Perspectives Of Healthcare Professionals Research Articles

Micro-costing from healthcare professional's perspective and acceptability of cutaneous leishmaniasis diagnostic tools in Morocco: A mixed-methods study.

In Morocco, cutaneous leishmaniasis (CL) represents a concern with three causative parasite species. Despite this, rapid diagnostic test (RDT) for CL is not part of the national control strategy. This study evaluates the acceptability and micro-costing of the CL Detect Rapid Test by Inbios International. The study was conducted from June 2019 to January 2020 and included 46 healthcare professionals from 40 primary healthcare centers and district labs. Data was collected by self-administered questionnaires and interviews and analysed using NVivo, Jamovi, and Python to generate a predictive model and sensitivity analysis by calculating the average Cost-Benefit Ratio for compared CL diagnostic scenarios. The exchange rate is 1 USD = 9.6 MAD (Moroccan Dirham) in November 2019. The CL-RDT received notable acceptance for its user-friendliness and time efficiency compared to traditional microscopy. Micro-costing data revealed that the average unit cost for microscopy is 15 MAD [7-31], whereas 75 MAD [52-131] for CL-RDT. Altogether, the diagnostic cost for microscopy is 115 MAD±4, marginally higher than the 102 MAD±2 for CL-RDT (p = 0,05). Sensitivity analysis identified the most cost-benefit scenarios based on a Cost-Benefit Ratio (CBR). The optimal approach involves using CL-RDT once at a primary healthcare centre (PHC) (CBR = 1.4), especially if the unitary cost is below 79 MAD. The second-best option is using CL-RDT once at a laboratory (CBR = 1.0), which is advantageous if priced under 54 MAD. However, using CL-RDT twice for the same lesion had a less favourable CBR of 0.6 and was only beneficial if priced below 09 MAD. The reference scenario was a single CL-RDT at the PHC followed by microscopy at a laboratory. In conclusion, the forthcoming CL-RDT, expected to feature enhanced sensitivity, is advocated for deployment in resource-limited endemic areas.

A qualitative exploration of the role of a palliative care pharmacist providing home-based care in the rural setting, from the perspective of health care professionals.

Pharmacists are often not recognised as a core part of palliative care teams, despite their ideal placement to assist with the burden of medication management. This study explored the role of pharmacists working in the rural palliative care team, in the home-based setting. Health care professionals working with palliative care patients in rural South Australia participated in semi-structured interviews. Data were analysed using thematic analysis. Data from 20 participants identified 10 themes. Theme 1: This model of care gives patients a choice. Theme 2: The pharmacist is a trusted source of support and information. Theme 3: Patient, carer and family distress is reduced. Theme 4: Enables patients to stay at home by improving medication knowledge and decreasing burden; 4.1-Patient, carer and family's understanding about medication management is improved, 4.2-Patient, carer and family travel is decreased, 4.3-Burden associated with getting to the doctor is decreased. Theme 5: Communication between all parties is enhanced; 5.1-Enhanced communication between the patient and health care team, 5.2-Enhanced communication within the health care team. Theme 6: Patient, carer and family burden of coordinating prescriptions and medications is reduced. Theme 7: Benefits health care professionals by improving medication knowledge, reducing workload and stress; 7.1-Understanding about medications and their management is improved, 7.2-Workload is reduced, 7.3-Work-related stress is reduced. Theme 8: The disparity of care between rural and urban patients is reduced. Theme 9: Helps to address rural workforce shortages. Theme 10: Challenges of this model of care; 10.1-A need for greater pharmacist capacity to meet demand, 10.2-A need for increased and sustained funding for the pharmacist role, 10.3-Large amount of travel to get to patients. Rural health care professionals are supportive of pharmacists working as part of the palliative care team in home-based settings and identified many benefits of this model of care.

Analysis of Job Satisfaction Antecedents and its Impact on Hospital Performance from The Perspective of Healthcare Professionals at XYZ Hospital in East Java

Analysis of Job Satisfaction Antecedents and its Impact on Hospital Performance from The Perspective of Healthcare Professionals at XYZ Hospital in East Java

Healthcare Professionals Perspectives on Discharge Planning for Patients with Mental Illness

Introduction: Discharge planning is transferring a patient to a different level of care to improve continuity of care by bridging the gap between hospital and community care. This study aimed to explore the perspectives of healthcare professionals involved in discharge planning for patients with mental illness. Method: This research used qualitative methods with a phenomenological approach. Ten participants were selected using a purposive sampling method, with inclusion criteria healthcare professionals involved in the discharge planning process for patients in psychiatric hospitals, had worked in the service for at least 5 years, and provided direct or indirect services to patients. Data were collected through in-depth interviews using interview guides, recording devices, and field notes. Data were analyzed using thematic analysis. Results: The study identified four themes related to discharge planning preparation for patients with mental illness perceptions of roles and experiences in discharge planning, internal and external barriers in discharge planning, internal and external support in discharge planning and expectations for the continuity of discharge planning. Conclusions: The findings indicate that there are still significant disparities in the way that discharge planning for patients with mental illness is implemented in different mental health service settings. These study findings are intended to serve as a further source of information to develop a discharge planning system that integrates patients with mental illnesses from the hospital into the community.

Robot-assisted mobilisation in the intensive care unit: does it offer relief to mobilising specialists? A qualitative longitudinal study at a German university hospital

BackgroundImmobility among intensive care patients can result in significant impairments. Reasons for this issue include a lack of specialised staff and equipment, as well as safety concerns associated with transferring patients to a therapy device. Nevertheless, early mobilisation is recognised as beneficial for improving patient outcomes. This study explores the perspectives of healthcare professionals on the use of a robotic system for patient mobilisation and identifies related stress and relief factors.MethodThis qualitative longitudinal study was conducted at a German university hospital, where 29 interviews were conducted with nurses at three different data collection points. The data were analysed using qualitative content analysis in accordance with Mayring.FindingsThe utilisation of the VEMOTION® robotic system generally did not lead to any physical discomfort. However, the adoption of this technology presented certain challenges. Non-routine users initially experienced psychological strain, primarily due to the extensive preparation required and the need to integrate the system into established routines. Additionally, structural factors, such as nurse-to-patient ratios and the layout of the care facilities, were identified as significant determinants affecting both the practicality of mobilisation and associated stress levels.ConclusionsRobotic systems like VEMOTION® can alleviate the physical workload of nurses. Successful integration and psychological adaptation depend on familiarity and routine use of the technology. Addressing structural and staffing factors is crucial for optimising robotic assistance in patient care. Further research should delve into these dynamics and explore the broader implications of technology adoption in healthcare.Trial registration: clinicaltrials.org TRN: NCT05071248, Date: 2021/10/21 URL: https://clinicaltrials.gov/ct2/show/NCT05071248

Orthopaedic practice in Indian secondary care - Exploring the notion of ‘integrated care’ from the perspectives of healthcare professionals and patients, with strategies for implementation

For the duration of my medical elective, I was placed in a government hospital by the name of Loknayak Jai Prakash Narayan Hospital. It specialises in trauma and orthopaedics, and is one of four government hospitals in Patna- the state capital of Bihar. My supervisor subspecialises in the hip and knee joint. Most patients belong to the lower socioeconomic classes and therefore rely on free delivery of care. During this essay I will reflect upon my firsthand experiences, as well as explore the existing literature, to highlight the importance of integrated care. Orthopaedics is a speciality that brings together many diverse groups of healthcare professionals. The NHS has always placed a strong emphasis on continuity of care by designing standardised frameworks. Coming from an alternative perspective, I seek to observe whether patients and healthcare professionals in Bihar also understand the concept of integrated care. Using examples I will look back to see how various teams work together within the Indian secondary care context.

Views and experiences of healthcare professionals and patients on the implementation of a 23-hour accelerated enhanced recovery programme: a mixed-method study

BackgroundAn accumulating body of research suggests that an accelerating enhanced recovery after colon surgery protocol is beneficial for patients, however, to obtain these effects, adherence to all elements of the protocol is important. The implementation of complex interventions, such as the Enhanced Recovery After Surgery protocol (ERAS), and their strict adherence have proven to be difficult. The same challenges can be expected in the implementation of the accelerated Enhanced Recovery Pathways (ERPs). This study aimed to understand the perspectives of both healthcare professionals (HCPs) and patients on the locally studied acCelerated enHanced recovery After SurgEry (CHASE) protocol.MethodsFor this mixed-method study, HCPs who provided CHASE care and patients who received CHASE care were recruited using purposive sampling. Ethical approval was obtained by the Medical Ethical Committee of the Zuyderland Medical Centre (NL71804.096.19, METCZ20190130, October 2022). Semi-structured, in-depth, one-on-one interviews were conducted with HCPs (n = 13) and patients (n = 11). The interviews consisted of a qualitative and quantitative part, the protocol evaluation and the Measurement Instrument or Determinant of Innovations-structured questionnaire. We explored the perspectives, barriers, and facilitators of the CHASE protocol implementation. The interviews were audiotaped, transcribed verbatim and analysed independently by two researchers using direct content analysis.ResultsThe results showed that overall, HCPs support the implementation of the CHASE protocol. The enablers were easy access to the protocol, the relevance of the intervention, and thorough patient education. Some of the reported barriers included the difficulty of recognizing CHASE patients, the need for regular feedback, and the updates on the implementation progress. Most patients were enthusiastic about early discharge after surgery and expressed satisfaction with the care they received. On the other hand, the patients sometimes received different information from different HCPs, considered the information to be too extensive and few experienced some discomfort with CHASE care.ConclusionBringing CHASE care into practice was challenging and required adaptation from HCPs. The experiences of HCPs showed that the protocol can be improved further, and the mostly positive experiences of patients are a motivation for this improvement. These results yielded practical implications to improve the implementation of accelerated ERPs.

Barriers and facilitators in diagnosing axial spondyloarthritis: a qualitative study

IntroductionDiagnosis of axial spondyloarthritis (axSpA) is frequently delayed for years after symptom onset. However, little is known about patient and healthcare professional (HCP) perspectives on barriers and facilitators in axSpA diagnosis. This study explored the experiences and perceptions of both groups regarding the factors affecting the timely diagnosis of axSpA.MethodSemi-structured interviews with patients with axSpA and axSpA-interested HCPs from the United Kingdom (UK) were performed by telephone or Microsoft Teams and focussed on the individuals’ perspective of the diagnostic journey for axSpA. Interview transcripts were thematically analysed.ResultsFourteen patients with axSpA (10 female, 4 male) and 14 UK based HCPs were recruited, the latter comprising of 5 physiotherapists, 4 General Practitioners, 3 rheumatologists, a nurse, and an occupational therapist. Barriers to diagnosis identified by patients and HCPs were: difficult to diagnose, a lack of awareness, unclear referral pathways, patient behaviour and patient/HCP communication. Patient-identified facilitators of diagnosis were patient advocacy, clear referral processes and pathways, increased awareness, and serendipity. HCPs identified promoting awareness as a facilitator of diagnosis, along with symptom recognition, improvements to healthcare practice and patient/HCP communications.ConclusionPoor communication and a lack of understanding of axSpA in the professional and public spheres undermine progress towards timely diagnosis of axSpA. Improving communication and awareness for patients and HCPs, along with systemic changes in healthcare (such as improved referral pathways) could reduce diagnostic delay.

Patient and clinician perspectives on supported mealtimes as part of anorexia nervosa treatment: A systematic review and qualitative synthesis.

To systematically review the literature on clinicians' and patients' experiences of supported mealtimes in the treatment of anorexia nervosa. This systematic review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD42022372565). PsycINFO, MEDLINE and Embase were searched up to the 20th of November 2023 for qualitative articles investigating the perspectives of healthcare professionals and patients on clinician-supported meals across all clinical settings. Data were analysed using thematic synthesis. The Critical Appraisal Skills Programme was used to evaluate the quality of selected studies. This review comprised of 26 studies; eight concerned with the perspectives of clinicians only, 16 addressing patients' views, and two studies exploring the views of both groups. Experiences of both groups were generally negative, and three overlapping themes were identified: lack of consistency in care provided, high levels of negative emotions and an uncomfortable power dynamic. This review suggests that supported mealtimes are experienced more positively by patients when rules are clear and consistently enforced, and when clinicians make informal conversation and supportive comments. Our findings highlight the need for best practice guidelines and clinician training to improve the delivery of supported mealtimes. Such guidelines and training should be coproduced in collaboration with patients and carers.

Family Centered Care: The Perspective of Nurses in the Neonatal Intensive Care Unit of Tamale Teaching Hospital, Ghana: A Qualitative Exploration

Background: Family-Centered Care is a care approach in which healthcare professionals collaborate with the patient's family to plan and make decisions regarding the patient's treatment. Family-Centered Care is widely acknowledged and documented as the optimal care approach for neonatal practice. Despite the growing use of this method, there is a lack of research on the perspectives of healthcare professionals and carers regarding Family-Centered Care. The study aimed to evaluate the viewpoints of nurses regarding FCC in the newborn critical care unit at the Tamale Teaching Hospital.
 Methodology: The study utilised an exploratory descriptive design employing a qualitative technique, in which focus group talks were held among participants. The material was transcribed and processed via thematic and content analysis techniques.
 Findings: Approximately majority of the participants demonstrated awareness of the idea of Family-Centered Care, which they elaborated upon through two main themes namely provision of care for both the patient and their family, and Involvement of relatives in the care of the patient.
 Recommendations: Majority of participants expressed that Family-Centered Care was not practiced in their unit. Nevertheless, all participants unanimously concurred that the approach had the potential to yield positive results in terms of patient care outcomes.

Youth, caregiver and healthcare professional perspectives on planning the implementation of a trauma-informed care programme: A qualitative study.

To explore youth, caregiver and staff perspectives on their vision of trauma-informed care, and to identify and understand potential considerations for the implementation of a trauma-informed care programme in an inpatient mental health unit within a paediatric hospital. We applied the Interpretive Description approach, guided by complexity theory and the Implementation Roadmap, and used Applied Thematic Analysis methods. Twenty-five individuals participated in individual or group interviews between March and June 2022, including 21 healthcare professionals, 3 youth and 1 caregiver. We identified two overarching themes. The first theme, 'Understanding and addressing the underlying reasons for distress', related to participants' understanding and vision of TIC in the current setting comprising: (a) 'Participants' understanding of TIC'; (b) 'Trauma screening and trauma processing within TIC'; (c) 'Taking "a more individualized approach"'; (d) 'Unit programming'; and (e) "Connecting to the community". The second theme, 'Factors that support or limit successful TIC implementation' comprises: (a) 'The need for a broad "cultural shift"'; (b) 'The physical environment on the unit'; and (c) 'Factors that may limit successful implementation'. We identified five key domains to consider within trauma-informed care implementation: (a) the centrality of engagement with youth, caregivers and staff in trauma-informed care delivery and implementation, (b) trauma-informed care core programme components, (c) factors that may support or limit success in implementing trauma-informed care within the mental health unit and (d) hospital-wide and (e) the importance of intersectoral collaboration (partnering with external organizations and sectors). When implementing TIC, there is an ongoing need to increase clarity regarding TIC interventions and implementation initiatives. Youth, caregiver and healthcare professional participants shared considerations important for planning the delivery and implementation of trauma-informed care in their setting. We identified five key domains to consider within trauma-informed care implementation: (a) the centrality of relational engagement, (b) trauma-informed care programme components, (c) factors that may support or limit successful implementation of trauma-informed care within the mental health unit and (d) hospital-wide and (e) the importance of intersectoral collaboration. Organizations wishing to implement trauma-informed care should consider ongoing engagement with all relevant knowledge user groups throughout the process. Standards for Reporting Qualitative Research (SRQR). The local hospital research institute's Patient and Family Advisory Committee reviewed the draft study methods and provided feedback.

Feasibility and Design Factors for Home-Based Pulmonary Rehabilitation of Patients With Chronic Obstructive Pulmonary Disease and Chronic Lung Diseases Based on a People-Object-Environment Framework: Qualitative Interview Study.

The feasibility of implementing home-based pulmonary rehabilitation (PR) can be assessed from the perspectives of patients with chronic lung disease and health care professionals involved in PR. Through a qualitative inquiry using interviews and the adoption of the people-object-environment framework, this study aims to understand the influences of interpersonal, environmental, and situational factors on the perceptions and considerations of individuals involved in home-based PR for patients with chronic lung disease. One-on-one interviews were conducted with 20 patients with chronic lung disease and 20 health care professionals for investigating their attitudes and opinions based on their experiences regarding home-based PR as well as for identifying the key factors affecting the benefits and drawbacks of such therapies. This study further evaluates the feasibility of using digital tools for medical diagnosis and treatment by examining the technology usage of both parties. The 4 key issues that all participants were the most concerned about were as follows: distance to outpatient medical care, medical efficiency, internet connectivity and equipment, and physical space for diagnosis and treatment. Interviews with patients and health care professionals revealed that the use of technology and internet was perceived differently depending on age and area of residence. Most participants reported that digital tools and internet connectivity had many benefits but still could not solve all the problems; moreover, these same digital tools and network transmission could lead to problems such as information security and digital divide concerns. This study also emphasizes the significant impact of human behavior and thinking on shaping the design of health care interventions and technologies. Understanding user perspectives and experiences is crucial for developing effective solutions for unmet needs. The results of this study indicate that despite the different perspectives of patients and health care professionals, their considerations of the key issues are very similar. Therefore, the implementation of plans related to telemedicine diagnosis, treatment, or rehabilitation should take the suggestions and considerations of both parties into account as crucial factors for telehealth care design.

Navigating complexity of the medication management system within the home setting-a functional resonance analysis method (FRAM) analysis of people with dementia and their carers' experiences.

There is a strong imperative to support people with dementia to live independently in their homes for as long as possible. A starting point is to understand how they manage medications on a daily basis. To understand how people with dementia and their informal carers manage medications within the home setting to inform the identification of opportunities to improve medication management. A qualitative study using the Functional Resonance Analysis Method (FRAM). Interview data with people with dementia and informal carers were analysed to (i) Identify and describe key functions, (ii) identify and describe variability in performing key functions, and its potential consequences and (iii) map performance variability to Resilient Healthcare capacities. A FRAM model was developed and consisted of 14 interdependent key functions. The interdependent nature of functions, and the different nature and sources of variability in how each key function was performed highlighted the level of complexity of the medication management system within the home setting. The medication system was managed almost entirely by the person with dementia and/or their informal carers. This shows the lack of system-level controls to support the safe functioning of the medication management system in the home setting. Future work will develop a comprehensive FRAM model that includes the perspectives of health and social care professionals and those from the third sectors to underpin the development of a range of system recommendations to strengthen resilience in the medication management system within the home setting.

Investigating barriers & facilitators for the successful implementation of the BP@home initiative in London: Primary care perspectives.

The COVID-19 pandemic led to the implementation of a national policy of shielding to safeguard clinically vulnerable patients. To ensure consistent care for high-risk patients with hypertension, NHS England introduced the BP@home initiative to enable patients to self-monitor their blood pressure by providing them with blood pressure monitors. This study aimed to identify barriers and facilitators to the implementation of the initiative based on the experience and perspectives of programme managers and healthcare professionals (HCPs) involved in its implementation in London. We conducted five semi-structured focus groups and one individual interview with a total of 20 healthcare professionals involved at different levels and stages in the BP@home initiative across four of the five London Integrated Care Systems (ICSs). All focus groups and interviews were audio-recorded, transcribed and analysed thematically following the Framework Method. Respondents reported being challenged by the lack of adequate IT, human and financial resources to support the substantial additional workload associated with the programme. These issues resulted in and reinforced the differential engagement capacities of PCNs, practices and patients, thus raising equity concerns among respondents. However respondents also identified several facilitators, including the integration of the eligibility criteria into the electronic health record (EHR), especially when combined with the adoption of practice-specific, pragmatic and opportunistic approaches to the onboarding of patients. Respondents also recommended the provision of blood pressure monitors (BPMs) on prescription, additional funding and training based on needs assessment, the incorporation of BP@home into daily practice and simplification of IT tools, and finally the adoption of a person-centred care approach. Contextualised using the second iteration of the Consolidated Framework for Implementation Research (CFIR), these findings support key evidence-based recommendations to help streamline the implementation of the BP@home initiative in London's primary care setting. Programs such as BP@Home are likely to become more common in primary care. To successfully support HCPs' aim to care for their hypertensive patients, their implementation must be accompanied by additional financial, human and training resources, as well as supported task-shifting for capacity building. Future studies should explore the perspectives of HCPs based in other parts of the UK as well as patients' experiences with remote monitoring of blood pressure.

A survey-based assessment of attitudes and needs regarding tinnitus healthcare among patients and healthcare professionals in Europe

Despite good agreement of national guidelines for the assessment and treatment of tinnitus, there is still substantial variation regarding tinnitus-related healthcare across Europe. In contrast to previous work, which has mainly focussed on the perspective of healthcare professionals, we here report the results of separate web-based surveys conducted with clinicians and researchers as well as tinnitus patients. These surveys were devised to obtain information about their respective attitudes and needs with respect to tinnitus healthcare, and to reveal possible interdisciplinary inconsistencies among clinicians and researchers. We mainly targeted participants from Germany, Cyprus, and Greece, the countries in which the institutions of the researchers involved in this project are based. Results showed, firstly, that the treatment satisfaction of the patients was overall more negative than that of the clinicians and researchers, and that the patients' treatment satisfaction did not depend on the number of different treatments they had received. Secondly, patients as well as clinicians and researchers indicated that they were interested in learning more about a variety of tinnitus-related topics, especially treatment strategies, with no marked differences between clinicians from different professional disciplines. This suggests similar tinnitus-specific educational needs in patients and healthcare professionals.

What are the barriers and facilitators to advance care planning with older people in long-term care facilities? A qualitative study.

To explore the views and preferences for advance care planning from the perspectives of residents, family members and healthcare professionals in long-term care facilities. A qualitative descriptive design. We conducted semi-structured interviews with 12 residents of long-term care facilities, 10 family members and 14 healthcare professionals. Data were analysed using reflexive thematic analysis. The social ecological model was used to develop implementation recommendations. We constructed a conceptual model of barriers and facilitators to advance care planning in long-term care facilities, drawing upon four dominant themes from the qualitative analysis: (1) The absence of discourse on end-of-life care: a lack of cultural climate to talk about death, the unspoken agreement to avoid conversations about death, and poor awareness of palliative care may hinder advance care planning initiation; (2) Relational decision-making process is a dual factor affecting advance care planning engagement; (3) Low trust and 'unsafe' cultures: a lack of honest information sharing, risks of violating social expectations and damaging social relationships, and risks of legal consequences may hinder willingness to engage in advance care planning; (4) Meeting and respecting residents' psychosocial needs: these can be addressed by readiness assessment, initiating advance care planning in an informal and equal manner and involving social workers. Our findings show that residents' voices were not being heard. It is necessary to identify residents' spontaneous conversation triggers, articulate the value of advance care planning in light of the family's values and preferences, and respect residents' psychosocial needs to promote advance care planning in long-term care facilities. Advance care planning may alleviate the decision-making burden of offspring in nuclear families. The evidence-based recommendations in this study will inform the implementation of context-specific advance care planning in Asia-Pacific regions. Patients and caregivers contributed to the interview pilot and data collection.

Health professionals' perceptions of the development needs of incident reporting software: A qualitative systematic review.

To systemically identify and synthesize information on health professionals' and students' perceptions regarding the development needs of incident reporting software. A systematic review of qualitative studies. A database search was conducted using Medline, CINAHL, Scopus, Web of Science and Medic without time or language limits in February 2023. A total of 4359 studies were identified. Qualitative studies concerning the perceptions of health professionals and students regarding the development needs of incident reporting software were included, based on screening and critical appraisal by two independent reviewers. A thematic synthesis was conducted. From 10 included studies, five analytical themes were analysed. Health professionals and students desired the following improvements or changes to incident reporting software: (1) the design of reporting software, (2) the anonymity of reporting, (3) the accessibility of reporting software, (4) the classification of fields and answer options and (5) feedback and tracking of reports. Wanted features included suitable reporting forms for various specialized fields that could be integrated into existing hospital information systems. Rapid, user-friendly reporting software using multiple reporting platforms and with flexible fields and predefined answer options was preferred. While anonymous reporting was favoured, the idea of reporting serious incidents with both patient and reporter names was also suggested. Health professionals and students provided concrete insights into the development needs for reporting software. Considering the underreporting of healthcare cases, the perspectives of healthcare professionals must be considered while developing user-friendly reporting tools. Reporting software that facilitates the reporting process could reduce underreporting. The ENTREQ reporting guideline was used to support the reporting of this systematic review. There was no patient or public contribution. The protocol is registered in the International Prospective Register of Systematic Reviews with register number CRD42023393804.

Interprofessional collaboration and the safety climate in hospitals: a scoping review

To map scientific production on the relationship between interprofessional collaboration and the safety climate of health professionals in hospital services. Web of Science, Embase and Google Scholar, with no time frame, using the acronym PCC P - Population - Health professionals; C - Concept - Interprofessional collaboration and safety climate; C - Context - Hospital service and respective search strategies. A total of 16 articles were selected that met the inclusion criteria, 15 of which were from North America and Europe. The majority used a quantitative approach, based on intervention studies with educational activities from an interprofessional perspective, and the results indicated improvements in the safety climate/culture. Some studies looked at interprofessional work from the perspective of healthcare professionals, identifying barriers and facilities for interprofessional work and its impact on patient safety. Interprofessional collaboration and the safety climate are strongly related, in a symbiosis in which both serve as a foundation for promoting safe practices, sharing ideas and clarifying roles.

Caring for older adults with cancerin Canada: Views from healthcare providers and cancer care allies in the community.

Cancer is common and disproportionately impacts older adults. Moreover, cancer care of older adults is complex, and the current Canadian cancer care system struggles to address all of the dimensions. In this project, our goal was to understand the barriers and facilitators to caring for older adults with cancer from perspectives of healthcare professionals and cancer care allies, which included community groups, seniors' centers, and other community-based supports. In collaboration with a patient advisory board, we conducted focus groups and interviews with multiple local healthcare professionals and cancer care alliesin British Columbia, Canada. We used a descriptive qualitative approach and conducted a thematic analysis using NVivo software. A total of 71 participants of various disciplines and cancer care allies participated. They identified both individual and system-level barriers. Priority system-level barriers for older adults included space and staffing constraints and disconnections within healthcare systems, and between healthcare practitioners and cancer care allies. Individual-level barriers relate to the complex health states of older adults, caregiver/support person needs, and the needs of an increasingly diverse population where English may not be a first or preferable language. This study identified key barriers and facilitators that demonstrate aligned priorities among a diverse group of healthcare practitioners and cancer care allies. In conjunction with perspectives from patients and caregivers, these findings will inform future improvements in cancer care. Namely, we emphasize the importance of connections among health systems and community networks, given the outpatient nature of cancer care and the needs of older adults.

What contextual features affect the outcome and sustainability of therapeutic patient education interventions?

Therapeutic patient education interventions are influenced by contextual factors. Therefore, describing the context is crucial to understanding how it can affect therapeutic patient education interventions and contribute to outcomes. We aimed to identify the contextual features that may affect the outcome and sustainability of therapeutic patient education interventions from a healthcare professional perspective. Semi-structured individual interviews were conducted with healthcare professionals involved in 14 therapeutic patient education interventions covering different chronic conditions (e.g., kidney and cardiovascular diseases, chronic pain, diabetes, obesity). Interviews were recorded and fully transcribed. We followed a general inductive approach to identify themes from healthcare professionals' discourse to properly capture their perception. Saturation was achieved with 28 interviews with 20 nurses, 6 dieticians, one physiotherapist and one psychologist. The average therapeutic patient education experience was 7 years. Identified contextual features clustered in 5 main themes: 1) conditions for the development of the intervention (genesis of the program: Who and what prompted it?; supports; content development; legislative framework); 2) integration of the program (in the healthcare pathway or the environment, relationship with the institution or local environment); 3) teamwork cohesion, interaction and integration with the environment (exchanges, cohesion of the team); 4) sustainability of the program; and 5) patient and healthcare professional contextual factors. New insights into contextual features that may be involved in therapeutic patient education interventions are represented in a framework based on the Medical Research Council evaluation framework. These features need to be addressed in studies of therapeutic patient education interventions and could help healthcare professionals build more effective interventions within the context. However, describing a list of elements of the context is not enough; analyses should also focus on how the contextual elements might affect an intervention and how they interact.