Improving continence services for older people from the service-providers' perspective: a qualitative interview study

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.Objective To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting 3 acute and 13 primary care National Health Service Trusts in England. Participants 16 continence service leads in England actively treating and managing older people with UI. Results In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.Funding was received from the New Dynamics of Ageing Programme, led by the Economic & Social Research Council, UK (grantnumber RES-353-25-0010)

Parenteral Nutrition in Advanced Cancer: The Healthcare Providers’ Perspective

Introduction: The evidence base for parenteral nutrition (PN) in advanced cancer patients is limited. We studied healthcare providers’ (HCPs’) experiences with PN in cancer patients, focusing on perceived treatment benefits and challenges. Methods: An 18-item online survey was emailed to HCPs attending one of three regional palliative care seminars held within a 6-month period. The survey included single-response items, multiple-response items, and free text boxes concerning PN. Descriptive statistics and qualitative thematic content analysis were applied. Results: One hundred and two seminar participants completed the survey. Ninety-three percent were female, 86% were nurses/oncological nurses, and 80% worked in primary care. Respondents reported a well-functioning collaboration across levels of care. They perceived that PN may increase the patients’ level of energy, improve the general condition, and reduce eating-related distress. On the downside, HCPs observed burdensome side effects, that the treatment was resource-demanding, and that decisions on PN withdrawal were difficult. Conclusion: The study results are based on the perspectives of more than 100 HCPs with comprehensive clinical experience with PN. Their knowledge represents an important experience base for improvement of healthcare services and advanced care planning.publishedVersio

Educating Tourists for Global Citizenship:A Microfinance Tourism Providers’ Perspective

Ethical tourism initiatives have increasingly been framed as tools to educate tourists about global citizenship (GC), yet it is unclear how these initiatives are conceptualised, planned and implemented by tourism providers. This paper focuses on a form of ethical tourism known as microfinance tourism (MFT). It critically explores MFT providers’ perspectives on what constitutes the goals of educating tourists about GC and how MFT can be designed and implemented to achieve these goals. The study adopted a qualitative approach utilising in-depth interviews with 12 key informants from 6 MFT organisations in Tanzania, Mexico, Jordan and Vietnam. The results reveal that MFT providers rely on an experiential learning process to educate tourists. However, as part of this learning process, MFT initiatives are located on a continuum, constituting those initiatives designed to increase tourists’ compassion and philanthropic actions (i.e. ‘thin’ GC) through to those initiatives seeking to build solidarity and global discussions between tourists in order to challenge the structures that perpetuate global injustice (i.e. ‘thick’ GC). These results highlight the diversity of tourism providers’ perspectives pertaining to GC, the effect diversity has on the design of tourism initiatives and the resultant outcomes of GC education utilising ethical tourism.Griffith Business School, Department of Tourism, Sport and Hotel ManagementNo Full Tex

Information systems security outsourcing key issues : a service providers' perspective

Completed research paperThere is a perception that information systems security outsourcing, in spite entailing a relationship between a client and one or more providers, tends to be studied and analysed from the perspective of the client. A gap is then believed to exist in the study of the information systems security outsourcing relationship from the point of view of the service provider. This research aims to identify the key issues of such a relationship from the perspective of the service provider and rank them according to their importance. The Delphi method was used to support the communication with the group of experts contributing to this research as well as to boost consensus within the group. Final interviews with participants were also conducted with the aim of reaching deeper into their opinions and to shed a brighter light over the results of the Delphi. A ranked list of the 13 most important key issues found is presented and discussed and propositions for further work are put forward in the wake of the study.Fundação para a Ciência e a Tecnologia (FCT

Information systems security outsourcing key issues: a service providers’ perspective

Mestrado em Gestão de Sistemas de InformaçãoThere is a perception that information systems security outsourcing, in spite entailing a relationship between a client and one or more providers, tends to be studied and analysed from the perspective of the client. A gap is then believed to exist in the study of the information systems security outsourcing relationship from the point of view of the service provider. This research aims to identify the key issues of such a relationship from the perspective of the service provider and rank them according to their importance. The Delphi method was used to support the communication with the group of experts contributing to this research as well as to boost consensus within the group. Final interviews with participants were also conducted with the aim of reaching deeper into their opinions and to shed a brighter light over the results of the Delphi. A ranked list of the 13 most important key issues found is presented and discussed and propositions for further work are put forward in the wake of the study

Visibility in multimodal maritime container transport chains - Logistics service providers' perspective

Nowadays, transparency and digitalization of actions in the whole supply chain are emphasized and firms are demanding visibility to better forecast, plan and control the flow of goods. The expectations towards fully real-time traceable cargo flow are high and logistics service providers are recommended to digitize their actions to stay in the highly competitive freight transport markets. When it comes to technology, it has been developed rapidly and can provide very sophisticated solutions to enhance visibility. Information flow is a key for visibility. Therefore, information and communication technology (ICT) is vital to enhance visibility. However, technology alone does not enable visibility. It requires collaboration with other involved actors in the transport chain. Multimodal maritime container transport chains are complex in a sense that they require deep collaboration in a form of IT-compatibility with vast number of players involved within the carriage of goods to enhance seamless and automatized exchange of information. It has been disclosed that the biggest logistics service providers have already been able to form such collaborative relationships with big shipping lines, for instance. Also, market leaders usually arrange the pre- and end-haulage of the transport with own assets and therefore information flow is advanced. However, freight transport industry is highly fragmented and majorly consists of small-sized firms. Margins in the freight transport markets are extremely low as customers do not see added value in freight transportation and therefore transportation is seen as an extra harmful cost for firms. Therefore, the idea of big IT-investments and integration of actions with other players is infeasible for some companies. In this study, visibility in multimodal maritime container transport chains is investigated in a wide sense by conducting semi-structured interviews among different-sized logistics service providers located in Finland. First, the current adoption of visibility is studied, the benefits of it are discussed and the barriers to adopt visibility are discussed. Furthermore, perceptions towards the importance of visibility as a service offering in the creation of competitive strategies are investigated

Assessing Healthcare Providers Perspective: Music Intervention for Open Heart Surgery Patients

Abstract Background: Benefits of music intervention after open heart surgery have been studied amongst several clinical settings, yet implementation is not frequently seen with patients in the cardiothoracic field. Open heart surgery is associated with postoperative pain that peaks the first few days after surgery. Multiple negative outcomes may result from ineffective pain management including, deep vein thrombosis, pneumonia, and poor wound healing leading to increased morbidity, mortality, and healthcare costs. Music intervention has been shown to relieve anxiety and pain, reduce stress, decrease S-cortisol levels and increase oxytocin levels. However, the literature is limited on the use or integration of music in this population. Objective: To assess the perception of healthcare providers towards the use of music intervention for patients who have undergone open heart surgery. Methods: 44 participants participated in an online survey assessing cardiothoracic health care providers’ knowledge, concerns, current use and/or their likelihood of implementation in regards to music intervention use for open heart surgery patients. Results: 21 (47.7%) participants had used music intervention, and 18 (85.7%) endorsed they believed music intervention had some to most significant influence on patient outcomes. Of those that had not used music (23, 52.3%), all 23 (100%) endorsed they were neutral to very likely on the idea of implementing music intervention if available. Conclusions. While # amount of participants had not used (or had used), we found the largest barriers to be related to potential unfamiliarity of the modality itself. Relevance to practice. Music intervention can be an integral part of the regimen administered to patients having undergone cardiovascular surgery with potential to decrease healthcare costs and increase patient outcomes and satisfaction. Perspective This article reflects key factors of influence on use of music intervention for pain, from users and non-users. When further evaluated, these survey results could assist in removing barriers between implementation of music intervention for postoperative open heart surgery patients, and others. Keywords: music intervention, music therapy, open heart surgery, cardiothoracic, alternative therapie