eHealth as a challenge to `expert' power: a focus group study of internet use for health information and management

Objective To investigate current use of the internet and eHealth amongst adults. Design Focus groups were conducted to explore participants' attitudes to and reasons for health internet use. Main outcome measures The focus group data were analysed and interpreted using thematic analysis. Results Three superordinate themes exploring eHealth behaviours were identified: decline in expert authority, pervasiveness of health information on the internet and empowerment. Results showed participants enjoyed the immediate benefits of eHealth information and felt empowered by increased knowledge, but they would be reluctant to lose face-to-face consultations with their GP. Conclusions Our findings illustrate changes in patient identity and a decline in expert authority with ramifications for the practitioner–patient relationship and subsequent implications for health management more generally.

Focus group method and methodology:current practice and recent debate

This paper considers the contemporary use of focus groups as a method of data collection within qualitative research settings. The authors draw upon their own experiences of using focus groups in educational and 'community' user-group environments in order to provide an overview of recent issues and debates surrounding the deployment of focus group methods and to pick out specific areas of contention in relation to both their epistemological and practical implications. Accordingly, the paper reflects on some of the realities of 'doing' focus groups whilst, at the same time, highlighting common problems and dilemmas which beginning researchers might encounter in their application. In turn, the paper raises a number of related issues around which there appears to have been a lack of academic discussion to date.

Patient involvement in primary care mental health:a focus group study

Background: Patient involvement in health care is a strong political driver in the NHS. However in spite of policy prominence, there has been only limited previous work exploring patient involvement for people with serious mental illness. Aim: To describe the views on, potential for, and types of patient involvement in primary care from the perspectives of primary care health professionals and patients with serious mental illness. Design of study: Qualitative study consisting of six patient, six health professional and six combined focus groups between May 2002 and January 2003. Setting: Six primary care trusts in the West Midlands, England. Method: Forty-five patients with serious mental illness, 39 GPs, and eight practice nurses participated in a series of 18 focus groups. All focus groups were audiotaped and fully transcribed. Nvivo was used to manage data more effectively. Results: Most patients felt that only other people with lived experience of mental illness could understand what they were going through. This experience could be used to help others navigate the health- and social-care systems, give advice about medication, and offer support at times of crisis. Many patients also saw paid employment within primary care as a way of addressing issues of poverty and social exclusion. Health professionals were, however, more reluctant to see patients as partners, be it in the consultation or in service delivery. Conclusions: Meaningful change in patient involvement requires commitment and belief from primary care practitioners that the views and experiences of people with serious mental illness are valid and valuable.

Patients' and health professionals' views on primary care for people with serious mental illness:focus group study

Objective: To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design: Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting: Six primary care trusts in the West Midlands. Participants: Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results: Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and preferred to consult their own GP, who listened and was willing to learn, rather than be referred to a different GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions: Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.

What do students really think? Understanding postgraduate students' perception of service quality

This paper explores the components of Service Quality in HE from the Business School Postgraduate student perspective. A six-dimensional scale measuring Service Quality is developed based on focus group and survey data. Our findings highlight that postgraduate students are highly outcome oriented; the award of a reputable degree to gain employment is more important than learning for life. Whilst developing employable graduates, Business Schools must not neglect the core service; teaching & learning. In the long-term this contributes to employability rates and the reputation of institutions. However, as student satisfaction is an increasingly paramount objective, balancing the core service and factors perceived as important by postgraduate students is key.

On the periphery of Europe:an investigation of the construction of Turkish-Cypriot adolescent identities

This research study investigates the identities of a group of adolescent Turkish Cypriot (TC) students in their final year of secondary education in northern Cyprus, which it is argued, lies on the periphery of Europe. The main aim is to explore the linguistic construction of TC youth identities within school contexts but primarily the classroom in a political context in which the uniquely ambiguous status of Turkish Cypriots within the European Union (EU) continues, and where Turkish Cypriots are considered to be Europeans as individuals but not as a separate political entity. A secondary focus is upon the students’ investment in learning the English language. Identity is defined as a lifelong process of 'the social positioning of self and the other' (Bucholtz and Hall, 2005:586) which is endlessly re-created (Tabouret-Keller, 1997) and the distinction between the terms 'identity' and 'identities' is discussed. The study explores the social construction of TC students' identities using an ethnomethodological case study. By using Conversation Analysis of selected extracts from the data collected through observations of classroom interactions, focus group discussions and interviews, the thesis shows that TC students perceive and enact 'in-betweener identities' in terms of their ethnicity, societal values, age, religion, languages and Europeanness. Being on the periphery of the EU, it is argued that the Turkish Cypriots of northern Cyprus are the ‘peripheral members of the EU, remaining present yet absent. They are personally EU citizens but not as a society and cannot be represented within EU institutions. But will they ever acquire full membership, as any peripheral member would aspire to have or will they remain in between occident and orient? The possible answers to this question and the resulting ideological associations will shape how and to what extent these TC students perceive and enact their identities.

Managing healthcare performance in analytical framework

Purpose – The purpose of the paper is to develop an integrated framework for performance management of healthcare services. Design/methodology/approach – This study develops a performance management framework for healthcare services using a combined analytic hierarchy process (AHP) and logical framework (LOGFRAME). The framework is then applied to the intensive care units of three different hospitals in developing nations. Numerous focus group discussions were undertaken, involving experts from the specific area under investigation. Findings – The study reveals that a combination of outcome, structure and process-based critical success factors and a combined AHP and LOGFRAME-based performance management framework helps manage performance of healthcare services. Practical implications – The proposed framework could be practiced in hospital-based healthcare services. Originality/value – The conventional approaches to healthcare performance management are either outcome-based or process-based, which cannot reveal improvement measures appropriately in order to assure superior performance. Additionally, they lack planning, implementing and evaluating improvement projects that are identified from performance measurement. This study presents an integrated approach to performance measurement and implementing framework of improvement projects.

Employer perceptions of skills gaps in retail:issues and implications for UK retailers

Purpose – This paper seeks to identify the skills gaps associated with retail employees in SME and multiple retail companies, and to investigate the potential training and business implications that arise from these skills gaps, from the point of view of retail employers. Design/methodology/approach – Research was conducted within one geographical region and across five counties within the UK. Telephone and face-to-face interviews and focus group workshops were conducted, resulting in responses from 52 retailers. Findings – The key issues and areas of concern to emerge were: the industry image and impact on recruitment and retention; employee and management skills gaps; and barriers to training. Research limitations/implications – The findings highlight the need for UK retail industry to raise the image of the sector, to identify the skills sets for specific roles, and to clarify the retail qualifications and training required delivering these. Originality/value – Succeeds in identifying the skills gaps associated with retail employees in SME and multiple retail companies and in investigating the potential training and business implications arising from these skills gaps.

Images of pharmacy as a career: a survey among groups of year 12 students at school

To explore the images and perceptions of pharmacy with potential applicants to undergraduate pharmacy education. There is currently considerable interest in the UK in studying aspects of the pharmacy profession because of the changing pharmacy agenda and the need to understand the workforce and its motivations. Aim: To explore the images and perceptions of pharmacy with potential applicants to undergraduate pharmacy education. Design: Four interactive focus groups involving 40 volunteer year 12 students (age 17). The focus group theme plan was designed after a review of relevant literature. A novel approach was employed using photographic images of pharmacists and doctors in varied settings. Subjects and setting: The research was carried out in six schools in the West Midlands, UK. Results: The students presented a rather negative image of pharmacy as a boring occupation in a laboratory or the back of a shop. Most had little idea of what pharmacists actually do. Unlike nursing, they were unaware of positive role models in the media. The small number who did have a realistic idea of pharmacy based it on their previous work experience in pharmacy. Conclusions: The focus group technique is useful for exploring hitherto untapped perceptions of the profession. Undertaking research with year 12 students provided some useful insights into the ways in which pharmacy as a profession is perceived. Although no claims to generalisability are made here, the results were fed into the design of quantitative surveys. The somewhat negative image presented suggests that the profession has more work to do in marketing itself to young people as a potential career choice.

An exploration of consumer resistance to innovation and its antecedents

Although firms are faced by a large number of market introduction failures, research into a major driver of these failures, customer resistance to innovation, is surprisingly scarce. While most authors have investigated positive adoption decisions, this paper focuses instead on consumer resistance to innovation. The current study presents a conceptual framework which explicates the major components of consumer resistance: (1) rejection, (2) postponement, and (3) opposition, and discusses two main groups of antecedents to consumer resistance: (1) degree of change required and (2) conflicts with the consumer’s prior belief structure. This framework is explored with both a literature review and a qualitative focus group study. These joint efforts result in the formulation of a model of consumer resistance. Finally, the authors discuss several relevant theoretical and strategic implications, and point out directions for future research.

Using grounded theory for theory building in operations management research:a study on inter-firm relationship governance

Purpose – Qualitative theory building approaches, such as grounded theory method (GTM), are still not very widespread and rigorously applied in operations management (OM) research. Yet it is agreed that more systematic observation of current industrial phenomena is necessary to help managers deal with their problems. The purpose of this paper is to provide an example to help guide other researchers on using GTM for theory building in OM research. Design/methodology/approach – A GTM study in the German automotive industry consisting of 31 interviews is followed by a validation stage comprising a survey (110 responses) and a focus group. Findings – The result is an example of conducting GTM research in OM, illustrated by the development of the novel collaborative enterprise governance framework for inter-firm relationship governance in the German automotive industry. Research limitations/implications – GTM is appropriate for qualitative theory building research, but the resultant theories need further testing. Research is necessary to identify the transferability of the collaborative enterprise governance concept to other industries than automotive, to other organisational areas than R&D and to product and service settings that are less complex and innovative. Practical implications – The paper helps researchers make more informed use of GTM when engaging in qualitative theory building research in OM. Originality/value – There is a lack of explicit and well-informed use of GTM in OM research because of poor understanding. This paper addresses this deficiency. The collaborative enterprise governance framework is a significant contribution in an area of growing importance within OM.

Measuring the operational performance of intensive care units using the analytic hierarchy process approach

Purpose - The purpose of this study is to develop a performance measurement model for service operations using the analytic hierarchy process approach. Design/methodology/approach - The study reviews current relevant literature on performance measurement and develops a model for performance measurement. The model is then applied to the intensive care units (ICUs) of three different hospitals in developing nations. Six focus group discussions were undertaken, involving experts from the specific area under investigation, in order to develop an understandable performance measurement model that was both quantitative and hierarchical. Findings - A combination of outcome, structure and process-based factors were used as a foundation for the model. The analyses of the links between them were used to reveal the relative importance of each and their associated sub factors. It was considered to be an effective quantitative tool by the stakeholders. Research limitations/implications - This research only applies the model to ICUs in healthcare services. Practical implications - Performance measurement is an important area within the operations management field. Although numerous models are routinely being deployed both in practice and research, there is always room for improvement. The present study proposes a hierarchical quantitative approach, which considers both subjective and objective performance criteria. Originality/value - This paper develops a hierarchical quantitative model for service performance measurement. It considers success factors with respect to outcomes, structure and processes with the involvement of the concerned stakeholders based upon the analytic hierarchy process approach. The unique model is applied to the ICUs of hospitals in order to demonstrate its effectiveness. The unique application provides a comparative international study of service performance measurement in ICUs of hospitals in three different countries. © Emerald Group Publishing Limited.

Identifying criteria for the assessment of pharmacy students' communication skills with patients

Objectives To identify criteria by which patients can assess the communication skills of pharmacy students. Method Potential assessment criteria were generated from 2 main sources: a literature review and a focus group discussion. A modified two-round Delphi survey was subsequently conducted with 35 professionals who were actively involved in teaching and assessing communication skills of pharmacy students to determine the importance and reliability of each criterion. Results Consensus ratings identified 7 criteria that were important measures of pharmacy students' communication skills and could be reliably assessed by patients. Conclusions A modified two-round Delphi consultation survey successfully identified criteria that can be used by patients to assess the communication skills of pharmacy undergraduates. Future work will examine the feasibility of using patients as assessors of communication skills of pharmacy students, preregistration pharmacists, and qualified pharmacists.

Collaborative enterprise governance : sustainable management of inter-firm R&D relationships in the German car industry

This research reports on the appropriate governance, i.e. design and management, of inter-firm R&D relationships in order to achieve sustainable competitive success for the whole partnership as well as its individual members. An exploratory study in the German automotive industry using inductive Grounded Theory was conducted. This involved data collection via 28 semi-structured interviews with 16 companies in order to form a set of 35 tentative propositions that have been validated via a questionnaire survey receiving 110 responses from 52 companies. The research has resulted in the consolidation of the validated propositions into a novel concept termed Collaborative Enterprise Governance. The core of the concept is a competence based contingency framework that helps decision makers in selecting the most appropriate governance strategy (i.e. sourcing strategy) for an inter-firm R&D relationship between a buyer and its supplier. Thereby, the concept does not draw on whole company-to-company connectivity. It rather conceptualises an inter-firm relationship to be composed of autonomous cross-functional units of the individual partner companies that contribute value to a particular joint R&D project via the possession of task specific competencies. The novel concept and its elements have been evaluated in a focus group with industrial experts of the German automotive industry and revealed positive effects on the sustainable competitive success of the whole partnership and the individual partner companies. However, it also showed that current practice does not apply the right mechanisms for its implementation and hence guidelines for practitioners and decision makers involved in inter-firm R&D collaboration in the automotive industry are offered on how to facilitate the implementation and usage of the Collaborative Enterprise Governance philosophy.

Supporting English language teachers doing further degrees at a distance:a web based strategy researched

This thesis explores how the world-wide-web can be used to support English language teachers doing further studies at a distance. The future of education worldwide is moving towards a requirement that we, as teacher educators, use the latest web technology not as a gambit, but as a viable tool to improve learning. By examining the literature on knowledge, teacher education and web training, a model of teacher knowledge development, along with statements of advice for web developers based upon the model are developed. Next, the applicability and viability of both the model and statements of advice are examined by developing a teacher support site (bttp://www. philseflsupport. com) according to these principles. The data collected from one focus group of users from sixteen different countries, all studying on the same distance Masters programme, is then analysed in depth. The outcomes from the research are threefold: A functioning website that is averaging around 15, 000 hits a month provides a professional contribution. An expanded model of teacher knowledge development that is based upon five theoretical principles that reflect the ever-expanding cyclical nature of teacher learning provides an academic contribution. A series of six statements of advice for developers of teacher support sites. These statements are grounded in the theoretical principles behind the model of teacher knowledge development and incorporate nine keys to effective web facilitation. Taken together, they provide a forward-looking contribution to the praxis of web supported teacher education, and thus to the potential dissemination of the research presented here. The research has succeeded in reducing the proliferation of terminology in teacher knowledge into a succinct model of teacher knowledge development. The model may now be used to further our understanding of how teachers learn and develop as other research builds upon the individual study here. NB: Appendix 4 is only available only available for consultation at Aston University Library with prior arrangement.