Perceptions Of Urgency Research Articles

Subjective Study on Pediatric Emergency Department Nurses′ Perceptions of Urgency Using Q Methodology

PurposeIn the emergency department (ED), triage significantly impacts patient safety. Therefore, triage nurses must make decisions accurately and timeously. This study aims to investigate how South Korean pediatric emergency nurses perceive urgency and classify severity using the Q methodology, which examines individuals’ subjectivity. MethodsWe collected 84 statements from a Q population based on a literature review and interviews, and selected 33 Q samples. The P samples included 30 pediatric emergency nurses at a Seoul tertiary-care hospital. The principal component factor analysis method was employed to analyze data using the PC-QUANL program. ResultsFour urgency perception types were identified among pediatric ED nurses. Type 1: “Experiential coping”; Type 2: “Careful reasoning”; Type 3: “Patient-centered thinking”; and Type 4: “Intuitive prediction.” These types appear to be an integrated process of knowledge and clinical experience that considers children’s characteristics and developmental stages. ConclusionsThis study may serve as a basis for future education to improve pediatric ED nurses’ urgency judgment and severity classification skills.

Influences on COVID-19 booster uptake among adults intending to receive a booster: a qualitative study.

Bivalent COVID-19 vaccine boosters have been recommended for all Americans 12 years of age and older. However, uptake remains suboptimal with only 17% of the United States (US) population boosted as of May 2023. This is a critical public health challenge for mitigating the ongoing effects of COVID-19 infection. COVID-19 booster uptake is not currently well understood, and few studies in the US have explored the vaccination process for booster uptake in a 'post-pandemic' context. This study fills gaps in the literature through qualitative analysis of interviews with a racially/ethnically diverse sample of Arkansans who received the COVID-19 vaccine main series and expressed intent to receive a booster (n = 14), but had not yet received the COVID-19 booster at the time we recruited them. All but one did not receive the booster by the time of the interview. Participants described influences on their vaccination behavior and uptake of boosters including reduced feelings of urgency; continued concerns about the side effects; social contagion as a driver of urgency; increasing practical barriers to access and missing provider recommendations. Our findings highlight the importance of considering vaccination as an ongoing, dynamic process drawing on past/current attitudes, prior experience, perceptions of risk and urgency and practical barriers. Based on these findings, healthcare providers should continue to provide strong, consistent recommendations for COVID-19 boosters to patients, even among those with histories of vaccine uptake.

On the Term “Environmental Refugee”: Normative Assumptions and Empirical Realities

Activist groups debate the complex connection between climate change and migration but generally agree on the normative value of describing those migrants as “environmental refugees.” They argue that using such a term, even though unrecognized under international law, might increase the urgency of this issue in the eyes of the public. Does the term do the normative work that has been assumed? To our knowledge, the idea has not been subject to empirical confirmation. In this research note, we present data from two experimental surveys conducted in the UK and the Netherlands (N = 2261) directly addressing that question. The findings significantly undermine the assumption that “environmental refugee” is normatively persuasive outside activists and academic circles. We demonstrate that using “environmental refugees” frames compared to “environmental migrants” does not increase the urgency of the climate migration problem in the eyes of the public, and as our results show, such frames may slightly lower perceptions of urgency. Yet, this result is rather negligible.

Patient perceptions of urgency of their pelvic floor disorders during the COVID-19 pandemic.

During the COVID-19 pandemic, many surgical societies released guidelines that included cancellation of elective cases.The aim of this study was to better understand our patients' perceptions of the severity of their pelvic floor disorders (PFDs) and to determine what factors influenced this perception. We also aimed to better understand who might be amenable to telemedicine visits and what factors influenced this decision. This is a cross-sectional quality improvement study that included women at least 18years of age diagnosed with a pelvic floor disorder being evaluated within a university Female Pelvic Medicine and Reconstructive Surgery clinic during the COVID-19 pandemic. Patients whose appointments and procedures were being cancelled were queried on whether they would be willing to answer a telephone questionnaire developed by the clinical and research teams. We gathered descriptive data from 97 female patients with PFDs using a primary phone questionnaire. The data were analyzed using proportions and descriptive statistics. Of the 97 patients, the majority (79%) viewed their conditions as non-urgent. Factors that influenced patients' perception of urgency included race (p=0.037), health status (p≤0.001), a history of diabetes (p=0.011), and willingness to attend an in-person appointment (p=0.010). Further, 52% of respondents were willing to attend a tele-health appointment. Statistically significant factors influencing this decision were ethnicity (p=0.019), marital status (p=0.019), and willingness to attend an in-person appointment (p=0.011). The majority of women did not view their conditions as urgent during the COVID-19 pandemic and were amenable to a telehealth appointment.

Discussion-based interprofessional education: A positive step toward promoting shared understanding between surgical residents and nurses

ABSTRACT Interprofessional education during medical training may improve communication by promoting collaboration and the development of shared mental models between professions. We implemented a novel discussion-based intervention for surgical residents and nurses to promote mutual understanding of workflows and communication practices. General surgery residents and inpatient nurses from our institution were recruited to participate. Surveys and paging data were collected prior to and following the intervention. Surveys contained original questions and validated subscales. Interventions involved facilitated discussions about workflows, perceptions of urgency, and technology preferences. Discussions were recorded and transcribed for qualitative content analysis. Pre and post-intervention survey responses were compared with descriptive sample statistics. Group characteristics were compared using Fisher’s exact tests. Eleven intervention groups were conducted (2–6 participants per group) (n = 38). Discussions achieved three aims: Information-Sharing (learning about each other’s workflows and preferences), 2) Interpersonal Relationship-Building (establishing rapport and fostering empathy) and 3) Interventional Brainstorming (discussing strategies to mitigate communication challenges). Post-intervention surveys revealed improved nurse-reported grasp of resident schedules and tailoring of communication methods based on workflow understanding; however, communication best practices remain limited by organizational and technological constraints. Systems-level changes must be prioritized to allow intentions toward collegial communication to thrive.

Low agreement among patients and clinicians about urgency and safety to wait for assessment in primary care after hours medical care: results of cross-sectional matched surveys

BackgroundDiscordance between patient and clinician perceived urgency may drive “inappropriate” presentations to after-hours medical services. This paper investigates the level of agreement between patient and clinicians’ perceptions of urgency and safety to wait for an assessment at after-hours primary care services in the ACT.MethodsCross-sectional survey voluntarily completed by patients and then clinicians at after-hours medical services in May/June, 2019. Agreement between patients and clinicians is measured by Fleiss kappa. Agreement is presented overall, within specific categories of urgency and safety to wait, and by after-hours service type.Results888 matched records were available from the dataset. Overall inter-observer agreement between patients and clinicians on the urgency of presentations was slight (Fleiss kappa = 0.166; 95% CI 0.117–0.215, p < 0.001). Agreement within specific ratings of urgency ranged from very poor to fair. Overall inter-rater agreement on how long it would be safe to wait for assessment was fair (Fleiss kappa = 0.209; 95% CI 0.165–0.253, p < 0.001). Agreement within specific ratings ranged from poor to fair. By site type, agreement between patients and clinicians on urgency ranged from not significant to fair and agreement for safety to wait ranged from very poor to slight. Agreement on urgency of issue was more often reported among patients attending their usual health service or seeing their usual clinician compared to patients attending an unfamiliar health service or clinician (χ2(1) = 7.283, p = 0.007 and χ2(1) = 16.268, p < 0.001, respectively).ConclusionsLow levels of agreement between patients and clinicians on perceived urgency and safety to wait for issues to be assessed indicate potential inefficiency in primary care use after-hours. Agreement on urgency of issues was more common among patients attending a familiar health service or familiar clinician. Improving health literacy, particularly health system literacy, and supporting continuity of care may help to support patients to engage with the most appropriate level of care at the most appropriate time.

Development of business-to-business relationships in turbulent environments

This research examines business relationship structure, formation, development, and maintenance where the socio-political and economic environment for both exchange partners is highly turbulent. Based on multiple case-study data from 33 firms located in the Middle East, we find that turbulent environments create perceptions of uncertainty, dependence, vulnerability, urgency, and crises, leading to the formation of interimistic relationships different from those found within non-turbulent environments. These relationships are characterised by a constant search for new partners and the maintenance of a diverse portfolio of relationships. Relationships typically develop rapidly comprising three phases where a unique dynamic and structure is apparent. Dominant relationship characteristics include competence-based trust alongside control, high levels of instantaneous commitment, informal and rapid adaptation, frequent informal communication, and significant and ongoing efforts at strengthening social bonds with existing and potential partners.

Public evaluations of four approaches to ocean-based carbon dioxide removal

ABSTRACT In the face of mounting global climatic pressures, negative emission technologies (NETs) for carbon dioxide removal (CDR) are increasingly proposed as necessary for meeting climate targets. While initial work has identified the potential of terrestrial NETs, a diverse set of marine/ocean-based NETs are gaining new and particular attention. Emerging studies on the feasibility of marine NETs are urgently needed, especially to explore the logics that public groups use to judge different approaches, and to ensure that design and governance of these technologies align with public values and priorities. This study explores factors of interest in understanding public views on four marine NETs, both perceptions of climate severity and urgency, and beliefs about marine environments. It uses a quantitative survey to explore how a representative sample of people in British Columbia, Canada and Washington state, United States evaluate four marine NETs: coastal restoration; ocean alkalinity enhancement; ocean fertilization; and offshore direct air carbon capture and storage. We find that perceived severity and urgency of climate change predicts greater comfort with all NETs studied, and views of marine environments as adaptable, fragile and manageable vary in predicting both greater and lesser comfort. Drawing upon these insights, the paper offers reflections on the conditional thinking linked with emerging views of marine NETs, concluding with methodological suggestions for future research on public perceptions as concerns the deployment of ocean-based CDR near and long term. Incorporating these insights into policy for ocean-based CDR will be important to ensuring responsible governance of these technologies. Key policy insights Incorporating research on public perceptions will be important to the design of marine NETs and accompanying policies. Public groups in both British Columbia and Washington expressed high levels of comfort with coastal restoration, some comfort with offshore direct air carbon capture and storage, and some discomfort with ocean alkalinity enhancement and ocean fertilization. Perceived severity and urgency of climate change predicted greater comfort with all approaches; this evidence aligns with a small but growing body of scholarship indicating openness to environmental intervention amongst public groups concerned with climate impacts. Beliefs about marine environments, namely whether they are ‘adaptable’, ‘manageable’ or ‘fragile’, also predicted comfort, suggesting that CDR in ocean contexts requires further examination regarding public perceptions.

Paediatric surgeons’ current knowledge and practices of obtaining assent from adolescents for elective reconstructive procedures

PurposeAdolescents develop their decision-making ability as they transition from childhood to adulthood. Participation in their medical care should be encouraged through obtaining assent, as recommended by the American Academy of...

Public perceptions of urgency of severe cases of COVID-19 and inflammatory gastrointestinal disease.

BackgroundThere is evidence that perceived urgency of medical complaints is associated with emergency care utilization. Patients’ perception of urgency can differ from physicians’ assessment. This study explored public perceptions of urgency of severe cases of COVID-19 and inflammatory gastrointestinal disease and analyzed variations in perceptions of urgency by characteristics of the afflicted person in the vignettes and sociodemographic characteristics of respondents.MethodsVignettes with severe symptoms of either inflammatory gastrointestinal disease or COVID-19 with comparable urgency of treatment were used in a telephone survey in Germany (N = 1,207). Besides disease, the vignettes varied in terms of sex, age (child, middle-aged person, old person) and daytime (Tuesday morning, Tuesday evening). Respondents were asked to rate the urgency of the reported symptoms with four items. A sum scale was computed. Variations in perceptions of urgency according to vignette characteristics and sociodemographic characteristics of the respondents (sex, age, educational level, migration background, children (yes/no) and personal affliction) were analyzed using a linear regression model.ResultsIn terms of vignette characteristics, multivariate analysis showed a lower estimated urgency for males, as well as for the middle-aged and aged persons, compared to the child vignettes, and for COVID-19, compared to inflammatory gastrointestinal disease. Regarding the characteristics of the respondents, estimated urgency increased with age and was lower among respondents, who were previously affected by the symptoms themselves.ConclusionAlthough urgency in the vignettes was comparable, variations in estimated urgency by age and sex of the afflicted person and the described disease as well as age and personal affliction of the respondents were identified. This could result in an inadequate health care service utilization. Therefore, variations in public perceptions of urgency should be considered in the planning of public campaigns on adequate health care services utilization.

Differences in Patient and Physician Perceptions of Urgency for Musculoskeletal Conditions During the COVID-19 Pandemic.

In 2020, the coronavirus disease 2019 (COVID-19) pandemic limited musculoskeletal care to urgent or "nonelective" office visits and procedures. No guidelines exist to inform patients or physicians what meets these criteria. The purpose of this multi-institutional study was to describe the differences in perceptions of urgency for musculoskeletal complaints between patients and providers during the COVID-19 pandemic. An anonymous survey was distributed to patients who visited the authors' orthopedic clinics in January and February 2020 and practicing orthopedic surgeons. The surveys were administered in May 2020 after COVID-19 was officially labeled a pandemic and included questions regarding demographic information and perceptions of orthopedic urgency. A total of 1491 patients and 128 physicians completed the surveys. A significantly higher percentage of physicians considered the following diagnoses an appropriate indication for an urgent visit compared with patients: fracture (P<.001), acute dislocation (P<.001), infection (P<.001), neurologic compromise (P<.001), tumor (P<.001), acute tendon injury (P<.001), weakness (P<.001), inability to bear weight (P<.001), post-surgical problem (P<.001), and painful joint effusion (P<.001). There were no significant differences in the perception of urgency for the following conditions: bursitis/tendonitis (P=1.00), joint/extremity deformity without pain (P=.113), and loss of range of motion of a joint (P=.467). Younger patients and those with higher levels of education were significantly more likely to consider their conditions urgent. Patients may require additional education to prevent delay in treatment of urgent conditions-especially time-sensitive conditions such as neurologic compromise, tumors, and infections-when access to physicians is limited. [Orthopedics. 2021;44(4):e534-e538.].

Crisis, uncertainty and urgency: processes of learning and emulation in tax policy making

This article examines how ideational factors shape policy making during crisis conditions. Crises can generate ‘problem uncertainty’, in which policymakers are uncertain about the nature of policy problems. Existing studies have linked such conditions to processes of policy learning. Yet crises can also trigger ‘policy urgency’, where policymakers’ preference for immediate policy action is paramount. This study suggests that bounded emulation, in which policymakers copy available solutions without learning, is related to perceptions of policy urgency. To probe the plausibility of the framework the study conducts a comparative analysis of value-added tax reform in Ontario and British Columbia, drawing on 41 semi-structured interviews, policy documents and news articles. The study finds that high uncertainty and moderate urgency facilitated policy learning in Ontario, while moderate uncertainty and high urgency fostered bounded emulation in British Columbia. The article identifies the implications of the findings for future research on ideas and policy change.

Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study

BackgroundHow quickly physicians respond to communications from bedside nurses is important for the delivery of safe inpatient care. Delays in physician responsiveness can impede care or contribute to patient harm....

A Question of Time: Sociotemporality in Academic Libraries

The clock and calendar regulate many library activities, but the seasonal and temporal dimensions of libraries are largely unexplored. Intrigued by observations of colleagues’ temporal attitudes and behavior, the authors drew on the work of sociologist Eviatar Zerubavel to investigate the perceptions of time, schedules, and urgency among professional library personnel. The data showed almost no statistically significant relationships between demographic categories and the employee’s approach to time; however, multiple significant relationships existed between the latter and the employee’s department. These findings can help academic librarians understand—and bridge—differences among themselves to build more vigorous organizations.

Visuals as a method of coastal environmental communication

This study explores the influence of visual imagery on individuals' perception of complex scientific information on coastal land loss. It investigates how mass media channels use visual frames to convey an environmental issue's outcomes and how these frames might influence perceptions of issue urgency and issue importance. The primary message frames explored in this study were gain/loss frames and temporal context. A content analysis was conducted to collect online images of coastal land loss in Louisiana and the potential message frames used to communicate this issue's outcomes to the public were identified for each image and coded. Focus group discussions were then used to evaluate the effectiveness of these message frames. Results suggest that visual cues can shape public understanding of coastal change and its risk to coastal communities. Particularly, images that refer to future environmental conditions (temporal context) are more likely to convey the urgency and importance of an issue. Images that emphasize environmental and economic losses may be more engaging to an audience, however these types of images may also reduce motivation to mitigate losses. Willingness to support environmental solutions appears to be a result of public's ability to visualize short-term goals and successes. Best practices for coastal managers to produce and deliver environmental imagery are discussed.

From Utopia Competition to Utopic Contentiousness: Reaffirming the Social in Large-Scale Transitions

In recent years a number studies have been produced offering a model of socio-political change, albeit erected on largely economic foundations. These studies, presenting a model of “utopia competition,” suggest that citizens invest economic resources in support of their preferred socio-political utopia, and societal dynamics are comprehended as a co-evolutionary process between competing utopias. The emergence and habituation of socio-political conditions are determined by economic contributions toward the acceptance of ideas about preferred ways to organise political and social arrangements. This paper provides an extension of such models by explicitly incorporating sociological insights, such as the existence of symbolic resources, discourse processes and the role of media in filtering communication, social perceptions of risk and urgency, and citizenry selection amongst alternative repertoires of contention (such as protests, voting, and direct lobbying). In short, we seek to reconfigure the conceptual and analytical scope of socio-political change from that of “competition” to “contention.” A broader notion of “utopic contentiousness” surely accommodates economic mechanisms for facilitating changes to socio-political figurations but, by the same token, does not preclude potential for phenomena such as societal backlash dynamics and rhetorical stalemates which could frustrate change.

Graduate Employability: New Graduates Perceptions of important, urgency and performance of Employability Skills in Malaysia

Graduate Employability: New Graduates Perceptions of important, urgency and performance of Employability Skills in Malaysia

Effect of Harm Anchors in Visual Displays of Test Results on Patient Perceptions of Urgency About Near-Normal Values: Experimental Study

BackgroundPatient-facing displays of laboratory test results typically provide patients with one reference point (the “standard range”).ObjectiveTo test the effect of including an additional harm anchor reference point in visual displays of laboratory test results, which indicates how far outside of the standard range values would need to be in order to suggest substantial patient risk.MethodsUsing a demographically diverse, online sample, we compared the reactions of 1618 adults in the United States who viewed visual line displays that included both standard range and harm anchor reference points (“Many doctors are not concerned until here”) to displays that included either (1) only a standard range, (2) standard range plus evaluative categories (eg, “borderline high”), or (3) a color gradient showing degree of deviation from the standard range.ResultsProviding the harm anchor reference point significantly reduced perceived urgency of close-to-normal alanine aminotransferase and creatinine results (P values <.001) but not generally for platelet count results. Notably, display type did not significantly alter perceptions of more extreme results in potentially harmful ranges. Harm anchors also substantially reduced the number of participants who wanted to contact their doctor urgently or go to the hospital about these test results.ConclusionsPresenting patients with evaluative cues regarding when test results become clinically concerning can reduce the perceived urgency of out-of-range results that do not require immediate clinical action.

Disentangling the Personal Agenda: Identity and School Board Members’ Perceptions of Problems and Solutions

ABSTRACTUsing data drawn from a 2009 nationwide survey of school board members, this study asks three questions: What are the policy priorities of school board members? How do members’ identities predict priorities? Lastly, is this relationship moderated by district context? Our results demonstrate that a variety of characteristics predict perceptions of issue urgency and cogent policy solutions for addressing student achievement. We also find evidence that the translation of Black identity to perceptions is moderated by district context. Our results indicate that attention to board members’ identities may be critical for developing effectively functioning boards and understanding local education policy.

Reasons for non-urgent presentations to the emergency department in Saudi Arabia

BackgroundThe majority of patients who attend emergency departments (EDs) in Saudi Arabia have non-urgent problems, resulting in overcrowding, excessive waiting times and delayed care for more acutely ill patients. The purpose of this research was to examine the reasons for non-urgent visits to a Saudi ED and factors associated with patient perceptions of urgency. MethodsWe administered a survey to 350 consecutively presenting Canadian Triage and Acuity Scale (CTAS) IV or V adult patients at a large tertiary ED in Riyadh region, Saudi Arabia, during 25 days of data collection in March 2013. ResultsOver half of the sample usually visited the ED to access healthcare. The most common reasons for attending the ED were not having a regular healthcare provider (63%), being able to receive care on the same day (62%), and the convenience of and access to medical care 24/7 (62%). Approximately two-thirds of CTAS V patients and one-third of CTAS IV patients believed their conditions were more urgent than their triage nurse rating. ConclusionMultiple factors influence non-urgent visits to the ED in the Saudi context including insufficient community awareness of the role of the ED and perceived lack of access to primary healthcare services.