Explore the vast range of titles available.

Background Longitudinal qualitative research is starting to be used in applied health research, having been popular in social research for several decades. There is potential for a large volume of complex data to be captured, over a span of months or years across several different methods. How to analyse this volume of data – with its inherent complexity - represents a problem for health researchers. There is a previous dearth of methodological literature which describes an appropriate analytic process which can be readily employed. Methods We document a worked example of the Pen Portrait analytic process, using the qualitative dataset for which the process was originally developed. Results Pen Portraits are recommended as a way in which longitudinal health research data can be concentrated into a focused account. The four stages of undertaking a pen portrait are: 1) understand and define what to focus on 2) design a basic structure 3) populate the content 4) interpretation. Instructive commentary and guidance is given throughout with consistent reference to the original study for which Pen Portraits were devised. The Pen Portrait analytic process was developed by the authors, borne out of a need to effectively integrate multiple qualitative methods collected over time. Pen Portraits are intended to be adaptable and flexible, in order to meet the differing analytic needs of qualitative longitudinal health studies. Conclusions The Pen Portrait analytic process provides a useful framework to enable researchers to conduct a robust analysis of multiple sources of qualitative data collected over time.

Background & objectives The comparative uses of different types of patient experience (PE) feedback as data within quality improvement (QI) are poorly understood. This paper reviews what types are currently available and categorizes them by their characteristics in order to better understand their roles in QI. Methods A scoping review of types of feedback currently available to hospital staff in the UK was undertaken. This comprised academic database searches for “measures of PE outcomes” (2000‐2016), and grey literature and websites for all types of “PE feedback” potentially available (2005‐2016). Through an iterative consensus process, we developed a list of characteristics and used this to present categories of similar types. Main results The scoping review returned 37 feedback types. A list of 12 characteristics was developed and applied, enabling identification of 4 categories that help understand potential use within QI—(1) Hospital‐initiated (validated) quantitative surveys: for example the NHS Adult Inpatient Survey; (2) Patient‐initiated qualitative feedback: for example complaints or twitter comments; (3) Hospital‐initiated qualitative feedback: for example Experience Based Co‐Design; (4) Other: for example Friends & Family Test. Of those routinely collected, few elicit “ready‐to‐use” data and those that do elicit data most suitable for measuring accountability, not for informing ward‐based improvement. Guidance does exist for linking collection of feedback to QI for some feedback types in Category 3 but these types  are not routinely used. Conclusion If feedback is to be used more frequently within QI, more attention must be paid to obtaining and making available the most appropriate types.

The current research examined the links between depressive symptomology and anxiety on the fading of affect associated with positive and negative autobiographical memories. Participants (N = 296) recalled and rated positive and negative events in terms of how pleasant or unpleasant they were at the time they occurred and at the time of event recollection. Multilevel mediation analyses identified evidence that higher levels of depressive symptoms were directly associated with lower affect fade for both negative and positive memories. Tests of indirect effects indicated that depressive symptoms were indirectly related to lower affect fade for negative (but not positive) autobiographical memories via the heightened tendency to think about negative (but not positive) memories. Anxiety was unrelated to affect fade both directly and indirectly. These results suggest that people higher in depressive symptoms retain more negative affect due to an increased likelihood of thinking about negative autobiographical events.

ObjectivesThere is growing evidence that patients can provide feedback on the safety of their care. The 44-item Patient Measure of Safety (PMOS) was developed for this purpose. While valid and reliable, the length of this questionnaire makes it potentially challenging for routine use. Our study aimed to produce revised, shortened versions of PMOS (PMOS-30 and PMOS-10), which retained the psychometric properties of the longer version.ParticipantsTo produce a shortened diagnostic measure, we analysed data from 2002 patients who completed PMOS-44, and examined the reliability of the revised measure (PMOS-30) in a sample of 751 patients. To produce a brief standalone measure, we again analysed data from 2002 patients who completed PMOS-44, and tested the reliability and validity of the brief standalone measure (PMOS-10) in a sample of 165 patients.MethodsThe process of shortening the questionnaire involved a combination of secondary data analysis (eg, Standard Deviation and inter-item correlations) and a consensus group exercise to produce PMOS-30 and examine face validity. Analysis of PMOS-30 data examined reliability (eg, Cronbach’s alpha). Further secondary data analysis (ie, corrected item-total correlations) produced PMOS-10, and primary data collection assessed its reliability and validity (eg, Cronbach’s alpha, analysis of variance).ResultsFourteen items were removed to produce PMOS-30 and the percentage of negatively worded items was reduced from 57% to 33%. PMOS-30 demonstrated good internal reliability (α=0.89). The 10 items with the highest corrected item-total correlations across both PMOS-44 and PMOS-30 composed PMOS-10. PMOS-10 had good internal reliability (α=0.79), demonstrated convergent validity; however, discriminant validity was not established.ConclusionsTwo revised, shortened versions of the original PMOS-44 (PMOS-30 and PMOS-10) were produced to capture patient feedback about safety in hospital. The measures demonstrated good reliability and validity, and preserved the psychometric properties of the original measure.

ObjectivesThe Computer-Aided Risk Score for Mortality (CARM) estimates the risk of in-hospital mortality following acute admission to the hospital by automatically amalgamating physiological measures, blood tests, gender, age and COVID-19 status. Our aims were to implement the score with a small group of practitioners and understand their first-hand experience of interacting with the score in situ.DesignPilot implementation evaluation study involving qualitative interviews.SettingThis study was conducted in one of the two National Health Service hospital trusts in the North of England in which the score was developed.ParticipantsMedical, older person and ICU/anaesthetic consultants and specialist grade registrars (n=116) and critical outreach nurses (n=7) were given access to CARM. Nine interviews were conducted in total, with eight doctors and one critical care outreach nurse.InterventionsParticipants were given access to the CARM score, visible after login to the patients’ electronic record, along with information about the development and intended use of the score.ResultsFour themes and 14 subthemes emerged from reflexive thematic analysis: (1) current use (including support or challenge clinical judgement and decision making, communicating risk of mortality and professional curiosity); (2) barriers and facilitators to use (including litigation, resource needs, perception of the evidence base, strengths and limitations), (3) implementation support needs (including roll-out and integration, access, training and education); and (4) recommendations for development (including presentation and functionality and potential additional data). Barriers and facilitators to use, and recommendations for development featured highly across most interviews.ConclusionOur in situ evaluation of the pilot implementation of CARM demonstrated its scope in supporting clinical decision making and communicating risk of mortality between clinical colleagues and with service users. It suggested to us barriers to implementation of the score. Our findings may support those seeking to develop, implement or improve the adoption of risk scores.

The current research examined the naive theories that individuals hold about how affect fades over time. In three studies (with various replications), participants read about positive and negative events and estimated the emotional impact of those events on either themselves or a hypothetical other over different time frames (i.e., 1 week, 1 month, 1 year-Studies la-lc) or how long it would take for specific amounts of fade to occur (Studies 2a & 2b). In a final study, participants were directly asked about their beliefs regarding affect fade. Results demonstrated that people have inaccurate expectations about affect fade for positive and negative events. Specifically, participants rate that positive events fade more in the short term, but that negative events fade more in the long term. Results are discussed in terms of how these (incorrect) naive theories of affect fade relate to metacognitive biases in memory and emotion.

Context Collecting feedback from patients about their experiences of health care is an important activity. However, improvement based on this feedback rarely materializes. In this study, we focus on answering the question—“what is impeding the use of patient experience feedback?” Methods We conducted a qualitative study in 2016 across three NHS hospital Trusts in the North of England. Focus groups were undertaken with ward‐based staff, and hospital managers were interviewed in‐depth (50 participants). We conducted a conceptual‐level analysis. Findings On a macro level, we found that the intense focus on the collection of patient experience feedback has developed into its own self‐perpetuating industry with a significant allocation of resource, effort and time being expended on this task. This is often at the expense of pan‐organizational learning or improvements being made. On a micro level, ward staff struggled to interact with feedback due to its complexity with questions raised about the value, validity and timeliness of data sources. Conclusions Macro and micro prohibiting factors come together in a perfect storm which provides a substantial impediment to improvements being made. Recommendations for policy change are put forward alongside recognition that high‐level organizational culture/systems are currently too sluggish to allow fruitful learning and action to occur from the feedback that patients give.

The current research examined the naïve theories that individuals hold about how affect fades over time. In three studies (with various replications), participants read about positive and negative events and estimated the emotional impact of those events on either themselves or a hypothetical other over different time frames (i.e., 1 week, 1 month, 1 year—Studies 1a–1c) or how long it would take for specific amounts of fade to occur (Studies 2a & 2b). In a final study, participants were directly asked about their beliefs regarding affect fade. Results demonstrated that people have inaccurate expectations about affect fade for positive and negative events. Specifically, participants rate that positive events fade more in the short term, but that negative events fade more in the long term. Results are discussed in terms of how these (incorrect) naïve theories of affect fade relate to metacognitive biases in memory and emotion.

Objectives The current study examined the relationship between dispositional mindfulness and fading affect bias, where the affect associated with negative events fades more quickly and fully than affect associated with positive events. Although much of the previous work has focused on conditions that hinder fading affect bias (e.g., depression, anxiety), few studies have examined individual difference variables that could enhance the asymmetric fading of positive and negative affect associated with autobiographical events. Methods Participants ( n  = 241) recalled and described positive and negative life events and rated the initial and current emotional intensity of those events. Events were also rated on importance, memorability, and how often they had been thought about. Participants also completed the Five Facet Mindfulness Questionnaire (FFMQ) to assess dispositional mindfulness. Results Fading affect bias emerged in the study and the strength of the effect was predicted by dispositional mindfulness. The relationship was driven by the observing and describing subscales of the FFMQ. The data fit a model where increased thinking about positive events, but not negative events, mediated the relationship between the observing subscale and fading affect bias. Conclusions The findings suggest that an ability to be centred in the present moment—as measured by dispositional mindfulness—enhances one’s capacity to move on from past events. Specifically, the ability to both observe and describe internal states and the external world enhances the beneficial asymmetric fade of affect associated with negative and positive life events. Preregistration This study is not preregistered.

BackgroundThe NHS Long Term Plan aims to make care more Patient-Centred through listening to patients. The acute nature of ED care presents barriers to collecting patient feedback. We have explored two interventions (PRASE and Y-PET), as mechanisms for collecting and reporting safety feedback (PRASE) and experience feedback (Y-PET) in EDs.An iterative approach was used to develop PMOS10 (PRASE questionnaire) for the ED which was tested in 5 departments with over 100 patients. The Y-PET was used alongside these tools in 2 departments with 40 patients.A mixture of patient volunteers and staff collected the feedback.Two questions from the PMOS10 proved to be unsuitable for the ED setting, and were substituted. Through further iterative tests, we now have a PMOS10(ED).Hospital volunteers and staff not associated with the department are best placed to collect unbiased results. Patients (or their relatives) who are awaiting transport home or a hospital bed are best placed to give feedback. The traffic light display of patient safety feedback provided in PRASE is useful for assurance but staff need more qualitative data to inspire change. PRASE patient comments go someway to providing this but are strongly enhanced by the open answers of the Y-PET. The Y-PET format for presenting qualitative data as headline areas to celebrate or improve was effective in engaging staff in feedback from both tools.ED patients can give valuable insight into how safe their care is and areas to celebrate and improve. Staff can engage with feedback themes and key quotes to initiate improvement.