Practitioner Views Research Articles

Conceptualising public mental health: development of a conceptual framework for public mental health

BackgroundNumerous determinants have been linked to public mental health; however, they have not been brought together in a comprehensive conceptual framework. The goal of this work was to bring together academic research, practitioner expertise, and public perspectives to create a public mental health conceptual framework.MethodsThe development process proceeded in four stages. First, we identified a comprehensive list of potential determinants through a state-of-the-art academic literature review, grey literature review, and created mind maps created by peer researchers. Next, we conducted in-person workshops, consultations, and an online survey with academics, practitioners, policy makers, and members of the public to review the potential determinants, nominate additional determinants, and prioritise determinants by importance for understanding public mental health. This iterative process resulted in the final list of determinants contained in the framework. We then conducted rapid reviews to define each determinant and to identify key research, interventions, and resources. Finally, we worked with a design team to visualise the conceptual framework as an online tool and printable infographic.ResultsWe found substantial overlap between sources reflecting a shared understanding of the key drivers of public mental health. The unique determinants that emerged from each data source highlighted the importance of using multiple sources to create a comprehensive model. 72 potential determinants were prioritised through stakeholder consultations, resulting in a final list of 55 determinants and organised into four levels: individual, family, community, and structural.ConclusionsThis is the most complete conceptual framework for public mental health to date, bringing together academic research, policy and practitioner views, and lived experience perspectives. The co-production processes and tools we used provides a template for researchers looking to include multiple perspectives in their research.The conceptual framework draws together current knowledge on each determinant, but also highlights areas where further research is needed to better understand the relationship between each factor and mental health, which can inform the research agenda. This online tool and infographic can be used by practitioners to identify interventions for promoting mental health, and by the general public as a resource to increase awareness of the broad factors which shape public mental health.

Patient and health practitioner views and experiences of a cancer trial before and during COVID-19: qualitative study

BackgroundUnderstanding patient and health practitioner perspectives on clinical trials can inform opportunities to enhance trial conduct and design, and therefore patient experience. Patients with haematological cancers have faced additional risk and uncertainty during the pandemic but it is unclear how they and practitioners have experienced cancer trials during this period. In the context of a haemato-oncology trial (PETReA), we compared patient and practitioner views and experiences of PETReA before and during COVID-19.MethodsQualitative study embedded within PETReA. Semi-structured interviews (N=41) with patients and practitioners from 16 NHS sites before (n=17) and during the first wave of COVID-19 (n=24). Analysis drew on the framework approach.ResultsPractitioners acknowledged the need for the trial to continue during the pandemic but their treatment preferences altered, becoming more pronounced for patients who had a favourable response to induction treatment, while staying unchanged for patients with a less favourable response. Practitioners commented that COVID-19 meant the evidence base for the trial arms was lacking or mixed, but that it likely increased the risks of maintenance treatment for patients with a favourable response to induction treatment. While only one participant interviewed withdrew from PETReA during the pandemic, others said they would consider withdrawing if information that they were at increased risk of severe illness from COVID-19 became available. During COVID-19, patients described less frequent contact with the trial team, which left some feeling less clear about their trial pathway. However, several described having in-depth, collaborative discussions with practitioners about the risks and benefits of randomisation in the context of COVID-19. Patients valued these discussions and were reassured by the emphasis practitioners placed on patients being free to withdraw if circumstances changed, and this helped patients feel comfortable about continuing in PETReA.ConclusionsThe findings point to ways trial communication can support patients to feel comfortable about continuing in a trial during uncertain times, including adopting a more in-depth, collaborative exploration of the risks and benefits of trial arms with patients and emphasising voluntariness. The results are relevant to trialists recruiting patients who are clinically extremely vulnerable or are at increased risk of poor COVID-19 outcomes despite being vaccinated.

Strengthening monitoring and evaluation of multiple benefits in conservation initiatives that aim to foster climate change adaptation

AbstractAs the need to monitor and evaluate progress on climate change adaptation is increasingly recognized, practitioners may benefit from applying lessons about effective monitoring from the conservation field. This study focuses on monitoring conservation interventions that aim to foster climate change adaptation by assessing: what ways practitioners are adopting best practices from monitoring and evaluation (M&E) in conservation; what practitioners are monitoring in relation to reported outcomes; how monitoring comprehensiveness varies in practice and what factors enable more comprehensive monitoring; and practitioner views on what could improve M&E of adaptation actions. We conducted this study using a portfolio of 76 adaptation projects implemented across the United States and employed a mixed‐methods design that included document analysis, an online survey, and semi‐structured interviews. The majority (84%) of projects reported social outcomes at project completion in addition to ecological outcomes (100%), but monitoring plans focused primarily on ecological and biophysical changes. Only 21% of projects connected monitoring metrics to a theory of change linking actions to expected outcomes. Involvement of an external research partner was identified as a key factor in supporting more comprehensive monitoring efforts. Results provide applied insights for enhancing delivery of social and ecological outcomes from adaptation projects, and suggest research pathways to improve monitoring and effectiveness of climate‐informed conservation.

Remote scanning support in magnetic resonance imaging: Friend or foe?

IntroductionRecent advances in technology have seen the introduction of remote scanning capabilities become a reality for departments, allowing staff to remotely access, observe and even scan without being by the scanner side. The COVID-19 pandemic has accelerated use of remote working which also aligns with the direction of travel for healthcare more widely. However for technology to succeed it needs to be acceptable for use by radiographers in clinical practice. MethodsFollowing trial of a remote scanning technology, a group of radiographers were surveyed for their views on its use in practice. The survey was based on the Technology Acceptance Model as well as providing opportunity for open feedback on views regarding the technology. ResultsPerceived ease of use was high but appears to have little influence over overall intention to use. Perceived usefulness was lower and demonstrated correlations with attitude towards and intended use of the remote technology, suggesting that this is a key area to address which would positively impact on acceptance. Other considerations that would help support effective implementation were highlighted with the majority stating the technology as friend rather than foe. ConclusionAs an early evaluation of practitioner views on remote scanning within MRI, the results highlight the areas that would benefit from further development before further roll out in practice. A clear vision of its use and robust governance is needed to effectively support its implementation and acceptance by radiographers. Implications for practiceIntroducing remote scanning technology has potential to support training and share skills of experienced radiographers across multiple locations. It has the potential to transform the way MRI departments work and increase safer supervision to enable wider utilization of the support workforce.

Clinician views on optimism and empathy in primary care consultations: a qualitative interview study

Practitioner expressions of optimism and empathy may improve treatment engagement, adherence, and patient satisfaction but are not delivered consistently amid the challenges of everyday clinical practice. To explore primary care practitioner (PCP) views about optimistic and empathic communication in consultations; and to identify behavioural, attitudinal, and/or contextual issues likely to encourage or deter PCPs from practising such communication. Qualitative interview study with 20 PCPs (GPs, practice nurses, and primary care physiotherapists). Semi-structured telephone interviews with 20 PCPs. Data were analysed thematically. A conceptual mismatch between optimism and patient expectations became apparent; when asked how PCPs communicate about the likely effects of a treatment, answers were focussed around managing patient expectations. When prompted, it became clear PCPs were open to communicating optimistically with patients, but emphasised the need for realism. Concerns arose that patients may not be receptive to optimistic messages, especially when holding negative expectations. PCPs felt that expressing empathy is fundamental to all clinical consultations, noting that it can be challenging. Some PCPs worried that increasing expressions of empathy might increase their risk of clinician burnout and felt guilty about (appropriately) communicating empathy while maintaining some emotional distance. PCPs agreed expressing realistic optimism during consultations could aid communication and would constitute a novel change to practice. PCPs strive for clinical empathy but can struggle to manage emotional self-protection. Specific training to help PCPs express realistic optimism and empathy, and better utilise efficient non-verbal skills could help these issues.

Remote family dispute resolution services for COVID and post-COVID times: Client and practitioner perspectives.

In 2020, residents in the state of Victoria, Australia endured months of government restrictions aimed at curbing multiple outbreaks of COVID‐19. Family Dispute Resolution (FDR) services continued to assist separating couples to sort out their parenting and property matters, necessitating a rapid and wholesale shift to remote delivery via telephone and video conferencing. This paper reports on interviews during and subsequent to ‘lockdown’ with clients of FDR services offered by a large, community‐sector provider. The data collected provide insights into the ways in which the pandemic affected the immediate needs and concerns of families as they navigated separation and shared parenting during the pandemic. Of importance to service development, the data include client responses to different methods of FDR service delivery and their reflections on how well these evolving methods were suited to their needs. Practitioner views were also sought on service delivery methods to provide a comprehensive picture of the advantages and challenges of remote delivery, and the ways in which it helped or hindered in catering to the needs of clients with safety concerns. Collectively the results of these analyses indicate that COVID has produced new risks and opportunities for the provision of FDR services, in both COVID and post‐COVID worlds. The evolving FDR service model will likely continue to feature multiple delivery options, regardless of the trajectory of the pandemic.

Preparing students for the workplace in developing countries: a study of accounting education in Libya

ABSTRACT Through qualitative analysis of a dozen semi-structured interviews, this study identifies the issues that limit the ability of accounting education programmes to prepare students for the workplace in Libya, a country in the MENA (Middle East and North Africa) region. Factors include: faculty’s lack of practical experience; weak links with the profession; a traditional curriculum; teacher-centred pedagogy; traditional forms of assessment; the number and quality of students; limited or outdated resources; and poor physical infrastructure. As a study of the preparation of students for the workplace in a developing country, which takes account of both faculty and practitioner views, this paper also contributes to the limited literature on accounting education in Libya. Considering the findings through the lens of institutional theory concepts leads to recommendations for options that are likely to be relevant not only to Libya but also to the wider MENA region and other developing countries.

General dental practitioner views on the current and future provision of advanced NHS restorative dentistry services: a cross-sectional survey in England.

Introduction Advanced NHS restorative dentistry services are an important aspect of patient care. Managed clinical networks (MCNs) have been proposed as a future model of care.Aim To assess general dental practitioners' (GDPs') satisfaction with the current provision of advanced NHS restorative dentistry services and assess their views on MCNs.Methods A self-administered, online survey was distributed by the Northern Dental Practice Based Research Network and was shared on social media.Results In total, 108 responses were received from GDPs working in England; 55% in the North East. GDPs felt current services for periodontics, endodontics, tooth surface loss and temporomandibular disorders were the most important and were most unsatisfied with periodontics, endodontics and tooth surface loss. The most important barriers to current referral practice were previous referral rejections and the return of costly treatment plans. Opinions were favourable towards the proposed MCNs, with one-third of participants feeling they were already suitable to apply to deliver Level 2 services. There was a notable imbalance between sexes, with fewer female dentists (57%) registering interest in joining an MCN compared to their male counterparts (76%) and female dentists also identifying more barriers to join MCNs, including access to suitable training. Recent graduates were least likely to cite a lack of time as a barrier to engaging with MCNs.Conclusions GDPs are currently unsatisfied with advanced NHS restorative dentistry services but appear keen to engage with MCNs. The survey identified important insights which may help healthcare planners develop services.Supplementary InformationZusatzmaterial online: Zu diesem Beitrag sind unter 10.1038/s41415-022-4035-y für autorisierte Leser zusätzliche Dateien abrufbar.

Patient and practitioner views on a combined face-to-face and digital intervention to support medication adherence in hypertension: a qualitative study within primary care

ObjectivesTo explore patients’ and healthcare practitioners’ (HCPs) views about non-adherence to hypertension medication and potential content of a combined very brief face-to-face discussion (VBI) and digital intervention (DI).MethodsA qualitative study...

Cluster randomised controlled trial to assess a tailored intervention to reduce antibiotic prescribing in rural China: study protocol

IntroductionUp to 80% of patients with respiratory tract infections (RTI) attending healthcare facilities in rural areas of China are prescribed antibiotics, many of which are unnecessary. Since 2009, China has...

A Qualitative Exploration of Primary Care Practitioner Views About Training to Treat Opioid Use Disorder

A Qualitative Exploration of Primary Care Practitioner Views About Training to Treat Opioid Use Disorder

Is present pharmacy education adapted to needs? Survey results from young practitioner views regarding pharmacy education outcome towards a national reform in Hungary

BackgroundThe pharmacist career is constantly adapting to societal and health care needs. The past decade has seen a growing demand for curricular development to align graduation outcome with workforce competencies. ObjectiveThis study aims to identify expectations for both didactic and experiential components of a new curriculum based on young pharmacist practitioner views. MethodsAn online survey questionnaire was used in 2019–2020 to evaluate the pharmacy curriculum to detect indicators or key areas which require comprehensive reform. ResultsThe predominant majority of the 205 study participants recommended reduction in credit hours for Natural Sciences (78.54%) and a similar increase in the Theoretical and Practical Expertise Module (77.9%). Pharmaceutical care, clinical therapeutics and clinical pharmacy competencies should also be more highlighted in the program. Findings indicate the current training does not prepare for problem-solving and daily workplace challenges (72.7%) or for extended pharmacist skills and competencies (71.71%). Results show inconsistency in practical training experience, as all respondents participated in practical training for drug manufacturing and analysis but 61.0% reported no hands-on skills training in a hospital-clinical simulation setting. Indications for practitioner involvement into the natural sciences and biomedical subjects (86.3%) confirm the obvious need for more practice-oriented education. ConclusionsEducational reforms seem to be inevitable to achieve measurable improvement in professional practice and skills competency. The country specific demand for a needs-based pharmacy education reflects global trends but may also provide useful insights for individual transitions to transform education through practice and improve practice through education.

Reiki practitioners’ perceptions of the impact of the COVID-19 pandemic on the experience, practice and future of Reiki

ObjectivesThis study examined the impact of the COVID-19 pandemic on the experience, practice and future of Reiki in the UK, including the personal impact of the pandemic on practitioners and their work, practitioner perceptions of the future of the profession and Reiki delivery, and practitioner experiences and views of distant Reiki in comparison to hands on or near the body treatments. MethodA qualitative study using semi-structured interviews was carried out with 10 Reiki practitioners. Interviews were recorded, transcribed verbatim and analysed using thematic analysis. ResultsThree themes were identified: adapting and growing with the challenges of COVID-19, Reiki for individual and community resilience, and moving from the mainstream hands on to lesser known distant Reiki. ConclusionWhile the COVID-19 pandemic personally impacted Reiki practitioners, they focused on turning adversity into opportunity, to overcome a sense of disconnectedness and social isolation, by providing social support and promoting individual and community resilience. Practitioners focused on self-care, personal development and reaching out to the community. Personal Protective Equipment was perceived as necessary for infection control but a potential barrier to the client's experience of Reiki. They saw value in adapting their practice as part of the future of the profession by utilising new technology and distant Reiki healing, but were clear this could not replace in person contact.

Practitioner Perspectives on a Restorative Community: An Inductive Evaluative Study of Conceptual, Pedagogical, and Routine Practice

The purpose of this study is to explore restorative practice (RP) within education, highlighting practitioner views from an inductive evaluative perspective. This is in response to the suggested ambiguity over what constitutes RP in education. Practitioner perspectives are explored, providing an insight into an established restorative school. New data offer further clarity on RP in education by describing embedded practice and highlighting sites for further specific task analysis. Methods include semi-structured questionnaires in the form of employee practice statements, situated within insider research. Eleven practice statements were completed, which were then subject to in-depth thematic analysis. The main findings of this study suggest that RP is clearly understood in this educational setting and participants described a wholistic approach that is part of a wider culture, not just practice as an intervention. Analysis suggests that this can be categorised into the following three themes: Conceptual, Pedagogical and Routine Practice. When used alongside one another, it is suggested that these themes create a restorative paradigm, which is of relevance to the field of education. As such, this paper is designed to provide a useful resource for schools, policy makers and researchers alike.

Parental and Practitioner Views of Telepractice for Pediatric Auditory Verbal Habilitation at a Time of Global Pandemic

Purpose: The aim of this study was to explore parents' and therapists' views of the benefits and challenges of telepractice for early intervention for children who are deaf or hard of hearing during the COVID-19 pandemic. Method: Surveys probed the views of (a) parents and (b) Listening and Spoken Language Specialist (LSLS) Certified Auditory Verbal Therapists (AVTs) in using telepractice to deliver auditory verbal (AV) sessions. The survey for parents covered technology, coaching, communication, learnings for the parent, learnings for the child, and parental preference. The survey for the therapists examined therapy style, technology, relationships with families, and coaching style. Using a convenience sample of 65 families and nine LSLS Certified AVTs, data were collected using Google Forms. Results: A response rate of 42% was achieved for the parents' survey. Families were overwhelmingly confident in the subjective effectiveness of AV sessions delivered by telepractice with modal ratings of 8 and 9 on a 10-point rating scale for telepractice sessions and in-person sessions, respectively. On average, however, parents rated in-person sessions at a significantly higher level. Eighty-five percent opted to continue with either AV delivered solely via telepractice or a blend of telepractice and in-person sessions. Changes in therapists' style included (a) increased interactions with the parent rather than the child and (b) an improvement in coaching techniques. Eight of nine therapists (89%) felt that sessions delivered via telepractice were equally effective as or more effective than in-person sessions. Discussion: The necessary transfer of all AV sessions to telepractice from in-person sessions during the global pandemic of COVID-19 was enacted successfully for the majority of families. Both parents and therapists described benefits and challenges of telepractice for AV intervention. Going forward, the high proportion of families requested either a blended service delivery of telepractice and in-person sessions or therapy via telepractice alone, demonstrating the families' satisfaction with this approach.

PRACTITIONER OPINIONS ON IMPORTANT TECHNOLOGY RELATED TO DATA MANAGEMENT AND ANALYSIS SKILLS FOR THE ACCOUNTING CURRICULUM

ABSTRACT Businesses operate in a global, data driven, and ever-changing technological environment, and Accounting is one of the most data driven business disciplines. Many academic accounting programs include a dedicated course for teaching technology related to the accounting profession, often referred to as Accounting Information Systems (AIS). Continual changes in technology necessitates a continual assessment of accounting course content with a view toward incorporating recent technological trends, including the management and analysis of accounting data. Based on a survey of certified accounting professionals in North Carolina, we identify a set of data-related topics considered to be of current importance for accounting graduates. These topics could be included in an existing AIS course, packaged as a stand-alone AIS course or incorporated into an applied Business Data Management/Analytics course, depending on the needs of the academic institution. Keywords Accounting, Data Analytics, IT Management, Practitioner views, Survey, Training, Undergraduate Business students

Patient and practitioner views on cancer risk discussions in primary care: a qualitative study.

BackgroundIt is estimated that nearly 600 000 cancer cases in the UK could have been avoided in the past 5 years if people had healthier lifestyles, with the principle modifiable risk factors being smoking, obesity, alcohol consumption, and inactivity. There is growing interest in the use of cancer risk information in general practice to encourage lifestyle modification.AimTo explore the views and experiences of patients and practitioners in relation to cancer prevention and cancer risk discussions in general practice.Design & settingQualitative study among patients and practitioners in general practices in Glasgow, UK.MethodSemi-structured interviews were conducted with nine practitioners (five GPs and four practice nurses, recruited purposively from practices based on list size and deprivation status), and 13 patients (aged 30–60 years, with two or more specified comorbidities).ResultsCurrently, cancer risk discussions focus on smoking and cancer, with links between alcohol and/or obesity and cancer rarely made. There was support for the use of the personalised cancer risk tool as an additional resource in primary care. Practitioners felt practice nurses were best placed to use it. Use in planned appointments (for example, chronic disease reviews) was preferred over opportunistic use. Concerns were expressed, however, about generating anxiety, time constraints, and widening inequalities.ConclusionHealth behaviour change is complex and the provision of information alone is unlikely to have significant effects. Personalised risk tools may have a role, but important concerns about their use remain, particularly in areas of socioeconomic disadvantage.

Combining data from consumers and traditional medicine practitioners to provide a more complete picture of Chinese bear bile markets

Abstract Understanding wildlife consumption is essential for the design and evaluation of effective conservation interventions to reduce illegal trade. This requires understanding both the consumers themselves and those who influence their behaviour. For example, in markets for wildlife‐based medicines, both consumers and medical practitioners have a role in which products are consumed. We used mixed methods to triangulate data on bear bile consumption from 3,646 members of the public, 80 pharmacy workers and 38 Traditional Chinese Medicine (TCM) doctors in four provincial capital cities across China. Bear bile can be sold legally in packaged TCM products made from farmed bile, or sold illegally, often as raw gallbladders from wild bears. We interviewed medical practitioners, and surveyed the public using both direct questions (DQ) and the Unmatched Count Technique (UCT), an indirect method used to improve reporting of sensitive behaviours. We applied a ‘combined’ UCT‐DQ analysis to produce a more robust consumption estimate. In all, 140 (3.8%) survey respondents directly reported recent (<3 years) bile consumption, but the combined UCT‐DQ estimate was 11.2%. In total, 14 survey respondents (0.4% sample and 10% recent consumers) self‐reported recent wild bile consumption. Almost a quarter of doctors and half of pharmacy workers had ever prescribed bile. Around half of doctors and over a quarter of pharmacy workers said that bear bile was the best medicine in certain situations. More than half of doctors and over a third of pharmacy workers thought wild bile was more effective than farmed, although we found no evidence of wild bile being formally prescribed. Consumers could name specific treatment uses of bile but almost half of recent consumers did not know the source of bile they had consumed. We show that gathering perspectives from different wildlife market actors can generate a more complete picture of trade. In China, bile consumption may be limited by its specific TCM treatment uses, but whether practitioner views on the greater effectiveness of wild bile are passed to consumers must be investigated further. With potential overlap between farmed and wild consumption, any interventions to change these markets must carefully consider how both consumers and practitioners may react. A free Plain Language Summary can be found within the Supporting Information of this article.

Development of an assessment guide to evaluate meaningful outcomes for people living with dementia who are engaged in reablement programs

Purpose Clinical practice guidelines for dementia recommend the provision of rehabilitative or reablement interventions that support functioning. This project sought to develop an assessment guide, centring on goal attainment scaling (GAS), for practitioners to measure attainment of meaningful outcomes for people living with dementia participating in reablement programs. Materials and methods To assist in guide development, two focus groups (people impacted by dementia [n = 10]) explored priority reablement goals. Two further focus groups (allied health practitioners [n = 11]) explored understanding and experience using GAS, opinions on what goals would be realistic, and how an assessment guide could best support practice. Results The key focus group themes that emerged and which underpinned guide development were: ‘what is possible’; ‘who sets the goals’; ‘practitioner perspectives on using GAS’. Leisure was a key goal priority for people impacted by dementia, and echoed by practitioners. The assessment guide is structured around three steps: choosing goals (using focus group derived Reablement Goal Lists); defining goals (using a new Dementia-specific SMART Framework); scoring goals (using GAS-Light). Conclusions Providing a structured approach to evaluation of reablement programs for people living with dementia could lead to more consistent service provision, improved outcomes and opportunities for benchmarking. Implications for Rehabilitation Dementia is a leading cause of disability in older people. Rehabilitative interventions such as reablement are recommended to support functioning in people living with dementia, but there is currently no consistent method of selecting and evaluating attainment of meaningful outcomes. This study describes the reablement goals identified by people impacted by dementia as being most important, along with allied health practitioner views on goal-setting and the use of Goal Attainment Scaling (GAS). Study findings were used to develop a structured assessment guide employing three steps: choosing reablement goals; defining those goals using a new dementia-specific SMART Framework; and scoring goals using GAS-Light. A consistent approach to goal selection and evaluation of attainment for people impacted by dementia participating in reablement programs may lead to more effective rehabilitative interventions in this group.

Barriers and facilitators to implementation of shared medical appointments in primary care for the management of long-term conditions: a systematic review and synthesis of qualitative studies

ObjectiveTo synthesise the published literature on practitioner, patient and carer views and experiences of shared medical appointments (SMAs) for the management of long-term conditions in primary care.DesignSystematic review of qualitative...