As subjects in drug clinical trials and participants in medical practice, patients can best understand their own conditions and needs. With this in mind, the FDA proposed "patient-centered drug discovery" and issued a set of guidelines to incorporate patient experiences, perspectives, needs, and preferences into the drug development and evaluation process. Guideline (2), methods for identifying important patient information, mainly describes methods and precautions for collecting and extracting patient experience data. This paper will focus on the characteristics, common methods and precautions of qualitative, quantitative and mixed research methods in the collection of patient experience data, in order to provide help for the comprehensive collection of patient experience data.
Qualitative research can provide interpretations of patients on experience, attitudes, beliefs and psychological changes of disease nursing, so it reflects the scientificity, humanity and ethicality of nursing science. How to assess and integrate findings derived from qualitative researches and use them in decision making is a key issue for researchers. This paper introduced how to evaluate the methodological quality and reporting quality of qualitative research, perform qualitative systematic review and meta-synthesis, and evaluate the quality of evidence of meta-syntheses using the ConQual tool.
Objective To explore the actual experience of epileptic patients in video electroencephalogram (VEEG) examination, and to provide reference basis for formulating corresponding nursing strategies and coping methods. MethodsIn this descriptive analysis study, 18 patients (11 males and 7 females, average age 37.78±18.7 years) receiving VEEG from January to April 2022 in the Second Affiliated Hospital of Guangzhou Medical University, underwent a semi-structural interview. Information obtained from the interview was analyzed using the Colaizzi 7-step method. ResultsThe actual experience of epileptic patients in video EEG examination can be summarized into two aspects: the medical experience and the need for nursing care. The medical experience includes positive and negative experience. The positive experience includes good service attitude, professional medical services, good endurance, and being hopeful. The negative experience includes a weird feeling in the head, insomnia, inconvenience in life, eye discomfort, psychological pressure, and pain. The need for nursing care includes needs for knowledge, strong needs for communicating with doctors, needs for humanistic care and female needs for female implementing the equipment. Conclusion Epileptic patients suffer from different degrees of discomfort and psychological pressure during VEEG examination. Both negative and positive experience exist. Medical staff should improve the content of nursing services according to the nursing needs of patients and provide professional VEEG examination services to patients.
A well-conducted evidence-based guideline not only considers the efficiency and the cost of the recommended intervention, but also the acceptability and feasibility of the intervention during implementation. Systematic reviews of qualitative research aim to provide qualitative evidence such as the acceptability and feasibility of the intervention. In developing evidence-based guidelines, qualitative evidence helps to:(1) Define the scope of guideline; (2) Assess the acceptability of interventions; (3) Assess the feasibility of interventions; (4) Identify considerations when implementing guidelines. Systematic reviews provide the fundamental evidence required to develop robust and trustworthy guidelines. The CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach aims to grade the evidence from systematic reviews of qualitative research. After critically and scientifically appraising by CERQual, the acceptance and feasibility of an intervention are given different grading, which is the critical process of developing evidence-based guidelines. This paper will demonstrate the value of systematic reviews of qualitative research in developing evidence-based guidelines and how to implement recommendations from qualitative evidence.
The PICO model is a general model in building problems of evidence-based medicine (EBM). However, with the deepening and refinement of the medical research and the rising of qualitative research, the PICO model could not satisfy all problems. This article introduces the expansions of the PICO model and puts forward the SPIDER model according to the qualitative problem and its relationship with the PICO model, which can build the best search strategy of clinical problems in a short time.
ObjectiveTo explore the psychological process and needs of the second victims of medical adverse events after the occurrence of adverse events, so as to provide reference for the psychological intervention strategies of medical institutions for the second victims of medical adverse events.MethodsThe second victims of medical adverse events in the First People’s Hospital of Ziyang were selected from April to July 2019. Qualitative research method was used to conduct semi-structured in-depth interviews with the second victims. Colaizzi method was used to analyze the transcripts through reading and rereading, coding, and thematizing. ResultsA total of 22 second victims of medical adverse events were interviewed. The second victims of medical adverse events experienced negative emotional experience, and the desire to seek emotional support was urgent. The psychological process of the second victims of medical adverse events mainly involved five stages: fear, anxiety, depression, guilt and recovery. Emotional support hada positive effect on regression. Conversely, negative or lack of emotional support had a negative effect on regression. ConclusionsThe emotional experience of the second victims of medical adverse events is relatively staged, and the recovery and regression are greatly affected by internal and external factors. Hospital administrators should take active measures and establish an emotional support mechanism for adverse events in order to reduce psychosomatic injuries and improve medical quality and efficiency.
ObjectiveTo systematically review the experience of parents caring for preterm infants after discharge from hospital. MethodsWe searched databases including The Cochrane Library, Joanna Briggs Institute Library, PubMed, EMbase, Scopus, ISI Web of Science, PsycINFO, CINAHL, CBM, CNKI and VIP from inception to May 2015, to collect qualitative studies in the experience of parents caring for preterm infants after discharge from hospital. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods. ResultsA total of nine studies were included. Thirty-one complete findings were grouped according to their similarities to form seven categories. These categories resulted in two synthesized findings:integration results 1:parents grow in the adaptation of their care giving roles for the preterm infants; integration results 2:they are eager and thankful for support, resource and information in this critical transition period. ConclusionHealth care workers should pay attention to the important influence of premature infants discharged from hospital on their parents. In the adaption period of premature parents, health care workers should give necessary care knowledge skills to guide the parents, to assist them to compete the role of caregivers as soon as possible and promote the healthy growth of premature infants after discharge.
In recent years, the application of qualitative evidence synthesis results in health and social care policy has increased, and assessment of the limitations of qualitative research methodologies is critical in ensuring the credibility of qualitative evidence synthesis results. However, currently commonly used assessment tools are not designed specifically for Cochrane systematic reviews or qualitative evidence synthesis, and most lack evidence-based development background. To address this gap, the Cochrane qualitative methodological limitations tool (CAMELOT) was created to provide authors with a standardized tool specifically designed to assess the limitations of qualitative research methodologies. Based on the operation guide of evidence-based evaluation tool and Delphi consensus survey method, this paper introduces the development process of CAMELOT and expounds its field contents in detail.
ObjectiveTo explore the real experiences of women of childbearing age with epilepsy during their reproductive decision-making process, and to provide a basis for clinical practitioners in managing the reproductive decision-making of this group of women and implementing decision support. MethodsSixteen women of childbearing age with epilepsy who were hospitalized in the Epilepsy Center of Beijing Tiantan Hospital, Capital Medical Universityi in Beijing from April 2024 to June 2024 were selected through purposive sampling. The Colaizzi phenomenological data analysis method was employed, and the data were organized and analyzed with the aid of Nvivo 11.0 software to extract themes. ResultsThree themes and eight sub-themes were extracted: The majority of patients had reproductive demands (personal role expectations, family and social pressure), Uncertainties in reproductive behaviors and outcomes (uncertainties in the pregnancy process caused by the disease, uncertainties in the reproductive outcome caused by the disease), and Encountering reproductive decision-making predicaments (lack of professional knowledge, conflicting information from different channels, multiple factors influencing reproductive decision-making, and various negative experiences associated with decision-making). ConclusionThe majority of women of childbearing age with epilepsy have reproductive needs and encounter decision-making predicaments. Medical staff should pay attention to their true experiences, offer adequate support and assistance, and help patients extricate themselves from the decision-making predicament to make scientific and rational decisions.
ObjectiveTo systematically review the qualitative research on the obstacles and promoting factors of artificial intelligence implementation in the real perioperative world. MethodsComputer searches were conducted on PubMed, CINAHL, Scopus, Web of Science, ACM Digital Library, Cochrane Library, CNKI, WanFang Data, and VIP databases to collect perioperative studies related to the clinical application of artificial intelligence. The search period was from database establishment until December 31, 2023. Based on the SPIDER model, the quality of the included literature was evaluated using the JBI Epidemiological Scale. The NASSS framework was used to integrate and analyze the qualitative factors discovered during the implementation of the perioperative artificial intelligence system, and a problem item pool was established. ResultsA total of 22 articles were included, and perioperative stakeholders mainly focused on perioperative artificial intelligence technology users such as anesthesiologists, anesthesiologists, and surgeons. The field of perioperative artificial intelligence services mainly focused on robot surgery. The JBI evaluation score was 4-8 points. The NASSS implementation factor framework consisted of 7 core themes and 27 secondary items. ConclusionIt is undeniable that perioperative artificial intelligence has a positive impact on the prognosis, medical quality, and efficiency of surgical patients. However, its clinical application will face influences from adopters, organizational structures, social culture, and other aspects, which will ultimately affect its implementation effect. The existing qualitative research on the influencing factors of perioperative artificial intelligence systems in clinical implementation has problems such as limited quantity, moderate quality, and lack of scientific research based on a systematic implementation factor framework. Conducting scientific and standardized application research will have a guiding effect on the future use of perioperative artificial intelligence and is expected to improve its final service effectiveness.