Code Blue: methodology for a qualitative study of teamwork during simulated cardiac arrest.

IntroductionIn-hospital cardiac arrest (IHCA) is a particularly vexing entity from the perspective of preparedness, as it is neither common nor truly rare. Survival from IHCA requires the coordinated efforts of multiple providers with different skill sets who may have little prior experience working together. Survival rates have remained low despite advances in therapy, suggesting that human factors may be at play.Methods and analysisThis qualitative study uses a quasiethnographic data collection approach combining focus group interviews with providers involved in IHCA resuscitation as well as analysis of video recordings from in situ-simulated cardiac arrest events. Using grounded theory-based analysis, we intend to understand the organisational, interpersonal, cognitive and behavioural dimensions of IHCA resuscitation, and to build a descriptive model of code team functioning.Ethics and disseminationThis ongoing study has been approved by the IRB at UC Davis Medical Center.ResultsThe results will be disseminated in a subsequent manuscript

Technology and Caregiving: Emerging Interventions and Directions for Research.

An array of technology-based interventions has increasingly become available to support family caregivers, primarily focusing on health and well-being, social isolation, financial, and psychological support. More recently the emergence of new technologies such as mobile and cloud, robotics, connected sensors, virtual/augmented/mixed reality, voice, and the evermore ubiquitous tools supported by advanced data analytics, coupled with the integration of multiple technologies through platform solutions, have opened a new era of technology-enabled interventions that can empower and support family caregivers. This paper proposes a conceptual framework for identifying and addressing the challenges that may need to be overcome to effectively apply technology-enabled solutions for family caregivers. The paper identifies a number of challenges that either moderate or mediate the full use of technologies for the benefit of caregivers. The challenges include issues related to equity, inclusion, and access; ethical concerns related to privacy and security; political and regulatory factors affecting interoperability and lack of standards; inclusive/human-centric design and issues; and inherent economic and distribution channel difficulties. The paper concludes with a summary of research questions and issues that form a framework for global research priorities

Health-Related Quality of Life After Lobectomy for Lung Cancer: Conceptual Framework and Measurement

BackgroundLung cancer surgery has a significant impact on health-related quality of life (HRQOL). In prior studies of HRQOL after lung cancer surgery, researchers selected the HRQOL domains of interest. To increase the patient-centeredness of these studies, we conducted a qualitative study to ascertain which aspects of HRQOL are most relevant to them postoperatively and to identify Patient-Reported Outcome Measurement Information System measures most germane to patients undergoing lobectomy for lung cancer.MethodsWe conducted in-depth semistructured interviews with 25 patients after lobectomy for lung cancer to solicit input regarding the physical, social, and emotional HRQOL domains relevant after surgery. Interviews were transcribed verbatim, and a thematic content analysis to identify HRQOL themes was performed. Themes were integrated to create a conceptual framework to guide outcome measurement selection.ResultsQualitative analysis indicated that within the physical health domain, patients were most concerned about general physical function (100% of participants), pain (96%), fatigue (96%), and dyspnea (76%). Neuropathic pain was reported by 28% of participants. Instrumental (100%) and emotional social support (88%) and positive emotions/relief/hope (96%) were also important. Two cross-cutting themes were the desire to maintain independence (32%) and preparing for surgery/expectations (92%).ConclusionsOur results indicate that a number of physical, social, and emotional HRQOL domains are relevant after lobectomy for lung cancer. These domains are currently represented by Patient-Reported Outcome Measurement Information System measures and can be readily assessed for clinical or research purposes

Views of Non-Physician Stakeholders on Barriers & Facilitators to AYA Cancer Care in Latin America

Cancer is the fourth leading cause of death in adolescent and young adults (AYA: ages15-39) worldwide. Over 90% of AYAs with cancer live in low-and-middle-incomecountries (LMIC). Little is known about thecurrent landscape of AYA oncology care in these settings. Guidelines for the care of thisunique population in LMIC in Latin America are lacking

“I know best:” women caring for kin with dementia

The dementia care literature in the home is vast, particularly in the health sciences where the focus remains on intervention to address carer emotional distress and burden. The sociological literature on dementia care has primarily utilized the illness disruption and (bio)medicalization models to show how meaning and practices are negotiated in the non-expert setting. Instead, I apply a feminist labor process perspective to examine the question of why women dementia kin carers resist relinquishing care responsibilities to others. This qualitative grounded theory study is based on seven waves of interviews (total = 98) conducted over approximately five years with 15 Latina dementia kin carers recruited through clinic and community sites in Northern California. Findings show how Latina kin carers exercise a degree of control and autonomy over the care process because they have developed tacit knowledge and skills to craft quality care of kin. In facing the dilemma of ceding care to others they perceive as unprepared, they reject available help. This study reveals how carers maintain quality care with dignity and comfort for the care recipient and themselves

The Promise of Mixed-Methods for Advancing Latino Health Research

Mixed-methods research in the social sciences has been conducted for quite some time. More recently, mixed-methods have become popular in health research, with the National Institutes of Health leading the impetus to fund studies that implement such an approach. The public health issues facing us today are great and they range from policy and other macro-level issues, to systems level problems to individuals' health behaviors. For Latinos, who are projected to become the largest minority group bearing a great deal of the burden of social inequality in the U.S., it is important to understand the deeply-rooted nature of these health disparities in order to close the gap in health outcomes. Mixed-methodology thus holds promise for advancing research on Latino heath by tackling health disparities from a variety of standpoints and approaches. The aim of this manuscript is to provide two examples of mixed methods research, each of which addresses a health topic of considerable importance to older Latinos and their families. These two examples will illustrate a) the complementary use of qualitative and quantitative methods to advance health of older Latinos in an area that is important from a public health perspective, and b) the "translation" of findings from observational studies (informed by social science and medicine) to the development and testing of interventions