregiver and hospice admission nurses needs during the hospice admission conversation so patients and their caregivers can make informed decisions about hospice.Methods: Resulting data set from this qualitative study included 60 h of observation and a total of 30 interviews with caregivers, patients and hospice admission nurses. Participants were from a large non-profit hospice; observation settings included: home, hospital and skilled nursing facility.Results: Four themes were identified: (1) Wide variation in patient knowledge of hospice care prior to the admission conversation, (2) competing expectations and objectives for the admission conversation between patients, caregivers and hospice admission team members, (3) organizational influences around the goals of the admission conversation, (4) importance of integrating the patient and caregiver perspective to improve the quality of admission conversations.Conclusion: Hospice services provided may be inconsistently explained by hospice personnel and therefore, can be misunderstood by patients and families. With the ubiquitous challenges surrounding hospice admission consults, there is a critical need for complete and accurate information during the admission process.Practice Implications: Providing accurate and pertinent information at the time of the admission consult can help mitigate misinformed expectations of services provided. [ABSTRACT FROM AUTHOR]- Published
- 2018
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4. Implementing, embedding and integrating self-management support tools for people with long-term conditions in primary care nursing: A qualitative study.
- Author
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Kennedy, Anne, Rogers, Anne, Bowen, Robert, Lee, Victoria, Blakeman, Tom, Gardner, Caroline, Morris, Rebecca, Protheroe, Joanne, and Chew-Graham, Carolyn
- Subjects
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CHRONIC disease treatment , *POVERTY areas , *AUTONOMY (Psychology) , *BEHAVIOR modification , *COMMUNICATION , *DECISION making , *EMPLOYEES , *EXPERIENCE , *FAMILY medicine , *HEALTH behavior , *INTERVIEWING , *MATHEMATICAL models , *RESEARCH methodology , *MEDICAL office nursing , *NURSE-patient relationships , *NURSES , *NURSING practice , *PATIENT compliance , *PATIENT education , *GENERAL practitioners , *PRIMARY health care , *PROFESSIONS , *RESEARCH funding , *HEALTH self-care , *TEACHING aids , *DISEASE management , *QUALITATIVE research , *THEORY , *OCCUPATIONAL roles , *RANDOMIZED controlled trials , *CHANGE management , *PATIENT-centered care , *DESCRIPTIVE statistics - Abstract
Background: An implementation gap exists between policy aspirations for provision and the delivery of self-management support in primary care. An evidence based training and support package using a whole systems approach implemented as part of a randomised controlled trial was delivered to general practice staff. The trial found no effect of the intervention on patient outcomes. This paper explores why self-management support failed to become part of normal practice. We focussed on implementation of tools which capture two key aspects of self-management support - education (guidebooks for patients) and forming collaborative partnerships (a shared decision-making tool). Objectives: To evaluate the implementation and embedding of self-management support in a United Kingdom primary care setting. Design: Qualitative semi-structured interviews with primary care professionals. Settings: 12 General Practices in the Northwest of England located within a deprived inner city area. Participants: Practices were approached 3-6 months after undergoing training in a selfmanagement support approach. A pragmatic sample of 37 members of staff - General Practitioners, nurses, and practice support staff from 12 practices agreed to take part. The analysis is based on interviews with 11 practice nurses and one assistant practitioner; all were female with between 2 and 21 years' experience of working in general practice. Methods: A qualitative design involving face-to-face, semi-structured interviews audio- recorded and transcribed. Normalisation Process Theory framework allowed a systematic evaluation of the factors influencing the work required to implement the tools. Findings: The guidebooks were embedded in daily practice but the shared decision- making tools were not. Guidebooks were considered to enhance patient-centredness and were minimally disruptive. Practice nurses were reluctant to engage with behaviour change discussions. Self-management support was not formulated as a practice priority and there was minimal support for this activity within the practice: it was not auditable; [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
5. Cancer patients' and professional caregivers' needs, preferences and factors associated with receiving and providing fertility-related information: A mixed-methods systematic review.
- Author
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Goossens, Joline, Delbaere, Ilse, Van Lancker, Aurélie, Beeckman, Dimitri, Verhaeghe, Sofie, and Van Hecke, Ann
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ATTITUDE (Psychology) , *CANCER patients , *CANCER patient medical care , *CINAHL database , *COMMUNICATION , *FERTILITY , *HEALTH , *INFORMATION storage & retrieval systems , *MEDICAL databases , *MEDICAL information storage & retrieval systems , *RESEARCH methodology , *MEDICAL personnel , *PATIENT-professional relations , *MEDLINE , *NURSES , *ONLINE information services , *PATIENT education , *PATIENT satisfaction , *PHYSICIANS , *PROBABILITY theory , *RESEARCH funding , *STATISTICS , *TUMORS , *INFORMATION resources , *SYSTEMATIC reviews , *REPRODUCTIVE health , *QUALITATIVE research , *QUANTITATIVE research , *COMMUNICATION barriers , *INFORMATION needs , *DESCRIPTIVE statistics , *FERTILITY preservation - Abstract
Objectives: Cancer treatment can impair fertility. The aim of this review was to investigate (1) fertility information needs, receipt and provision, (2) fertility information preferences, and (3) factors associated with receiving/providing fertility information. Cancer patients' and professional caregivers' perspectives were considered. Design: Mixed-methods systematic review. Data sources: Six electronic databases (PubMed, Web of Science, CINAHL, CRD, Embase) were systematically screened to retrieve articles published between January 2001 and March 2012. Reference lists and conference abstracts were checked for additional publications. Review methods: The principles outlined in the Cochrane Handbook for Systematic Reviews of Intervention were applied. Publications were included if they explored fertility-related information/communication in cancer patients/survivors of reproductive age or professional caregivers. The Critical Appraisal Skills Programme for Qualitative Studies and the Quality Assessment Tool for Quantitative Studies were used to assess the methodological quality. A standardised form based on the Cochrane guidelines for systematic reviews was used to extract the data. Two independent reviewers performed all methodological steps. Results: Of the 1872 papers found, 27 were included in this review. The majority (66- 100%) of the cancer patients wanted information about the impact of cancer therapy on fertility. The need and importance were higher in younger and childless patients, and in patients having childbearing plans. The number of patients receiving this information ranged from 0% to 85%. Several factors were associated with the lack of information receipt, including female gender and age 35 years or older. Patients preferred information via an individual consultation. In the diagnostic phase patients needed information about the impact of the treatment on fertility and preservation options. At the end or after the treatment, information needs shifted towards long term effects. Professional caregivers experienced several barriers in providing fertility information, including caregiver-, patient- and institutional-related factors. Nurses in particular, perceived difficulty in providing fertility-related information due to additional barriers associated with limited responsibility and opportunity in fertility information provision. Conclusion: Professional caregivers experienced multiple barriers that hinder information provision. Further exploration of the role of Advanced Nurse Practitioners/Midwifes and the development of an evidence based intervention to overcome caregiver-related barriers are recommended to improve information provision. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
6. Factors influencing the ability to self-manage diabetes for adults living with type 1 or 2 diabetes.
- Author
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Wilkinson, Amanda, Whitehead, Lisa, and Ritchie, Lorraine
- Subjects
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TYPE 2 diabetes treatment , *TREATMENT of diabetes , *TYPE 1 diabetes , *ADAPTABILITY (Personality) , *CINAHL database , *COMMUNICATION , *DATABASES , *DIABETES , *PEOPLE with diabetes , *MEDICAL information storage & retrieval systems , *PSYCHOLOGY information storage & retrieval systems , *LEARNING , *PATIENT-professional relations , *MEDLINE , *PATIENT compliance , *PATIENT education , *HEALTH self-care , *SYSTEMATIC reviews , *QUALITATIVE research , *SOCIAL support , *THEMATIC analysis , *DESCRIPTIVE statistics - Abstract
Background: Diabetes mellitus is one of the most common non-communicable long-term conditions in the world and is linked to high mortality, morbidity, loss of quality of life and high social and economic cost. Diabetes presents a serious health challenge, as it is a significant cause of ill health and premature death. Identification of barriers to self-care is critical for finding ways to reduce the adverse effects of this long-term condition. Objective: This review identified issues that influence ability to self-care for adults living with diabetes types 1 or 2. Design: A systematic review of qualitative research studies using the Joanna Briggs Institute (JBI) approach. Data sources: An electronic search of Health Sciences databases for primary published qualitative studies was conducted April 2011. Reference lists of included articles were reviewed to identify other potential papers. Review methods: Studies that investigated issues identified by individuals living with diabetes type 1 or 2 that influenced ability to self-care were analysed using a process of meta-aggregation. Meta-aggregation involves the extraction of findings, the synthesis of findings through grouping or aggregating similar findings into themes and labelling with appropriate names and a statement that defines the theme and meta-aggregating the themes into overarching syntheses. Methodological quality was assessed by two reviewers against the JBI quality appraisal criteria for qualitative studies. Results: Thirty-seven qualitative studies were reviewed. The main issues impacting on an individual's ability to self-care were 'communication', 'education', 'personal factors', 'provider issues' and 'support'. Multiple barriers were found to influence the day-to-day management of diabetes. Key issues related to communication with health care providers, an education programme that allowed for incremental knowledge gain and experiential and vicarious learning and the provision of culturally sensitive care. Conclusions: People living with diabetes face many issues in their day-to-day manage- ment of the disease, compounded by vulnerability to wider situational, cultural and social issues. Self-care ability is a dynamic, evolutionary process that varies from person to person and involves moving from a disease focused existence to maximising life. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
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