Study aim |
To identify and explore the perspectives of nurses and other multidisciplinary stroke team members on nurses’ practice in stroke rehabilitation |
To explore undergraduate baccalaureate nursing students’ understanding of clinical safety |
To elicit stakeholders’ viewpoints about the dimensions at stake in determining marketing authorisation (MA) and about the processes used to grant MA (including whether the cost of the treatment should be considered in the MA procedure) |
Topic |
Perceptions of treatment/change/intervention |
Education |
Cancer |
Development of the Q-set |
Data from previous study |
Refined from a concourse used in a previous Q study |
Review of the literature; semi-structured interviews |
Number of statements in Q-set |
32 |
43 |
34 |
Ranking scale and anchors |
Most disagree (-4) to Most agree (+ 4) |
Most disagree (-5) to Most agree (+ 5) |
Most disagree (-4) to Most agree (+ 4) |
Example statement |
Nurses are the most appropriate professional to liaise between stroke survivors, families and the stroke unit team |
The student makes independent clinical decisions beyond his/her competency |
If a treatment can prolong lifespan, even by one month, it should be given MA whatever its cost to society |
Delivery method |
Face-to-face |
Face-to-face |
Online (Flash Q) |
Participants |
63 healthcare employees regularly working with/visiting patients on a stroke unit (registered nurse, healthcare assistant, therapist, physician, dietician, social worker, clinical psychologist, orthoptist) |
68 first year nursing students |
48 healthcare employees (oncologists, healthcare decision makers, individuals from the pharmaceutical industry) and 104 consumers (patients; members of the general population) |
Analysis |
PCA; Varimax; PQMethod |
Centroid; Varimax; PQMethod |
PCA; Manual rotation; PQMethod |
Other methods |
Post-sorting questions/additional comments; semi-structured interviews |
Post-sorting group discussion |
Post-sorting questions/additional comments |
Factors/viewpoints |
n = 4 |
n = 4 |
n = 3 |
|
1. Integrate rehabilitation principles in routine nursing practice; 2. Physical care activity takes priority over rehabilitation principles; 3. Support the wider stroke team to provide stroke rehabilitation; 4. Be cautious about nurse’ engagement in stroke rehabilitation practice |
1. Overwhelming sense of inner discomfort; 2. Practicing contrary to conventions; 3. Lacking in professional integrity; 4. Disharmonising relations |
1. Quality of life, opportunity cost and participative democracy; 2. Quality of life and patient centeredness; 3. Length of life |
Variance explained |
66% |
Not reported |
44% |
Study implications |
Results gave insight into similarities and differences in viewpoints amongst clinical staff on nursing practices in stroke units. Study findings demonstrated the need for structured competency-based multidisciplinary training in rehabilitation skills to facilitate partnerships between registered nurses and healthcare assistants in stroke rehabilitation |
The study found that compromised clinical safety is a complex concept involving personal, professional and programic variables. The authors suggested that study findings could be used to develop learning environments that are safety-oriented and student-centred |
Based on the study findings, the authors indicated that there is a need for transparency and re-evaluation of treatments after they have received marketing authorisation. They also suggest that authorisation criteria should include a greater focus on quality of life in the context of advances cancer care |