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Harding E, Sullivan MP, Camic PM, Yong KXX, Stott J, Crutch SJ. "I Want to Do Something" - Exploring What Makes Activities Meaningful for Community-Dwelling People Living With Dementia: A Focused Ethnographic Study. Qual Health Res 2024:10497323241239487. [PMID: 38648467 DOI: 10.1177/10497323241239487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Supporting ageing in place, quality of life, and activity engagement are public health priorities for people with dementia. The importance of maintaining opportunities for meaningful activities has been widely acknowledged for those with dementia in long-term care, but little is known about what makes activities meaningful for, and how they are experienced by, people with different types of dementia in their own homes. This study used focussed ethnographic methods to explore the motivations and meanings of everyday activity engagement within the homes of 10 people with memory-led Alzheimer's disease and 10 people with posterior cortical atrophy. While participants' interactions with their everyday environments were challenged by their diagnoses, they were all finding ways to continue meaning-making via various activities. The main findings are encapsulated in three themes: (1) The fun and the function of activities; (2) Reciprocities of care, and (3) The constitution and continuity of (a changing) self. Ongoing engagement with both fun and functional activities offered participants living with different dementias opportunities to connect with others, to offer care and support (as well as receive it), and to maintain a sense of self and identity. Implications are discussed regarding the development and delivery of tailored interventions and support to enable continued engagement in meaningful activities for people with different types of dementia living in the community.
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Affiliation(s)
- Emma Harding
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Mary Pat Sullivan
- School of Social Work, Faculty of Education and Professional Studies, Nipissing University, Nipissing, ON, Canada
| | - Paul M Camic
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Joshua Stott
- UCL Division of Psychology and Language Sciences, Department of Clinical, Educational, and Health Psychology, UCL, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, UCL, London, UK
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Gupta S, Howden S, Moffat M, Pope L, Kennedy C. Girls in scrubs: An ethnographic exploration of the clinical learning environment. Med Educ 2024. [PMID: 38581403 DOI: 10.1111/medu.15379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Gender bias is an enduring issue in the medical profession despite women being more represented within medical schools and the health care workforce in numerous countries across the world. There have been frequent calls for further exploration of gender-based discriminations within medical education, owing to its lasting impact on student's professional development and career trajectories. This paper presents an ethnographic exploration of the experiences of female medical students and doctors in the clinical learning environment (CLE), aiming to disrupt the cycle of gender inequity in the clinical workplace. METHODS Our research field involved two teaching wards in a Scottish urban hospital, where 120 h of non-participant observations were conducted over 10 months. Combining purposive and convenience sampling, we conducted 36 individual interviews with key informants, which included medical students, foundation doctors, postgraduate trainees, consultant supervisors, and other health care professionals such as nurses and pharmacists. Data was thematically analysed using Bourdieu's theory of social power reproduction. The research team brought diverse professional backgrounds and perspectives to the exploration of data on gendered encounters. RESULTS Combining the observational and interview data, five themes were generated, which suggested gender-related differentials in social and cultural capital that the participants acquired in the CLE. Experiences of discriminatory behaviour and stereotypical thought processes impacted the female students' engagement and drive towards learning, implying an adverse influence on habitus. In contrast, the valuable influence of gendered role-models in building confidence and self-efficacy signified a positive transformation of habitus. The research participants displayed considerable internalisation of the gendered processes in the CLE that appeared to be linked to the transient nature of clinical placements. CONCLUSIONS This research reveals that despite constituting the majority demographic of medical school, female students struggle to gain social and cultural capital. Gendered hierarchies that structure clinical workplaces disadvantage female students and doctors, and the differential experiences transform their habitus. Based on our theoretically informed investigation, we advocate for role-models given their positive impact on students' and doctors' habitus. Additionally, medical educators may consider extended clinical placements that provide opportunities for female students and early-career doctors to secure social and cultural capital through integrating better in health care teams and building meaningful interprofessional relationships.
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Affiliation(s)
| | - Stella Howden
- Learning and Teaching Academy, Herriot-Watt University, Edinburgh, UK
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Sørstrøm AK, Ludvigsen MS, Kymre IG. Facilitating planned home death: A qualitative study on home care nurses' experiences of enablers and barriers. J Adv Nurs 2024. [PMID: 38515196 DOI: 10.1111/jan.16171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/20/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
AIM The aim of this study was to explore home care nurses' experience of enablers and barriers for planned home death in municipal health care. DESIGN A focused ethnography. METHODS This qualitative study collected data from 20 semi-structured interviews of home care nurses and 8.5 h of participant observations. Data was analyzed using thematic analysis. RESULTS The findings in our study show that home care nurses consider supportive cultures, a commitment to safety and continuity when facilitating planned home deaths and family rotations to be enablers for planned home deaths. Barriers to planned home deaths involve a lack of palliative experience affecting confidence, shortages of nurses and medical supplies and night shift challenges. CONCLUSION This study underscores the need for supportive organizational cultures, ongoing education and improved communication and staffing policies to enhance the quality of care and the experiences of patients and home care nurses, especially in the context of planned home deaths. IMPACT The study adds knowledge to the evidence base of the practice of facilitating planned home deaths. The findings of the study could offer valuable insights for shaping future policies or devising effective implementation strategies. REPORTING METHOD Adherence to the COREQ guidelines for reporting qualitative research was maintained. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. WHAT DOES THIS ARTICLE CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Identified enablers and barriers provide a new perspective, contributing to a comprehensive understanding of planning home deaths. The study emphasizes supportive cultures, safety commitment and family rotations as crucial for planned home deaths, guiding healthcare professionals to adopt best practices and enhance palliative care quality.
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Affiliation(s)
| | - Mette Spliid Ludvigsen
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Department of Clinical Medicine - Randers Regional Hospital, Aarhus University, Aarhus, Denmark
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Shali M, Bakhshi F, Hasanpour M. Culture of patient care among international nursing students: a focused ethnographic study. BMC Nurs 2024; 23:163. [PMID: 38448913 PMCID: PMC10916181 DOI: 10.1186/s12912-024-01807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 02/19/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND This study was conducted to describe and explain the culture of patient care in international nursing students. METHODS This qualitative study was conducted using focused ethnography. Participants (n = 21) were purposefully selected from non-Iranian international students and their nursing instructors. Data collection included semi-structured interviews, and field-note taking. Data were analyzed with the Roper and Shapira inductive approach of ethnographic content analysis. RESULTS The cultural model of the study included the acquisition of cultural competence through acceptance of differences and finding commonalities. Subcategories were: "avoiding cultural bias", "trying to be on the path of adaptation", "appealing to the support and companionship of colleagues", "coping with culture shock", "acculturation", "getting help from cultural intelligence", "cultural empathy", and "language and communication enhancement". CONCLUSION Cultural competence is teachable. The pattern of formation is through accepting differences and searching for commonalities. Suggestions for promoting the culture of care among international students include effective use of peer groups and teaching different national ethnicities and cultures.
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Affiliation(s)
- Mahboube Shali
- Critical Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bakhshi
- Research Center for Nursing and Midwifery Care, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marzieh Hasanpour
- Pediatric and Newborn Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tohid Squ., Dr. Mirkhani [East Nosrat] St., Tehran, 1419733171, Iran.
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Faro EZ, Taber P, Seaman AT, Rubinstein EB, Fix GM, Healy H, Reisinger HS. Implicit and explicit: a scoping review exploring the contribution of anthropological practice in implementation science. Implement Sci 2024; 19:12. [PMID: 38347574 PMCID: PMC10863116 DOI: 10.1186/s13012-024-01344-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/20/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND This study's goal is to identify the existing variation in how, why, and by whom anthropological practice is conducted as part of implementation science projects. As doctorally trained anthropologists, we sought to characterize how and why the term "ethnography" was variously applied in the implementation science literature and characterize the practice of anthropology within and across the field. METHODS While we follow the PRISMA-ScR checklist, we present the work with a narrative approach to accurately reflect our review process. A health services librarian developed a search strategy using subject headings and keywords for the following databases: PubMed, Embase (Elsevier), Cochrane CENTRAL (Wiley), CIHAHL (EBSCO), PsycINFO (EBSCO), Web of Science Core Collection, and Anthropology Plus (EBSCO). We focused on the practice of anthropology in implementation research conducted in a healthcare setting, in English, with no date restrictions. Studies were included if they applied one or several elements of anthropological methods in terms of study design, data collection, and/or analysis. RESULTS The database searches produced 3450 results combined after duplicates were removed, which were added to Rayyan for two rounds of screening by title and abstract. A total of 487 articles were included in the full-text screening. Of these, 227 were included and received data extraction that we recorded and analyzed with descriptive statistics in three main domains: (1) anthropological methods; (2) implementation science methods; and (3) study context. We found the use of characteristic tools of anthropology like ethnography and field notes are usually not systematically described but often mentioned. Further, we found that research design decisions and compromises (e.g., length of time in the field, logistics of stakeholder involvement, reconciling diverse firsthand experiences) that often impact anthropological approaches are not systematically described. CONCLUSIONS Anthropological work often supports larger, mixed-methods implementation projects without being thoroughly reported. Context is essential to anthropological practice and implicitly fundamental to implementation research, yet the goals of anthropology and how its practice informs larger research projects are often not explicitly stated.
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Affiliation(s)
- Elissa Z Faro
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
| | - Peter Taber
- Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Aaron T Seaman
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, USA
| | - Ellen B Rubinstein
- Department of Sociology and Anthropology, North Dakota State University, Fargo, ND, USA
| | - Gemmae M Fix
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford and VA Boston Healthcare System, Bedford, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Heather Healy
- Hardin Library for the Health Sciences, University of Iowa, Iowa City, IA, USA
| | - Heather Schacht Reisinger
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, USA
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
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Woodgate RL, Gonzalez M, Ripat JD, Edwards M, Rempel G. Exploring fathers' experiences of caring for a child with complex care needs through ethnography and arts-based methodologies. BMC Pediatr 2024; 24:93. [PMID: 38308237 PMCID: PMC10835869 DOI: 10.1186/s12887-024-04567-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/15/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Although the number of children living with complex care needs (CCN) is increasing worldwide, there is limited data on the experience of fathers caring for children with CCN. This paper reports on findings specific to fathers' experiences of caring for their child with CCN and highlights recommendations provided for parents of children with CCN, service providers, and policymakers. The findings emerged from a larger study designed to examine how Canadian families of children with CCN participate in society. METHODS We used the qualitative research approach of ethnography and arts-based methodologies (ecomaps and photovoice) as well as purposive and snowball sampling techniques. Four parents were engaged as advisors and twenty-nine fathers participated in interviews (all were married or in a relationship; age range of 28 to 55 years). In line with an ethnographic approach, data analysis involved several iterative steps including comparing data from the first, second, and third set of interviews and refining themes. RESULTS One overarching theme, striving to be there for the child with CCN, was identified. Five supporting themes further exemplified how fathers strived to be there for their child: 1) contributing to the parental team through various roles; 2) building accessibility through adaptation; 3) engaging in activities with the child; 4) expressing admiration and pride in their children; and 5) meaning making. Recommendations for parents included making and nurturing connections and asking for help while recommendations for healthcare and social service providers included communicating authentically with families and listening to parents. Fathers also indicated that leadership and funding for programs of families of children with CCN should be priorities for policymakers. CONCLUSIONS In addition to documenting fathers' active involvement in their child's care and development, our findings provide new insights into how fathers make participation in everyday life accessible and inclusive for their children. Study findings also point to 1) priority areas for policymakers (e.g., accessible physical environments); 2) factors that are critical for fostering collaborative care teams with fathers; and 3) the need for complex care teams in the adult health care system. Implications for those providing psychosocial support for these families are noted as well as knowledge gaps worthy of future exploration such as the role of diversity or intersectionality in fathering children with CCN.
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Affiliation(s)
- Roberta L Woodgate
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada.
| | - Miriam Gonzalez
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada
| | - Jacquie D Ripat
- College of Rehabilitation Sciences, Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, R215-771 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada
| | - Marie Edwards
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada
| | - Gina Rempel
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, CE-208 Children's Hospital, Health Sciences Centre, Max Rady College of Medicine, University of Manitoba, 840 Sherbrook Street, Winnipeg, MB, R3A 1S1, Canada
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Umubyeyi B, Babenko-Mould Y, Hynie M, Regan S, Leipert B. A nurturing and caring environment to facilitate nursing students' professional development in Rwanda: a focused ethnographic study. Int J Nurs Educ Scholarsh 2024; 21:ijnes-2023-0064. [PMID: 38167136 DOI: 10.1515/ijnes-2023-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To explore the values, practices, and behaviours that support nursing students' professional development in practice-based learning environments in Rwanda. METHODS A focused ethnographic approach was used. Nursing students (n=12), nurses (n=11), clinical instructors (n=7) and nurse leaders (n=8) from three teaching hospitals and an educational program participated in the study. Data was collected trough individual interviews and participant observation. RESULTS Participants embraced a culture of preparing nursing students for their professional roles as a professional responsibility, and a means of securing the nursing profession. Modeling the appropriate behaviours to students and respecting them as learners and humans constituted the caring attributes that sustain a positive learning environment for their professional growth. CONCLUSIONS Nurturing and caring environments offer students opportunities to integrate caring attitudes into their interactions with patients and to develop professionally. IMPLICATIONS FOR INTERNATIONAL AUDIENCE Findings underscore the need to enhance caring values within nursing curricula.
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Affiliation(s)
- Benoite Umubyeyi
- Département de Recherche, Enseignement et Formation, Maison Médicale Jeanne Garnier, Paris, France
- Faculty of Health Sciences, Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Yolanda Babenko-Mould
- Faculty of Health Sciences, Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Michaela Hynie
- Department of Psychology, York University, Toronto, ON, Canada
| | - Sandra Regan
- Faculty of Health Sciences, Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Beverly Leipert
- Faculty of Health Sciences, Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
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Opara UC, Petrucka P. A Critical Comparison of Focused Ethnography and Interpretive Phenomenology in Nursing Research. Glob Qual Nurs Res 2024; 11:23333936241238097. [PMID: 38495317 PMCID: PMC10943724 DOI: 10.1177/23333936241238097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Abstract
Choosing an appropriate qualitative methodology in nursing research is a researcher's first step before beginning a study. Such a step is critical as the selected qualitative methodology should be congruent with the research questions, study assumptions, data gathering and analysis to promote the utility of such research in enhancing nursing knowledge. In this paper, we compare focused ethnography by Roper and Shapira and interpretive phenomenology by Benner. Though these methodologies are naturalistic and appear similar, both have different methodological underpinnings. The historical, ontological, epistemological, and axiological philosophy guiding each methodology are described. In addition, the methodological underpinnings of both methodologies and a justification for use in nursing research are provided. This paper will assist future researchers who aim to employ these methodologies in nursing research.
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Martín-Palomo MT, González-Calo I, Lucchetti G, Badanta B. Experiences of health and social professionals using care technologies with older adults during the COVID-19 pandemic: A qualitative study. Public Health Nurs 2024; 41:101-111. [PMID: 37897095 DOI: 10.1111/phn.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/23/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE To investigate the perceptions and experiences of health and social care professionals concerning the use of technology for the care of older adults during the COVID-19 pandemic. DESIGN AND MEASURES A phenomenological qualitative, exploratory, and descriptive design using semi-structured interviews. SAMPLE Twenty Spanish health and social care workers in six Spanish cities between February and July 2021, during the COVID-19 pandemic. RESULTS During the COVID-19 pandemic care workers have become more familiar with technology devices, but they also recognize certain barriers for the implementation of technology, mainly in nursing homes and homecare, related to concerns of lack of humanization and difficulties in accessing and using these devices. CONCLUSION Politicians and social and healthcare managers should be aware of the benefits of techno-care, reducing the difficulties in implementing it and making more funding and further training available to care providers.
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Affiliation(s)
- María Teresa Martín-Palomo
- Institut of Sociology and Center for Migration Studies and Intercultural Relations (CEMyRI), Almería University, Andalucia, Spain
| | - Inés González-Calo
- Department of Social Sciences, University of Almería, Research Group under the Andalusian Research: "Social Inequality and Domination in Andalusia", (SEJ 339), Andalucia, Spain
| | - Giancarlo Lucchetti
- Department of Medicine, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Bárbara Badanta
- Department of Nursing; Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Research Group under the Andalusian Research CTS 1050 "Complex Care, Chronic and Health Outcomes", and Center for Migration Studies and Intercultural Relations (CEMyRI), Seville, Spain
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Rasmussen IL, Halberg N, Jensen PS. 'Why doesn't anyone ask me'? Patients' experiences of receiving, performing and practices of oral care in an acute Orthopaedic Department. Scand J Caring Sci 2023; 37:1079-1090. [PMID: 37231993 DOI: 10.1111/scs.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/12/2023] [Accepted: 05/07/2023] [Indexed: 05/27/2023]
Abstract
AIMS AND OBJECTIVES Oral care is an integrated part of everyday life. Within nursing, barriers related to providing oral care often lead to unmet caring needs. Poor oral care is associated with a risk of respiratory and cardiovascular complications during hospitalisation. Knowledge on patients' perspectives of maintaining or receiving oral care during admissions are limited. Following the Fundamentals of Care (FOC) framework, this study uses a person-centred approach to explore patients' perceptions and experiences of receiving or performing oral care, including the nursing staff's clinical practices. METHODOLOGICAL DESIGN AND JUSTIFICATION A focussed ethnographic approach was used to explore patients' perspectives and clinical practices during acute admissions in an Orthopaedic Department. ETHICS ISSUES AND APPROVAL The local Data Protection Agency and the Ethics Committee approved the study. RESEARCH METHODS, RESULTS AND CONCLUSIONS Data were collected in an Orthopaedic ward at a Copenhagen University hospital, Hvidovre, and consisted of 14 days of field observations of clinical practices and 15 patient interviews. Data were analysed inductively using qualitative content analysis. Two themes were identified. The first, 'The purpose of oral care is defined by the eye of the beholder', describes the social implications for the patients and how patients reject the assumption of oral care being a transgressive act. The second, 'The unspoken need', focus on the lack of dialogue, including the limited provision of oral care and how the nursing staff assesses patients' ability to perform oral care (in)dependently without including the patients. CONCLUSION Oral care is related to the patient's psychological and physical well-being and affects social appearance. When oral care is provided respectfully, patients do not experience oral care as a transgressive act. Nursing staff's self-assessments of the patients' (in)dependency to perform oral care risk leading to incorrect care. Developing and implementing interventions applicable to the clinical practice is needed.
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Affiliation(s)
- Isabella Lund Rasmussen
- The Research Unit of Orthopedic Nursing, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
| | - Nina Halberg
- The Research Unit of Orthopedic Nursing, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
- Center of Health Promotion and Health Strategies, Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Pia Søe Jensen
- The Research Unit of Orthopedic Nursing, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
- Center of Health Promotion and Health Strategies, Department of People and Technology, Roskilde University, Roskilde, Denmark
- Department of Clinical Research, Copenhagen University Hospital, Hvidovre, Denmark
- Research Unit Nursing and Health Care, Health, Aarhus University, Aarhus, Denmark
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Sørstrøm AK, Ludvigsen MS, Kymre IG. Home care nurses facilitating planned home deaths. A focused ethnography. BMC Palliat Care 2023; 22:175. [PMID: 37940911 PMCID: PMC10634003 DOI: 10.1186/s12904-023-01303-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Home care nurses provide complex palliative care for patients who want to die in their own homes. This study aimed to explore home care nurses' facilitation of planned home death to better understand nursing practices. METHODS Data were collected between March 2019 and March 2020 using participant observations and semi-structured interviews. In addition, the number of planned home deaths was recorded. The analysis was guided by Roper and Shapira`s framework on focused ethnography. RESULTS Twenty home care nurses (three men) in eight home care areas in two Norwegian municipalities met the inclusion criteria. Eight home deaths were registered, seven participatory observations were performed, and 20 semi-structured interviews were completed. Home care nurses find facilitating planned home deaths to be rewarding work, to the point of going above and beyond. At the same time, they describe facilitating planned home deaths as demanding work due to organizational stressors such as staff shortages, heavy workloads, and time restraints. While they tend to patients' needs, they also express concern for the wellbeing of the next of kin. They find it challenging to juggle the needs of the patients with the needs of next of kin, as these are not always correlated. CONCLUSION Home care nurses are pushing the boundaries of their practice when facilitating planned home deaths while compensating for a fragile system by going above and beyond for patients and their next of kin. Providing insights into the work of home care nurses providing palliative care in patients' homes can impact recruiting and retaining nurses in the workforce and influence local practices and policies.
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Affiliation(s)
| | - Mette Spliid Ludvigsen
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Department of Clinical Medicine - Randers Regional Hospital, Aarhus University, Aarhus, Denmark
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Picot S, Harrington A, Fuller J. Finding the Hidden Professional Culture of Mental Health Nursing-Spiritual Care for Individuals with a Co-morbid Life-Limiting Illness. Issues Ment Health Nurs 2023; 44:951-959. [PMID: 37734156 DOI: 10.1080/01612840.2023.2246064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
People with severe mental illness are dying up to thirty years earlier than the general population. The limited literature on their experience of dying indicates that they often suffer from inequities in their access to healthcare services, and further, what care they do receive is frequently poor. Living with both a mental illness and facing death can engender spiritual concerns and dying at a younger age is a risk factor for spiritual despair. Hence, addressing spiritual concerns can be an important dimension of mental health nursing care. The aim of this ethnographic study of 11 senior and experienced mental health nurses was to determine if the culture of the mental health service impacted their spiritual care for those patients who were facing death. The data highlighted that the nurses felt comfortable in providing spiritual care when the person was suffering from psychosis. Yet, the results also revealed that nurses felt disempowered by the dominance of the biomedical culture, in which they felt unable to articulate their care. However, it was identified that their spiritual care was inherent within the professional values, knowledge, and skills of mental health nursing and framed through their therapeutic relationships. Therefore, strategies need to be used by the organization to assist nurses to reclaim their power and assist the mental health service to further develop and engage in spiritual care practices.
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Affiliation(s)
- Sharon Picot
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Ann Harrington
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Charles Sturt University, Barton, Australia
| | - Jeffrey Fuller
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Sugiyama K, Omote S, Okamoto R. Experiences of Japanese women simultaneously caring for children and older people: An ethnographic study. Heliyon 2023; 9:e20375. [PMID: 37810144 PMCID: PMC10560044 DOI: 10.1016/j.heliyon.2023.e20375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
Background Japan has experienced a rapid decline in birth rate and an aging population, coupled with women choosing to delay having children. Family carers are therefore increasingly expected to accept simultaneous responsibilities for both children and parents. This responsibility often falls on women in Japan, but little is known about their views. This study aimed to understand how Japanese women who are simultaneously responsible for caring for children and older people perceive their experiences. Methods This was an ethnographic study conducted in central Japan. Over a period of 3 years and 5 months, we observed 19 people active in a peer support group for people with both childcare and caregiving responsibilities. We also carried out individual interviews with 14 Japanese women who were raising children and caring for parents or parents-in-law. Results Five key themes emerged. These were "Accepting both childcare and caregiving as my role," "Inability to fulfill the role of mother," "Being supported by children and grandparents," "Unable to talk to anyone about the pressures of caregiving," and "Realizing that caregiving is not the only way to live." Conclusions Japanese women who provided care to both children and older people were influenced by traditional Japanese values. However, they had a sense of mission and accepted the role of providing for their families. They felt guilty about not being able to fulfill their role as mothers, and were lonely, with no one to understand or advise them. If the burden of caregiving is concentrated on women, there is an increased risk that their children will become involved in providing some of the care for older people. It may therefore be necessary to develop a support system for female carers, and to increase understanding of the potential harm of placing caregiving responsibility solely on women.
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Affiliation(s)
- Kimi Sugiyama
- Division of Health Sciences, Doctoral Course of Graduate School of Medical Sciences, Kanazawa University, Japan
- School of Nursing, Kanazawa Medical University, Japan
| | - Shizuko Omote
- Division of Nursing, Faculty of Health Science, Kanazawa University, Japan
| | - Rie Okamoto
- Division of Nursing, Faculty of Health Science, Kanazawa University, Japan
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Lluch C, O'Mahony J, D'Souza M, Hawa R. Health Literacy of Healthcare Providers and Mental Health Needs of Immigrant Perinatal Women in British Columbia: A Critical Ethnography. Issues Ment Health Nurs 2023; 44:746-757. [PMID: 37437242 DOI: 10.1080/01612840.2023.2227267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
AIMS This research explores how health care providers determine the mental health needs of immigrant women in the perinatal phase of childbirth. The contextual factors that affect the mental health of these women and influence their engagement with the British Columbian communities in which they reside are investigated. METHOD Using a critical ethnographic approach, eight health care providers were interviewed to gain insight into health care provider's health literacy and immigrant perinatal women's mental health. Each participant was interviewed for 45-60 min in the period from January to February 2021 to obtain relevant data. RESULTS Three themes emerged from the data analysis: the health care provider's role and his/her health literacy, the health literacy of the participant, and the impact of the ongoing COVID-19 pandemic on the participant's situation. CONCLUSIONS The findings indicate that a healthy working relationship between the health care provider and an immigrant woman in the perinatal phase of childbirth is essential to facilitate an effective interchange of health information.
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Affiliation(s)
- Conchitina Lluch
- School of Nursing, Thompson Rivers University, Kamloops, BC, Canada
| | - Joyce O'Mahony
- School of Nursing, Thompson Rivers University, Kamloops, BC, Canada
| | - Melba D'Souza
- School of Nursing, Thompson Rivers University, Kamloops, BC, Canada
| | - Roula Hawa
- Family Studies & Human Development, School of Behavioural and Social Sciences, Brescia University College at Western, London, ON, Canada
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Elliott J, van Wyk P, Butler R, Giosa JL, Sims Gould J, Tong CE, Taabazuing MM, Johnson H, Coyne P, Mitchell F, Whate A, Callon A, Carson J, Stolee P. Developing an in-depth understanding of patient and caregiver engagement across care transitions from hospital: protocol for a qualitative study exploring experiences in Canada. BMJ Open 2023; 13:e077436. [PMID: 37479510 PMCID: PMC10364181 DOI: 10.1136/bmjopen-2023-077436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION Patient and caregiver engagement is critical, and often compromised, at points of transition between care settings, which are more common, and more challenging, for patients with complex medical problems. The consequences of poor care transitions are well-documented, both for patients and caregivers, and for the healthcare system. With an ageing population, there is greater need to focus on care transition experiences of older adults, who are often more medically complex, and more likely to require care from multiple providers across settings. The overall goal of this study is to understand what factors facilitate or hinder patient and caregiver engagement through transitions in care, and how these current engagement practices align with a previously developed engagement framework (CHOICE Framework). This study also aims to co-develop resources needed to support engagement and identify how these resources and materials should be implemented in practice. METHODS AND ANALYSIS This study uses ethnographic approaches to explore the dynamics of patient and caregiver engagement, or lack thereof, during care transitions across three regions within Ontario. With the help of a front-line champion, patients (n=18-24), caregivers (n=18-24) and healthcare providers (n=36-54) are recruited from an acute care hospital unit (or similar) and followed through their care journey. Data are collected using in-depth semi-structured interviews. Workshops will be held to co-develop strategies and a plan for future implementation of resources and materials. Analysis of the data will use inductive and deductive coding techniques. ETHICS AND DISSEMINATION Ethics clearance was obtained through the Western University Research Ethics Board, University of Windsor Research Ethics Board and the University of Waterloo Office of Research Ethics. The findings from this study are intended to contribute valuable evidence to further bridge the knowledge to practice gap in patient and caregiver engagement through care transitions. Findings will be disseminated through publications, conference presentations and reports.
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Affiliation(s)
- Jacobi Elliott
- Lawson Health Research Institute, London, Ontario, Canada
- Specialized Geriatric Services, St. Joseph's Health Care London, London, Ontario, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Paula van Wyk
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Roy Butler
- Senior Leadership, St. Joseph's Health Care London, London, Ontario, Canada
| | - Justine L Giosa
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- SE Research Centre, Toronto, Ontario, Canada
| | | | - Catherine E Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Mary Margaret Taabazuing
- Department of Medicine, Division of Geriatric Medicine, Western University, London, Ontario, Canada
| | - Helen Johnson
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Paige Coyne
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
- Henry Ford Health System, Detroit, Michigan, USA
| | - Fallon Mitchell
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Alexandra Whate
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne Callon
- Patient and Caregiver Partner, London, Ontario, Canada
| | - Judith Carson
- Patient and Caregiver Partner, Waterloo, Ontario, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Siew Pien L, Haycock-Stuart E, Atan A, Shamsuddin NA. Understanding Parental Role in Children's Participation in Decision Making during Hospitalisation: An Ethnographic Study in Malaysia. Malays J Med Sci 2023; 30:143-150. [PMID: 37425390 PMCID: PMC10325123 DOI: 10.21315/mjms2023.30.3.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/06/2022] [Indexed: 07/11/2023] Open
Abstract
Introduction Despite a growing recognition internationally that children have a right to participate in matters that affect their lives, they are not always involved in decision-making processes concerning their health care. There is a lack of information on how parents influence children's participation in this decision making. This study explored the roles parents assume in processes regarding their children's participation in communication exchanges and decision making in a paediatric oncology unit in Malaysia. Methods This study adopted a focused ethnography design within a constructivist research paradigm. Participant observations and semi-structured interviews were conducted with 21 parents, 21 children and 19 nurses in a paediatric oncology unit in Malaysia. All observation fieldnotes and interview recordings were transcribed verbatim. A focused ethnographic data analysis technique was performed to analyse the data. Results Three themes emerged regarding parents' roles in the communication and decision-making processes involving their children: i) facilitators of communication; ii) communication brokers and iii) communication buffers. Conclusion Parents controlled decision-making processes concerning their children, while children preferred and welcomed parents as consultants in the decision-making processes regarding their health care.
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Affiliation(s)
- Lee Siew Pien
- Kulliyyah (Faculty) of Nursing, International Islamic University Malaysia, Pahang, Malaysia
| | - Elaine Haycock-Stuart
- School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Ashikin Atan
- Kulliyyah (Faculty) of Nursing, International Islamic University Malaysia, Pahang, Malaysia
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Sarigiovannis P, Foster NE, Jowett S, Saunders B. Developing a best practice framework for musculoskeletal outpatient physiotherapy delegation: the MOPeD mixed-methods research study protocol. BMJ Open 2023; 13:e072989. [PMID: 36931674 PMCID: PMC10030620 DOI: 10.1136/bmjopen-2023-072989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION Physiotherapy assistants/support workers are an important part of the physiotherapy workforce in the UK. Many of them work in National Health Service (NHS) physiotherapy outpatient services treating patients with musculoskeletal (MSK) conditions. In many services, they take responsibility, under professional supervision, for types of clinical work traditionally undertaken by physiotherapists such as leading exercise classes and treating individual patients. Nevertheless, their role(s) are relatively undefined and as such, there is considerable variation in the duties and tasks they undertake. This study aims to design a framework of 'best practice' in delegation to guide the work of clinicians in NHS physiotherapy MSK services and facilitate standardisation of practice to ensure that patients receive safe and effective treatment by the most appropriate person. METHODS AND ANALYSIS This mixed-methods study will be conducted in four stages. In stage 1, a focused ethnography in two MSK outpatient physiotherapy services will explore how the current use of delegation is informed by the culture within the clinical setting as well as views, attitudes about, and experiences of, delegation among clinicians, managers and patients. In stage 2a, nominal group technique will be used with three separate groups (physiotherapists/physiotherapy assistants/support workers, managers) to reach a consensus about what components should be included in a best practice framework of delegation. In stage 2b, a discrete choice experiment will elicit patients' preferences between care from physiotherapists and physiotherapy assistants/support workers within MSK physiotherapy services. In the final stage, the results of all previous stages will be triangulated to inform the development of a best practice delegation framework for future testing and use within NHS MSK outpatient physiotherapy services. ETHICS AND DISSEMINATION Ethical approval has been granted by the South West-Frenchay Research Ethics Committee. The findings will be disseminated in peer-reviewed journals, conference presentations, the lay press and social media.
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Affiliation(s)
- Panos Sarigiovannis
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- North Integrated Musculoskeletal Service, Midlands Partnership NHS Foundation Trust, Stafford, UK
| | - Nadine E Foster
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Brisbane, Australia
| | - Sue Jowett
- Health Economics Unit, Institute of Applied Health Research, Public Health Building, University of Birmingham, Birmingham, UK
| | - Benjamin Saunders
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
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Rees J, Burton A, Walters K, Cooper C. Exploring the provision and support of care for long-term conditions in dementia: A qualitative study combining interviews and document analysis. Dementia (London) 2023; 22:820-837. [PMID: 36883009 PMCID: PMC9996169 DOI: 10.1177/14713012231161854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND The challenge of managing multiple long-term conditions is a prevalent issue for people with dementia and those who support their care. The presence of dementia complicates healthcare delivery and the development of personalised care plans, as health systems and clinical guidelines are often designed around single condition services. OBJECTIVE This study aimed to explore how care for long-term conditions is provided and supported for people with dementia in the community. METHODS In a qualitative, case study design, consecutive telephone or video-call interviews were conducted with people with dementia, their family carers and healthcare providers over a four-month period. Participant accounts were triangulated with documentary analysis of primary care medical records and event-based diaries kept by participants with dementia. Thematic analysis was used to develop across-group themes. FINDINGS Six main themes were identified from eight case studies: 1) Balancing support and independence, 2) Implementing and adapting advice for dementia contexts, 3) Prioritising physical, cognitive and mental health needs, 4) Competing and entwined needs and priorities, 5) Curating supportive professional networks, 6) Family carer support and coping. DISCUSSION These findings reflect the dynamic nature of dementia care which requires the adaptation of support in response to changing need. We witnessed the daily realities for families of implementing care recommendations in the community, which were often adapted for the contexts of family carers' priorities for care of the person living with dementia and what they were able to provide. Realistic self-management plans which are deliverable in practice must consider the intersection of physical, cognitive and mental health needs and priorities, and family carers needs and resources.
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Affiliation(s)
- Jessica Rees
- Division of Psychiatry, 4919University College London, London, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health4919, University College London, London, UK
| | - Kate Walters
- Primary Care and Population Health, 4919University College London, London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental health, Wolfson Institute of Population Health, 4617Queen Mary University of London, London, UK
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19
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Tervo H, Laukkanen E, Kuosmanen L. The cultural meaning of Sámi language, costume, and food to the Sámi, from the perspective of well-being. Int J Circumpolar Health 2022; 81:2133349. [PMID: 36222024 PMCID: PMC9578450 DOI: 10.1080/22423982.2022.2133349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The Sámi people, a northern indigenous people, have a statutory right to receive social and health services, which should take cultural characteristics into consideration. Cultural sensitivity is integral to the ethical principles of social and health care; however, based on previous research, the Sámi’s cultural rights have not been recognised. To reinforce their language rights and develop culturally sensitive health care, research is needed to determine what Sámi cultural characteristics mean to Sámi people’s well-being. The aim of this study was to describe and understand the meaning of cultural characteristics to the well-being of different generations of Sámi. In this research two Sámi experts described what the Sámi language, costume and food meant to them from a well-being perspective. Data-driven content analysis was applied to their responses. During everyday life, to the Sámi their cultural characteristics represent safety, awareness of one’s roots, inner strength, the ability to be oneself, continuity, and communality. These meanings are interconnected with changing environment for the different generations and reflect Sámi people’s lived experiences. Consideration of their cultural characteristics in the provision of social and health care will support the Sámi peoples´ integrity and cultural uniqueness, empowering both individual Sámi and their society.
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Affiliation(s)
- Hellevi Tervo
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Emilia Laukkanen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Lauri Kuosmanen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Holmberg B, Godskesen T. Dignity in bodily care at the end of life in a nursing home: an ethnographic study. BMC Geriatr 2022; 22. [PMID: 35871666 PMCID: PMC9310487 DOI: 10.1186/s12877-022-03244-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nursing homes (NHs) are populated by the frailest older people who have multiple physical or mental conditions and palliative care needs that may convey the violation of dignity. Although dignity is a commonly used concept and a core value of end-of-life care, it is assumed to be complex, ambiguous, and multivalent. Thus, the aim of this study was to explore aspects of dignity in older persons’ everyday lives in a NH. Design A focused ethnographic study design. Methods Data consisted of 170 h of fieldwork, including observations (n = 39) with residents (n = 19) and assistant nurses (n = 22) in a Swedish NH. Interviews were undertaken with residents several times (in total, n = 35, mean 70 min/resident). To study dignity and dignity-related concerns, we used the Chochinov model of dignity to direct the deductive analysis. Results The study showed that residents suffered from illness-related concerns that inhibited their possibilities to live a dignified life at the NH. Their failing bodies were the most significant threat to their dignity, as loss of abilities was constantly progressing. Together with a fear of becoming more dependent, this caused feelings of agony, loneliness, and meaninglessness. The most dignity-conserving repertoire came from within themselves. Their self-knowledge had provided them with tools to distinguish what was still possible from what they just had to accept. Socially, the residents’ dignity depended on assistant nurses’ routines and behaviour. Their dignity was violated by long waiting times, lack of integrity in care, deteriorating routines, and also by distanced and sometimes harsh encounters with assistant nurses. Because the residents cherished autonomy and self-determination, while still needing much help, these circumstances placed them in a vulnerable situation. Conclusions According to residents’ narratives, important dignity-conserving abilities came from within themselves. Dignity-conserving interventions did occur, such as emphatic listening and bodily care, performed in respect for residents’ preferences. However, no strategies for future crises or preparing for death were observed. To protect residents’ dignity, NHs must apply a palliative care approach to provide holistic care that comprises attention to personal, bodily, social, spiritual, and psychological needs to increase well-being and prevent suffering.
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Ozavci G, Bucknall T, Woodward‐Kron R, Hughes C, Jorm C, Manias E. Towards patient-centred communication in the management of older patients' medications across transitions of care: A focused ethnographic study. J Clin Nurs 2022; 31:3235-3249. [PMID: 34873761 PMCID: PMC9786755 DOI: 10.1111/jocn.16162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/08/2021] [Accepted: 11/23/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Communication about managing medications during transitions of care can be a challenging process for older patients since they often have complex medication regimens. Previous studies highlighted that links between communication breakdowns and medication incidents in older patients occur mainly at discharge or in the post-discharge period. Little attention has been paid to exploring communication strategies facilitating patient-centred medication communication at transitions of care from a discourse-analytic perspective. OBJECTIVES To explore, through a discursive lens, strategies that enable patient-centred medication communication at transitions of care. DESIGN A focused ethnographic study was employed for this study. The study was reported according to the COREQ checklist. METHODS Interviews, observations and focus groups were analysed utilising Critical Discourse Analysis and the Medication Communication Model following thematic analysis. Data collection was undertaken in eight wards across two metropolitan hospitals in Australia. RESULTS Patient preferences and beliefs about medications were identified as important characteristics of patient-centred communication. Strategies included empathetic talk prioritising patients' medication needs and preferences for medications; informative talk clarifying patients' concerns; and encouraging talk for enhancing shared decision-making with older patients. Challenges relating to the use of these strategies included patients' hearing, speech or cognitive impairments, language barriers and absence of interpreters or family members during care transitions. RELEVANCE TO CLINICAL PRACTICE To enhance medication communication, nurses, doctors and pharmacists should incorporate older patients' preferences, previous experiences and beliefs, and consider the challenges faced by patients across transitions. Strategies encouraging patients' contribution to decision-making processes are crucial to patient-centeredness in medication communication. Nurses need to engage in informative talk more frequently when administering the medications to ensure older patients' understanding of medications prescribed or altered in hospital settings.
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Affiliation(s)
- Guncag Ozavci
- Centre for Quality and Patient Safety ResearchThe School of Nursing and MidwiferyInstitute for Health TransformationAlfred HealthDeakin UniversityBurwoodVic.Australia
| | - Tracey Bucknall
- Centre for Quality and Patient Safety ResearchThe School of Nursing and MidwiferyInstitute for Health TransformationAlfred HealthDeakin UniversityBurwoodVic.Australia
| | - Robyn Woodward‐Kron
- Department of Medical EducationMelbourne Medical SchoolThe University of MelbourneParkvilleVic.Australia
| | - Carmel Hughes
- School of PharmacyQueen's University BelfastBelfastUK
| | - Christine Jorm
- School of Public HealthThe University of SydneyCamperdownNSWAustralia
| | - Elizabeth Manias
- Centre for Quality and Patient Safety ResearchThe School of Nursing and MidwiferyInstitute for Health TransformationAlfred HealthDeakin UniversityBurwoodVic.Australia
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Dong Z, Wei L, Sun X, Xiang J, Hu Y, Lin M, Tan Y. Experiences of nurses working in nurse-led clinics in Traditional Chinese Medicine hospitals: A focused ethnographic study. Nurs Open 2022; 10:603-612. [PMID: 36054474 PMCID: PMC9834534 DOI: 10.1002/nop2.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 12/03/2021] [Accepted: 07/29/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Traditional Chinese Medicine (TCM) nurse-led clinics (NLC) is an innovative working model in China, representing the specialization and extension of nurses' role. However, as a pioneer in TCM nursing, this new model of working is facing both opportunities and challenges because it is known little about the operational status of NLCs. AIMS To explore the experiences of nurses who work in NLC in TCM hospitals. MATERIALS & METHODS A focused ethnographic study was conducted in three TCM hospitals affiliated with Guangzhou University of Chinese Medicine. We interviewed eleven nurses in those hospitals and observed seven of them working with patients. We used snowball sampling for data collection including interview, non-participant observation and documents from medical records. All the data were processed as following steps: (a) coding for descriptive labels; (b) sorting for patterns; (c) identifying outliers or negative cases; (d) generalizing with construction and theories and (e) noting reflective remarks. RESULTS Nurse-led clinics help nurses develop their skills and knowledge that are highly recognized by public since they meet the growing needs of patients and also relieve the workload of physicians in the hospitals. However, lack of specialization is still a major challenge in NLCs due to insufficiency of full-time staff with specialized education, nurse-led practice without standardized guidelines, restrictions on prescription right of nurses, and also inadequate support from hospitals. DISCUSSIONS As a revolutionary innovation of working model for nurses in TCM hospitals, NLCs could improve quality of care and lead to a comprehensive promotion of nursing career. However, there are several challenges on providing high quality care for patients whilst improving educational development of nurses. This study suggests that nurses, hospital administration and the government should cooperate with each other to develop standard nursing programs for NLCs. CONCLUSIONS It is imperative to identify nursing roles, collect available resources, and develop supportive policies and training programs to enhance the quality of NLCs.
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Affiliation(s)
- Zhaoyang Dong
- School of Nursing, Guangzhou University of Chinese MedicineGuangzhouChina
| | - Lin Wei
- Guangzhou University of Chinese MedicineGuangzhouChina,Guangdong Province Hospital of Traditional Chinese MedicineGuangzhouChina
| | - Xinglan Sun
- Guangzhou First People's HospitalGuangzhouChina
| | - Jiagen Xiang
- School of Nursing, Guangzhou University of Chinese MedicineGuangzhouChina
| | - Yanan Hu
- School of Nursing, Guangzhou University of Chinese MedicineGuangzhouChina
| | - Meizhen Lin
- Guangzhou University of Chinese MedicineGuangzhouChina,Guangdong Province Hospital of Traditional Chinese MedicineGuangzhouChina
| | - Yibing Tan
- School of Nursing, Guangzhou University of Chinese MedicineGuangzhouChina
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Chauvette A, Kleib M, Paul P. Developing nursing students' informatics competencies - A Canadian faculty perspective. Int J Nurs Educ Scholarsh 2022; 19:ijnes-2021-0165. [PMID: 35697520 DOI: 10.1515/ijnes-2021-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/26/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to explore nursing faculty experiences in integrating digital tools to support undergraduate students' learning and development of nursing informatics competencies. METHODS This focused ethnography study used a combination of semi-structured interviews, document reviews, and field visits. Convenience and snowball sampling were applied to recruit participants. Data were analyzed concurrently with data collection, using thematic analysis. RESULTS Twenty-one faculty members from nine undergraduate nursing programs in Western Canada participated. Themes discussed include: 1) meaning of the term nursing informatics, 2) faculty perceived nursing informatics competence, 3) developing students' nursing informatics competencies, 4) facilitators, and 5) challenges. CONCLUSIONS Nursing faculty are relatively engaged in developing students' informatics competencies. However, challenges must be addressed and faculty need more support to improve their own informatics capacity. Implications for Practice and Research: This study has implications for faculty, nursing program administrators, and nursing organizations.
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Affiliation(s)
- Amelia Chauvette
- Health and Social Development, Okanagan College, Penticton, BC, Canada
| | - Manal Kleib
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Pauline Paul
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Wisnesky UD, Paul P, Olson J, Dahlke S. Perceptions and experiences of functional mobility for community‐dwelling older people: A focused ethnography. Int J Older People Nurs 2022; 17:e12464. [DOI: 10.1111/opn.12464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/07/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Uirá Duarte Wisnesky
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
- Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada
| | - Pauline Paul
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
| | - Joanne Olson
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
| | - Sherry Dahlke
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
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Lauritzen J, Sørensen EE, Pedersen PU, Bjerrum MB. Needs of carers participating in support groups and caring for a person with dementia: A focused ethnographic study. Dementia 2022; 21:1219-1232. [DOI: 10.1177/14713012211072928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims The aim is to explore and understand how support group participation meets carers’ perceived needs for information and social and emotional support when caring for a person with dementia who lives at home. Design Focused ethnographic design. Methods Participant observations and semi-structured interviews with 25 carers were conducted. An inductive content analysis of the data was performed. Findings Two themes were identified: “Strengthening the sense of self” and “Managing uncertain benefits.” Conclusion Carers’ level of information about dementia was partly met, thereby strengthening their sense of self and joy. Maintaining shared decision-making in financial matters was viewed as an expression of respect and reciprocity. Getting acquainted with peers and dementia coordinators was viewed as emotional and social support but was also used strategically to gain easier access to health care services. By fulfilling their needs, support group meetings became meaningful, which motivated carers to continue providing care.
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Affiliation(s)
- Jette Lauritzen
- Department of Public Health, Health, Aarhus University, Aarhus, Denmark; and Department of Nursing, Aarhus, Faculty of Health Sciences, VIA University College, Aarhus, Denmark
| | - Erik E Sørensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark; and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Preben U Pedersen
- Danish Center of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Merete B Bjerrum
- Department of Public Health, Health, Aarhus University, Aarhus, Denmark
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Richter S, Sullivan G, Urindwanayo D, Kelly I. Experiences of nurse educators facilitating and teaching in an international setting. Int J Nurs Pract 2021; 28:e13028. [PMID: 34907622 DOI: 10.1111/ijn.13028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 06/20/2021] [Accepted: 11/14/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Multiple studies focus on the experiences of visiting students from high resource regions that participated in clinical placements in lower resource countries but less focus on the experiences of the educators accompanying students. AIM The purpose of this study was to explore the experiences of educators during an international clinical placement of nursing students in a country in West Africa. METHODS We implemented a focussed ethnographic design. We purposively sampled educators who accompanied students on an international clinical placement. Data collection from 2018 to 2019 consisted of in-depth individual interviews. We utilized Roper and Shapira's (2000, 10.4135/9781483328294.) data analysis process, which includes coding keywords, identifying patterns and theorizing. FINDINGS Three themes emerged from the data: rewards in accompanying students, challenges experienced and the need for mentoring and continuous support. Educators found it rewarding to see growth in students, how students developed as global citizens, how students developed critical thinking and problem-solving skills and create lifelong friendships. CONCLUSION Educators who accompany nursing students to international clinical placement experience valuable learning and challenging issues. Educators must navigate, support and advance student learning when on an international placement. It is crucial to have adequate institutional support from both the home and host country.
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Affiliation(s)
- Solina Richter
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ginger Sullivan
- School of Nursing, University of Victoria, Victoria, British Columbia, Canada
| | | | - Isabelle Kelly
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Kumpula E, Ekstrand P, Gustafsson LK. Balancing security and care: Gender relations of nursing staff in forensic psychiatric care. Nurs Inq 2021; 29:e12478. [PMID: 34843144 DOI: 10.1111/nin.12478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 11/30/2022]
Abstract
This study departs from the built-in tension of the dual goals of forensic psychiatric care in Sweden, which are to protect society as well as to care for patients. The majority of violence that takes place is perpetrated by men. Therefore, the views of nursing staff on violence as a gendered phenomenon have an impact on the care provision. There is a need for further knowledge of how norms of violence are intertwined with the construction of gender. The aim of this study was to use a gender perspective to demonstrate the views of nursing staff on security and care and the consequences for their relationships with patients. The study adopts an ethnographic approach, with data consisting of field notes from participatory observations and interviews with nursing staff at two maximum-security clinics. We show how the perceptions of nursing staff about gender relations are based on heteronormative thinking, which affects their practice. This implies that if gender is ignored in relation to the dual goals, there is a risk of perpetrating patterns of unequal conditions. Therefore, it is vital to make gender visible to counteract unequal conditions for nursing staff and address patients' individual care needs.
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Affiliation(s)
- Esa Kumpula
- School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden
| | - Per Ekstrand
- Swedish Red Cross University College, Stockholm, Sweden
| | - Lena-Karin Gustafsson
- School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
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Al‐Shamaly HS. Patterns of communicating care and caring in the intensive care unit. Nurs Open 2021; 9:277-298. [PMID: 34536338 PMCID: PMC8685886 DOI: 10.1002/nop2.1061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/26/2021] [Accepted: 09/02/2021] [Indexed: 11/11/2022] Open
Abstract
Aim To explore the perceptions and experiences of nurses in communicating the care and caring in the intensive care unit (ICU). Design A focused ethnography. Methods This study was conducted in an Australian metropolitan hospital, in which data were gathered from multiple sources: participant observations, document reviews, interviews, and participant's additional written information ‐ over
six months (April‐September, 2014). The data were analysed thematically. Findings This study addressed inclusively communicating care and caring to patients, families, nurses and other health professionals in ICU. The findings identified main themes concerning the changing patterns of communicating the care and caring in ICU, various patterns of communication used, enablers and barriers of communicating care and caring, and significant issues in communicating care and caring in ICU. Documentation of patients’ psychological and emotional needs, and nurses’ caring behaviours are crucial. These findings need further consideration from all stakeholders.
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Dupuis-blanchard S, Maillet D, Thériault D, Leblanc F, Bigonnesse C. “Be Their Advocate”: Families’ Experience with a Relative in LTC during the COVID-19 Pandemic. Can J Aging 2021; 40:628-38. [DOI: 10.1017/s0714980821000398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractShortly after the COVID-19 pandemic was declared, strict visitor restrictions were issued for long-term care facilities (LTCFs). A year later, restrictions are still in place and they continue to impact family members who have limited or no in-person contact with their relative in LTCFs. The goal of this qualitative longitudinal focused ethnography was to understand the experience of family members who have a relative in a LTCF where visiting has been restricted during the pandemic. Seventeen family members participated in two interviews that were 6 months apart. Data analysis highlighted five key drivers, defined as the workforce, communication deficits, characteristics of care, public health directives, and autonomy of relative which in turn resulted in three main themes: psychological distress, surveillance, and visiting challenges. This study provides a glimpse into the difficult experiences of families with a relative residing in a LTCF in the province of New Brunswick.
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Okraku OO, Yohani S. Resilience in the Face of Adversity: a Focused Ethnography of Former Girl Child Soldiers Living in Ghana. Int Migration & Integration 2021. [DOI: 10.1007/s12134-020-00769-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tong CE, Sims-Gould J, Lusina-Furst S, McKay H. More than a meeting: identifying the needs of the community-based seniors' services sector as providers of health promotion services. BMC Res Notes 2021; 14:339. [PMID: 34461980 PMCID: PMC8404247 DOI: 10.1186/s13104-021-05753-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 08/20/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Many economically developed countries have seen a decline in publicly funded community programming. Within this context, community-based seniors' service (CBSS) organizations have been increasingly tasked to deliver programs to support the health and wellbeing of older citizens (e.g., home support, physical activity programs, and chronic disease management education). The primary objective of this study was to capture of the current needs of CBSS leaders in British Columbia, Canada, who attended a seminal event in the CBSS sector's development-the inaugural Summit on Aging. RESULTS Our evaluation of the Summit included: pre/post Summit surveys (N = 79/76), ethnographic observations, and follow-up interviews (n = 22). Our detailed evaluation plan may inform others undertaking similar data collection; the most informative results were derived from the follow-up interviews and our findings suggest that interviews may be sufficient for similar evaluations. Summit delegates identified key opportunities to strengthen the CBSS as a sector, including enhanced collaboration; improved mechanisms that foster connecting and collaborating; and more resources, including training and qualified staff, to increase their capacity to deliver community-based health services. These findings echo work already completed in the community-based health promotion sector.
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Affiliation(s)
- Catherine E Tong
- Centre for Hip Health & Mobility, University of British Columbia, Robert H.N. Ho Building, 7/F - 2635 Laurel St., Vancouver, BC, V5Z 1M9, Canada. .,School of Public Health & Health Systems, Faculty of Health, University of Waterloo, Waterloo, Canada.
| | - Joanie Sims-Gould
- Centre for Hip Health & Mobility, University of British Columbia, Robert H.N. Ho Building, 7/F - 2635 Laurel St., Vancouver, BC, V5Z 1M9, Canada.,Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sarah Lusina-Furst
- Centre for Hip Health & Mobility, University of British Columbia, Robert H.N. Ho Building, 7/F - 2635 Laurel St., Vancouver, BC, V5Z 1M9, Canada
| | - Heather McKay
- Centre for Hip Health & Mobility, University of British Columbia, Robert H.N. Ho Building, 7/F - 2635 Laurel St., Vancouver, BC, V5Z 1M9, Canada.,Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Wong JYH, Ho JWC, Lee AM, Fong DYT, Chu N, Leung S, Chan YYW, Lam SH, Leung IPF, Macfarlane D, Cerin E, Taylor AJ, Cheng KK. Lived experience of dietary change among Chinese colorectal cancer survivors in Hong Kong: A qualitative study. BMJ Open 2021; 11:e051052. [PMID: 34433608 PMCID: PMC8388278 DOI: 10.1136/bmjopen-2021-051052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This is a qualitative study which aims to understand the lived experience of dietary changes among Chinese survivors of colorectal cancer who participated in a dietary intervention. SETTING The surgical and oncological departments of four public hospitals in Hong Kong. PARTICIPANTS Fifty-five Chinese colorectal cancer survivors who were aged 18 years or above and had received potentially curative treatment in the surgical and oncological departments in Hong Kong were examined. Participants' mean age was 64 years, with 29 (53%) males. INTERVENTION A 12-month dietary intervention delivered via face-to-face motivational interviews, fortnightly motivational phone calls, monthly electronic pamphlets, quarterly newsletters and quarterly group meeting. OUTCOME MEASURE We adopted the qualitative approach to capture participants' perspectives and to apply the understanding pragmatically in everyday life. Content analysis was conducted. RESULTS We identified themes of motives to changes of dietary practices including (1) individual commitment to dietary change; (2) adaptive strategies in interpersonal contexts and (3) working with healthcare professionals during the journey. CONCLUSIONS The findings demonstrated how Chinese custom and culture posing unique challenges to colorectal cancer survivors and the need of having dietary advice from healthcare professionals. Participants were motivated to change their eating habits by support from family, friends and healthcare professionals. Our findings could help healthcare professionals provide specific dietary advice and guidance to Chinese colorectal cancer survivors. TRIAL REGISTRATION NUMBER NCT01708824.
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Affiliation(s)
- Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Judy Wai Chu Ho
- Division of Colorectal Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Antoinette Marie Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Natural Chu
- Division of Colorectal Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Sharron Leung
- Division of Nursing Education, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Y Y Wynnie Chan
- School of Professional and Continuing Education, University of Hong Kong, Hong Kong, Hong Kong
| | - Sharon Hs Lam
- Division of Colorectal Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Ivy P F Leung
- Department of Dietetics, Queen Elizabeth Hospital, Hospital Authority Kowloon Central Cluster, Kowloon, Hong Kong
| | - Duncan Macfarlane
- Institute of Human Performance, University of Hong Kong, Hong Kong, Hong Kong
| | - Ester Cerin
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Aliki J Taylor
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
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Saint Arnault D, Sinko L. Comparative Ethnographic Narrative Analysis Method: Comparing Culture in Narratives. Glob Qual Nurs Res 2021; 8:23333936211020722. [PMID: 34423074 PMCID: PMC8375330 DOI: 10.1177/23333936211020722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/22/2022] Open
Abstract
Narrative data analysis aims to understand the stories’ content, structure, or function. However narrative data can also be used to examine how context influences self-concepts, relationship dynamics, and meaning-making. This methodological paper explores the potential of narrative analysis to discover and compare the processes by which culture shapes selfhood and meaning making. We describe the development of the Comparative Ethnographic Narrative Analysis Method as an analytic procedure to systematically compare narrators’ experiences, meaning making, decisions, and actions across cultures. This analytic strategy seeks to discover shared themes, examine culturally distinct themes, and illuminate meta-level cultural beliefs and values that link shared themes. We emphasize the need for a shared research question, comparable samples, shared non-biased instruments, and high-fidelity training if one uses this qualitative method for cross-cultural research. Finally, specific issues, trouble-shooting practices, and implications are discussed.
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Bradley G, Baker K, Bailey C. The meaning of rehabilitation: a qualitative study exploring perspectives of occupational therapists and physiotherapists working with older people in acute care. Disabil Rehabil 2021; 43:2295-2303. [PMID: 31800328 DOI: 10.1080/09638288.2019.1697762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/22/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore how occupational therapists and physiotherapists constructed and interpreted the meaning of rehabilitation in relation to older people in acute care. DESIGN A focussed ethnographic study was undertaken, primarily using observation, interviewing and review of clinical records within one acute medical ward in a general hospital in the UK. Five patient participants gave consent for their episode of care to be studied, with observations and interviews primarily involving the identified patients and five occupational therapy and physiotherapy professionals. RESULTS Four themes were identified: rehabilitation as a process to facilitate physical improvement; rehabilitation as physiotherapy-led; rehabilitation as a place…but not here; and rehabilitation as a process which prioritises safety over function. Such conceptualisations of rehabilitation were recognised as rooted in social and historical perceptions and challenged the ideals of rehabilitation professionals. CONCLUSIONS The meaning of rehabilitation in acute care is shaped by a range of cultural, contextual and systemic influences. Recognising these influences, and subsequent challenges to rehabilitation ideals, can encourage professionals to work towards meaningful change.Implications for RehabilitationA reductionist version of rehabilitation was evident within this context which placed value on physical improvement, achieving optimum safety and led by physiotherapy.This version of rehabilitation was unsatisfactory to occupational therapists and physiotherapists in this setting and different to their ideals.Where rehabilitation may be associated with another place, practitioners should reflect on whether this is influencing patients becoming a lower priority for interventions whilst waiting and address this, if required, within their own reasoning, prioritisation and delegation.Those who recognise similarities with their own practice context could individually, and within teams, revisit definitions of rehabilitation to notice, document and have conversations about the ideals of their professions versus the reality of practice.Occupational therapists and physiotherapists can be champions for organisational and cultural change to promote rehabilitation as a multi-disciplinary phase of care working towards optimising improvements in wellbeing, function and safety, irrespective of location.
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Affiliation(s)
- Gemma Bradley
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
| | - Katherine Baker
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
| | - Catherine Bailey
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
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Negarandeh R, Hassankhani H, Jabraeili M, Abbaszadeh M, Best A. Health care staff support for mothers in NICU: a focused ethnography study. BMC Pregnancy Childbirth 2021; 21:520. [PMID: 34289802 PMCID: PMC8296702 DOI: 10.1186/s12884-021-03991-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/08/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Mothers of premature newborns in the neonatal intensive care unit (NICU) have complex needs and require a significant amount of support during the NICU admission. However, little is known about mothers' support needs in the NICU. This study aimed to explore health care staff and mothers' experiences of meeting the mothers support needs in the NICU. This study aimed to explore health care staff and mothers' experiences of meeting the mothers' support needs in the NICU. METHODS A focused ethnographic approach was adopted. Observations and interviews with 21 mothers, 18 nurses, and five physicians were undertaken over a seven months period. Qualitative data analysis was conducted using the Roper and Shapira (2000) five-step framework. RESULT Two main themes of "insufficient provision of the mothers' support needs" (subthemes: inadequate accompany of the mothers in care, assigning monitoring and care to the mothers, inadequate sharing of medical the information) and "supporting the mothers in certain circumstances" (subthemes: reassuring the mothers, supporting the mothers with reduced functional capacity, providing information) were obtained. CONCLUSION The mothers experienced a gap between expected and actual support provided by health care staff. Although, the health care staff believed that mothers' support was a necessity, it was not their main concerns, and they considered workload as a barrier for the mothers support in the NICU.
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Affiliation(s)
- Reza Negarandeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Hassankhani
- Center of Qualitative Studies, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahnaz Jabraeili
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Amy Best
- Campus Teacher, School of Nursing, Massey University Wellington, Wellington, Australia
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Richter S, Yohani S, Vallianatos H, Higginbottom G. Health literacy as a determinant of healthy eating and active living in Canadian immigrant youth. Health Promot Int 2021; 36:406-416. [PMID: 32754742 DOI: 10.1093/heapro/daaa053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of the study was to explore health literacy and community engagement in relation to active living with newcomer young people and their families. We employed a case study design and a participatory approach. The data collected included photovoice and photo-assisted focus group interviews, which included an initial stage when youth participated in workshops creating collages on healthy living. A follow-up focus group centred on discussion of the collages with subsequent training on the photovoice method and the use of the cameras, and a second focus group, which incorporated photos taken by participants during the programming and their leisure time. Different themes were developed from the data: active living, balance, body talk, challenges, environment and health, culture and health, family, health and food, health and safety, knowledge, source of knowledge, peers and friends, personal hygiene, recreational activities, socio-emotional health, social isolation and spiritual health. Excerpts were taken from the different themes to demonstrate the immigrant/refugee youths' understanding of levels of health literacy and its contribution to healthy eating and active living. The qualitative findings are presented under the different tenets of health literacy. Health literacy extends beyond the individual level and effects the whole family and communities; intervention need to extend to include community connections and involvement activities. Future research needs to focus on the long-term effects of critical health literacy among immigrant communities.
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Affiliation(s)
- Solina Richter
- Faculty of Nursing, 11405 87th Avenue, Edmonton, AB, Canada T6G 1C9
| | - Sophie Yohani
- Department of Educational Psychology, 6-102 Education North University of Alberta, Edmonton, AB, Canada T6G 2G5
| | - Helen Vallianatos
- Department of Anthropology, University of Alberta, 13-15 HM Tory Building University of Alberta, Edmonton, Alberta, Canada T6G 2H4
| | - Gina Higginbottom
- School of Health Sciences, University of Nottingham, Medical School Queen's Medical Centre, Nottingham NG7 2HA
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Abstract
Purpose: Intimate care procedures, such as bathing and toileting, are often regarded as simple, humble tasks. However, the provision of such care transforms a very private, personal activity into a social process. Understanding this complex process and the psychological impact it has on those providing and receiving care is critical in order to mitigate potential distress. The purpose of this study to examine the experience of delivering and receiving intimate personal care in the NH. Methods: A focused ethnographic approach with participant observation, semi-structured interviews, focus groups and drop-in sessions, document review, and field notes. Data were analysed using constant comparative analysis. Results: Quality care in this context is predicated on the care provider recognition of the emotional impact of care delivery on the care recipient. Our analysis identified that the overarching theme, of providing quality person-centred intimate care, requires creating and maintaining a relational space that promotes integrity. Conclusions: The provision of intimate personal care consists of a complex interplay at the level of resident/care provider interaction (micro level); health care organization (meso level); and policy (macro level). Each of these levels interacts with and influences the other two. The components identified in our model may provide the basis from which to further examine resident experiences of quality intimate personal care.
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Affiliation(s)
- Genevieve N Thompson
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Susan E McClement
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sheryl Peters
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harvey Chochinov
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Laura Funk
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, Manitoba, Canada
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Kalogirou MR, Dahlke S, Davidson S, Yamamoto S. How the hospital context influences nurses' environmentally responsible practice: A focused ethnography. J Adv Nurs 2021; 77:3806-3819. [PMID: 34138473 DOI: 10.1111/jan.14936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 04/08/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022]
Abstract
AIM To describe ways in which a hospital context, physically and culturally, influences nurses' abilities to promote and engage with environmentally responsible practice. DESIGN A focused ethnographic study. METHODS Data were collected during May and August, 2019. Nurses (n = 22) working in the emergency room and three medicine units within a large Western Canadian hospital were invited to participate. Semi-structured interviews were conducted, and observations were collected. Reporting is in accordance with the consolidated criteria for reporting qualitative research. RESULTS Three themes were identified: patient care not environmental care, organizational role and operational efficiency. Overall, participants indicated patient care was their primary priority, and due to their workload, they were unable to simultaneously consider the environmental impact of their work. Participants stated they had difficulties practicing in environmentally responsible ways because they felt unsupported by their hospital organization. Regardless, there was a desire for the organization to support environmentally responsible practices. CONCLUSION Climate change is a major health concern, and partnership between hospitals and nurses is necessary to ensure environmentally responsible healthcare is delivered. We suggest both a top-down and bottom-up approach to help develop hospital contexts that are relevant and environmentally responsible. IMPACT Nurses have a professional responsibility to address climate change, yet this study identified that nurses found it challenging to practice in environmentally responsible ways within the hospital context. Challenges they faced are related to their workload, their misaligned nursing priorities and, more importantly, because they felt unsupported by their hospital. Findings are important to both the nursing profession as well as other hospital leaders so that a culture of environmentally responsible healthcare can be developed within hospitals.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Shelby Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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van Schothorst-van Roekel J, Weggelaar-Jansen AMJWM, Hilders CCGJM, De Bont AA, Wallenburg I. Nurses in the lead: a qualitative study on the development of distinct nursing roles in daily nursing practice. BMC Nurs 2021; 20:97. [PMID: 34120594 PMCID: PMC8201810 DOI: 10.1186/s12912-021-00613-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Transitions in healthcare delivery, such as the rapidly growing numbers of older people and increasing social and healthcare needs, combined with nursing shortages has sparked renewed interest in differentiations in nursing staff and skill mix. Policy attempts to implement new competency frameworks and job profiles often fails for not serving existing nursing practices. This study is aimed to understand how licensed vocational nurses (VNs) and nurses with a Bachelor of Science degree (BNs) shape distinct nursing roles in daily practice. Methods A qualitative study was conducted in four wards (neurology, oncology, pneumatology and surgery) of a Dutch teaching hospital. Various ethnographic methods were used: shadowing nurses in daily practice (65h), observations and participation in relevant meetings (n=56), informal conversations (up to 15 h), 22 semi-structured interviews and member-checking with four focus groups (19 nurses in total). Data was analyzed using thematic analysis. Results Hospital nurses developed new role distinctions in a series of small-change experiments, based on action and appraisal. Our findings show that: (1) this developmental approach incorporated the nurses’ invisible work; (2) nurses’ roles evolved through the accumulation of small changes that included embedding the new routines in organizational structures; (3) the experimental approach supported the professionalization of nurses, enabling them to translate national legislation into hospital policies and supporting the nurses’ (bottom-up) evolution of practices. The new roles required the special knowledge and skills of Bachelor-trained nurses to support healthcare quality improvement and connect the patients’ needs to organizational capacity. Conclusions Conducting small-change experiments, anchored by action and appraisal rather than by design, clarified the distinctions between vocational and Bachelor-trained nurses. The process stimulated personal leadership and boosted the responsibility nurses feel for their own development and the nursing profession in general. This study indicates that experimental nursing role development provides opportunities for nursing professionalization and gives nurses, managers and policymakers the opportunity of a ‘two-way-window’ in nursing role development, aligning policy initiatives with daily nursing practices. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00613-3.
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Affiliation(s)
| | | | - Carina C G J M Hilders
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University, Rotterdam, The Netherlands
| | - Antoinette A De Bont
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University, Rotterdam, The Netherlands
| | - Iris Wallenburg
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University, Rotterdam, The Netherlands
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Mazzini E, Soncini F, Cerullo L, Genovese L, Apolone G, Ghirotto L, Mazzi G, Costantini M. A focused ethnography in the context of a European cancer research hospital accreditation program. BMC Health Serv Res 2021; 21:446. [PMID: 33975580 PMCID: PMC8111912 DOI: 10.1186/s12913-021-06466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/28/2021] [Indexed: 05/31/2023] Open
Abstract
Background A quality accreditation program (AP) is designed to guarantee predefined quality standards of healthcare organizations. Evidence of the impact of quality standards remains scarce and somewhat challenging to document. This study aimed to investigate the accreditation of a cancer research hospital (Italy), promoted by the Organization of European Cancer Institutes (OECI), by focusing on the individual, group, and organizational experiences resulting from the OECI AP. Methods A focused ethnography study was carried out to analyze the relevance of participation in the accreditation process. Twenty-nine key informants were involved in four focus group meetings, and twelve semistructured interviews were conducted with professionals and managers. Inductive qualitative content analysis was applied to examine all transcripts. Results Four main categories emerged: a) OECI AP as an opportunity to foster diversity within professional roles; b) OECI AP as a possibility for change; c) perceived barriers; and d) OECI AP-solicited expectations. Conclusions The accreditation process is an opportunity for improving the quality and variety of care services for cancer patients through promoting an interdisciplinary approach to care provision. Perceiving accreditation as an opportunity is a prerequisite for overcoming the barriers that professionals involved in the process may report. Critical to a positive change is sharing the values and the framework, which are at the basis of accreditation programs. Improving the information-sharing process among managers and professionals may limit the risk of unmet expectations and prevent demotivation by future accreditation programs. Finally, we found that positive changes are more likely to happen when an accreditation process is considered an activity whose results depend on managers’ and professionals’ joint work.
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Affiliation(s)
- Elisa Mazzini
- Azienda USL - IRCCS di Reggio Emilia, viale Umberto I, 50, 42123, Reggio Emilia, Italy
| | - Francesco Soncini
- Istituto Ortopedico Rizzoli - IRCCS, Via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy
| | - Loredana Cerullo
- Azienda USL - IRCCS di Reggio Emilia, viale Umberto I, 50, 42123, Reggio Emilia, Italy
| | - Lucia Genovese
- Azienda USL - IRCCS di Reggio Emilia, viale Umberto I, 50, 42123, Reggio Emilia, Italy
| | - Giovanni Apolone
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Luca Ghirotto
- Azienda USL - IRCCS di Reggio Emilia, viale Umberto I, 50, 42123, Reggio Emilia, Italy
| | - Giorgio Mazzi
- Azienda USL - IRCCS di Reggio Emilia, viale Umberto I, 50, 42123, Reggio Emilia, Italy
| | - Massimo Costantini
- Azienda USL - IRCCS di Reggio Emilia, viale Umberto I, 50, 42123, Reggio Emilia, Italy.
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Mashallahi A, Rahmani F, Gholizadeh L, Ostadtaghizadeh A. Nurses' experience of caring for people living with HIV: a focused ethnography. Int Nurs Rev 2021; 68:318-327. [PMID: 33969882 DOI: 10.1111/inr.12667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 12/11/2020] [Accepted: 02/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Healthcare providers have been found to have limited knowledge and skills in interacting with people living with HIV. These factors can adversely affect providers' practice, jeopardize their safety and compromise the care of the patients. AIMS This study aimed to explore the experiences of Iranian nurses who were caring for patients with HIV. METHODS A focused ethnography approach was used. Participants consisted of 12 nurses working in teaching hospitals affiliated to Urmia University of Medical Sciences and recruited by purposeful sampling. Semi-structured interviews, field observations and field notes were used for data collection. Data were analysed employing content analysis. FINDINGS Three main themes emerged from the analysis of the participants' experiences of providing care to patients with HIV: 'excessive fear of being infected', 'concerns about the possible consequences' and 'lack of self-confidence in care provision'. DISCUSSION/CONCLUSION Nurses have experienced a great deal of fear of self and cross-contamination when providing care to people living with HIV. Social stigma and discrimination against people living with HIV amplified the nurses' experience of fear. Providing appropriate education and training for nurses can improve their attitudes, emotions and self-confidence while providing care to such people and increasing the quality of care provided. IMPLICATIONS FOR NURSING AND HEALTH POLICY Planning more educational programmes focusing on improving their misunderstandings about HIV could result in positive outcomes: for nurses to provide high-quality care and for people living with HIV who receive this care. The healthcare system should consider the culture of care provided by nurses to these people.
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Affiliation(s)
- A Mashallahi
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - F Rahmani
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - L Gholizadeh
- Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - A Ostadtaghizadeh
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Bradley G, Baker K, Bailey C. Exploring how occupational therapists and physiotherapists evaluate rehabilitation potential of older people in acute care. Br J Occup Ther 2021. [DOI: 10.1177/03080226211011386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Evaluations of rehabilitation potential are an everyday occurrence, yet the concept is poorly understood and there is a lack of understanding about the reasoning process. This study aimed to explore how occupational therapists and physiotherapists evaluated the rehabilitation potential of older people following an acute hospital admission. Method Focused ethnography was utilised, primarily using observation, interviewing and review of records within one acute medical ward in a general hospital in the United Kingdom. Five patient participants gave consent for their episode of care to be studied, for interactions with professionals to be observed and for their clinical records to be reviewed. Three occupational therapists and two physiotherapists then participated in individual interviews. Findings Thematic analysis of data led to the identification of a four-stage reasoning process. The four stages are as follows: gathering baseline information; provision of curative and supportive interventions; provision and monitoring of rehabilitative interventions; the evaluation of rehabilitation potential and decision about the subsequent pathway. Conclusions The reasoning process illustrates the professional reasoning of occupational therapists and physiotherapists when evaluating rehabilitation potential for older adults in acute care. However, it also highlights vulnerabilities to professional reasoning which may contribute to subjectivity, inconsistency or risk to patients.
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Affiliation(s)
- Gemma Bradley
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK
| | - Katherine Baker
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK
| | - Catherine Bailey
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK
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Smith L, Phillipson L, Knight P. Re-imagining care transitions for people with dementia and complex support needs in residential aged care: using co-designed sensory objects and a focused ethnography to recognise micro transitions. Ageing and Society. [DOI: 10.1017/s0144686x2100043x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The concept of transition is often used in health and lifecourse research to understand a significant movement from one state or place to another. While people with dementia experience more major transitions than their peers, they are often excluded from transitional care research. This study set out to develop meaningful transitional supports for people with dementia and complex support needs who were undertaking a significant planned geographical transition from their current residential aged care facility to a new purpose-built facility. Using the language of complex support needs acknowledges that participants in this study have a breadth and depth of need, including cognitive, physical, psycho-social and communication impairments and social and cultural disadvantage associated with ageing, institutionalisation and social isolation. To support their move, Participatory Action Research was used to support the co-creation of transitional objects (personalised scarves and blankets) with 15 people with dementia, their families and care staff. Whilst these objects were useful in supporting transition, it was not in the way we imagined. Whilst our initial focus had been on supporting a significant geographical transition, rather it was four types of micro transitions in which the transitional objects were used: small physical transitions (from one place to another); social transitions (entering or exiting personal interactions); activity transitions (moving between activities); and time travel (moving between different times). Reimagining transitions from the perspective of people with dementia and complex support needs involves the recognition of the need for supports for micro as well as macro transitions. Personalised objects to support these everyday micro transitions have the potential to make the lives of people with dementia and complex support needs more manageable, meaningful and comprehensible. Reimagining transitions in dementia in this way helps us reimagine dementia itself, as a constantly fluid, dynamic and responsive series of moments which also has implications for the re-imagination of dementia care.
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Abstract
BACKGROUND As a non-European Union member state, Albania is increasingly orienting itself on Western models regarding human rights, patient rights, and legal regulations for healthcare. Due to its limited fiscal and legal power, enforcing legal and ethical regulations poses a major problem. AIM The aim of this study is to investigate nurse's knowledge and experiences regarding ethical and legal issues in Albanian elder care in state-funded and privately run institutions. RESEARCH DESIGN The study was conducted using an inductive and qualitative design, utilizing a focused ethnographic approach, based on Roper and Shapira's framework. METHOD Data were collected between June 2017 and September 2018 using participant observation, field notes, and semi-structured interviews with 15 nurses in seven different elder care institutions. In total, 100 h of observation and 15 interviews were performed. Data analysis was based on Mayring's qualitative content analysis. ETHICAL CONSIDERATION The approval for the study was obtained from UMIT-The Health and Life Sciences University, Austria. FINDINGS The findings of the study fell into the following main categories: "Everyday care issues," "End-of-life issues," "Legal issues," and "Ethical-legal education and conflicts." DISCUSSION The participants reported many ethical and legal issues when describing their everyday challenges and displayed a strong lack of ethical and legal education. Despite a wide spectrum in the quality of care between private and state-funded nursing homes, older people mostly do not know their own diagnosis. CONCLUSION This study indicates that further ethical and legal education is needed. Furthermore, nurses need to be better prepared for ethical conflicts with families, as strengthening patient rights could come into conflict with traditional rights of the Albanian family.
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Affiliation(s)
- Nertila Podgorica
- UMIT-Private University for Health Sciences, Medical Informatics and Technology, Austria; FH Gesundheit-Health University of Applied Sciences Tyrol, Austria
| | | | | | - Daniela Deufert
- UMIT-Private University for Health Sciences, Medical Informatics and Technology, Austria
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Rio JHM, Fuller J, Taylor K, Muir-Cochrane E. The impact of workplace culture on the accountability of mental health nurses to involve consumers in care planning: A focused ethnography. Nurs Health Sci 2021; 23:255-262. [PMID: 33389799 DOI: 10.1111/nhs.12807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 02/03/2023]
Abstract
Recovery-oriented mental health practice guidelines recommend regular consumer involvement in care plans, yet in many acute settings, these are not routinely created thereby compromising accountability. This study explored the impact of workplace culture on the capacity of mental health nurses to involve consumers in care planning and consequently to work accountably. A focused ethnography was undertaken in one Australian inpatient unit involving mental health nurses and other health professionals. Data were derived from in-depth semistructured interviews with 12 nurses and 6 months of nonparticipant observation of multidisciplinary meetings and clinical handovers. Workplace culture had an impact on mental health nurses' accountability practices. A culture that prioritized reduction in length of stay resulted in less recovery-oriented care. Health professionals who paid more attention to crisis and risk management resulted in fewer opportunities for consumer-involved care planning.
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Affiliation(s)
- Josephien H M Rio
- College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,College of Medicine & Public Health, Flinders University, Bedford Park, South Australia, Australia.,Riverland Mallee Coorong Local Health Network (Mental Health Services), Berri, South Australia, Australia
| | - Jeffrey Fuller
- College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Kerry Taylor
- College of Medicine & Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Eimear Muir-Cochrane
- College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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46
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Kapofu LK. Researching the sociocultural: Modelling a responsive focused ethnography. Methodological Innovations 2021. [DOI: 10.1177/2059799120987785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Assuming a methodological posture, this work extends the increasing legitimacy of the sociocultural in qualitative studies. Confronted by sociological questions with potential anthropological answers, this study straddled ethnographies and invoked attributes from both conventional and focused ethnography in a responsive focused ethnography. Responsive-focused ethnography transcends the strictures of traditional sociocultural dichotomies in understanding contemporary institutional arrangements. Experience during its deployment hints a responsive explorative frame for cultural excavation devoid of any illusions of the hidden nature of sociocultural reality. Deployment of this model also demonstrated the possibility of more holistic focused ethnographies with utility in addressing sociological questions with anthropological understandings across diverse contexts.
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Kamei T, Yamamoto Y, Kanamori T, Tomioka S. A Prospective Longitudinal Mixed Methods Study of Program Evaluation in an Intergenerational Program: Intergenerational Interactions and Program Satisfactions Involving Non-Frail, Frail, Cognitively Impaired Older Adults, and School Aged-Children. Journal of Intergenerational Relationships 2021. [DOI: 10.1080/15350770.2020.1853650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Tomoko Kamei
- St. Luke’s International University, Tokyo, Japan
| | - Yuko Yamamoto
- Tokyo Healthcare University Chiba Faculty of Nursing, Funabashi, Japan
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Wan AN, Nasr AS. Return to learn: An ethnographic study of adolescent young adults returning to school post-concussion. J Clin Nurs 2021; 30:793-802. [PMID: 33351994 DOI: 10.1111/jocn.15617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/07/2020] [Accepted: 12/13/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE The Centers for Disease Control and Prevention estimates that 3.8 million concussions occur in the United States each year. Concussion symptoms can negatively impact the academic performance of adolescents after they return to school. The purpose of this study was to better understand the perceptions of parent-adolescent dyads as male and female adolescents returned to learn after sustaining a concussion. METHODS A qualitative ethnographic study of 10, English-speaking, parent-adolescent dyads was conducted, following the adolescents return to school after a recent concussion. Dyads were recruited from a Concussion Clinic in Menlo Park, California between October 2018 and October 2019. Adolescents were aged 14-16 years old. Each dyad participated in a semistructured interview. Interviews were subsequently transcribed and analysed using thematic analysis. This qualitative study design utilised COREQ (File S1). This study was approved by the Institutional Review Board and ethics committee. CONCLUSIONS Three categories were identified: adolescents feeling misunderstood by school staff about their injuries, adolescents feeling overwhelmed by their injuries, and academic accommodations lacking clarity and implementation. The overarching theme that emerged was clear: Parents and adolescents lacked consistent guidelines for the adolescents' return to learn after a concussion. RELEVANCE TO CLINICAL PRACTICE Post-concussion syndrome as a result of head injury is a complex condition that requires a multidisciplinary approach to treatment. This treatment should be individualised and appropriately adjusted to provide the adolescent with the most optimal environment for recovery. This study provides data to suggest that more guidance from the medical provider or treatment team is needed for teachers and school administrators in order to create an ideal return to learn environment for the adolescent who is recovering from a head injury.
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Affiliation(s)
- Anna N Wan
- Stanford Children's Hospital, Palo Alto, CA, USA
| | - Annette S Nasr
- Stanford Children's Hospital, Palo Alto, CA, USA.,Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.,Director Department of Nursing Research and Evidence-Based Practice, Stanford Children's Hospital, Palo Alto, CA, USA
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49
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Badanta B, Lucchetti G, Fernández-García E, Barrientos-Trigo S. Prevalence and factors associated with substance use among Chinese immigrants in Spain: A mixed-design study. Public Health Nurs 2020; 38:339-349. [PMID: 33368553 DOI: 10.1111/phn.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the use of tobacco, alcohol, and illicit drugs and its associated factors among Chinese immigrants living in Spain. DESIGN AND MEASURES A mixed-method design, using surveys and semi-structured interviews. SAMPLE A total of 133 Chinese immigrants and stakeholders were assessed in the quantitative study and 7 stakeholders were interviewed in the qualitative study. RESULTS The use of tobacco and alcohol was higher than the use of illicit drugs in Chinese immigrants. The prevalence of daily smokers was greater in men than in women (37.3% vs. 2.5%, p < .001). Men consumed more alcohol (76% vs. 50.6%, p = .004) and more frequently (21.6% daily vs. 2.4%, p = .024) than women. The use of illicit drugs was low and Cannabis was the most illicit drug consumed (4%). Qualitative data revealed that due to a great workload, the workers tended to avoid behaviors of illicit drug consumption, but not of alcohol and tobacco, in which the consumption is associated with business meetings and leisure. CONCLUSION This study found that Chinese immigrants in Spain consume more alcohol and tobacco than illicit drugs and that men have a high consumption compared to women. These findings reveal important cultural differences that should be addressed by public health managers in order to develop strategies that consider the characteristics of this population.
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Affiliation(s)
- Bárbara Badanta
- Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Seville, Spain.,Research Group under the Andalusian Research CTS 1050 Complex Care, Chronic and Health Outcomes Seville, Seville, Spain
| | - Giancarlo Lucchetti
- Research Group under the Andalusian Research CTS 1050 Complex Care, Chronic and Health Outcomes Seville, Seville, Spain.,School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Elena Fernández-García
- Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Seville, Spain.,Research Group under the Andalusian Research CTS 1050 Complex Care, Chronic and Health Outcomes Seville, Seville, Spain
| | - Sergio Barrientos-Trigo
- Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Seville, Spain.,Research Group under the Andalusian Research CTS 1050 Complex Care, Chronic and Health Outcomes Seville, Seville, Spain
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Latimer M, Sylliboy JR, Francis J, Amey S, Rudderham S, Finley GA, MacLeod E, Paul K. Co-creating better healthcare experiences for First Nations children and youth: The FIRST approach emerges from Two-Eyed seeing. Paediatr Neonatal Pain 2020; 2:104-112. [PMID: 35548261 PMCID: PMC8975202 DOI: 10.1002/pne2.12024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/29/2020] [Accepted: 05/03/2020] [Indexed: 11/06/2022]
Abstract
To achieve health, Indigenous people seek a life that balances mental, spiritual, emotional, and physical wellness, yet the scope of these four dimensions is not typically considered in the Western-based health system. Indigenous people experience ongoing pain and hurt in all these dimensions as a result of a colonial legacy that persists in current-day policy and care contexts. Exploring ways to support Indigenous people to embrace ways of being well and reducing chronic pain has not been a priority area in health research. This community-based, qualitative study in four First Nations communities involved conversation sessions with 188 First Nations children, youth, parents, and Elders and 32 professionals who practice in those communities. The purpose was to gather perspectives related to pain expression, care experiences, and the strategies to improve the healthcare encounter. Thematic analysis was used to identify a more culturally thoughtful approach for clinicians to consider when First Nations people seek care. Two-Eyed Seeing consisting of four iterative steps was used to co-create the FIRST approach validating for community members that their perspectives were heard and providing a clinical approach for culturally safe practices with children, youth, and families. An overarching theme in the results was a clearer understanding about how pain and hurt translate into participants' health experiences and their desire to have their knowledge reflected in their health care. Participants describe experiencing pain and hurt in all four dimensions of health and from a historical, cultural, and spiritual identity, as well as from a community, family, and individual perspective. The FIRST approach captures Indigenous knowledge relating to Family, Information, Relationship, Safe-Space, and Two-Eyed treatment in the healthcare encounter. Considerations of this approach in clinical practice could enhance respectful and trusting relationships, knowledge exchange for better care experiences, and potentially improvement of culturally sensitive outcomes for Indigenous people.
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Affiliation(s)
- Margot Latimer
- IWK Health Centre Halifax Nova Scotia Canada.,Dalhousie University Halifax Nova Scotia Canada
| | - John R Sylliboy
- IWK Health Centre Halifax Nova Scotia Canada.,McGill University Montreal Quebec Canada
| | - Julie Francis
- IWK Health Centre Halifax Nova Scotia Canada.,Eskasoni First Nation Health Centre Nova Scotia Canada
| | - Sharon Amey
- IWK Health Centre Halifax Nova Scotia Canada
| | | | - G Allen Finley
- IWK Health Centre Halifax Nova Scotia Canada.,Dalhousie University Halifax Nova Scotia Canada
| | | | - Kara Paul
- IWK Health Centre Halifax Nova Scotia Canada
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