Patient Involvement in Decision-Making: An Important Parameter for Better Patient Experience—An Observational Study (STROBE Compliant)

Makkar, Namrata; Jain, Kanika; Siddharth, Vijaydeep; Sarkar, Siddharth

doi:10.1177/2374373518790043

Cited by 10 publications

(4 citation statements)

References 21 publications

(22 reference statements)

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“…When implementing a QI programme, involving patients and their families as members of a multidisciplinary team can empower patients, which is necessary for improved outcomes 61 62. We implemented floor markings, patient recordings of walking distances and their frequencies on whiteboards and used colour-coded flags to empower and motivate patients to perform appropriate activities and mobilisation.…”

Section: Discussionmentioning

confidence: 99%

Enhancing early functional independence following cardiac surgery: a quality improvement programme

Jacob,

Jayaprabha Surendran,

Gupta

et al. 2023

BMJ Open Qual

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Early mobility and activity programmes following cardiac surgery are vital for improved patient outcomes, as they accelerate the recovery of functional capacity and walking distance. We observed that only 5.3% of our patients achieved a Functional Independence Measurement (FIM) score of 80% or more by the third postoperative day (POD). Additionally, the average 6-minute walk distance achieved by the fourth POD was only 188 m. Therefore, a quality improvement (QI) project was implemented with the aim of attaining a FIM score of 80% by the third POD for more than 80% of patient underwent/undergoing cardiac surgery without complications.A model-for-improvement framework was used to drive continuous improvement. This project was implemented in February 2021. Baseline data were prospectively collected between November 2020 and January 2021 (preintervention). Outcomes were analysed using standard control chart rules to detect changes over time. Unpaired Student t-tests assessed significant differences in mean levels between two groups, (preintervention vs postintervention).χ2tests were conducted between the two groups according to gender and patient satisfaction scores.The percentage of patients who achieved a FIM score of 80% or more by the third POD gradually increased to 91.4% 5 months following programme implementation and was sustained thereafter. The mean patient FIM score significantly improved to 81.20±3.77 (p<0.001) by the third POD. Similarly, the mean 6-minute walk distance increased to 267.90±36.10 m (p<0.001) by the fourth POD. The percentage of patients who displayed the level of confidence needed to carry out activities of daily living (ADL) and exercises independently at home increased to 89.4% (p<0.001) by the fifth POD. No adverse events associated with the mobility and activity programme were reported.This QI project demonstrated a substantial improvement in patient functional independence, walking distance and the level of confidence needed to independently carry out ADL and exercises following cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Enhancing early functional independence following cardiac surgery: a quality improvement programme

Jacob,

Jayaprabha Surendran,

Gupta

et al. 2023

BMJ Open Qual

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“…Generally speaking, understanding the patients’ perspective on healthcare is a fundamental requirement of contemporary health service delivery and essential condition to patient-centred care. 7 8 In recent years, to a lesser extent, the impacts of TIVADs on the quality of life, satisfaction and tolerability have been assessed through some quantitative surveys. 9–11 What is more, previous research showed that kinesiophobia, the fear of limb movement after TIVAD implantation, was common in patients with cancer, and it was closely related to the subjective experience of daily activities.…”

Section: Introductionmentioning

confidence: 99%

“…However, aside from these medical problems, patients may need to face psychological and social problems, which will affect their quality of life. Generally speaking, understanding the patients’ perspective on healthcare is a fundamental requirement of contemporary health service delivery and essential condition to patient-centred care 7 8. In recent years, to a lesser extent, the impacts of TIVADs on the quality of life, satisfaction and tolerability have been assessed through some quantitative surveys 9–11.…”

Section: Introductionmentioning

confidence: 99%

Indwelling experience and coping strategies of upper arm infusion ports in patients with cancer: a qualitative study

Wang

Qiu

2023

BMJ Open

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ObjectivesThe upper arm infusion ports have been proven to be advanced and safe, but the experience from the perspective of patients is lacking. This study explored the indwelling experience and coping strategies of upper arm infusion ports in patients with cancer.DesignQualitative exploratory study.SettingThis study was conducted between May 2021 and August 2021 at a level III-A general hospital in Shanghai, China.ParticipantsThe participants, who are patients with cancer implanted with the upper arm infusion ports, included 10 women and 6 men, and the average age was 54.4±8.3 years old.MethodsData were selected from semistructured in-depth interviews and analysed by thematic analysis.ResultsThere were 10 descriptive topics and 4 analytical topics in 2 parts. The indwelling experience includes positive experience (treatment benefit, life convenience) and negative experience (physical discomfort, social anxiety, psychological distress). Coping strategies include emotional-focused strategies (self-acceptance, avoidance and self-protection) and problem-focused strategies (information seeking, functional exercise and remove as soon as possible).ConclusionThe infusion port in the upper arm is beneficial to the safety and quality of life of patients with cancer. At the same time, there are challenges in physical, psychological and social adaptation. Patients respond with some measures, but obstacles may arise during implementation.

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“…Such approaches have increasingly come under scrutiny for regarding the problem as being individual (the patient) rather than systematic (the health system) and the assumption that lifelong medication is the 'gold standard (Grover et al, 2021;Keogh et al, 2022;Novick et al, 2014;Tew et al, 2012). More recent approaches emphasize patients' autonomy, navigating side-effects and symptom alleviation, and the validity of the desire to cease treatment (Grover et al, 2021;Makkar et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Co-creating Mental Health services that prevent a descent into Homelessness

Rajan

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Homelessness is a global issue exacerbated by poverty, forced migration, rapid urbanization, and lack of affordable housing. In India, around 1.8 million people were homeless in the 2011 Census, with many forced to sleep on the streets or in unofficial settlements. The link between homelessness, poverty, and mental illness is complex and uncertain. The increased risk of mental illness from poverty creates a greater risk of homelessness, with approximately 25% of homeless people experiencing serious mental health issues in India. The Poverty, Mental Illness & Homelessness (PMIH) nexus is particularly relevant in India due to its large homeless population, high resource inequalities, and high prevalence of mental illness. This thesis aims to understand the factors influencing homelessness in the population attending the clinic and find ways to leverage them in improving services. It focusses on the experiential knowledge of diverse stakeholders, including primarily women with severe mental illness, and identify pathways otherwise left unseen. By addressing the research gap and focusing on the experiences of women with severe mental illness, the Banyan better solutions may be found to address the complexities of poverty, mental illness, and homelessness in India. The interactive research approach and mixed methods are used to address the persistent problem of PMIH in outpatient clinics. The study focuses on understanding factors of homelessness among people with mental illness and the service needs and usage of those accessing outpatient facilities. It finds that 32.65% of women with mental illness accessing outpatient clinics reported experiencing homelessness, with low educational attainment and relational disruptions being associated with higher odds. Eliminating gender-based differences in education could be a crucial policy and practice direction to reduce homelessness risks among women with mental illness. The study examines the lived experiences of women with mental health issues in Tamil Nadu who have been treated by The Banyan. Six themes related to protective factors against homelessness were identified: resilience emerging from trauma, treatment adherence, responsibility and purpose, family and relationships, spirituality, and employment and living space. 95% felt they were not at risk of becoming homeless, indicating hopefulness about future prospects. However, the majority struggled in terms of quality of life, highlighting the complex relationship between resilience and challenges. In part 2, the study discusses the service needs of clients during the Covid-19 pandemic situation, emphasizing the need for expanding mental health interventions to include individuals with psychosocial disabilities. Social work practitioners play a crucial role in crisis intervention, providing clinical services and coordinating interdepartmental liasoning work. Key recommendations include involving trained community-level workers, involving non-government organizations, creating a single window system for all social protection measures, including mental illness as an eligibility category in disability social protection schemes, and continuing useful mechanisms implemented during the pandemic in the post-pandemic world. In conclusion, this thesis emphasizes the integration of information and reflexive practice in preventing homelessness among vulnerable individuals, emphasizing the importance of social entitlement policies, greater flexibility in support and institutionalization of practices, and exploring the experiences of men and their narratives.

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Patient Involvement in Decision-Making: An Important Parameter for Better Patient Experience—An Observational Study (STROBE Compliant)

Cited by 10 publications

References 21 publications

Enhancing early functional independence following cardiac surgery: a quality improvement programme

Enhancing early functional independence following cardiac surgery: a quality improvement programme

Indwelling experience and coping strategies of upper arm infusion ports in patients with cancer: a qualitative study

Co-creating Mental Health services that prevent a descent into Homelessness

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