ObjectivesThis study compares rapid and traditional analyses of a UK health service evaluation dataset to explore differences in researcher time and consistency of outputs.DesignMixed methods study, quantitatively and qualitatively comparing qualitative methods.SettingData from a home birth service evaluation study in a hospital in the English National Health Service, which took place between October and December 2014. Two research teams independently analysed focus group and interview transcript data: one team used a thematic analysis approach using the framework method, and the second used rapid analysis.ParticipantsHome birth midwives (6), midwifery support workers (4), commissioners (4), managers (6), and community midwives (12) and a patient representative (1) participated in the original study.Primary outcome measuresTime taken to complete analysis in person hours; analysis findings and recommendations matched, partially matched or not matched across the two teams.ResultsRapid analysis data management took less time than thematic analysis (43 hours vs 116.5 hours). Rapid analysis took 100 hours, and thematic analysis took 126.5 hours in total, with interpretation and write up taking much longer in the rapid analysis (52 hours vs 8 hours). Rapid analysis findings overlapped with 79% of thematic analysis findings, and thematic analysis overlapped with 63% of the rapid analysis findings. Rapid analysis recommendations overlapped with 55% of those from the thematic analysis, and thematic analysis overlapped with 59% of the rapid analysis recommendations.ConclusionsRapid analysis delivered a modest time saving. Excessive time to interpret data in rapid analysis in this study may be due to differences between research teams. There was overlap in outputs between approaches, more in findings than recommendations. Rapid analysis may have the potential to deliver valid, timely findings while taking less time. We recommend further comparisons using additional data sets with more similar research teams.
This study aimed to implement and evaluate a work-based personal resilience enhancement intervention for forensic nurses. A mixed methods design consisting of surveys, interviews, and a case study approach, whereby the experiences of a group of nurses were studied in relation to their experiences of an intervention programme to enhance personal resilience, was utilized. Nurses working on forensic inpatient wards were invited to participate. Senior nurses were recruited as mentors. Data were collected via pre-and post-programme surveys to evaluate nurses' levels of resilience. Post-programme interviews were undertaken with nurses and mentors to explore their experiences of the programme. Descriptive statistics of survey data examined changes in nurses' resilience levels pre-and post-intervention. Free-text survey data and interview data were analysed thematically. The SQUIRE 2.0 checklist was adhered to. Twenty-nine nurses participated. Levels of personal resilience (M = 4.12, SD = 0.60) were significantly higher postprogramme than pre-programme (M = 3.42, SD = 0.70), (t49 = 3.80, P = 0.000, 95% CI = 0.32, 1.07). Nurses felt the programme had a marked impact on their personal resilience, selfawareness, confidence, and professional relationships. The benefits of the programme demonstrate the advantages of providing a nurturing environment for nurses to consolidate their resilience levels. Findings demonstrated that resilience enhancement programmes can increase nurses' levels of resilience and confidence and improve inter-professional relationships. Our findings are important for clinicians, nurse managers, and policymakers considering strategies for improving the workplace environment for nurses. The long-term impact of resilience programmes may improve nurse retention and recruitment.
Healthcare professionals must provide adequate time for reassurance and explanations of decision-making. Easy-to-read information regarding appropriate antibiotic usage should be easily accessible for parents.
BackgroundTreatment decision tools have been developed in many fields of medicine, including psychiatry, however benefits for patients have not been sustained once the support is withdrawn. We have developed a web-based computerised clinical decision support tool (CDST), which can provide patients and clinicians with continuous, up-to-date, personalised information about the efficacy and tolerability of competing interventions. To test the feasibility and acceptability of the CDST we conducted a focus group study, aimed to explore the views of clinicians, patients and carers.MethodsThe CDST was developed in Oxford. To tailor treatments at an individual level, the CDST combines the best available evidence from the scientific literature with patient preferences and values, and with patient medical profile to generate personalised clinical recommendations. We conducted three focus groups comprising of three different participant types: consultant psychiatrists, participants with a mental health diagnosis and/or experience of caring for someone with a mental health diagnosis, and primary care practitioners and nurses. Each 1-h focus group started with a short visual demonstration of the CDST. To standardise the discussion during the focus groups, we used the same topic guide that covered themes relating to the acceptability and usability of the CDST. Focus groups were recorded and any identifying participant details were anonymised. Data were analysed thematically and managed using the Framework method and the constant comparative method.ResultsThe focus groups took place in Oxford between October 2016 and January 2017. Overall 31 participants attended (12 consultants, 11 primary care practitioners and 8 patients or carers). The main themes that emerged related to CDST applications in clinical practice, communication, conflicting priorities, record keeping and data management. CDST was considered a useful clinical decision support, with recognised value in promoting clinician-patient collaboration and contributing to the development of personalised medicine. One major benefit of the CDST was perceived to be the open discussion about the possible side-effects of medications. Participants from all the three groups, however, universally commented that the terminology and language presented on the CDST were too medicalised, potentially leading to ethical issues around consent to treatment.ConclusionsThe CDST can improve communication pathways between patients, carers and clinicians, identifying care priorities and providing an up-to-date platform for implementing evidence-based practice, with regard to prescribing practices.
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