A longitudinal qualitative exploration of healthcare and informal support needs among survivors of critical illness: the RELINQUISH protocol.

Introduction and background: Survival following critical illness is associated with a significant burden of physical, emotional and psychosocial morbidity. Recovery can be protracted and incomplete, with important and sustained effects upon everyday life, including family life, social participation and return to work. In stark contrast with other critically ill patient groups (eg, those following cardiothoracic surgery), there are comparatively few interventional studies of rehabilitation among the general intensive care unit patient population. This paper outlines the protocol for a sub study of the RECOVER study: a randomised controlled trial evaluating a complex intervention of enhanced ward-based rehabilitation for patients following discharge from intensive care. Methods and analysis: The RELINQUISH study is a nested longitudinal, qualitative study of family support and perceived healthcare needs among RECOVER participants at key stages of the recovery process and at up to 1 year following hospital discharge. Its central premise is that recovery is a dynamic process wherein patients’ needs evolve over time. RELINQUISH is novel in that we will incorporate two parallel strategies into our data analysis: (1) a pragmatic health services-oriented approach, using an a priori analytical construct, the ‘Timing it Right’ framework and (2) a constructivist grounded theory approach which allows the emergence of new themes and theoretical understandings from the data. We will subsequently use Qualitative Health Needs Assessment methodology to inform the development of timely and responsive healthcare interventions throughout the recovery process. Ethics and dissemination: The protocol has been approved by the Lothian Research Ethics Committee (protocol number HSRU011). The study has been added to the UK Clinical Research Network Database (study ID. 9986). The authors will disseminate the findings in peer reviewed publications and to relevant critical care stakeholder groups.

Priorities for future intensive care research in the UK: results of a James Lind Alliance Priority Setting Partnership.

This James Lind Alliance (JLA) Priority Setting Partnership aimed to identify and prioritise unanswered questions about adult intensive care that are important to people who have been critically ill, their families, and the health professionals who care for them. Consensus techniques (modified Delphi and Nominal Group) were used to generate suggestions using online and postal surveys. Following verification and iterative editorial review, research topics were constructed from these suggestions. These topics were presented in a second online and postal survey for rating. A Nominal Group of 21 clinicians, patients and family representatives subsequently met to rank the most important research topics and produce a prioritised list. The project was coordinated by a representative Steering Group and independently overseen by the JLA. The initial survey and review of the literature generated over 1,300 suggestions. Preliminary editing and verification permitted us to encapsulate these suggestions within 151 research topics. Iterative review by members of the Steering Group produced 37 topic statements, subsequently rated by participants. Using the mode to determine importance, 19 topics were presented to the group from which a ‘top three’ intensive care research priorities were identified and a further nine topics were prioritised. By applying and adapting the JLA methodology to focus on an area of care rather than to a single disease, we have provided a means to ensure that patients, their families and professionals materially contribute to the prioritisation of intensive care research in the UK.

The perceptions of postgraduate international students of examinations.

The increasing internationalisation of higher education means that many students in the UK are not native English speakers, possibly putting them at a disadvantage in an examination environment. However, exams continue to be used even though although they are often deprecated as an assessment instrument in postgraduate courses. This article explores the implications from these observations for module leaders and for higher education institutions. Three themes emerge: the impact of internationalisation, the use of exams at postgraduate level and the language and cultural issues faced by international students. A review of university policy and quality documents revealed a general commitment to internationalisation but some gaps in policy support, for students with English as a second or foreign language. A survey of students in two computing programmes evaluated these themes. The results did not show up any major issues, though there were a number of suggestions to improve the exam process to address feelings of bias to UK or native-English-speaking students. The research therefore established that the university’s internationalisation and diversity strategy is broadly reflected in students’ experiences, with the possible exception of students who were recruited with insufficient English to be able to engage successfully with the material. The contrast in responses when analysed by home country or English proficiency suggest that Learning, Teaching and Assessment (LTA) practice in this context should be clear whether and when language or culture are the main barrier to students. Pragmatic recommendations are made for improvement in examination practice, and to assessment processes generally in this context. Areas for further work are identified.

The Development of a Holistic and Quantitative Tool for the Assessment and Improvement of Survey Quality.

There are a variety of guidelines and methods available to measure and assess survey quality. Most of these are based on qualitative descriptions. In practice, they are not easy to implement and it is very difficult to make comparisons between surveys. Hence there is a theoretical and pragmatic demand to develop a mainly quantitative based survey assessment tool. This research aimed to meet this need and make contributions to the evaluation and improvement of survey quality. Acknowledging the critical importance of measurement issues in survey research, this thesis starts with a comprehensive introduction to measurement theory and identifies the types of measurement errors associated with measurement procedures through three experiments. Then it moves on to describe concepts, guidelines and methods available for measuring and assessing survey quality. Combining these with measurement principles leads to the development of a quantitative based statistical holistic tool to measure and assess survey quality. The criteria, weights and subweights for the assessment tool are determined using Multi-Criteria Decision-Making (MCDM) and a survey questionnaire based on the Delphi method. Finally the model is applied to a database of surveys which was constructed to develop methods of classification, assessment and improvement of survey quality. The model developed in this thesis enables survey researchers and/or commissioners to make a holistic assessment of the value of the particular survey(s). This model is an Excel based audit which takes a holistic approach, following all stages of the survey from inception, to design, construction, execution, analysis and dissemination. At each stage a set of criteria are applied to assess quality. Scores attained against these assessments are weighted by the importance of the criteria and summed to give an overall assessment of the stage. The total score for a survey can be obtained by a combination of the scores for every stage weighted again by the importance of each stage. The advantage of this is to construct a means of survey assessment which can be used in a diagnostic manner to assess and improve survey quality.

Scottish Community Councils online: the 2014 survey.

This document reports the results of a survey, carried out in late spring 2014, of the public web presences of potentially over 1300 Scottish Community Councils (CCs). It follows on from similar survey in summer 2012. The report reviews content-types associated with up-to-date presences and examines Community Councils’ social media use, using three archetypes which may be used to derive models and examples of good practice, and create recommendations for Community Councils and their Local Authorities (LAs). The research found that there has little change overall since 2012, which combined with a high level of churn implies an increasing number of digitally disengaged Community Councils. A good way forward would be for to CCs emulate and adapt the examples of good practice identified, by publishing minutes, news, planning and local area information, limiting publication of other types of content, and using social media to engage with citizens. A number of broader recommendations are made to LAs, including that that they publish CC schemes on their websites, provide training in online methods and work together via their CCLOs and IT teams to support CCs