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PubMed2006

Complex perspectives on learning objectives: stakeholders' beliefs about core objectives based on focus group interviews.

OBJECTIVE: To understand core curriculum design and involvement of stakeholders. METHODS: Twelve homogeneous focus group interviews with a total of 88 students, house officers, senior doctors and nurses concerning an undergraduate emergency medicine curriculum. Following content coding of transcripts, we analysed by condensation, categorisation and qualitative content analyses. RESULTS: The focus group participants gave a range of reasons for defining objectives or outcomes. They found their involvement in the process essential. Their argumentation and beliefs differed significantly, revealing 2 opposite perspectives: objectives as context-free theory-based rules versus objectives as personal practice-based guidelines. The students favoured theory-based objectives, which should be defined by experts conclusively as minimum levels and checklists. The senior doctors preferred practice-based objectives, which should be decided in a collaborative, local, continuous process, and should be expressed as ideals and expectations. The house officers held both perspectives. Adding to complexity, participants also interpreted competence inconsistently and mixed concepts such as knowledge, observation, supervision, experience and expertise. DISCUSSION: Participating novices' perspectives on objectives differed completely from expertise level participants. These differences in perspectives should not be underestimated, as they can lead easily to misunderstandings among stakeholders, or between stakeholders, educational leaders and curriculum designers. We recommend that concepts are discussed with stakeholders in order to reach a common understanding and point of departure for discussing outcomes. Differences in perspectives, in our opinion, need to be recognised, respected and incorporated into the curriculum design process.

Attitude of Health Personnel↗
PubMed1996

The subjective meaning of illness in severe otosclerosis: a descriptive study in three steps based on focus group interviews and written questionnaire.

The aim of this study of otosclerosis patients was to highlight the circumstances specific to an operable middle ear disease and to describe the psychologically unique aspects accompanying this disorder. In a first step five subjects participated in four focus group interviews, from which emanated a questionnaire answered in a second step by 28 randomly chosen subjects. Finally a second series of supplementary focus interviews were conducted with another group of subjects, after which the interview material was subjected to code-mapping, agreement and validation. The study results indicate that ear surgery was a very important occurrence in the lives of the patients and a unique aspect was that they were burdened by a sense of responsibility for deciding in favour of or against the ear surgery and in choosing the time for operation. An event as tangible as an operation impacts on the individual's psychological processing of the fact that one of his or her senses is damaged. The message to the person's surroundings is very clear: the operation makes others understand how serious the situation is, gives rise to a sense of sympathy. These factors together may promote adaptation to the handicap, or alternately, at least for some persons, may impede adaptation to the necessary hearing aids. To some individuals hearing aids were strongly associated with periods of deteriorating hearing and therefore had negative connotations. Thus the hearing aid was used while waiting for surgery or instead of surgery. The constant hope of regaining one's hearing through ear surgery, although not totally realistic in these cases of severe otosclerosis, always makes the hearing aid the second best solution. The overall conclusion from this study is that there are specific circumstances of an operable ear disease which have great impact upon quality of life, well-being and adaptation. The psychological situation is one of instability, feelings of responsibility and at times of anxiety. Patients with otosclerosis are sometimes told that they are better off than others with impaired hearing, because surgery can improve their hearing and because good amplification through hearing aids can be achieved in persons with conductive hearing losses. It is our hope that this study has helped to provide a fuller picture of the facts of life for persons with severe otosclerosis.

Adaptation, Psychological↗
PubMedDate not supplied

The use of focus group interviews in pediatric health care research.

OBJECTIVE: To review and synethize the research material on focus groups with children and adolescents and to provide guidelines for future development. METHODS: Psychlit, Medline, and Cinahl electronic databases, as well as the reference lists of those articles consulted, were reviewed for information regarding focus groups with participants under the age of 18 years. Both empirical and methodological articles were part of this review. RESULTS: We review the utility of focus groups for exploratory research, program evaluation, program development, and questionnaire construction or adaptation. Based on previous research, we provide guidelines for focus groups with children and adolescents and outline suggestions for future development. CONCLUSIONS: There is evidence to suggest that focus groups are a valuable means of eliciting children's views on health-related matters, given an appropriate research question. However, empirical research is required in order to investigate systematically the effect of different processes and variables on the final outcome of focus group interviews.

Adolescent↗
PubMed2000

Cultural challenges in end-of-life care: reflections from focus groups' interviews with hospice staff in Stockholm.

Cultural challenges in end-of-life care: reflections from focus groups' interviews with hospice staff in Stockholm During the past few decades, Swedish society has changed from a society with a few ethnic groups to one with over a hundred groups of different ethnic backgrounds, languages and religions. As society is becoming increasingly multicultural, cultural issues are also becoming an important feature in health care, particularly in end-of-life care where the questions of existential nature are of great importance. However, cultural issues in health care, especially at hospices, have not been studied sufficiently in Sweden. The purpose of this study was to gather reflections about cultural issues among hospice staff after a 3-day seminar in multicultural end-of-life care, by using a qualitative focus groups method. The 19 participants (majority nurses) were divided into three groups, one per hospice unit. A discussion guide was developed with the following themes: 1) post-training experiences of working with patients with multicultural background; 2) experiences gained by participating in the course of multicultural end-of-life care; 3) post-training reflections about one's own culture; 4) ideas or thoughts regarding work with patients from other cultures arising from the training; and 5) the need for further training in multicultural end-of-life care. One of the study's main findings was that to better understand other cultures it is important to raise awareness about the staff's own culture and to pay attention to culture especially in the context of the individual. The findings from focus groups provide insight regarding the need for planning flexible training in cultural issues to match the needs of the staff at the hospice units studied.

Adult↗
PubMedDate not supplied

Focus group interviews: assessment of continuing education needs for the advanced practice nurse.

This article reports the use of focus group interviews to promote the development of continuing education programs that meet the needs of advanced practice nurses (APNs). The three major needs identified were: a) enhancement of clinical practice skills and knowledge in specialty areas, b) education about future changes in the APN role, and c) education in management strategies for the changing health care delivery system. A summary of the investigation and implications for continuing nursing education departments are also presented.

Clinical Competence↗
PubMed1996

Focus group interview as a data gathering tool: its application to nurses' understanding of HIV infection and AIDS.

The focus group interview (FGI) is a research method not commonly used by nurses. It is an effective method if qualitative data are needed and may be used independently to get indepth information, but also can be used in conjunction with tools such as questionnaires, to elicit information that could not be gathered otherwise. For the FGI to be applied correctly the researcher must be well versed with its contents, and ensure that the primary reason for using such a method is solely to collect data. Other reasons like decision-making or reaching a consensus would not be appropriate. The researcher has shown how this method was used in a study in a specialised hospital in Durban which examined professional nurses' knowledge and understanding of AIDS and HIV infection. The results not only illustrated knowledge and understanding, but raised sensitive issues and dilemmas related to caring for HIV infected patients. Areas of further research were highlighted and recommendations made.

Group Processes↗
PubMed1992

Perceptions of emergency care by the elderly: results of multicenter focus group interviews.

STUDY OBJECTIVE: To determine the elderly's perception of emergency care and to identify specific problems and solutions. DESIGN: Focus group interviews. SETTING AND TYPE OF PARTICIPANTS: Community senior citizen centers in Boston; Los Angeles; Pittsburgh; Youngstown, Ohio; and Norwalk, Connecticut. Senior citizens who had had emergency care in the past year participated. MEASUREMENT AND RESULTS: Participants were satisfied with their overall medical care. Long waits were a hardship for patients and their families. The elderly are not familiar with the process of emergency care. They were frightened by their injury or illness. Their anxiety was not allayed until they were informed of the nature of their illness and what their treatment and disposition was to be. The emergency department environment frequently made them uncomfortable. There was considerable confusion caused by the billing process. CONCLUSIONS: The elderly would benefit from prior or concurrent education regarding emergency care. Staff should be more sensitive to the anxiety felt by the elderly, should explain the reasons for delays in care, and what to expect. Patients should be informed of the nature and seriousness of their illness as soon as possible. Family and friends may be encouraged to stay with patients. The billing process needs to be clarified and simplified.

Aged↗
PubMedDate not supplied

[Consultation skills training is necessary in medical education. Evaluation by student questionnaire and focus group interviews].

At Lund University Medical School communication skills are taught during both the preclinical and clinical part of the medical programme. As part of the training during the 5th year the students are required to videotape at least one patient consultation at a local primary health care centre. The students then meet in groups of 6-7 participants and a group leader to watch the recorded consultations and discuss them. To evaluate the quality of the consultation skills training and to identify potential weaknesses, we used both a quantitative and a qualitative method. A written questionnaire was distributed to all students and three focus group interviews, two with students and one with group leaders, were performed. The focus groups consisted of 5-6 participants each. The students were overall pleased with the training, and the majority thought that their consultation skills had improved. More commitment from the tutors at the health care centres was needed in order for the students to successfully record a complete consultation. Nearly all students found that the participants cooperated well in the groups, and that the group leader helped to create a positive atmosphere and gave constructive advice.

Clinical Competence↗
PubMed1998

Focus group interviews: a methodology for socially sensitive research.

Conducting nursing research is becoming an increasingly important part of the advanced practice nursing role. Avenues of inquiry include research methods from both the quantitative and qualitative paradigms. The focus group interview is an ideal venue to combine the two methods and generate new knowledge. This article presents the unique suitability of the method for socially sensitive issues that challenge advanced practice nurses and their clients.

Data Interpretation, Statistical↗
PubMed1985

The role of focus group interviews in designing a smoking prevention program.

The purpose of this study was to gather data that would be applied to the design of an adolescent smoking prevention program. Focus group interviews, a form of qualitative research used in social marketing, were used to gather information from the adolescent participants to ensure that the program would reflect the needs and interests of the target population. The participants consisted of sixth graders from urban and rural areas, and black and white populations of low socioeconomic status. A total of eight focus groups was conducted with eight participants in each focus group. Activities such as auctions, roleplays, and guided discussions were carried out to learn about participant likes, dislikes, values, ideas, and abilities to turn down cigarettes. Following substantiation by a quantitative evaluation, this information was incorporated into the program and materials to ensure the maximum effectiveness of the intervention.

Adolescent↗
PubMed2001

Factors attributing to the psychological recovery from the 1999 Taiwan earthquake among junior high school students: a focus group interview study.

The aim of this study was to evaluate the factors contributing to the psychological recovery from the 1999 Taiwan earthquake from the perspective of adolescents in Chungliao. A total of 22 junior high school students who had significant decrease of Impact of Event Scale (IES) scores in the follow-up period of 9 months were recruited to participate in one of three focus groups. By applying the method of focus group interviewing, adolescents' attributions of factors relating to the improvements of psychological reactions were collected. All interviews were tape-recorded and the transcripts were approached by content analysis. Four major factors contributing to psychological recovery from the earthquake are clustered: (1) self-healing effect as time passed away; (2) assistance from people of the non-afflicted areas; (3) being engaged in interests in leisure time; and (4) other important events happening after the earthquake. Several factors contributed to the psychological recovery of adolescents from the experience of the earthquake. The results of this study can serve as the basis of further treatment strategies for the adolescent refugees from major disasters.

Adaptation, Psychological↗
PubMedDate not supplied

Intimacy and women with type 2 diabetes: an exploratory study using focus group interviews.

PURPOSE: This study explored if and how women perceived diabetes as affecting their social and sexual intimacy and if they wished to receive professional attention for any sexual disturbances that they experience. METHODS: A series of five focus group interviews were conducted with 33 women with type 2 diabetes, ages 44 to 80 years, who also completed a questionnaire on sexual functioning: Two thirds were married and one third were sexually active. RESULTS: Categories resulting from the qualitative analysis were guilt and embarrassment in diabetes; female intimacy and shame; sexual dysfunction, an invisible problem; and the female patient. Asking women about intimacy revealed self-blame and embarrassment regarding their diabetes and sexual functioning. Several women who had experienced sexual dysfunction described barriers that made it difficult to obtain optimal care and/or self-care measures to cope with vaginal dryness, pain during intercourse, and decreased desire. Many of the women had the social and emotional resources to cope with their disease. Nonetheless, they experienced guilt, shame, and embarrassment, which are potentially oppressive features of having type 2 diabetes. CONCLUSIONS: Asking women with type 2 diabetes about intimacy in a contextually adequate way at routine follow-up visits could give them a chance to discuss both sexual and social intimacy concerns related to their diabetes.

Adaptation, Psychological↗
PubMed1999

[Cross-sectorial cooperation regarding cancer patients in a recently started care program. Ideas and themes based on focus group interviews with general practitioners and oncologists].

This study identified ideas for an improved collaboration between general practitioners and oncologists regarding patients with cancer. A qualitative research-method with focused group interviews was chosen. The results demonstrated that both oncologists and general practitioners would like the general practitioners to take more active part in the total care programme for cancer patients. Some of the needed improvements were more detailed referral letters including description of treatment plans, information about what the patient had been told and general information about the specific cancer disease. Both parts desire bilateral information exchange and a dialogue about the distribution of tasks. Both parts are willing to collaborate but this is at present restricted due to lack of knowledge of each others' working areas and the oncologists' impression that general practitioners need more medical knowledge regarding specific aspects of cancer. A randomized intervention study using ideas from this study may clarify if it is possible to improve the collaboration and thereby the cancer patients' satisfaction with care.

Clinical Competence↗
PubMed2004

Rheumatology outcomes: the patient's perspective. A multicentre focus group interview study of Swedish rheumatoid arthritis patients.

OBJECTIVES: Patients with rheumatoid arthritis (RA) and clinicians have different views about benefits from treatments. More knowledge is needed about how patients assess outcomes in order to update current measurements. METHODS: Focus group interviews were performed at four Swedish rheumatology clinics. A total of 25 patients with RA were included, representing a wide range of ages and disease duration. Predetermined topics relating to important outcomes from and satisfaction/dissatisfaction with RA treatments were discussed. RESULTS: The participants' initial outcome assessments included physical and psychosocial items, which comprised overall treatment goals such as impairment in social roles, fatigue, daily activities and self-confidence. The identified themes were 'Normal life', 'Physical capacity', 'Independence' and 'Well-being'. Satisfaction with treatment was associated with the quality of communication between staff and the patient. The participants assumed this as a prerequisite for a treatment to work. Patients wanted to be accepted as experts on their own bodies, and expected all clinicians to be experts on RA. This made it possible for patients to 'take charge' of their life situation. Good resources for and access to rheumatology care were desired. CONCLUSIONS: Suggesting a holistic approach to rheumatology care, the study results indicate that the illness and outcomes have to be evaluated within an individual RA patient's total life situation, described in the identified themes: 'Normal life', 'Physical capacity', 'Independence' and 'Well-being'. Development and validation of measurements covering these issues is suggested. More research is needed about communication and how patients experience their roles in the rheumatology clinic.

Activities of Daily Living↗
PubMed1998

Focus group interviews examining attitudes to randomised trials among breast cancer patients and the general community.

OBJECTIVE: To explore the knowledge of, and attitudes towards, randomised clinical trials among women in the community and breast cancer patients. DESIGN: Focus group interviews were conducted with women in the community and women previously treated for localised breast cancer. PARTICIPANTS: Twenty one mothers or grandmothers of children attending a local primary school and 20 breast cancer patients identified from the records of the Medical Oncology Department, Royal Prince Alfred Hospital, participated in one of eight focus group discussions examining knowledge of and attitudes towards randomised clinical trials. RESULTS: Most women did not have a good understanding of the need for clinical trials and the manner and safeguards with which they are conducted. They did not understand the need for randomisation and were often confused about the use of placebos. Many women were wary about medical research and saw it as a gamble, only to be considered if all else failed. Clinical trials were felt to be of benefit to future generations and perhaps family members if they should fall ill. However, they were not thought to be of benefit to the individual patient. CONCLUSIONS: These results suggest that greater community awareness of clinical trials is needed to improve participation in clinical trials. These focus group findings require validation in a larger sample.

Adult↗
PubMed1991

Focus group interview with parents of children with medically complex needs: an intimate look at their perceptions and feelings.

The purpose of this paper was to identify the needs of parents of children with medically complex needs from their own perception. In order to provide in-depth information, the focus group interview technique was used. Several strong recurrent themes were identified. The most persistent need was for a general organization or framework with which the care providers could operate. Along these same lines, the fragmentation of training, needs and services was consistently stated. A general lack of information in terms of home care and how to plan for the future was identified. Support groups were universally lauded for the invaluable services provided to the care parents.

Counseling↗
PubMed1999

[Evaluation of 24-hour home help services in a community by the focus group interview method].

The 24-hour home help services that provide day and night care services at home becomes a public health interest in Japan. The purpose of this study was to evaluate the system of 24-hour home help services in a community that has successfully developed it. Participants of this focus group interview were home helpers who were actually engaged in 24-hour home help services in A town of Akita Prefecture. The focus group session was tape-recorded and the tapes were transcribed. The transcripts were evaluated and summarized in order to identify major categories and number of descriptive statements in each category. The results were as follows. First, the home helpers considered that their system of 24-hour home help services could be technically transferred to other communities in Japan. Secondary, the political leadership and the democratic system of community participation were the essential elements for promoting the 24-hour home help services. Thirdly, the regular meetings for discussion about cases and opinion exchanges were required more extensively in the future.

Community Networks↗
PubMed1995

Incorporating mobile mammography units into primary care: focus group interviews among inner-city health center patients.

Mammography screening is underutilized, especially among women of lower socioeconomic status (SES). Mobile mammography units reduce cost and patient burden of mammography, and therefore might enhance screening rates among underserved populations. Few studies have explored factors associated with the acceptability of mobile mammography; none have targeted low-SES women. To explore these issues, we conducted focus group interviews in five university-affiliated urban primary-care clinics. The forty-three participants were 74% African-American, ranged in age from 40 to 70 years and most (67%) had household incomes below $15,000. A trained moderator led the groups of eight to 12 women through standardized, open-end interview questions exploring perceptions of mobile mammography. Findings suggest mammography vans are acceptable under only certain circumstances, including advance notice and assurance of privacy and quality. Convenience was important; 53% related being more likely to have mammograms if scheduled in conjunction with primary-care visits. Participants felt strongly that vans were inappropriate for public forums such as shopping centers. Association with primary-care health centers seemed to legitimize mammography vans and to allay concerns. If mammography screening is to become more widespread among low-income populations, these exploratory findings must be addressed in research and intervention development.

Adult↗