المؤلفون: Knight, Lynn V., Bligh, John

المصدر: Advances in Health Sciences Education. Aug 2006 11(3):221-234.

تمت مراجعته من قبل الزملاء: Y

Page Count: 14

الواصفات: Medical Schools, Physicians, Hospitals, Educational Practices, Foreign Countries, Clinical Teaching (Health Professions), Interviews, Qualitative Research, Teacher Effectiveness, Context Effect, Attitudes

مصطلحات جغرافية: United Kingdom

مستخلص: Background: Change is ubiquitous. Current trends in both educational and clinical settings bring new challenges to clinicians and have the potential to threaten the quality of clinical teaching. Objective: To investigate hospital specialists' perceptions of clinical teaching in the context of change. Design: Qualitative study using in-depth semi-structured interviews. Setting: Three hospital trusts in the United Kingdom associated with a new medical school. Participants: A purposive sample of 15 clinicians from each of the three participating hospitals was approached. A total of 13 participated in the in-depth interviews: three from hospital A, six from hospital B and four from hospital C. Results: The two main themes of "Characteristics of Good and Bad Teachers" and "Clinical Teaching Approaches" emerged. These were underpinned by a number of sub-themes; including some seen by participants as potential barriers to teaching and learning, for example, organisational and personal issues. Conclusions: Potential barriers to teaching and learning, including why good clinical teachers may at times seen to be intimidating or to cause humiliation and problems of engaging with new educational practices, can be understood within the context of change resistance. Knowing more about how clinical teachers think about their task as educators is essential and this should underpin staff development and training programmes.

Abstractor: As Provided

المؤلفون: Ryan, Tony, Harrison, Madeleine, Gardiner, Clare, Jones, Amanda

المصدر: Journal of Advanced Nursing (John Wiley & Sons, Inc.); Oct2017, Vol. 73 Issue 10, p2351-2360, 10p

مصطلحات موضوعية: STROKE treatment, ACADEMIC medical centers, ATTITUDE (Psychology), COMMUNICATION, FAMILIES, FOCUS groups, HEALTH, HEALTH care teams, LENGTH of stay in hospitals, HOSPITALS, HOSPITAL admission & discharge, INTERPERSONAL relations, INTERVIEWING, RESEARCH methodology, MEDICAL personnel, PATIENT-professional relations, PATIENT satisfaction, PHYSICIANS, PUBLIC hospitals, RESEARCH, RESEARCH funding, INFORMATION resources, QUALITATIVE research, PROFESSIONAL practice, SOCIAL support, INFORMATION-seeking behavior, THEMATIC analysis, PATIENT-centered care, PATIENTS' families, PATIENTS' attitudes, STROKE rehabilitation, STROKE patients, FAMILY attitudes, STROKE units

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Aims To explore the organized stroke unit experience from the multiple perspectives of stroke survivor, family carer and the multi-disciplinary team. Background Organized stroke unit care reduces morbidity, mortality and institutionalization and is promoted globally as the most effective form of acute and postacute provision. Little research has focused on how care is experienced in this setting from the perspectives of those who receive and provide care. Design This study used a qualitative approach, employing Framework Analysis. This methodology allows for a flexible approach to data collection and a comprehensive and systematic method of analysis. Method Semi-structured interviews were undertaken during 2011 and 2012 with former stroke unit stroke survivors, family carers and senior stroke physicians. In addition, eight focus groups were conducted with members of the multi-disciplinary team. Results One hundred and twenty-five participants were recruited. Three key themes were identified across all data sets. First, two important processes are described: responses to the impact of stroke and seeking information and stroke-specific knowledge. These are underpinned by a third theme: the challenge in building relationships in organized stroke unit care. Conclusions Stroke unit care provides satisfaction for stroke survivors, particularly in relation to highly specialized medical and nursing care and therapy. It is proposed that moves towards organized stroke unit care, particularly with the emphasis on reduction of length of stay and a focus on hyper-acute models, have implications for interpersonal care practices and the sharing of stroke-specific knowledge. [ABSTRACT FROM AUTHOR]

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المؤلفون: Twigger, Sharon, Yardley, Sarah J.

المصدر: Palliative Medicine; Oct2017, Vol. 31 Issue 9, p833-841, 9p, 1 Chart

مصطلحات موضوعية: CLINICAL competence, COMMUNICATION, ETHICS, EXPERIENCE, HOSPICE care, HOSPITALS, INTERVIEWING, RESEARCH methodology, MEDICAL care, MEDICAL quality control, MEDICAL practice, MEDICAL specialties & specialists, PATIENTS, RESEARCH funding, TERMINALLY ill, QUALITATIVE research, THEMATIC analysis, ACQUISITION of data, EVALUATION of human services programs, DATA analysis software, PHYSICIANS' attitudes

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Background: The Liverpool Care Pathway was used in UK hospitals (late 1990s to July 2014) in an attempt to generate hospice-style high-quality end-of-life care in acute settings. Despite being widely established, there was limited research or contextual evidence regarding this approach or its impact. Growing criticism from the public, media, politicians and healthcare professionals culminated with a critical independent review (July 2013) and subsequent withdrawal of the Liverpool Care Pathway. Aim: This research explores experiences of doctors using the Liverpool Care Pathway, prior to and during its withdrawal, to better understand shortfallings and inform future initiatives in hospital end-of-life care. Design: Individual semi-structured audio-recorded interviews were transcribed verbatim and concurrently analysed using thematic analysis. Setting/participants: Following ethical approval, volunteer participants from an acute UK hospital were sought (n = 73). A total of 18 specialist doctors were purposively selected. Results: Seven themes shaped doctors’ experiences of using the Liverpool Care Pathway: (1) changing perceptions according to length of clinical practice, (2) individual interpretation and application of the Liverpool Care Pathway, (3) limitations arising from setting, speciality and basic end-of-life care competence, (4) understanding and acceptance of medical uncertainty at the end-of-life, (5) centrality of communication and fear of discussing dying, (6) external challenges, including a culture to cure, role modelling and the media and (7) desire for reassurance in end-of-life care decisions. Conclusion: Future initiatives in hospital end-of-life care must address doctors’ fears, (in)abilty to tolerate medical uncertainty, communication skills and understanding of the dying phase, in order to provide optimum care in the last days of life. [ABSTRACT FROM AUTHOR]

: Copyright of Palliative Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Harrison, Reema, Birks, Yvonne, Bosanquet, Kate, Iedema, Rick

المصدر: Journal of Evaluation in Clinical Practice; Aug2017, Vol. 23 Issue 4, p713-718, 6p

مصطلحات موضوعية: INTERVIEWING, RESEARCH methodology, NURSES, PATIENT safety, PHYSICIANS, QUALITATIVE research, ADVERSE health care events

مصطلحات جغرافية: UNITED Kingdom

الشركة/الكيان: GREAT Britain. National Health Service

مستخلص: Background Open and honest discussion between healthcare providers and patients and families affected by error is considered to be a central feature of high quality and safer patient care, evidenced by the implementation of open disclosure policies and guidance internationally. This paper discusses the perceived enablers that UK doctors and nurses report as facilitating the enactment of open disclosure. Methods Semistructured interviews with 13 doctors and 22 nurses from a range of levels and specialities from 5 national health service hospitals and primary care trusts in the UK were conducted and analysed using a framework approach. Results Five themes were identified which appear to capture the factors that are critical in supporting open disclosure: open disclosure as a moral and professional duty, positive past experiences, perceptions of reduced litigation, role models and guidance, and clarity. Conclusion Greater openness in relation to adverse events requires health professionals to recognise candour as a professional and moral duty, exemplified in the behaviour of senior clinicians and that seems more likely to occur in a nonpunitive, learning environment. Recognising incident disclosure as part of ongoing respectful and open communication with patients throughout their care is critical. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Evaluation in Clinical Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Seymour, Jane, Rietjens, Judith, Bruinsma, Sophie, Deliens, Luc, Sterckx, Sigrid, Mortier, Freddy, Brown, Jayne, Mathers, Nigel, van der Heide, Agnes

المصدر: Palliative Medicine; Jan2015, Vol. 29 Issue 1, p48-59, 12p

مصطلحات موضوعية: CANCER patients, HOME care services, HOSPICE care, HOSPITALS, INTERVIEWING, RESEARCH methodology, CASE studies, MEDICAL practice, NURSES, PALLIATIVE treatment, PHYSICIANS, RESEARCH, RESEARCH funding, TIME, QUALITATIVE research

مصطلحات جغرافية: BELGIUM, UNITED Kingdom, NETHERLANDS

مستخلص: The article cites a study which examines reported practice of Great Britain, Belgian and Dutch physicians and nurses. The study data was collected using qualitative case studies through interviews. British respondents reported a continuum of practice from the provision of low doses of sedatives to control terminal restlessness to rarely encountered deep sedation.

المؤلفون: Pontin, David, Jordan, Nikki

المصدر: Palliative Medicine; Feb2013, Vol. 27 Issue 2, p165-171, 7p, 1 Diagram, 1 Chart

مصطلحات موضوعية: FOCUS groups, HOSPITALS, NURSES, PALLIATIVE treatment, PHYSICIANS, PROGNOSIS, SOUND recordings, QUALITATIVE research, JUDGMENT sampling, THEMATIC analysis, DATA analysis software

مصطلحات جغرافية: UNITED Kingdom

مستخلص: The article discusses the experience of prognostication in specialist palliative care professionals. According to the authors, results of the research highlighted difficulties of prognostication which include communication uncertainty, confidence in prognostication, and dealing with the reaction. The benefits included patient informed decision-making, prioritizing needs and care, and planning patient care, however, research is needed to identify the intricacy and emotional labour involved.

المؤلفون: Gardiner, Clare, Cobb, Mark, Gott, Merryn, Ingleton, Christine

المصدر: Age & Ageing; Mar2011, Vol. 40 Issue 2, p233-238, 6p, 2 Charts

مصطلحات موضوعية: ATTITUDE (Psychology), FOCUS groups, HEALTH services accessibility, INTERVIEWING, RESEARCH methodology, MEDICAL personnel, NURSES, PALLIATIVE treatment, PHYSICIANS, PUBLIC hospitals, RESEARCH funding, RESPONSIBILITY, QUALITATIVE research, OCCUPATIONAL roles, NARRATIVES

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Background: the need for access to high-quality palliative care at the end of life is becoming of increasing public health concern. The majority of deaths in the UK occur in acute hospitals, and older people are particularly likely to die in this setting. However, little is known about the barriers to palliative care provision for older people within acute hospitals.Objective: to explore the perspectives of health professionals regarding barriers to optimal palliative care for older people in acute hospitals.Methods: fifty-eight health professionals participated in eight focus groups and four semi-structured interviews.Results: participants identified various barriers to palliative care provision for older people, including attitudinal differences to the care of older people, a focus on curative treatments within hospitals and a lack of resources. Participants also reported differing understandings of whose responsibility it was to provide palliative care for older people, and uncertainly over the roles of specialist and generalist palliative care providers in acute hospitals.Conclusions: numerous barriers exist to the provision of high-quality palliative care for older people within acute hospital settings. Additional research is now required to further explore age-related issues contributing to poor access to palliative care. [ABSTRACT FROM PUBLISHER]

: Copyright of Age & Ageing is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Clissett, Philip¹ philip.clissett@nottingham.ac.uk, Porock, Davina², Harwood, Rowan H.³, Gladman, John R. F.⁴

المصدر: International Journal of Nursing Studies. 2013, Vol. 50 Issue 11, p1495-1503. 9p.

مصطلحات موضوعية: *DEMENTIA, *HOSPITAL care of older people, *CAREGIVERS, *COMMUNICATIVE competence, *CRITICAL care medicine, *FAMILIES, *HEALTH care teams, *HEALTH facilities, *HOSPITAL wards, *HOSPITALS, *WORKING hours, *HUMAN comfort, *INDIVIDUALITY, *INTERVIEWING, *MARITAL status, *PATIENT-professional relations, *NURSE-patient relationships, *SCIENTIFIC observation, *PHYSICIANS, *QUALITATIVE research, *UNOBTRUSIVE measures, *PATIENT-centered care, *DATA analysis software, *HOSPITAL nursing staff, *OLD age

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Background: Person-centred care has been identified as the ideal approach to caring for people with dementia. Developed in relation to long stay settings, there are challenges to its implementation in acute settings. However, international policy indicates that acute care for people with dementia should be informed by the principles of person-centred care and interventions should be designed to sustain their personhood. Objectives: Using Kitwood's five dimensions of personhood as an a priori framework, the aim of this paper was to explore the way in which current approaches to care in acute settings had the potential to enhance personhood in older adults with dementia. Design: Data collected to explore the current experiences of people with dementia, family carers and co-patients (patients sharing the ward with people with mental health problems) during hospitalisation for acute illness were analysed using a dementia framework that described core elements of person centred care for people with dementia. Settings: Recruitment was from two major hospitals within the East Midlands region of the UK, focusing on patients who were admitted to general medical, health care for older people, and orthopaedic wards. Participants: Participants were people aged over 70 on the identified acute wards, identified through a screeing process as having possible mental health problems. 34 patients and their relatives were recruited: this analysis focused on the 29 patients with cognitive impairment. Method: The study involved 72 h of ward-based non-participant observations of care complemented by 30 formal interviews after discharge concerning the experiences of the 29 patients with cognitive impairment. Analysis used the five domains of Kitwood's model of personhood as an a priori framework: identity, inclusion, attachment, comfort and occupation. Results: While there were examples of good practice, health care professionals in acute settings were not grasping all opportunities to sustain personhood for people with dementia. Conclusions: There is a need for the concept of person-centred care to be valued at the level of both the individual and the organisation/team for people with dementia to have appropriate care in acute settings. [ABSTRACT FROM AUTHOR]