scholarly journals Satisfaction with Fertility Preservation Decisions among Adolescent Males with Cancer: A Mixed Methods Study

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3559
Author(s):  
Charleen I. Theroux ◽  
Kylie N. Hill ◽  
Anna L. Olsavsky ◽  
James L. Klosky ◽  
Nicholas D. Yeager ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Fertility Preservation ◽  
Childhood Cancer Survivors ◽  
Mixed Methods Study ◽  
Decision Quality ◽  
Structured Interviews ◽  
Short Term ◽  
Male Adolescents ◽  
Decisional Satisfaction ◽  
Ongoing Support

Half of male childhood cancer survivors experience treatment-related fertility impairment, which can lead to distress. Survivors often regret forgoing fertility preservation (FP), and decisional dissatisfaction is associated with a lower quality of life. This mixed methods study examined short-term FP decisional satisfaction among families of male adolescents newly diagnosed with cancer who received an initial fertility consult and completed an FP values clarification tool. One-two months after the FP decision, thirty-nine families completed the Brief Subjective Decision Quality measure. Decisional satisfaction was compared for participants (mothers, fathers, adolescents) who did and did not attempt to bank. Semi-structured interviews included the following question: How do you/your family feel about the banking decision now/in the future? Decisional quality scores were moderate-high (M = 5.74–6.33 out of 7), with no significant differences between non-attempter (n = 15) and attempter (n = 24) families (adolescents: p = 0.83, d = 0.08; mothers: p = 0.18, d = 0.45; fathers: p = 0.32, d = 0.44). Three qualitative themes emerged among non-attempter families: (1) satisfaction with decision (50% of participants), (2) acceptance of decision (60%), and (3) potential for future regret (40%). Satisfaction with decision was the only theme identified in attempter families (93%). Quantitively, short-term decisional satisfaction was high regardless of the banking attempt. However, the qualitative findings suggest that the experiences of families who did not bank may be more nuanced, as several participants discussed a potential for future regret, highlighting the importance of ongoing support.

Risk perception on the labour ward: A mixed methods study

2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue
Keyword(s):  
Mixed Methods ◽  
Lived Experience ◽  
Healthcare Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Daily Basis ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Staff Support ◽  
Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

scholarly journals An intervention to decrease burnout and increase retention of early career nurses: a mixed methods study of acceptability and feasibility

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Judy Brook ◽  
Leanne M. Aitken ◽  
Julie-Ann MacLaren ◽  
Debra Salmon
Keyword(s):  
Mixed Methods ◽  
Nursing Students ◽  
Focus Groups ◽  
Academic Staff ◽  
Skills Training ◽  
Early Career ◽  
Mixed Methods Study ◽  
Healthcare Organisation ◽  
Structured Interviews ◽  
Over Time

Abstract Aims To understand the experiences of nursing students and academic staff of an intervention to decrease burnout and increase retention of early career nurses, in order to identify acceptability and feasibility in a single centre. Background Internationally, retention of nurses is a persistent challenge but there is a dearth of knowledge about the perspectives of stakeholders regarding the acceptability and feasibility of interventions to resolve the issue. This study reports an intervention comprising of mindfulness, psychological skills training and cognitive realignment to prepare participants for early careers as nurses. Methods This is an explanatory sequential mixed methods study, conducted by a UK university and healthcare organisation. Participants were final year pre-registration nursing students (n = 74) and academics (n = 7) involved in the implementation of the intervention. Pre and post measures of acceptability were taken using a questionnaire adapted from the Theoretical Framework of Acceptability. Wilcoxon Signed Ranks test was used to assess change in acceptability over time. Qualitative data from semi-structured interviews, focus groups and field notes were thematically analysed, adhering to COREQ guidelines. Data were collected February to December 2019. Results One hundred and five questionnaires, 12 interviews with students and 2 focus groups engaging 7 academic staff were completed. The intervention was perceived as generally acceptable with significant positive increases in acceptability scores over time. Student nurses perceived the intervention equipped them with skills and experience that offered enduring personal benefit. Challenges related to the practice environment and academic assessment pressures. Reported benefits align with known protective factors against burnout and leaving the profession. Conclusion Planning is needed to embed the intervention into curricula and maximise relationships with placement partners. Evaluating acceptability and feasibility offers new knowledge about the value of the intervention for increasing retention and decreasing burnout for early career nurses. Wider implementation is both feasible and recommended by participants.

scholarly journals Evaluating the motivation of Red Cross Health volunteers in the COVID-19 pandemic: a mixed-methods study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042579
Author(s):  
Leonardo W Heyerdahl ◽  
Muriel Vray ◽  
Vincent Leger ◽  
Lénaig Le Fouler ◽  
Julien Antouly ◽  
...  
Keyword(s):  
Public Health ◽  
Mixed Methods ◽  
Vulnerable Populations ◽  
Health Workers ◽  
Mixed Methods Study ◽  
Red Cross ◽  
Volunteer Motivation ◽  
Structured Interviews ◽  
Current Crisis ◽  
French Red Cross

IntroductionVoluntary organisations provide essential support to vulnerable populations and front-line health responders to the COVID-19 pandemic. The French Red Cross (FRC) is prominent among organisations offering health and support services in the current crisis. Comprised primarily of lay volunteers and some trained health workers, FRC volunteers in the Paris (France) region have faced challenges in adapting to pandemic conditions, working with sick and vulnerable populations, managing limited resources and coping with high demand for their services. Existing studies of volunteers focus on individual, social and organisational determinants of motivation, but attend less to contextual ones. Public health incertitude about the COVID-19 pandemic is an important feature of this pandemic. Whether and how uncertainty interacts with volunteer understandings and experiences of their work and organisational relations to contribute to Red Cross worker motivation is the focus of this investigation.Methods and analysisThis mixed-methods study will investigate volunteer motivation using ethnographic methods and social network listening. Semi-structured interviews and observations will illuminate FRC volunteer work relations, experiences and concerns during the pandemic. A questionnaire targeting a sample of Paris region volunteers will allow quantification of motivation. These findings will iteratively shape and be influenced by a social media (Twitter) analysis of biomedical and public health uncertainties and debates around COVID-19. These tweets provide insight into a French lay public’s interpretations of these debates. We evaluate whether and how socio-political conditions and discourses concerning COVID-19 interact with volunteer experiences, working conditions and organisational relations to influence volunteer motivation. Data collection began on 15 June 2020 and will continue until 15 April 2021.Ethics and disseminationThe protocol has received ethical approval from the Institut Pasteur Institutional Review Board (no 2020-03). We will disseminate findings through peer-reviewed articles, conference presentations and recommendations to the FRC.

scholarly journals Ringing the changes: the role of telephone communication in a helpline and befriending service targeting loneliness in older people

2018 ◽  
Vol 39 (7) ◽  
pp. 1528-1551 ◽  
Author(s):  
CLAIRE PRESTON ◽  
STEPHEN MOORE
Keyword(s):  
Mixed Methods ◽  
Older People ◽  
Thematic Analysis ◽  
Emotional Support ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Voice Communication ◽  
Telephone Communication ◽  
The United Kingdom

ABSTRACTThe drive to deliver services addressing loneliness in older people by telephone and online makes it increasingly relevant to consider how the mode of communication affects the way people interact with services and the capacity of services to meet their needs. This paper is based on the qualitative strand of a larger mixed-methods study of a national phoneline tackling loneliness in older people in the United Kingdom. The research comprised thematic analysis of four focus groups with staff and 42 semi-structured interviews with callers. It explored the associations between telephone-delivery, how individuals used the services and how the services were able to respond. To understand these associations, it was useful to identify some constituent characteristics of telephone communication in this context: namely its availability, reach and non-visual nature. This enabled various insights and comparison with other communication media. For example, the availability of the services attracted people seeking frequent emotional support but this presented challenges to staff. More positively, the ability of the services to connect disparate individuals enabled them to form different kinds of satisfying relationships. The evolution of mixed communication forms, such as internet-based voice communication and smartphone-based visual communication, makes analysis at the level of a technology's characteristics useful. Such a cross-cutting perspective can inform both the design of interventions and assessment of their suitability for different manifestations of loneliness.

scholarly journals Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study

2020 ◽  
Author(s):  
Anne van Tuijl ◽  
Hub C. Wollersheim ◽  
Cornelia R.M.G. Fluit ◽  
Petra. J. van Gurp ◽  
Hiske Calsbeek
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Learning By Doing ◽  
Mixed Methods Study ◽  
Quality Improvement Initiative ◽  
Structured Interviews ◽  
Priority Score ◽  
A Priority

Abstract Background: Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice. Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about the determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative . A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts were performed to gain insight on how to analyse and address the determinants in our tool Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.

scholarly journals Experiences of GP trainees in undertaking telephone consultations: a mixed-methods study

BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101008 ◽  
Author(s):  
Umar Chaudhry ◽  
Judith Ibison ◽  
Tess Harris ◽  
Imran Rafi ◽  
Miles Johnston ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Clinical Information ◽  
Mixed Methods Study ◽  
Strong Positive Correlation ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Electronic Survey ◽  
Positive Experiences ◽  
Positive Correlations ◽  
Observation Tools

BackgroundPrimary care telephone consultations are increasingly used for patient triage, reviews, and providing clinical information. They are also a key postgraduate training component yet little is known about GP trainees’ preparation for, or experiences and perceptions of, them.AimTo understand the experiences, perceptions, and training of GP trainees in conducting telephone consultations.Design & settingA mixed-methods study was undertaken of North Central and East London (NCEL) GP trainees.MethodA cross-sectional electronic survey of trainees was performed with subsequent semi-structured interviews. Survey data were analysed using descriptive statistics, and qualitative data using thematic analysis.ResultsThe survey response was 16% (n = 100/618), and 10 participated in semi-structured interviews. Trainees felt least confident with complicated telephone consulting, and there was a strong positive correlation between the percentage reporting having received training and their confidence (R2 = 0.71, P<0.0001). Positive experiences included managing workload and convenience. Negative experiences included complex encounters, communication barriers, and absence of examination. Trainees reported that training for telephone consultations needed strengthening, and that recently introduced audio-clinical observation tools (COTs) were useful. Positive correlations were found between the length of out-of-hours (OOH) but not in-hours training and the level of supervision or feedback received for telephone consultations.ConclusionThis project sheds light on GP trainees’ current experiences of telephone consultations and the need to enhance future training. The findings will inform a wider debate among stakeholders and postgraduate learners regarding training for telephone consultations, and potentially for other remote technologies.

scholarly journals Exploration of sedentary behaviour among general practitioners: protocol for a mixed methods study

2021 ◽  
Vol 8 (1) ◽  
pp. 51
Author(s):  
Richard S. Mayne ◽  
Nigel D. Hart ◽  
Neil Heron
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Sedentary Behaviour ◽  
General Practitioners ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
New Ways Of Working ◽  
Adverse Health Outcomes ◽  
Sequential Mixed Methods ◽  
Working Day

<p class="abstract"><strong>Background:</strong> Many general practitioners (GPs) are sedentary for most of their working day. Levels of sedentary behaviour may have been exacerbated by increased use of telemedicine in light of the COVID-19 pandemic, as this is traditionally performed while sitting down. Excessive sedentary behaviour is associated with many adverse health outcomes and increased all-cause mortality. This study will gain quantitative data on levels of sedentary behaviour among GPs and general practice specialty trainees (GPSTs), to identify to what extent general practice is a sedentary occupation, as well as qualitative data regarding the barriers and facilitators to reducing sedentary behaviour in the general practice setting.</p><p class="abstract"><strong>Methods:</strong> The study follows a sequential, mixed-methods model. The first stage will involve the dissemination of a questionnaire survey, where participants self-estimate their sedentary behaviour on a working day and on a non-working day. The second stage will use thigh-worn accelerometers and a sleep/work log to obtain objective data regarding sedentary behaviour among a purposive subset of participants who responded to the questionnaire. The third stage will involve semi-structured interviews with a purposive subset of accelerometer study participants, analysed with the application of a theoretical framework regarding the acceptability of healthcare interventions.</p><p class="abstract"><strong>Conclusions: </strong>This paper outlines a protocol for a sequential, mixed-methods study exploring sedentary behaviour among GPs and GPSTs. Findings of this study will shed light on the new ways of working as a result of the COVID-19 pandemic, which will be relevant to clinicians working in similar primary care settings throughout the world.</p><p class="abstract"><strong>Trial Registration:</strong> ClinicalTrials.gov Identifier: NCT04556695. Date of registration: 21<sup>st</sup> September 2020.</p><p class="abstract"> </p>

scholarly journals Engagement with and delivery of the ‘parkrun practice initiative’ in general practice: a mixed methods study

2020 ◽  
Vol 70 (697) ◽  
pp. e573-e580
Author(s):  
Joanna Fleming ◽  
Carol Bryce ◽  
Joanne Parsons ◽  
Chrissie Wellington ◽  
Jeremy Dale
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Focus Group ◽  
Online Survey ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Practice Staff ◽  
Health And Wellbeing ◽  
Positive Effects ◽  
Improve Patient

BackgroundThe parkrun practice initiative, a joint collaboration between parkrun and the Royal College of General Practitioners, was launched to encourage general practices to improve the health and wellbeing of patients and staff through participating in local 5 km parkrun events. Why and how practices engage with the initiative is unknown.AimTo investigate engagement with and delivery of the parkrun practice initiative in general practice.Design and settingMixed methods study conducted from April–July 2019 comprising an online survey of all registered parkrun practices, and interviews and a focus group with practice staff in the West Midlands.MethodThe designated contacts at 780 registered parkrun practices were invited to complete an online survey. A purposive sample of parkrun practice staff and non-registered practice staff took part either in semi-structured interviews or a focus group, with transcripts analysed thematically.ResultsOf the total number of parkrun practices, 306 (39.2%) completed the survey. Sixteen practice staff (from nine parkrun practices and four non-registered practices) took part in either semi-structured interviews (n = 12) or a focus group (n = 4). Key motivators for becoming a parkrun practice were: to improve patient and staff health and wellbeing, and to become more engaged with the community and enhance practice image. Practices most commonly encouraged patients, carers, and staff to take part in parkrun and displayed parkrun flyers and posters. Challenges in implementing activities included lack of time (both personal and during consultations) and getting staff involved. Where staff did engage there were positive effects on morale and participation. Non-registered practices were receptive to the initiative, but had apprehensions about the commitment involved.ConclusionPractices were keen to improve patient and staff health. Addressing time constraints and staff support needs to be considered when implementing the initiative.

scholarly journals How Effective Is Youth Volunteering as an Employment Strategy? A Mixed Methods Study of England

Sociology ◽  
2020 ◽  
Vol 54 (4) ◽  
pp. 763-781
Author(s):  
Bryony Hoskins ◽  
Pauline Leonard ◽  
Rachel Wilde
Keyword(s):  
Mixed Methods ◽  
Citizenship Education ◽  
Qualitative Interviews ◽  
Longitudinal Survey ◽  
Mixed Methods Study ◽  
Short Term ◽  
Mixed Methods Approach ◽  
Negative Effect ◽  
Support Policy ◽  
The Relationship

Volunteering is routinely advocated in British policy as a key mechanism for young people to gain employment, but with little evidence of its viability as a strategy. Indeed, the limited research in this area suggests the link is weak and that access to good quality volunteering is differentiated along class lines. This article draws on a mixed methods approach, using survey data from the Citizenship Education Longitudinal Survey and qualitative interviews, to analyse the relationship between youth volunteering and employment. It finds that volunteering is not unequivocally beneficial for employment, particularly if it does not offer career-related experience or is imposed rather than self-initiated. It can even have a negative effect on employment. Furthermore, social class mediates access to volunteering opportunities most likely to convert into employment. We conclude there is little evidence to support policy assumptions that, in the short term, volunteering has a positive relationship to paid employment.

scholarly journals Does Sense make sense? Mixed methods study of a Dutch sexual health program

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Joosten ◽  
L Jochems ◽  
C Wijsen ◽  
T Heijman ◽  
A Timen
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Young People ◽  
Sexual Health ◽  
Health Care Professionals ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Open Atmosphere ◽  
Study Results

Abstract In the Netherlands, the Sense program addresses several key elements of sexual health for young people &lt;25 year. This program offers free consultations at the PHS concerning STI, contraceptives, pregnancy or sexuality. The performance of this program has not been studied yet. This mixed methods study investigates facilitators and barriers of a Sense consultation from the perspective of clients and health care professionals (HCP) and investigates the outcome of the consultation at three points in time. Semi-structured interviews were conducted after consultation among 16 clients and 6 HCP. Questionnaires were collected directly after consultation and at 3, 6 and 12 months after consultation. Two cohorts were recruited; clients with STI consultation only and clients with questions related to sexuality, contraception and pregnancy (Sense consultation, SC). Satisfaction of the consultation and applicability of the given advice was measured. In the follow up presence of STI, pregnancy, sexual problem and contraceptive use was measured. A minority of the interviewed clients were familiar with Sense, highly valued the expertise of the HCP and the open atmosphere during the consultation. Reasons for visiting Sense included expertise, more anonymity and feeling more comfortable than at the GP. The questionnaire after consultation was returned by 144 STI clients and 32 SC clients. Both type of consultation were highly valued and advice was easily applicable. The follow up cohort included 97 STI clients and 23 SC clients. Response rate of the 3- and 6 month-questionnaires was 61%. Results of the full one year follow-up are expected in September 2019. Study results provide evidence for a highly valued Sense program, by both clients and HCP. Sense is a platform to discuss STI, contraception and sexuality in an open atmosphere, though familiarity with Sense is low. A major conclusion is that an STI consultation provides the opportunity to address questions related to sexuality. Key messages The Sense program is highly valued by young people, and yet the program is not widely known among young people. There is need for more publicity to the program to enable more young people to use this program and to improve the sexual health care of young Dutch people.

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