Affective Attitudes Research Articles

Affective bond and attitude towards mathematics in university students of the Peruvian Amazon

Affective bond and attitude towards mathematics in university students of the Peruvian Amazon

Strategies to Strengthen the Affective Domain in Learning Pancasila and Citizenship Education for Class XII Students of MAN 4 Pandeglang

This study aims to determine the strategies to strengthen the affective domain in Civics learning in class XII students and to determine the inhibiting and supporting factors in implementing the affective domain strengthening strategy in Civics learning in class XII students at MAN 4 Pandeglang. This research uses a type of qualitative approach with descriptive methods. The results found were that the strategy of strengthening the affective domain of students used learning models and methods aimed at improving the affective domain of students for the better, such as the habituation model in the form of assignment methods and monitoring good attitudes and behavior of students, exemplary models in the form of method of displaying good attitude and behavior. The strategy to strengthen the affective domain can run well and students can follow and be able to achieve the goals of strengthening the affective domain. Then the way to overcome the obstacles experienced in implementing the strategy to strengthen the affective domain in Civics learning is to use a personal approach to students, especially students whose affective domain or attitude is lacking and also students who experience difficulties in learning.

THE ABC’s OF STUDENT DISPOSITIONS TOWARDS WRITTEN FEEDBACK IN ESL CLASSROOMS IN ACCRA METROPOLIS, GHANA

Educators and researchers interested in the development of second language learners’ writing skills place premium on how feedback is provided and the crucial role student attitudes play in determining the efficacy of feedback in the execution of L2 writing instruction. In line with this standpoint, the current study investigates the affective, behavioral, and cognitive dimensions of student dispositions towards written feedback in English composition classrooms in senior high schools in the Accra Metropolis in Ghana. The study was based on Eagly and Chaiken’s (1998) ABC model of attitude. Following a sequential explanatory design, 12 students each from the 5 major programs in each school were sampled from 2 each of Categories A, B, and C schools to respond to questionnaires. Afterward, 36 of these students were purposively sampled to take part in interviews. Statistical Package for the Social Sciences was used to analyze the quantitative data generating means and standard deviations. Also, the interview data were thematically analyzed. The findings show that students generally have positive cognitive, affective, and behavioral attitudes towards teacher direct and unfocused feedback but have negative attitudes towards peer feedback and teacher indirect and focused feedback. From these findings, it is suggested that English language teachers in Ghanaian ESL classrooms should carefully consider the attitudes of their students in determining the use of written feedback in order to optimize the impact of the feedback on the development of the writing proficiencies of the students.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0269/a.php" alt="Hit counter" /></p>

THE ACCEPTABILITY, FEASIBILITY & APPROPRIATENESS OF A NOVEL BIOMARKER-GUIDED QUALITY IMPROVEMENT TREATMENT BUNDLE FOR PATIENTS WITH SUBCLINICAL ACUTE KIDNEY INJURY AFTER CARDIAC SURGERY

<h3>Objective</h3> Urinary cell cycle arrest biomarkers TIMP-2 & IGFBP7 are predictive for subsequent KDIGO-defined AKI, & diagnostic for subclinical AKI, after cardiac surgery. Early identification of a subclinical disease state allows implementation of renal protective measures, which reduce subsequent KDIGO-defined moderate–severe AKI. Following an innovation project, using biomarkers to guide use of a renal care bundle, we sought to assess the acceptability, feasibility & appropriateness of the intervention amongst clinicians. <h3>Design & Method</h3> If [TIMP-2]x[IGFBP7]>0.30ng/ml)2/1000 in cardiac patients 2h after ICU admission, they received a renal care bundle of: nephrotoxin cessation, advanced haemodynamic monitoring & protocolised optimisation, 12hrly serum creatinine & fluid balance, avoidance of hyperglycaemia, avoidance of radiocontrast agents, discontinuation of ACE inhibitors, & avoidance of starch/gelatine/chloride-rich solutions. Following conclusion of the project, the medical, surgical & nursing staff were surveyed to gauge acceptability of this assessment-intervention bundle. Two frameworks of acceptability were assessed. Questions based around Weiner's framework of acceptability elicited responses on a scale of high (5) to low degree (1) of acceptability, feasibility and appropriateness. The individual domains of Sekhon's acceptability score were assessed using separate questions, with an average percentage of agreement assigned to each domain (affective attitude, ethical consequence, patient & user experience, burden of intervention, intention and opportunity cost), before assessing correlation with general acceptability. <h3>Results</h3> Cardiac ICU nurses (63.2%; n=12), cardiothoracic surgeons (10.5%; n=2) and cardiac anaesthesiologists/intensivists (26.3%; n=5) were surveyed, with 89.5% (n=17) completing all questions. Across the four measures of acceptability, an average 83.8% of respondents assigned positive acceptable responses (4-5) with an average of 82.4% indicating a high degree of feasibility (4-5) and 85.3% reported the highest degrees (4-5) of appropriateness. For the Sekhon acceptability scale, there was 83.5% general acceptability. For the highest-scoring domains, strong correlation was seen between general acceptability and affective attitude (82.4%; R=0.79, p<0.001), and moderate correlation for user (81.2%; R=0.69, p=0.002) & patient (83.5%; R=0.65, p=0.005) experience, with weaker correlation for ethical consequences (83.5%; R=0.33, p=0.2). For those domains with lower degrees of acceptability, the domain of intention was moderately correlated with overall acceptability (71.8%; R=0.41, p=0.1), and burden (68.2%; R=0.38, p=0.14) and opportunity costs (69.4%; R=0.3, p=0.24) were weakly correlated. <h3>Conclusions</h3> Using validated metrics of acceptability, feasibility and appropriateness, the suitability of this assessment-intervention bundle was confirmed amongst the multidisciplinary team. The high degree of general acceptability was contributed to by the affective attitude of adoption, and by user & patient experience. Staff awareness of the burden and opportunity costs involved did not appear to be prohibitively negative.

Effect of a Hands-On Chemistry Intervention on the behavioural and effective attitudes of learners from low socio-economic high schools

This research focused on the effect that three easily accessible, cost-effective, and hands-on chemistry experiments which are aligned to Curriculum Assessment Policy Statements (CAPS), had on Grade 9 learners from low socio-economic high schools. These experiments were conducted in an after-school science club format at two quintile-1 high schools situated in Gqeberha, South Africa. The learners' behavioural and affective attitudes were examined using group interviews (n = 6) and a survey (n = 61). The findings from this study showed that learners wanted to share knowledge with their peers and community after learning new scientific skills at the science-club. Learners also recognized the economic and practical importance of science related careers. Responses revealed that learners lose interest if the science does not actively connect or engage with their current circumstances. This study also showed that learners were further motivated to pursue studies in Physical Science in Grades 10 to 12.

AN ANALYSIS OF STUDENTS’ ATTITUDE IN LEARNING ENGLISH AT ELEVENTH GRADE OF SMA NEGERI 2 GU

The problem in this study was how were the students’ attitude in learning English at eleventh grade of SMA Negeri 2 Gu? This study aimed at determining and identifying students’ attitude in learning English in the eleventh grade of SMA Negeri 2 Gu. The design of this study was a descriptive qualitative. Subjects of the research were fifteen students of eleventh grade at SMA Negeri 2 Gu. Techniquies of data collection in this study were questionnaire and interviw. Techniques of data analysis used were data reduction, data display and conclusion. The result showed thwt te students had positive attitude in learning English, which consisted of aspect of cognitive attitude, aspect of affective attitude and aspect of behavior attitude. In all aspects students’ attitude were in the good category. Based on three aspects of attitudes, the most dominant aspect of attitude was the affective attitude aspect.

Does public policy affect attitudes? Evidence from age-based health insurance coverage policies in the United States

The existing literature provides evidence that public opinion and attitudes often affect public policy. However, little is known about how public policy might affect attitudes and norms. I present new evidence on this topic by using age-based health insurance policies in the United States as natural experiments. I first exploit the discrete drop in insurance coverage rates at age 26 due to the Affordable Care Act’s dependent coverage mandate and show that this policy is associated with statistically significant deterioration in attitudes towards the necessity of health insurance among young adults who are affected by this policy the most. Next, I show that gaining health insurance at 65 due to the onset of Medicare does not have a significant impact on attitudes towards health insurance among the elderly. These findings are widespread across different demographic groups, robust under alternative model specifications, and observed only after the policies are adopted.

Advancing cluster randomised trials in children’s therapy: a survey of the acceptability of trial behaviours to therapists and parents

BackgroundRandomised controlled trials of non-pharmacological interventions in children’s therapy are rare. This is, in part, due to the challenges of the acceptability of common trial designs to therapists and service users. This study investigated the acceptability of participation in cluster randomised controlled trials to therapists and service users.MethodsA national electronic survey of UK occupational therapists, physiotherapists, speech and language therapists, service managers, and parents of children who use their services. Participants were recruited by NHS Trusts sharing a link to an online questionnaire with children’s therapists in their Trust and with parents via Trust social media channels. National professional and parent networks also recruited to the survey. We aimed for a sample size of 325 therapists, 30 service managers, and 60 parents. Trial participation was operationalised as three behaviours undertaken by both therapists and parents: agreeing to take part in a trial, discussing a trial, and sharing information with a research team. Acceptability of the behaviours was measured using an online questionnaire based on the Theoretical Framework of Acceptability constructs: affective attitude, self-efficacy, and burden. The general acceptability of trials was measured using the acceptability constructs of intervention coherence and perceived effectiveness. Data were collected from June to September 2020. Numerical data were analysed using descriptive statistics and textual data by descriptive summary.ResultsA total of 345 survey responses were recorded. Following exclusions, 249 therapists and 40 parents provided data which was 69.6% (289/415) of the target sample size. It was not possible to track the number of people invited to take the survey nor those who viewed, but did not complete, the online questionnaire for calculation of response rates. A completion rate (participants who completed the last page of the survey divided by the participants who completed the first, mandatory, page of the survey) of 42.9% was achieved. Of the three specified trial behaviours, 140/249 (56.2%) therapists were least confident about agreeing to take part in a trial. Therapists (135/249, 52.6%) reported some confidence they could discuss a trial with a parent and child at an appointment. One hundred twenty of 249 (48.2%) therapists reported confidence in sharing information with a research team through questionnaires and interviews or sharing routine health data. Therapists (140/249, 56.2%) felt that taking part in the trial would take a lot of effort and resources. Support and resources, confidence with intervention allocation, and sense of control and professional autonomy over clinical practice were factors that positively affected the acceptability of trials. Of the 40 parents, twelve provided complete data. Most parents (18/40, 45%) agreed that it was clear how trials improve children’s therapies and outcomes and that a cluster randomised trial made sense to them in their therapy situation (12/29, 30%).ConclusionsUsing trials to evaluate therapy interventions is, in principle, acceptable to therapists, but their willingness to participate in trials is variable. The willingness to participate may be particularly influenced by their views related to the burden associated with trials, intervention allocation, and professional autonomy.

Bi-dimensional values and attitudes toward online fast food-buying intention during the COVID-19 pandemic: An application of VAB model.

The purpose of the study is to determine the factors of online fast food-buying intention among Bangladeshi Millennials during the COVID-19 pandemic. The study adopted the Value-Attitude-Behavior (VAB) model and designed it as a higher-order constructs model to predict buying intention. Using a quantitative method (i.e., cross-sectional survey), data was collected from 325 respondents via a structured questionnaire and subsequently analyzed using Structural Equation Modeling (SEM) through AMOS software. The findings of the study revealed that convenience and food quality generate utilitarian values, while subjective norms and novelty-seeking form hedonic values. Also, utilitarian and hedonic values significantly affect cognitive and affective attitudes. As opposed to food quality, the cognitive attitude, affective attitude, self-identity, and subjective norms were observed to affect behavioral intention, with affective attitude producing the strongest association, albeit with the high explanatory power of the model. Consequently, this study offers a number of theoretical and policy implications to design better interventions that address public health regarding fast food consumption.

Psychometric properties of the Spanish version of the Weight Self-Stigma Questionnaire (S-WSSQ) in a sample of participants with obesity seeking weight loss treatment

PurposeWeight self-stigma may be defined as a self-devaluation due to one’s identification with the group of people with obesity. The Weight Self-Stigma Questionnaire (WSSQ) is an instrument specifically designed to measure weight self-stigma in populations with overweight or obesity. The objective of this study was to adapt the WSSQ to the Spanish population (S-WSSQ) following the guidelines for cross-cultural adaptations.MethodsThe sample comprised 165 participants with obesity seeking weight loss treatment (65% women) at the “Hospital de Valme” (Seville, Spain). Scales to measure life satisfaction, self-esteem, positive and negative affect, and antifat attitudes were used to analyze the convergent and divergent validity of the S-WSSQ.ResultsA confirmatory factor analysis showed adequate values of the goodness of fit indexes of a two-factor model (χ2/df = 2.01 CFI = 0.92, IFI = 0.92, SRMR = 0.08, RMSEA = 0.078), replicating the structure found by the original authors. Cronbach’s alphas of the two factors were 0.76 (self-devaluation) and 0.77 (fear of enacted stigma). Composite Reliability values were 0.72 (self-devaluation) and 0.76 (fear of enacted stigma). Self-devaluation and fear of enacted stigma were negatively related to self-esteem, and positive affect, and positively related to negative affect and antifat attitudes. Finally, life satisfaction was negatively correlated to fear of enacted stigma.ConclusionsBased on these results, it is concluded that the S-WSSQ has good psychometric properties and might be used by the Spanish-speaking scientific community to measure weight self-stigma.Level of evidenceLevel V, descriptive study.

Inwiefern sind philosophische Erfahrungen epistemisch transformativ?

AbstractDrawing on Laurie A. Paul’s notion of “transformative experience”, this paper explores transformative philosophical experiences and analyses the structure of the attitude underlying them. It is argued that these experiences have to be explained not in cognitive terms but as a change in our affective attitude. More precisely, these experiences lead us to feel values in a novel manner. However, in order to make the philosophical experience epistemically transformative and provide a new perspective from which we can acquire new philosophical insights, this feeling of value must meet certain moral conditions such as being open, humble and aware of possible self-deceptive tendencies. Since affectivity is central to the person we are, epistemically transformative experiences in philosophy go hand in hand with personal transformation.

Potential conflict as an opportunity for coexistence: cosmovision and attitudes of Arhuaco people towards jaguars

Human responses to alterations caused by wildlife in human livelihoods depend on psychological and cultural factors, in addition to tangible factors. The ideas of transforming the discourse of conflict into a vision of coexistence, as well as of promoting a dialogue between science and ancestral knowledge, have been increasingly valued in biodiversity conservation. In ten communities of the Arhuaco people (Sierra Nevada de Santa Marta, Colombia), we qualitatively explored the role of the jaguar (Panthera onca) and its main prey (deer, peccary and paca) in the Arhuaco cosmovision, as well as how these people interpret and manage the alterations caused by these species on their livelihood from a cultural perspective. We evaluated quantitatively their cognitive, affective, and behavioral attitudes towards coexistence with these species. Our findings show that attitudes towards coexistence with the jaguar and its main prey were significantly more positive among those who have been affected by wildlife (i.e., livestock depredation and crop consumption) or who, according to their occupation (ranchers-farmers), have a higher risk of being affected. These attitudes could be better understood in light of the principles of the Arhuaco cosmovision, that have a profoundly ecological ethic, in which the jaguar plays a primordial role in the spiritual, cosmogonic, and natural order. Guaranteeing the protection of Arhuaco culture and territory could be very valuable for the conservation of the jaguar and biodiversity in the ecoregion of the Sierra Nevada de Santa Marta.

Vietnamese Teachers’ Attitudes Toward English as a Lingua Franca (ELF) and Classroom EFL Teaching Practices

This paper reports high school teachers’ attitudes toward English as a lingua franca (ELF) and their classroom EFL teaching practices in a province in Vietnam. This mixed-methods study involved 109 high school teachers from 11 high schools in answering the questionnaires, and 22 of them were invited for semi-structured interviews. The findings indicated that high school teachers had positive attitudes toward ELF in three attitude components, including cognitive, affective, and behavioral attitudes. Additionally, they integrated activities for the promotion of ELF to their students in relation to eight sub-variables from cultural knowledge, vocabulary, pronunciation, and grammar to four language skills of students. Although facing difficulties in designing activities for ELF promotion, high school teachers still tried their best to introduce the existence of ELF and help their students accessible to the use of ELF in language learning. This study featured some limitations, but it can be of reference for the research context and other similar ones.

Reflecting on physical activity across 2 years of the COVID-19 pandemic: Predictors of intention-behavior profiles.

The COVID-19 pandemic has affected how many people engage in regular moderate-to-vigorous intensity physical activity (MVPA). The purpose of this study was to predict current and dynamic (across 2 years of the pandemic) intention and MVPA profiles using the multi-process action control (M-PAC) framework. A representative sample of 977 English-speaking Canadians (18 + years) completed measures of reflective (instrumental attitude, affective attitude, perceived capability, and opportunity), regulatory (planning and self-monitoring), and reflexive (habit and identity) processes, intention, and MVPA. These measures included current assessments and reflections prior to the COVID-19 restrictions. Three current intention-behavior profiles (nonintenders, unsuccessful intenders, and successful intenders) and five dynamic intention-MVPA by prepandemic MVPA profiles (consistent nonintenders, relapsed nonintenders, consistent unsuccessful intenders, relapsed unsuccessful intenders, and consistent successful intenders) emerged from these data, showing few increased MVPA across the pandemic. The current and dynamic profiles were subsequently predicted by changes in specific reflective, regulatory, and reflexive processes across the pandemic; however, only change in identity was the critical predictor of successful MVPA engagement in the dynamic 2-year MVPA profiles. Collectively, the findings support the joint promotion of reflective, regulatory, and reflexive processes in the choice of behavior change techniques to promote postpandemic MVPA intention and behavior.

The relationships between attitudes, personal characteristics and behaviour of stockpeople on dairy goat farms

AbstractThe aim of this study was to investigate the human-animal relationship on dairy goat farms, in particular associations between stockpeople's attitudes towards goats(Capra hircus)and actual behaviour when handling goats and making decisions. Data were collected on 45 Austrian and German dairy goat farms. Attitude questionnaires of 119 stockpeople (58 female, 61 male) were analysed and 14 attitude components were extracted by five Principal Component Analyses (PCA) regarding general attitudes about goats and human-animal relationship, behavioural attitudes about specific human-goat interactions and interactions during milking, and affective attitudes. To investigate associations between stockpeople's attitudes and their subsequent behaviour, we calculated linear and logistic regression analysis on their behaviour during milking (n = 53 milkers) and on management decisions (n = 45 farms). Several attitude components were predictors of behaviour during milking. The attitude‘Needs of goats’was included in all models: the higher stock-people scored on‘Needs of goats’, the more positive interactions they showed and the less likely they were to use negative interactions. Gender influenced five attitude components: females showing greater agreement than males on positive general and affective attitudes, eg‘Needs of goats.’Regarding management, the more strongly decision-makers disagreed on using negative interactions during milking, the better was their farm's housing and management. To conclude, these results highlight the importance of the stock-people's attitudes, not only for the interactions with their animals, but also for their decisions related to management and housing. Our results indicate opportunities for improvement of animal welfare by training specifically targeting stockpeople's attitudes.

Evaluation of a Health Care Worker Training Intervention to Improve the Early Diagnosis and Referral of Childhood Cancers in Ghana: A Qualitative Descriptive Study.

This study sought to (1) evaluate the perceived effectiveness of an early childhood cancer warning signs and symptoms (EWSS) training intervention on health care worker (HCW) knowledge, attitudes, and clinical practice; (2) evaluate the ease of implementation of training received, including potential barriers and facilitators; and (3) provide insights into program improvements for future iterations of the intervention. Using a qualitative descriptive study design, we conducted in-depth, semistructured interviews with 23 purposively sampled Ghanaian HCW recipients of the EWSS training intervention. We undertook iterative thematic analysis of data concurrently with interviews and used a modified version of the theoretical framework of acceptability to guide the evaluation of the training intervention. We identified six themes-affective attitude, burden, intervention coherence, perceived effectiveness, self-efficacy, and quality improvement-that structure participant perceptions of the effectiveness of the EWSS training. Participants generally had a positive attitude to the training intervention, found the content relatively easy to understand, and communicated the positive impacts of the training on their day-to-day practice. However, they also identified patient- and system-level challenges to the real-world implementation of intervention components, including patients' cultural and religious beliefs about illnesses, patients' financial constraints, and inadequately funded health systems. Our findings suggest that although an HCW-focused training intervention has the potential to improve timely diagnosis and referral for childhood cancers in Ghana and comparable health system contexts, complementary interventions to address patient- and system-level implementation challenges are required to translate improvements in HCW knowledge to sustained impact on health outcomes for children with cancer.

Factors Affecting Consumers Intentions to Purchase Dairy Products in Pakistan: A Cognitive Affective-Attitude Approach

Non-communicable diseases have increased globally, forcing consumers to consider their diets. One of the greatest diets to minimize NCDs is dairy products, but researchers have paid little attention to consumer buying intentions, especially in underdeveloped countries like Pakistan. As a result, researchers in Pakistan looked into how distinct utilitarian and hedonic attributes of dairy products influenced customer intentions. A cognitive-affective attitude approach based on the SOR model was used to construct a comprehensive conceptual model to better comprehend customers’ intentions about dairy products. Students at the university were given a self-administered questionnaire. In order to evaluate the hypotheses, a sample of 411 customers was analyzed using PLS-SEM. Results revealed that utilitarian and hedonic attributes positively influence consumers’ cognitive and affective attitudes, which ultimately leads to consumer purchasing intention to buy dairy products in Pakistan. This research depicts some unique insights for dairy product producers, marketers, and researchers.

Affective Attitudes in the Face of the COVID-19 Pandemic: The Dynamics of Negative Emotions and a Sense of Threat in Poles in the First Wave of the Pandemic.

For millions of people, the COVID-19 pandemic situation and its accompanying restrictions have been a source of threat and confrontation with negative emotions. The pandemic's universal and long-term character, as well as the ensuing drastic limitation of control over one's life, have made it necessary to work out adaptive strategies that would reduce negative experiences and eventually lead to the restoration of well-being. The aim of this research was to identify strategies that people use in response to a long-term threat that restore affective balance and a subjective sense of security. We registered selected manifestations of affective reactions to the pandemic situation. The researchers focused on the dynamics of changes in the areas of (1) experienced negative emotions (asked in an indirect way) and (2) a subjective feeling of threat regarding the pandemic (in three different contexts: Poland, Europe, and worldwide) during the first phase of the pandemic in Poland. It was expected that both the negative emotions and the sense of threat would decrease with time. In addition, it was anticipated that the physical distance would modify the assessment of the situation as threatening depending on the geographical proximity: in Poland, Europe, and worldwide. We used the mixed quasi-experimental design in the series of four studies conducted by Internet in March, May, June, and July 2020. The intensity of negative emotions and the sense of threat caused by the pandemic situation in Poland, Europe, and worldwide were measured. Despite the objective number of confirmed COVID-19 cases during each of the stages of the study, both the intensity of emotions attributed by participants as well as the feeling of threat were found to have decreased. In addition, surprisingly, a reversed effect of the distance was revealed: namely, a sense of threat experienced towards distant locations (Europe and the world) was found to be more acute when compared with the threat experienced in Poland. The obtained results are interpreted as a manifestation of adaptive perception of the threat that lies beyond one's control, which takes the form of unconscious, biased distortions: unrealistic optimism. The decrease in the intensity of negative emotions explains unrealistic absolute optimism, while the perception of the situation in Poland as less threatening than in Europe and around the world is predicted by unrealistic comparative optimism.

Transforming Children's Live Experiences with Species into Conservation Willingness: The Mediating Roles of Biodiversity Knowledge and Affective Attitudes

&lt;p style="text-align:justify"&gt;The loss of direct experiences with nature among today's children is of concern as it affects their conservation willingness (CW). While little is known about the influence of live experiences on CW, much less is known about how these events are related. This study aimed to examine the serial mediating effects of biodiversity knowledge (BK) and affective attitudes (AA) on the relationship between live experiences with species and CW. An online questionnaire was administered to 429 school children (11-12 years) in the Maldives. A two-serial mediation analysis revealed that live experiences exerted significant negative direct and positive indirect effects on CW. Thus, although a predictive sequential pathway from live experiences to BK to AA to CW was confirmed, partial mediation involving other mediators or moderators is likely. The direct effects of live experiences on BK and AA and of BK on AA suggest that experiential learning that stimulates AA is necessary to achieve overall positive impacts on CW. Therefore, educators and policymakers are critical in providing first-hand experiences to instill positive biodiversity conservation traits in children, enabling successful education for sustainable development and long-term biodiversity conservation.&lt;/p&gt;

Understanding factors that could influence patient acceptability of the use of the PINCER intervention in primary care: A qualitative exploration using the Theoretical Framework of Acceptability.

IntroductionMedication errors are an important cause of morbidity and mortality. The pharmacist-led IT-based intervention to reduce clinically important medication errors (PINCER) intervention was shown to reduce medication errors when tested in a cluster randomised controlled trial and when implemented across one region of England. Now that it has been rolled out nationally, and to enhance findings from evaluations with staff and stakeholders, this paper is the first to report patients’ perceived acceptability on the use of PINCER in primary care and proposes suggestions on how delivery of PINCER related care could be delivered in a way that is acceptable and not unnecessarily burdensome.MethodsA total of 46 participants living with long-term health conditions who had experience of medication reviews and/or monitoring were recruited through patient participant groups and social media. Semi-structured, qualitative interviews and focus groups were conducted face-to-face or via telephone. A thematic analysis was conducted and findings mapped to the constructs of the Theoretical Framework of Acceptability (TFA).ResultsTwo themes were identified and interpreted within the most relevant TFA construct: Perceptions on the purpose and components of PINCER (Affective Attitude and Intervention Coherence) and Perceived patient implications (Burden and Self-efficacy). Overall perceptions on PINCER were positive with participants showing good understanding of the components. Access to medication reviews, which PINCER related care can involve, was reported to be limited and a lack of consistency in practitioners delivering reviews was considered challenging, as was lack of communication between primary care and other health-care providers. Patients thought it would be helpful if medication reviews and prescription renewal times were synchronised. Remote medication review consultations were more convenient for some but viewed as a barrier to communication by others. It was acknowledged that some patients may be more resistant to change and more willing to accept changes initiated by general practitioners.ConclusionsParticipants found the concept of PINCER acceptable; however, acceptability could be improved if awareness on the role of primary care pharmacists is raised and patient-pharmacist relationships enhanced. Being transparent with communication and delivering streamlined and consistent but flexible PINCER related care is recommended.