Metodologiske og praktiske utfordringer ved bruk av fokusgrupper som forskningsmetode - med fokus på pårørende som informanter

Hensikten med denne artikkelen er å belyse de metodologiske og praktiske utfordringene forskere vil kunne møte i prosessen når fokusgruppeintervju skal planlegges, gjennomføres og analyseres. Artikkelen omhandler egne erfaringer med pårørende som informanter, hvor metoden har mange fordeler. Likevel vil forskeren møte noen utfordringer når fokusgruppeintervju velges som forskningsmetode. Det er derfor viktig å fokusere på kompleksiteten i forskningsprosessen for å få et kvalitativt godt datamateriale. Ulike metodiske aspekt som troverdighet, pålitelighet, samstemmighet og overførbarhet vil bli diskutert i tillegg til diskusjon omkring interaksjonen i gruppene og mellom forskeren og deltakerne i fokusgruppene

Metodologiske og praktiske utfordringer ved bruk av fokusgrupper som forskningsmetode - med fokus på pårørende som informanter

Hensikten med denne artikkelen er å belyse de metodologiske og praktiske utfordringene forskere vil kunne møte i prosessen når fokusgruppeintervju skal planlegges, gjennomføres og analyseres. Artikkelen omhandler egne erfaringer med pårørende som informanter, hvor metoden har mange fordeler. Likevel vil forskeren møte noen utfordringer når fokusgruppeintervju velges som forskningsmetode. Det er derfor viktig å fokusere på kompleksiteten i forskningsprosessen for å få et kvalitativt godt datamateriale. Ulike metodiske aspekt som troverdighet, pålitelighet, samstemmighet og overførbarhet vil bli diskutert i tillegg til diskusjon omkring interaksjonen i gruppene og mellom forskeren og deltakerne i fokusgruppene

Perceptions about traditional and novel methods to learn about postoperative pain management: a qualitative study.

To access publisher's full text version of this article click on the hyperlink belowAIM: The aim of this study was to explore the perceptions of surgical patients about traditional and novel methods to learn about postoperative pain management. BACKGROUND: Patient education is an important part of postoperative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice. DESIGN: A qualitative design with a vignette and semi-structured interviews used for data collection. METHODS: A purposeful sample of 13 postsurgical patients, who had been discharged from hospital, was recruited during 2013-2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about postoperative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach. FINDINGS: Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualized the factors affecting patients' perceptions: (1) 'Trusting the source', sub-categorized into 'Being familiar with the method' and 'Having own prejudgments'; and (2) 'Being motivated to learn' sub-categorized into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'. CONCLUSION: To implement successfully novel educational methods into postoperative care, healthcare professionals need to be aware of the factors influencing patients' perceptions about how to learn, such as trust and motivation.Landspitali University Hospital Research Fund Icelandic Nurses' Association Research Fun

Perceptions about traditional and novel methods to learn about post-operative pain management : - a qualitative study.

Aim: To explore the perceptions of surgical patients about traditional and novel methods to learn about post-operative pain management.Background: Patient education is an important part of post-operative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice.Design: A qualitative design with a vignette and semi-structured interviews used for data collection.Methods: A purposeful sample of 13 post-surgical patients, who had been discharged from hospital, was recruited during 2013 - 2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about post-operative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach.Findings: Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualised the factors affecting patients' perceptions: 1) 'Trusting the source', sub-categorised into 'Being familiar with the method' and 'Having own prejudgments'; and 2) 'Being motivated to learn' sub-categorised into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'.Conclusion: In order to implement successfully novel educational methods into post-operative care, healthcare professionals need to be aware of the factors influencing patients' perceptions abouthow to learn, such as trust and motivation.Funding agencies: Landspitali University Hospital Research Fund; Icelandic Nurses Association Research Fund</p

Characteristics associated with anxiety, depressive symptoms, and quality-of-life in a large cohort of implantable cardioverter defibrillator recipients

Objective: Although most patients with implantable cardioverter defibrillators (ICDs) adjust well, some have considerable psychological distress. Factors associated with psychological adjustment in ICD-recipients are still not well understood. Our purpose was to describe quality-of-life (QoL) and prevalence of self-reported symptoms of anxiety and depression in a large national cohort of ICD-recipients, and to determine socio-demographic, clinical, and ICD-related factors associated with these variables

An insight into healthcare professionals' perspectives on discussing implantable cardioverter defibrillator deactivation

International studies have examined patients' views concerning the discussion of deactivating an implantable cardioverter defibrillator (ICD). Findings reported that many patients were either not informed about the subject or were informed late in their illness trajectory. To explore healthcare professionals' perspectives on discussing ICD deactivation and identify priorities for clinical practice and future research. Eleven interviews were conducted, involving heart failure nurses, physicians, and an allied professional. All were responsible for the care of patients with an ICD, from the United Kingdom or Sweden. A semi-structured guide was used. All interviews were audio-recorded, transcribed, translated (as applicable) and analysed independently by experienced researchers, using framework analysis. Findings were presented, along with published work at a stakeholder meeting, and a consensus agreement was reached on priorities for clinical practice and future research. Four themes emerged from the exploratory interviews. Healthcare professionals described the discussion about deactivation as challenging, requiring compassion and involvement of family members. They agreed that the topic should be initiated prior to, or shortly after device implantation. This was reflected in the priorities to improve communication, through the increased availability and implementation of prompts and tools, as well as the provision of tailored information to patients and family members. Stakeholders recognised the future potential of digital technology in device education. Discussing deactivation remains challenging. Healthcare professionals recognised the need to initiate the discussion early, with compassion and involvement of family members. Priorities were agreed by stakeholders, which require clinical implementation and further research

Development, usability, and efficacy of a serious game to help patients learn about pain management after surgery: an evaluation study

Background: Postoperative pain is a persistent problem after surgery and can delay recovery and develop into chronic pain. Better patient education has been proposed to improve pain management of patients. Serious games have not been previously developed to help patients to learn how to manage their postoperative pain. Objective: The aim of this study was to describe the development of a computer-based game for surgical patients to learn about postoperative pain management and to evaluate the usability, user experience, and efficacy of the game. Methods: A computer game was developed by an interdisciplinary team following a structured approach. The usability, user experience, and efficacy of the game were evaluated using self-reported questionnaires (AttrakDiff2, Postoperative Pain Management Game Survey, Patient Knowledge About Postoperative Pain Management questionnaire), semi-structured interviews, and direct observation in one session with 20 participants recruited from the general public via Facebook (mean age 48 [SD 14]; 11 women). Adjusted Barriers Questionnaire II and 3 questions on health literacy were used to collect background information. Results: Theories of self-care and adult learning, evidence for the educational needs of patients about pain management, and principles of gamification were used to develop the computer game. Ease of use and usefulness received a median score between 2.00 (IQR 1.00) and 5.00 (IQR 2.00) (possible scores 0-5; IQR, interquartile range), and ease of use was further confirmed by observation. Participants expressed satisfaction with this novel method of learning, despite some technological challenges. The attributes of the game, measured with AttrakDiff2, received a median score above 0 in all dimensions; highest for attraction (median 1.43, IQR 0.93) followed by pragmatic quality (median 1.31, IQR 1.04), hedonic quality interaction (median 1.00, IQR 1.04), and hedonic quality stimulation (median 0.57, IQR 0.68). Knowledge of pain medication and pain management strategies improved after playing the game (P=.001). Conclusions: A computer game can be an efficient method of learning about pain management; it has the potential to improve knowledge and is appreciated by users. To assess the game’s usability and efficacy in the context of preparation for surgery, an evaluation with a larger sample, including surgical patients and older people, is required

Expectations of Tele-Yoga in Persons With Long-Term Illness : Qualitative Content Analysis

Background: Yoga is a mind-body exercise that has demonstrated its feasibility and safety even for individuals with severe long-term illness. Engaging in yoga has the potential to yield positive effects on both physical and mental well-being. Tele-yoga is a novel approach to rehabilitation in which participants practice group yoga with a live-streamed yoga instructor digitally via a tablet. This is especially beneficial for individuals who may find it difficult to leave their homes to participate in an exercise session. As part of our ongoing evaluation of the tele-yoga intervention in individuals with long-term illness, we have undertaken an exploration of participants' expectations regarding yoga in general and tele-yoga specifically. Understanding these expectations is crucial, as they can significantly impact their satisfaction with treatment and care and influence overall intervention outcomes. Objective: This study aims to explore the expectations of tele-yoga among individuals with long-term illness before starting a tele-yoga intervention. Methods: The study employed an inductive qualitative design and is part of a process evaluation within an ongoing randomized controlled trial. A total of 89 participants were interviewed before the start of the tele-yoga intervention. The interview guide encompassed questions about their general perceptions of yoga and the specific expectations they held for the upcoming tele-yoga sessions. The interviews were transcribed and analyzed using inductive qualitative content analysis. Results: Participants expressed their expectations for tele-yoga, focusing on the anticipated improvements in physical function and overall health. These expectations included hopes for reduced respiratory issues; relief from discomfort, aches, and pains; as well as increased physical flexibility, coordination, and overall well-being. Besides, they expected to achieve improved psychological well-being and performance; to acquire strategies to manage stress, anger, and anxiety; and to have their motivational drive strengthened and influence other activities. Participants described tele-yoga as a new and exciting technical solution that would facilitate the delivery of yoga. A few participants remained a little hesitant toward the use of technology, with some expectations based on previous experiences. When asked about expectations, some had no idea about what to expect. Participants also had varying perspectives on yoga, with some finding it mysterious and difficult to understand. Participants expressed thoughts that they found the idea of tele-yoga taking place in groups exciting and enjoyable. They also had expectations that being part of a group would provide opportunities for mutual inspiration and encouragement among the group members. Conclusions: Expectations before an intervention can provide valuable insights into understanding the factors influencing adherence to tele-yoga and its outcomes. Our findings provide a wide range of expectations for tele-yoga, spanning both physical and mental aspects. Moreover, the technology's potential to facilitate yoga delivery and the supportive nature of digital group interactions were evident from the results.Erratum in Correction: Expectations of Tele-Yoga in Persons With Long-Term Illness: Qualitative Content Analysis. Hedbom T, Liljeroos M, Thylén I, Orwelius L, Jaarsma T, Strömberg A. J Med Internet Res. 2023 Dec 19;25:e55077. doi: 10.2196/55077.</p

Missed opportunities! End of life decision making and discussions in implantable cardioverter defibrillator recipients

© 2019 Elsevier Inc. Background: Recent guidelines highlight the need for clinician-patient discussions regarding end-of-life (EOL) choices prior to implantable cardioverter defibrillator (ICD) implantation. Health literacy could affect the quality and quantity of such discussions. Objective: Our objective was to determine the association of health literacy with experiences, attitudes, and knowledge of the ICD at EOL. Methods: In this cross-sectional study, we used validated instruments to measure health literacy and patient experiences, attitudes, and knowledge of the ICD at EOL. Results: Of the 240 ICD recipients, 76% of participants reported never having discussed the implications of a future withdrawal of defibrillation therapy with their healthcare provider. Increased odds of choosing to maintain defibrillation therapy were associated with female gender and lower ICD knowledge. Conclusions: From patients’ perspectives, EOL discussions with providers were minimal. Most patients hold misperceptions about ICD function that could interfere with optimal EOL care, particularly for those with inadequate health literacy