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PubMed1999

A protocol building software tool for medical device quality control tests.

Q-Pro is an application for Quality Control and Inspection of Medical Devices. General system requirements include friendly and comprehensive graphical environment and proper, quick, easy and intuitive user interface. Functions such as, a tool library for protocol design widely used multimedia, as well as, a support of a local database for protocol and inventory data archiving are provided by the system. In order to serve the different categories of users, involved in Quality Control procedures, the system has been split into three modules of different functionality and complexity, each of which can work as a stand-alone application. The implementation of protocols and use of the software functions, as well as, the user interface itself have been proved by the evaluators to be clear and intuitive. The software seems to adapt easily to different kinds of Quality Control procedures and objectives. Q-Pro effectively supports and enhances the processes to attain a highly tuned, professional, responsive and effective quality control and preventive maintenance procedures for biomedical equipment management.

Data Collection↗

PubMedDate not supplied

[Promoting physical activity: going to school by the Piedibus (walking school bus)].

The Local Health Service of Lecco has proposed the project called Piedibus (Walking school bus), the organisation of safe pedestrian pathways from home to school, in order to promote the increase of physical activity among children. This article describes how the project has been planned and made operational. It provides some results about the community participation and the satisfaction of students, teachers and accompanying volunteers. The project organisation is centered on community participation with large institutional involvement. At the moment (October 2004), independently of weather conditions, 12 Piedibus lines, with more than 500 pupils and 90 accompanying volunteers, are running daily in the Lecco Province. For the next school year 2004-2005 we estimate that the number of lines and users involved will double. The opinion of children, teachers and volunteers has been in general very favourable toward the project: 91.4% of participating students stated they liked the initiative very much and 87.4% among them prefer to go to school by the Piedibus than by any other means. Teacher and volunteers outlined the social value of the project and the increase in physical activity as positive aspects of the project. The overall impact at a province level is outlined by the Media coverage with over 60 articles and numerous radio and television broadcasts.

Adolescent↗

PubMed2000

User acceptability--a critical success factor for picture archiving and communication system implementation.

The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

Academic Medical Centers↗

PubMed2003

Establishing nursing research priorities on a paediatric haematology, oncology, immunology and infectious diseases unit: involving doctors and parents.

Following a Delphi survey undertaken with nurses on a specialist children's unit to identify priorities for nursing research, this paper outlines the results of a survey to ascertain the views of doctors and parents regarding the results of the Delphi. This approach was in keeping with national guidance on multi-professional working in paediatric oncology and the importance of service-user involvement in planning and evaluating care. Convenience samples of doctors (n=16) and parents (n=10) were asked to rank the priorities previously identified by nurses. Results highlighted that in the main, nurses, doctors and parents agreed on the key areas that should take priority for research. Nurse's knowledge of day-to-day symptom management, children's quality of life, negotiation and communication in relation to care provision were identified by all three groups as high priorities. There were some areas where the views varied: this was generally in relation to the different primary focus of the individual groups-parents being very concerned with the effect of daily ward routines and procedures and their child's overall hospital experience, nurses with issues such as staff retention and morale, whereas doctors were more concerned with issues around information giving and consent to treatment. Limitations of the study, including sample selection and the transient nature of the population involved are discussed within the paper. The paper concludes that all three groups shared similar views, being focused on issues directly related to patient care. Consensus between the groups should result in future research initiatives reflecting a shared focus and responding to an identified need.

Attitude of Health Personnel↗

PubMedDate not supplied

Views of family carers and older people of information technology.

This article is the second in a series of four describing recent developments in Sweden aimed at promoting partnerships between older people, their families and formal service providers. The last article (Vol 11(11): 759-63) described the development of an information and communication technology (ICT) project ACTION -- Assisting Carers using Telematics Interventions to meet Older persons' Needs -- and focused on the use of CT to help family carers to be more prepared for their caregiving role. This article focuses on the concept of usability within the ACTION project and the importance of working closely with participants in order to create an information and communication service that is both acceptable and of direct benefit to family members in their everyday caring situations. Nielsen's (1993) Model of Usability is described within the overall context of the project and is used as a framework for the cycle of development and testing that underpin ACTION. A variety of research methods are highlighted, with a central theme being that of user involvement, with particular reference to the USERfit approach (Poulson et al, 1996). The education and training of older people and their family carers to use the ACTION technology is outlined and examples are given of the empowering effects of the use of the service and its user-driven focus. Recommendations for the further technical development of ACTION are firmly based on the comments and suggestions provided by older people and the family carers themselves.

Aged↗

PubMed2002

Capturing users' experiences of participating in cancer trials.

Randomized controlled trials are accepted to be the research design of choice to evaluate the effectiveness of health care interventions and are commonly used to evaluate cancer treatments. There are concerns, however, that levels of recruitment to trials are often much lower than anticipated, particularly in cancer trials. Several research methods have been used to collect aspects of users' experiences of participating in cancer trials. Perhaps the most common method has been through measures of outcome and the impact of treatments on quality of life (QoL), using standardized schedules to capture physical, social and psychological health. In some areas of cancer, individual patient testimonies illuminate particular issues or narratives. Another body of research has grown around issues of user involvement in trials, including surveys of recruitment and participation, as well as investigations of patient preferences and experiences of participation. We searched MEDLINE and the Cochrane Trials Library from 1995 to 2001 for relevant publications. In this article, we review the literature in these areas and examine whether users' experiences of participating in cancer trials can be used to assist in the design or conduct of trials.

Female↗

PubMed1986

Oral contraceptive use has no adverse effect on the prognosis of breast cancer.

This study evaluates the possible effect of OC use on the prognosis of established breast cancer. Three hundred forty-seven patients with primary invasive breast carcinoma age 50 and under treated from 1971 to 1981 are included in this study. There were 112 OC Users (U) and 235 Non-Users (NU). Separate retrospective analysis were done for a group of 154 patients (59 U and 95 NU) under age 35 (Group A) and for 193 patients (53 U and 140 NU) age 35 to 50 (Group B), in order to pay particular attention to relationship of duration, recency and latency of OC usage. Both subsets of U and NU presented similar clinical characteristics regarding menstrual, reproductive, family history, histology, receptor status. Users presented with a similar extent of disease as Non-Users. No significant differences were found between U and NU in disease-free interval (Gr A p = .41; Gr B p = .81), metastatic period (Gr A p = .66; Gr B p = .41) or survival (Gr A p = .54; Gr B p = .79), either alone or when adjusted for extent of node involvement. Users of less than two years (78 patients) had a similar survival (Gr A = .54; Gr B p = .36) as those of longer duration (33 patients). Recent OC users within a year of diagnosis had a similar survival as other users who stopped the pills more than one year (Gr A p = .86; Gr B p = .14). No significant differences were noticed in survival between the patients who began the use 10 years or more before diagnosis from those beginning more recently (Gr A p = .82; Gr B p = .69). Our data suggests no adverse effect of OC on the outcome of breast cancer, regardless the duration of use, latency or recency period.

Adult↗

PubMed2003

Older people as health service consumers 2: health and illness in a village context.

Involving users in the future shaping and development of health care services is part of the drive to restore public confidence in the NHS (NHS Executive 2002). A fundamental part of this process is working in partnership with patients, and attempting to include marginalized groups. Illness, infirmity and lack of knowledge may prevent older people from being actively involved in decisions about health care services, and the culture to which they belong may act as a further barrier. For true partnership and patient involvement, there needs to be a common understanding of the meaning of health and illness. This article discusses the prevailing cultural health beliefs within an elderly, white village community in South England.

Adaptation, Psychological↗

PubMed2004

Service users, metaphors and teamworking in mental health.

Despite the United Kingdom's recent governmental mental health policy directives aimed at strengthening professional collaboration and increasing service user involvement, the prevailing mental health care culture remains steeped in a discourse of treatment and care, control and compliance and professional expertise. Drawing upon the data collected during the two phases of a 2-year national evaluation undertaken for the English National Board for Nursing, Midwifery and Health Visiting, the perceptions of a group of mental health service users in relation to their experiences and contact with the multi-professional team are explored. A series of metaphorical descriptions were developed with these service users drawn from their experience. These begin to illuminate a realistic way of thinking about how teams are set up, how and why they carry out their various roles, and the need to think in non-professional terms about the relationships that are developed with service users. A hierarchy of power was noted that was congruent with the outcomes of other studies. However, there was also a concurrent acknowledgement of the 'usefulness'(to the individual service user) of each of the professional group members. This appeared to have been constructed alongside the power hierarchy and serves to illustrate how individual service users sought to find an accommodation within the social system they were placed in. This paper argues however, that the use of metaphors, as a form of shared communication, can be an effective first step in working towards this objective. Working in the way described here can allow for a greater shared understanding of what each group is experiencing and help ensure that future service development reflects a broader view of the mental health care world.

Attitude to Health↗

PubMed1999

Making sense of the electronic resource marketplace: trends in health-related electronic resources.

Changes in the practice of medicine and technological developments offer librarians unprecedented opportunities to select and organize electronic resources, use the Web to deliver content throughout the organization, and improve knowledge at the point of need. The confusing array of available products, access routes, and pricing plans makes it difficult to anticipate the needs of users, identify the top resources, budget effectively, make sound collection management decisions, and organize the resources effectively and seamlessly. The electronic resource marketplace requires much vigilance, considerable patience, and continuous evaluation. There are several strategies that librarians can employ to stay ahead of the electronic resource curve, including taking advantage of free trials from publishers; marketing free trials and involving users in evaluating new products; watching and testing products marketed to the clientele; agreeing to beta test new products and services; working with aggregators or republishers; joining vendor advisory boards; benchmarking institutional resources against five to eight competitors; and forming or joining a consortium for group negotiating and purchasing. This article provides a brief snapshot of leading biomedical resources; showcases several libraries that have excelled in identifying, acquiring, and organizing electronic resources; and discusses strategies and trends of potential interest to biomedical librarians, especially those working in hospital settings.

Computer Communication Networks↗

PubMed2004

Patient and nurse accounts of violent incidents in a medium secure unit.

Most studies examining violence in a forensic setting have adopted a statistical approach to associate relevant predictors and the likelihood of violence. Views of patients and nurses have been a relatively neglected research area. This study explored patients' and nurses' accounts of violent incidents, considering similarities and differences in their narratives. Permission was obtained from the local National Health Service Research Ethics Board and the Research Ethics Committee of University of East London. Anonymized transcripts were produced from semi-structured interviews conducted in a Medium Secure Unit with four nurses and four patients, who consented to talk at length with the first author about violent events they had witnessed on the Unit. Grounded theory analysis of the data generated a core category, 'control', and five constituent themes: the construction of identity of the perpetrator of violence; nurses' dual role of caring and controlling; aspects of parentalism involved in control; following set policies and procedures; and segregation from mainstream society. Because of widespread social interest and media coverage in the topic, discursive examination was made of aspects of social context arising within the data. This study was small scale and exploratory, and further confirmatory research is needed. Nevertheless, clear contrasts between the nurse and patient accounts indicated tentative suggestions for training (including user involvement) and intervention in managing violent behaviour.

Adult↗

PubMed2006

Introducing patient cards in clinical routine: evaluation of two research projects.

OBJECTIVE: Two research projects were analyzed in order to identify key factors of success and/or failure in introducing patient card-based systems in clinical routine. METHODS: In DIABCARD an evaluation study focussing on user friendliness and user acceptance was conducted. In ByMedCard-HCPP the project's system was validated and the timeliness of the project's work analyzed. RESULTS: User friendliness and user acceptance of the DIABCARD system were fairly high. The ByMedCard-HCPP system was complete in its major components and functionalities; introducing the ByMedCard-HCPP system in clinical routine delayed the project. CONCLUSIONS: A multitude of key factors of success such as utilized technologies, user involvement, and commitment of partners seems to contribute to the success and/or failure of introducing patient card-based systems in healthcare.

Diffusion of Innovation↗

PubMed2002

IS4ALL: a working group promoting universal design in Health Telematics.

In this article, we present an overview of the work being carried out by the EC-funded project IS4ALL (IST-1999-14101). Specifically, we describe the methodological frame of reference, which drives the project's objective to introduce universal access principles into the design of Health Telematics applications and services. Health Telematics is chosen due to some distinctive characteristics, such as the variety of end users involved, the changing healthcare contexts of use and the penetration of new computer-mediated activities, which re-shape the way in which healthcare practices are structured and organized.

European Union↗

PubMed2000

The patient care development programme: organisational development through user and staff involvement.

A number of approaches have been developed in recent years to try effectively to engage service users in the process of planning and delivering health-care services. The consumerist methodology for the strategy described in this paper was designed to maximise staff involvement in capturing user views, in order to develop services at a district general hospital. This strategy--the Patient Care Development Programme (PCDP)--provides a framework for both staff and patient involvement in shaping and influencing the development of health-care services. Uses the findings from applying the strategy to modify care packages, roles, skills, layouts, protocols and procedures, in response to both the "shortfalls" and the service strengths that the patient's view uncovers. Discusses the results of an evaluation of the programme which has been replicated in another part of the UK. The PCDP now forms part of a clinical governance framework and is being used to develop multi-agency integrated care pathways.

Community Participation↗

PubMed2005

Pilot study in the development of an interactive multimedia learning environment for sexual health interventions: a focus group approach.

In the UK there are high rates of sexually transmitted infections and unintended pregnancies amongst young people. There is limited and contradictory evidence that current sexual health education interventions are effective or that they improve access to appropriate sexual health services. This paper describes the outcome of focus group work with young people that was undertaken to inform the design of an Interactive Multimedia Learning Environment that incorporates message framing, intended for use in sexual health promotion. The focus group work addressed sexual attitudes, behaviour, risk perception, and knowledge of sexual health and sexual health services in Nottingham. The results provided new insights into young peoples' sexual behaviour, and their diversity of knowledge and beliefs. Common themes expressed regarding sexual health services included concerns about confidentiality, lack of confidence to access services and fear of the unknown. The results showed that while the adolescents are reasonably knowledgeable about infection, they do not know as much about the relevant services to treat it. This work emphasizes the need for user involvement throughout the design and development of a sexual health intervention, and will form the basis of the next part of the project.

Focus Groups↗

PubMed1991

Best kept secrets ... First Coast Systems, Inc. (FCS).

The FCS/APaCS system is a viable option for small-to medium-size hospitals (up to 400 beds). The table-driven system takes full advantage of IBM AS/400 computer architecture. A comprehensive application set, provided in an integrated database environment, is adaptable to multi-facility environments. Price/performance appears to be competitive. Commitment to IBM AS/400 environment assures cost-effective hardware platforms backed by IBM support and resources. As an IBM Health Industry Business Partner, FCS (and its clients) benefits from IBM's well-known commitment to quality and service. Corporate emphasis on user involvement and satisfaction, along with a commitment to quality and service for the APaCS systems, assures clients of "leading edge" capabilities in this evolutionary healthcare delivery environment. FCS/APaCS will be a strong contender in selected marketing environments.

Computers↗

PubMed2000

Accessing the user's perspective.

Pressure is increasing on health care providers in the UK to demonstrate that they incorporate the views of users when planning and evaluating services. Most recently this has been seen in the commissioning of the National Patients' Experiences Survey. It is timely therefore to review the progress that has been made in trying to access the user's perspective. The aim of this paper is to assist individual service providers in planning their own strategy of user involvement and evaluation, based on an awareness of the current state of knowledge in this area. It reviews the results of research in the field of patient satisfaction over the last 20 years; summarises the main problems in the area, and suggests ways forward. Three main points emerge: the importance of developing and substantiating theory in this field to support study design; the need to exercise care if using quantitative methods and global satisfaction scores, until the process of evaluation is better understood, and the need to consider how a sensitive user-led agenda can be developed. The paper calls for a pause for reflection on the reason for our inquiry into user opinion, and for careful consideration of how we might best design studies to obtain information to fulfil this inquiry.

Journal Article↗

PubMed1999

Training, skills and caseloads of community mental health support workers involved in case management: evaluation from the initial UK demonstration sites.

This paper describes phase one of a three phase, Department of Health funded project, led by the Mental Health Programme of the Royal College of Nursing Institute in collaboration with the Research Unit of the Royal College of Psychiatrists and the School of Social Work at the University of East Anglia. Its project aims were to establish whether the work of demonstration sites in mental health case management had developed beyond their original structure, to compare their current profile with the general literature on case management and assertive outreach and to use this data to reach consensus about issues affecting the work of those healthcare workers who currently see themselves working as case managers. Central to these aims were the experiences and narratives of the demonstration site case managers themselves. In 1995 data were collected from six fieldwork sites in England using semistructured interviews. Similarities and differences between the literature and the fieldwork data were used to inform a consensus conference. The main areas of investigation were organizational considerations, the nature of innovative projects and user involvement. The paper concludes that there are serious problems with the perceived role of case managers, their support and training and further difficulties attributed to interagency working. Finally, it is clear that the exact nature of the client group most suited to UK case management typology has not yet been resolved.

Case Management↗