HSJ awards 2005. Recuitment and retention. Winner: training and involving service users and cares in all appointments.
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Awards and Prizes↗
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Results for “user involvement”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Involving service users in quality initiatives.
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Health Services Research↗
Primary Care Trusts involving the community: is community development the way forward?
Patient and user involvement is central to current government thinking on the NHS. More comprehensive approaches to organised community participation and community development have received less support and examples of effective and genuine participation in key areas such as primary care decision-making are rare. The initiative described in this paper was established in Newcastle upon Tyne in 1995 to promote community participation in decision-making about local health services. It has particular relevance to current concerns about addressing social exclusion and tackling health inequalities since it operates in an area of social disadvantage with a significant black and ethnic minority population (6 percent). This case study is based on an independent evaluation which used multiple research methods, including interviews, questionnaire surveys and direct observation, to assess the project's practice and impact. Describes a community development approach to public participation. An emphasis on inclusive practices has facilitated meaningful involvement of minority groups such as ethnic minority residents and those with disabilities who tend to be marginalised in public debate. Argues that the project has made a significant impact on the ways in which local health services are planned and delivered
Community Participation↗
Positive outcomes of participatory ergonomics in terms of greater comfort and higher productivity.
UNLABELLED: Ergonomics sometimes has a negative connotation, as it is seen to be connected to illness or guidelines that limit innovations. This paper is focused on the positive aspects of ergonomics in improvement of the working environment. It consists of a part that studies the literature on success factors in the process towards higher productivity and greater comfort, the formulation of a model and a hypothesis, which is illustrated by four cases. The model distinguishes the success factors in 'goal', 'involvement' and 'process'. GOALS: evidence is found in the literature that a positive approach has benefits in terms of shareholder value and productivity, and for comfort. Involvement: the literature shows that participation of end-users and management contributes to success. PROCESS: in the process it is essential to have a good inventory of the problems, a structured approach, a steering group responsible for the guidance, and end-users involvement in testing of ideas and prototypes. It is hypothesized that the chance of success increases by empowerment (making the end-user responsible for deciding on the next step in the process) and positive experiences of end-users with the potential improvement (end-users feel or see the benefits). The four cases illustrate that the hypothesis can be used in evaluating cases.
Community Participation↗
How patient involvement in care is improving service provision.
An emphasis on public and service-user involvement runs through the core initiatives of the modernisation agenda as outlined in The NHS Plan (Department of Health, 2000) and related policy documents. This article discusses problems that have prevented the NHS from being responsive to the views of service users and what the implementation of policies can offer in terms of overcoming such problems. In addition, initiatives and other ways of identifying and delivering public or patient needs are considered.
Benchmarking↗
The need for change in UK mental health services: South Asian service users' views.
OBJECTIVES: UK literature on mental health services for ethnic minority service users relies heavily on perceptions of professionals, carers and community representatives. This research investigates the views of South Asian service users themselves about experiences of mental health services and how they might be improved. DESIGN: Thematic analysis of material from focus groups and individual interviews with Asian mental health service users within one local area. RESULTS: South Asian service users clearly identify the impact of socio-economic exclusion upon their mental health. Cultural and institutional exclusion compound this, leading to continuing insensitivity towards their particular needs within hospital and community-based services. Asian service users feel unsafe to share their particular concerns within many service settings. They see advocacy that recognises their experience of exclusion as a significant resource for mental health improvement. They want sounder financing of culturally appropriate services for recovery; further development of the cultural competence of staff within mainstream services; and educational programmes about mental health directed at minority communities. CONCLUSION: UK mental health services remain unresponsive to the consistently expressed views of South Asian service users. A major cultural change is required if the UK Government initiative Delivering Race Equality is to impact successfully at the local level. It will have a greater chance of success if the rhetoric of user involvement is matched by systematic consultation with South Asian service users.
Adult↗
How to involve cancer patients at the end of life as co-researchers.
The importance of user involvement in the organisation and delivery of health services and the conduct of research has increased over recent decades. Involving people at the end of life in research remains an under-developed area of research activity. The Macmillan Listening Study, a UK-wide study exploring research views and priorities of people affected by cancer, adopted a participatory research approach. Patients and carers, including two participants receiving palliative care services, collaborated in all aspects of the study as co-researchers. In this paper, we discuss the experience of working with co-researchers to collect data from two hospices. We will discuss practical, ethical and methodological challenges, including specific training needs and the emotional demands of conducting the research. Recommendations are made to facilitate successful collaboration with palliative care service users in end of life research.
Delivery of Health Care↗
Automated identification of axonal growth cones in time-lapse image sequences.
The isolation and purification of axon guidance molecules has enabled in vitro studies of the effects of axon guidance molecule gradients on numerous neuronal cell types. In a typical experiment, cultured neurons are exposed to a chemotactic gradient and their growth is recorded by manual identification of the axon tip position from two or more micrographs. Detailed and statistically valid quantification of axon growth requires evaluation of a large number of neurons at closely spaced time points (e.g. using a time-lapse microscopy setup). However, manual tracing becomes increasingly impractical for recording axon growth as the number of time points and/or neurons increases. We present a software tool that automatically identifies and records the axon tip position in each phase-contrast image of a time-lapse series with minimal user involvement. The software outputs several quantitative measures of axon growth, and allows users to develop custom measurements. For, example analysis of growth velocity for a dissociated E13 mouse cortical neuron revealed frequent extension and retraction events with an average growth velocity of 0.05 +/- 0.14 microm/min. Comparison of software-identified axon tip positions with manually identified axon tip positions shows that the software's performance is indistinguishable from that of skilled human users.
Animals↗
The use of the nominal group technique as an evaluative tool in the teaching and summative assessment of the inter-personal skills of student mental health nurses.
Nominal group technique is a semi-quantitative/qualitative evaluative methodology. It has been used in health care education for generating ideas to develop curricula and find solutions to problems in programme delivery. This paper aims to describe the use of nominal group technique and present the data from nominal group evaluations of a developing module which used novel approaches to the teaching and assessment of interpersonal skills. Evaluations took place over 3 years. Thirty-six students took part in annual groups. Analysis of the data produced the following themes based on items generated in the groups: role play, marking, course content, teaching style and user involvement. Findings indicate that students valued the role play, feedback from service users and emphasis on engagement and collaboration elements of the module. The areas which participants found difficult and desired change included anxiety during experiential practice, the "snap shot" nature of assessment and the use of specific interventions. Indications are also given regarding the impact of changes made by teaching staff over the 3 year evaluation period. The findings support themes within the existing literature on the teaching of interpersonal skills and may to some extent point the way toward best practice in this area. The paper discusses these findings and their implications for nurse education.
Adult↗
Psychometric assessment of the Hallucinogen Rating Scale.
Reliability and convergent-discriminant validity of a Spanish version of the Hallucinogen Rating Scale (HRS) were assessed in two differentiated populations of hallucinogen users involving the retrospective assessment of drug effects. In Study 1 (immediate assessment), 75 European users of the South American hallucinogenic drink ayahuasca answered the HRS 4 h after drug intake in their habitual setting. In Study 2 (delayed assessment), 56 adult polydrug users answered the HRS and a short form of the Addiction Research Center Inventory (ARCI) recalling the effects they experienced when they last took a hallucinogen, in order to test the convergent-discriminant validity of HRS with the scales of the standard questionnaire used in most studies involving psychoactive drugs. The HRS scales showed increases after both the immediate and delayed retrospective assessment of drug effects. Reliability data indicated that four of the six scales show an acceptable level of internal consistency. Significant but limited correlations were found between the Perception and Somaesthesia scales and the ARCI LSD scale, pointing out the questionnaire's construct validity. Thus, the HRS was sensitive to hallucinogenic drug effects other than those elicited by intravenous N,N-dimethyltryptamine (DMT), for which it was originally designed, and showed reasonable reliability and convergent validity. Results suggest its usefulness in the evaluation of subjective effects elicited by psychoactive drugs with hallucinogenic properties, and constitute a preliminary approach to the effects of ayahuasca in European subjects.
Adolescent↗
Creating alliances: the views of users and carers on the education and training needs of community mental health nurses.
The Sussex Education and Training Consortium commissioned a development project to identify the education and training needs of Community Mental Health Nurses (CMHNs) working with people with severe mental illness. The concerns of various stakeholding groups were identified using a qualitative methodology, Responsive Evaluation. This paper reports the views of 52 service users and representatives and 24 carers and career support workers as expressed in semi-structured interviews and focused discussion groups. Users and carers were able to identify specific areas that require attention in the education and training of CMHNs. Users want CMHNs to have wide knowledge of mental illness, medication, therapies and services and the understanding and confidence to work in an empowering way. They also want CMHNs to systematically involve users and their carers in care planning and to make more explicit any communication with other professionals and agencies. Carers want more involvement and information and CMHNs made more aware of the role that carers play and the specific problems they face. Users and their organisations would like significant involvement in the provision of CMHN education and training at all levels. Developments to CMHN education and training are suggested with recommendations for research and evaluation.
Adult↗
Experimental heroin users: an epidemiologic and psychosocial approach.
An interview study was conducted on a sample of experimental heroin users involved in an adolescent heroin epidemic. Results showed that heroin use patterns varied, with high users stabilizing at a low frequency of use over a long period of time. Results also showed that experimental users were more likely to occur in the late phase of a local heroin outbreak. Psychosocial data indicated that high users differed from low users in that they had less supportive family experiences, more experience with the criminal justice system, and less positive feelings about self and future.
Adolescent↗
Lack of adequate medical involvement in patient centred information technology.
A pre-requisite to successful systems, recognised in all industries for many years, is adequate user involvement. However, lack of medical involvement continues to be a major reason for the failure of computerised clinical systems. This paper explores why this is the case. It examines the underlying reasons for lack of involvement by doctors and discusses possible solutions.
Attitude to Computers↗
Older people as health service consumers: background to a study.
User involvement in health care has received a high profile within the NHS Plan (Department of Health, 2000a), giving patients a greater say in their treatment and in the way that the NHS works. Older people, i.e. those over 65 years of age, as a group, are the highest users of hospital and community services (DH, 2001a). The national service framework (NSF) for older people (DH, 2001a) highlights the need to listen to older people, help them make informed choices and involve them in achieving a healthy lifestyle. While the NSF for older people rightly attempts to ensure fair and equitable access to health care services for older people, it is assumed that they want to be involved, and want to exercise their rights as users. This assumption needs to be tested. This study, presented as a series of four articles, sets out to explore if there is a consumerist ethic among older people in relation to health care. The first paper outlines some of the literature reviewed together with the methodology.
Aged↗
An experimental electronic patient record for stroke patients. Part 2: system description.
This article presents an electronic patient record (EPR) for stroke patients. At the neurology department of the Maastricht University Hospital, coordination and communication of the multidisciplinary team for stroke patients is intended to be supported by an EPR. Existing, structured, paper nursing and medical records served as a starting point for the development of the EPR. In close cooperation with future users, the database structure, and data entry and data retrieval aspects of the user interface were adapted to the domain of stroke. The result is a combined electronic medical and nursing record that has potential to improve record keeping and to truly support daily routines. The challenges encountered in the development process were maintaining continuous user involvement and conflicting points of view regarding the relevance of clinical data. Conclusively, we state that intensive user participation improved the EPR, coupling with the existing hospital information system and other systems will be advantageous and the fact that the paper records were structured in advance will smooth the unavoidable changes in work patterns.
Decision Support Systems, Clinical↗
The design of a user interface for a ventilator-management advisor.
The lack of user acceptance for many medical decision-support systems should force medical software developers to rethink strategies for user interaction with decision-support programs. Participatory design is an emerging method for the development for computer applications that emphasizes user involvement in both the design and implementation phases. We have applied participatory design to the development of a user interface for VentPlan, an application that assists physicians in the management of artificial respiration of critically ill patients. In this paper, we present a case history of the participatory design process and describe the resulting interface for the VentPlan program. As a result of applying participatory design ideas, we gained insight as to how to implement VentPlan more effectively.
Critical Care↗
Computer human interaction for image information systems.
Increasingly images are being incorporated into computer-information systems, allowing faster and more reliable access to legal documents, fingerprints, medical images, and so on. But designing viable computer-human interactions (CHI) for image-information systems can be particularly difficult. This article presents an overall approach to developing viable image CHI involving user metaphors for comprehending image data, and methods for locating, accessing, and displaying computer images. Since medical-image applications involve almost all image display problems, a medical-image radiology-workstation application is used as a driving example to present critical image CHI issues.
Data Display↗
Resistance to computerization. An examination of the relationship between resistance and the cognitive style of the clinician.
The introduction of computer technology into the health care environment has been fraught with difficulty. The literature has identified that while there are many applications that have been successfully implemented, there are many others that have met significant resistance. As such, the diffusion of computer technology has been scattered and uneven in the health care arena. Some scholars attribute the problems of resistance to structural variables such as value conflicts, power conflicts, and ones that involve the man-machine interface. Other view the resistance as process-oriented, citing such key factors as inadequate training, lack of user involvement, and discomfort due to organizational change. It is held here that the essence of resistance to computerization in clinical settings is based upon the difference between the cognitive style of the user and that required by the computer. It appears that since the decision-making methods of the user tend to favor intuitive processes, he or she becomes more resistant to using a system that forces qualitative information into quantitative niches. This study examines the cognitive style of two groups of health care providers within a hospital, and attempts to provide insight into how personal decision-making processes are related to resistance to computerization. It is suggested that a more thorough understanding of this relationship will enhance the ability of health care facilities to implement new systems in the future.
Adult↗