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Development of an educational video to support guideline panels in incorporating patient values and preferences into recommendation-making: qualitative one-on-one interviews and brainstorming meetings

Por: Zeng · L. · Li · R. · Li · S.-A. · Clarissa · S. · Agoritsas · T. · Chen · J. · Li · X. · Vandvik · P. O. · Brignardello-Petersen · R. · Li · X. · Zhang · L. · Guyatt · G.
Objectives

The aim of this study was to develop an educational video introducing an innovative panel survey approach to facilitate guideline panels in making inferences about patient values and preferences.

Design

A user testing of the educational video through one-on-one interviews and iterative refinement of the video through brainstorming meetings.

Setting

Interviews and brainstorming meetings were conducted through Zoom.

Participants

The participants of the interviews include guideline panellists who had used the panel survey approach, and guideline panellists who had not used the approach but would or would not participate in a panel survey soon. The participants of the brainstorming meetings were a steering committee with expertise in guideline methodology and qualitative research.

Primary and secondary outcome measures

The understandability and usefulness of the educational video.

Results

We interviewed 18 guideline panellists from eight different guideline panels, all of whom carefully reviewed the video. Most participants found the video useful in explaining the panel survey approach and its role in incorporating patient values and preferences. Participants suggested improvements, including clarifying key concepts and using plain language instead of technical terminology to make the content more accessible. The major change the steering committee decided to make through brainstorming meetings was to add clarification, refine the wording and replace some text with animation.

Conclusion

User testing resulted in an improved educational video that is more useful and understandable for guideline panellists. Wider implementation of this resource has the potential to enhance the incorporation of patient values and preferences in guideline recommendations, supporting more patient-centred decision-making.

Investigating Person‐Centred Care Planning in Care Homes Across England: An Exploratory Study of Practices and Contextual Factors

ABSTRACT

Aims

To report how person-centred care principles are applied to care planning and to explore the contextual factors affecting their implementation in older adult care homes in England.

Design

A combined framework analysis and quantitative content analysis study.

Methods

Using a semi-structured questionnaire, we interviewed 22 care home managers in England, exploring topics around care planning processes. Audio recordings were transcribed verbatim. Transcripts were analysed through a combined framework approach and content analysis.

Results

Most care home managers discussed person-centred care planning in terms of understanding residents' values and preferences and their engagement in decision-making. Factors facilitating person-centred planning implementation included accessible planning tools, supportive care home leadership, effective communication and collaborative partnerships. Inhibiting factors included regulatory and care practice misalignment, time constraints and adverse staffing conditions.

Conclusion

Differences between care home practitioners' understanding and practice of person-centred care planning require further examination to improve understanding of the sector's complexity and to develop suitable care planning instruments.

Implications for the Profession

Findings demonstrate a need for improved staff access to specialised person-centred care training and an opportunity for care home nursing practitioners to lead the co-development of digital person-centred care planning tools that reflect the reality of long-term care settings.

Impact

Identifying factors influencing the implementation of holistic approaches to care planning makes clear the need for modernising long-term care policy and practice to adapt to the contemporary challenges of the care home sector.

Reporting Method

Study reporting was guided by the Standards for Reporting Qualitative Research.

Patient or Public Contribution

Two public involvement advisors with lived experience of caring for a relative living in a care home contributed to the development of the interview guide, advised on care home engagement, guided the interpretation of the findings and commented on the drafted manuscript.

‘Being an Outsider’ and ‘Being an Insider’: A Focused Ethnography of Family Members' Visitation Experiences in an Adult ICU

ABSTRACT

Aims

To explore how the restricted visitation policy impacts family members' visitation experiences and perceptions in an adult intensive care unit (ICU).

Design

Focused ethnography.

Methods

Data collection included 39 observation sessions (totalling 65.3 h), 19 semi-structured interviews with family members, and document analysis of policies relevant to ICU visitation. Fieldwork was conducted in a general adult ICU at a tertiary hospital in China from April 2021 to December 2021. Data were analysed using reflexive thematic analysis.

Results

Family visitation was represented by ‘being an outsider’ and ‘being an insider.’ ‘Being an outsider’ illustrates that the restricted visitation policy operated as a structural mechanism constructing the ICU as the staff's territory, positioning families as outsiders by limiting their access, information, and involvement in patient care. ‘Being an insider’ captures how family members constructed the waiting area as a socially meaningful family space where they reclaimed presence and formed a supportive community.

Conclusion

Family visitation was shaped by the intersection of structural constraints, culturally embedded family roles, and relational dynamics among families. Restricted visitation policies reinforced family members’ powerlessness and limited their involvement.

Implications for the Profession and/or Patient Care

The findings highlight the need to critically reconsider restricted visitation policies. Flexible, context-sensitive visitation approaches that take into account cultural norms and family roles may better support family involvement in ICUs.

Impact

The study contributes theoretically informed and culturally grounded insights into how the restricted visitation policies function as active structural constraints on family members' visitation experiences. It supports global efforts to develop inclusive, family-centred ICU visitation practices that recognise the structural and relational needs of family members.

Reporting Method

The Standards for Reporting Qualitative Research guidelines were followed.

Patient or Public Contribution

No patient or public contribution.

General Dementia Training for the Social Care Workforce: A Systematic Review

ABSTRACT

Aim

The aim of this systematic review was to assess and synthesize the global evidence on existing general dementia training and education for the social care workforce.

Design

Mixed-methods systematic review.

Data Sources

Systematic searches on five databases (PubMed, APA PsychINFO, CINAHL Plus, Scopus, Web of Science) were conducted for articles published between 2010 and July 2024.

Methods

Each abstract and full text was screened by two research team members, with conflicts of inclusion dissolved by a third team member. Data were extracted and studies narratively synthesized by the group into comparisons of content, delivery mode, workforce and outcomes/impact.

Results

Twenty-seven studies from 13 mainly high-income countries were included in this review. Most studies provided training to care home staff, with studies using remote, in-person and blended training delivery modes. While the focus was on generic dementia education, various interventions have been evidenced in the social care workforce, to different effects. Most changes in outcomes were reported for staff knowledge and confidence, while evidence on impacts on people with dementia is limited and mixed.

Conclusion

There are various types of in-person and remote dementia training available for the social care workforce, with overall positive impacts on knowledge and change in care delivery. Evidenced interventions need to be implemented across countries and have the potential to improve dementia knowledge, particularly in lower- and middle-income countries where evidence and the social care workforce are limited.

Implications for the Profession and/or Patient Care

Findings provide clear recommendations on the value and benefit of diverse dementia training on the social care workforce, care delivery and limited but emerging evidence on service user outcomes. Nurses are key parts of the staff working in social care settings, including care homes and would thus benefit from the identified dementia training.

Patient or Public Contribution

Two former unpaid carers and three voluntary sector staff helped interpret the findings and reviewed drafts of the manuscript. They are co-authors.

An Integrative Review of Response Rates in Nursing Research Utilizing Online Surveys

imageBackground Online surveys in nursing research have both advantages and disadvantages. Reaching a sample and attaining an appropriate response rate is an ongoing challenge and necessitates careful consideration when designing a nursing research study using an online survey approach. Objective In this study, we aimed to explore response rates and survey characteristics of studies by nurse researchers that used online methodologies to survey nurses, nursing students, and nursing faculty. Methods We conducted an integrative review of research studies that used online surveys for data collection published from 2011 to 2021. We examined response rates and survey characteristics such as recruitment method, use of incentives, question type, length of survey, time to complete the survey, and use of reminders. Results Our review included 51 studies published by nurses with target samples of nurses, nursing students, or nursing faculty. Study sample sizes ranged from 48 to 29,283, the number of respondents ranged from 29 to 3,607, and the response rates ranged from 3.4% to 98%, with an average of 42.46%. Few patterns emerged regarding recruitment or other factors to enhance response rates; only five studies used incentives. Conclusion Response rates to online surveys are unlikely to reach the rates seen in older mailed surveys. Researchers need to design online survey studies to be easily accessible, concise, and appealing to participants.
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