Search results

The purpose of this paper is to provide an overview of the perspectives of patient advisors (PAs) on the current state of antimicrobial resistance (AR) and stewardship in Canada and identifies next steps, with the goal of stimulating further collaboration for action between leaders and PAs as well as research.

The perspectives of PAs were gathered using an electronic online survey of 72 respondents. A search of peer reviewed literature and publicly available reports informed the development of the survey and the articulation of a more comprehensive viewpoint in this paper.

PAs view AR as a serious and growing public health threat. They believe sharing the responsibility for infection prevention and control and antimicrobial stewardship will help to control the problem. They see healthcare professionals as the most appropriate stakeholders to influence behaviors associated with appropriate antibiotic use, however, they also see value in public campaigns. Importantly, they identify several opportunities for PA contribution: education of care providers, patients, families, and the public; co-design and development of materials, policies, improvement initiatives, and research; and participation in and promotion of public campaigns.

Engaging PAs as partners at all system levels is becoming common practice. PAs bring a unique and complementary perspective that could contribute to antimicrobial stewardship efforts.

This paper begins to bridge a gap between literature and practice, and proposes that PAs can contribute to antimicrobial stewardship efforts.

The purpose of this article is to assess whether tele‐nursing in Scotland (NHS24), when compared with traditional face‐to‐face nursing, facilitates greater employee control over working time and therefore a potentially better work‐life balance.

The article draws on evidence from two independent research projects; a survey of 64 ward nurses and midwives, which involved face‐to‐face interviews; and a field study of tele‐nursing in a large site in Scotland, using interviews and observations of 15 nurse advisors or tele‐nurses.

Three elements of work organisation are central in shaping nurses' working hours and their control over the balance between their work and their home life: the management of working hours; the degree of mutual dependency of nurses within teams; and the nature of patient care.

The two pieces of research reported offer a strong basis for comparative study. However, the two projects were designed independently, though research questions overlapped and one researcher conducted the field work in both settings; there is an imbalance in the number of interviews conducted in each setting; and the nurse advisor interviewees are of the same clinical grade, whereas a variety of grades and clinical areas are represented among the hospital nurse interviewees.

This is the first study of work‐life balance amongst tele‐nurses. The research demonstrates that call centre work has rationalised, depersonalised and yet enabled more “control” by nurses over their work‐life balance, while paradoxically offering less autonomy in their task environment. In conventional work settings professional values make it difficult for nurses to disengage from the workplace.

How far is our position within the mental health system ‐ as service user, survivor, carer or practitioner, for example ‐ fixed and defines what we can achieve? Is ‘expertise by experience’ something we all have and can share, irrespective of position, even when it may differ dramatically? Toby Williamson, previously head of policy at the Mental Health Foundation and an experienced practitioner, and David Crepaz‐Keay, senior policy advisor responsible for public and patient involvement at the Foundation and well known particularly within the survivor movement, debate these issues in an open and frank exchange of emails.

Telephone triage or hear and treat (H&T) describes the process of UK ambulance services nurses and paramedics undertaking enhanced telephone assessments of patients to determine the most appropriate response, which can sometimes result in no ambulance being sent. Given, however, that 999 is not considered an advice service, it may be reasonable to assert that the expectation of those calling 999 is always an immediate ambulance response. This may not always be realised and may affect patient experience. The purpose of this paper is to ascertain the following: to what extent are the views of UK ambulance telephone triage service users being gathered? In answering this research question, this review also aims to explore the findings to determine service users’ expectations of ambulance telephone triage and the possibility that these expectations are influenced by the UK media. The findings of which could be used to inform the need and nature of future research.

Phase one consisted of a computerised literature search of online databases CINAHL, Pubmed, Science Direct, Cochrane library, Web of Science and UK government-funded databases. Phase two consisted of searches of all UK ambulance services websites and the submission of freedom of information requests. Phase three consisted of a computerised literature search of the ProQuest international news-stream database.

A total of 78 results were identified and after further screening 34 results were excluded, leaving 44 for final review. The extent to which users experience of ambulance service telephone triage are being gathered is low; and often limited to one off pieces of non-peer reviewed work. Patients felt overall that they were treated with respect, dignity and care. However, being listened to, reducing anxiety and a need for prompt assurances remain important to those whose overriding expectation is that an ambulance should attend every time a 999 call is made. There appears to be a balanced media portrayal of H&T with the UK media. However, unrealistic public expectations represent a significant barrier to providing sustainable care that users consider to be of high quality.

Some user experiences may have been gathered in more broad research exercises which explored various aspects of 999 ambulance service experience. This was not included if it could not be clearly differentiated as being related to H&T and thus may have resulted in data being omitted. It was not possible to systematically search social media platforms (such as facebook or twitter) for any media results related to this search strategy; only traditional print and online media platforms. This also may have resulted in data being omitted. The inclusion of non-peer reviewed research results and grey literature represents a possible limitation to the conclusions drawn within this review. The concept of Insider Research Bias cannot be ignored within this review. The author himself practices in telephone triage within a UK ambulance service; however, this insider bias is mitigated by the clearly articulated systematic methodology and use of the Critical Appraisal Skills framework. In a similar vein, reviews of this nature are also often conducted as part of a team, to reduce bias, increase objectivity and ensure the validity of findings. This review was a sole effort, and while this is not uncommon, there were no cross checks by peers of the search terms, strategy, paper selection, exclusion criteria or data extraction. This lack of peer critique is considered a possible limitation in mitigating selection and reviewer bias.

The results of this review would suggest a need to increase the amount of research and patient feedback gathered from those being assessed and managed by ambulance service telephone triage within the UK. Ambulance services could hold regular monthly small-scale qualitative interviews with patients and families to ascertain their views, perceptions and anxieties which can then provide an up-to-date understanding of user expectations and the health educational needs of local communities. Patient feedback received directly to ambulance services or via the Patient Advice and Liaison Service could be retrospectively analysed by researchers to determine key themes of positive practice or negative patient experience. Such feedback can be tracked through time and be used as a pre and post community intervention measure, to determine any changes. Moving forward, nationally standardised research frameworks should be adopted to provide more easily collated local and national data, which can monitor improvement strategies and provide a comparison between services to aid the sharing of best practice principles.

There is no other piece of work published which has reviewed the data in this area of clinical practice within the UK.

The purpose of this paper is to draw attention to the discursive construction of multimorbidity. The study illustrates how the social reality of multimorbidity and the agency of patients are discursively constructed in scientific articles addressing care for people with multiple chronic conditions.

The study is based on the postmodern assumptions about the power of talk and language in the construction of reality. Totally 20, scientific articles were analysed by critically oriented discourse analysis. The interpretations of the findings draw on the agency theories and principals of critical management studies.

Four discourses were identified: medical, technical, collaborative and individual. The individual discourse challenges patients to become self-managers of their health. It may, however, go too far in the pursuit of patients’ active agency. The potential restrictions and consequences of a “business-like” orientation must be paid careful attention when dealing with patients with multimorbidity.

The data consisted solely of scientific texts and findings therefore serve as limited illustrations of the discursive construction of multimorbidity. In future, research focusing for example on political documents and practice talk of professionals and patients is needed.

The findings highlight the power of talk and importance of ethical considerations in the development of care for challenging patient groups.

By identifying the prevailing discourses the study attempts to cast doubt on the taken-for-granted understandings about the agency of patients with multimorbidity.

High patient satisfaction is not simply a customer service goal; it is an important dimension of quality and part of financial incentives and public reporting requirements. However, patient experience is often siloed within health system organizational charts and considered separately from quality and safety initiatives, instead of being seen predominantly as a “customer service” initiative. Representatives from 52 health care systems across the United States completed an online survey to explore both the processes and infrastructure hospitals employ to improve patient experience, and the metrics hospitals use to assess the quality of patient experience beyond patient satisfaction survey data. When asked about performance metrics beyond satisfaction, most hospitals or systems noted other metrics of the entire patient experience such as the rate of complaints or grievances and direct feedback from patient and family advisors. Additionally, respondents suggested that a broader definition of “quality of the patient experience” may be appropriate to encompass measures of access, clinical processes, and quality of care and patient safety outcomes. Almost all respondents that we surveyed listed metrics from these less traditional categories, indicating that performance improvement within the patient experience domain in these organizations is linked with other areas of hospital performance that rely on the same metrics, such as clinical quality and patient safety.

Diabetes is regarded as a global epidemic with 382 million people globally suffering from diabetes. It also has major implications on patients’ quality of life. There are also high cost of treatment associated with diabetes for both patient and healthcare provider. Telemonitoring represents an excellent technology opportunity to redefine health care delivery. Using technology for home-based care promises the ability to deliver more cost effective care whilst also enhancing quality of care and patient satisfaction. The paper aims to discuss these issues.

The current research aims to contribute to the methodological design of action research projects in their use to implementation health technologies such as telemonitoring. In particular, it seeks create a model which can be used to demonstrate the efficacy of the use of the action research method as a viable alternative to the traditional randomised control trials methodology currently employed in healthcare.

The paper contributes towards the methodological design to investigate the area of practice making use of the telemonitoring programme within a Victorian Health Services Network using action research.

It intends to address the research problem of the low utilisation of telemonitoring within Monash Health as a whole, and more specifically within the diabetes unit. In this context the research intends to utilise the benefits of telemonitoring to improve clinical outcomes of patients by increasing insulin stabilisation. It is also intended the research organisation benefits by increased efficiency by decreasing clinical workforce time spent on managing patient insulin data.

The purpose of this paper is to study the US-based (American) physiotherapy customers’ goals to engage in value cocreation activities during their well-being experience.

The authors perform Smart PLS-SEM analysis of the primary data of physiotherapy service customers in the USA.

The findings show that the US well-being customer engages in physiotherapy for individualizing, empowering, development, concerted and ethical motives but not for relating motives. These findings are contrasted with previous research to show that the service-dominant logic is not sufficient to account for the contextual complexity of the well-being experience and to explain the identified differences across culturally different customer segments.

By integrating insights from health-care and cross-cultural literature, the authors highlight the importance of relationship dynamics, culture and institutional context in well-being sector and develop a more comprehensive understanding of the cocreation behaviors in this industry. This helps advance the value cocreation research in well-being sector and promote the well-being experiences such as physiotherapy.

The authors draw from a variety of disciplinary perspectives and challenge the service-dominant (S-D) logic as insufficient in explaining the value cocreation between the customer and expert in the well-being sector. The authors adapt physician–patient relationship model from health-care literature and cultural values of power distance from cross-cultural literature to complement the S-D logic to account for the complexity and nuanced context of the well-being cocreation experience.

Managing risk and making decisions presents an increasing challenge to doctors as they are encouraged to adopt a partnership approach with patients to dealing with risk, within a “risk society” constructed around individuality, uncertainty, blame and responsibility. In‐depth interviews, stimulated by clinical vignettes, were used to explore the key position of doctors within this risk society. Analysis, sensitised through contemporary texts, revealed unexpected findings that portrayed doctors as reflexive jugglers of risk. Discourses in this study revealed indecision and uncertainty, balanced against needs to preserve professional roles and engage patients in addressing risk, whilst preventing widespread harm and conflict. In concluding, the alternative approaches to risk with older people will suggest a more trusting and positive process that presents a real opportunity for truly sharing risk and decisions that benefit both doctor and patient.

The purpose of this paper is to find out the anti‐smoking counselling frequency and its correlates in a sample of Chinese physicians.

In this paper, 268 physicians in Baoding, a city near Beijing, filled out a questionnaire asking about their own smoking status, their anti‐smoking behaviors as well as their opinions on how to reduce cigarette smoking in China.

The paper finds that 54 percent of the male and 8.4 percent of the female physicians were current cigarette smokers. When asked whether they had counselled their patients about cigarette smoking in the past year, 43.7 percent answered “always”; 38.1 percent “often”; 13.1 percent “sometimes”; 2.6 percent “occasionally”, and 2.6 percent said: “not much”. However, only 9.0 percent said that they were “very successful”. Physicians' anti‐smoking counselling practices were highly correlated with their own smoking status; whether they perceived their past anti‐smoking activities as successful; whether they thought that they should set examples by not smoking; whether they felt that they had the responsibility to help patients and whether they perceived themselves as influential in persuading patients to quit smoking.

The paper shows that messages aimed at increasing Chinese physicians' anti‐smoking counselling should appeal to their responsibility, exemplary role, and unique influence on patients' health‐related behaviors.

The paper adds to the few studies on Chinese physicians' cigarette smoking behavior and their anti‐smoking activities. In a country where cigarette smoking is a way of life among males, and few people are aware of the health consequences of cigarette smoking, physicians' efforts can be a spearhead to a cessation campaign.