Analysis Of Free-text Comments Research Articles

Solihull Approach training in undergraduate midwifery education: a pilot study

Background/Aims To date, Solihull training for midwives in Northern Ireland has been facilitated as continuing professional development; however, incorporating Solihull Approach Antenatal Foundation Training in undergraduate midwifery education has been recommended. The aim of this pilot study was to evaluate the provision of this training for undergraduate midwifery students. Methods This mixed-method evaluation study used pre- and post-test questionnaires with a purposive sample of 24 final year midwifery students. The data were analysed using descriptive statistics with thematic analysis of free text comments. Results Four themes emerged: perceived benefits in clinical practice; increased knowledge and confidence; increased recognition of the public health role of the midwife; and integration and timing of the training. Conclusions The innovative initiative was positively evaluated and considered an enhancement to current education provision. However, the initiative would have been welcomed earlier in the education programme. Implications for practice Solihull Approach training will be provided at undergraduate level and introduced earlier in the programme, with the subsequent potential to incrementally build on this foundation and include further tiers of training. The impact of students' application of the Solihull Approach in clinical practice warrants further investigation.

Constructing and validating authentic assessments: the case of a new technology-based assessment of economic literacy

BackgroundAuthentic situations are considered a source of learning due to their real world relevance. This can encourage learners to acquire new knowledge. Increasing digitisation and associated resources, such as professional development opportunities for teachers, technology tools, or digital equipment for schools enable the development and implementation of authentic assessments. The basic academic principles for acquiring economic literacy are already provided in lower secondary school. This article examines, using the example of a new authentic technology-based assessment (TBA)—Economic Literacy—Assessing the Status Quo in Grade 8 (ECON 2022) -, the processes involved in constructing a TBA. The purpose is to develop a curricular valid measurement instrument for surveying the current state of economic literacy in the 8th grade of a German federal state. This study explores which economic competencies students—typically between 14 and 15 years of age—possess in Grade 8, and what level of competence can therefore be expected of them at the beginning of a vocational training programme. The assessment is geared toward the curriculum of the subject of economics and is based on a domain model. This article presents the background and construction process for the development of ECON 2022 as a TBA.MethodsTo check the validity of test construction with a focus on the implementation of the authentic assessment and an analysis of difficulty-generating characteristics, the ECON 2022 test items were validated with an expert survey (N = 25). The two-stage data analysis comprised a descriptive quantifying analysis of the rating from the difficulty-generating characteristics specificity, cognitive demand and modelling and the design criterion authenticity. A set of experts rated the criteria. The expert survey was then compared with a previously conducted rating by the research team. The analysis of free-text comments on individual items was carried out discursively and qualitatively by the research team. Both sources of information were used to adapt the test items to measured item difficulties from the field test. For this purpose, items of great difficulty were changed to slightly easier items. In this context, the paper focuses on two central research questions: - How does the authenticity of a test environment relate to difficulty-generating criteria at item level? - Does the authenticity of a test environment have an impact on test results?ResultsResults are as follows. (1) The ECON 2022 assessment offers an example of a test design in which the use of TBAs can support innovative and interactive item development. (2) Using the ECON 2022 assessment enabled the implementation of an assessment of economic literacy using authentic situations and the mapping of different facets of economic competence. (3) The validation study showed that the actual item difficulty did not correlate significantly with the authenticity of the assessment, and authenticity thus did not contribute to item difficulty.ConclusionThe results of the study show that we were successful in developing an authentic TBA in ECON 2022. ECON 2022 allows us to examine economic literacy in schools with a high degree of curricular validity and relevance and to analyse what level of competence and knowledge can be expected of students when they enter a vocational training occupation.

Case-based learning with a twist: Testing the effectiveness of integrated case-based learning in an undergraduate dental curriculum

Introduction: Integrated Case-based learning (i-CBL) is a variation of traditional case-based learning in which integrated cases are developed to emulate real-life scenarios that healthcare practitioners encounter in everyday practice. This study explores the effectiveness and relative success of i-CBL pedagogy in an undergraduate dental curriculum.
 Objective: To assess the impact of the i-CBL as a pedagogical strategy in an undergraduate dental curriculum..
 Methodology: i-CBL was introduced in three years of a Bachelor of Dental Surgery (BDS) program. Cases based on integrated modules in the curriculum were developed and vetted by trained faculty. Students were also introduced to the i-CBL concept, and their detailed online feedback was taken on completing each i-CBL session in their academic year. Descriptive and analytic statistics were used for the Likert response data, and thematic analysis was conducted for the free text items. 
 Results: Eighty-three feedback questionnaires were collected from students throughout the year (18.2% first year, 47.5% second Year and 34.3% third Year). There was a significant difference in the students' perceptions regarding the conduct of the i-CBL over the three BDS years (p=0.00). However, there was no significant difference in their delivery by the concerned tutors (p=0.468) and the scenario construct (p=0.55). Thematic analysis of free text comments also highlighted overall student satisfaction with the i-CBL pedagogy.
 Conclusion: This study highlights the value of introducing i-CBL. More focus on faculty training and the development of appropriate cases will be helpful for effective student learning.

Czech women's experiences with maternity care – analysis of free text comments

Czech women's experiences with maternity care – analysis of free text comments

What do bereaved relatives of cancer patients dying in hospital want to tell us? Analysis of free-text comments from the International Care of the Dying Evaluation (i-CODE) survey: a mixed methods approach

PurposeWe conducted an international survey of bereaved relatives of cancer patients dying in hospitals in seven countries, with the aim to assess and improve the quality of care. The survey used the i-CODE (International Care of the Dying Evaluation) questionnaire. Here, we report findings from the free-text comments submitted with the questionnaires. We explored for topic areas which would potentially be important for improving the quality of care. Further, we examined who reported free-texts and in what way, to reduce bias without ignoring the function the free-texts may have for those contributing.MethodsWe used a combined qualitative-quantitative approach: logistic regression analysis to study the effect of respondents’ socio-demographic characteristics on the probability of free-texts contributions and thematic analysis to understand the free-text meaning. The primary survey outcomes, (1) how frequently the dying person was treated with dignity and respect and (2) support for the relative, were related to free-text content.ResultsIn total, 914 questionnaires were submitted; 457/914 (50%) contained free-text comments. We found no socio-demographic differences between the respondents providing free-texts and those who did not. We discovered different types of free-texts (“feedback,” “narrative,” “self-revelation”) containing themes of which “continuity of care,” “the one person who can make a difference,” and “the importance of being a companion to the dying” represent care dimensions supplementing the questionnaire items. A free-text type of grateful feedback was associated with well perceived support for the relative.ConclusionBereaved relatives used the free-texts to report details related to i-CODE items and to dimensions otherwise not represented. They highlighted the importance of the perceived support from human interaction between staff and the dying patient and themselves; and that more than professional competence alone, personal, meaningful interactions have profound importance.

Pharmacy students' experience of technology-enhanced learning during the COVID-19 pandemic

BackgroundWith the advent of the COVID-19 pandemic, pharmacy students and educators experienced an abrupt shift as programmes that were previously taught exclusively in-person were then predominantly taught online. This sudden change provided little time for students to prepare for the new learning environment. ObjectivesThe study objective was to explore pharmacy students' experiences of technology-enhanced learning during the COVID-19 pandemic. MethodsA cross-sectional survey was developed and distributed by email to all 3rd year (N = 76) and 4th year (N = 68) pharmacy students undertaking an MPharm programme in an Irish university. ResultsA total of 32 responses were collected, including 20 third year and 12 fourth year pharmacy students (response rates of 26.3% and 17.6%, respectively). The majority of respondents reported good or very good internet speed (71%) and stability (59%). Almost all were confident or very confident using Canvas (97%) prior to the onset of online learning. Respondents preferred engaging with other students in-person rather than online for coursework (68.8%) and learning new material (56.3%). Students favoured face-to-face delivery, with a recording of the session available online afterwards, for lectures (68.8%), workshops (50%) and tutorials (56.3%). Analysis of free-text comments indicates that respondents used recorded content to support exam revision and that a key drawback of online learning was social isolation. ImplicationsPharmacy students favoured a blended learning approach, with in-person learning being recorded to support study and revision. Students' experience of TEL during the pandemic should be considered in the development and ongoing review of pharmacy programmes.

Partnership between academics and practitioners – Addressing the challenges in forensic science

This research discusses the development of academic-practitioner partnerships in forensic science and examines the opinions and experience of those involved in the field. An anonymous online survey was completed by 56 participants who work in the field of forensic science. The questions related to their work experience, their experience of research and partnership, and their opinions on the benefits and barriers that exist. The results were analysed using a mixed methods approach, with quantitative analysis of the responses to closed questions using two-way chi-square statistical analysis, and qualitative analysis of the free text responses using reflexive thematic analysis. This work identifies the demand for partnership, the perceived benefits and barriers that exist, and establishes how the role of the participant (academic, pracademic or practitioner) impacts their view of partnership. We include the term pracademic to mean an individual who has worked as a practitioner and an academic, not necessarily simultaneously. Quantitative analysis identified that there was very little statistically significant difference in the responses between groups. Pracademics considered that ‘institutional and cultural’ and ‘lack of the respect of the other role’ were more significant barriers than the other groups. Association was also found between those with greater experience of research and the view that partnership ‘improved legitimacy in practice’ and ‘increased legitimacy of research’. There was also statistical significance in those with more than average experience of partnership who identified ‘improved legitimacy in practice’ as a benefit of partnership.Reflexive thematic analysis of free text comments identified a need and demand for partnership with three key themes developed as being necessary for successful partnership. These are the ‘three ‘R’s’ – the need for effective communication and the development of a Relationship; the Relevance of the partnership to the participants role; and the inclusion of personal Reward such as improved practice or better research.

"You can't touch, you can't bond": Exploring COVID-19 pandemic impacts on rheumatoid arthritis patient goals and communication with clinicians.

"You can't touch, you can't bond": Exploring COVID-19 pandemic impacts on rheumatoid arthritis patient goals and communication with clinicians.

A qualitative analysis of free text comments of participants from a massive open online mindfulness course.

IntroductionMindfulness-based interventions are associated with improved health and wellbeing. Online mindfulness interventions offer potential scalability and cost advantages over face-to-face interventions. However, little is known about the experiences of learners, what they identify as being helpful to developing a practice of mindfulness and what outcomes they experience from undertaking an online mindfulness program.MethodsThe Mindfulness for Wellbeing and Peak Performance Massive Open Online Course is a 4-week mindfulness program which includes psychoeducation, mindfulness meditation, applications and moderated discussion forums. Of the 3,335 participants who completed the March 2020 course, 527 (16%) responded to the final forum which invited participants to describe the highlights of the course. In order to enhance understanding of participant experiences and perceived outcomes of undertaking the course, a qualitative analysis of these free text comments was conducted using reflexive thematic analysis.ResultsTwo overarching themes were identified: (1) internal mechanisms of developing mindfulness (subthemes: paying attention to the present moment, learning to let go and find acceptance, cultivating an attitude of gentleness, and learning through a sense of belonging) and (2) the translation of mindfulness into daily living (subthemes: mindfulness being a support to mental wellbeing, learning to deal with uncertainty and adversity, living a more conscious life, a greater connection with self and others and channeling attention into productivity).DiscussionThe themes and subthemes provided insights into the mechanisms learners used to develop mindfulness and how they translated mindfulness into their lives in a variety of beneficial ways. This understanding of learners' experiences could inform delivery of future online mindfulness interventions.

Enhancing medication risk communication in developing countries: a cross-sectional survey among doctors and pharmacists in Malaysia

BackgroundMedication risk communication is essential to ensure the safe use of medicines. However, very few nations worldwide have established effective risk communication systems. To date, the effectiveness of risk communication among healthcare professionals in Malaysia has never been evaluated. Our study aimed to (i) evaluate doctors’ and pharmacists’ awareness of regulatory risk communication methods; (ii) identify factors predicting the usefulness of these methods; and (iii) compare respondents’ preferences for risk communication to outline suggestions for enhancement.MethodsWe conducted a nationwide cross-sectional survey covering four commonly used risk communications, namely a national drug bulletin, safety alerts, Direct Healthcare Professional Communication letters (DHPCs), and educational materials. Multiple logistic regression analysis was used to determine the association between independent variables and the usefulness of risk communication. We performed qualitative analysis of free-text responses to gain insights on respondents’ perspectives on risk communication.ResultsOf the 1146 responses received, 650 were from pharmacists (56.7%). Among the four methods surveyed, 71.5% of respondents were aware of educational materials, while awareness of the other three methods ranged from 20.7 to 53.9%. Pharmacists had higher awareness of all four methods compared to doctors. Private sector respondents were more aware of DHPCs compared to those from the public sector. The strongest predictors for finding risk communication useful were being a pharmacist [odds ratio (OR) = 18.2; 95% CI: 10.98–30.07; p < 0.001], having ≥30 years’ work experience [OR = 4.9; 95% CI: 1.98–12.08; p < 0.001], and working in the pharmaceutical industry [OR = 4.6; 95% CI: 1.08–19.72; p = 0.039]. Both doctors and pharmacists preferred risk communication in the English-language and electronic format. However, other preferences differed between the professions and sectors. Analysis of free-text comments revealed five core themes to guide risk communication enhancement strategies.ConclusionsRisk communication awareness differed between public and private sector doctors and pharmacists depending on communication source. Integrating our findings with the theory of effective communication, we provide suggestions for developing strategic plans on enhancing risk communication. Public-private sector collaboration is key in ensuring risk communication effectiveness.

Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018–2019

ObjectivesIn response to increasing incidence of scarlet fever and wider outbreaks of group A streptococcal infections in London, we aimed to characterise the epidemiology, symptoms, management and consequences of scarlet...

Abstract 11386: Self-Service Analysis of Best Practice Alert Acknowledgement Comments as a Method for Evaluation Reveals Opportunities for Optimization of Clinical Decision Support for Patients with Prolonged QT Syndrome

Introduction: The main goal of Clinical Decision Support (CDS) is to provide timely and useful information for providers to deliver high-quality and safe care. Issues, like alert fatigue and provider burnout are commonly cited as unintended consequences of the CDS systems. Herein, we describe leveraging electronic health record (EHR) self-service reporting tools to gain insights on a CDS rule designed to avoid providers from ordering QT-prolonging medication in patients with history of QT-prolongation. Methods: Our EHR (Epic) SlicerDicer reporting tool was used to identify the frequency of QT-prolongation Best Practice Advisory (BPA) triggerings from 1/1/2020 to 12/31/2020 across Mayo Clinic sites. Additionally, associated patient encounter and BPA-specific data were queried. Text from acknowledgement comments to the BPA were reviewed and central themes and comments were categorized. Epic Clarity Data Warehouse was queried to identify the BPA-triggering medications and frequencies. Comparisons of percent action taken on the BPA were compared internally to Mayo Clinic’s BPA benchmark, and with national benchmarks using Epic BestPractice Pulse dashboard. Results: A total of 17,538 BPAs of interest were triggered across the Mayo Clinic sites in 2020, of which 3,696 (20.1%) were acted upon through either monitoring or medication discontinuation. This is below Mayo Clinic’s median of 29.2% for inpatient BPAs and 45.6% BPAs for outpatient, but above the national median of 10% (IQR 6.1-13.1%) for inpatient and 10% (IQR 4.3-19.5%) for outpatient BPAs actioned upon. A total of 30 different medications triggered the BPA, with the most common being ondansetron (41.5%), amiodarone (11.3%), and haloperidol (10.1%). User comments were left on 2,382 orders (13.5%) that acknowledged the BPA, but provided argument to prescribe drug. Three most common themes identified from comments on overridden BPAs: patient previously tolerated medication (19.0%), QT interval not prolonged on recent ECG (14.2%), and patient on hospice care (5.2%). Conclusion: Analysis of free text comments of CDS can be and should be performed to reveal opportunities for further improvement of CDS. Providers should be encouraged to provide comments when encountering CDS interventions.

Termination of wanted pregnancy and suicidal ideation in hyperemesis gravidarum: A mixed methods study.

BackgroundDifficulty accessing medication and poor patient experience have been implicated as risk factors for termination of pregnancy and suicidal ideation in women with hyperemesis gravidarum. We aimed to gain further insight into these factors in order to further inform and improve patient care.MethodsWe performed a sub-analysis on quantitative data generated through a UK-wide survey of 5071 participants. A qualitative analysis of free text comments was performed using an inductive thematic approach.Results41.2% % of women taking prescribed medications had to actively request them. ‘Extremely poor’ or ‘poor’ experiences were described in 39.4% and 30.0% of participants in primary and secondary care respectively. Protective factors for termination of pregnancy and suicidal ideation include holistic support from family, friends and healthcare providers.ConclusionOptimal care in hyperemesis gravidarum should incorporate timely access to pharmacotherapy, assessment of mental health, consideration of referral to specialist services and care being delivered in a compassionate manner.

"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.

In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for dealing with desire to die in everyday clinical practice. Between 01/2018 and 03/2018, a two-round Delphi survey was carried out with national (German) and international palliative care experts. Free text comments were reinvestigated to identify controversies surrounding the desire to die phenomenon. An additional in-depth analysis focused on statements expressing attitudes towards proactively addressing (potential) desires to die. Within the Delphi survey, 103 of 149 multi-professional participants (almost all of them with practical and only six with exclusively theoretical expertise in palliative care) generated 444 free text comments. Thereof, we identified three main categories related to dealing with desire to die: “outer framework“, “extended care system” and “health-professional-patient-relationship”. Ambivalences, taboos and uncertainties surrounding desire to die in palliative care became apparent. Experts are divided concerning the practice of proactively addressing desire to die. Even if these conversations–especially the proactive approach–are also viewed critically, we conclude that open-ended and respectful communication about desire to die between health professionals and patients can be understood as an eligible intervention in palliative care. Proactively addressing the topic is a possible way to open up such conversations.

Prohibit, Protect, or Adapt? The Changing Role of Volunteers in Palliative and Hospice Care Services During the COVID-19 Pandemic. A Multinational Survey (Covpall).

Volunteers are common within palliative care services, and provide support that enhances care quality. The support they provided, and any role changes, during the coronavirus disease 2019 (COVID-19) pandemic are unknown. The aim of this study is to understand volunteer deployment and activities within palliative care services, and to identify what may affect any changes in volunteer service provision, during the COVID-19 pandemic. Multi-national online survey disseminated via key stakeholders to specialist palliative care services, completed by lead clinicians. Data collected on volunteer roles, deployment, and changes in volunteer engagement. Analysis included descriptive statistics, a multivariable logistic regression, and analysis of free-text comments using a content analysis approach. 458 respondents: 277 UK, 85 rest of Europe, and 95 rest of the world. 68.5% indicated volunteer use pre-COVID-19 across a number of roles (from 458): direct patient facing support (58.7%), indirect support (52.0%), back office (48.5%) and fundraising (45.6%). 11% had volunteers with COVID-19. Of those responding to a question on change in volunteer deployment (328 of 458) most (256/328, 78%) indicated less or much less use of volunteers. Less use of volunteers was associated with being an in-patient hospice, (odds ratio [OR]=0.15, 95% CI=0.07-0.3, P<.001). This reduction in volunteers was felt to protect potentially vulnerable volunteers, with policy changes preventing volunteer support. However, adapting was also seen where new roles were created, or existing roles pivoted to provide virtual support. Volunteers were mostly prevented from supporting many forms of palliative care which may have quality and safety implications given their previously central roles. Volunteer re-deployment plans are needed that take a more considered approach, using volunteers more flexibly to enhance care while ensuring safe working practices. Consideration needs to be given to widening the volunteer base away from those who may be considered to be most vulnerable to COVID-19.

Medical Interactive Recovery Assistant: a useful clinical tool in paediatric shoulder rehabilitation?

Background/aims Outpatient physical therapy is the mainstay of treatment in shoulder instability, but lack of motivation and intermittent monitoring of progress is associated with poor compliance. ‘Exergames’ (a combination of videogames and physical exercise) may provide an additional or alternative motivational factor. The aim of this study was to determine the applicability of the Medical Interactive Recovery Assistant Xbox Kinect gaming software in the management of adolescent atraumatic shoulder instability. Methods Patients completed six 30-minute sessions playing games using the Medical Interactive Recovery Assistant while participating in a therapy programme. Pain and fatigue questionnaires, functional assessments and a framework analysis of free-text comments were used. Results A total of 20 female patients (15 unilateral, five bilateral pathology, mean age 14.1 years) completed the sessions. An average session length was 10.8 mins (range 0–24 mins). After each session using the Medical Interactive Recovery Assistant, 80% were neither in pain, nor overly tired. At 2 weeks, the Stanmore Percentage of Normal Shoulder Assessment scores had improved by a mean 17.9% and 10 (50%) patients showed improvements in Oxford Shoulder Instability Scores. Overall, 15 participants (75%) liked the technology; however six (32%) preferred standard physiotherapy, because of software limitations and lack of personal interaction. Conclusions Medical Interactive Recovery Assistant gamification is applicable for this patient cohort and could be integrated into adolescent atraumatic shoulder instability rehabilitation programmes; however, results emphasise the importance of personal contact.

Developing a differential attainment e-learning course for consultants who supervise trainees within Oxleas NHS Foundation Trust

AimsTo create an e-learning course to promote awareness of differential attainment and encourage supervisors to reflect on their own experiences and practice.MethodFunding was gained from Health Education England to create the e-learning course. A questionnaire was constructed to gauge baseline knowledge and attitudes towards differential attainment amongst the consultant body. All consultants attending a local Faculty Day were asked to respond, and following this an explorative discussion on the topic was chaired by the authors. The results of the survey were collated and free-text answers were coded thematically. In parallel, information from academic publications and professional resources was gathered and summarised. A script was created with support from web developers Kineo and was refined over several drafts. The e-learning module was published on the Oxleas learning environment on the 10th February 2021.Result34 supervisors responded to our questionnaire. 75% had heard of DA, with 45% identifying personal experience of it. However only 35% identified it as a problem in their work place and 39% did not consider it in their clinical practice. Thematic analysis of free text comments revealed three main themes – emotions and experiences associated with differential attainment, a desire for increased training and a desire for more open discussions with struggling trainees. Some answers also revealed poor or incomplete understanding of the topic.From the questionnaire and the literature, four key areas were identified – defining differential attainment, describing the scope of the problem, challenging misconceptions about differential attainment and the role of the social network in attainment. These four areas became section titles for the e-learning course.ConclusionThere is an appetite for information pertaining to differential attainment amongst our consultant body. A trainer facing e-learning course was created to promote awareness and reflection on current practice. Evaluation of the impact of the module is ongoing. The course is being shared with the confederation of South London local education providers.

Researchers\u2019 perceptions of malaria eradication: findings from a mixed-methods analysis of a large online survey

BackgroundThe value of malaria eradication, the permanent reduction to zero of the worldwide incidence of malaria infection caused by human malaria parasites, would be enormous. However, the expected value of an investment in an intended, but uncertain, outcome hinges on the probability of, and time until, its fulfilment. Though the long-term benefits of global malaria eradication promise to be large, the upfront costs and uncertainty regarding feasibility and timeframe make it difficult for policymakers and researchers to forecast the return on investment.MethodsA large online survey of 844 peer-reviewed malaria researchers of different scientific backgrounds administered in order to estimate the probability and time frame of eradication. Adjustments were made for potential selection bias, and thematic analysis of free text comments was carried out.ResultsThe average perceived likelihood of global eradication among malaria researchers approximates the number of years into the future: approximately 10% of researchers believe that eradication will occur in the next 10 years, 30% believe it will occur in the next 30 years, and half believe eradication will require 50 years or more. Researchers who gave free form comments highlighted systemic challenges and the need for innovation as chief among obstacles to achieving global malaria eradication.ConclusionsThe findings highlight the difficulty and complexity of malaria eradication, and can be used in prospective cost–benefit analyses to inform stakeholders regarding the likely return on eradication-specific investments.

Factors affecting quality of end-of-life hospital care - a qualitative analysis of free text comments from the i-CODE survey in Norway

BackgroundThe ERANet-LAC CODE (Care Of the Dying Evaluation) international survey assessed quality of care for dying cancer patients in seven countries, by use of the i-CODE questionnaire completed by bereaved relatives. The aim of this sub study was to explore which factors improve or reduce quality of end-of-life (EOL) care from Norwegian relatives’ point of view, as expressed in free text comments.Methods194 relatives of cancer patients dying in seven Norwegian hospitals completed the i-CODE questionnaire 6–8 weeks after bereavement; recruitment period 14 months; response rate 58%. Responders were similar to non-responders in terms of demographic details.104 participants (58% spouse/partner) added free text comments, which were analyzed by systematic text condensation.ResultsOf the 104 comments, 45% contained negative descriptions, 27% positive and 23% mixed. 78% described previous experiences, whereas 22% alluded to the last 2 days of life. 64% of the comments represented medical/surgical/oncological wards and 36% palliative care units. Four main categories were developed from the free text comments: 1) Participants described how attentive care towards the practical needs of patients and relatives promoted dignity at the end of life, which could easily be lost when this awareness was missing. 2) They experienced that lack of staff, care continuity, professional competence or healthcare service coordination caused uncertainty and poor symptom alleviation. 3) Inadequate information to patient and family members generated unpredictable and distressing final illness trajectories. 4) Availability and professional support from healthcare providers created safety and enhanced coping in a difficult situation.ConclusionsOur findings suggest that hospitals caring for cancer patients at the end of life and their relatives, should systematically identify and attend to practical needs, as well as address important organizational issues. Education of staff members ought to emphasize how professional conduct and communication fundamentally affect patient care and relatives’ coping.

EHealth and telemedicine: Practices and beliefs among healthcare professionals and medical students at a medical university.

Digitalization affects almost every aspect of modern daily life including healthcare delivery. Successful adoption and sustainable integration of information technology-based eHealth and telemedicine concepts in clinical practice depend on constant evaluation of end user needs, proficiencies, and preferences. We therefore assessed how current and future healthcare professionals perceived health technology solutions and whether their perceptions differed. We conducted an online survey among a purposive sample of employees and students at the Medical University of Vienna, Austria. The structured questionnaire collected self-reported practices and beliefs in the context of eHealth and telemedicine among 905 participants (59.0% females), of which 48.4% were employees and 51.6% were students. Participants expressed moderate knowledge of eHealth and telemedicine concepts with higher levels among employees compared to students (both: p<0.05). Compared to employees, students were less convinced that online health information improves patient knowledge (p<0.001), but were more optimistic that telemedicine reduces healthcare costs (p<0.05). Participants doubted that telemedicine services would enhance the doctor-patient relationship and raised concerns regarding data security and privacy issues. Accordingly, quantitative context analysis of free text comments revealed that the four most frequently mentioned themes were related to issues concerning data privacy and security, questions of responsibility, doctor-patient interaction, and reliability of information. This study provides valuable insights into how current and future healthcare professionals differ in their perceptions regarding eHealth and telemedicine. These findings raise awareness of the need to bridge the gap between digital age groups and professional groups, especially in clinical healthcare delivery in a clocked-through, strenuous academic setting as found at a medical university.