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Background In implementation science, vast gaps exist between theoretical and practical knowledge. These gaps prevail in the process of getting from problem analysis to selecting implementation strategies while engaging stakeholders including care users.Objective To describe a process of how to get from problem analysis to strategy selection, how to engage stakeholders, and to provide insights into stakeholders' experiences.Design A qualitative descriptive design.Setting and participants The setting was a care organization providing long-term care to people with acquired brain injuries who are communication vulnerable. Fourteen stakeholders (care users, professionals and researchers) participated. Data were collected by a document review, five interviews and one focus group. Inductive content analysis and deductive framework analysis were applied.Intervention Stakeholder engagement.Main outcome measures A three-step process model and stakeholders experiences.Results and conclusion We formulated a three-step process: (a) reaching consensus and prioritizing barriers; (b) categorizing the prioritized barriers and idealization; and (c) composing strategies. Two subthemes continuously played a role in how stakeholders were engaged during the process: communication supportive strategies and continuous contact. The experiences of stakeholder participation resulted in the following themes: stakeholders and their roles, use of co-creation methods and communication supportive strategies, building relationships, stimulus of stakeholders to engage, sharing power, empowerment of stakeholders, feeling a shared responsibility and learning from one another. We conclude that the inclusion of communication-vulnerable care users is possible if meetings are prepared, communication-friendly presentations and reports are used, and relationship building is prioritized.

Background: Patients are expected to participate in the hospital discharge process, assume self-management after discharge and communicate relevant information to their general practitioner; however, patients report that they are not being sufficiently empowered to take on these responsibilities. The aim of this study was to explore and understand the discharge process with a focus on medicines communication, from the patient perspective. Methods: Patients were included at a hospital ward, observed during health-care personnel encounters on the day of discharge and interviewed 1-2 weeks after discharge. A process analysis was performed, and a content analysis combined data from observations and data from patient interviews focusing on medicines communication in the discharge process. Results: A total of 9 patients were observed on the day of discharge, equalling 67.5 hours of observations. The analysis resulted in the following themes: (a) the observed discharge process; (b) patient initiatives; and (c) the patient role. The medicines communication in the discharge process appeared unstructured. Various patient preferences and needs were revealed. The elements of the best practice structured discharge conversation were observed; however, some patients did not have a discharge conversation at all. Conclusions: The study contributes to a broader understanding of the discharge process, how patients experience it, including their role. It is evident that the discharge process is not always tailored to meet the patients’ needs. More focus on early patient involvement and communication, in order to better prepare patients for self-management of their medications, is important for their health outcomes.

This paper presents a qualitative content analysis of survey data collected from behavioral health care providers from throughout New York regarding the challenges faced as a result of COVID-19. Survey responses from 295 agency and program administrators and staff, representing 238 organizations, were analyzed. Ten themes were identified: business operations, service provision, telehealth, safety, client concerns, staff concerns, supplies, technology, illness/grief/loss, and communication. These themes represent concerns that arose from the rapid transition to widespread use of telehealth, limited technology accessibility for both staff and clients, reduced revenue and billing changes, impact of COVID-19 infection itself and subsequent deaths of clients and staff, and necessary modifications for organizational communication both internally and externally. The implications of these challenges and the need for further research to identify how to best address them are discussed.

BackgroundThe number of people with multiple chronic conditions increases as a result of ageing. To deal with the complex health-care needs of these patients, it is important that health-care professionals collaborate in interprofessional teams. To deliver patient-centred care, it is often recommended to include the patient as a member of the team.ObjectiveTo gain more insight into how health-care professionals and patients, who are used to participate in interprofessional team meetings, experience and organize patient participation in the team meetings.MethodsA qualitative study including observations of meetings (n=8), followed by semi-structured interviews with participating health-care professionals (n=8), patients and/or relatives (n=11). Professionals and patients were asked about their experiences of patient participation immediately after the team meetings. Results from both observations and interviews were analysed using content analysis.ResultsThe findings show a variety of influencing factors related to patient participation that can be divided into five categories: (i) structure and task distribution, (ii) group composition, (iii) relationship between professionals and patients or relatives, (iv) patients' characteristics and (v) the purpose of the meeting.ConclusionPatient participation during team meetings was appreciated by professionals and patients. A tailored approach to patient involvement during team meetings is preferable. When considering the presence of patients in team meetings, it is recommended to pay attention to patients' willingness and ability to participate, and the necessary information shared before the meeting. Participating patients seem to appreciate support and preparation for the meeting.

Straipsnyje nagrinėjamas vaikų kompiuterinės kultūros komunikacinis diskursas, vykstantis patirtinio žinojimo kontekste. Atskleidžiama, kaip šio diskurso empiriniam tyrimui yra taikoma viena iš šiuolaikinių metodologinių prieigų - socialinės tikrovės konstravimo teorija (Berger, Luckman, 1999). Nurodomas minėto diskurso turinys ir jo socialinės-edukacinės prasmės, išryškinančios vaikų kompiuterinės kultūros visavertiškumą, jos svarbumą, kuriant bendrąją komunikacinę kultūrą. The paper deals with a communicative discourse of children’s computer culture. A theoretical approach to a research on a communicative discourse of children’s computer culture in the context of social reality construction is presented highlighting the aspects of communication freedom, communication mobility, communication relations, changes of roles, significance (positive and negative) of communication. The paper reveals how one of modern methodological approaches, a social reality construction theory (Berger, Luckman, 1999). The procedure of carrying out this kind of research and the characteristics of data analysis have been described. Methodological approaches based on phenomenology, postmodern discourse, theory of social reality construction and methodology of qualitative research of a carried out qualitative research are presented. Children’s understanding of a communicative discourse of computer culture has been described using the method of an essay; research organisation and qualitative data analysis procedures based on I. E. Seidman’s strategy, inductive logics, content analysis and the method of continuous comparison are presented. Referring to the peculiarities of children’s virtual communication the authors have described children’s communicative discourse of computer culture in detail and have identified that children construct a communicative discourse of computer culture recognizing a computer as a communication technology. They have showed the content of this discourse as well as its socio-educational meaning highlighting full-fledgedness of children’s computer culture and its significance for the development of general communicative culture of society. Children’s computer culture has been advocated as a modern socio-educational phenomenon as well as a children’s life practice of worldview significance for both the educators and the parents. It is important to understand and tolerate in order to develop children’s as creators of communicative culture competences.

Purpose This paper aims to examine the challenges facing fish farmers in the use of information and communication technology (ICT) in information sharing on fish farming. Design/methodology/approach This study used both quantitative and qualitative methods. It involved 240 fish farmers who were randomly selected. Questionnaires, focus group discussions (FGDs), observation and key informant’s interviews were used as methods of data collection. Both descriptive and inferential statistics were used to analyse quantitative data, while content analysis was used for qualitative data. Findings It was found that the most frequently used ICTs by fish farmers in sharing agricultural information were mobile phones, radio and television. Also, the study revealed that major challenges facing fish farmers in sharing information include unfavourable radio or television broadcasting time, high cost of acquiring and maintenance of ICT facilities, lack of training on ICT, poor network connectivity and low level of literacy. Moreover, it was further found that there was negative significant relationship (P < 0.05) between challenges associated with the use and degree of ICT usage by fish farmers. Originality/value The study is original with the exception of areas where citations have been made. Besides, it provides awareness and understanding of the challenges facing fish farmers in ICT usage in information sharing on fish farming, and this will enable improvement of timely provision and access to relevant information and hence improved fish farming production.

The purpose of the paper is to describe how residents express preferences for end-of-life (EOL) care. For this qualitative study, we conducted semi-structured interviews and completed conventional content analysis to describe how residents’ expressed their preferences for care at the end of life. Sixteen residents from four nursing homes (NH) in southeastern Pennsylvania participated in this study. Residents were on average 88 years old, primarily non White, and widowed. Three key domains emerged from the analyses: Preferences for Today, Anticipating the End of My Life, and Preferences for Final Days . Residents linked their everyday living and EOL preferences by using ‘if and then’ logic to convey anticipation and readiness related to EOL. These findings suggest new strategies to start discussions of EOL care preferences with NH residents.

In this paper we explore how different ways of training communication skills can be successfully implemented in higher education, and which effects these activities may have on science students’ learning. Using content analysis, we studied a material consisting of 34 reports, written by 70 academic science teachers, as part of a teacher-training course on communication in science higher education. In the course, the teachers developed and implemented communication tasks into their content courses, and analysed and reported on the observed learning outcomes. The tasks covered both written and oral communication addressing different audiences, inside as well as outside of academia. We found that integrating different ways of communication training in science courses entailed improved skills in sharing and discussing science information, and in addition, increased subject understanding. Thus, we conclude that the integration of communication training may effectively support students’ science learning in higher education. (Less)

Health journalists are central gatekeepers who select, frame, and communicate health news to a broad audience, but the selection and content of health news are also influenced by the sources journalists, rely on (Hinnant, Len-Rios,Oh, 2012). In this paper, we examine whether the traditional elitist sourcing practices (e.g., research institutions, government) are still important in a digitalized news environment where bottom-up non-elite actors (e.g., patients, civil society organizations) can act as producers (Bruns, 2003). Our main goal, therefore, is to detect whether sourcing practices in health journalism can be linked with strategies of empowerment. We use a multi-method approach combining quantitative and qualitative research methods. First, two content analyses are developed to examine health-related news in Belgian magazines (popular weeklies, health magazines, general interest magazines, and women's magazines). The analyses highlight sourcing practices as visible in the texts and give an overview of the different stakeholders represented as sources. In the first wave, the content analysis includes 1047 health-related news items in 19 different Belgian magazines (March-June 2013). In the second wave, a smaller sample of 202 health-related items in 10 magazines was studied for follow-up reasons (February 2015). Second, to contextualize the findings of the quantitative analysis, we interviewed 16 health journalists and editors-in-chief. The results illustrate that journalists consider patients and blogs as relevant sources for health news; nonetheless, elitist sourcing practices still prevail at the cost of bottom-up communication. However, the in-depth interviews demonstrate that journalists increasingly consult patients and civil society actors to give health issues a more "human" face. Importantly, the study reveals that this strategy is differently applied by the various types of magazines. While popular weeklies and women's magazines give a voice to ordinary citizens to translate complex issues and connect with their audiences, general interest magazines and health magazines prefer elite sources and use ordinary citizen stories as a way of "window dressing."

Purpose A sentinel event is an unexpected occurrence resulting in death or serious physical or psychological injury or the risk thereof. The purpose of this paper is to investigate the influencing factors of sentinel events in the emergency department of a military hospital in Tehran to find out some of the effective solutions. Design/methodology/approach In this qualitative study with content analysis approach, 20 hospital healthcare personnel participated as participants from the fields of medicine and nursing. Purposive random sampling and semi-structured interviews were used for data collection. Atlas.ti software version 5.2 was used for data analysis. Findings Four themes and 32 subthemes were identified by numerous revisions and combining the codes. The four main themes of sentinel events were: causes, incidence barriers, cause prevention solutions, and barriers’ improvement solutions. Moreover, these main factors were related to these issues: staff and patients’ education, communication, assessment, patients and their companions, employee rights, leadership, care continuum, human factors, physical environment, information management and medication use. Some solutions were also suggested according to these factors and a policy was recommended. Practical implications Hospital managers and authorities should try to find the main causes of sentinel events by periodical analysis to find ways to prevent them in the future, using logical and reasonable solutions. Originality/value This study confirms that strategies to reduce the sentinel events in emergency departments should focus on empowerment of all staff.

© 2015 The Author(s). Published by Taylor & Francis. Good practice guidelines recommend that women who undergo mastectomy are offered reconstructive surgery. However, many who choose this option report a degree of decisional regret and dissatisfaction because their pre-surgical expectations were not met. This paper reports an acceptability study of a new intervention (PEGASUS) that aims to support shared decision-making by eliciting womens pre-surgical expectations and setting patient-centred goals. Eighteen women contemplating breast reconstruction completed the PEGASUS intervention. Semi-structured interviews were conducted with 12 women and 3 health professionals to explore their experiences of using PEGASUS. Interview transcripts were subjected to a thematic analysis, and a content analysis was conducted on 79 goals that the 18 women identified. Feedback was extremely positive - women found that completing PEGASUS alongside a discussion with a specially trained health professional helped them prepare for the surgical consultation and increased their trust in their surgeon. Staff reported that PEGASUS facilitated patient-centred discussions and informed the decisions made about potential surgery. This preliminary study suggests that this novel intervention is acceptable to patients and health professionals alike. Further work is needed to evaluate its efficacy and then its effectiveness with a larger sample of women, and its potential use with other patient groups.

Background Commensality is a remarkable human act, and tends to be more present among families. Nevertheless, it is possible that eating at the table is being taking for granted when one refers to family meals. Thus, this paper aims to analyze working mothers' discourses about family meals eaten at the table, on the couch and in the bed/bedroom. Methods The participants were thirty mothers working in public universities of the Brazilian region called Baixada Santista. A qualitative study was conducted, using semi-structured interviews. In the transcripts the words “table”, “couch”, “bed”, “bedroom” were located and the excerpts containing them were extracted and analyzed according to a classical and exploratory content analysis. Results The table is a significant component of meals that unite the family. While for some the meal at the table is an enjoyable moment, it is a stiff moment for others. Indeed, manners and the notion of hierarchy appeared only for the table. Regarding the couch, it seems that the family chose to eat there, because it is a more casual and relaxed setting. Eating in the bed was related to precarity, intimacy and casualness. In the three settings, watching television was a common practice, replacing or being added to talking. Conclusions Commensality is such an important practice that appears in different settings and even in precarity contexts. The table emerged as the maximal cornerstone of commensality. However, when it was not present, new arrangements were made. Especially the couch seems to be a new commensal space, less formal and rigid, but able to allow some collective conviviality. Eating in the bed was a less common practice. Finally, the significant role that television assumed in meals is highlighted.

Objective: This study intends to investigate interns and faculty members’ insights into constructing relationship between physicians and patients at 3 more accredited Iranian universities of medical sciences. Method: Applying PRECEDE PROCEED model, semi-structured interviews were completed with 7 interns and 14 faculty members and two themes were emerged from directed content analysis. The meaning units of the first theme, barriers to effective doctor-patient relationship, are discussed in this paper. Results: According to the participants, building doctor-patient relationship is influenced by many contextual and regulatory factors as well as content, process and perceptual skills of physicians. Conclusions: Faculty and curriculum development, as well as foundation of the department of communication skills at medical schools are recommended to eliminate the impact of poor communication on patients’ satisfaction and physicians’ self-efficacy specific to their communication skills. Practice Implications: Applying theories and models of health education and health promotion, researchers and educators can use the most predictive constructs of theories to design and implement effective interventions.