Health Expectations最新文献

{"title":"Understanding the Meaning of Loneliness and Social Engagement for the Workings of a Social Network Intervention Connecting People to Resources and Valued Activities","authors":"Rebecca Band, Anne Rogers","doi":"10.1111/hex.70111","DOIUrl":"10.1111/hex.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Addressing loneliness, which is associated with poor mental and physical health, implicates the need for connectivity to a broad set of situated relationships and activities in the contexts of people's everyday lives. Social engagement has been identified as a relevant psychosocial mechanism mediating health and wellness and is central to addressing loneliness. The aim here is to explore the way in which people identified as lonely conceptualise their experiences of loneliness and social engagement for the purposes of incorporating these into the design and workings of an intervention that allows people to map their social networks and connect them to community-based valued activities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured qualitative interviews were undertaken with 20 participants, aged 21–82 years old (mean age 59.7) nested within a pragmatic, community-based randomised controlled trial in the north and south of England. Participants had wide-ranging social network sizes (from 1 to 10 individuals) and reported variable impact of loneliness on their lives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Loneliness consisted as an absence of intimacy in the face of being surrounded by others, a sense of entrapment and boredom, lacking access to meaningful activities and difficulties in relating to others. The analysis highlighted the role that important relationships have in mediating loneliness. Individual readiness, skills and confidence in forming new connections and engaging with new activities are important barriers that exist in overcoming loneliness. For many, wider socio-political factors, such as transport provision, availability of resources and costs associated with social engagement are also important barriers which are difficult to overcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Exploring the link between feelings, experiences and meaning of loneliness and the way in which a network intervention can be incorporated offers a focus for mediating the richness and opportunities that arise from locality-based connections and collective activities in the broader social environment. However, any intervention seeking to address loneliness requires a further focus on both individual and relational factors which might contribute to addressing loneliness and increasing a sense of wellness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The study team ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural Humility in Action: Learning From Refugee and Migrant Women and Healthcare Providers to Improve Maternal Health Services in Australia","authors":"Delia Rambaldini-Gooding, Katarzyna Olcoń, Luke Molloy, Leissa Pitts, Sofia Lema, Eman Baghdadi, Jane Williams, Chris Degeling","doi":"10.1111/hex.70106","DOIUrl":"10.1111/hex.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Access to culturally appropriate healthcare is vital to ensure refugee and migrant women receive optimal care, particularly during the perinatal period. Refugee and migrant women report lower satisfaction with pregnancy care due to language barriers and a perceived lack of understanding of their needs. The aim of this study is to explore how to improve the experiences of migrant and refugee women with maternal health services through the lens of cultural humility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Working collaboratively with maternal health service providers and managers and local refugee and migrant women, this research project used a World Café methodology to provide these stakeholders with an opportunity to discuss maternal healthcare in the region. World Café participants (<i>n</i> = 34) included women from multicultural backgrounds (<i>n</i> = 20), maternal healthcare providers such as midwives, social workers and management (<i>n</i> = 5) multicultural healthcare providers (<i>n</i> = 7) and a community-based birth educator (<i>n</i> = 1). Data were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A key finding of the World Café was the need for staff training that is co-designed and co-delivered with members of multicultural communities and healthcare providers to enhance the practice of cultural humility. Training should focus on women's stories that capture the cultural nuances around pregnancy and birthing, their support needs including trauma-informed care, and the importance of effective cross-cultural communication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This research gave refugee and migrant women a voice in future decision-making, specifically in maternal health staff training. The refugee and migrant women shared their perspectives on how to enhance cultural humility practices in maternity services for them. The research has led to opportunities such as community-based antenatal classes and improvements in maternity services development strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Public Contribution</h3>\u0000 \u0000 <p>The project actively engaged with maternal healthcare providers, multicultural and refugee healthcare providers and women from multicultural communities in the design of the project and as participants. Their expertise and experience have been invaluable and have informed pilot programmes that emerged from this study.</p>\u0000 </section>\u0000","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Key Moments in Type 2 Diabetes Management: A Qualitative Study of the Experiences of People With Type 2 Diabetes and Diabetes Health Coaches","authors":"Jack B. Joyce,&nbsp;Carolyn Newbert,&nbsp;Nicola Guess,&nbsp;Kate Fryer,&nbsp;Caroline A. Mitchell,&nbsp;Liliia Bespala,&nbsp;Elizabeth Morris,&nbsp;Paul Aveyard,&nbsp;Susan A. Jebb,&nbsp;Charlotte Albury","doi":"10.1111/hex.70108","DOIUrl":"10.1111/hex.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>For people with type 2 diabetes who are overweight, weight loss increases the likelihood of achieving diabetes remission. The aim here was to draw on the experiences of people living with type 2 diabetes and coaches who deliver type 2 diabetes prevention and remission programmes. This was done to develop a service that increases the proportion of people who achieve remission by identifying an effective weight management service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Research Design and Methods</h3>\u0000 \u0000 <p>A qualitative researcher and co-researcher with type 2 diabetes conducted 37 narrative interviews with adults with type 2 diabetes (October 2022–June 2023) and 16 semi-structured interviews with health coaches delivering type 2 diabetes programmes in England. Data were analysed using Reflexive Thematic Analysis. Participants were diverse in ethnicity, socioeconomic status, age, gender and years since diabetes diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four themes were generated relating to moments in a person's diabetes care: (1) coming to terms with diagnosis, (2) lightbulb moments, (3) sustaining change as normal and (4) becoming expert/building confidence. These four themes were united under a high-level interpretivist theme: ‘Same journey, different experience’, capturing the mismatch between a linear rigid care pathway described by coaches and the diversity of experience of people living with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Coaches and people with type 2 diabetes are aligned on their reports of key moments in adapting to diabetes. Participants’ desire for flexibility in their care contrasted with coach reports of rigid service provision. These insights may enable more people with type 2 diabetes to engage and adhere to weight management services aimed at diabetes remission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Motivating Implicit Chinese to Express Themselves Is the Biggest Barrier’: A Qualitative Study of Chinese Researchers' Perceptions of Barriers and Facilitators to Patient Engagement in Research","authors":"Lin Yang,&nbsp;Yu-xiao Liu,&nbsp;Bi-xia Wang,&nbsp;Meng-jiao Yu,&nbsp;Wei-Wei Bian,&nbsp;Cai-feng Wang,&nbsp;Hong Ruan","doi":"10.1111/hex.70112","DOIUrl":"10.1111/hex.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patient Engagement in Research (PER) has demonstrated benefits for patients, researchers and research outcomes. However, China lacks substantial experience in implementing PER. The implementation of PER in China faces unique challenges due to social-cultural differences. This study explores the perspectives of Chinese researchers to identify barriers and facilitators, aiming to guide future PER initiatives and enhance the role of patients in research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Purposive sampling was employed to recruit clinical researchers with diverse healthcare backgrounds in China. Semi-structured interviews, conducted by a qualified researcher, followed interview guidelines derived from a literature review and pilot study modifications. Thematic analysis was applied using QSR Nvivo 8.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13 participants were included. Five main themes were identified from interview: (1) selection of patients for research engagement, (2) strategies to alleviate the patient burden in implementing PER, (3) strategies to encourage patients for active expression, (4) benefits to attract patient engagement and (5) researcher's preparation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The cultural trait of ‘reservedness’ in Chinese culture hinders active expression by patients in the research engagement process. Researchers tend to recruit patients with specific characteristics and emphasize the importance of aligning benefits with patient values to motivate engagement. Addressing patient burden is crucial, and researchers should be well-prepared before PER. These findings underscore the necessity of adopting culturally adapted strategies in PER to effectively address specific challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The public participated in the interpretation of the interview results, enriching our understanding of the results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘The Letter Says I May or May Not Be Eligible… It Is a Big Doubt and Frustrating:’ A Qualitative Study on Barriers and Facilitators to Children's Oral Healthcare From the Perspective of Karen Refugee Parents in Victoria","authors":"Sudheer Babu Balla,&nbsp;Jyothi Tadakamadla,&nbsp;Santosh Kumar Tadakamadla","doi":"10.1111/hex.70110","DOIUrl":"10.1111/hex.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Australia has a longstanding tradition of resettling refugees and individuals in humanitarian need. Among these, the Karen community from Southeast Asia is rapidly growing in Australia. The absence of data on the barriers they face in accessing dental services is concerning. This study explores the barriers and facilitators Karen refugees encounter when seeking oral healthcare for their children in Australia, aiming to understand their experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a qualitative research design with a phenomenological approach, we conducted semi-structured interviews with 23 parents (17 females and 6 males) who had been in Australia for 1–17 years. Each interview, lasting between 35 and 60 min, was audio-recorded and transcribed verbatim. The transcripts were thematically analysed through an inductive, data-driven approach, focusing on open coding and participant-based meanings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Nine main themes were identified. At the individual level, cultural practices, parental behaviours and perceptions were the primary barriers. At the organisational level, long waiting lists in the public dental system were significant barriers. Additionally, a lack of knowledge about financial benefits and government support for children's dental care deterred refugees from seeking dental services. The results also highlighted the strengths of support networks, free dental care for children and school-based dental care programmes. Parents reported experiences of inadequate oral healthcare, citing issues such as insufficient cultural sensitivity training among dental service providers, interpreter problems and shortages. These experiences revealed gaps in the provision of oral healthcare services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>When designing tailored oral health promotion programs, all stakeholders must consider the lived experiences of refugees as valuable sources of information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The authors thank the parents and carers from the Karen refugee community for sharing their experiences with the oral healthcare of their children. Recruitment was facilitated by the Karen Organisation of Bendigo and Bendigo Community Health Services. An interpreter from the Karen refugee community assisted in all the interviews.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Barriers and Facilitators to Patients and Members of the Public Contributing to Rapid Health Technology Assessments for NICE: A Qualitative Study","authors":"Eugenie Evelynne Johnson,&nbsp;Debbie Smith,&nbsp;Becky Harmston,&nbsp;Emily Hunter,&nbsp;Emma Belilios,&nbsp;Fiona Pearson","doi":"10.1111/hex.70109","DOIUrl":"10.1111/hex.70109","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Evidence and External Assessment Groups (EAGs) assist in the National Institute of Health and Care Excellence's Technology Appraisal programme by either critiquing evidence provided by companies on different health technologies, or by carrying out an independent search and evaluation of the published evidence. Historically, there has been little patient and public involvement within the work of EAGs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To identify key barriers and facilitators to patient and public involvement in EAG Reports feeding into the National Institute for Health and Care Excellence's Health Technology Appraisal process.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A primary qualitative study consisting of one-to-one interviews with EAG researchers and focus groups with members of the public. From anonymised transcripts, data were deductively coded using a framework analysis against the Theoretical Domains Framework and translated to the COM-B model. Coding was triangulated through inductive thematic analysis, guided by the principles of Braun and Clarke.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ten researchers were interviewed and four focus groups with a total of 26 members of the public were undertaken. Both EAG researchers and the public felt they did not have enough knowledge, time and money to be able to embed patient and public involvement; researchers suggested that patient and public involvement might not be relevant to the scope of their Reports. Members of the public highlighted a lack of awareness of the Technology Appraisal process and that jargon may stop them being involved. Both researchers and members of the public said having specific guidance on how to embed patient and public involvement in EAG Reports would be helpful, including guidance on how to write plain language summaries.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The perspectives of both EAG researchers and members of the public suggest work needs to be conducted to produce frameworks for patient and public involvement and plain language summaries within EAG Reports specifically. Additionally, that further awareness-raising of Technology Appraisals and the role of EAGs would help members of the public to contribute effectively to EAG Reports.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 \u0000 ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Queue: Exploring Waiting Practices in the Stories of Patients With Breast Cancer","authors":"Nada Akrouh,&nbsp;Rik Wehrens,&nbsp;Erna Scholtes,&nbsp;Hester van de Bovenkamp","doi":"10.1111/hex.70086","DOIUrl":"10.1111/hex.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Waiting is an important topic in healthcare debates, mostly discussed in the form of waiting lists and waiting times. In this discourse, the experiential element of waiting stays hidden. Understanding the waiting experiences of patients can help to better understand healthcare waiting practices, which have a large impact on patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a thematic analysis on 12 patients' books of women with breast cancer. We focused on the theme of waiting within these stories, through an abductive analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified three themes within the waiting practices of patients with breast cancer: (1) Thickening of time, (2) contaminated time and (3) navigating time. The theme thickening of time highlights waiting moments where time is experienced as moving at a very slow pace with intense emotional impact. The theme of contaminated time highlights the waiting processes as an ongoing component of experiencing illness. The theme of navigating time highlights patients' temporal agency, showing their waiting work in the form of strategies for dealing with practical and emotional aspects of waiting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The waiting experiences of patients provide insights into the burden of waiting, which is partly connected to the way healthcare services are organised and the experience of illness. Understanding these multifaceted experiences of patients helps pinpoint areas for healthcare quality improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The choice for the theme and approach of this research, waiting, was developed with a citizen science initiative of collecting patient stories.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Decision-Making and Body Mass Index in Australian Antenatal Care: An Exploratory OPTION12 Evaluation","authors":"Madeline Hawke,&nbsp;Linda Sweet,&nbsp;Julie Considine","doi":"10.1111/hex.70107","DOIUrl":"10.1111/hex.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Shared decision-making is recommended as a person-centred approach to decision-making in antenatal care. Little is known about the implementation of shared decision-making in antenatal care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>An exploratory study to understand how shared decision-making is implemented in antenatal clinics and whether body mass index influences maternity clinicians’ use of shared decision-making when providing antenatal care for women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-six antenatal clinic consultations were audio-recorded with maternity clinicians and women with body mass index ≥ 35 kg/m², and a comparison group of women with body mass index 18.5–24.9 kg/m². Data were analysed quantitatively using the OPTION12 scale. Narrative case studies are presented to compare shared decision-making behaviour related to induction of labour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve clinicians and 26 pregnant women were recruited to the study. The total scores ranged from 0 to 24, with a mean score of 9 and a median of 9.5 indicating low implementation of shared decision-making by clinicians and limited involvement of women in decision-making. No difference was observed in OPTION12 scores in decision-making for women by body mass index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that shared decision-making is limited in the antenatal clinic setting for all women, regardless of body mass index. Further research is required to confirm the findings of this exploratory study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The perspectives of women with body mass index ≥ 35 kg/m² informed many aspects of this study including the language/terminology adopted by researchers. A consumer group reviewed the language used in the study materials, to ensure readability and avoidance of stigmatising terminology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumer Involvement in the Design and Development of Medication Safety Interventions or Services in Primary Care: A Scoping Review","authors":"Megan DelDot,&nbsp;Esther Lau,&nbsp;Nicole Rayner,&nbsp;Jean Spinks,&nbsp;Fiona Kelly,&nbsp;Lisa Nissen","doi":"10.1111/hex.70092","DOIUrl":"10.1111/hex.70092","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Medication-related problems remain a significant burden despite the availability of various interventions and services in primary care. Involving health care consumers to design interventions or services across health disciplines is becoming more widely used as this type of engagement reportedly leads to more accessible, acceptable and sustainable health services and quality of life. We conducted a scoping review to examine when and how consumers have been involved in the design and development of medication safety interventions or services within the primary care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We searched five key databases (MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Embase (Elsevier) and Cochrane Library (Wiley)) for relevant articles published up to February 2024. Studies were included if they involved adult consumers (≥ 18 years), their families, carers or the wider community as stakeholders. This review only included studies where the aim was to improve safe and effective medication use, delivered exclusively in primary care. To examine consumer involvement approaches and methods we adapted a framework describing the stages of consumer involvement for the data extraction tool.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Overall, 15 studies were included (comprising 24 articles). Codesign, experience-based codesign, coproduction and participatory action research were commonly used approaches. Meetings, interviews, surveys/questionnaires were commonly used methods. Two studies reported consumer involvement across all stages of the research study, and only one study described the consumer experience of being involved in the research process. The impact of consumer involvement on the effectiveness of these services or interventions was mixed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The potential benefits of consumer involvement in the design and development of medication safety interventions or services may not have been fully maximised, given that genuine consumer involvement across all stages of the research study appears uncommon. More transparent and consistent reporting around the description of consumers involved, their experience of being involved and overall impact and quality of consumer participation is needed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This scoping review was undertaken without consumers, patients, service ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-Creation in Research: Further Reflections From the ‘Co-Creating Safe Spaces’ Project","authors":"Scott J. Fitzpatrick,&nbsp;Heather Lamb,&nbsp;Erin Oldman,&nbsp;Melanie Giugni,&nbsp;Cassandra Chakouch,&nbsp;Alyssa R. Morse,&nbsp;Amelia Gulliver,&nbsp;Erin Stewart,&nbsp;Stride Safe Space and Safe Haven Team,&nbsp;Helen T. Oni,&nbsp;Benn Miller,&nbsp;Bronwen Edwards,&nbsp;Kelly Stewart,&nbsp;Vida Bliokas,&nbsp;Louise A. Ellis,&nbsp;Fiona Shand,&nbsp;Alison L. Calear,&nbsp;Michelle Banfield","doi":"10.1111/hex.70103","DOIUrl":"10.1111/hex.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Applied research using co-creation methods is rarely described or evaluated in detail. Practical evidence of co-creation processes and collaboration effectiveness is needed to better understand its complex and dynamic nature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a case study design and survey method, we assessed processes of co-implementation and co-evaluation grounded in our own experiences from the Co-Creating Safe Spaces project. We examine these in the context of a published systematic framework designed to improve clarity about co-creation processes and report on how co-creation was experienced by collaborative partners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our study showed the interconnectedness between co-implementation and co-evaluation processes and the importance of aligning research with program processes to ensure it is responsive to emergent local needs and problems. Given relatively low levels of researcher embeddedness across sites, service champions played a pivotal role in data collection. Survey findings indicated strong support for a healthy collaboration with some concerns expressed over individual partner's areas of responsibility and ability to deliver on commitments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Co-creation can be a very robust approach to translational research but is a complex endeavour. Ongoing reflexivity and attention to relational aspects support genuine collaboration and provide a foundation for addressing challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>People with lived experience of emotional distress and/or suicidal crisis, including researchers from both academic and non-research backgrounds, service managers, peer workers, carers and advocates, were involved in this research and authored this paper.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"27 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}