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      Perceptions of patients undergoing percutaneous coronary intervention on pre‐operative education in China: A qualitative study

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          Abstract

          Objectives

          To explore the perceptions of patients undergoing percutaneous coronary intervention (PCI) regarding their pre‐operative health education.

          Methods

          A qualitative study using semi‐structured, in‐depth interviews was conducted in one cardiology unit in China from July 2019 to December 2019. Purposeful sampling of 17 patients undergoing PCI was interviewed about their perceptions of pre‐operative health education. Thematic analysis of the transcribed data was then used to identify the themes.

          Results

          Four themes emerged from the data:(a) triple roles of pre‐operative education with the categories of relief (reliving fear); burden (leading to stress); and meaningless (changing nothing); (b) family member involvement with the categories of shared responsibility and family members’ duty; (c) facilitators in the process of pre‐operative health education with the categories of emotional support, plain language and individualized pre‐operative education; (d) inhibitors in the process of pre‐operative health education with the categories of contradiction and threatening words.

          Conclusions

          Pre‐operative health education for patients undergoing PCI should be aligned with the individual patients’ information‐seeking styles and personal differences, emphasizing individualized patient education. Traditional Chinese philosophy should be considered in the practice of pre‐operative education for patients undergoing PCI, which emphasizes family member involvement; at the same time, patient empowerment and self‐care should also be stressed. In addition, emotional support and plain language from health professionals are important in pre‐operative health education for patients undergoing PCI; contradiction should be avoided, and threatening words should be used with caution and with consideration for cultural variations during pre‐operative education for patients undergoing PCI.

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          Most cited references58

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            How does communication heal? Pathways linking clinician-patient communication to health outcomes.

            Although prior research indicates that features of clinician-patient communication can predict health outcomes weeks and months after the consultation, the mechanisms accounting for these findings are poorly understood. While talk itself can be therapeutic (e.g., lessening the patient's anxiety, providing comfort), more often clinician-patient communication influences health outcomes via a more indirect route. Proximal outcomes of the interaction include patient understanding, trust, and clinician-patient agreement. These affect intermediate outcomes (e.g., increased adherence, better self-care skills) which, in turn, affect health and well-being. Seven pathways through which communication can lead to better health include increased access to care, greater patient knowledge and shared understanding, higher quality medical decisions, enhanced therapeutic alliances, increased social support, patient agency and empowerment, and better management of emotions. Future research should hypothesize pathways connecting communication to health outcomes and select measures specific to that pathway. Clinicians and patients should maximize the therapeutic effects of communication by explicitly orienting communication to achieve intermediate outcomes (e.g., trust, mutual understanding, adherence, social support, self-efficacy) associated with improved health.
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              Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear boundaries?

              I Coyne (1997)
              Sampling is a very complex issue in qualitative research as there are many variations of qualitative sampling described in the literature and much confusion and overlapping of types of sampling, particularly in the case of purposeful and theoretical sampling. The terms purposeful and theoretical are viewed synonomously and used interchangeably in the literature. Many of the most frequent misinterpretations relate to the disparate meanings and usage of the terminology. It is important that the terminology is examined so that underlying assumptions be made more explicit. Lack of shared meanings and terminology in the nursing discourse creates confusion for the neophyte researcher and increases the production of studies with weak methodologies. This paper analyses critically purposeful and theoretical sampling and offers clarification on the use of theoretical sampling for nursing research. The aim is not to make prescriptive statements on sampling; rather, to enhance understanding of the differences between purposeful and theoretical sampling for nursing research.
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                Author and article information

                Contributors
                rebeccamalei@126.com
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                13 November 2020
                February 2021
                : 24
                : 1 ( doiID: 10.1111/hex.v24.1 )
                : 121-130
                Affiliations
                [ 1 ] Department of Nursing The First Affiliated Hospital of Kunming Medical University Kunming China
                [ 2 ] Cardiology Department The First Affiliated Hospital of Kunming Medical University Kunming China
                [ 3 ] ICU in Geriatric Department The First Affiliated Hospital of Kunming Medical University Kunming China
                [ 4 ] Urology Department The First Affiliated Hospital of Kunming Medical University Kunming China
                [ 5 ] Psychiatric Department The First Affiliated Hospital of Kunming Medical University Kunming China
                [ 6 ] Neurosurgery Department The First Affiliated Hospital of Kunming Medical University Kunming China
                [ 7 ] General Surgery Department The First Affiliated Hospital of Kunming Medical University Kunming China
                Author notes
                [*] [* ] Correspondence

                Ma Fang, Department of Nursing, The First Affiliated Hospital of Kunming Medical University, 295#, Xichang Road, Kunming, China.

                Email: rebeccamalei@ 123456126.com

                Author information
                https://orcid.org/0000-0002-2375-3369
                https://orcid.org/0000-0003-0522-5199
                https://orcid.org/0000-0002-3949-1869
                https://orcid.org/0000-0001-5663-6188
                https://orcid.org/0000-0002-8937-3414
                https://orcid.org/0000-0002-5326-4363
                https://orcid.org/0000-0003-2615-0472
                https://orcid.org/0000-0003-4013-8349
                https://orcid.org/0000-0002-0784-6346
                Article
                HEX13156
                10.1111/hex.13156
                7879546
                33185951
                45bd1812-fcfc-4a71-a2c6-be8cd00f8eb7
                © 2020 The Authors. Health Expectations published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 April 2020
                : 23 September 2020
                : 28 October 2020
                Page count
                Figures: 0, Tables: 1, Pages: 0, Words: 7379
                Funding
                Funded by: Priority Union Foundation of Yunnan Provincial Science and Technology Department and Kunming Medical University
                Award ID: 2018FE001(−218)
                Categories
                Original Research Paper
                Original Research Papers
                Custom metadata
                2.0
                February 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.7 mode:remove_FC converted:12.02.2021

                Health & Social care
                china,percutaneous coronary intervention,pre‐operative health education,qualitative research

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