analysiinf heLth lexute 2

Objectives by the End of the Lecture

• Ability to provide clinical recommendations based on research findings

• Relate findings to three specific areas:

  • Type of care provided (treatment methods)

  • Systems and processes of delivering care

  • Interaction with patients and their families (whanau)

Differences between Qualitative and Quantitative Research

• Qualitative Research:

  • Focuses on understanding individual perspectives and experiences in health care

  • Involves diversity in study participants based on inclusion/exclusion criteria to capture various viewpoints

  • Aims to reveal the meanings that experiences hold for individuals

  • Accepts the notion of multiple perspectives; findings are not generalizable to a broader population

• Quantitative Research:

  • Typically involves statistical analysis and is more generalizable

  • Leads to broad policy or societal recommendations often made at government levels

Implications of Qualitative Research

• Findings from qualitative research assist in understanding the following:

  • Care for Patients:

  • Insights into how research results inform treatment strategies

  • Relationship Dynamics:

  • Understanding how clinicians relate to patients and their families

  • Healthcare Provision Context:

  • Considerations around systems and processes in healthcare delivery

• These insights are more personalized and context-specific compared to quantitative research results.

Review of Selected Studies

Study 1: Therapeutic Alliance Between Patients and Clinicians

• Methodology:

  • Utilized individual interviews and focus groups for data collection

• Key Findings:

  • The therapeutic alliance consists of three components:

  • Personal Connection: Building rapport with the patient

  • Professional Collaboration: Joint efforts towards health management

  • Family Collaboration: Engaging with extended family in care processes

  • Patients value different components at different levels, with priorities shifting over time

  • Relationship breakdowns often stem from clinician errors in understanding patient preferences or needs

  • Recovery of the alliance depends significantly on the prior relationship quality.

• Clinical Recommendations:

  • A person-centered or whanau-centered approach is essential in developing therapeutic relationships

  • Tailor engagement strategies based on individual patient preferences that may change over time

  • Use of self-disclosure can enhance the relationship while maintaining professional boundaries, ensuring relevance in shared information

  • Address any relationship breakdowns proactively to restore trust and communication.

Study 2: Health Care Inequities for Maori Using Telehealth During COVID-19

• Methodology:

  • Interviews with Maori health professionals, Maori patients using telehealth, and those visiting clinics

• Key Findings:

  • Benefits of Telehealth:

  • Increased safety by minimizing in-person interaction

  • Reduction in transport costs and time commitments

  • Options for different interaction modalities

  • Challenges:

  • Necessity for enhanced health literacy and access to technology

  • Limitations on conducting physical assessments

  • Suggested improvements include developing tailored online systems for clinical contexts, supporting technology use, and weighing telehealth's role against therapeutic rapport building challenges.

• Clinical Recommendations:

  • Ensure equipment access for patients and simplify technology usage instructions

  • Offer multiple telehealth options to accommodate patient preferences (e.g. video calls vs. phone calls)

  • Address online safety concerns for patient data during telehealth interactions

  • Explore hybrid appointment models combining in-person and online interactions to maintain rapport.

Study 3: Engagement in Physical Activity for People with COPD

• Methodology:

  • 26 participants with varying severities of COPD were interviewed

• Key Findings:

  • Barriers to Engagement:

  • Health-related issues (fatigue, mobility, breathing difficulties)

  • Psychological factors (embarrassment, fear, frustration)

  • Lack of perceived necessity among older populations

  • Facilitators of Activity:

  • Personal motivation, positive attitude, and self-efficacy

  • Goal setting and accomplishing milestones significantly enhance engagement

• Clinical Recommendations:

  • Build up patients’ self-efficacy through confidence-building strategies

  • Explore patients' beliefs around physical activity to address misconceptions and reinforce benefits

  • Support patients by assisting in realistic goal setting for physical activity inclusion into daily routines.

Study 4: Prehabilitation Before Total Hip and Knee Arthroplasty

• Methodology:

  • Interviews and focus groups involving patients, family, and clinicians

• Key Findings:

  • Limitations in availability and accessibility of informational materials and sessions

  • Patients desired clearer, personalized responses to inquiries regarding their care

  • Preferences for information delivery varied significantly among patients

• Clinical Recommendations:

  • Provide clear, accessible information that resonates with patients' comprehension levels, including various formats (visual, written, electronic)

  • Encourage and enable time for patients to ask detailed questions and receive reasoned explanations for recommendations

  • Cater to varied preferences for information delivery, particularly considering the older demographic involved in surgeries.

Study 5: Barriers to Healthcare Participation among Older Pacific People

• Methodology:

  • Participatory action research with 104 co-researchers utilizing traditional Pacific methodologies

• Key Findings:

  • Significant barriers to healthcare access related to financial constraints and transport issues

  • Poor engagement due to inadequate relationship-building by healthcare professionals

• Clinical Recommendations:

  • Implement community-centric health service delivery to overcome barriers

  • Enhance relationship-building efforts through continuity in care and culturally sensitive approaches

  • Provide assistance navigating healthcare systems, potentially through the assistance of previous patients who can guide newcomers.

Summary of Implications for Clinical Practice

• Qualitative research findings yield rich insights into personal and contextual factors affecting patient care

• Understand that qualitative insights are less about sweeping changes and more about tailored interventions and individualized care strategies

• Embrace qualitative research as a means to enhance interpersonal relationships and improve healthcare accessibility and understanding.

• Recognize the importance of interpreting findings in the context of the involved research participants to align with clinical contexts effectively.