Identification of causes and consequences of Kolberi among Iranian Kurdish women: a grounded theory study

BACKGROUND

Women turn to Kolberi for various reasons, which cause numerous challenges for them. Thus, it is imperative to identify these causes and problems. Since no study has ever been undertaken to deal with this participant, the present research aims to identify the causes and consequences of Kolberi among Kurdish women in Iran.

METHOD

The present research uses the grounded theory approach to investigate 28 female Kurdish Kolbers. To achieve several participants, purposive, snowball, and theoretical sampling methods were used, while face-to-face semi-structured interviews were used to gather data. The process of data collection and analysis took 10 months, from April to December 2022. The data were analyzed using the Strauss and Corbin method and MAXQDA-20018 software. The Guba and Lincoln criteria were also met to increase the trustworthiness of the results.

FINDINGS

Analysis of the data led to 143 initial codes, 31 subcategories, and 9 main categories: Causal condition (individual characteristics and economic factors); predisposing conditions (social and cultural factors, familial factors); intervening conditions (advantages and characteristics of Kolberi); strategies (strengthening compatibility with Kolberi); and consequences (individual problems, social problems and positive consequences).

CONCLUSION

Measures such as training occupational skills for women and providing employment conditions for them, increasing social, financial, and mental support for women without guardians, creating border markets, and expanding women's handicrafts can help prevent female Kolberi.

A grounded theory-based qualitative approach for examining local implementation of public health policies during crises

Background

COVID-19's emergence questions the agility of health policy deployment in a context of urgency. This exceptional pandemic offers a unique Implementation Science study opportunity. It reveals how actors adapt, coordinate, and mitigate an unknown global threat to safeguard populations from an initially mysterious virus. Limited research has explored how involved players act and adapt their practices to fulfil health protection missions during a global health crisis. Bridging the gap between public policy expectations and achievements requires a methodology for stakeholder identification and implementation practice description.

Objective

Focusing on COVID-19 management in France's second-largest region, we investigate ministerial recommendation implementation and the emergence of new links, coordination modes, and practices.

Methods

Due to the novel subject, we adopted grounded theory. Initial documentary data collection identifies stakeholders for subsequent interviews. Open-ended coding of collected discourse enables content analysis.

Results

Findings reveal a crisis-driven re-evaluation of stakeholder relationships. This research identifies three levels of implementation of health policies at the local level (administrative, organizational and operational) and reveals different types of coordination specific to each of these levels. Our results provide insights on how to better coordinate and implement healthcare policies in a period of crisis. Recommendations include real-life simulations of large-scale crises.

Conclusion

Our work establishes a methodological foundation for analysing coordination dynamics. Future research could compare these findings with other unpredictable health emergencies, such as episiotomic veterinary health crises.•The first step of the method is to analyse the guidelines of health policy implementation during the Covid-19 crisis and to identify the main stakeholders in charge of the local health policy implementation.•The second step consists of interviewing these stakeholders using a co-constructed sample and structural coding of their speech to reveal the forms of coordination between stakeholders.

Grounded theory-based analysis of occupational health and safety management modes in supply chain by core enterprises --evidence from China

The implementation of occupational health and safety management in the supply chain by core enterprises is a significant step towards improving the working conditions of their suppliers. To guide core enterprises to adopt active and effective management modes, it is crucial to identify the characteristics of different management modes and classify them accordingly. This paper employs the grounded theory method to conduct an in-depth analysis of occupational health and safety management modes within the supply chain of core enterprises. This research mainly adopts semi-structured interview method. A total of 16 person-times are interviewed, and 210,000 words of in-depth interview scripts are obtained. After three coding process of the grounded theory，the evolution model of occupational health and safety management modes in supply chain by core enterprises was established. The research results indicate that core enterprises currently employ three modes of occupational health and safety management for their suppliers: defensive mode, passive mode, and strategic mode. Different modes have distinct characteristics in four dimensions of cognition, motivation, strategy and result. This research may provide strategic guidelines for core enterprises to evolve from the defensive mode to the strategic mode.

A study of the mechanism for intergenerational transmission of gender roles in single-parent families

The divorce rate in China is rising yearly, and the concept of marriage is changing, triggering many social topics related to single parents. Among them, gender-awareness education for children in single-parent families is particularly worthy of attention, as there has been insufficient exploration of how parents transfer their gender role concepts to their children. This study conducted in-depth interviews with 58 single parents and children from 29 families in Suzhou and constructed the mechanism for intergenerational transmission of gender roles in single-parent families based on grounded theory. It found that single parents' gender stereotypes, the starting point of the intergenerational transmission mechanism, have been diluted. It affords them a more enlightened attitude towards child-rearing style, and they expect more equality in the gender role of their offspring. However, in some parents' actual parenting process, when the children's sexualization behaviours exceed their acceptance range, they will communicate with children in an authoritative and didactic way to "correct" the children's behaviour. In addition to direct verbal instruction, parents' expectations of their children's gender roles will be implicitly conveyed through various parent-child interactions in daily life to affect the formation of their children's gender roles. In the intergenerational transmission of gender roles, external people (such as grandparents, teachers and peer groups) have horizontal socialisation effects on children to modify or strengthen the results of gender education from their parents. Under the comprehensive influence of the above factors, the children's gender roles are finally determined. These studies expand previous theories and studies and have significant theoretical and practical implications.

Barriers and enablers to the family meal across time; a grounded theory study comparing South Australian parents' perspectives

Family meals are positively associated with numerous beneficial health and social outcomes. Current discourse however claims that parents are faced with numerous barriers when trying to bring the family together to share a meal. Solutions for overcoming barriers to a positive shared family meal are often individualistic and do not address the systemic pressures and burdens families have faced for decades. The aim of this study was to explore the systemic and novel barriers and enablers to shared family meals as experienced by families across time. To achieve this, a qualitative study informed by grounded theory was conducted. Parents of South Australian families were recruited and interviewed in the 1990s, and a new sample of parents were recruited and interviewed in 2020. Transcripts were analysed using grounded theory and comparative analysis methods. Thirty-two parents from 16 families were interviewed in the 1990s, and 22 parents from 10 families in 2020. Ten factors were identified presenting as either enablers or barriers to the family meal, depending on the context they were experienced. Barriers and enablers were largely consistent across time. Scheduling and flexibility, children's disruptions and children's independence, privileges required to have family meals and motivation and commitment to the family meal were identified as persistent enablers and barriers across time. These findings indicate that parents are faced with similar challenges they have been facing for decades and are still not being adequately supported to execute family meals regularly. Recognising that factors present as either barriers or enablers to the family meal provides us with opportunities to transform barriers to enablers and support families to have regular, meaningful family meals.

The impact of emotionally challenging situations on medical students' professional identity formation

In their interactions with patients and health care professionals during work-based learning, medical students are known to experience emotionally challenging situations that can evoke negative feelings. Students have to manage these emotions. Students learn and develop their professional identity formation through interactions with patients and members of the healthcare teams. Earlier studies have highlighted the issues involved with processing emotionally challenging situations, although studies concerning learning and professional identity formation in response to these experiences are rare. In this study, we explored medical students' experiences of emotionally challenging situations in work-based learning, and the impact these experiences had on forming medical students' professional identities. We conducted an analysis of narrative data (n = 85), using a constructivist grounded theory approach. The narratives were made up of medical students' reflective essays at the end of their education (tenth term). The analysis showed that students' main concern when facing emotionally challenging situations during their work-based education was the struggle to achieve and maintain a professional approach. They reported different strategies for managing their feelings and how these strategies led to diverse consequences. In the process, students also described arriving at insights into their own personal needs and shortcomings. We consider this development of self-awareness and resulting self-knowledge to be an important part of the continuously ongoing socialization process of forming a professional identity. Thus, experiencing emotionally challenging situations can be considered a unique and invaluable opportunity, as well as a catalyst for students' development. We believe that highlighting the impact of emotions in medical education can constitute an important contribution to knowledge about the process of professional identity formation. This knowledge can enable faculty to provide students with more effective and sufficient support, facilitating their journey in becoming physicians.

"Eat more protein, build more muscle": A grounded theory study of muscle-building behaviors among Canadian adolescents and young adults

Unique risk factors for the development of muscle dissatisfaction and engagement in muscle-building behaviors have been described by theoretical frameworks and supported by empirical research. What remains unknown are the unique processes, including catalysts and facilitators, which underpin engagement in muscle-building behaviors. Therefore, this study used a grounded theory methodology to elucidate the process of engagement in muscle-building behaviors. Thirty-three individual semi-structured interviews with Canadian adolescents and young adults ages 16-30 years were conducted. Transcripts were analyzed using initial and focused coding to identify themes that explained the grounded theory. The core theme underpinning the grounded theory was balancing aesthetic, health, and functional goals in relation to participants' engagement in muscle-building behaviors. Participants described experiences that encompassed several unique phases of muscle-building engagement, including the initiation phase, beginner phase, preservation phase, and intensification phase. Participants also described unique methods of gathering information on muscle-building behaviors, and their own analysis and decision-making processes driving their behaviors. Findings from this study extend prior theory and research by conceptualizing a novel process theory of engagement in muscle-building behaviors among adolescent and young adults, resulting in important implications for research and practice.

Research on the mechanism of short video information interaction behavior of college students with psychological disorders based on grounded theory

BACKGROUND

The utilization of short videos by individuals often leads to the emergence of information exchange behavior. Previous studies have shown that certain students with psychological disorders exhibit addictive tendencies towards short video-related software. Therefore, it is essential to address the psychology and behavior of college students with psychological disorders while engaging with short videos. This study aims to explore the mechanism of short video information interaction behavior among college students with psychological disorders.

METHODS

We conducted semi-structured interviews with 30 college students afflicted by psychological disorders in a prefecture-level city in Henan Province, China from September to December 2022. Based on the Grounded theory, we encoded 30 text materials across three levels to explore the mechanism of short video information interaction behavior among college students with psychological disorders, and subsequently build a model framework.

RESULTS

The findings of this study suggest that college students with psychological disorders exhibit negative cognition tendencies that can lead to strongly negative emotions, excacerbated by a lack of social support. These adverse factors collectively drive the consumption of short video content in this demographic, providing a virtual environment where they can fulfill their unmet social needs. Therefore, the mechanism governing short video messages interaction among college students with psychological disorders encompasses negative cognitive tendencies, negative emotions, lack of social support, post-video-watching behaviors, and the gratification of social needs within the confines of a virtual environment.

CONCLUSIONS

This study comprehensively analyzes the motivation and complexity of college students with psychological disorders in short video interaction. Although short videos provide this group with some ways of self-expression and emotional support, they still have a negative impact on their physical and mental health. The short video interaction of college students with psychological disorders is affected by many factors, including their negative cognitive tendencies, negative emotions, lack of social support, post-video-watching behaviors, and the gratification of social needs within the confines of a virtual environment. These findings deepened our understanding to the mechanism of short video information interaction behavior among college students with psychological disorders, also provided us with guidance on facilitating the proper use of short video and maintaining the mental health. In future researches, researchers can discuss more about intervention measures to help this demographic cope with the challenges from short video interaction.

Risk-taking in consumers' online purchases of health supplements and natural products: a grounded theory approach

BACKGROUND

Health supplements and natural products are widely used by the general public to support physical function and prevent disease. Additionally, with the advent of e-commerce, these products have become easily accessible to the general public. Although several theoretical models have been used to explain the use of health supplements and natural products, empirical evidence on how consumers make decisions to purchase online health supplements and natural products remains limited.

METHODS

In this study, a grounded theory approach was used to develop a substantive theoretical model with the aim of investigating the decision-making process of consumers when purchasing health supplements and natural products online. Malaysian adult consumers who had purchased these products via the Internet were either purposively or theoretically sampled. A total of 18 virtual in-depth interviews (IDIs) were conducted to elicit participants' experiences and priorities in relation to this activity. All the IDIs were audio-recorded and transcribed verbatim. The data were analysed using open coding, focus coding and theoretical coding. The analytical interpretations and theoretical concepts were recorded in research memos.

RESULTS

Consumers' decisions to purchase a health supplement or natural product over the Internet are based on a series of assessments regarding the perceived benefits and risks of this activity, which may be related to the product or the process. In the online marketplace, consumers attempt to choose products, online sellers, sales platforms and/or purchase mechanisms with lower perceived risk, which ultimately enhances their confidence in five elements related to the purchase: (1) product effectiveness, (2) product safety, (3) purchase convenience, (4) fair purchase and (5) online security. Consumers take an acceptable level of risk to purchase these products online, and this acceptable level is unique to each individual and is based on their perception of having control over the potential consequences if the worst-case scenario occurs.

CONCLUSIONS

In this study, a substantive theoretical model is developed to demonstrate how consumers decide to purchase online health supplements and natural products by accepting an acceptable level of risk associated with the product or process. The emerging model is potentially transferable to other populations in similar contexts.

Comprehensive safety risk evaluation of fireworks production enterprises using the frequency-based ANP and BPNN

The fireworks industry has long struggled with the problem of safety. Scientific, reasonable, and operable evaluation models are prerequisites of reducing risk. Based on the data from over 100 fireworks production safety accidents in China from 2010 to 2022, two evaluation models were established from the perspective of safety risk definition. Firstly, a weight calculation derivative method, the frequency-based analytic network process (ANP), was proposed creatively. This method optimized the importance ranking index calculation process in the ANP by considering the causal frequency of risk factors in the historical accident samples, thus determining how much each indicator affects the likelihood of accidents. Secondly, utilizing the historical accident samples as the dataset, a back propagation neural network (BPNN) model was developed to extract the mathematical relationship between each risk factor and the severity of accident consequence. Finally, the frequency-based ANP and BPNN models were combined to determine the safety risk level of the fireworks production enterprises. Meanwhile, the safety evaluation research samples were used as the comparison set for empirical study with historical accident samples, involving 100 fireworks production enterprises in China evaluated from 2017 to 2020. The significance result of zero shows that there is a statistically significant difference between the likelihood evaluation results of the accident and non-accident companies. Additionally, the severity evaluation model exhibits an excellent result, revealing a classification accuracy of 98.21 %, a mean square error of 8.97 × 10-4, a percent bias of 1.24 %, and a correlation coefficient and Nash-Sutcliffe efficiency coefficient both of 0.96. The frequency-based ANP and BPNN models integrate self-learning, self-adaptive, and fuzzy information processing, obtaining more accurate and objective evaluation results. This work provides a new strategy for the promotion and application of artificial intelligence in the field of safety risk evaluation, thus offering real-time safety risk evaluation and decision support of the safety management for the enterprises.

Navigating China's carbon neutrality journey: insights from policy instruments and implementation strategies across provincial regions

China's critical reliance on well-crafted public policies, coupled with the effective execution of central government directives at the local level, drives the achievement of the "dual carbon" goal including the peaking of CO2 emissions and attaining carbon neutrality. Therefore, examining policy records can unveil the holistic strategy for attaining carbon neutrality during the period of peak CO2 emissions; at the same time, it can also highlight the potential obstacles in policy implementation. In this study, we adopt a policy instruments perspective to investigate data related to policies addressing peak CO2 emissions across 29 provincial administrative regions in China. We apply Nvivo12 software to conduct a quantitative literature assessment and content analysis to establish a theoretical framework for the policy process. This framework encompasses dimensions such as political feasibility, regional coordination, attributes of low-carbon initiatives, and policy refinement. Subsequently, we employ the model to carry out a retrospective analysis of policy documents pertaining to peak CO2 emissions in China. Our research findings underscore the pivotal role of political feasibility in shaping policy effectiveness, while also highlighting the facilitative influence of regional coordination, shedding light on the essential synergy between provinces and cities in achieving emissions reduction goals. Similarly, the estimated results highlight the motivating impact of specific attributes within low-carbon initiatives. Moreover, policy enhancements are identified as a critical driver in advancing the path toward carbon neutrality. Consequently, to achieve the objective of carbon neutrality, it is imperative for every province and city to sequentially reach the peak of CO2 emissions. Our research offers a comprehensive "China strategy," providing valuable insights to guide future policy formulation and accelerate progress toward sustainable environmental objectives.

A grounded theory study of alarm fatigue among nurses in intensive care units

OBJECTIVES

The aim of this study was to explore the process of how nurses experienced and dealt with alarm fatigue in intensive care units based on Iranian nurses' perceptions and experiences.

BACKGROUND

Alarm fatigue is the overstimulation of senses due to the constant ringing of alarms in intensive care units. It is associated with nurses' desensitization to critical alarms that can directly influence patient safety and quality of care.

METHODS

A qualitative exploratory study using the grounded theory approach by Strauss and Corbin was carried out. Participants were 20 nurses working in intensive care units. The sampling process was started purposively and continued theoretically. Data were collected using semi-structured, in-depth, and individual interviews and continued to data saturation. The constant comparative analysis approach was used consisting of the following steps: open coding, developing concepts, analysing the context, entering the process into data analysis, integrating categories.

FINDINGS

The participants' main concern in the exposure to alarm fatigue was 'threat to personal balance'. The core category in this research was 'trying to create a holistic balance', which reflected a set of strategies that the nurses consistently and continuously used to deal with alarm fatigue and consisted of four main categories as follows: 'smart care', 'deliberate balancing', 'conditional prioritisation', and 'negligent performance'. Threat to personal balance was strengthened by 'inappropriate circuit of individual roles', 'distortion of the organisational structure', and 'insecurity of the infrastructure'. The consequences of this process was harm to the patient, burnout among nurse, and damage to the healthcare organisation.

CONCLUSIONS

The research findings have practical implications for healthcare management, policymaking, nursing education, research, and clinical practice. Mitigating staff shortages, improving staff competencies, enhancing nurses' authority for responding to alarms, modifying care routines, improving the physical environment, and removing problems related to alarm equipment can prevent alarm fatigue and its unappropriated consequences.

Endeavouring interplay: a grounded theory study of how nurse educators' work with simulation-based learning

BACKGROUND

Simulation-based learning is frequently used as a teaching and learning strategy in nursing and other health professions educations, and educators have a key role as facilitators. This facilitator role provides them with a particularly relevant perspective to help us understand and theorize around the essence of simulation-based learning, and how it is approached. This study aims to explore nurse educators' experiences and strategies in simulation-based learning.

METHOD

Data were collected in 2018-2021 using in-depth interviews with eight nurse educators. Transcripts were analysed through constant comparison using Classical Grounded Theory approach.

RESULT

The participants' main concern was how to Maximize students' learning-space in simulation. To resolve this, four strategies were identified: legitimizing simulation, self-development, preparing students, and tailoring simulation. Legitimisation, and self-development were found to be important prerequisites for developing the learning space and were therefore defined as the background or context of the theory. Nurse students were the focus of the two remaining categories, preparing students and tailoring simulation, and are thus defined as being in the foreground of the theory. The dynamics of these four strategies were captured in the Grounded theory of Endeavouring interplay.

CONCLUSION

The theory of Endeavouring interplay illustrates the complexity educators are encountering when aiming to optimize simulation as a learning space for nurse students. The strategies used are adapted to the organisational climate, available resources and context, and include striving to legitimize simulation, pursue self-development in the role as facilitator, help students prepare for simulation-based learning, and tailor the simulation to both contextual factors and individual student needs.

'Whose role is it anyway?' Experiences of community nurses in the delivery and support of oral health care for older people living at home: a grounded theory study

BACKGROUND

Older people who receive care at home are likely to require support with oral health care. Community nurses, who are also referred to as district or home care nurses, have an important role with this population. This is because they are the healthcare professionals who are most likely to encounter this population, who may also not be receiving regular dental care or oral health promotion. However, few studies have explored community nursing experiences in the delivery and support of oral healthcare for older people living at home.

METHODS

A grounded theory approach was used to explore experiences of community nurses in the delivery and support of oral health care for older people living at home. Fifteen practising community nurses from the United Kingdom participated in one-to-one semi-structed interviews from May 2021 to December 2021. These interviews were audio-recorded, transcribed verbatim and analysed using constant comparative analysis. Ethical approval was obtained for this study prior to data collection.

RESULTS

Four categories emerged from the data to support development of the core phenomena. These four categories were: (1) Education, in relation to what community nurses knew about oral health, (2) Practice, with regards to how community nurses delivered oral health care to older people in their own home, (3) Confidence, with consideration to the extent to which this supported or impeded community nurses in providing oral healthcare to older people and (4) Motivation, in terms of the extent to which community nurses thought they could or should influence future practice improvement in the area. The core category was (C) Uncertainty as it was both present and central across all four categories and related to community nursing understanding about their specific role, and the role of other professionals, with reference to oral health of their patients.

CONCLUSIONS

This study reveals community nurses' uncertainty in providing oral healthcare to older adults at home. Emphasising comprehensive and continuous oral health education can boost nurses' confidence in patient support. Interprofessional collaboration and clear role definitions with oral health professionals are crucial for improving oral health outcomes in this vulnerable population.

Shifting focus: A grounded theory of how family members to critically ill patients manage their situation

OBJECTIVES

Critical illness is a life-threatening condition for the patient, which affects their family members as a traumatic experience. Well-known long-term consequences include impact on mental health and health-related quality of life. This study aims to develop a grounded theory to explain pattern of behaviours in family members of critically ill patients cared for in an intensive care unit, addressing the period from when the patient becomes critically ill until recovery at home.

RESEARCH METHODOLOGY/DESIGN

We used a classic grounded theory to explore the main concern for family members of intensive care patients. Fourteen interviews and seven observations with a total of 21 participants were analysed. Data were collected from February 2019 to June 2021.

SETTING

Three general intensive care units in Sweden, consisting of a university hospital and two county hospitals.

FINDINGS

The theory Shifting focus explains how family members' main concern, living on hold, is managed. This theory involves different strategies: decoding, sheltering and emotional processing. The theory has three different outcomes: adjusting focus, emotional resigning or remaining in focus.

CONCLUSION

Family members could stand in the shadow of the patients' critical illness and needs. This emotional adversity is processed through shifting focus from one's own needs and well-being to the patient's survival, needs and well-being. This theory can raise awareness of how family members of critically ill patients manage the process from critical illness until return to everyday life at home. Future research focusing on family members' need for support and information, to reduce stress in everyday life, is needed.

IMPLICATIONS FOR CLINICAL PRACTICE

Healthcare professionals should support family members in shifting focus by interaction, clear and honest communication, and through mediating hope.

A model to explain smokeless tobacco consumption in adults: A grounded theory study

Introduction

Smokeless tobacco use remains a significant public health concern, necessitating the acquisition of comprehensive and extensive data to effectively address and control its consumption. Understanding the underlying patterns of consumption is crucial for this purpose.

Objective

This study aimed to develop a model that explains smokeless tobacco consumption among adults in the southeastern province of Iran, specifically in the city of Chabahar.

Methods

A qualitative study was conducted using a grounded theory approach with inductive processes. The participants consisted of 30 adults aged 18-64 years from Chabahar City in southeastern Iran. Purposive sampling was used to select participants, and data collection continued until theoretical saturation was achieved. Data analysis followed Strauss and Corbin's perspective, involving four stages: Analyzing Data for Concepts, Analyzing Data for Context, Bringing Process into the Analysis, and Integrating Categories.

Results

The analysis of data yielded three main categories: "starting to use," "continued use," and "cessation attempts," each with their respective subcategories. Additionally, two main categories related to the consequences of smokeless tobacco consumption were identified: "addiction and efforts to overcome addiction," also with their respective subcategories.

Conclusion

The Dependency Cycle Model in Consumption provides a comprehensive understanding of the contextual factors, processes, and consequences associated with smokeless tobacco consumption. This model serves as a valuable tool for researchers aiming to develop effective interventions in the field of smokeless tobacco consumption.

Being devastated by critical illness journey in the family: A grounded theory approach of post-intensive care syndrome-family

OBJECTIVES

This study aimed to explore the meaning and structure of postintensive care syndrome experienced by families of critically ill patients.

METHODS

This qualitative study applied the constructivist grounded theory approach and conducted one or two interviews with eight participants with postintensive care syndrome-family for a total of 12 interviews. The contents of the interviews were analysed through line-by-line coding, focused coding, and categorisation. Data collection and analysis were iterative, to enable continuous comparative analysis.

FINDINGS

The core category of postintensive care syndrome experienced by families was 'being devastated by the critical illness journey in the family' and comprised the interactions of four categories: 'overwhelming intensive care experience', 'taking responsibility for the recovery trajectory of critical illness', 'life devastated by the trauma of intensive care and family caregiving', and 'balancing and compromising'.

CONCLUSION

Based on this grounded theory approach, postintensive care syndrome experienced by families is a complex and ongoing phenomenon that arises from the recovery trajectory of a critical illness. It involves mental, physical, social and familial aspects, particularly the impact on the patient's family.

IMPLICATIONS FOR CLINICAL PRACTICE

The findings can guide critical care nurses to understand postintensive care syndrome experienced by families in providing patient or family-centred care. To improve the long-term outcomes and quality of life for families, it is necessary to assess their unique needs within the continuum of post-intensive care syndrome experienced by the family and to propose interventions to satisfy those needs.

The seewo interactive whiteboard (IWB) for ESL teaching: How useful it is?

The perceived usefulness (PU) of a technology is critical for its final adoption; however, what makes an interactive whiteboard (IWB) perceived useful remains unclear. This study aims to investigate how pre-service teachers perceive the usefulness of Seewo interactive whiteboards for ESL (English-as-a-second-language) instruction. We recruited 80 pre-service ESL teachers, divided them into 16 groups, provided five weeks of training, and conducted focus group interviews to gather qualitative feedback. The data were analyzed using grounded theory techniques with the aid of the software Nvivo. Three research questions were addressed: how pre-service ESL teachers perceive the usefulness of Seewo IWB in terms of its functions that enhance the learning process (PU-process), how they perceive the usefulness of Seewo IWB in terms of its functions that improve learning outcomes (PU-outcome), and how they perceive the non-usefulness of Seewo IWB. The findings shed light on the determinants of the perceived usefulness (PU) concept, which is crucial for fostering a higher intention to accept technology.

Recurrence of medical errors despite years of preventive measures: A grounded theory study

BACKGROUND

Despite great efforts to improve patient safety, serious preventable medical errors continue to occur. Accurate rooting causes of error recurrence are essential for reviewing methods to prevent them. This study aimed to identify the main causes of the recurrence of medical errors despite their previous occurrence.

MATERIALS AND METHODS

This qualitative study was performed using the grounded theory method, with theoretical sampling from April to July 2021, through semi-structured interviews with 25 experts and treatment staff of hospitals under the auspices of four universities of medical sciences in Iran.

RESULTS

Four main parts were identified: 1) primary and secondary factors leading to the occurrence of errors, 2) error prevention policies, 3) causes of error repetition, and 4) contextual factors.

CONCLUSION

The attention, seriousness, and commitment of health system managers, from top to bottom, to patient safety are essential for preventing error recurrence. The institutionalization of patient safety education from universities and attention to individual, social, and cultural factors should also be given serious attention.

The voice of the profession: how the ethical demand is professionally refracted in the work of general practitioners

BACKGROUND

Among the myriad voices advocating diverging ideas of what general practice ought to be, none seem to adequately capture its ethical core. There is a paucity of attempts to integrate moral theory with empirical accounts of the embodied moral knowledge of GPs in order to inform a general normative theory of good general practice. In this article, we present an empirically grounded model of the professional morality of GPs, and discuss its implications in relation to ethical theories to see whether it might be sustainable as a general practice ethic.

METHODS

We observed and interviewed sixteen GPs and GP residents working in health care centres in four Swedish regions between 2015-2017. In keeping with Straussian Grounded Theory, sampling was initially purposeful and later theoretically guided, and data generation, analysis and theoretical integration proceeded in parallel. The focal concept of this article was refined through multidimensional property supplementation.

RESULTS

The voice of the profession is one of four concepts in our emerging theory that attempt to capture various motives that affect GPs' everyday moral decisionmaking. It reflects how GPs appreciate the situation by passing three professional-moral judgments: Shall I see what is before me, or take a bird's-eye view? Shall I intervene, or stay my hand? And do I need to speak up, or should I rather shut up? By thus framing the problem, the GP narrows down the range of considerations, allowing them to focus on its morally most pertinent aspects. This process is best understood as a way of heeding Løgstrup's ethical demand. Refracted through the lens of the GP's professional understanding of life, the ethical demand gives rise to specific moral imperatives that may stand in opposition to the express wishes of the other, social norms, or the GP's self-interest.

CONCLUSIONS

The voice of the profession makes sense of how GPs frame problematic situations in moral terms. It is coherent enough to be sustainable as a general practice ethic, and might be helpful in explaining why ethical decisions that GPs intuitively understand as justified, but for which social support is lacking, can nevertheless be legitimate.

A focus groups study of staff team experiences of providing interdisciplinary rehabilitation for people with dementia and their caregivers-a co-creative journey

BACKGROUND

The World Health Organization claims that rehabilitation is important to meet the needs of persons with dementia. Rehabilitation programmes, however, are not routinely available. Person-centred, multidimensional, and interdisciplinary rehabilitation can increase the opportunities for older adults with dementia and their informal primary caregivers to continue to live an active life and participate in society. To our knowledge, staff team experiences of such rehabilitation programmes, involving older adults with dementia and their informal caregivers has not been previously explored.

METHODS

The aim of this qualitative focus group study was to explore the experiences of a comprehensive staff team providing person-centred multidimensional, interdisciplinary rehabilitation to community-dwelling older adults with dementia, including education and support for informal primary caregivers. The 13 staff team members comprised 10 professions who, during a 16-week intervention period, provided individualised interventions while involving the rehabilitation participants. After the rehabilitation period the staff team members were divided in two focus groups who met on three occasions each (in total six focus groups) and discussed their experiences. The Grounded Theory method was used for data collection and analysis.

RESULTS

The analysis resulted in four categories: Achieving involvement in rehabilitation is challenging, Considering various realities by acting as a link, Offering time and continuity create added value, and Creating a holistic view through knowledge exchange, and the core category: Refining a co-creative process towards making a difference. The core category resembles the collaboration that the staff had within their teams, which included participants with dementia and caregivers, and with the goal that the intervention should make a difference for the participants. This was conducted with flexibility in a collaborative and creative process.

CONCLUSIONS

The staff team perceived that by working in comprehensive teams they could provide individualised rehabilitation in creative collaboration with the participants through interaction, knowledge exchange, time and continuity, coordination and flexibility, and a holistic view. Challenges to overcome were the involvement of the person with dementia in goal setting and the mediating role of the staff team members. The staff pointed out that by refinement they could achieve well-functioning, competence-enhancing and timesaving teamwork.

Patients' perspectives on irritable bowel syndrome: a qualitative analysis based on social media in China

AIM

To explore the perspectives, experience, and concerns of patients with irritable bowel syndrome (IBS) in China.

METHODS

We used data mining to investigate posts shared in Baidu Tieba concerned with IBS; we collected the data through the crawler code, and mined the cleaned data's themes based on Latent Dirichlet allocation (LDA) and the Grounded theory.

RESULTS

We found 5746 network posts related to IBS. LDA analysis generated 20 topics, and grounded theory analysis established eight topics. Combining the two methods, we finally arranged the topics according to five concepts: difficulty in obtaining disease information; serious psychosocial problems; dissatisfied with the treatment; lack of social support; and low quality of life.

CONCLUSION

Social media research improved patient-centric understanding of patients' experiences and perceptions. Our study may facilitate doctor-patient communication and assist in the formulation of medical policies.

Medication supply chain resilience during disasters: exploration of causes, strategies, and consequences applying Strauss and Corbin's approach to the grounded theory

BACKGROUND

Due to the importance of procurement of medicines and medical supplies during disasters and the significance of an existing resilient supply chain, the present study aimed to explore the causes, strategies, and consequences of the medication supply chain resilience during the Kermanshah, Iran, earthquake experience in 2018.

METHODS

This was a qualitative study based on the grounded theory method. The suggested approach by Strauss and Corbin was used. Thirty-two in-depth and semi-structured interviews were conducted via theoretical sampling, and data were saturated. Open-ended and probing questions were used, and all the interviews were recorded with the prior permission of the participants. Field notes and memoing were also used along with the interviews. Transcribed data were analyzed in three levels of open coding, selective, and axial coding by two researchers with sufficient reflexivity without any conflict of interest.

RESULTS

The results led to the identification of eight main categories, including "Disaster Management Structure", "Information Management", "Supply Chain Monitoring", "Socio-Cultural Factors", "Planning", "Resource Management", "Medical Service Coverage", and "Waste of time and resources". According to Strauss and Corbin's model, socio-cultural factors and inappropriate structures and planning related to the health system during disasters may waste time and resources.

CONCLUSIONS

"Waste of time and resources" during disasters can be considered the main determinant that can damage the resilience of the medication supply chain. Policymakers need to seek applied strategies for decreasing waste. Socio-cultural interventions, preparedness of information infrastructures and coordination among the stewards and the community during disasters can help the supply chain preserve its resilience and act more effectively.

Four psychological processes navigated by patients during their journey of healing and recovering from depression: a grounded theory study

This study explored the psychological processes that patients navigated when healing and recovering from depression. A grounded theory approach was used. Twenty patients who had recovered from depression participated. Four categories emerged depicting the psychological processes navigated by the participants during the recovery process: (1) acceptance: acceptance of depression and agreement to treatment; (2) transformation: change of mindsets and behaviours; (3) adaptation: stress regulation and change of focus; (4) integration: progress of depressive symptoms and moving on with 'regular' life. Each phase is related to the other phases, mental health professionals could assist patients with depression achieve the integration phase.

Factors triggering the progressive detachment of nurses toward the fundamental needs of patients: findings from a qualitative study

The progressive desensitization of nurses in relation to fundamental needs (FNs) has been documented in anecdotical, scientific, and policy literature with nurses spending limited time at the bedside, thus affecting the quality of care and clinical outcomes. A potential reason that has been recognized is the limited nursing staff available in the units. However, other cultural, social, and psychological factors which have not been investigated to date may have a role in triggering the phenomenon. To investigate nurses' perceptions of the reasons that progressively detach clinical nurses from the FNs of patients, was the main intent of the study. In 2020, a qualitative study based on grounded theory following the Standards for Reporting Qualitative Research guidelines was performed. Purposeful sampling was adopted, by including 22 clinical nurses designated as 'good nurses' according to the perception of nurses working in executive and academic position. All agreed to be interviewed face-to-face. The detachment of nurses from the patients' FNs has been explained by three main factors that are interconnected: namely 'Being personally and professionally convinced regarding the role of FNs', 'Being progressively detached from the FNs', and 'Being forced to be detached from FNs'. Nurses also identified a category including strategies aimed at preventing detachment and 'Rediscovering the FNs as the core of nursing'. Nurses are personally and professionally convinced about the relevance of the FNs. However, they distance themselves from the FNs due to: (a) factors mainly attributable to internal personal and professional forces, such as the emotional fatigue that daily work entails; and (b) external forces related to the work environment where nurses work. To prevent this detrimental process that may result in negative outcomes for patients and their relatives, several strategies at the individual, organizational, and educational levels should be implemented.