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      The dynamic nature of patient engagement within a Canadian patient‐oriented kidney health research network: Perspectives of researchers and patient partners

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          Abstract

          Introduction

          Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can‐SOLVE CKD) is a pan‐Canadian health research network that engages patients as partners across 18 unique projects and core infrastructure. In this qualitative study, we explored how research teams integrated patient partners into network research activities to inform our patient engagement approach.

          Methods

          To capture a breadth of perspectives, this qualitative descriptive study purposively sampled researchers and patient partners across 18 network research teams. We conducted 4 focus groups (2 patients and 2 researchers; n = 26) and 28 individual telephone interviews ( n = 12 patient partners; n = 16 researchers). Transcripts were coded in duplicate, and themes were developed through an inductive, thematic analysis approach.

          Results

          We included 24 patient partners and 24 researchers from 17 of the 18 projects and all core committees within the network. Overarching concepts relate participants' initial impressions and uncertainty about patient engagement to an evolving appreciation of its value, impact and sustainability. We identified four themes with subthemes that characterized the dynamic nature of patient engagement and how participants integrated patients across network initiatives: (1) Reinforcing a shared purpose ( learning together, collective commitment, evolving attitudes); (2) Fostering a culture of responsive and innovative research ( accessible supports, strengthened process and product); (3) Aligning priorities, goals and needs ( amenability to patient involvement, mutually productive relationships, harmonizing expectations ); (4) Building a path to sustainability ( value creation, capacity building, sustaining knowledge use).

          Conclusions

          Our findings demonstrate the dynamic and adaptive processes related to patient engagement within a national, patient‐oriented kidney health research network. Optimization of support structures and capacity are key factors to promote sustainability of engagement processes within and beyond the network.

          Patient or Public Contribution

          This project was conceived in collaboration with a Can‐SOLVE CKD patient partner (N. F.), with lived experience of kidney failure. He also co‐designed the study′s protocol, led focus groups and researcher interviews, and contributed to data analysis. L. G. has lived experience as a caregiver for a person with CKD and facilitated patient partner focus groups. The patient partners, both of whom are listed authors, provided important insights that shaped our interpretation and presentation of study findings.

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          Most cited references45

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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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            Whatever happened to qualitative description?

            The general view of descriptive research as a lower level form of inquiry has influenced some researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description. Qualitative descriptive studies have as their goal a comprehensive summary of events in the everyday terms of those events. Researchers conducting qualitative descriptive studies stay close to their data and to the surface of words and events. Qualitative descriptive designs typically are an eclectic but reasonable combination of sampling, and data collection, analysis, and re-presentation techniques. Qualitative descriptive study is the method of choice when straight descriptions of phenomena are desired. Copyright 2000 John Wiley & Sons,
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              Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization.

              End-stage renal disease substantially increases the risks of death, cardiovascular disease, and use of specialized health care, but the effects of less severe kidney dysfunction on these outcomes are less well defined. We estimated the longitudinal glomerular filtration rate (GFR) among 1,120,295 adults within a large, integrated system of health care delivery in whom serum creatinine had been measured between 1996 and 2000 and who had not undergone dialysis or kidney transplantation. We examined the multivariable association between the estimated GFR and the risks of death, cardiovascular events, and hospitalization. The median follow-up was 2.84 years, the mean age was 52 years, and 55 percent of the group were women. After adjustment, the risk of death increased as the GFR decreased below 60 ml per minute per 1.73 m2 of body-surface area: the adjusted hazard ratio for death was 1.2 with an estimated GFR of 45 to 59 ml per minute per 1.73 m2 (95 percent confidence interval, 1.1 to 1.2), 1.8 with an estimated GFR of 30 to 44 ml per minute per 1.73 m2 (95 percent confidence interval, 1.7 to 1.9), 3.2 with an estimated GFR of 15 to 29 ml per minute per 1.73 m2 (95 percent confidence interval, 3.1 to 3.4), and 5.9 with an estimated GFR of less than 15 ml per minute per 1.73 m2 (95 percent confidence interval, 5.4 to 6.5). The adjusted hazard ratio for cardiovascular events also increased inversely with the estimated GFR: 1.4 (95 percent confidence interval, 1.4 to 1.5), 2.0 (95 percent confidence interval, 1.9 to 2.1), 2.8 (95 percent confidence interval, 2.6 to 2.9), and 3.4 (95 percent confidence interval, 3.1 to 3.8), respectively. The adjusted risk of hospitalization with a reduced estimated GFR followed a similar pattern. An independent, graded association was observed between a reduced estimated GFR and the risk of death, cardiovascular events, and hospitalization in a large, community-based population. These findings highlight the clinical and public health importance of chronic renal insufficiency. Copyright 2004 Massachusetts Medical Society
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                Author and article information

                Contributors
                Role: Assistant Professormeghan.elliott@albertahealthservices.ca
                Role: Research Associate
                Role: Associate Professor
                Role: Patient Partner
                Role: Professor
                Role: Associate Professor, Patient Partner
                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
                27 January 2023
                April 2023
                : 26
                : 2 ( doiID: 10.1111/hex.v26.2 )
                : 905-918
                Affiliations
                [ 1 ] Department of Medicine University of Calgary Calgary Alberta Canada
                [ 2 ] Department of Community Health Sciences University of Calgary Calgary Alberta Canada
                [ 3 ] O′Brien Institute for Public Health University of Calgary Calgary Alberta Canada
                [ 4 ] Faculty of Nursing University of Alberta Edmonton Alberta Canada
                [ 5 ] CanSOLVE CKD Network Patient Partner Vancouver BC Canada
                [ 6 ] Department of Family Medicine and Emergency Medicine Université de Montréal Quebec Montreal Canada
                Author notes
                [*] [* ] Correspondence Meghan J. Elliott, MD, MSc, Assistant Professor, Department of Medicine, University of Calgary TRW Bldg, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada.

                Email: meghan.elliott@ 123456albertahealthservices.ca

                Author information
                https://orcid.org/0000-0002-5434-2917
                http://orcid.org/0000-0001-7242-1910
                http://orcid.org/0000-0002-3840-2641
                Article
                HEX13716
                10.1111/hex.13716
                10010076
                36704935
                8f45b4a6-fd71-45dd-8a89-833a8525df66
                © 2023 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
                : 12 January 2023
                : 23 June 2022
                : 17 January 2023
                Page count
                Figures: 0, Tables: 3, Pages: 14, Words: 10533
                Funding
                Funded by: Can‐SOLVE CKD Network (supported by CIHR)
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                April 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.6 mode:remove_FC converted:13.03.2023

                Health & Social care
                chronic kidney disease,patient engagement,patient‐oriented research,qualitative research

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