Browsing by Author "Solomon, Josie"
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Item Metadata only The compatibility of prescribing guidelines and the doctor-patient partnership: A primary caremixed-methods study.(British Journal of General Practice, 2012) Solomon, Josie; Raynor, D. K.; Knapp, P.; Atkin, KarlItem Metadata only Our lives, our community: The voice of the public on domestic abuse and child safeguarding concerns.(International Conference of Primary Care & Public Health, Imperial College London, 2015-11) Solomon, Josie; Taylor, S.Our lives, our community: The voice of the public on domestic abuse and child safeguarding concerns. J. Solomon and S. Taylor Background Prevention of child and domestic abuse is a public health priority, which requires an integrated approach 1,2. Although it is acknowledged that safeguarding is everybody’s responsibility, this tends to refer to professionals rather than citizens 2. Therefore NHS Primary Care Organizations in the East Midlands commissioned this study to identify the types of scenarios that the public have concerns about, and their thresholds for those concerns. Methods Four qualitative focus groups were conducted with members of the public representing a broad demographic range. Focus groups were recorded, transcribed verbatim, coded thematically and analysed using an interpretive approach. Findings Participants were unsure about whom to refer their concerns to. Furthermore, the emotional distress associated with concerns often acted as a deterrent to reporting. Six categories of types of concern were identified: domestic abuse, neglectful parenting, over-disciplining children, distressed children, suspicious symptoms and inappropriate physical contact. Interpretation There is a need for professionals to listen to the public’s public concerns, offer assistance with signposting and emotional support. The project is continuing to a second stage, in which professional DVD dramatizations have been created of each type of concern. These are being used as a basis of an inter-agency Delphi-style consultation. References 1. Department of Health. Protecting people, Promoting health, 2012. 2. HM Government UK. Working Together to Safeguard Children, 2013.Item Embargo Patients' attitudes to risk in lung cancer surgery: A qualitative study.(Lung Cancer, 2015-11) Powell, H. A.; Jones, L. L.; Baldwin, D. R.; Duffy, J. P.; Hubbard, R. B.; Tod, A. M.; Tata, L. J.; Solomon, Josie; Bains, M.Lung Cancer. 2015 Nov;90(2):358-63. doi: 10.1016/j.lungcan.2015.08.014. Epub 2015 Aug 24. Patients' attitudes to risk in lung cancer surgery: A qualitative study. Powell HA1, Jones LL2, Baldwin DR3, Duffy JP4, Hubbard RB5, Tod AM6, Tata LJ5, Solomon J7, Bains M5. Author information 1 University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. Electronic address: helen.powell5@nhs.net. 2 Public Health, Epidemiology & Biostatistics, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. 3 University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK; Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK. 4 Department of Thoracic Surgery, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK. 5 University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. 6 School of Nursing, Midwifery and Social Work, Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK. 7 Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester LE1 9BH, UK. Abstract OBJECTIVES: Lung cancer surgery leads to long term survival for some patients but little is known about how patients decide whether to accept the associated surgical risks. The objective of this qualitative study was to explore patients' attitudes to the risks associated with lung cancer surgery. METHODS: Fifteen patients with resectable lung cancer, recruited via multi-disciplinary team meetings at an English tertiary referral centre, participated in semi-structured interviews to explore their attitudes to the morbidity and mortality risks associated with lung cancer surgery. Transcripts were analysed using the framework method. RESULTS: Participants reported being 'pleased' to hear that they were suitable for surgery and felt that surgery was not a treatment to be turned down because they did not see any alternatives. Participants had some knowledge of perioperative risks, including mortality estimates; however, many voiced a preference not to know these risks and to let the medical team decide their treatment plan. Some found it difficult to relate the potential risks and complications of surgery to their own situation and appeared willing to accept high perioperative mortality risks. Generally, participants were willing to accept quite severe long-term postoperative breathlessness; however, it was apparent that many actually found this possibility difficult to imagine. CONCLUSION: Patients do not necessarily wish to know details of risks associated with lung cancer surgery and may wish to defer decisions about treatment to their medical team. Investment in the doctor-patient relationship, particularly for the surgeon, is therefore important in the management of patients with lung cancer. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved. KEYWORDS: Lung neoplasm; Morbidity; Mortality; Qualitative Research; Risk; Thoracic surgery PMID: 26323214 DOI: 10.1016/j.lungcan.2015.08.014Item Open Access Supporting the provision of pharmacy medication reviews to marginalised (medically underserved) groups: a before/after questionnaire study investigating the impact of a patient–professional co-produced digital educational intervention(BMJ Open, 2019-09-17) Latif, Asam; Waring, Justin; Chen, Li-chia; Pollock, Kristian; Solomon, Josie; Gulzar, Nargis; Gulzar, Sulma; Anderson, Emma; Choudhary, Shahida; Abbasi, Nasa; Wharrad, Heather; Anderson, ClaireObjectives People who are marginalised (medically underserved) experience significant health disparities and their voices are often ‘seldom heard’. Interventions to improve professional awareness and engagement with these groups are urgently needed. This study uses a co-production approach to develop an online digital educational intervention in order to improve pharmacy staffs’ intention to offer a community pharmacy medication review service to medically underserved groups. Design Before/after (3 months) self-completion online questionnaire. Setting Community pharmacies in the Nottinghamshire (England) geographical area. Participants Community pharmacy staff. Intervention Online digital educational intervention. Primary and secondary outcome measures The primary outcome measure was ‘behaviour change intention’ using a validated 12-item survey measure. The secondary outcome measure was pharmacist self-reported recruitment of underserved groups to the medication review service. Results All pharmacies in the Nottinghamshire area (n=237) were approached in June 2017 and responses were received from 149 staff (from 122 pharmacies). At 3 months (after completing the baseline questionnaire), 96 participants (from 80 pharmacies) completed a follow-up questionnaire, of which two-thirds (n=62) reported completing the e-learning. A before/after comparison analysis found an improving trend in all the five constructs of behaviour change intention (intention, social influence, beliefs about capabilities, moral norms and beliefs about consequences), with a significant increase in mean score of participants’ ‘beliefs about capabilities’ (0.44; 95% CI 0.11 to 0.76, p=0.009). In the short-term, no significant change was detected in the number of patients being offered and the patient completing a medication review. Conclusions Although increases in the numbers of patients being offered a medication review was not detected, the intervention has the potential to significantly improve pharmacy professionals’ 'beliefs about capabilities' in the short-term. Wider organisational and policy barriers to engagement with marginalised groups may need to be addressed. Future research should focus on the interplay between digital learning and practice to better identify and understand effective practice change pathways.Item Open Access Supporting underserved patients with their medicines: a patient / professional co-produced education intervention for community pharmacy staff to improve the provision and delivery of Medicine Use Reviews(BMJ Open Access, 2016-12-09) Latif, Asam; Pollock, Kristian; Anderson, Claire; Waring, Justin; Solomon, Josie; Chan, Li-Chia; Anderson, Emma; Gulzar, Sulma; Abbasi, Nasa; Wharrad, HeatherIntroduction Community pharmacy increasingly features in global strategies to modernise the delivery of primary healthcare. Medicine Use Reviews (MURs) form part of the English Government's medicines management strategy to improve adherence and reduce medicine waste. MURs provide space for patient–pharmacist dialogue to discuss the well-known problems patients experience with medicine taking. However, ‘underserved’ communities (eg, black and minority ethnic communities, people with mental illness), who may benefit the most, may not receive this support. This study aims to develop, implement and evaluate an e-learning education intervention which is coproduced between patients from underserved communities and pharmacy teams to improve MUR provision. Methods and analysis This mixed-methods evaluative study will involve a 2-stage design. Stage 1 involves coproduction of an e-learning resource through mixed patient–professional development (n=2) and review (n=2) workshops, alongside informative semistructured interviews with patients (n=10) and pharmacy staff (n=10). Stage 2 involves the implementation and evaluation of the intervention with community pharmacy staff within all community pharmacies within the Nottinghamshire geographical area (n=237). Online questionnaires will be completed at baseline and postintervention (3 months) to assess changes in engagement with underserved communities and changes in self-reported attitudes and behaviour. To triangulate findings, 10 pharmacies will record at baseline and postintervention, details of actual numbers of MURs performed and the proportion that are from underserved communities. Descriptive and inferential statistics will be used to analyse the data. The evaluation will also include a thematic analysis of one-to-one interviews with pharmacy teams to explore the impact on clinical practice (n=20). Interviews with patients belonging to underserved communities, and who received an MUR, will also be conducted (n=20). Ethics and dissemination The study has received ethical approval from the NHS Research Ethics Committee (East Midlands–Derby) and governance clearance through the NHS Health Research Authority. Following the evaluation, the educational intervention will be freely accessible online.Item Open Access Towards equity: a qualitative exploration of the implementation and impact of a digital educational intervention for pharmacy professionals in England(Springer, 2019-10-12) Latif, Asam; Waring, Justin; Pollock, Kristian; Solomon, Josie; Gulzar, Nargis; Choudhary, Shahida; Anderson, ClaireBackground Patients belonging to marginalised (medically under-served) groups experience problems with medicines (i.e. non-adherence, side effects) and poorer health outcomes largely due to inequitable access to healthcare (arising from poor governance, cultural exclusion etc.). In order to promote service equity and outcomes for patients, the focus of this paper is to explore the implementation and impact of a new co-produced digital educational intervention on one National Health Service (NHS) funded community pharmacy medicines management service. Methods Semi-structured interviews with a total of 32 participants. This included a purposive sample of 22 community pharmacy professionals, (16 pharmacists and 6 pharmacy support staff) all who offered the medicine management service. In order to obtain a fuller picture of the barriers to learning, five professionals who were unable to complete the learning were also included. Ten patients (from a marginalised group) who had received the service (as a result of the digital educational intervention) were also interviewed. Drawing on an interpretative analysis, Normalisation Process Theory (NPT) was used as a theoretical framework. Results Three themes are explored. The first is how the digital learning intervention was implemented and applied. Despite being well received, pharmacists found it challenging completing and cascading the learning due to organisational constraints (e.g. lack of time, workload). Using the four NPT constructs (coherence, cognitive participation, collective action and reflexive monitoring) the second theme exposes the impact of the learning and the organisational process of ‘normalisation’. Professional reflective accounts revealed instances where inequitable access to health services were evident. Those completing the intervention felt more aware, capable and better equipped to engage with the needs of patients who were from a marginalised group. Operationally there was minimal structural change in service delivery constraining translation of learning to practice. The impact on patients, explored in our final theme, revealed that they experience significant disadvantage and problems with their medicines. The medication review was welcomed and the discussion with the pharmacist was helpful in addressing their medicine-related concerns. Conclusions The co-produced digital educational intervention increases pharmacy professionals’ awareness and motivation to engage with marginalised groups. However structural barriers often hindered translation into practice. Patients reported significant health and medicine challenges that were going unnoticed. They welcomed the additional support the medication review offered. Policy makers and employers should better enable and facilitate ways for pharmacy professionals to better engage with marginalised groups. The impact of the educational intervention on patients’ health and medicines management could be substantial if supported and promoted effectively.Item Metadata only Worlds apart? An exploration of prescribing and medicine-taking decisions by patients, GPs and local policy makers(Elsevier, 2013) Solomon, Josie; Knapp, P.; Raynor, D. K.; Atkin, Karl