Communicating about the management of medications as patients move across transition points of care: an observation and interview study

RATIONALE, AIMS AND OBJECTIVES: As patients move across transition points, effective medication management is critical for patient safety. The aims of this study were to examine how health professionals, patients and family members communicate about managing medications as patients moved across transition points of care and to identify possible sources of communication failure.

METHOD: A descriptive approach was used involving observations and interviews. The emergency departments and medical wards of two hospitals were involved. Observations focused on how health professionals managed medications during interactions with other health professionals, patients and family members, as patients moved across clinical settings. Follow-up interviews with participants were also undertaken. Thematic analysis was completed of transcribed data, and descriptive statistics were used to analyse characteristics of communication failure.

RESULTS: Three key themes were identified: environmental challenges, interprofessional relationships, and patient and family beliefs and responsibilities. As patients moved between environments, insufficient tracking occurred about medication changes. Before hospital admission, patients participated in self-care medication activities, which did not always involve exemplary behaviours or match the medications that doctors prescribed. During observations, 432 instances of communication failure (42.8%) were detected, which related to purpose, content, audience and occasion of the communication.

CONCLUSIONS: Extensive challenges exist involving the management of medications at transition points of care. Bedside handovers and ward rounds can be utilized as patient counselling opportunities about changes in the medication regimen. Greater attention is needed on how patients in the community make medication-related decisions.

Interview in Melbourne with Meg Labrum, National Film and Sound Archive of Australia, Canberra, June 16, 2015

A conversation with Meg Labrum (National Film and Sound Archive, Canberra),arguing that women have a disproportionate impact upon the programming of silent film at festivals. It asks how she works and, specifically, how the change to digital has impacted archival outreach and access today in Australia.

Interview with Mariann Lewinsky, Il Cinema Ritrovato, Bologna, July 2, 2015

A conversation with Mariann Lewinsky, Il Cinema Ritrovato, arguing that women have a disproportionate impact upon the programming of silent film at festivals. It asks how she works and, specifically, how the change to digital has impacted archival outreach and access across the globe today.

Interview with Karola Gramann, Kinothek Asta Nielsen, Frankfurt, January 9, 2015

A conversation with Karola Gramann, Kinothek Asta Nielsen, Frankfurt, arguing that women have a disproportionate impact upon the programming of silent film at festivals. It asks how she works and, specifically, how the change to digital has impacted archival outreach and access across the globe today.

Explaining engagement in self-monitoring among participants of the DESMOND self-monitoring trial: a qualitative interview study

BACKGROUND: The Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) Self-monitoring Trial reported that people with newly diagnosed type 2 diabetes attending community-based structured education and randomized to self-monitoring of blood glucose (SMBG) or urine monitoring had comparable improvements in biomedical outcomes, but differences in satisfaction with, and continued use of monitoring method, well-being and perceived threat from diabetes. OBJECTIVES: To explore experiences of SMBG and urine monitoring following structured education. We specifically addressed the perceived usefulness of each monitoring method and the associated well-being. METHODS: Qualitative semi-structured interviews with 18 adults with newly diagnosed type 2 diabetes participating in the DESMOND Self-monitoring Trial (SMBG, N=10; urine monitoring, N=8)~12 months into the trial. Analysis was informed by the constant comparative approach. RESULTS: Interviewees reported SMBG as accurate, convenient and useful. Declining use was explained by having established a pattern of managing blood glucose with less frequent monitoring or lack of feedback or encouragement from health care professionals. Many initially positive views of urine monitoring progressively changed due to perceived inaccuracy, leading some to switch to SMBG. Perceiving diabetes as less serious was attributable to lack of symptoms, treatment with diet alone and-in the urine-monitoring group-consistently negative readings. Urine monitoring also provided less visible evidence of diabetes and of the effect of behaviour on glucose. CONCLUSIONS: The findings highlight the importance for professionals of considering patients' preferences when using self-monitoring technologies, including how these change over time, when supporting the self-care behaviours of people with type 2 diabetes.

Perceptions of ad hoc supervision encounters in general practice training: a qualitative interview-based study

BACKGROUND: Ad hoc supervision encounters occur between general practitioner (GP) supervisors and general practice registrars outside scheduled teaching sessions. Anecdotally reported as important learning opportunities, these encounters are rarely explored in the literature. OBJECTIVE: This study examined supervisors', registrars' and practice managers' perceptions of ad hoc supervisory encounters. METHODS: Semi-structured interviews were conducted with purposively sampled supervisors, registrars and practice managers from regional general practice settings. Data were analysed using template analysis. RESULTS: Fifteen respondents participated in the interviews. Their perceptions of ad hoc encounters were reported under the categories of immediacy, safety, education, professional identity and supervisor stress. DISCUSSION: Ad hoc encounters in general practice registrar training are highly valued for supporting patient safety and registrar education. The encounters serve a range of practical purposes for supervisors, registrars and practices, and warrant further exploration on how to optimise their benefits within general practice.

Australian prosecutors perceptions of the utility of child investigative interview protocols

Investigative interviews with alleged victims form the central plank of evidence in the prosecution of child sexual abuse. Despite interviewers being provided with a guiding framework, child sexual abuse cases are often not prosecuted because of poor-quality evidence. The purpose of this study was to elicit feedback from prosecutors about the structure and format of current interview protocols and the ways in which these could potentially be improved from an evidential perspective. Focus group discussions (ranging in length from 180 to 190 minutes) were conducted with 13 Crown prosecutors representing every jurisdiction of Australia. Thematic analysis of the focus group discussions revealed that prosecutors were supportive of the structure of interview protocols, however, concerns were raised about four of the interview elements. These elements were the oath and truth–lie competency test, the ground rules, the practice narrative and eliciting a disclosure. The prosecutors’ concerns and their implications for protocol developers and trainers are discussed.

Identifying the characteristics of child sexual abuse cases that exit the criminal justice system before the forensic interview

Most child sexual abuse cases do not result in conviction; rather, they result in attrition at an earlier point in the system. Although research has looked at case characteristics associated with attrition at later stages of the system (i.e. the laying of charges and prosecution stages), to date, no research has studied the case characteristics associated with attrition as soon as a report has been made to authorities. The aim of this study was to determine the case characteristics (child complainant, suspect and additional case characteristics) associated with attrition when a case first enters the criminal justice system before a forensic interview is conducted. All child sexual abuse incidents reported to police in one jurisdiction of Australia in 2011 were examined. Three case characteristics were found to predict attrition: previous disclosure, abuse frequency and the child complainant’s age. Specifically, cases were more likely to result in attrition when the child had not previously disclosed the abuse to an adult, the abuse was a single incident rather than repeated, and a curvilinear relationship was found for child age. Cases involving children aged 7–12 years were less likely to result in attrition than cases involving younger (0–6 years) and older (13–15 years) children. This information should assist professionals and researchers in developing interventions to reduce the attrition when necessary during this early stage of the criminal justice system.

Using elicitation interview within a phenomenographic framework : developing the breadth of research designs associated with game based approaches

This paper describes how elicitation interview technique was used within a phenomenographic research design to explore physical education teachers’ experiences of teaching games using a Game Based Approach (GBA). Participants taught in one of two different international contexts, Australia or England, and all had some experience of using a GBA to teach games. The focus of the paper is the presentation and discussion of the unique research design used to generate understanding about GBA teaching experiences as well as extending the examination of GBAs from different philosophical viewpoints. Authors’ reflections on the utilised research design are presented with concluding discussion identifying further research opportunities relating to GBAs in teaching and coaching contexts.

Professionals' perceptions regarding the suitability of investigative interview protocols with Aboriginal children

Objective: Despite the heterogeneity of Australian Aboriginal peoples, certain styles of relating are shared and are markedly different to the communication styles of non-Aboriginal peoples. These differences may affect the suitability of current investigative interview protocols to Australian Aboriginal children. This study aimed to qualitatively evaluate the applicability of an investigative interview protocol to Australian Aboriginal children and examine how it could be modified to better suit the communication styles in many Aboriginal communities. Method: A diverse group of 28 participants who had expertise in Aboriginal language and culture, as well as an understanding of the child investigative interview process, each partook in an in-depth semi-structured interview where they were prompted to reflect on Aboriginal language and culture with reference to a current interview protocol (in the context of sexual assault investigation). Results: Thematic analysis revealed overall support for the narrative-based structure of the interview protocol when eliciting information from Aboriginal children. A number of concerns were also identified, and these largely related to the syntax and vocabulary within the protocol, as well as the methods of questioning and building rapport with the child. Conclusions: Directions for future research and potential modifications to investigative interview protocols to better suit Aboriginal children are discussed.

Examining interview techniques to assist children’s recall of repeated events.

This thesis tested interview techniques expected to assist children reporting on repeated events, such as ongoing abuse. The quality and quantity of information children provided was improved by several techniques that rehearsed children in key cognitive tasks. Developmental trends were found whereby techniques often assisted older children more than younger children.