Partnering with consumers to co-design a person-centred coding framework for qualitative patient experience data.

BACKGROUND: Patient Reported Experience Measures (PREMs) provide health organisations insight into how 'person-centric' care is. Qualitative data in PREMs surveys provide essential context about experience but are challenging to analyse at an organisational level. OBJECTIVE: To co-design a person-centred coding framework to assist in the analysis of qualitative PREMs data. PATIENT INVOLVEMENT: Consumer representatives were involved in problem identification, co-design, coding of raw data (testing), evaluation and manuscript authorship. METHODOLOGY: Co-design principles guided production of a deductive coding framework with Picker Principles of Person-Centred Care as a conceptual framework. The framework was co-designed over 4 stages, with cross-professional stakeholders (including two consumer representatives): 1) assessment of current state and understanding priorities; 2) adapting Picker Principles of Person-Centred Care as a coding framework; 3) testing and evaluation of a coding template over two quality improvement (QI) cycles against measures of inter-coder reliability and perceived usefulness; 4) endorsement and planning for implementation. RESULTS: The Picker Principles were a suitable coding framework for inpatient PREMs data, and a coding template in an electronic spreadsheet met end-user needs. Results of the first QI cycle indicated a need for 'less academic' domain names and definitions, which were reviewed and updated to a first-person perspective in partnership with a consumer representative. Inter-coder reliability measures and qualitative feedback improved after cycle two testing and evaluation. DISCUSSION: This single site study produced a feasible solution to apply person-centred principles to analyse PREMs data and requires testing in different settings. Cross-disciplinary partnerships enabled the development of a reliable and acceptable deductive coding framework that was usable for people without prior experience in qualitative data analysis. PRACTICAL VALUE: Our solution offers an example for health services to harness the value of qualitative PREMs data and partner with consumers to take person-centric action to improve the safety, equity, and experience of healthcare.

Feasibility study of brief Group Transdiagnostic Cognitive Behavioural Treatment delivered via Zoom for anxiety and depression in primary care.

AIM: To report the feasibility of delivering and the effectiveness of brief Group Transdiagnostic Cognitive Behavioural Therapy (TCBT) via Zoom for anxiety and/or depression in primary care. METHODS: Participants were eligible for this open-label study if their primary care clinician recommended brief psychological intervention for clinically diagnosed anxiety and/or depression. Group TCBT included an individual assessment followed by four x 2-hour manualised therapy sessions. Primary outcome measures assessed recruitment, adherence to treatment and reliable recovery measured using the PHQ-9 and GAD-7. RESULTS: Twenty-two participants received TCBT over three groups. Recruitment and adherence to TCBT met feasibility thresholds for delivering group TCBT via Zoom. Improvements in the PHQ-9, GAD-7 and reliable recovery were present 3 and 6 months following treatment commencement. CONCLUSION: Brief TCBT delivered using Zoom is a feasible treatment for anxiety and depression diagnosed in primary care. Definitive RCTs are required to provide confirmatory evidence of efficacy for brief group TCBT in this setting.

Challenging the distal-to-proximal cannulation technique for administration of anticancer therapies: a prospective cohort study.

BACKGROUND: Distal-to-proximal technique has been recommended for anticancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous venous puncture proximal to the administration site. OBJECTIVES: This study aims to identify if the practice of 24-hour delay between a venous puncture and subsequent cannulation for anticancer therapies at a distal site is necessary for preventing extravasation. METHODS: A prospective cohort study was conducted with 72 outpatients receiving anticancer therapy via an administration site distal to at least 1 previous venous puncture on the same arm in a tertiary cancer center in Australia. Participants were interviewed and assessed at baseline data before treatment and on day 7 for incidence of extravasation/phlebitis. RESULTS: Of 72 participants with 99 occasions of treatment, there was 1 incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and 2 incidents of phlebitis at the administration site. CONCLUSION: A 24-hour delay is unnecessary if an alternative vein can be accessed for anticancer therapy after a proximal venous puncture. IMPLICATIONS FOR PRACTICE: Infiltration can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anticancer therapy at a distal site if the nurse can confidently determine that the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.