39 results found
Wedderburn S, Archer S, Tischkowitz M, et al., 2021, Update: Variable implementation of the 2018 UKCGG/UKGTN guidelines for breast cancer gene panel tests offered by UK genetics services, Journal of Medical Genetics, Vol: 58, Pages: 579-580, ISSN: 0022-2593
Archer S, Cheung NHY, Williams I, et al., 2021, The impact of digital health interventions on the psychological outcomes of patients and families receiving paediatric palliative care: a systematic review and narrative synthesis, Palliative Medicine, ISSN: 0269-2163
Background:Digital health interventions are becoming increasingly important and may be particularly relevant for paediatric palliative care. In line with the aims of palliative care, digital health interventions should aim to maintain, if not improve, psychological wellbeing. However, the extent to which the psychological outcomes of digital health interventions are assessed is currently unknown.Aim:To identify and synthesise the literature exploring the impact of all digital health interventions on the psychological outcomes of patients and families receiving paediatric palliative care.Design:Systematic review and narrative synthesis.Data sources:MEDLINE, EMBASE, Health Management Information Consortium, PsycINFO, Cumulative Index to Nursing and Allied Health Literature and the Midwives Information & Resource Service were searched on the 27th July 2020, in addition to the first five pages of Google Scholar. To be included in the review, papers must have contained: quantitative or qualitative data on psychosocial outcomes, data from patients aged 0–18 receiving palliative care or their families, a digital health intervention, and been written in English.Results:Three studies were included in the review. All looked at the psychological impact of telehealth interventions. Papers demonstrated fair or good quality reporting but had small sample sizes and varied designs.Conclusions:Despite the design and development of digital health interventions that span the technological landscape, little research has assessed their psychosocial impact in the paediatric palliative care community. Whilst the evidence base around the role of these interventions continues to grow, their impact on children and their families must not be overlooked.
Archer S, Calanzani N, Honey S, et al., 2021, Impact of the COVID-19 pandemic on cancer assessment in primary care: a qualitative study of GP views, British Journal of General Practice Open, ISSN: 2398-3795
Lee A, Yang X, Tyrer J, et al., 2021, A Comprehensive Epithelial Tubo-Ovarian Cancer Risk Prediction Model Incorporating Genetic and Epidemiological Risk Factors, Journal of Medical Genetics, ISSN: 0022-2593
Bielinska A, Archer S, Obanobi A, et al., 2021, Advance care planning in older hospitalised patients following an emergency admission: a mixed methods study, PLoS One, Vol: 16, Pages: 1-14, ISSN: 1932-6203
Introduction: Although advance care planning may be beneficial for older adults in the last year of life, its relevance following an emergency hospitalisation requires further investigation. This study quantifies the one-year mortality outcomes of all emergency admissions for patients aged 70+ years and explores patient views on the value of advance care planning following acute hospitalisation.Method: This mixed methods study used a two-stage approach: firstly, a quantitative longitudinal cohort study exploring the one-year mortality of patients aged 70+ admitted as an emergency to a large multi-centre hospital cohort; secondly, a qualitative semi-structured interview study gathering information on patient views of advance care planning.Results: There were 14,260 emergency admissions for 70+-year olds over a 12-month period. One-year mortality for admissions across all conditions was 22.6%. The majority of these deaths (59.3%) were within 3 months of admission. Binary logistic regression analysis indicated higher one-year mortality with increasing age and male sex. Interviews with 20 patients resulted in one superordinate theme, “Planning for health and wellbeing in the spectrum of illness”. Sub-themes entitled (1) Advance care planning benefitting healthcare for physical and psycho-social health, (2) Contemplation of physical deterioration death and dying and 3) Collaborating with healthcare professionals to undertake advance care planning, suggest that views of advance care planning are shaped by experiences of acute hospitalisation.Conclusion: Since approximately 1 in 5 patients aged 70+ admitted to hospital as an emergency are in the last year of life, acute hospitalisation can act as a trigger for tailored ACP. Older hospitalised patients believe that advance care planning can benefit physical and psychosocial health and that discussions should consider a spectrum of possibilities, from future health to the potential of chronic illness, disability
Joshi M, Archer S, Morbi A, et al., 2021, Short-Term Wearable Sensors for In-Hospital Medical and Surgical Patients: Mixed Methods Analysis of Patient Perspectives, JMIR Perioperative Medicine, ISSN: 2561-9128
Carver T, Hartley S, Lee A, et al., 2020, CanRisk Tool - A web interface for the prediction of breast and ovarian cancer risk and the likelihood of carrying genetic pathogenic variants., Cancer Epidemiology, Biomarkers and Prevention, ISSN: 1055-9965
Archer S, Holch T, Armes J, et al., 2020, ‘No turning back’ Psycho-oncology in the time of COVID-19 - insights from a survey of UK professionals, Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer, Vol: 29, Pages: 1430-1435, ISSN: 1057-9249
Soosaipillai G, Archer S, Ashrafian H, et al., 2020, Breaking bad news training in the COVID-19 era and beyond, Journal of Medical Education and Curricular Development, Vol: 7, Pages: 1-4, ISSN: 2382-1205
COVID-19 has disrupted the status quo for healthcare education. As a result, redeployed doctors and nurses are caring for patients at the end of their lives and breaking bad news with little experience or training. This article aims to understand why redeployed doctors and nurses feel unprepared to break bad news through a content analysis of their training curricula. As digital learning has come to the forefront in health care education during this time, relevant digital resources for breaking bad news training are suggested.
Montague J, Phillips E, Holland F, et al., 2020, Expanding Hermeneutic Horizons: Working as Multiple Researchers and with Multiple Participants, Research Methods in Medicine & Health Sciences
Bielinska A, Archer S, Soosaipillai G, et al., 2020, Views of advance care planning in caregivers of older hospitalised patients following an emergency admission: a qualitative study, Journal of Health Psychology, ISSN: 1359-1053
This study explores the views of advance care planning in caregivers of older hospitalised patients following an emergency admission. Semi-structured interviews were conducted with eight carers, mostly with a personal relationship to the older patient. Thematic analysis generated three themes: (1) working with uncertainty – it all sounds very fine. . . what is the reality?, (2) supporting the older person – you have to look at it on an individual basis and (3) enabling the process – when you do it properly. The belief that advance care planning can support older individuals and scepticism whether advance care planning can be enabled among social and healthcare challenges are discussed.
Archer S, Thibaut B, Dewa L, et al., 2020, Barriers and facilitators to incident reporting in mental healthcare settings: a qualitative study, Journal of Psychiatric and Mental Health Nursing, Vol: 27, Pages: 211-223, ISSN: 1351-0126
IntroductionBarriers and facilitators to incident reporting have been widely researched in general healthcare. However, it is unclear if the findings are applicable to mental healthcare where care is increasingly complex.AimTo investigate if barriers and facilitators affecting incident reporting in mental healthcare are consistent with factors identified in other healthcare settings.MethodData were collected from focus groups (n=8) with 52 members of staff from across [a large Mental Health] Trust and analysed with thematic analysis.ResultsFive themes were identified during the analysis. Three themes (i)learning and improvement, (ii)time, and (iii)fear were consistent with the existing wider literature on barriers and facilitators to incident reporting. Two further themes (iv)interaction between patient diagnosis and incidents and (v)aftermath of an incident – prosecution specifically linked to the provision of mental healthcare.ConclusionsWhilst some barriers and facilitators to incident reporting identified in other settings are also prevalent in the mental healthcare setting, the increased incidence of violent and aggressive behaviour within mental healthcare presents a unique challenge for incident reporting.Clinical ImplicationsAlthough Interventions to improve incident reporting may be adapted/adopted from other settings, there is a need to develop specific interventions to improve reporting of violent and aggressive incidents.
Arora S, Tsang F, Kekecs Z, et al., 2020, Patient Safety Education 20 years after the Institute of Medicine Report: results from a cross-sectional National Survey, Journal of Patient Safety, ISSN: 1549-8417
Objectives Educating healthcare professionals in patient safety is essential to achieving sustainable improvements in care. This study aimed to identify the key constituents of patient safety education alongside its facilitators and barriers from a frontline perspective.Methods An electronic survey was sent to 592 healthcare professionals and educators in patient safety education in the United Kingdom. Two independent reviewers conducted a thematic analysis of the free-text data. Themes focused on effective content, learning practices and facilitators and barriers to patient safety education.Results Of 592 individuals completing the survey, 545 (92%) submitted analyzable responses. Interrater reliability of coding was high with Cohen k value of 0.86. Participants endorsed experiential and interactive learning as ideal modalities for delivery and expressed a need for content to be based on real clinical cases and tailored to the needs of the learners. The most commonly mentioned facilitators were standardization of methods and assessment (49%), dedicated funding (21%), and culture of openness (20%). Staffing problems and high workload (41%) and lack of accessibility of training (23%) were identified as primary barriers of efficacy and uptake.Conclusions This study identified key factors to the success of patient safety education in terms of content and delivery alongside facilitators and barriers. Future curricula developers and interventions should improve standardization, funding, culture, and access so as to optimize education programs to enhance patient safety.
Archer S, Babb de Villiers C, Scheibl F, et al., 2020, Evaluating clinician acceptability of the prototype CanRisk tool for predicting risk of breast and ovarian cancer: a multi-methods study, PLoS One, Vol: 15, ISSN: 1932-6203
BackgroundThere is a growing focus on the development of multi-factorial cancer risk prediction algorithms alongside tools that operationalise them for clinical use. BOADICEA is a breast and ovarian cancer risk prediction model incorporating genetic and other risk factors. A new user-friendly Web-based tool (CanRisk.org) has been developed to apply BOADICEA. This study aimed to explore the acceptability of the prototype CanRisk tool among two healthcare professional groups to inform further development, evaluation and implementation.MethodA multi-methods approach was used. Clinicians from primary care and specialist genetics clinics in England, France and Germany were invited to use the CanRisk prototype with two test cases (either face-to-face with a simulated patient or via a written vignette). Their views about the tool were examined via a semi-structured interview or equivalent open-ended questionnaire. Qualitative data were subjected to thematic analysis and organised around Sekhon’s Theoretical Framework of Acceptability.ResultsSeventy-five clinicians participated, 21 from primary care and 54 from specialist genetics clinics. Participants were from England (n = 37), France (n = 23) and Germany (n = 15). The prototype CanRisk tool was generally acceptable to most participants due to its intuitive design. Primary care clinicians were concerned about the amount of time needed to complete, interpret and communicate risk information. Clinicians from both settings were apprehensive about the impact of the CanRisk tool on their consultations and lack of opportunities to interpret risk scores before sharing them with their patients.ConclusionsThe findings highlight the challenges associated with developing a complex tool for use in different clinical settings; they also helped refine the tool. This prototype may not have been versatile enough for clinical use in both primary care and specialist genetics clinics where the needs of clinicians are different, emphas
Thibaut B, Dewa L, Ramtale S, et al., 2019, Patient safety in inpatient mental health settings: a systematic review, BMJ Open, Vol: 9, Pages: 1-19, ISSN: 2044-6055
Objectives: Patients in inpatient mental health settings face similar risks to those in other areas of health care (e.g. medication errors). In addition, some unsafe behaviours associated with serious mental health problems (e.g. self-harm), and the measures taken to address these (e.g. restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology. Design: Systematic review and meta-synthesis. Embase, CINAHL, HMIC, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to “mental health”, “patient safety”, “inpatient setting” and “research”. Study quality was assessed using the Hawker checklist. Data was extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random effects model.Results: Of the 57,637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150,000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control. Conclusions: Patient safety in inpatient mental health settings is under researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety which require investment in research, policy development, and translation into clinical practice.
Reynolds J, Archer S, Pilling M, et al., 2019, Public acceptability of nudging and taxing to reduce consumption of alcohol, tobacco, and food: A population-based survey experiment, Social Science and Medicine, Vol: 236, Pages: 1-10, ISSN: 0277-9536
There is growing evidence for the effectiveness of choice architecture or ‘nudge’ interventions to change a range of behaviours including the consumption of alcohol, tobacco and food. Public acceptability is key to implementing these and other interventions. However, few studies have assessed public acceptability of these interventions, including the extent to which acceptability varies with the type of intervention, the target behaviour and with evidence of intervention effectiveness. These were assessed in an online study using a between-participants full factorial design with three factors: Policy (availability vs size vs labelling vs tax) x Behaviour (alcohol consumption vs tobacco use vs high-calorie snack food consumption) x Evidence communication (no message vs assertion of policy effectiveness vs assertion and quantification of policy effectiveness [e.g., a 10% change in behaviour]). Participants (N = 7058) were randomly allocated to one of the 36 groups. The primary outcome was acceptability of the policy. Acceptability differed across policy, behaviour and evidence communication (all ps < .001). Labelling was the most acceptable policy (supported by 78%) and Availability the least (47%). Tobacco use was the most acceptable behaviour to be targeted by policies (73%) compared with policies targeting Alcohol (55%) and Food (54%). Relative to the control group (60%), asserting evidence of effectiveness increased acceptability (63%); adding a quantification to this assertion did not significantly increase this further (65%). Public acceptability for nudges and taxes to improve population health varies with the behaviour targeted and the type of intervention but is generally favourable. Communicating that these policies are effective can increase support by a small but significant amount, suggesting that highlighting effectiveness could contribute to mobilising public demand for policies. While uncertainty remains about the strength of public supp
Phillips E, Archer S, Montague J, et al., 2019, Experiences of enhanced recovery after surgery in general gynaecology patients: an interpretative phenomenological analysis, Health Psychology Open, ISSN: 2055-1029
Archer SA, Pinto A, Vuik S, et al., 2019, Surgery, complications and quality of life: a longitudinal cohort study exploring the role of psychosocial factors, Annals of Surgery, Vol: 270, Pages: 95-101, ISSN: 0003-4932
Objective:To determine if psychosocial factors moderate the relationship between surgical complications and quality of life (QoL).Summary Background:Patients who experience surgical complications have significantly worse post-operative QoL than patients with an uncomplicated recovery. Psychosocial factors, such as coping style and level of social support influence how people deal with stressful events, but it is unclear if they impact on QoL following a surgical complication. These findings can inform the development of appropriate interventions that support patients post-operatively. Methods:This is a longitudinal cohort study; data were collected at pre-op, 1 month post-op, 4 months post-op and 12 months post-op. A total of 785 patients undergoing major elective gastro-intestinal, vascular or cardio-thoracic surgery were recruited from 28 National Health Service (NHS) sites in England and Scotland took part in the study.Results:Patients who experience major surgical complications report significantly reduced levels of physical and mental QoL (p<0.05) but they make a full recovery over time. Findings indicate that a range of psychosocial factors such as the use of humor as a coping style and the level of health care professional support may moderate the impact of surgical complications on QoL.Conclusion:Surgical complications alongside other socio-demographic and psychosocial factors contribute to changes in QoL; the results from this exploratory study suggest that interventions that increase the availability of healthcare professional support and promote more effective coping strategies prior to surgery may be useful, particularly in the earlier stages of recovery where QoL is most severely compromised. However, these relationships should be further explored in longitudinal studies that include other types of surgery and employ rigorous recruitment and follow up procedures.
Sabharwal S, Archer S, Cadoux-Hudson D, et al., 2019, Exploring elderly patients' experiences of recovery following complex proximal humerus fracture: A qualitative study., J Health Psychol, Pages: 1359105319850883-1359105319850883
This study explores the experiences and perceptions of recovery in elderly patients who had sustained a proximal humerus fracture. In-depth semi-structured interviews were conducted with 15 patients over the age of 65. Thematic analysis identified aspects of care that impacted upon patient experience and quality of life. Seven main patient-reported themes were identified, including pain, sleep, shoulder function, emotional state, social support, relationship with their professional and experience of healthcare institution. These themes offer insight into the experiences of adults receiving care for proximal humerus fracture and highlight that existing quantitative measures of quality of life do not measure domains that are important to patients.
Le Boutillier C, Archer S, Barry C, et al., 2019, Conceptual framework for living with and beyond cancer: A systematic review and narrative synthesis, Psycho-Oncology, Vol: 28, Pages: 948-959, ISSN: 1057-9249
ObjectiveThe concept of living with and beyond cancer is now emerging in policy and literature. Rather than viewing this notion simply as a linear timeline, developing an agreed understanding of the lived experience of people affected by cancer will aid the development of person‐centred models of care.MethodsA systematic review was conducted. The review question was “What does the term ‘living with and beyond cancer’ mean to people affected by cancer?” The protocol for the review was preregistered in the PROSPERO database (PROSPERO CRD42017059860). All included studies were qualitative, so narrative synthesis was used to integrate descriptions and definitions of living with and beyond cancer into an empirically based conceptual framework.ResultsOut of 2345 papers that were identified and 180 that were reviewed, a total of 73 papers were included. The synthesis yielded three interlinked themes: Adversity (realising cancer), Restoration (readjusting life with cancer), and Compatibility (reconciling cancer), resulting in the ARC framework.ConclusionsThree themes describe the experience of living with and beyond cancer: adversity, restoration, and compatibility. The ARC framework provides an empirically informed grounding for future research and practice in supportive cancer care for this population.
Shah N, Martin G, Archer S, et al., 2019, Exploring mobile working in healthcare: Clinical perspectives on transitioning to a mobile first culture of work, International Journal of Medical Informatics, Vol: 125, Pages: 96-101, ISSN: 1386-5056
ObjectivesThis study investigated the views of healthcare professionals (HCPs) as end-users of mobile technologies to inform the requirements for a successful move towards a mobile first culture of work within secondary care. Many HCPs already used mobile devices to support their day-to-day practice and so transitioning to an organisational led mobile way of working is both needed and timely.Materials and methodsIn-depth focus groups and interviews at a UK academic hospital were conducted with HCPs (nurses, doctors, and allied health professionals). The interviews elicited views from HCPs about the use of mobile technologies in their clinical work and discussed their experiences of previous technology deployments.ResultsThirty-four HCPs participated. Three themes were identified: integrating mobile working in hospital care; addressing data governance and accountability for mobile working; and handling the pace of change. The acceptance of mobile working is determined by whether it enhances, rather than hinders clinical practice whilst holding end-user’s confidence; measuring the impact of the administrative burden on workload, changes to professional accountability and safeguarding patient data are serious issues that need consideration; and the pace of change needs to work for all stakeholders.Discussion and conclusionsThe benefits of adopting mobile technologies are well recognised, however, technical and policy related factors identified by professional end-users require answers in order to successfully integrate mobile working into current practice. Adopting a mobile first approach to work is timely and achievable, but can only be delivered on a foundation of positive end-user engagement and strong organisational leadership.
Pannick S, Archer S, Long S, et al., 2019, What matters to medical ward patients, and do we measure it? A qualitative comparison of patient priorities and current practice in quality measurement, on UK NHS medical wards, BMJ Open, Vol: 9, ISSN: 2044-6055
Objectives To compare the quality metrics selected for public display on medical wards to patients’ and carers’ expressed quality priorities.Methods Multimodal qualitative evaluation of general medical wards and semi-structured interviews.Setting UK tertiary National Health Service (public) hospital.Participants Fourteen patients and carers on acute medical wards and geriatric wards.Results Quality metrics on public display evaluated hand hygiene, hospital-acquired infections, nurse staffing, pressure ulcers, falls and patient feedback. The intended audience for these metrics was unclear, and the displays gave no indication as to whether performance was improving or worsening. Interviews identified three perceived key components of high-quality ward care: communication, staff attitudes and hygiene. These aligned poorly with the priorities on display. Suboptimal performance reporting had the potential to reduce patients’ trust in their medical teams. More philosophically, patients’ and carers’ ongoing experiences of care would override any other evaluation, and they felt little need for measures relating to previous performance. The display of performance reports only served to emphasise patients’ and carers’ lack of control in this inpatient setting.Conclusions There is a gap between general medical inpatients’ care priorities and the aspects of care that are publicly reported. Patients and carers do not act as ‘informed choosers’ of healthcare in the inpatient setting, and tokenistic quality measurement may have unintended consequences.
Pucher P, Johnston M, Archer S, et al., 2019, Informing the consent process for surgeons: A survey study of patient preferences, perceptions and risk tolerance, Journal of Surgical Research, Vol: 235, Pages: 298-302, ISSN: 0022-4804
BackgroundDespite the ethical and statutory requirement to obtain consent for surgical procedures, the actual process itself is less well defined. The degree of disclosure and detail expected may vary greatly. A recent shift toward a more patient-centered approach in both clinical and medico-legal practice has significant implications for ensuring appropriate and legal practice in obtaining informed consent before surgery.MethodsTwo hundred patients undergoing elective surgery across two hospitals returned a survey of attitudes toward consent, perceived important elements in the consent process, and risk tolerance, as well as demographic details.ResultsNo significant associations between patient demographics and survey responses were found. Patients were least concerned with the environment in which consent was taken and the disclosure of uncommon complications. The most important factors related to communication and rapport between clinician and patients, as opposed to procedure- or complication-specific items. A majority of patients preferred risks to be described using proportional descriptors, rather than percentage or non-numeric descriptors.ConclusionsRisk tolerance and desired level of disclosure varies for each patient and should not be presumed to be covered by standardized proformas. We suggest an individualized approach, taking into account each patient's background, understanding, and needs, is crucial for consent. Communications skills must be prioritized to ensure patient satisfaction and reduced risk of litigation.
Archer SA, Holland FG, Montague J, 2018, ‘Do you mean I’m not whole?’: Exploring the role of support in women’s experiences of mastectomy without reconstruction, Journal of Health Psychology, Vol: 23, Pages: 1598-1609, ISSN: 1461-7277
This study explores the role of others in supporting younger women who opt not to reconstruct their breast post-mastectomy. Semi-structured interviews were conducted with six women, diagnosed with breast cancer in their 30s/40s. The women lived in England, had been diagnosed a minimum of 5 years previously and had undergone unilateral mastectomy. An interpretative phenomenological analysis revealed three themes; Assuring the self: “I’ll love you whatever”, Challenging the self: ‘Do you mean I’m not whole?’, and Accepting the self: ‘I’ve come out the other side’. The women’s experiences of positive support and challenges to their sense of self are discussed.
Wahl J, Sheffield D, Maratos F, et al., 2018, Development of a Compassion for Cancer curriculum for female breast cancer patients in stages I-III and cancer survivors. Origins, rationale and initial observations, Mindfulness and Compassion
Dewa LH, Murray K, Thibaut B, et al., 2018, Identifying research priorities for patient safety in mental health: an international expert Delphi study, BMJ Open, Vol: 8, ISSN: 2044-6055
Objective Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health.Design Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements.Setting and participants Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included.Main outcome measures Agreement in research priorities on a five-point scale.Results Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important.Conclusions This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this.
Holland FG, Petersen K, Archer SA, 2018, Thresholds of size: An interpretative phenomenological analysis of childhood messages around body, health and weight, Journal of Critical Dietetics, Vol: 4, Pages: 25-36, ISSN: 1923-1237
This study explores the lived experiences of non-dieting, middle-aged Western women classified as ‘overweight’ or ‘obese’ onBMI charts. Qualitative research that has focused on non-weight loss experiences with this population has been rare. Thisstudy aims to allow their experiences to be heard within the mainstream health literature. Four women from aged 40-55years were interviewed about their early messages and experiences around food, body, health and weight. An interpretativephenomenological analysis was conducted. Three themes were identified: 1) family culture and body norms 2) thresholds ofsize and 3) action and outcome. Participants identified a range of influences upon their early body appraisal, with parents,extended family, peers and community members contributing to their understanding of what constituted as an acceptablesize. The impact upon their sense of identity and emotional wellbeing is discussed. This study contributes to the role of themodelling and messages around size and value given by important others and the psychological ramifications these can haveover time.
Archer SA, Hull L, Soukup T, et al., 2017, Development of a Theoretical Framework of Factors Affecting Patient Safety Incident Reporting: A Theoretical Review of the Literature, BMJ Open, Vol: 7, ISSN: 2044-6055
Objectives The development and implementation of incident reporting systems within healthcare continues to be a fundamental strategy to reduce preventable patient harm and improve the quality and safety of healthcare. We sought to identify factors contributing to patient safety incident reporting.Design To facilitate improvements in incident reporting, a theoretical framework, encompassing factors that act as barriers and enablers ofreporting, was developed. Embase, Ovid MEDLINE(R) and PsycINFO were searched to identify relevant articles published between January 1980 and May 2014. A comprehensive search strategy including MeSH terms and keywords was developed to identify relevant articles. Data were extracted by three independent researchers; to ensure the accuracy of data extraction, all studies eligible for inclusion were rescreened by two reviewers.Results The literature search identified 3049 potentially eligible articles; of these, 110 articles, including >29 726 participants, met the inclusion criteria. In total, 748 barriers were identified (frequency count) across the 110 articles. In comparison, 372 facilitators to incident reporting and 118 negative cases were identified. The top two barriers cited were fear of adverse consequences (161, representing 21.52% of barriers) and process and systems of reporting (110, representing 14.71% of barriers). In comparison, the top two facilitators were organisational (97, representing 26.08% of facilitators) and process and systems of reporting (75, representing 20.16% of facilitators).Conclusion A wide range of factors contributing to engagement in incident reporting exist. Efforts that address the current tendency to under-report must consider the full range of factors in order to develop interventions as well as a strategic policy approach for improvement.
Phillips E, Montague J, Archer SA, 2017, "A peculiar time in my life": Making sense of illness and recovery with gynaecological cancer, International Journal of Qualitative Studies on Health & Well-Being, Vol: 12, ISSN: 1748-2623
Worldwide there are nearly 1.1 million new cases of gynaecological cancer annually. In England, uterine, ovarian and cervical cancers comprize the third most common type of new cancer in women. Research with gynaecological cancer patients within 6 months of diagnosis is rare, as is data collection that is roughly contemporaneous with treatment. Our aim was to explore the experiences of women who were, at study entry, within 6 weeks of surgery or were undergoing chemotherapy or radiotherapy. Methods: An interpretative phenomenological analysis (IPA) of data from 16 women in five focus groups was conducted in the UK, exploring women’s experiences of being diagnosed with and treated for gynaecological cancer. Results: Participants conceptualized their experiences temporally, from the shock of diagnosis, through their cancer treatment, to thinking about recovery. They tried to make sense of diagnosis, even with treatment being complete. In the context of the Self-Regulation Model, these women were struggling to interpret a changing and multi-faceted illness identity, and attempting to return to pre-illness levels of health. Conclusions: This study adds to this under-studied time period in cancer survivorship. The results suggest that survivors’ goals may change from returning to pre-illness status to reformulating goals as survival time increases.
Callender T, Riley J, Droney J, et al., 2017, The determinants of dying where we choose: an analysis of coordinate my care, Annals of Internal Medicine, Vol: 167, Pages: 519-521, ISSN: 1539-3704
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