Intensive care clincians' information acquisition during the first wave of the Covid 19 pandemic

INTRODUCTION: The global pandemic caused by novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has led to an unprecedented demand on critical care resources. The United Kingdom experienced its ‘first wave’ of Coronavirus–19 (Covid-19) disease in Spring 2020. Critical care units had to make major changes to their working practices in a short space of time and faced multiple challenges in doing so, including the challenge of caring for patients in multiple organ failure secondary to Covid-19 infection in the absence of an established evidence base of best practice. We undertook a qualitative investigation of the personal and professional challenges faced by critical care consultants in one Scottish health board in acquiring and evaluating information to guide clinical decision making during the first wave of the SARS-CoV-2 pandemic. METHODS: Critical care consultants in NHS Lothian working in critical care from March to May 2020 were eligible to participate in the study. Participants were invited to take part in a one-to-one semi structured interview conducted using Microsoft Teams videoconferencing software. Reflexive thematic analysis was used as the method for data analysis using qualitative research methodology informed by a subtle realist position. RESULTS: Analysis of the interview data generated the following themes: The Knowledge Gap; Trust in Information; and Implications for Practice. Illustrative quotes are presented in the text and thematic tables. DISCUSSION: This study explored the experiences of critical care consultant physicians in acquiring and evaluating information to guide clinical decision making during the first wave of the SARS CoV2 pandemic. This study revealed that clinicians were profoundly affected by the pandemic and the ways in which it changed how they could access information to guide clinical decision making. The paucity of reliable information on SARS-CoV-2 posed a significant threat to the clinical confidence of participants. Two strategies were adopted to ease mounting pressures – an organised approach to data collection and the establishment of a local community of collaborative decision-making. These findings contribute to the wider literature by describing health care professionals’ experiences in unprecedented times and could inform recommendations for future clinical practice. This could include governance around responsible information sharing in professional instant messaging groups, and medical journal guidelines on suspension of usual peer review and other quality assurance processes during pandemics

Editorial: teaching social and behavioural sciences in medical education

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Reflections on Researching with Children Using "Family Group Interviews" as Part of a Qualitative Longitudinal Study

Family sociologists often conduct research which generates and compares parents’ and children’s perspectives as a way of ensuring children’s voices are heard and building an understanding of family practices and cultures. It is far less common, however, for children to be interviewed in the presence of parents or to interview families as a group. Primarily, this is a response to concerns that, given generational power relations, the presence of parents may serve to influence, police, or silence children’s voices. However, by making such methodological assumptions and, in turn, not generating group accounts with parents and children, we may be missing opportunities to add further methods to our toolkit and additional analytical dimensions to our explorations and understandings of families’ and children’s lives. In this article, we reflect on our experiences of conducting family group interviews as the second wave of a qualitative longitudinal study, involving parents and children who gave individual accounts at the first and third/final waves. We explore the factors involved in designing this method into a research project, the challenges of conducting family group interviews, and of analysing the data produced. In so doing, we contribute to the methodological debate on researching with children in the context of families

Addressing contraception at the time of abortion: experiences of women and health professionals

This study set out to identify similarities and differences between the experiences of women who received abortion care and of health professionals who gave that care in both SRHC and hospital settings. In relation to contraception specifically, we aimed to establish whether, and in what ways, receiving care in the two types of settings influences and informs decisions about future contraceptive use. Findings from this study can further understanding, and inform policy development around how contraceptive advice and methods are provided at the time of abortion