Experience or perception: What healthcare providers need when using the Utrecht Symptom Diary-4 Dimensional, a mixed-methods study.

IF 2.7 Q2 HEALTH CARE SCIENCES & SERVICES
Palliative Care and Social Practice Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI:10.1177/26323524241281748
Tom Lormans, Everlien de Graaf, Carlo Leget, Saskia Teunissen
{"title":"Experience or perception: What healthcare providers need when using the Utrecht Symptom Diary-4 Dimensional, a mixed-methods study.","authors":"Tom Lormans, Everlien de Graaf, Carlo Leget, Saskia Teunissen","doi":"10.1177/26323524241281748","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Utrecht Symptom Diary-4 Dimensional (USD-4D), an adaptation of the Edmonton Symptom Assessment System, supports healthcare providers (HCPs) in identifying, monitoring, and exploring multidimensional symptoms and needs of patients in the palliative phase. For the USD-4D to be optimally implemented in clinical palliative care, it is essential to know and understand the needs of HCPs when using it.</p><p><strong>Objective: </strong>To identify and interpret the needs of HCPs when using the USD-4D in clinical palliative care, operationalized as perceived facilitators and barriers.</p><p><strong>Design: </strong>An explanatory mixed-methods study with a sequential design.</p><p><strong>Methods: </strong>Data were collected between October 2019 and September 2020. In phase I, quantitative data were collected through a survey targeting Dutch HCPs working in palliative care. Facilitators were identified as items answered positively by ⩾80% of participants, while barriers were identified as items answered negatively by ⩾20% of participants. In phase II, these identified facilitators and barriers were explored in depth through mixed composition focus groups. The Capability-Opportunity-Motivation-Behavior (COM-B) model was utilized to contextualize and interpret the perceived facilitators and barriers.</p><p><strong>Results: </strong>A total of 122 HCPs completed the survey, with 95% of the respondents being women with a mean age of 48 years and 72% being nurses. Additionally, 53% of the respondents had no prior experience with the USD-4D. In phase II, 21 HCPs participated in focus groups. 95% of the participants were women with a mean age of 49 years and 67% being nurses. HCPs pinpointed facilitators primarily related to the potential benefits of the USD-4D for daily patient care. Conversely, the identified barriers included issues related to HCPs' behavior, knowledge gaps, uncertainty regarding their abilities and attitudes toward the USD-4D, and technical obstacles.</p><p><strong>Conclusion: </strong>Facilitators and barriers across all facets of the COM-B model were recognized, with a notable emphasis on motivational barriers. It should be acknowledged that facilitators and barriers can evolve throughout the implementation process, underscoring the importance of viewing implementation and integration as fluid and continuous endeavors. Facilitators and barriers are closely linked to HCPs' reflective capacities, emphasizing the need for tailored intervention strategies that align with different stages of USD-4D implementation.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241281748"},"PeriodicalIF":2.7000,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528593/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Palliative Care and Social Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/26323524241281748","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The Utrecht Symptom Diary-4 Dimensional (USD-4D), an adaptation of the Edmonton Symptom Assessment System, supports healthcare providers (HCPs) in identifying, monitoring, and exploring multidimensional symptoms and needs of patients in the palliative phase. For the USD-4D to be optimally implemented in clinical palliative care, it is essential to know and understand the needs of HCPs when using it.

Objective: To identify and interpret the needs of HCPs when using the USD-4D in clinical palliative care, operationalized as perceived facilitators and barriers.

Design: An explanatory mixed-methods study with a sequential design.

Methods: Data were collected between October 2019 and September 2020. In phase I, quantitative data were collected through a survey targeting Dutch HCPs working in palliative care. Facilitators were identified as items answered positively by ⩾80% of participants, while barriers were identified as items answered negatively by ⩾20% of participants. In phase II, these identified facilitators and barriers were explored in depth through mixed composition focus groups. The Capability-Opportunity-Motivation-Behavior (COM-B) model was utilized to contextualize and interpret the perceived facilitators and barriers.

Results: A total of 122 HCPs completed the survey, with 95% of the respondents being women with a mean age of 48 years and 72% being nurses. Additionally, 53% of the respondents had no prior experience with the USD-4D. In phase II, 21 HCPs participated in focus groups. 95% of the participants were women with a mean age of 49 years and 67% being nurses. HCPs pinpointed facilitators primarily related to the potential benefits of the USD-4D for daily patient care. Conversely, the identified barriers included issues related to HCPs' behavior, knowledge gaps, uncertainty regarding their abilities and attitudes toward the USD-4D, and technical obstacles.

Conclusion: Facilitators and barriers across all facets of the COM-B model were recognized, with a notable emphasis on motivational barriers. It should be acknowledged that facilitators and barriers can evolve throughout the implementation process, underscoring the importance of viewing implementation and integration as fluid and continuous endeavors. Facilitators and barriers are closely linked to HCPs' reflective capacities, emphasizing the need for tailored intervention strategies that align with different stages of USD-4D implementation.

经验或感知:使用乌得勒支症状日记-4 维度时医疗服务提供者的需求,一项混合方法研究。
背景:乌得勒支症状日记-4维(USD-4D)是对埃德蒙顿症状评估系统(Edmonton Symptom Assessment System)的改编,可帮助医疗服务提供者(HCPs)识别、监测和探索姑息阶段患者的多维症状和需求。要在临床姑息关怀中以最佳方式实施USD-4D,就必须了解和理解医护人员在使用该系统时的需求:目的:确定并解释医护人员在临床姑息关怀中使用USD-4D时的需求,具体表现为感知到的促进因素和障碍:方法:在2019年10月至9月期间收集数据:数据收集时间为 2019 年 10 月至 2020 年 9 月。在第一阶段,通过针对从事姑息治疗的荷兰卫生保健人员的调查收集定量数据。80%的参与者对促进因素的回答是肯定的,而20%的参与者对障碍因素的回答是否定的。在第二阶段,通过混合组成的焦点小组对这些已确定的促进因素和障碍进行了深入探讨。利用能力-机会-动机-行为(COM-B)模型对感知到的促进因素和障碍进行了背景分析和解释:共有 122 名高级保健人员完成了调查,其中 95% 的受访者为女性,平均年龄为 48 岁,72% 的受访者为护士。此外,53% 的受访者以前没有使用过 USD-4D 的经验。在第二阶段,21 名保健医生参加了焦点小组。95% 的参与者为女性,平均年龄为 49 岁,67% 为护士。高级保健人员指出的促进因素主要与 USD-4D 对日常病人护理的潜在益处有关。相反,所发现的障碍包括与 HCPs 行为相关的问题、知识差距、对自己能力的不确定性和对 USD-4D 的态度以及技术障碍:结论:COM-B 模型各方面的促进因素和障碍都得到了认可,其中动机障碍尤为突出。应当承认,在整个实施过程中,促进因素和障碍都会发生变化,这就强调了将实施和整合视为流动和持续努力的重要性。促进因素和障碍与保健专业人员的反思能力密切相关,这就强调了有必要根据实施 USD-4D 的不同阶段制定有针对性的干预策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Palliative Care and Social Practice
Palliative Care and Social Practice Nursing-Advanced and Specialized Nursing
CiteScore
2.90
自引率
0.00%
发文量
37
审稿时长
9 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信