scholarly journals Attending to Methodological Challenges in Qualitative Research to Foster Participation of Individuals with Chronic Critical Illness and Communication Impairments

2021 ◽  
Vol 8 ◽  
pp. 233339362110000
Author(s):  
Fuchsia Howard ◽  
Sarah Crowe ◽  
Scott Beck ◽  
Gregory Haljan

Individuals with chronic critical illness experience multiple complex physiological disturbances including ongoing respiratory failure, requiring prolonged mechanical ventilation, and thus communication impairments. In conducting a qualitative interpretive description study, we sought to ensure that individuals with chronic critical illness themselves were included as participants. Our commitment to recruiting these individuals to the study and ensuring their data meaningfully informed the analysis and findings required us to reconsider and challenge some of the traditional notions of high-quality qualitative research and develop appropriate practical strategies. These strategies included: (1) centering participant abilities and preferences, (2) adopting a flexible approach to conducting interviews, (3) engaging in a therapeutic relationship, and (4) valuing “thin” data. In this article, we extend existing literature describing the complexities of conducting research with individuals with communication impairments and strategies to consider in the hopes of informing future research with other populations historically excluded from study participation.

Author(s):  
Christopher E Cox

Patients who have chronic critical illness, operationally defined as those requiring prolonged mechanical ventilation, are markedly increasing in number and commonly experience profound, persistent physical and psychological debilitation. This patient population consumes an extraordinary amount of health care resources attributed to both the acute hospitalization as well as complex post-discharge treatments provided across multiple post-acute care facilities. Currently, the US health care system incentivizes these patient flow dynamics. Health care policy changes addressing post-acute care payment are inevitable. This chapter highlights potential patient, family, physician, and systems targets for current and future interventions, designed to improve quality and reduce costs for this patient population.


2019 ◽  
Vol 6 (4) ◽  
pp. p503
Author(s):  
Siyabulela C. Fobosi

Accessing the field for the purposes of conducting research often starts with negotiation and engagement with gatekeepers. This is the first requirement for the research to be conducted; however, this step has challenges. While research has been conducted on negotiating access and research ethics, very little is known about the experiences of doctoral students from the Global South on negotiating access in fieldwork, and thus giving an account of what it entails conducting qualitative research from the Global South. As such, this article engages with the challenges of negotiating access to the field for my PhD studies. Due to the nature of research for my thesis, I conducted interviews with key informants from the departments and participants from the taxi ranks. In this article, I problematize the view that gaining access to the field is a simple process, by exposing my own uncomfortable encounters during the process.


2021 ◽  
Author(s):  
David J Zorko ◽  
James Dayre McNally ◽  
Bram Rochwerg ◽  
Neethi Pinto ◽  
Rachel Couban ◽  
...  

Due to improvements in the delivery of intensive care, survival of even the most critically ill of children has increased, leading to a growing proportion of children with chronic and/or complex medical conditions in the pediatric intensive care unit (PICU). Some of these children are at significant risk of recurrent critical illness and persistent long-term morbidity, and become ‘superusers’ of PICU resources. These children are increasingly recognized as a unique high-risk population in the PICU referred to as children with chronic critical illness (CCI). To date, this population has been understudied, in part due to pediatric CCI being a novel concept without an accepted definition to consistently identify these children. This scoping review is the first step in the development of a consensus case definition for pediatric CCI. This comprehensive literature review will seek to first evaluate existing or suggested definitions of pediatric CCI, and in their absence, identify key terms and constructs to inform the development of a working definition of pediatric CCI for future research.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0248883
Author(s):  
Hilmi Demirkiran ◽  
Mehmet Kilic ◽  
Yakup Tomak ◽  
Tahir Dalkiran ◽  
Sadik Yurttutan ◽  
...  

Our aim was to determine characteristics of children with chronic critical illness (CCI) admitted to the pediatric intensive care unit (PICU) of a tertiary care children’s hospital in Turkey. The current study was a multicenter retrospective cohort study that was done from 2014 to 2017. It involved three university hospitals PICUs in which multiple criteria were set to identify pediatric CCIs. Pediatric patients staying in the ICU for at least 14 days and having at least one additional criterion, including prolonged mechanical ventilation, tracheostomy, sepsis, severe wound (burn) or trauma, encephalopathy, traumatic brain injury, status epilepticus, being postoperative, and neuromuscular disease, was accepted as CCI. In order to identify the newborn as a chronic critical patient, a stay in the intensive care unit for at least 30 days in addition to prematurity was required. Eight hundred eighty seven (11.14%) of the patients who were admitted to the PICU met the definition of CCI and 775 of them (87.3%) were discharged to their home. Of CCI patients, 289 (32.6%) were premature and 678 (76.4%) had prolonged mechanical ventilation. The total cost values for 2017 were statistically higher than the other years. As the length of ICU stay increased, the costs also increased. Interestingly, high incidence rates were observed for PCCI in our hospitals and these patients occupied 38.01% of the intensive care bed capacity. In conclusion, we observed that prematurity and prolonged mechanical ventilation increase the length of ICU stay, which also increased the costs. More work is needed to better understand PCCI.


2017 ◽  
Vol 42 ◽  
pp. 405-406
Author(s):  
Paola Tonin Carpeggiani ◽  
Júlia Bertholdo Bossardi ◽  
Fabricio Piccoli Fortuna ◽  
Vanessa Piccoli ◽  
Nicole Elen Lira ◽  
...  

2014 ◽  
Vol 20 (9) ◽  
pp. 884-893 ◽  
Author(s):  
Rifka Schulman ◽  
Erin Moshier ◽  
Lisa Rho ◽  
Martin Casey ◽  
James Godbold ◽  
...  

2014 ◽  
Vol 1 (1) ◽  
pp. 581-584
Author(s):  
Dumitrascu Mihaela ◽  
Ileana Ciutacu ◽  
Iulian Vasile Săvulescu

AbstractThe purpose of this paper is to see the situation regarding the indicators from the Sustainability Reports. For this we use a qualitative research, a content analysis of these reports. Our sample is composed by the banks that develop their activity in our country for which we analysed the last year reports at group level. We choose only an industry sector to obtain the homogeneity of the sample. The findings reveal a number of 86 indicators, which were used in these reports. We analyzed the Global Reporting Initiative (GRI) indicators used by 12 companies. The most reported indicators are EN4, EN8, LA1, LA10, while the last reported indicators are E5, E10 E13 E15, EN20, EN21, EN23, EN27, HR9, HR10 The results obtained are important for future research in this area, for both managers and researchers.


Author(s):  
Robin Lee ◽  
Karen Dahri ◽  
Tim T Y Lau ◽  
Stephen Shalansky

<p><strong>ABSTRACT</strong></p><p><strong>Background: </strong>Few studies have attempted to determine the proportion of Canadian hospital pharmacists involved in clinical research, despite a general consensus that research should be an essential component of a pharmacist’s professional role.</p><p><strong>Objectives: </strong>The primary objective was to characterize the involvement in clinical pharmacy research of hospital pharmacists in the 4 health authorities of the Lower Mainland of British Columbia (collectively known as the Lower Mainland Pharmacy Services). The secondary objective was to identify perceived barriers to conducting research.</p><p><strong>Methods: </strong>Pharmacists employed within Lower Mainland Pharmacy Services were invited to participate in an online cross-sectional survey, for completion in August and September 2015. Descriptive statistics were used to analyze the results. Groups of survey participants were compared to examine differences in measured outcomes.</p><p><strong>Results: </strong>A total of 534 pharmacists were surveyed, with a response rate of 16% (85/534). Overall, 77% (55/71) of the respondents reported having participated in research, and 87% (62/71) expressed interest in conducting future research. Chart reviews (78%, 36/46) and surveys (41%, 19/46) were the most common study designs used in prior research. Participants self-identified their research-related strengths as literature evaluation (46%, 27/59) and hypothesis generation (44%, 26/59). Conversely, 81% (48/59) of respondents self-identified statistical analysis as a weakness. Most respondents stated that personal satisfaction (82%, 49/60) and the opportunity to learn about disease states (78%, 47/60) were the driving factors for conducting research. The most commonly cited barrier to conducting research was lack of time (92%, 55/60). Opportunities to join existing teams (73%, 44/60) and mentorship programs (70%, 42/60) were identified as the most popular arrangements for encouraging future research.</p><p><strong>Conclusions: </strong>Most of the pharmacists who responded to this survey reported having participated in clinical pharmacy research, but a lack of dedicated time appears to be a major hurdle to greater research participation. A targeted program increasing exposure to existing research teams and mentorship opportunities is recommended for promoting future research.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte : </strong>Peu d’études ont cherché à déterminer la proportion de “pharmaciens d’hôpitaux canadiens qui contribuent à la recherché clinique, et ce, malgré un consensus voulant que la recherche doive être un élément essentiel du rôle professionnel des pharmaciens.</p><p><strong>Objectifs : </strong>L’objectif principal était d’offrir un portrait de la contribution à la recherche sur la pharmacie clinique des pharmaciens d’hôpitaux des quatre régies régionales des basses-terres continentales de la Colombie-Britannique (appelées collectivement <em>Lower Mainland Pharmacy Services</em>, c.-à-d. services de pharmacie des basses-terres continentales). L’objectif secondaire était de recenser les éléments perçus comme des obstacles à la réalisation de recherches.</p><p><strong>Méthodes : </strong>Les pharmaciens employés au sein des services de pharmacie des basses-terres continentales ont été invités à participer par voie électronique à une enquête transversale qui devait être complétée en août et en septembre 2015. Des statistiques descriptives ont été employées pour analyser les résultats. On a aussi comparé des groupes de participants à l’enquête afin d’examiner les différences entre les résultats mesurés.</p><p><strong>Résultats : </strong>Au total, 534 pharmaciens ont été sondés et le taux de réponse était de 16 % (85/534). Dans l’ensemble, 77 % (55/71) des répondants indiquaient avoir participé à des recherches et 87 % (62/71) souhaitaient faire de la recherche dans l’avenir. L’analyse de dossiers médicaux (78 %, 36/46) et les sondages (41 %, 19/46) représentaient les plans d’étude les plus utilisés par les répondants au cours de recherches antérieures. Les participants ont indiqué que leurs forces en lien avec la recherche étaient leur capacité d’évaluer la littérature (46 %, 27/59) et de formuler des hypothèses (44 %, 26/59). En revanche, 81 % (48/59) ont signalé l’analyse statistique comme leur point faible. La plupart des répondants croyaient que la satisfaction personnelle (82 %, 49/60) et la perspective d’acquérir des connaissances sur les maladies (78 %, 47/60) représentaient les principaux facteurs les motivant à faire de la recherche. Ce qui était évoqué le plus souvent comme un obstacle à la recherche était le manqué de temps (92 %, 55/60). Les occasions de se joindre à des équipes en place (73 %, 44/60) et les programmes de mentorat (70 %, 42/60) ont été désignés comme les dispositions les plus attrayantes pour encourager à poursuivre de futures recherches.</p><strong>Conclusions : </strong>La plupart des pharmaciens ayant répondu au sondage ont indiqué avoir contribué à des recherches en pharmacie clinique, mais le manque de temps réservé pour la recherche semblait être un obstacle important à une plus grande participation aux activités de recherche. Un programme ciblé multipliant les possibilités de fréquenter des équipes de recherche déjà établies et offrant plus d’occasions de mentorat serait une façon de promouvoir de futures recherches.


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