Showing papers by "Karen Francis published in 2020"

From textual to visual: the use of concept mapping as an analytical tool in a grounded theory study:

Abstract: Dealing with a large amount of qualitative data during the analytical process can be challenging especially when the data needs to be regularly discussed with other research team members. For researchers employing grounded theory methodology and methods, using visual tools such as concept maps or diagrams can be a beneficial approach at all phases of the research. Concept maps can assist researchers to visualize emerging concepts from raw data, efficiently communicate the developing theory under construction and demonstrate progress in the analytical thinking process. However, despite the usefulness of concept mapping, there is limited and detailed information on the use of concept mapping to guide novice researchers. This research presents the distinctive experiences of the authors in utilizing concept mapping to facilitate the analytical process of theory generation they undertook when conducting a grounded theory study examining diabetes health education in an Indonesian context. It is recommended that researchers consider the flexibility and efficacy of concept mapping as a tool to assist them with the process of data analysis in qualitative research.

Health care providers' perceptions of factors that influence the provision of acute stroke care in urban and rural settings: A qualitative study.

Abstract: Objectives:Individuals living in rural areas have comparatively less access to acute stroke care than their urban counterparts. Understanding the local barriers and facilitators to the use of curre...

The characteristics of Queensland private physiotherapy practitioners' interprofessional interactions: a cross-sectional survey study.

Abstract: Effective interprofessional collaboration (IPC) contributes to superior patient outcomes, facilitates cost-efficient health care, and increases patient and practitioner satisfaction. However, there is concern that IPC may be difficult to implement in clinical settings that do not conform to formal team-based processes, such as mono-professional physiotherapy private practice facilities. The aim of this study was to describe the characteristics of private physiotherapy practitioners' interprofessional interactions, including their experiences and perceptions regarding IPC. A custom developed cross-sectional online survey instrument was used to collect data from physiotherapists employed in private practice facilities in Queensland, Australia. In all, 49 (20% response rate) physiotherapists completed the survey. Only a small proportion (14%) indicated that their interprofessional interactions were a daily occurrence, and less than one-third of all respondents (31%) participated in formal, multi-professional face-to-face planned meetings. Most participants (76%) reported a moderate-to-high level of satisfaction regarding their interprofessional interactions. Despite low self-reported levels of interprofessional activity and other data indicating that IPC is necessary for holistic patient care, this study shows that physiotherapists were predominately satisfied when interacting with health practitioners from various professional backgrounds. Further research is required to inform the implementation of robust strategies that will support sustainable models of IPC in physiotherapy private practice.

Diabetes Self-Management: What Role Does the Family Play?.

Abstract: Purpose: This paper aims to explicate one of the major findings of a research study seeking to understand how Indonesian people with diabetes learn about their disease. The one key finding discussed in this paper is how families influence the learning and self-management processes adopted by Indonesian people with diabetes. Design/methodology/approach: A grounded theory methodology was adopted to investigate how Indonesian people with diabetes learn about their disease. Twenty-eight semi-structured interviews were undertaken with Indonesian people living with diabetes, families of people living with diabetes, healthcare professionals and other healthcare providers. Data was analysed by using constant comparative analysis during three coding stages. Findings: The study explicated the basic social process of how people with diabetes in Indonesia learn about their disease through a generated theory "Learning, choosing, and acting: self-management of diabetes in Indonesia". This study found family engagement was integral to Indonesian people living with diabetes who were self-managing their disease. Families assisted with seeking information, providing recommendations, selecting and implementing actions, appraising implemented actions, and informing others about their experiences. By acknowledging that family is involved in this process, the healthcare professional can adequately provide health education to both the person with diabetes and their families. Involving families in health education is crucial as family can influence decision making made by people with diabetes in a proper or improper way. Thus, clinicians need to also skilfully recognise difficulties these people encounter by monitoring their self-management progress and by working closely with them and their family members. Originality/value: This is the first study conducted in Indonesia that specifically investigates the process of how people with diabetes learn about their disease. The involvement of families in this process is a central finding of the study. Families can enhance the overall health and well-being of the person with diabetes, aid in early recognition of aberration to health status and trigger the initiation of interventions to re-establish homeostasis if they are actively engaged and supported by health professionals.

Regional differences in access to acute ischaemic stroke care and patient outcomes.

Abstract: Background: Advances in stroke management such as acute stroke units and thrombolysis are not uniformly distributed throughout our population, with rural areas being relatively disadvantaged. It remains unclear, however, whether such disparities have led to corresponding differences in patient outcomes. Aims: To describe the regional differences in acute ischaemic stroke care and outcomes within the Australian state of Tasmania. Methods: A retrospective case note audit was used to assess the care and outcomes of 395 acute ischaemic stroke patients admitted to Tasmania’s four major public hospitals. Sixteen care processes were recorded, which covered time-critical treatment, allied health interventions and secondary prevention. Outcome measures were assessed using 30-day mortality and discharge destination, both of which were analysed for differences between urban and rural hospitals using logistic regression. Results: No patients in rural hospitals were administered thrombolysis; these hospitals also did not have acute stroke units. With few exceptions, patients’ access to the remaining care indicators was comparable between regions. After adjusting for confounders, there were no significant differences between regions in terms of 30-day mortality (odds ratio (OR) = 0.99, 95% confidence interval (CI) 0.46–2.18) or discharge destination (OR = 1.24, 95% CI 0.81–1.91). Conclusions: With the exception of acute stroke unit care and thrombolysis, acute ischaemic stroke care within Tasmania’s urban and rural hospitals was broadly similar. No significant differences were found between regions in terms of patient outcomes. Future studies are encouraged to employ larger data sets, which capture a broader range of urban and rural sites and record patient outcomes at extended interval.

Development of a Survey Instrument to Explore the Characteristics of Australian Private Physiotherapy Practitioners’ Interprofessional Interactions

Abstract: Background: Interprofessional collaboration is a complex process defined by the relationships and interactions between health practitioners from diverse professional backgrounds. Although the benefits of a collaborative health workforce are widely acknowledged, it is currently poorly understood to what extent private physiotherapy practitioners engage in interprofessional collaboration as a part of their clinical practice, and whether they consider to be adequately trained in this area. Information regarding the frequency, modes of communication, and perceived level of satisfaction associated with private physiotherapy practitioners’ interprofessional interactions is also limited. Purpose: The aim of this paper is to describe the development of a survey instrument that can be used to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions. Methods: A multiphase process was used to develop the survey instrument. The research team conducted a literature search which resulted in the generation of 34 individual survey items. After the initial pool of survey items was developed, three experienced physiotherapists were invited to review the items. The draft survey instrument was then subject to online testing with private physiotherapy practitioners to evaluate the utility of the instrument. Results: All three physiotherapists invited to review the initial pool of survey items provided written feedback to the research team. Following revision, five private physiotherapy practitioners participated in pilot testing the survey instrument. Pilot testing revealed that approximately 10 minutes was required to complete the online survey. Conclusions: The final survey instrument has 29 questions in six sections with categorical, Likert and free text response options and can be used to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions. Information obtained from future research projects utilising this survey may guide the development of effective interventions aimed at enhancing the nature and quality of clinical interactions between private physiotherapy practitioners and other health practitioners working in Australia.