Penny Vicary

Multidimensional collaboration: reflections on action research in a clinical context

This paper reflects on the challenges and benefits of multidimensional collaboration in an action research study to evaluate and improve preoperative education for patients awaiting colorectal surgery. Three cycles of planning, acting, observing and reflecting were designed to evaluate practice and implement change in this interactive setting, calling for specific and distinct collaborations. Data collection includes: observing educational interactions; administering patient evaluation questionnaires; interviewing healthcare staff, patients and carers; patient and carer focus groups; and examining written and audiovisual educational materials. The study revolves around and depends on multi-dimensional collaborations. Reflecting on these collaborations highlights the diversity of perspectives held by all those engaged in the study and enhances the action research lessons. Successfully maintaining the collaborations recognises the need for negotiation, inclusivity, comprehension, brokerage, and problem-solving. Managing the potential tensions is crucial to the successful implementation of changes introduced to practice and thus has important implications for patients’ well-being. This paper describes the experiences from an action research project involving new and specific collaborations, focusing on a particular healthcare setting. It exemplifies the challenges of the collaborative action research process and examines how both researchers and practitioners might reflect on the translation of theory into educational practices within a hospital colorectal department. Despite its context-specific features, the reflections on the types of challenges faced and lessons learned provide implications for action researchers in diverse healthcare settings across the world.

Developing patient education to enhance recovery after colorectal surgery through action research: a qualitative study

Objectives To understand the role of preoperative education for patients undergoing colorectal surgery by involving patients, carers and staff in: (1) identifying its perceived value and deficits for enhanced recovery; (2) modifying current education practices to address educational deficits; and (3) evaluating these changes for preparing patients to enhance their recovery. Design Qualitative study of three cycles of action research using mixed methods within a 24-month naturalistic enquiry to identify, implement and evaluate changes through observations, questionnaires, semistructured longitudinal interviews, focus groups and documentation review. Setting A UK 1200-bed National Health Service (NHS) hospital providing colorectal surgery in a small city in a rural county. Participants Ninety-sevenpatients having colorectal surgery, 19 carers and 22 clinical staff. Results Themes identified were: (1) knowledge and engagement; (2) situated understanding and confidence building; and (3) partnership and proactive involvement in enhancing recovery. All patients articulated needs to prepare mentally and physically to plan for colorectal surgery and rehabilitation. Patients and carers wanted to counter uncertainty about medical procedures: likely bodily changes, recovery timescales and future. They therefore sought as much personalised, relevant information as possible about their disease, planned surgery and recovery. Staff implemented preoperative education to more specifically inform and respond multimodally to individual needs. Conclusions Patients wanted to be proactively involved in managing their recovery to re-engage with their everyday lives. Preoperative education supported this through developing patients’ situated understanding of hospital and bodily processes related to colorectal surgery. Situated understanding was achieved through educational product to give knowledge and processes promoting engagement. Multimodal, comprehensive and timely preoperative education on the whole patient pathway facilitates active engagement. Situated understanding increased patients’ confidence to work in partnership with healthcare professionals and proactively self-manage recovery.

Patient and public involvement in reducing health and care research waste

Plain English summaryAs much as 85 % of health research is believed to be wasted because it is not published or reported, the design is poor or does not consider what is already known in the topic area. Although a great deal of work has been done in the UK to reduce research waste, the role of patients and the public has not been discussed.This paper describes a survey, on the role of patients in reducing research waste, which was carried out as part of a larger piece of work on reducing waste in healthcare. The study found that patients were interested in reducing research waste. The key roles they play in research, for example being co-applicants for funding, members of project teams, co-researchers, means they have some shared responsibility for making sure the quality of research is high. This includes finding out what is already known about a topic and getting the study design right before seeking funding, publishing and reporting the results when the study is finished. Recognising where waste happens is part of good management of a research study.AbstractBackground Eighty five per cent of health research expenditure is potentially wasted due to failure to publish research, unclear reporting of research that is published, and the failure of new research studies to systematically review previous research in the same topic area, poor study design and conduct. A great deal of progress has been made to address this issue but the role of patients and the public has not been considered.Main A small survey was undertaken, as part of a larger programme of work on reducing health and care waste, to understand the role of patients in reducing research waste. The study showed that patients are interested in this issue particularly in relation to the prioritisation of research and patient and public involvement.Conclusions Patients undertake key roles in the research process including co-applicancy, project management, or as co-researchers. This brings responsibility for ensuring high quality research and value for money. Responsibility for recognition of the potential for wasteful practices is part of the conduct and operation of research studies.

Addressing patients’ colorectal cancer needs in preoperative education

Purpose – The purpose of this paper is to understand and develop ways to enhance patients’ experiences of preoperative education received prior to surgery for colorectal cancer. Design/methodology/approach – Based in the UK, three-action research cycles were undertaken to evaluate preoperative education, identify changes seen by patients and staff as likely to improve the service and to re-evaluate such changes following implementation. Data in each cycle were collected from: observations of clinic interactions; patient questionnaires; individual semi-structured interviews with multidisciplinary colorectal unit staff; longitudinal semi-structured interviews with patients and carers pre-surgery, two weeks post-surgery and 12 weeks post-surgery; patient and carer focus groups post-surgery; and existing educational material. Findings – In total, 138 participants shared their experiences of either giving or receiving preoperative education. Findings were themed into why patients want preoperative education, a...

Correction to: Abstracts from the NIHR INVOLVE Conference 2017

CorrectionAfter publication of this supplement [1], it was brought to our attention that errors were apparent in the following abstracts and are included in this correction.In abstract O13 the funding and and disclaimer statement were accidentally omitted. This has been corrected in the abstract in this erratum.In abstract P13 the funding and and disclaimer statement were accidentally omitted. This has been corrected in the abstract in this erratum.

Regional working in east of England: co-designing a PPI feedback tool

Aims Patient and public involvement (PPI) in antimicrobial medicines development research is a new and challenging area. We aim to share some of the barriers and strategies to developing a toolkit to support PPI in this area. The PPI toolkit development is part of COMBACTE-MAGNET, a European project funded by the Innovative Medicines Initiative Joint Undertaking (www.imi.europa.eu) to seek new ways of treating multi-resistant bacterial infections. Why is it important and to whom? There is currently no literature focusing on PPI in antimicrobial medicines development research. The toolkit addresses the need for evidence-based guidance on how to carry out PPI throughout the antimicrobial medicines development lifecycle. Learning from the toolkit development process will be important to researchers, PPI leads, and patient and public contributors who are interested in developing PPI in new and/or challenging clinical areas. What difference has, or could, this project make? The toolkit will showcase the importance of PPI in antimicrobial medicines development research, to change perception and increase the receptivity of various stakeholders, including pharmaceutical companies, towards PPI. This is intended to result in the establishment or improvement of PPI-related policies in this area, with the toolkit serving as a practical guide on how to conduct and evaluate PPI. Key learning points Delegates will learn about the challenges of developing a toolkit with European collaborators in an area of research that is driven by the pharmaceutical industry, with little/no experience of PPI to date, due to concerns about its complexities and confidentiality issues. They will also learn about strategies that can facilitate the toolkit development process, which may be useful for their own projects.All abstracts from the NIHR INVOLVE Conference 2017. Poster 27 - P27 Discovering the role of public co-applicant on a National Institute for Health Research (NIHR) Programme grant Research Involvement and Engagement 2017, 3(Suppl 1):P27