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PubMed2006

Validation of a quality-of-life questionnaire for patients with pituitary adenoma.

BACKGROUND: The purpose of this study was to develop and validate a self-administered questionnaire to measure the health-related quality of life of patients with pituitary adenoma. METHODS: A patient-centred iterative process, involving a literature review and focus group interviews with 84 patients, was used to develop a preliminary 106-item questionnaire and to validate it. The final questionnaire comprised the 30 most important items chosen by 20 patients and 17 items considered important by health care professionals. For assessment of its validity and reliability, 55 patients were asked to complete the final questionnaire, RAND-36, FACT- G/FACT-Br, and Karnofsky Performance Scale (KPS). Concurrent validity of the results of our questionnaire with those of the other instruments was assessed with Pearson correlation coefficients. Known-group validity for the scores of extreme groups was assessed with a Student's t test. Test-retest reliability was determined with Pearson correlation coefficients and a Student's t test for two sets of scores obtained one month apart. RESULTS: Forty-seven (85.5%) of the 55 questionnaires were completed. Our questionnaire was well correlated with the RAND-36, the FACT-Br, the FACT-G, and the KPS in the general health domain, but not with the KPS overall. Extreme groups (n = 20) were significantly different. Test-retest reliability (n = 24) was 0.88, and scores one month apart were not significantly different. CONCLUSION: Our patient-centred health-related quality of life questionnaire developed for patients with pituitary adenoma had good validity and reliability. This questionnaire could be used as a patient-centred outcome measure in clinical trials and for assessment of disease progression.

Adenoma↗

PubMed1995

Communicating with persons with Alzheimer's disease: experiences of family and formal caregivers.

The purpose of this exploratory study was to examine and compare communication processes used by family members and formal caregivers to manage behavioral problems such as fearfulness, agitation, and wandering, that commonly occur when caring for persons with Alzheimer's Disease (AD). Two groups of caregivers of persons with AD (formal and family) comprised the sample for the study. Two themes emerged from the focus group interviews: environmental adjustments and reassurance. Results suggest that interventions must be individualized. Enhancing the caregiver's skills to manage disruptive behavior may prolong his or her ability to provide in-home care for the family member with AD.

Adaptation, Psychological↗

PubMed1996

[Dimensions of leadership practice by nursing service managers].

Leadership development is an important component of the nursing service manager's personal and professional development. Competent leadership is required to lead the nursing service in the right direction within the context of dynamic political and social changes. Various internal and external environmental variables have a significant influence on leadership behaviour and practice. The purpose with this study is to explore and describe the characteristics or dimensions of leadership excellence by the nursing service manager. An exploratory and descriptive research design was followed and data collection was done by means of focus group interviews. The results do not show a significant difference between the knowledge already generated by research, or described in the literature, but is utilised as the basis of leadership development of nursing service managers. A leadership development programme for nursing service managers, based on the results of this study, is recommended.

Focus Groups↗

PubMed1993

The Save our Sisters Project. A social network strategy for reaching rural black women.

Why are older black women screened less for breast cancer? What can be done to narrow the racial gap in mammography screening? These are the questions addressed by the Save Our Sisters (SOS) Project, a pilot demonstration study funded by the National Cancer Institute in a rural county of North Carolina. The target population is 2600 black women 50-74 years of age residing in the county. To assist these women to obtain annual mammograms, SOS has recruited and trained 64 black women who are "natural helpers" to serve as lay health advisors. The lay health advisors reach older black women through their existing kin, friendship, and job networks. Responses from 14 focus group interviews found that when it is a matter of older black women's health concerns, women turn to certain women for social support. Responses revealed factors related to the individual woman and her social network that influence rural black women's seeking breast cancer screening. These results were applied to the Social Change model for designing the training and three network intervention strategies: (1) providing social support (information and referrals, emotional caring, and tangible assistance) through interpersonal counseling with women in their social networks; (2) working as a group, planning and implementing breast cancer control and prevention activities through community-based organizations to which advisors belong (e.g., church groups, civic groups, and social groups); and (3) establishing themselves as a non-profit, community-based SOS Association to sustain project interventions after the funding period. The SOS Community Advisory Group and the advisors developed innovative methods of recruitment, implementation, and follow-up. The community programs they have initiated are: (1) the Adopt-A-Sister Program, which assists black women who cannot afford the cost of a mammogram; (2) a committee on understanding the health care system, which assists women in negotiating regulations and using health care providers; (3) a training committee, which recruits and trains additional advisors; (4) a support group for black women with diagnoses of breast cancer; and (5) a speakers bureau, which has produced a 10-minute video, brochure, and tee-shirts as community education materials.

Black or African American↗

PubMedDate not supplied

Knowledge base and preferred methods of obtaining knowledge of glaucoma patients.

PURPOSE: To gather information regarding patient's understanding of glaucoma and the manner in which patients wish to learn about the disease with the intent of improving patient education. METHODS: Forty-four of sixty randomly selected ophthalmologists (73%) asked four of their patients consecutively to complete a questionnaire about glaucoma. The selection of questions was based on focus group interviews and suggestions from several experts. Topics included knowledge about glaucoma and its treatment, the need for information, and preferred providers and methods of patient education. RESULTS: Fifty percent of the patients had 49% or less correct answers to questions about glaucoma or its treatment. Per item the correct answers ranged from 5% to 90%. Lack of knowledge was associated with low level of education, short duration of glaucoma, high age, and no preference for the Internet as method of supplying information. These variables, however, did not identify groups with a considerable lack of knowledge sufficiently accurately to target patient education. A high need for information was observed and included information about the patient's own glaucoma. Almost all patients preferred the ophthalmologist and many also a nurse or a representative of the Glaucoma Patient Society as providers of information. Written material was the preferred method. CONCLUSIONS: Patient education should address all patients. A patient education program should cover a wide range of topics with a focus on general information through written material and information tailored to the individual glaucoma patient's needs. The ophthalmologist is a key- person, but others could play an important role in patient education.

Adult↗

PubMed2003

An exploratory study on needs of parents of adults with a severe learning disability in a residential setting.

Parents are the key figures in the lifelong rehabilitation of adult children with a learning disability, including those who have a severe learning disability (i.e., having an IQ level between 20-25 and 35-40) (Hong Kong Rehabilitation Programme Plan, 1999). To provide specialized care, parents have to cope with a great deal of parenting demands. The purpose of this study was to explore parental needs in caring for adult children with a severe learning disability in residential setting. Focus group research design was adopted. Twenty-five parents of adults with a severe learning disability from a hospital in Hong Kong were invited to participate in five focus group interviews. The data were analysed by content analysis. Inter-coder reliability was established with inter-coder agreement of 0.8. Six broad categories of parental needs were revealed. Findings of the study may assist nurses to plan appropriate care for both the parents and the residents.

Adult↗

PubMedDate not supplied

Illness representation and smoking behavior: a focus group study of HIV-positive men.

Focus group interviews were conducted with 13 men living with HIV (mean age = 44.7) to explore their beliefs about cigarette smoking and HIV. Interview data were audiotaped, transcribed verbatim, and systematically analyzed using inductive techniques. Participants believed cigarette smoking provides a number of benefits to persons living with HIV. Although participants acknowledged that smoking has disadvantages, smokers generally discounted health risks, noting how it improves their sense of well-being and reasoning that they would not live long enough to suffer its consequences. Although smoking is a risk factor for HIV-related morbidity and mortality, rates of smoking are high among men living with HIV. Research completed with other population groups finds beliefs are significant in explaining variance in smoking behavior change. Smoking-cessation programs targeting HIV-positive men may be more successful if illness-specific belief systems are taken into account. Additional study is warranted to substantiate the effectiveness of this approach.

Adult↗

PubMed2003

Medical Students for Choice: origins, current orientations, and potential impact.

BACKGROUND: Medical Students for Choice is a U.S.-based organization concerned with the shortage of abortion providers, the lack of abortion education in medical schools, and violence against abortion providers. Created in 1993, MSFC has 110 chapters in North America with 7,000 student affiliates. DESCRIPTION: The rapid spread of MSFC chapters since its creation prompted the Northeastern Ohio Universities College of Medicine's chapter to undertake group interviews of 40 medical students affiliated with 7 MSFC chapters in 4 midwestern states in the United States. EVALUATION: Interview questions were developed to identify students' motivations for affiliation with MSFC, how abortion was currently addressed in the medical curriculum and where it should be, how students think abortion providers are perceived by the medical community, and how they plan to integrate their commitment to reproductive choice in their future practice. CONCLUSIONS: Not all students affiliated with MSFC will become abortion providers, but they are politically enthusiastic and committed to the inclusion of abortion in medical training and to legitimizing and normalizing its provision. More research tracking this group across time and geography will add much to understanding abortion services in the United States and what part the medical curriculum plays in educating students to provide comprehensive reproductive health services for women.

Abortion, Induced↗

PubMed2005

Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care.

OBJECTIVE: The aim of this study was to explore factors that influence general practitioners' (GPs') decisions regarding screening for high alcohol consumption. METHODS: GPs working at three primary healthcare centres in Sweden participated in focus group interviews. The interviews were recorded and transcribed verbatim, and a deductive framework approach was used for the analysis. RESULTS: The majority of the participating GPs did not believe in asking all patients about their alcohol consumption. Reported factors that influenced how many and which patients were questioned about alcohol consumption were time, age of the patient, consultation setting, patient-physician relationship, what symptoms the patient presented with, and knowledge of measures if patients appear to have a high alcohol consumption. Thus, alcohol screening and intervention were not performed in all patient groups as was originally intended, but were performed in limited groups of patients such as those with alcohol-related symptoms. CONCLUSIONS: Although the number of participants in this study was small and the conclusions cannot be generalized, the results provide some valuable insights into why GPs are hesitant to engage in screening for high alcohol consumption. Since prevention of alcohol-related health problems is an important public health issue, many different screening and intervention strategies have to be formulated and evaluated in order to reach patients with both hazardous and harmful alcohol consumption within the healthcare system. Screening all consecutive patients for a limited period or screening patient groups known to include a fairly high frequency of high alcohol consumers are two ways of limiting the time requirements and increasing role legitimacy. Still, there is a need for a broader public health strategy involving many players in the community in alcohol preventive measures, especially in more primary preventive approaches.

Alcohol Drinking↗

PubMed2000

Increasing uptake rates of cervical cancer screening amongst Hong Kong Chinese women: the role of the practitioner.

Women's attendance for regular cervical screening has been identified as a significant factor in the prevention of cervical cancer. Evidence suggests, however, that both extrinsic and intrinsic factors influence women's attendance patterns for screening. Extrinsic factors, in particular the practitioner undertaking the screening procedure, have been shown to influence women's return rates for further screening. In Hong Kong, where uptake rates amongst Chinese women remain comparatively low, a study was undertaken to examine Chinese women's experiences and perceptions of cervical screening undertaken by either a female doctor or nurse. A multiple case study design using both qualitative and quantitative methods of data collection was employed. This paper reports the findings from the qualitative data obtained from 52 women participating in 12 focus group interviews held in the two case studies. Thematic analysis of the data demonstrated the importance of the caring nature, communication skills, experience and expertise of the practitioner to women's attendance pattern for screening. The experience and expertise of the practitioner, described by women as teaching, minimizing pain and discomfort and being considerate, were considered more influential to uptake rates than the professional discipline of the practitioner. Findings such as these indicate the importance of the influence of the practitioner in determining uptake rates for cervical screening amongst this population group.

Adult↗

PubMedDate not supplied

Investigating the educational needs of licensed nursing staff and certified nursing assistants in nursing homes regarding end-of-life care.

Nursing homes care for people at the end of life (EOL). There is evidence to suggest, however, that nursing staff in these settings is often unprepared to provide a high level of EOL care. This article reports the findings from three preliminary studies that investigated the needs of licensed staff and certified nursing assistants in nursing homes regarding EOL care. The studies involved needs assessment surveys, focus group interviews with staff members, and telephone interviews with nursing home administrators. Data show that the major needs included a lack of knowledge and skills in symptom management; communication difficulties; conflicts with families and physicians; and emotional distress in dealing with time constraints and attachment to residents. Implications for nursing home staff education are described.

Attitude of Health Personnel↗

PubMed1993

Barriers to adherence to preventive services reminder letters: the patient's perspective.

BACKGROUND: Despite an emerging consensus as to which preventive services are appropriate, a minority of patients receive them. Although adherence to recommendations for some interventions has increased, research studies have shown that adherence rates can be further improved through a better understanding of patient attitudes and motivations regarding preventive services. METHODS: Using components of the Patient Path Model, this study examined the response to patient reminder letters for cholesterol screening sent to 1077 adult patients between August and October 1990. The research strategy incorporated both quantitative and qualitative methods, including a telephone survey and focus group interviews of nonresponders to the reminder letter. RESULTS: Three hundred seven patients were surveyed by telephone to ascertain their reasons for nonresponse. One hundred fifty-four (50.2%) did not recall receiving the reminder letter, 84 (27.4%) recalled receiving the letter but did not recall its content, and 69 (22.5%) recalled both receiving the letter and its content. No consistent reason for nonadherence emerged among the 69 nonresponders who recalled the reminder. Twenty-seven of the nonresponders who did not recall receiving the cholesterol reminder participated in the focus groups. The participants stressed the importance of distinguishing the reminder letter from a bill, conveying a personally relevant message, and addressing logistical barriers to preventive services. CONCLUSIONS: Careful attention to the format and content of patient reminder letters is necessary to improve adherence to preventive services recommendations.

Adult↗

PubMed2002

The psychiatric consultation-liaison nurse: thriving in a general hospital setting.

One outcome of mainstreaming of psychiatric services into the general health system is that nurses working in general hospitals now have increased contact with patients experiencing mental health problems. The literature suggests that general and comprehensive nurses do not believe they have the skills, confidence and knowledge to care adequately for patients in their care who have a mental health problems. The Psychiatric Consultation-Liaison Nurse (PCLN) can assist and educate general nurses in the care of patients with mental health problems who are receiving care in a medical/surgical setting. This study is based upon the findings of a Nurse Practitioner Pilot Study funded by the Department of Human Services (Victoria). In this paper the authors will present a brief overview of the role and model of practice of the PCLN, the means of referral, a profile of consultations and an overview of educational and policy development activity. The findings of the evaluation based on a combination of a Health Professional Satisfaction Survey and Focus Group Interviews will also be presented. The positive contribution of the PCLN to the confidence of nurses and how this might impact on patient outcomes will be highlighted. The value placed on the PCLN role by general hospital staff is evidence of psychiatric nursing not just surviving but thriving.

Attitude of Health Personnel↗

PubMed2004

The impact of visit frequency on the relationship between service quality and outpatient satisfaction: a South Korean study.

OBJECTIVE: To examine the relative impact of four service quality dimensions on outpatient satisfaction and to test the invariance of the structural relationships between the service quality dimensions and satisfaction across three patient groups of varying numbers of prior visits to the same hospital as outpatients. DATA SOURCES/STUDY SETTING: Survey of 557 outpatients using a self-administered questionnaire over a 10-day period at a general hospital in Sungnam, South Korea. DATA COLLECTION: Patients answered questions related to two main constructs, patient satisfaction and health care service quality. The health care service quality measures (30 items) were developed based on the results of three focus group interviews and the SERVQUAL scale, while satisfaction (3 items) was measured using a previously validated scale. STUDY DESIGN: Confirmatory factor analysis was used to assess the construct validity of the service quality scale by testing convergent and divergent validity. A structural equation model specifying the four service quality dimensions as exogenous variables and patient satisfaction as an endogenous variable was estimated to assess the relative impact of each of the service quality dimensions on satisfaction. This was followed by a multigroup LISREL analysis that tested the invariance of structural coefficients across three groups with different frequencies of outpatient visits to the hospital. PRINCIPAL FINDINGS: Findings support the causal relationship between service quality and satisfaction in the context of the South Korean health care environment. The four service quality dimensions showed varying patterns of impact on patient satisfaction across the three different outpatient groups. CONCLUSION: The hospital management needs to be aware of the relative importance of each of the service quality dimensions in satisfaction formation of outpatients, which varies across different hospital utilization groups, and use this in strategic considerations.

Adult↗

PubMed2004

Sibling perspectives on severe mental illness: reflections on self and family.

Through focus group interviews, participants were asked to describe the impact over time of having a sibling with severe mental illness. Transcript content was then organized into categories and overarching themes using grounded-theory analysis. Respondents' personal and interpersonal experiences are presented, along with suggestions for professional outreach and further research.

Adult↗

PubMed1995

Pain: the views of elderly people living in long-term residential care settings.

While an individual's beliefs and attitudes have long been considered important factors in how people respond to pain, few studies have attempted to provide in-depth descriptions of the nature of such pain beliefs and attitudes. The aim of this research was to investigate the views of pain and pain management practices held by elderly people living in long-term residential care settings. Ten 60-90 minute focus group interviews, each involving around five elderly people, were conducted in four large, long-term residential care settings in Brisbane, Australia. Categories of beliefs and attitudes regarding pain were identified following analysis of the verbatim transcripts of these interviews. Findings suggest that many elderly people living in long-term residential care settings may have become resigned to pain, that they are ambivalent about the benefit of any action for their pain and that they may be reluctant to express their pain. Implications of these beliefs and attitudes are discussed.

Aged↗

PubMed1999

[Contribution of a combined approach in an analysis of training needs in two health regions in Morocco].

UNLABELLED: A study using a combination of three techniques of qualitative research (nominal group, focus group, interview) was carried out in 1996 among 72 health professionals that occupy a position of responsibility at the level of the wilayas of Fes and Marrakech (Morocco). For the entirety of the study, 14 meetings were held with experts (administrators, nurses, doctors and delegates). OBJECTIVE: To study the advantages and limitations of a combinatory approach that triangulates three methods of qualitative research to identify and analyze training needs of administrators, nurses, doctors and delegates that hold a position of responsibility at the level of the wilayas of Fes and Marrakech. RESULTS: The focus group allowed for the establishment of lists of problems encountered that were susceptible to being resolved through a training intervention: 1) Planning methods are not used and needs analysis of resources remains arbitrary; 2) Methods of management are not mastered by the people holding the responsible positions; 3) The management of human resources is centralized and there is no policy of personnel motivation. The main accompanying measures proposed by the participants were: 1) to decentralize the process of planning and to train the responsible people in the methods and techniques of planning; 2) to introduce new methods of health services administration. Training themes by order of priority were: health planning, management, regulations and legal instruments, management of human and material resources. DISCUSSION: The combinatory approach allowed for a list to be established of the training needs of health professionals. It also provided an instantaneous diagnosis of the organisations and programmes for which they are responsible. But this triangulation of techniques has several limitations related to the researchers' interpretation of these needs, to their socio-cultural system of reference and to their interests that often don't coincide with those of the experts in the field. CONCLUSION: This study allowed for the development of an outline that puts the role of experts back in the planning process of a training project and combines the needs of experts with institutional needs in order to reach a better adequacy of the triad of needs-demand-responses.

Attitude of Health Personnel↗

PubMed2000

Perceived job image among police officers in Singapore: factorial dimensions and differential effects.

The authors examined the perceived job image of police officers in Singapore and its differential effects on their work-related attitudes (e.g., job satisfaction, organizational commitment, and intention to quit). The authors obtained data from questionnaire surveys and focus-group interviews. Perceived job image consisted of 4 dimensions: (a) prestige, (b) integrity, (c) competence, and (d) nonroutine job nature. Results of hierarchical regression analyses suggested that the first 2 dimensions of the perceived job image construct were salient in affecting the police officers' work-related attitudes.

Adult↗