Guidelines are widely used as a method for translating research evidence into clinical advice for medical practitioners. However, in many cases the uptake of guidelines is poor, for example, hypertension management guidelines. We conducted a qualitative research project to explore the barriers to the optimal treatment of hypertension by GPs. In our research we found that rather than a lack of knowledge and awareness of the existing hypertension guidelines, other barriers were operating such as: clinical uncertainty about the true underlying blood pressure and distrust of the technology used to measure it; distrust toward the evidence underpinning the management of hypertension; patient age, gender and co-morbidity; perceived patient attitude; clinical inertia; whole-person care and systems issues such as lack of resources and lack of time in consultations. After presenting our research findings to a group of researchers and clinicians who develop guidelines (in our case the High Blood Pressure Research Council of Australia) they chose to delay the intended production of a new guideline and to instead investigate possible methods of improving the uptake of existing guidelines using qualitative methods. This demonstrates the usefulness of engaging both the end-users and producers of the evidence/guidelines in the translational process of change.
There are few studies that investigate how people personally affected by a chronic disease associated with cigarette smoking account for their illness. Chronic obstructive pulmonary disease (COPD) is a respiratory condition largely caused by cigarette smoking. In order to better understand how people diagnosed with COPD view the relationship between cigarette smoking and their illness we conducted semi-structured interviews with 19 participants. We found a widespread scepticism among our respondents about medical attempts to link their illness with cigarette smoking, and doubts about whether their illness was in fact COPD at all. Only four participants described smoking as the principal reason why they had developed breathing problems. Most participants gave multi-causal accounts that emphasised explanatory factors such as a familial tendency to respiratory illness or workplace exposure to pollution. Our findings have relevance for the development of smoking cessation interventions for people with COPD.
Aims: The aims of this study were to understand the experience of participation in visual art from the perspective of adults undergoing outpatient physical rehabilitation and to determine whether art has a place in this context. Method: This qualitative study involved interviewing adults who attended a weekly art class run by a qualified art teacher and occupational therapists in an outpatient physical rehabilitation setting. Nine participants with neurological conditions discussed their experience of the programme and the goals they were working towards or had achieved through painting. Findings: The themes that emerged from the study show that art contributed to the participants meeting their individual rehabilitation goals. It also assisted the participants in using time, increasing enjoyment, regaining confidence and planning for engagement in future activities. All these achievements were seen by the participants to contribute to their rehabilitation or recovery. The identified themes align with the aims of rehabilitation and are similar to findings from many other studies investigating the use of art by people affected by illness or disability. Conclusion: The findings of this study inform clinical practice in the use of visual art with clients in rehabilitation and validate its place in a physical rehabilitation programme.
To investigate mothers' infant feeding experiences (breastfeeding/formula milk feeding) with the aim of understanding how women experience cessation of exclusive breastfeeding.
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