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1.
Qual Health Res ; : 10497323241235882, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38485670

RESUMO

There is an increasing emphasis on transdisciplinary research to address the complex challenges faced by health systems. However, research has not adequately explored how members of transdisciplinary research teams perceive, understand, and promote transdisciplinary collaboration. As such, there is a need to investigate collaborative behaviors, knowledge, and the impacts of transdisciplinary research. To address this gap, we conducted a longitudinal realist evaluation of transdisciplinary collaboration within a 5-year National Health and Medical Research Council-funded Center of Research Excellence in Transdisciplinary Frailty Research. The current study aimed to explore researchers' perceptions and promotion of transdisciplinary research specifically within the context of frailty research using qualitative methods. Participants described transdisciplinary research as a collaborative and integrative approach that involves individuals from various disciplines working together to tackle complex research problems. However, participants often used terms like interdisciplinary and multidisciplinary interchangeably, indicating that a shared understanding of transdisciplinary research is needed. Barriers to transdisciplinary collaboration included time constraints, geographical distance, and entrenched collaboration patterns. To overcome these challenges, participants suggested implementing strategies such as creating a shared vision and goals, establishing appropriate collaboration systems and structures, and role modeling collaborative behaviors, values, and attitudes. Our findings underscore the need for practical knowledge in developing transdisciplinary collaboration and leadership skills across different career stages. In the absence of formal training, sustained and immersive programs that connect researchers with peers, educators, and role models from various disciplines and provide experiential learning opportunities, may be valuable in fostering successful transdisciplinary collaboration.

2.
Health Expect ; 2023 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-37830439

RESUMO

BACKGROUND: Chronic conditions and multimorbidity, the presence of two or more chronic conditions, are increasingly common in older adults. Effective management of chronic conditions and multimorbidity in older adults requires a collaborative and person-centred approach that considers the individual's goals, preferences and priorities. However, ensuring high-quality personalised care for older adults with multimorbidity can be challenging due to the complexity of their care needs, limited time and a lack of patient preparation to discuss their personal goals and preferences with their healthcare team. OBJECTIVE: To codesign a communication and goal-setting tool, My Wellbeing Journal, to support personalised care planning for older adults with chronic conditions and multimorbidity. DESIGN: We drew on an experience-based codesign approach to develop My Wellbeing Journal. This article reports on the final end-user feedback, which was collected via an online survey with older adults and their carers. SETTING AND PARTICIPANTS: Older adults with chronic conditions, multimorbidity and informal carers living in Australia. Personalised care planning was considered in the context of primary care. RESULTS: A total of 88 participants completed the online survey. The survey focused on participants' feedback on the tool in terms of effectiveness, efficiency, satisfaction and errors encountered. This feedback resulted in modifications to My Wellbeing Journal, which can be used during clinical encounters to facilitate communication, goal setting and progress tracking. DISCUSSION AND CONCLUSIONS: Clinicians and carers can use the tool to guide discussions with older adults about their care planning and help them set realistic goals that are meaningful to them. The findings of this study could be used to inform the development of recommendations for healthcare providers to implement person-centred, goal-oriented care for older adults with chronic conditions and multimorbidity. PATIENT OR PUBLIC CONTRIBUTION: Older adults living with chronic conditions and multimorbidity and their carers have contributed to the development of a tool that has the potential to significantly enhance the experience of personalised care planning. Their direct involvement as collaborators has ensured that the tool is optimised to meet the standards of effectiveness and usability.

3.
Health Res Policy Syst ; 21(1): 20, 2023 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-36944997

RESUMO

BACKGROUND: Transdisciplinary research and knowledge translation are increasingly regarded as key concepts underpinning applied research across the health and social sciences, due to their presumed potential in addressing complex, "wicked" problems and improving the use of research in practice and policy, respectively. Despite sharing an impact mandate, the relationship between transdisciplinary research collaboration and knowledge translation remains unclear. In response, we examined the relationship between transdisciplinary collaboration and knowledge translation to generate these understandings with a view towards maximizing the impact of collaborative efforts. METHODS: We undertook a realist evaluation and longitudinal case study of a 5-year National Health and Medical Research Council-funded Centre of Research Excellence in Transdisciplinary Frailty Research. Data were collected between February 2017 and March 2020 over three rounds of theory development, refinement and testing using interviews, observation, document review and visual elicitation as data sources. The Human Research Ethics Committee of the University of Adelaide approved this study. RESULTS: Iterative analysis of narrative interviews and visual data led to the development of three overarching programme theories explicating the reciprocal relationship between KT understandings and transdisciplinary team process. These programme theories revolve around the concept of a network, which we define in alignment with extant theoretical literature on network mechanisms and complex networks as graphically representable networks of agents/people (nodes) joined by social relationships (links). Our findings demonstrate that under the right contextual conditions, transdisciplinary team members respond through an improved ability to (1) navigate the network, (2) negotiate the network and (3) mobilize the network. CONCLUSIONS: This research demonstrates the reciprocity and mutually supportive relationship between transdisciplinary research and knowledge translation. Our findings suggest that embedding a collaborative knowledge translation framework and providing resources such as facilitation and distributed leadership within a transdisciplinary team can improve collaboration and support transdisciplinary research objectives.


Assuntos
Pesquisa Interdisciplinar , Ciência Translacional Biomédica , Humanos , Aprendizagem , Liderança , Rede Social
4.
Qual Health Res ; 32(13): 1935-1951, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36062369

RESUMO

Online peer-to-peer communities provide environments in which people with similar health concerns can interact and exchange information that can support self-care of long-term conditions. However, current theories have not adequately accounted for how self-care support is enacted in online communities. We conducted an observational netnography to identify and analyze posts in a publicly accessible online community (discussion forum boards) designed for older people. A Straussian grounded theory approach was used to examine 659 posts in health-related message boards. Self-care support involved the construction of three interrelated identities: (1) the support seeking self, in which members described problems and requested information; (2) the empathizing self, in which they described similar experiences and offered support; and (3) the influencing self, in which they provided information or advice. Online communities appear to be an important source of peer support and information and may be a cost-effective approach to supplement standard care.


Assuntos
Autocuidado , Apoio Social , Humanos , Idoso , Grupo Associado , Teoria Fundamentada , Internet
5.
Age Ageing ; 50(1): 227-232, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33006601

RESUMO

BACKGROUND AND OBJECTIVES: despite growing support for the clinical application of frailty, including regular frailty screening for older adults, little is known about how older adults perceive frailty screening. The purpose of this study was to examine older adults' perspectives on frailty screening to inform knowledge translation and service improvements for older adults with frailty. RESEARCH DESIGN: interpretive descriptive qualitative design. PARTICIPANTS: a total of 39 non-frail (18%), pre-frail (33%) and frail or very frail (49%) South Australian older adults aged 62-99 years, sampled from community, assisted living and residential aged care settings. METHODS: seven focus groups were conducted and analysed by two independent investigators using inductive thematic analysis. RESULTS: three themes were identified. First, older adults question the necessity and logic of an objective frailty measure. Second, older adults believe any efforts at frailty screening need to culminate in an action. Third, older adults emphasise that frailty screening needs to be conducted sensitively given negative perceptions of the term frailty and the potential adverse effects of frailty labelling. DISCUSSION AND IMPLICATIONS: previous screening experiences and underlying beliefs about the nature of frailty as inevitable shaped openness to, and acceptance of, frailty screening. Findings correspond with previous research illuminating the lack of public awareness of frailty and the nascent stage of frailty screening implementation. Incorporating consumer perspectives, along with perspectives of other stakeholder groups when considering implementing frailty screening, is likely to impact uptake and optimise suitability-important considerations in person-centred care provision.


Assuntos
Fragilidade , Idoso , Austrália , Idoso Fragilizado , Fragilidade/diagnóstico , Avaliação Geriátrica , Humanos , Programas de Rastreamento , Percepção , Pesquisa Translacional Biomédica
6.
J Adv Nurs ; 77(7): 3218-3225, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33855741

RESUMO

AIMS: The aim of this study is to generate an in-depth understanding of youth perceptions and experiences of living with type 2 diabetes to inform knowledge translation, research and intervention development. DESIGN: Interpretive descriptive qualitative study. METHODS: Twenty to 25 youth aged 10-18 years with a diagnosis of type 2 diabetes will be purposively recruited through the Diabetes Education Resource for Children and Adolescents in Winnipeg, Manitoba, and through the Improving Renal Complications in Adolescents With Type 2 Diabetes Through the REsearch [iCARE] cohort. Socio-demographic information will be collected. Semi-structured interviews will occur iteratively with inductive thematic analysis. Data will be professionally transcribed and managed using NVivo 1.0 software. The University Ethics Committee approved this study (May 2020). DISCUSSION: There is a critical gap in understanding youth experiences of type 2 diabetes. Research involving youth with type 2 diabetes is predominantly quantitative in nature, largely reflecting risk factors, underlying mechanisms and treatment outcomes associated with diabetes management. In-depth qualitative research on youth experiences can help identify youth priorities, provide insight into critical misalignments between stakeholder perspectives, and drive forward a more consolidated youth-centred research agenda. IMPACT: Understanding and applying knowledge of youth experiences is critical as the prevalence of, and challenges associated with, youth onset type 2 diabetes continues to increase worldwide. This research will generate a robust interpretive description of youth lived experiences and perceptions of type 2 diabetes where such research is lacking, to inform basic and applied research within an interdisciplinary investigative and clinical research team with relevance to other jurisdictions. In response to calls for youth-oriented research in type 2 diabetes, this work will catalyse collaborative knowledge translation using creative and youth-directed initiatives.


Assuntos
Diabetes Mellitus Tipo 2 , Adolescente , Criança , Humanos , Manitoba , Percepção , Pesquisa Qualitativa , Pesquisa Translacional Biomédica
7.
BMC Geriatr ; 20(1): 152, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32321431

RESUMO

BACKGROUND: Frailty exposes older people to an elevated risk of a range of negative outcomes. Emerging evidence that frailty can be effectively treated within community settings has stimulated calls for more proactive screening within primary care. Assessing feasibility is a critical preliminary step in assessing the efficacy of interventions such as screening. However, few studies have explored the feasibility and acceptability of administering frailty screening instruments within general practice, and even fewer have incorporated patient perspectives. Our study had three objectives: To 1) assess overall feasibility of the instruments (completion time and rate); 2) assess patient acceptability towards the instruments; and 3) assess the feasibility and acceptability of the instruments to administering nurses. METHODS: The feasibility and acceptability of several frailty screening instruments (PRISMA-7, Edmonton Frail Scale, FRAIL Scale Questionnaire, Gait Speed, Groningen Frailty Indicator, Reported Edmonton Frail Scale and Kihon Checklist) was explored within the context of a larger diagnostic test accuracy (DTA) study. Completion time and rate was collected for all participants (N = 243). A sub-sample of patients (n = 30) rated each instrument for ease of completion and provided comment on perceived acceptability. Lastly, five of six administering nurses involved in the DTA study participated in semi-structured face-to-face interviews, rating the instruments against several feasibility and acceptability criteria (time, space, equipment, skill required to implement, acceptability to patients and nurses, ease of scoring) and providing comment on their responses. RESULTS: The PRISMA-7 returned the highest overall feasibility and acceptability, requiring minimal space, equipment, skills and time to implement, and returning the fastest completion rate and highest patient and nurse acceptability rating. All screening instruments were faster to implement than the two reference standards (Fried's Frailty Phenotype and Frailty Index). Self-administered instruments were subject to lower rates of completion than nurse-administered instruments. CONCLUSIONS: This study has demonstrated that a number of commonly used frailty screening instruments are potentially feasible for implementation within general practice. Ultimately, more research is needed to determine how contextual factors, such as differences in individual patient and clinician preferences, setting and system factors, impact on the feasibility of screening in practice.


Assuntos
Idoso Fragilizado/psicologia , Fragilidade/diagnóstico , Avaliação Geriátrica/métodos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Fragilidade/epidemiologia , Humanos , Vida Independente , Masculino
8.
BMC Geriatr ; 20(1): 17, 2020 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-31948387

RESUMO

BACKGROUND: Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clinical and research focus in aged care is the concept of frailty and its associations with fragility, sarcopenia, falls and rehabilitation. Currently, research is lacking on how orthopaedic surgeons perceive frailty and the role of frailty screening. A baseline understanding of these perceptions is needed to inform integration of frailty identification and management for patient optimization in orthopaedic practices, as well as research and education efforts of patients and healthcare professionals in orthopaedic contexts. METHODS: We used an exploratory design guided by qualitative description to conduct 15 semi-structured telephone and in-person interviews across three orthopaedic surgeon subgroups (Registrars, Junior Consultants, and Senior Consultants). Data collection and analysis occurred iteratively and was guided by thematic saturation. RESULTS: Orthopaedic surgeons have a disparate understanding of frailty. Between colleagues, frailty is often referred to non-specifically to suggest a general state of risk to the patient. Frailty screening is regarded positively but its specific utility in orthopaedic environments is questioned. Easy-to-administer frailty screening tools that are not exclusive assessments of functional status are viewed most satisfactorily. However these tools are rarely used. CONCLUSIONS: There is little understanding among orthopaedic surgeons of frailty as a phenotype. Beliefs around modifiability of frailty were dissimilar as were the impact of related risk factors, such a cognitive status, chronic disease, social isolation, and environmental influences. This in turn may significantly impact on the occurrence and treatment outcomes of fragility fracture, a common orthopaedic problem in older populations. This study highlights need for knowledge translation efforts (e.g. education) to achieve cohesive understanding of frailty among health professionals.


Assuntos
Fragilidade , Cirurgiões Ortopédicos , Ortopedia , Fraturas por Osteoporose , Idoso , Fragilidade/diagnóstico , Humanos , Programas de Rastreamento
9.
Aging Clin Exp Res ; 31(5): 653-660, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30132204

RESUMO

BACKGROUND: The primary care setting is the ideal location for identifying the condition of frailty in older adults. AIMS: The aim of this pragmatic study was twofold: (1) to identify data items to extract the data required for an electronic Frailty Index (eFI) from electronic health records (EHRs); and (2) test the ability of an eFI to accurately and feasibly identify frailty in older adults. METHODS: In a rural South Australian primary care clinic, we derived an eFI from routinely collected EHRs using methodology described by Clegg et al. We assessed feasibility and accuracy of the eFI, including complexities in data extraction. The reference standard for comparison was Fried's frailty phenotype. RESULTS: The mean (SD) age of participants was 80.2 (4.8) years, with 36 (60.0%) female (n = 60). Frailty prevalence was 21.7% by Fried's frailty phenotype, and 35.0% by eFI (scores > 0.21). When deriving the eFI, 85% of EHRs were perceived as easy or neutral difficulty to extract the required data from. Complexities in data extraction were present in EHRs of patients with multiple health problems and/or where the majority of data items were located other than on the patient's summary problem list. DISCUSSION: This study demonstrated that it is entirely feasible to extract an eFI from routinely collected Australian primary care data. We have outlined a process for extracting an eFI from EHRs without needing to modify existing infrastructure. Results from this study can inform the development of automated eFIs, including which data items to best access data from.


Assuntos
Fragilidade/diagnóstico , Avaliação Geriátrica/métodos , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Registros Eletrônicos de Saúde/normas , Registros Eletrônicos de Saúde/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/epidemiologia , Humanos , Masculino , Prevalência , Atenção Primária à Saúde/estatística & dados numéricos
10.
BMC Pediatr ; 18(1): 186, 2018 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-29871611

RESUMO

BACKGROUND: Although it is well established that family-centered education is critical to managing childhood asthma, the information needs of parents of children with asthma are not being met through current educational approaches. Patient-driven educational materials that leverage the power of the storytelling and the arts show promise in communicating health information and assisting in illness self-management. However, such arts-based knowledge translation approaches are in their infancy, and little is known about how to develop such tools for parents. This paper reports on the development of "My Asthma Diary" - an innovative knowledge translation tool based on rigorous research evidence and tailored to parents' asthma-related information needs. METHODS: We used a multi-stage process to develop four eBook prototypes of "My Asthma Diary." We conducted formative research on parents' information needs and identified high quality research evidence on childhood asthma, and used these data to inform the development of the asthma eBooks. We established interdisciplinary consulting teams with health researchers, practitioners, and artists to help iteratively create the knowledge translation tools. RESULTS: We describe the iterative, transdisciplinary process of developing asthma eBooks which incorporates: (I) parents' preferences and information needs on childhood asthma, (II) quality evidence on childhood asthma and its management, and (III) the engaging and informative powers of storytelling and visual art as methods to communicate complex health information to parents. We identified four dominant methodological and procedural challenges encountered during this process: (I) working within an inter-disciplinary team, (II) quantity and ordering of information, (III) creating a composite narrative, and (IV) balancing actual and ideal management scenarios. CONCLUSIONS: We describe a replicable and rigorous multi-staged approach to developing a patient-driven, creative knowledge translation tool, which can be adapted for use with different populations and contexts. We identified specific procedural and methodological challenges that others conducting comparable work should consider, particularly as creative, patient-driven knowledge translation strategies continue to emerge across health disciplines.


Assuntos
Asma/terapia , Livros Ilustrados , Educação em Saúde/métodos , Pais/psicologia , Pesquisa Translacional Biomédica , Arte , Criança , Comunicação , Humanos , Narração
12.
J Clin Nurs ; 27(11-12): 2473-2480, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28940657

RESUMO

AIMS AND OBJECTIVES: To explore the concept of futurism and the emergence of robotics in relation to the fundamentals of care, highlighting how nurses need a more anticipatory and contemporary position towards technology to maintain relevance in the future. BACKGROUND: The future of nursing in Western countries will soon be linked with the emergence of robotics for efficient and cost-effective provision of fundamental care. Their emergence and roles with care of the body and more broadly assisting people with their daily living activities has enormous implications for the profession and health care. Despite this importance, how nursing understands and will respond to technological trends and developments is insufficiently reflected in the professions discourse. DESIGN: A discursive article. METHODS: Literature from nursing fundamentals of care/fundamental care, information science, technology, humanities and philosophy informed the arguments in this article. CONCLUSIONS: This article examines the intersection of futurism and the fundamentals of care, and how adopting an anticipatory and posthuman perspective towards technological-care integration is necessary amidst a robot revolution in the techno-era. RELEVANCE TO CLINICAL PRACTICE: Nurses are currently challenged to understand, prioritise and deliver fundamental care. Health systems are challenged by a lack of care predicated by shortfalls in skilled staff and deficiencies in staff mobilisation. Both challenges can be compounded or alleviated by further integration of technology, but to maximise benefit requires forethought and understanding. This article can help open needed dialogue around planning for the future and is a call to action for the nursing profession to conceptualise its position on exponential technological growth and fundamental care provision.


Assuntos
Papel do Profissional de Enfermagem , Enfermagem/tendências , Previsões , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Robótica/tendências , Tecnologia/tendências
13.
BMC Geriatr ; 17(1): 87, 2017 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-28415977

RESUMO

BACKGROUND: Accompanying the unprecedented growth in the older adult population worldwide is an increase in the prevalence of frailty, an age-related clinical state of increased vulnerability to stressor events. This increased vulnerability results in lower social engagement and quality of life, increased dependency, and higher rates of morbidity, health service utilization and mortality. Early identification of frailty is necessary to guide implementation of interventions to prevent associated functional decline. Consensus is lacking on how to clinically recognize and manage frailty. It is unknown how healthcare providers and healthcare consumers understand and perceive frailty, whether or not they regard frailty as a public health concern; and information on the indirect and direct experiences of consumer and healthcare provider groups towards frailty are markedly limited. METHODS: We will conduct a qualitative study of consumer, practice nurse, general practitioner, emergency department physician, and orthopedic surgeons' perspectives of frailty and frailty screening in metropolitan and non-metropolitan South Australia. We will use tailored combinations of semi-structured interviews and arts-based data collection methods depending on each stakeholder group, followed by inductive and iterative analysis of data using qualitative description. DISCUSSION: Using stakeholder driven approaches to understanding and addressing frailty and frailty screening in context is critical as the prevalence and burden of frailty is likely to increase worldwide. We will use the findings from the Perceptions of Frailty and Frailty Screening study to inform a context-driven identification, implementation and evaluation of a frailty-screening tool; drive awareness, knowledge, and skills development strategies across stakeholder groups; and guide future efforts to embed emerging knowledge about frailty and its management across diverse South Australian contexts using a collaborative knowledge translation approach. Study findings will help achieve a coordinated frailty and healthy ageing strategy with relevance to other jurisdictions in Australia and abroad, and application of the stakeholder driven approach will help illuminate how its applicability to other jurisdictions.


Assuntos
Idoso Fragilizado , Avaliação Geriátrica/métodos , Programas de Rastreamento/métodos , Qualidade de Vida , Idoso , Austrália , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/organização & administração , Humanos , Pesquisa Qualitativa , Projetos de Pesquisa , Pesquisa Translacional Biomédica/métodos
14.
Nurs Inq ; 24(2)2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27572849

RESUMO

The arts and nursing are profoundly connected. While the relationship between nursing and art has persisted over time, the majority of nursing scholarship on the arts has historically centered upon the art of nursing practice and the cultivation and application of aesthetic knowing. However, there is a burgeoning use of arts-based strategies is nursing education, research, and practice. Correspondingly, there is a need to understand how such approaches can uniquely contribute knowledge to the nursing discipline in order to support arts-integration for nursing scholars. We structure our inquiry into arts' contributions according to two dominant methods of engaging with arts-based strategies: knowing about (e.g., phenomena) vis-à-vis art-viewing, and knowing through (e.g., embodied knowing) vis-à-vis art-making. In doing so, we explore critical contributions of art to nursing research and educational practices, including arts' capacity to augment traditional research and communication approaches, democratize the research space, challenge issues of representation, and facilitate education, dissemination, and reflexivity.


Assuntos
Arte , Comunicação , Conhecimentos, Atitudes e Prática em Saúde , Educação em Enfermagem , Humanos , Pesquisa em Enfermagem
15.
Res Nurs Health ; 38(1): 19-28, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25557981

RESUMO

Parents of children with asthma provide the vast majority of day-to-day asthma care. Understanding their information needs is an essential step to provide meaningful and effective family-centered asthma education. To gain insight into the information needs and information deficits of parents of children with asthma, we conducted an interpretive descriptive study to capture the perspectives of 21 parents from diverse backgrounds whose 23 children with asthma had a range of illness trajectories and management scenarios. Parents were purposively sampled from two asthma clinics and one pediatric emergency department in a large urban center in North America. Semi-structured interviews were conducted in 2011-2012. In data analysis, parents' self-identified information needs were distinguished from analysts' interpretations of information deficits. Participants' knowledge did not always reflect time since diagnosis, and information needs and deficits persisted for years. Parents often reported receiving little or no little or no education about asthma and its management. An asthma management information hierarchy was identified, starting with the most foundational, recognizing severity; followed by acute management; prevention versus crisis orientation; and knowing "about" asthma. In the absence of adequate and accurate education, parents' beliefs about the nature of asthma as an acute rather than chronic condition shaped their asthma management decisions and information-seeking behaviors. Information deficits were affected by interactions with health care providers. These parents' pervasive unmet information needs and deficits highlight the need for comprehensive, problem-oriented asthma education.


Assuntos
Asma/terapia , Comportamento de Busca de Informação , Pais/educação , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Entrevistas como Assunto , Masculino , Avaliação das Necessidades , Pais/psicologia , Pesquisa Qualitativa , Estados Unidos
16.
Worldviews Evid Based Nurs ; 11(5): 316-24, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25132050

RESUMO

BACKGROUND: Arts-based approaches to knowledge translation are emerging as powerful interprofessional strategies with potential to facilitate evidence uptake, communication, knowledge, attitude, and behavior change across healthcare provider and consumer groups. These strategies are in the early stages of development. To date, no classification system for arts-based knowledge translation exists, which limits development and understandings of effectiveness in evidence syntheses. PURPOSE: We developed a classification schema of arts-based knowledge translation strategies based on two mechanisms by which these approaches function: (a) the degree of precision in key message delivery, and (b) the degree of end-user participation. We demonstrate how this classification is necessary to explore how context, time, and location shape arts-based knowledge translation strategies. DISCUSSION: Classifying arts-based knowledge translation strategies according to their core attributes extends understandings of the appropriateness of these approaches for various healthcare settings and provider groups. The classification schema developed may enhance understanding of how, where, and for whom arts-based knowledge translation approaches are effective, and enable theorizing of essential knowledge translation constructs, such as the influence of context, time, and location on utilization strategies. LINKING EVIDENCE TO ACTION: The classification schema developed may encourage systematic inquiry into the effectiveness of these approaches in diverse interprofessional contexts.


Assuntos
Arte , Comunicação , Medicina Baseada em Evidências/métodos , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Ensino/classificação , Pesquisa Translacional Biomédica/classificação , Medicina Baseada em Evidências/organização & administração , Humanos , Ensino/métodos , Pesquisa Translacional Biomédica/educação
17.
Int J Health Policy Manag ; 12: 7694, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38618817

RESUMO

Brown et al show that research investments in an organization with a research and translation mandate can make important gains for research impact across domains, including quality of care and patient outcomes. Their multi-stage mixed methods evaluation provides insight into research capacity development in rural health systems in Australia and draws attention towards persistent geographic inequities. In extension of this important contribution, here, a focus on the "what and the why" of embedded research is offered. Specific attention is paid to the sustainability potentials of systematized data capture systems, funding-operational mandate alignments, researcher-scientist career pathways, and networked approaches to mentorship.


Assuntos
Sistema de Aprendizagem em Saúde , Humanos , Austrália , Serviços de Saúde , Hospitais , Investimentos em Saúde
18.
Front Health Serv ; 3: 1068297, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38174215

RESUMO

There is a global movement towards stakeholder engagement in healthcare research. This movement has been catalyzed by a need to create context relevant evidence of maximal utility to health service provision and policy. The concept of "co-implementation" has potential to inform and extend these discussions of partnership and to complement the growing literature on collaborative implementation. Attending to this concept may preempt conceptual confusion and provide opportunities for sustainable and context-responsive embedded research necessary for the strengthening of health systems. In this perspective article, I seek to advance the discussion of co-implementation through an examination of the concept and through consideration of it merits to the health sciences.

19.
Nurs Philos ; 13(3): 179-88, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22672677

RESUMO

In 1978, Carper identified 'four fundamental patterns of knowing' that became largely foundational to subsequent epistemological discourse within the nursing discipline. These patterns of empirical, personal, aesthetic, and ethical knowing were presented as conceptually distinct yet related patterns of knowing. In order to provide an alternative conceptualization of aesthetics in nursing, the main tenants of Carper's discussion of aesthetic knowing will be revisited, and the foundations for her arguments will be examined. Specifically, Dewey's Art as Experience will be examined in relation to the 'holism' of nursing, and an alternative position on pragmatic aesthetics in nursing will be offered. A preliminary reintegration of the four patterns of knowing will then be presented as will an example of a potential cultivation of aesthetics in nursing, through an example of Rodin's 19th century sculpture, the Burghers of Calais.


Assuntos
Estética , Enfermagem Holística , Cuidados de Enfermagem , Empatia , Humanos , Conhecimento , Percepção
20.
BMC Prim Care ; 23(1): 160, 2022 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-35754037

RESUMO

BACKGROUND: Frailty is a highly prevalent clinical syndrome increasing older people's vulnerability to risk of adverse outcomes. Better frailty identification through expanded screening implementation has been advocated within general practice settings, both internationally and within Australia. However, little is known about practitioner perceptions of the feasibility of specific instruments, and the underlying motivations behind those perceptions. Consequently, the purpose of this study was to explore the attitudes and perceptions of a convenience and volunteer sample of Australian general practitioners (GPs) and practice nurses (PNs) towards common frailty screening instruments. METHODS: The feasibility of several frailty screening instruments (PRISMA-7 [P7], Edmonton Frail Scale [EFS], FRAIL Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC] and Timed Up and Go [TUG]) to 43 Australian GPs and PNs was assessed. The study adopted a concurrent embedded mixed-methods design incorporating quantitative (ranking exercise) and qualitative (content analysis) data collection integrated during the analysis phase. RESULTS: Practitioners assessed multi-dimensional instruments (EFS, GFI, KC) as having relatively higher clinical utility, better integration into existing assessment processes and stronger links to intervention over uni-dimensional (GST, TUG) and simple (FQ, P7) instruments. CONCLUSIONS: While existing frailty screening instruments show promise as an initial step in supporting better care for older people, all the included instruments were associated with perceived advantages and disadvantages. Ultimately, clinicians will need to weigh several factors in their selection of the optimal screening instrument. Further translational research, with a focus on contextual fit, is needed to support clinical decision-making on the selection of instruments for frailty screening.


Assuntos
Fragilidade , Medicina Geral , Idoso , Austrália/epidemiologia , Estudos de Viabilidade , Idoso Fragilizado , Fragilidade/diagnóstico , Avaliação Geriátrica/métodos , Humanos
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