Core Set Of Questions Research Articles

Advanced nurse practitioner well‐being: A 4‐year cohort mixed methods study

AbstractAimsTo examine changes in advanced nurse practitioner (ANP) well‐being, satisfaction and motivation over a four‐year period.DesignLongitudinal Cohort study.MethodsSurveys were carried out each year from 2019 to 2022 with the same cohort of ANPs in the United Kingdom (UK). The survey consisted of demographics, questions on contemporary issues in advanced practice, National Health Service (NHS) staff survey questions and validated questionnaires. A core set of questions were asked every year with some changes in response to the COVID‐19 pandemic.ResultsResponse rate ranged from 40% to 59% and appeared to be affected by COVID‐19. Staff satisfaction with pay and the well‐being score were stable throughout. Other questions on well‐being, job satisfaction and motivation saw statistically significant reductions after 4 years. Open‐ended questions about ongoing well‐being concerns show participants are concerned about exhaustion levels caused by workload, staffing issues, abuse from patients and colleagues' mental health.ConclusionThe findings highlight a decline in ANP well‐being, job satisfaction and motivation post‐COVID‐19. Reasons for this, explored in the qualitative data, show that ANPs have faced extremely difficult working conditions. Urgent action is required to prevent a workforce retention crisis as many nursing staff are close to retirement and may not be motivated to remain in post.ImpactThis study has followed ANPs through the most challenging years the NHS has ever seen. Job satisfaction, motivation and enjoyment of the job all significantly reduced over time. In many areas, the ANP role has been used to fill medical workforce gaps, and this will become harder to do if ANPs are dissatisfied, disaffected and struggling with stress and burnout. Addressing these issues should be a priority for policymakers and managers.Patient or public contributionNone as this study focussed on staff. Staff stakeholders involved in the design and conduct of the study.

Russian-language translation and cultural adaptation of the Norwegian ‘Patient Experience Questionnaire’

The availability of patient-reported experience measures (PREM) is an unmet need in Russian healthcare. To translate, adapt culturally, and validate PREM for outpatients. A core set of questions from the Patient Experience Questionnaire (PEQ, in Norwegian, available in English) was translated to Russian (forward-backward translation). Acceptability, construct validity, and reliability were assessed. Patients aged ≥18 y.o. were invited to complete the questionnaire via QR-code within 24 h after a medical encounter. A questionnaire with adequate conceptual and linguistic equivalence was obtained. For four questions, a rating scale was replaced by Likert-type. A total of 308 responses were received (median age 55 y.o., 52% females). The correlation matrix was factorable. Four factors were extracted using varimax rotation: 1) outcome of this specific visit; 2) communication experiences; 3) communication competency; 4) emotions after this visit. These explained 65.4% of the total variance. Three items were excluded. The model was confirmed to be adequate. The Cronbach alpha was >0.9. Item-total correlation confirmed discriminative validity. These preliminary results show that the Russian version of PEQ, adapted to national features, shows good psychometric properties. External validation is needed for the broad implementation of this PREM. This research is first attempt to use PREM in the Russian Federation. The use of quick response codes is feasible and eases survey conduction. The more PREMs are used the higher the quality of healthcare.

International Perspectives on Modifications to the Surgical Safety Checklist

Modification of the World Health Organization's Surgical Safety Checklist (SSC) is a critical component of its implementation. To facilitate the SSC's use, it is important to know how surgical teams modify their SSCs, their reasons for making modifications, and the opportunities and challenges teams face in SSC tailoring. To study SSC modifications in high-income hospital settings in 5 countries: Australia, Canada, New Zealand, the United States, and the United Kingdom. This qualitative study used semistructured interviews based on the survey used in the quantitative study. Each interviewee was asked a core set of questions and various follow-up questions based on their survey responses. Interviews were conducted from July 2019 to February 2020 in person and online using teleconferencing software. Surgeons, anesthesiologists, nurses, and hospital administrators from the 5 countries were recruited through a survey and snowball sampling. Interviewees' attitudes and perceptions on SSC modifications and their perceived impact on operating rooms. A total of 51 surgical team members and hospital administrators from the 5 countries were interviewed (37 [75%] with >10 years of service; 28 [55%] women). There were 15 (29%) surgeons, 13 (26%) nurses, 15 (29%) anesthesiologists, and 8 (16%) health administrators. Five themes emerged concerning the awareness and involvement in SSC modifications; reasons for modifications; types of modifications; the outcomes of modifications; and perceived barriers to SSC modifications. Based on the interviews, some SSCs may go many years without being revisited or modified. SSCs are modified to ensure they address local issues and standards of practice and that they are fit for purpose. Modifications are also made following adverse events to reduce the risk of reoccurrence. Interviewees described adding, moving, and removing elements from their SSCs, which increased their sense of ownership in their SSC and participation in its performance. Some barriers to modification included leadership and the SSC's inclusion in hospitals' electronic medical record. In this qualitative study of surgical team members and administrators, interviewees described addressing contemporary surgical issues through various SSC modifications. The process of SSC modification may improve team cohesion and buy-in in addition to providing opportunities for teams to improve patient safety.

Inequality Generation & Persistence as Multidimensional Processes: An Interdisciplinary Agenda

The papers included in this issue are the result of sustained collaborations within the Successful Societies program, which has meet three times a year since 2003. Each team of authors developed their contribution through extensive discussions at meetings of the entire group over two years. Program members (Bloemraad, Grusky, Hall, Jenson, Kymlicka, Lamont, Pierson, Polletta, Raibmon, Son Hing, and Wilson) and advisory committee members (Gourevitch, Le Gales, and Markus) have created teams to attack a question of mutual interest. In all cases, authors focus on the core set of questions and theoretical concerns outlined in this introductory essay, and their contributions draw on a continuing conversation among members of the group. This results in a productive yet all too rare conversation drawing on insights from sociology, political science, social psychology, and history.

P6 - How to Form a Successful Collaboration From “Farm Gate” to “Consumer Plate” to Support Food Systems Education

Objective: Form a collaboration for food systems programming that brings together Extension educators from “farm gate” to “consumer plate.” Target Audience: Extension professionals working with consumers, youth, agriculture producers, food service, and food processors. Theory, Prior Research, Rationale: Today's consumer faces many decisions influencing food choices. However, 98% of Americans are several generations removed from direct farming, according to former United States Secretary of Agriculture, Tom Vilsack. As a result, they are less familiar with how our food systems work. Description: In response to consumer concerns (i.e. food safety, GMOs, pesticides, etc.), we formed a statewide interdisciplinary team of agriculture, family/consumer science, food science, and 4-H professionals to work together to reach consumers from “farm gate” to “consumer plate.” The steps, which are continually evolving, included dividing into teams [production agriculture, food processing, youth, and consumers/food service] who met together and separately, electronically and face-to-face; establishing a listserv and web-based location to share information; creating a logic model; conducting a statewide survey to determine program priorities; identifying areas to work together; and developing core questions all teams could use in clientele surveys. Evaluation: Quantitative and qualitative data support this approach. The survey [n = 1,208] identified food safety as our state's top priority and gave us a common emphasis; staff in different disciplines collaborated in developing programs, articles, and social media; and the core set of questions used with all clientele helped aggregate data. Consequently, we could report on our overall impact and say, “Over 42,000 youth and adults statewide made changes and/or reinforced knowledge of food safety practices from when food is produced until food reaches consumers' plates.” Conclusions and Implications: This statewide collaboration model could be replicated and implemented by others in extension for greater outreach in food systems education. Funding: None.

A Patient-centered Approach to Evaluate the Information Needs of Women With Ductal Carcinoma In Situ.

To evaluate the information needs of ductal carcinoma in situ (DCIS) patients. Four focus groups involving 24 previously treated DCIS patients were conducted to develop a comprehensive list of questions they felt were important to have answered at the time of diagnosis. Using a survey, a separate group of patients treated for DCIS then rated the importance of having each of these questions addressed before treatment decision making. Response options were "essential," "desired," "not important," "no opinion," and "avoid." For each essential/desired question, respondents specified how addressing it would help them: "understand," "decide," "plan," "not sure," or "other." Focus group participants generated 117 questions used in the survey. Fifty-seven patients completed the survey (55% response rate). Respondents rated a median of 66 questions as essential. The most commonly cited reason for rating a question essential was to "understand," followed by to "decide." The top questions women deemed essential to help them understand were disease specific, whereas the top questions deemed essential to help women decide were predominantly treatment specific, pertaining to available options, recurrence and survival outcomes, and timelines to decide and start treatment. DCIS patients want a large number of questions answered, mostly for understanding, and also for deciding and planning. A core set of questions that most patients consider essential for decision making has been formulated and may be used in the clinical setting and in research to develop educational resources and decision-making tools specific to DCIS.

The value of connected health information: perceptions of electronic health record users in Canada.

BackgroundAs health care becomes more complex, it becomes more important for clinicians and patients to share information. Electronic health information exchange can help address this need. To this end, all provinces and territories (PTs) in Canada have created interoperable electronic health records (iEHRs). These secure systems offer authorized users an integrated view of a person’s healthcare history across the continuum of care. They include information such as lab results, medications, diagnostic images, clinical reports and immunization profiles. This study explores user experiences and perceived outcomes of iEHR use.MethodsSurveys conducted between 2006 and 2014 asked iEHR users in six Canadian PTs about system, information and service quality; iEHR use and user satisfaction; and net quality and productivity benefits. The surveys had a core set of questions that used Likert-type scales. Results were synthesized across surveys for each evaluative dimension. Consensus among researchers and subject matter experts on whether to classify the outcomes as positive, mixed/neutral, or negative was established using a modified Delphi technique.ResultsA total of 2316 iEHR users responded to the six surveys. Information quality was the most studied area. Results varied across PTs, but positive outcomes were more common than mixed/neutral or negative outcomes by a 19:1:1 ratio across this dimension. The next most frequently studied aspects were user satisfaction, the impact of iEHR use on quality of care, and the impact on productivity. In all three areas, there were more positive than mixed/neutral or /negative results (ratios of 13:1:1, 14:3:1, and 15:2:1respectively).ConclusionsOverall, users of iEHRs that provide secure access to patient information collated from across the health system tend to report positive outcomes, including quality of care and productivity. This study is an important first step in understanding user perspectives on iEHRs and health information exchange more broadly.

A Window on Trends and Shifting Interpretations of Youth Sexual Behaviour: The Japan Association of Sex Education's 'Wakamono no Sei' Hakusho Reports from 1975 to 2007

The sexual awareness (seiishiki) and behaviour of Japanese youth first emerged as areas of public concern in the early 1970s. In 1971, the Prime Minister's Office1 (PMO) carried out a questionnaire survey of a nationally representative group of young people focusing on sexual awareness (Sōrifu Seishōnen Taisaku Honbu 1972). Following this, in 1974, the PMO commissioned the Japanese Association of Sex Education (JASE) to carry out a more comprehensive survey that also investigated the sexual behaviour of Japanese youth. This was published in 1975 (JASE 1975). These two surveys, commissioned by the government, signalled the new legitimacy of youth sexuality as a topic of research and as such lifted the taboo that had been in place for over four decades.2 Since 1974, JASE has carried out a total of six national surveys (1974, 1981, 1987–1988, 1993–1994, 1999 and 2005–2006) focusing on the sexual awareness and behaviour of Japanese youth. Over time, the range of questions and the youth target group have been expanded. This research offers an unprecedented view of the (heterosexual) sexual awareness, values and behaviour of young people living in both the large cities and more provincial towns in Japan over a period of 32 years. This is a period that saw remarkable changes in the context of youth in Japan with increasing affluence, a massive extension of tertiary level education and the advent of the ‘information age’. It was also a period of rapid change in the status and lives of Japanese women. A key question raised in the surveys is in what ways have these changes impacted on youth sexuality. There is no other set of data in Japan that offers such a comprehensive overview of trends in youth sexuality. Indeed, even within an international context, these surveys are unique for the breadth of ground that they cover and the fact that data on a core set of questions have been collected at regular intervals over a period of 32 years.

Daron Acemoglu: 2005 John Bates Clark Medalist

Daron Acemoglu, winner of the 2005 John Bates Clark Medal, uses theoretical and empirical analysis to tackle critical issues in a variety of fields in economics, including labor economics, macroeconomics, and political economy. His unparalleled combination of originality, thoroughness, and prolificacy has propelled him to the frontier of each field that he has explored. The Clark medal committee notes that “his work is always motivated by real-world questions that arise when facts are difficult to reconcile with existing theory.” Daron focuses on a core set of questions and uses the best tools available to answer them. What determines the accumulation of human capital both during formal schooling and on the job? How do the implications of labor market frictions depend on the information available to job searchers? How do economic incentives affect the type of technological change that we observe? Why are there such enormous differences in output per worker and total factor productivity across countries?

Measuring Hospital Care from the Patients' Perspective: An Overview of the CAHPS® Hospital Survey Development Process

To describe the developmental process for the CAHPS Hospital Survey. A pilot was conducted in three states with 19,720 hospital discharges. A rigorous, multi-step process was used to develop the CAHPS Hospital Survey. It included a public call for measures, multiple Federal Register notices soliciting public input, a review of the relevant literature, meetings with hospitals, consumers and survey vendors, cognitive interviews with consumer, a large-scale pilot test in three states and consumer testing and numerous small-scale field tests. The current version of the CAHPS Hospital Survey has survey items in seven domains, two overall ratings of the hospital and five items used for adjusting for the mix of patients across hospitals and for analytical purposes. The CAHPS Hospital Survey is a core set of questions that can be administered as a stand-alone questionnaire or combined with a broader set of hospital specific items.

A European spine registry.

New joint replacement registries are being widely implemented across national and international organizations. The need for a continuous long-term post-market surveillance of implants has been recognized, and has become increasingly important to ensure the quality of prosthetic components. Registry data with large case numbers represent an acceptable alternative to controlled randomized clinical trials, which are often difficult to conduct in orthopedic surgery. The variety of implants and procedures in spinal surgery not only induces the same need for long-term monitoring of post-surgical product performance as in the joint replacement subspecialties, but also renders essential the establishment of a comprehensive spine registry for all major pathologies and interventions. In cooperation with the M.E. Müller Institute for Evaluative Research in Orthopedic Surgery (MEM-CED) at the University of Berne, Switzerland, the Spine Society of Europe (SSE) has launched Spine Tango: the first modular and multilevel European online registry for spinal surgery. Within Spine Tango, the major challenge in registry design and structure is the definition of and agreement upon a core set of questions as a common European dataset. Additional questions for national or individual interest can also be dynamically added to the core dataset. An automated implant tracking system has also been setup, which allows highly precise product documentation without additional work for clinical staff members.

Identifying depression and anxiety in a 40‐year epidemiological investigation: the Stirling County study

AbstractAs a longitudinal investigation, the ‘Stirling County study’ involves a 40‐year period beginning with the drawing of a sample in 1952 for a survey of psychiatric disorders. In 1970 a new sample was drawn and subjects from 1952 were followed, and in 1992 another new sample was drawn and all 1952 and 1970 subjects were followed. During these years, knowledge about psychiatric disorders has increased in the population at large; changes in everyday language about them have occurred and criteria for identifying them have been improved. This report describes adaptations of methods designed to overcome some of the problems inherent in such changes.A revised computerized algorithm named DPAX‐2 (DP for depression and AX for anxiety) is described. The first version, DPAX‐1, deals with a core set of questions that have been asked in identical fashion throughout the study. Early investigations of validity indicated that DPAX‐1 appeared to be an adequate method for the period from 1952 through 1970. The revised version was constructed after data gathering for the 1990s phase of research documented that vocabulary changes had taken place. DPAX‐2 addresses these changes by having more questions about states of sadness and apprehension. It also takes into account improvements introduced as ‘supplements’ that come after the core questions in the interview schedule. These improvements were available in the data collected for 1970 but have not thus far been utilized in reports about longitudinal findings because of their absence from the 1952 data.Evidence is presented that DPAX‐1 and DPAX‐2 were well correlated in 1970 and became considerably less so by 1992. This result, in conjunction with increased diagnostic sophistication in the responses of subjects to open‐ended questions in the 1990s, suggests that the common parlance, especially about depression, began to change after 1970. It was also mainly after 1970 when antidepressant medications began to be widely used, a fact that may have influenced awareness about depression and the language for describing it.For comparison, depression and anxiety modules of the more recently developed Diagnostic Interview Schedule (DIS) were also part of the interview protocol in the 1990s. To explore validity, the Structured Clinical Interview for DSM‐IIIR (SCID) was administered to a subsample. Agreement with the SCID results was better for DPAX‐2 than for DPAX‐1. Agreement with SCID was somewhat higher for the DIS, but DPAX‐2 and the DIS showed almost equivalent sensitivity. In conclusion, the most satisfactory approach to studying the effects of ‘time's arrow’ in the Stirling County study will be to use DPAX‐1 for the period 1952 to 1970 and DPAX‐2 for the period 1970 to 1992. The level of articulation between the two versions will therefore be discernible at the middle phase of the study. Copyright © 1998 Whurr Publishers Ltd.