1,720,989 research outputs found
Involving users in the development of effective critical care discharge information: a focus group study
Get PDFBackground Discharge from critical care to a general care unit is a difficult period, and more effective information is needed to support patients and their families at this time.Objectives This study sought the views of patients, relatives and health care staff on (1) the most effective methods of delivering critical care discharge information, (2) the required information content of any proposed strategies, (3) the benefits and limitations of any existing strategies, and (4) potential resource implications.Methods In this qualitative focus group study, 11 adult patients, 8 family members, and 23 health care staff in Eng-land took part in 8 focus group interviews at 2 hospitals. The computer software program NVIVO7 was used for thematic analysis of the data.Results Three key themes were identified from the data: (1) considerations related to effective discharge information, (2) goals of critical care discharge information, and (3) resource implications.Conclusions This focus group study provides unique user insight into what influences successful and unsuccessful information giving. Based on real experiences, it adds to the limited international body of current evidence. Findings will be of value in designing future critical care discharge information and identifying the related resource implications
Providing critical care patients with a personalised discharge summary: A questionnaire survey and retrospective analysis exploring feasibility and effectiveness
No full textObjectives: This paper reports on the potential value and feasibility of providing patients with a personalised discharge summary of their critical care stay. Design and methods: Fifty-one patient discharge summaries, written by nurses during a randomised controlled trial, were retrospectively analysed for readability, structure and quality. A questionnaire survey completed by trial patients (n= 42), their relatives (n= 21) and nurses (n= 170) explored user experience and feasibility. Quantitative questionnaire data were analysed descriptively and inferentially; qualitative data were subjected to content analysis. Results: Most completed summaries achieved at least an average readability score and were of an acceptable quality. Motivation, time constraints and competing priorities were identified as key barriers to writing an effective summary; however, in the majority of cases, writing them had taken less than 15. minutes. Questionnaire data support that patient discharge summaries can help patients, relatives and ward nurses better understand and patients accept, what happened in critical care. Conclusion: Patient discharge summaries are likely to be a useful adjunct to existing discharge information, but further work is required to determine when and how they should be provided. With appropriate training and support, it is feasible for nurses to write discharge summaries in a busy critical care environment.</p
User centred critical care discharge information to support early critical illness rehabilitation; development and evaluation using the Medical Research Council’s complex interventions framework
Get PDFObjectives: this paper reports on an intervention designed during an ongoing 2 phase project aimed at improving early critical illness rehabilitation. It focuses specifically on the justification for a newly developed critical care discharge information pack: ‘User Centred Critical care Discharge Information Pack’(UCCDIP). The intervention is described in detail and the chosen research methods are discussed. Background: discharge from critical care to a ward is a difficult time for patients and relatives. Research suggests that effective information has the potential to reduce relocation stress and optimize recovery. Methods: using the Medical Research Council framework for the development and evaluation of complex interventions, a phase I focus group study and collaboration with service users/carers informed the development of a new critical care discharge information pack, currently being evaluated in a phase II Randomised Controlled Trial. Conclusion: UCCDIP acknowledges the patients’ need to understand what they have been through and the progress they have made. It provides for the different information needs of patients and relatives, recognising their physical and psychological vulnerability. Through its use of reflection and participation, UCCDIP has the potential to optimise support of adult patients and their families during early critical illness rehabilitation
The role of pilot testing for a randomised control trial of a complex intervention in critical care
No full textRandomised controlled trials (RCTs) involving diverse population groups in complex health care settings can be difficult to successfully undertake and pose practical and methodological challenges. For this reason, undertaking a pilot study is recommended by the Medical Research Council prior to conducting a definitive trial. This paper reports a pragmatic review of the challenges encountered by the research team during a single centre pilot RCT and discusses how feasible it was to deliver and evaluate a complex intervention in practice. The psycho-social intervention designed for this trial was a ‘user-centred critical care discharge information pack’. The pack was designed to support patients and their families during and after their discharge from a critical care unit. It consisted of two written booklets, one for the patient and one for the family member. In total, 221 patients met our inclusion criteria, of whom 158 (71%) were recruited. The pilot RCT identified important lessons for the design of future trials. Challenges included those associated with the recruitment of potential participants, assessing capacity and obtaining informed consent. Problems with attrition, intervention delivery and the choice of data collection tools and time-points were also apparent. Our findings demonstrate that the evaluation of complex interventions is feasible in clinical practice. The importance of adhering to a robust research protocol, maintaining efficient and effective communication between researchers and clinical staff is emphasised. Findings further support the importance of conducting a pilot study prior to embarking on a definitive RCT.</p
Evaluating the feasibility and effectiveness of a critical care discharge information pack for patients and their families; a pilot cluster randomized controlled trial
No full textObjectivesTo evaluate the feasibility and effectiveness of an information pack, based on self-regulation theory, designed to support patients and their families immediately before, during and after discharge from an intensive care unit. Design and settingProspective assessor-blinded pilot cluster randomized controlled trial (in conjunction with a questionnaire survey of trial participants’ experience) in two intensive care units in England. ParticipantsPatients (+/- a family member) who had spent at least 72 hours in an intensive care unit, declared medically fit for discharge to a general ward.RandomizationCluster randomization (by day of discharge decision) was used to allocate participants to one of three study groups. InterventionA user centred critical care discharge information pack (UCCDIP) containing two booklets; one for the patient (which included a personalized discharge summary) and one for the family, given prior to discharge to the ward. Primary outcomePsychological well-being measured using hospital anxiety and depression scores (HADS), assessed at 5+/-1 days post unit discharge and 28 days/hospital discharge. Statistical significance (p ? 0.05) was determined using Chi Square (?2) and Kruskal Wallis (H).Results One hundred and fifty eight patients were allocated to: intervention (UCCDIP) (n=51), control 1: ad-hoc verbal information (n=59), control 2: booklet published by ICUsteps (n=48). There were no statistically significant differences in the primary outcome. The a priori enrolment goal was not reached and attrition was high. Using HADS as a primary outcome measure, an estimated sample size of 286 is required to power a definitive trial.ConclusionsFindings from this pilot RCT provide important preliminary data regarding the circumstances under which an intervention based on the principles of UCCDIP could be effective, and the sample size required to demonstrate this.<br/
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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