Presentation on theme: "Involving volunteer visitors in data collection National Centre for Training and Education in Prosthetics and Orthotics University of Strathclyde Glasgow."— Presentation transcript:
Involving volunteer visitors in data collection National Centre for Training and Education in Prosthetics and Orthotics University of Strathclyde Glasgow Scotland Brian Callaghan
Callaghan BG, Condie ME (2003). A post-discharge quality of life outcome measure for lower limb amputees: test-retest reliability and construct validity. Clinical Rehabilitation 17, 858- 865. Quality of life assessment in lower limb amputees (Callaghan and Condie, 2003)
1.Adapt the Patient Generated Index (PGI) for Amputees 2.Test-Retest Reliability and Construct Validity Study Aims of Project
Participants (N = 39) –Inclusion Criteria Over 16-years of Age Unilateral /Transfemoral Amputation Fitted with a Prosthesis Discharged 1-Year –Patient Selection SPARG Database 7 Participating Rehabilitation Centres Method
Procedure –Murray Foundation Visitors (N = 10) 1 st Visit (at home) –PGI and SF-12 2 nd Visit (at home 1-month later) –PGI Only Method
Procedure –Murray Foundation Visitors (N = 10) Before Study –Training day After Study –Debriefing day Method
–Murray Foundation Visitors (N = 9) Eight open-ended questions (given independently) to elicit experiences of MF visitors. Responses (with frequencies) Debriefing Day
Question. Do you feel that the training you received at The National Centre was sufficient to enable you to carry out your interviews? Answer. yes (x9)
Question. What do you feel are the most important skills for carrying out interviews with fellow amputees? Answers. empathy (x2) patience (x1) listening (x5) guiding [pts] to understand questions (x1)
Question. Do you think that the participants you interviewed gave more information to you than they would have to me [Brian]? Answer. yes (x9)
Question. What sorts of things do you think the participants talked to you about that they might have felt uncomfortable talking to me about? Answers. NHS staff (x1) personal issues (x1) comfort/pain (x1) partners feelings (x1) hygiene (x1) sex (x1) toilet issues (x1) anxiety (x1) day to day activities (x1)
Question. What do you think makes for a good interview? Answers. relaxed atmosphere (x3) willing participant (x1) one-to-one (x1) pt in good condition/no pain (x1) pt understands what's required (x1) pts home (x1) pt comfortable/not intimidated (x1)
Question. What do you think makes for a bad interview? Answers. hurried (x1) no empathy (x2) over prompting (x1) other family present (x1) complicated questions (x1) pressure to say right thing (pt feels) (x1) tension (x1) interviewer uncomfortable (x1) chip-on-shoulder amputee ?!
Question. Are there any questions, or types of questions, that you would feel uncomfortable asking a participant? Answers. no (x3) sex/personal (x4) standard of living (x1) smoking/drinking (x1)
Question. If you signed a declaration of confidentiality, but then a participant revealed to you during an interview that they might harm themselves in some way, would you tell me or anyone else? Answers. yes (x4) possibly (x3) no (x2)
Callaghan BG, Johnston M, Condie ME (2001-2004). Predictors of prosthetic fitting, use and recovery following lower limb amputation: illness related cognitions, attitudes towards prosthetic use, psychological distress and functional limitations. (funded by Chief Scientist Office (CSO), Scottish Health Executive) Psychosocial predictors of prosthetic use and recovery (Callaghan, Johnston, Condie, 2001-2004)
Participants (N = 170) A 12-month Cohort of New Unilateral Lower Limb Amputees (transtibial and transfemoral) –Additional Inclusion Criteria Over 50-years of Age Fluent in English Pass Cognitive Screening Test PVD (Peripheral Vascular Disease) 8 Participating Rehabilitation Centres Method Participants
–Questionnaire Development TPB (Attitudes Towards Prosthetic Use) –Assessment Times 3-4 weeks post-operative 1-month post-discharge from rehabilitation 6-months post-discharge from rehabilitation –Data Collection Principle Researcher Senior Physiotherapist Murray Foundation Volunteers Method Procedure
Training Day –Murray Foundation Visitors (N = 18) Research Methods in Healthcare (Revisited) Outline
1. The New Study Introduction Aims and purposes Research questions Methods Procedures Implications How results could benefit lower limb amputees in Scotland Discussion Talking about the study with visiting volunteers Questions and answers
2. The Measures To Be Used Introduction to the measures Guidelines for use Instruction booklets will again be provided LCI RLOC HADS FMA (questions 3, 4, 6 and 11) PGI (revisited)
3. Interview Technique (revisited) Understanding ethical conduct Understanding confidentiality Understanding objectivity Understanding impartiality Interview demonstration by Research Fellow Practice interviewing techniques Visiting Volunteers
4. Administrative Procedure Understanding materials the interview package (e.g.,questionnaire, guidelines for use, return stamped addressed envelope, etc.) Understanding procedure (e.g., returning questionnaires, contacting Research Fellow, etc) How visits are arranged by Research Fellow How visits are allocated to a volunteer visitor Being in contacting with Research Fellow at all times!
Interim Feedback Day –Murray Foundation Visitors (N = 8) Matters Arising Difficult interviewees Lost follow-ups Participants encouraged by seeing visitor!
Theory of Planned Behaviour Normative Beliefs Intention Control Beliefs Behavioural Beliefs Subjective Norm Perceived Behavioural Control Attitude Toward the Behaviour Behaviour Ajzen I (1991). The theory of planned behaviour. Organisational Behaviour and Decision Process 50, 179-211. Social Cognition Models
Theory of Planned Behaviour Normative Beliefs I will intend to do this behaviour? Subjective Norm Behaviour If I want to comply with the perceived approval of other people/groups I value? If I value the expected outcomes as being beneficial to me? If I believe I have the skills and resources required to overcome likely obstacles? Ajzen I (1991). The theory of planned behaviour. Organisational Behaviour and Decision Process 50, 179-211.
Theory of Planned Behaviour Normative Beliefs I will intend to do a behaviour? Subjective NormBehaviour (Prosthetic Use) I would like to impress my peers the way this visitor has impressed me? I would like to be as mobile and independent as this visitor? I have a prosthesis too and if this visitor can do it then so can I? Ajzen I (1991). The theory of planned behaviour. Organisational Behaviour and Decision Process 50, 179-211.
Self-efficacy Bandura A (1986). Social foundations of thought and action: a social cognitive theory. Englewood Cliffs, NJ: Prentice Hall. Perceived self-efficacy refers to beliefs in ones capabilities to organise and execute the courses of action required to produce given levels of attainment or manage prospective situations (Bandura, 1986).
Self-efficacy (in Social Cognitive Model) Self-efficacy Proximal Goals Impediments Outcome Expectations Behaviour Bandura A (1991). Social cognitive theory of self-regulation. Organizational Behaviour And Human Decision Processes 50, 248-287. Social Cognition Models
Enhancing Self-efficacy Vicarious Modeling Somatic /Mood States Social Persuasion Mastery Experiences Self-efficacy Bandura A (1977). Social learning theory. New York: General Learning Press.
Interpret information from....watching others perform the behaviour..biological and emotional feedback..being persuaded you can do the behaviour..practicing the behaviour Self-efficacy Bandura A (1977). Social learning theory. New York: General Learning Press. Enhancing Self-efficacy
Interpret information from....biological and emotional feedback..practicing the behaviour Self-efficacy Bandura A (1977). Social learning theory. New York: General Learning Press. Enhancing Self-efficacy..being encouraged by fellow amputees verbal support..watching fellow amputees adapting and coping well