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Rationale, aims and objectives Despite extensive evidence on the value of patient decision support interventions ( DESIs), there is no consensus on optimal DESI formats. Assessing clinicians' perceptions about DESI formats can help facilitate their adoption. The aim of this study was to assess clinicians' perceptions of DESIs formats and potential use in practice. Methods Semi-structured qualitative interviews were conducted with doctors from diverse practice areas (internal medicine, OB/ GYN, surgery, medical oncology, emergency medicine) and elicited perceptions toward patient DESIs formats (digital vs. paper) and timing of administration. Questions also elicited beliefs underlying attitudes, perceived social norms and self-efficacy for using DESIs and the feasibility of doing so. Data analysis was conducted using a thematic analysis approach. Results Participants identified strengths of both more comprehensive digital and shorter paper-based tools and thought they could complement each other. Participants consistently expressed the advantages of using DESIs outside the consultation to supplement clinical discussions about cancer decisions given the amount of information to discuss during these emotion-laden conversations. Participants felt that patients with older age and lower socio-economic status were more likely to use a paper-based compared with a digital DESI. Participants also noted challenges related to reliable resources such as computers and Internet in the practice setting, which would be necessary for implementing the digital DESIs on site. Conclusions Clinicians' perceptions and opinions about value of DESIs can vary widely across doctor, patient and clinic characteristics. A one-size-fits-all approach to implementation might not be feasible, suggesting that flexible approaches to providing decision support for patients are needed to drive broader adoption. [ABSTRACT FROM AUTHOR]

Rationale: Healthcare research exploring the lived experiences of health care professionals from different disciplines, such as nursing, medicine, and allied health, has repeatedly highlighted many methodological challenges, especially in understanding the individual human experience within complex systems. In response, complexity theory and phenomenological approaches emerged and evolved in ways that potentially offered researchers frameworks to inform an understanding of the individual human experience. However, while these two theoretical approaches inform a method of inquiry, there is a gap in understanding the phenomenon of 'being' and how this is embodied within complex systems such as the healthcare system. The Aims and Objectives: The aim of this paper is to present an integrated theoretical framework, namely complex adaptive phenomenology (CAP). CAP aims to address this inquiry gap by offering a structured conceptual framework wherein complexity theory and phenomenology are complementary but multi‐dimensional. The key objective of CAP was to synthesize and integrate two methods of inquiry that examine the relational aspects of 'being', that is the gestalt of perception, action, and context, The authors argue that CAP is well‐suited to complex research contexts such as healthcare. The framework focuses on the reciprocal, co‐constructive relationships extant between perception, meaning, context, and action that shape experiences of 'being' within complex systems. Complexity theory's connectionist orientation explains the relationships that are formative of the experience of being, while phenomenology explores the manifestations of these formative relationships by attending to the notion of 'being' itself. Conclusion: The authors propose that an integrated framework, of phenomenology and complexity theory, can provide a platform for deeper understandings of the experiences of health professionals and contribute to healthcare scholarship. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives: Strong health systems are said to be paramount to achieving effective and equitable health care. The World Health Organization has been advocating for using system-wide approaches such as 'systems thinking' to guide intervention design and evaluation. In this paper we report the system-wide effects of a complex health system intervention in Zambia known as Better Health Outcome through Mentorship and Assessment (BHOMA) that aimed to improve service quality. Methods: We conducted a qualitative study in three target districts. We used a systems thinking conceptual framework to guide the analysis focusing on intended and unintended consequences of the intervention. NVivo version 10 was used for data analysis. Results: The addressed community responded positively to the BHOMA intervention. The indications were that in the short term there was increased demand for services but the health worker capacity was not severely affected. This means that the prediction that service demand would increase with implementation of BHOMA was correct and the workload also increased, but the help of clinic lay supporters meant that some of the work of clinicians was transferred to these lay workers. However, from a systems perspective, unintended consequences also occurred during the implementation of the BHOMA. Conclusions: We applied an innovative approach to evaluate a complex intervention in low-income settings, exploring empirically how systems thinking can be applied in the context of health system strengthening. Although the intervention had some positive outcomes by employing system-wide approaches, we also noted unintended consequences. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Methods Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. Results From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Conclusions Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. [ABSTRACT FROM AUTHOR]

The aim of this study was to employ knowledge user perspectives to develop recommendations that facilitate implementation of a complex, shared decision‐making (SDM)‐based intervention in an interprofessional setting. This study was part of a larger knowledge translation (KT) study in which interprofessional teams from five freestanding, academically affiliated, rehabilitation hospitals were tasked with implementing a cognitive strategy‐based intervention approach that incorporates SDM known as Cognitive Orientation to daily Occupational Performance (CO‐OP) to treat survivors of stroke. At the end of the 4‐month CO‐OP KT implementation support period, 10 clinicians, two from each site, volunteered as CO‐OP site champions. A semi‐structured focus group was conducted with 10 site champions 3 months following the implementation support period. To meet the study objective, an exploratory qualitative research design was used. The focus group session was audio‐recorded, transcribed verbatim and analyzed through the lens of the integrated promoting action on research implementation in health services (iPARIHS) framework. The focus group participants (n = 8) consisted of occupational therapists, physical therapists, and speech language pathologists. Ten recommendations for CO‐OP implementation were extracted and co‐constructed from the focus group transcript. The recommendations reflected all four iPARHIS constructs: Facilitation, Context, Innovation, and Recipients. Implementation recommendations, from the knowledge user perspective, highlight that context‐specific facilitation is key to integrating a novel, complex intervention into interprofessional practice. Facilitators should lay out a framework for training, communication and implementation that is structured but still provides flexibility for iterative learning and active problem‐solving within the relevant practice context. [ABSTRACT FROM AUTHOR]

Abstract: Rational, aims and objectives: The aim of this review was to identify general theoretical frameworks used in online social network interventions for behavioral change. To address this research question, a PRISMA‐compliant systematic review was conducted. Methods: A systematic review (PROSPERO registration number CRD42014007555) was conducted using 3 electronic databases (PsycINFO, Pubmed, and Embase). Four reviewers screened 1788 abstracts. Results: 15 studies were selected according to the eligibility criteria. Randomized controlled trials and controlled studies were assessed using Cochrane Collaboration's “risk‐of‐bias” tool, and narrative synthesis. Five eligible articles used the social cognitive theory as a framework to develop interventions targeting behavioral change. Other theoretical frameworks were related to the dynamics of social networks, intention models, and community engagement theories. Only one of the studies selected in the review mentioned a well‐known theory from the field of health psychology. Conclusion: Conclusions were that guidelines are lacking in the design of online social network interventions for behavioral change. Existing theories and models from health psychology that are traditionally used for in situ behavioral change should be considered when designing online social network interventions in a health care setting. [ABSTRACT FROM AUTHOR]

A primary purpose of research is to generate new knowledge. Scientific advances have progressively identified optimal ways to achieve this purpose. Included in this evolution are the notions of evidence-based medicine, decision aids, shared decision making, measurement and evaluation as well as implementation. The importance of including qualitative and quantitative methods in our research is now understood. We have debated the meaning of evidence and how to implement it. However, we have yet to consider how to include in our study findings other types of information such as tacit and experiential knowledge. This key consideration needs to take place before we translate new findings or 'knowledge' into clinical practice. This article critiques assumptions regarding the nature of knowledge and suggests a framework for implementing research findings into practice. [ABSTRACT FROM AUTHOR]