Abstract:Aims and objectives
To explore the healthcare professionals (HCP) experience of providing care coordination to people living with multimorbidity.
Background
There is increasing interest in improving care of people living with multimorbidity who need care coordination to help manage their health. Little is known about the experiences of HCP working with people living with multimorbidity.
Design
Phenomenological approach to understanding the experiences of HCP.
Methods
We interviewed 18 HCP, including 11 registe… Show more
“…[by focussing on the person]…..it’s not about what we need to achieve, but it's about what they want out of their life and their health and all that…’. (Peart et al, 2020, page 6)‘… it’s probably the first time in my career that I actually feel that we are really doing patient‐centred [care]. It’s about them, it’s not about the system, or the funding, or anything like that.…”
Section: Resultsmentioning
confidence: 99%
“…It’s actually more focused on the patient and their whole life’. (Peart et al, 2020, page 6) ‘absolutely but the role of nurse [is] pivotal in bringing it all together and providing continuity of care…..caring for the whole person when services, specialities and pathways are fragmented’. (O’Conner et al, 2018, page 6)…”
Aims and objectives
To identify and synthesise the available qualitative evidence on nurses’ perceptions and beliefs related to the care of adults living with multimorbidity.
Background
The rising prevalence of adults living with multimorbidity has increased demand for health care and challenges nursing care. No review has been conducted to date of the studies of nurses’ perceptions and beliefs related to the provision of care to guide policy makers, practitioners and further research to identify and deliver quality care for persons living with multimorbidity.
Design
Systematic review of qualitative studies conducted in line with the PRISMA checklist.
Methodology
Eight electronic publication databases and sources of grey literature were searched to identify original qualitative studies of the experience of nurses caring for adults with multiple chronic conditions with no restrictions on the date of publication or study context. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data were extracted using the Joanna Briggs Institute standardised data extraction tool for qualitative research. Data synthesis was undertaken through meta‐aggregation.
Results
Eleven qualitative studies were included in the review. All studies met eight or more of the 10 assessment criteria of the JBI Critical Appraisal Checklist for Qualitative Research. Four synthesised findings were generated from the aggregated findings: (i) the challenge of providing nursing care; (ii) the need to deliver holistic and person‐centred nursing care; (iii) the importance of developing a therapeutic nurse–patient relationship, and (iv) delivering nursing care as part of an interprofessional care team.
Conclusions
The complexity of multimorbidity and the predominant single‐disease model of chronic care present challenges for the delivery of nursing care to adults living with multimorbidity.
Relevance to clinical practice
The nursing care of persons with multimorbidity needs to incorporate holistic assessment and person‐centred care principles as part of a collaborative and interprofessional team approach.
PROSPERO Registration
CRD42020186773.
“…[by focussing on the person]…..it’s not about what we need to achieve, but it's about what they want out of their life and their health and all that…’. (Peart et al, 2020, page 6)‘… it’s probably the first time in my career that I actually feel that we are really doing patient‐centred [care]. It’s about them, it’s not about the system, or the funding, or anything like that.…”
Section: Resultsmentioning
confidence: 99%
“…It’s actually more focused on the patient and their whole life’. (Peart et al, 2020, page 6) ‘absolutely but the role of nurse [is] pivotal in bringing it all together and providing continuity of care…..caring for the whole person when services, specialities and pathways are fragmented’. (O’Conner et al, 2018, page 6)…”
Aims and objectives
To identify and synthesise the available qualitative evidence on nurses’ perceptions and beliefs related to the care of adults living with multimorbidity.
Background
The rising prevalence of adults living with multimorbidity has increased demand for health care and challenges nursing care. No review has been conducted to date of the studies of nurses’ perceptions and beliefs related to the provision of care to guide policy makers, practitioners and further research to identify and deliver quality care for persons living with multimorbidity.
Design
Systematic review of qualitative studies conducted in line with the PRISMA checklist.
Methodology
Eight electronic publication databases and sources of grey literature were searched to identify original qualitative studies of the experience of nurses caring for adults with multiple chronic conditions with no restrictions on the date of publication or study context. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data were extracted using the Joanna Briggs Institute standardised data extraction tool for qualitative research. Data synthesis was undertaken through meta‐aggregation.
Results
Eleven qualitative studies were included in the review. All studies met eight or more of the 10 assessment criteria of the JBI Critical Appraisal Checklist for Qualitative Research. Four synthesised findings were generated from the aggregated findings: (i) the challenge of providing nursing care; (ii) the need to deliver holistic and person‐centred nursing care; (iii) the importance of developing a therapeutic nurse–patient relationship, and (iv) delivering nursing care as part of an interprofessional care team.
Conclusions
The complexity of multimorbidity and the predominant single‐disease model of chronic care present challenges for the delivery of nursing care to adults living with multimorbidity.
Relevance to clinical practice
The nursing care of persons with multimorbidity needs to incorporate holistic assessment and person‐centred care principles as part of a collaborative and interprofessional team approach.
PROSPERO Registration
CRD42020186773.
“…Many IPA studies have considered the sample size of 1, 4, 9, 15 and more as a respondent (Smith and Osborn, 2008). Many authors have used IPA in their research work across many disciplines concepts such as spiritualty (Agarwal et al, 2020), elearning (Phutela and Dwivedi, 2020), whistleblowing (Chaudhary et al, 2019); Gupta and Chaudhary (2017), research (Saini and Chaudhary, 2019), genderism (Farmer and Byrd, 2015), emotions (Gill, 2015) and health sciences (Peart et al, 2020;Smith, 2011). In this research, IPA is used to understand the barriers faced in online teaching and assessments during the era of COVID-19 where lockdown had made teachers teach and conduct the assessment in their home environment settings.…”
Purpose
In India, the COVID-19 outbreak has been declared an epidemic in all its states and union territories. To combat COVID-19, lockdown was imposed on March 25, 2020 which has adversely affected the education system in the country. It has changed the traditional education system to the educational technologies (EdTechs) model, where teaching and assessments are conducted online. This paper aims to identify the barriers faced by teachers during online teaching and assessment in different home environment settings in India.
Design/methodology/approach
Interpretative phenomenological analysis (IPA) of qualitative research methodology has been used in this research. The study was conducted among the teachers working in the government and private universities of Uttarakhand, India. Semi-structured in-depth interviews were conducted among 19 teachers to collect data regarding the barriers faced by them during online teaching and assessment. ATLAS.ti, version 8 was used to analyze the interview data.
Findings
The findings revealed four categories of barriers that are faced by teachers during online teaching and assessments. Under home environment settings, a lack of basic facilities, external distraction and family interruption during teaching and conducting assessments were major issues reported. Institutional support barriers such as the budget for purchasing advanced technologies, a lack of training, a lack of technical support and a lack of clarity and direction were also reported. Teachers also faced technical difficulties. The difficulties were grouped under a lack of technical support, it included a lack of technical infrastructure, limited awareness of online teaching platforms and security concerns. Teachers’ personal problems including a lack of technical knowledge, negative attitude, course integration with technology and a lack of motivation are identified as the fourth category to damper their engagement in online teaching and assessments.
Practical implications
The findings of the study can be helpful to the regulatory authorities and employers of higher education institutions who are planning to adopt online teaching as a regular activity in the future. The insights gained from the findings can help them to revisit their existing policy frameworks by designing new strategies and technical structures to assist their teachers in successfully embracing the EdTech to deal with any crisis in the future.
Originality/value
Many authors have conducted research to address the problems faced by students related to online teaching and learning during COVID-19 in India. To the best of the authors’ knowledge, this is the first study that addresses the challenges faced by teachers during the online teaching and assessment in the home environment settings by using qualitative analysis (IPA) techniques. The current study replenishes the gap by contributing to the literature of online teaching and assessment under the home environment settings during the pandemic situation.
“… 5 The commonality between case management and multidisciplinary care team approaches like HARP, PAC and RIR is they are transitional care coordination programmes designed to assist patients as they journey through a fragmented healthcare system. 6 Transitional care programmes lie at the intersection between hospital-based care and primary and community-based services. Patients are often enrolled in these transitional care programmes just before or during discharge from hospital and they can act as a post-discharge service.…”
ObjectivesTo explore the experiences of health professionals involved in delivering a multidisciplinary Community Care programme that provides a transitional care coordination service for patients visiting a tertiary hospital service in Melbourne, Australia.DesignReflexive thematic analysis was used to identify themes from descriptions of delivering the programme, including its perceived strengths and challenges.Participants12 healthcare professionals from four disciplines working in the Community Care programme were interviewed.ResultsFour themes were identified: (1) ‘increasingly complex’, depicts the experience of delivering care to patients with increasingly complex health needs; (2) ‘plugging unexpected gaps’, describes meeting patient’s healthcare needs; (3) ‘disconnected’, explains system-based issues which made participants feel disconnected from the wider health service; (4) ‘a misunderstood programme’, illustrates that a poor understanding of the programme within the health service is a barrier to patient enrolment which may have been exacerbated by a service name change.ConclusionsThe healthcare professionals involved in this study described the experience of providing care to patients as challenging, but felt they made a positive difference. By unravelling the patients’ health problems in context of their surroundings, they were able to recognise the increasingly complex patients’ health needs. The disconnection they faced to integrate within the wider healthcare system made their role at times difficult. This disconnection was partly contributed to by the fact that they felt the programme was misunderstood.
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