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Mema B, Helmers A, Proulx C, Min KSK, Navne LE. Through the looking glass: qualitative study of critical care clinicians engaging in humanities. Intensive Care Med 2024; 50:427-436. [PMID: 38451286 DOI: 10.1007/s00134-024-07331-9] [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: 11/07/2023] [Accepted: 01/20/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Critical care medicine is facing an epidemic of burnout and consequent attrition. Interventions are needed to re-establish the medical field as a place of professional growth, resilience, and personal well-being. Humanities facilitate creation, reflection, and meaning-making, holding the promise of personal and community transformation. This study aimed to explore how clinicians engage with a humanities program, and what role and impact do the humanities play in their individual and collective journey. METHODS This is a qualitative study employing a phenomenological approach. Participants were faculty and trainees who participated in the program. Data consisted of (a) 60-h observations of humanities evenings, (b) more than 200 humanities artifacts brought by participants, and (c) 15 in-depth participant interviews. Data were analyzed inductively and reflectively by a team of researchers. RESULTS Participants were motivated to engage with the humanities curriculum because of past experiences with art, identifying a desire to re-explore their creativity to make meaning from their clinical experiences and a wish to socialize with and understand their colleagues through a different lens. The evenings facilitated self-expression, and inspired and empowered participants to create art pieces and re-engage with art in their daily lives. More importantly, they found a community where they could be vulnerable and supported, where shared experiences were discussed, emotions were validated, and relationships were deepened between colleagues. CONCLUSIONS Humanities may impact resilience and personal and community well-being by facilitating reflection and meaning-making of challenging clinical work and building bonds between colleagues.
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Affiliation(s)
- Briseida Mema
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Andrew Helmers
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Catherine Proulx
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- University of Toronto, Toronto, Canada
| | - Kyung-Seo Kay Min
- Rare Book School (RBS), University of Virginia, Charlottesville, USA
| | - Laura E Navne
- The Danish Center for Social Science Research, VIVE, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Carbonell-Soliva Á, Nouni-García R, López-Pineda A, Cordero-Fort A, Pérez-Jover V, Quesada JA, Orozco-Beltrán D, Nolasco A, Castellano-Vázquez JM, Mira-Solves JJ, Gil-Guillen VF, Carratala-Munuera C. Opinions and perceptions of patients with cardiovascular disease on adherence: a qualitative study of focus groups. BMC Prim Care 2024; 25:59. [PMID: 38365594 PMCID: PMC10870481 DOI: 10.1186/s12875-024-02286-8] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/25/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Cardiovascular diseases are becoming more frequent throughout the world. Adherence to both pharmacological and non-pharmacological treatment, as well as lifestyles, is important for good management and control of the disease. This study aims to explore the opinions and perceptions of patients with ischemic heart disease on the difficulties associated with therapeutic adherence. METHODS An interpretive phenomenological study was carried out using focus groups and one semi-structured interview. The MAXQDA qualitative data analysis program was used for inductive interpretation of the group discourses and interview. Data were coded, and these were grouped by categories and then consolidated under the main themes identified. RESULTS Two in-person focus groups and one remote semi-structured interview were performed. Twelve participants (6 men and 6 women) from the Hospital de San Juan de Alicante participated, two of them being family companions . The main themes identified were aspects related to the individual, heart disease, drug treatment, and the perception of the health care system. CONCLUSIONS Adhering to recommendations on healthy behaviors and taking prescribed medications for cardiovascular disease was important for most participants. However, they sometimes found polypharmacy difficult to manage, especially when they did not perceive the symptoms of their disease. Participants related the concept of fear to therapeutic adherence, believing that the latter increased with the former. The relationship with health professionals was described as optimal, but, nevertheless, the coordination of the health care system was seen as limited.
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Affiliation(s)
- Álvaro Carbonell-Soliva
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
| | - Rauf Nouni-García
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
- Institute of Health and Biomedical research of Alicante, Alicante Spain General University Hospital of Alicante, Diagnostic center, Fifth floor. Pintor Baeza street, 12, Alicante, 03110, Spain
| | - Adriana López-Pineda
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain.
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain.
- Foundation for the Promotion of Health and Biomedical Research of the Valencian, Community. N-332, 03550 San Juan de Alicante, Alicante, Spain.
| | - Alberto Cordero-Fort
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain
- Biomedical Network Research Center for Cardiovascular Diseases (CIBERCV), Madrid, 28029, Spain
| | - Virtudes Pérez-Jover
- Health Psychology Department, Miguel Hernandez University of Elche, Elche, Spain
| | - Jose A Quesada
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
| | - Domingo Orozco-Beltrán
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
- University Hospital of San Juan de Alicante, San Juan de Alicante, Alicante, 03550, Spain
| | - Andreu Nolasco
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - Jose Maria Castellano-Vázquez
- Comprehensive Center for Cardiovascular Diseases, Montepríncipe University Hospital, HM Hospitales Group, Madrid, Spain
| | | | - Vicente F Gil-Guillen
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
- Institute of Health and Biomedical research of Alicante, Alicante Spain General University Hospital of Alicante, Diagnostic center, Fifth floor. Pintor Baeza street, 12, Alicante, 03110, Spain
- General University Hospital of Elda, Alicante, 03600, Spain
| | - Concepción Carratala-Munuera
- Network for Research on Chronicity, Primary Care. and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Clinical Medicine Department, School of Medicine, University Miguel Hernández de Elche, Alicante, 03550, Spain
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Bahl NKH, Nafstad HE, Blakar RM, Øversveen E, Brodahl M, Ness O, Prilleltensky I. How older adults recovering from substance use problems experience mattering. BMC Health Serv Res 2023; 23:1453. [PMID: 38129831 PMCID: PMC10740266 DOI: 10.1186/s12913-023-10413-x] [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: 06/09/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
AIM Mattering (to feel valued and add value to self and others) is a fundamental human experience and mechanism in recovery. In this paper, we concern ourselves with the recovery of older adults with substance problems. This population is on the rise in many Western countries. To offer mattering enhancing programs for this group, more knowledge about later life mattering in service-assisted recovery processes is needed. This study aims to explore experiences of mattering in older adults receiving services to recover from substance use problems. METHODS A collaborative and deductive reflexive thematic approach was applied in analysing 23 interviews with participants using substance use services. Participants were recovering from different substance use problems: alcohol, medication and illegal substances. The participants were recruited from three different Norwegian social contexts: two urban and one medium size municipality. The age of the sample ranged from 65-80 years, with approximately equal numbers for those aged 60-69 (12 participants) and 70-80 (11 participants). Seven participants were women and 16 men. RESULTS Three main themes were identified in the analysis: "relational experiences of mattering and not mattering", "service-related experiences of mattering and not mattering" and "recovery and psychological sense of community as interrelated phenomena to experiences of mattering". The findings illustrate various nuanced experiences of mattering and not mattering in later life recovery processes. CONCLUSIONS Overall, the participants' mattering experiences rested on fair, healthy and positive community relationships and fair and attentive services, where participants could feel valued and also have a chance to add value to others. Experiences of not mattering were precipitated by lack of support, disrespect, devaluation and loss of relationships, and also by being ignored and not receiving fair treatment and help by professionals. Importantly, reciprocal and enhancing relations between mattering, recovery and relational PSOC seem to exist and to be significant for the older adults' access to substance use services. Several practical implications are suggested to promote the therapeutic and preventive potentials of later life mattering in recovery.
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Affiliation(s)
- Nina Kavita Heggen Bahl
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs hospital, Trondheim University Hospital, Klostergata 48, 7030, Trondheim, Norway.
| | - Hilde Eileen Nafstad
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
| | - Rolv Mikkel Blakar
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
| | - Emil Øversveen
- Department of Sociology and Political Science, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Morten Brodahl
- Norwegian National Advisory Unit On Concurrent Substance Abuse and Mental Health Disorders, Mental Health Division, Innlandet Hospital Trust, Divisjon Psykisk Helsevern, 2381, Brumunddal, Norway
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Isaac Prilleltensky
- School of Education and Human Development, University of Miami, Coral Gables, Florida, USA
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Mueller F, Bachar A, Arif MA, King GW, Stylianou AP, Sutkin G. Cognitive models for mentally visualizing a sharp instrument in a blind procedure. Global Surg Educ 2023; 2:79. [PMID: 37900008 PMCID: PMC10604355 DOI: 10.1007/s44186-023-00153-1] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/02/2023] [Accepted: 07/16/2023] [Indexed: 10/31/2023]
Abstract
Purpose Our objective was to understand the cognitive strategies used by surgeons to mentally visualize navigation of a surgical instrument through blind space. Methods We conducted semi-structured interviews with 15 expert and novice surgeons following simulated retropubic trocar passage on 3D-printed models of pelvises segmented from preop MRIs. Midurethral sling surgery involves blind passage of a trocar among the urethra, bladder, iliac vessels, and bowel while relying primarily on haptic feedback from the suprapubic bone (SPB) for guidance. Our conceptual foundation was based on Lahav's study on blind people's mental mapping of spaces using haptic cues. Participants detailed how they mentally pictured the trocar's location relative to vital anatomy. We coded all responses and used constant comparative analysis to generate themes, confirmed with member checking. Results Expert and novice participants utilized multiple cognitive strategies combined with haptic feedback to accomplish safe trocar passage. Some used a step-by-step route strategy, visualizing sequential 2D axial images of anatomy adjacent to the SPB. Others used a map strategy, forming global 3D pictures. Although these mental pictures vanished when they were "lost," a safe zone could be reestablished by touching the SPB. Experts were more likely to relate their body position to the trocar path and rely on minor variations in resistance. Novices were more inclined toward backtracking of the trocar. Conclusions Our findings may be extended to any blind surgical procedure. Teaching visualization strategies and incorporating tactile feedback can be used intraoperatively to help learners navigate their instrument safely around vital organs.
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Affiliation(s)
- Faith Mueller
- Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Austin Bachar
- Female Pelvic Medicine and Reconstructive Surgery, University of Missouri Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, USA
| | - Md A. Arif
- School of Science & Engineering, University of Missouri Kansas City, Kansas City, MO, USA
| | - Gregory W. King
- School of Science & Engineering, University of Missouri Kansas City, Kansas City, MO, USA
| | - Antonis P. Stylianou
- School of Science & Engineering, University of Missouri Kansas City, Kansas City, MO, USA
| | - Gary Sutkin
- Female Pelvic Medicine and Reconstructive Surgery, University of Missouri Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, USA
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Antonsen T, Stenberg C, Hansen KH, André B, Bogsti WB. Nursing students' experience of an alternative model for supervision during practical studies in the municipal health service: A qualitative study. Heliyon 2023; 9:e21719. [PMID: 38027589 PMCID: PMC10643253 DOI: 10.1016/j.heliyon.2023.e21719] [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: 05/12/2023] [Revised: 10/13/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Aim The aim of the study is to describe how Norwegian nursing students experience clinical practice when the Strengthened Supervision in Practice model is used together with peer learning. Background Clinical practice is one of the most important parts of nursing education and the nurse supervisor plays an important role in the education of nursing students. Challenges arise because nursing students do not always receive quality supervision in practice. The quality of supervision affects the learning outcomes and well-being of the students during clinical practice. To meet the challenge that students do not always receive high-quality supervision, we wanted to try out a new supervision model Strengthened Supervision in Practice. Peer learning was also tried out in clinical practice. Method The study used a qualitative design. Data were collected from three focus group interviews with a total of 11 nursing students participating. Findings Clinical nurses are the most competent to supervise and assess nursing students in clinical practice. Peer learning provides safety in a learning situation. Conclusions This study shows that the supervisor and their supervision competence are important for the student's learning. Cooperation with the lecturer in common meetings is important to make sure supervisors have quality guidance and assessment skills. The Strengthened Supervision in Practice model seems to meet expectations, but further research is necessary to develop the model further.
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Affiliation(s)
- Therese Antonsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway
| | - Carita Stenberg
- Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology(NTNU), N-2802, Gjøvik, Norway
| | - Kristin Hartveit Hansen
- Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology(NTNU), N-2802, Gjøvik, Norway
| | - Beate André
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway
| | - Wenche Bergseth Bogsti
- Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology(NTNU), N-2802, Gjøvik, Norway
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Dillon M, Olson R, Mescouto K, Costa N, Setchell J. How physiotherapists attend to the human aspects of care when working with people with low back pain: a thematic analysis. Health Sociol Rev 2023; 32:277-293. [PMID: 36632019 DOI: 10.1080/14461242.2022.2161927] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Pain is a multidimensional experience. Physiotherapy has attempted to enhance earlier biomedical approaches to patient care through approaches like the 'biopsychosocial' model. Nevertheless, physiotherapy continues to focus on biomedical and/or behavioural aspects of care. We critically investigated how physiotherapists attend to human (psychosocial, emotional, existential, and moral) aspects of low back pain care. We co-analysed ethnographic data with researchers, patients, and physiotherapists using concepts of conforming, tinkering and abandoning 'scripts'. Data included observations of 28 physiotherapy interactions between 26 patients and 10 physiotherapists and 7 researcher-clinician dialogues. Analysis suggests when conforming to scripts, clinicians have difficulty recognising and responding to emotions; time pressure limited clinicians focus, and a biological focus often distracted from psychosocial aspects of people's back pain experiences. In contrast, tinkering with or abandoning scripts allowed space to broaden the focus. Drawing from theorists such as Butler (1999) and Gibson et al. (2020) our analysis contributes to health sociology, arguing that 'tinkering' with or 'abandoning' scripts can foster more humanistic, flexible and reflexive approaches to care. Although health sociologists have explored tinkering, abandoning is new; within physiotherapy, it encapsulates being able to respond with agility to non-physical elements of care without constraint from traditional ways of thinking and doing.
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Affiliation(s)
- M Dillon
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - R Olson
- School of Social Science, The University of Queensland, Brisbane, Australia
| | - K Mescouto
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - N Costa
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Public Health, The University of Sydney, Sydney, Australia
| | - J Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Manojlovich M, Blok A, Wright N, Azhari E, Farris KB, Friese CR, Mackler E, Titler M, Byrnes M. Photo elicitation, an approach to better understanding the patient experience with OAAs: pilot study and future implications. Support Care Cancer 2023; 31:652. [PMID: 37878093 DOI: 10.1007/s00520-023-08128-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023]
Abstract
PURPOSE Oral anti-cancer agents (OAAs) represent a new frontier in cancer treatment, but we do not know how well patients incorporate the strategies that they are taught for managing the side effects of OAAs into their daily lives. The purpose of this study was to understand how OAA side effects influenced patients' lives and what strategies patients used to manage them. METHODS The study used an interpretive descriptive design utilizing photo elicitation interviews (PEI). Two pharmacists employed at the study ambulatory oncology clinic assisted with recruitment. Participants took photos and subsequent interviews focused on talking to participants about each photo, eliciting participant perspectives describing side effects of OAAs and management strategies. A directed content analysis approach was used to analyze the transcribed interviews. RESULTS A total of nine participants were included in the study. Three themes and associated sub-themes emerged: making changes to nutritional habits due to OAA side effects (hydration and food), strategies to alleviate OAA side effects (medication and non-medication related), and methods of coping with OAA effects (intra- and interpersonal). Changing nutritional habits was an important strategy to manage OAA side effects. Medication-related strategies to alleviate OAA side effects could be nuanced and, additionally, there was wide variability in coping methods used. CONCLUSION Patient education on OAAs and side effects is not always tailored to each unique patient and their circumstances. This study uncovered how participants devised their own distinct strategies to prevent or manage OAA side effects in an effort to help improve patients' experiences when taking OAAs.
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Affiliation(s)
| | - Amanda Blok
- US Department of Veterans Affairs (VA) Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Nathan Wright
- US Department of Veterans Affairs (VA) Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Emily Azhari
- University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Karen B Farris
- University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | | | - Emily Mackler
- University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Marita Titler
- University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Mary Byrnes
- Department of Surgery, University of Michigan School of Medicine, Ann Arbor, MI, USA
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Moro-López-Menchero P, Fernández-de-Las-Peñas C, Güeita-Rodríguez J, Gómez-Sanchez SM, Gil-Crujera A, Palacios-Ceña D. Carpal tunnel syndrome in the workplace. Triggers, coping strategies, and economic impact: A qualitative study from the perspective of women manual workers. J Hand Ther 2023; 36:817-824. [PMID: 37591728 DOI: 10.1016/j.jht.2023.06.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/28/2023] [Accepted: 06/02/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) may lead to significant work limitations, especially in female manual workers. There is scarce evidence on the perspective of female manual workers with CTS. PURPOSE To explore the perspective of female workers who suffer from CTS regarding triggers, coping strategies, and economic impact. STUDY DESIGN A qualitative phenomenological study was conducted involving 18 manual workers with CTS diagnosed by the neurology service of a public hospital. METHODS Purposive sampling was applied, and data were collected using in-depth interviews and researchers' notes. An inductive thematic analysis was applied to identify themes reflecting the participants' experience. Guba and Lincoln criteria were applied to establish the trustworthiness of the data. RESULTS The mean age of participants was 40.06 years (SD 9.86). Four themes were identified: (a) coping with work limitations; (b) work activities that aggravate symptoms; (c) relationships at work; and (d) the economic burden of CTS. The effect of work on CTS, daily constraints, work situations that trigger the symptoms, and the strategies used by participants to adapt to their work are described. In addition, they recounted how relationships with managers and coworkers are modified and how CTS affects family finances. CONCLUSIONS The findings describe aggravating factors among working women, coping strategies used, and the social and occupational impact of CTS.
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Affiliation(s)
- Paloma Moro-López-Menchero
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos, Universidad Rey Juan Carlos, Alcorcón, Spain.
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Manual Therapy, Dry Needling and Therapeutic Exercise, Universidad Rey Juan Carlos, Alcorcón, Spain.
| | - Javier Güeita-Rodríguez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos, Universidad Rey Juan Carlos, Alcorcón, Spain.
| | - Stella Maris Gómez-Sanchez
- Research Group GAMDES, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Spain.
| | - Antonio Gil-Crujera
- Research Group GAMDES, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Spain.
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos, Universidad Rey Juan Carlos, Alcorcón, Spain.
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Hörberg U, Otteborn H, Syrén S. Family orientation in forensic psychiatric care: An uncertain foundation of distrust. Arch Psychiatr Nurs 2023; 46:65-70. [PMID: 37813506 DOI: 10.1016/j.apnu.2023.08.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/10/2023] [Accepted: 08/17/2023] [Indexed: 10/17/2023]
Abstract
The patients in forensic psychiatric care (FPC) are affected by their illness and the care they receive, but their families are also affected. The family-systems nursing theory has the mutual influence of the family as constituting a core starting point for the health of both the individual and the family and focuses on helping families cope with their situation. The aim of the study was to describe healthcare professionals' experiences of their family-oriented work within FPC. The findings are presented in three themes: A longed-for reciprocity within and with the family, Maintaining a problem-oriented and individual-based tradition, and Caring built on a foundation of distrust. Family-oriented work among healthcare professionals in FPC can only be realized through a pervasive shift in perspective from a predominantly problem-oriented patient focus towards a focus on interactional interplay and patterns. This is based on the belief that there are potential resources for patients and families to change in a healthy way. An educational intervention is suggested as a core starting point for developing a family-oriented practice for healthcare professionals in forensic psychiatric settings.
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Affiliation(s)
- Ulrica Hörberg
- Linnæus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences, 351 95 Växjö, Sweden.
| | | | - Susanne Syrén
- Linnæus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences, 391 82 Kalmar, Sweden.
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Kunnen YS, Roemeling OP, Smailhodzic E. What are barriers and facilitators in sustaining lean management in healthcare? A qualitative literature review. BMC Health Serv Res 2023; 23:958. [PMID: 37674182 PMCID: PMC10483794 DOI: 10.1186/s12913-023-09978-4] [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: 09/25/2022] [Accepted: 08/28/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Lean management (LM) is a continuous improvement methodology originating from manufacturing and is widely adopted in healthcare to improve processes. LM shows promising results in healthcare and research on the topic is increasing. However, it can be difficult to sustain LM over time, and an overview of facilitators or barriers that influence the sustainment of LM in a healthcare context is unavailable. METHODS Prior to search, five inclusion and exclusion criteria were defined to establish suitability of identified articles for our research question. This study was based on 24 selected peer-reviewed studies that reported on the sustainment of LM in healthcare organisations, published in the last five years. Following the Preferred Reporting Items for Systemtic Reviews and Meta-Analyses (PRISMA) guidelines, all articles were scanned, retrieved for full-text and analysed thematically. RESULTS Following thematic analysis, we identified four overarching themes: Mobilising Employees, Guiding Change Efforts, Methods, and Local Context. Key facilitators for supporting LM are fostering an improvement culture and learning culture, providing professional development opportunities, assigning more responsibilities to employees in decision making processes and appointing change agents to act as local LM leaders. Key barriers for sustaining LM include overburdening employees with responsibilities, omitting staff involvement during LM implementation, lack of patient engagement, lack of resources to engage with LM, a lack of leadership commitment and follow-up on projects, and a lack of knowledge of LM among leaders. CONCLUSION Overall, studies emphasise the importance of actively involving and engaging the workforce to embed LM into organisational culture. Reflecting on the origins of LM, healthcare organisations can find inspiration in the virtue of respecting people in their journey to sustain and cultivate an improvement culture. LM provides potential to change healthcare for the better and could help healthcare organisations to cope with increasing external pressures.
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Affiliation(s)
- Y S Kunnen
- Faculty of Economics and Business, University of Groningen, Groningen, the Netherlands
- Department of Innovation Management and Strategy, University of Groningen, Nettelbosje 2, Groningen, 9700 AV, the Netherlands
| | - O P Roemeling
- Department of Innovation Management and Strategy, University of Groningen, Nettelbosje 2, Groningen, 9700 AV, the Netherlands.
| | - E Smailhodzic
- Department of Innovation Management and Strategy, University of Groningen, Nettelbosje 2, Groningen, 9700 AV, the Netherlands
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Abstract
BACKGROUND AND OBJECTIVES Globally, older adults are undergoing spine surgery for degenerative spine disease at exponential rates. However, little is known about their experiences of living with and having surgery for this debilitating condition. This study investigated older adults' understanding and experiences of living with and having surgery for degenerative spine disease. RESEARCH DESIGN AND METHODS Qualitative methods, grounded theory, guided the study. Fourteen older adults (≥65 years) were recruited for in-depth interviews at 2 time-points: T1 during hospitalization and T2, 1-3-months postdischarge. A total of 28 interviews were conducted. Consistent with grounded theory, purposive, and theoretical sampling were used. Data analysis included open, axial, and selective coding. RESULTS A conceptual model was developed illustrating the process older adults with degenerative spine disease experience, trying to get their life back. Three key categories were identified (1) Losing Me, (2) Fixing Me, and (3) Recovering Me. Losing Me was described as a prolonged process of losing functional independence and the ability to socialize. Fixing Me consisted of preparing for surgery and recovery. Recovering Me involved monitoring progression and reclaiming their personhood. Conditions, including setbacks and delays, slowed their trajectory. Throughout, participants continually adjusted expectations. DISCUSSION AND IMPLICATIONS The conceptual model, based on real patient experiences, details how older adults living with and having surgery for degenerative spine disease engage in recovering who they were prior to the onset of symptoms. Our findings provide a framework for understanding a complex, protracted trajectory that involves transitions from health to illness working toward health again.
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Affiliation(s)
- Andrea L Strayer
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Barbara J King
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
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12
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Grenier A. The qualitative embedded case study method: Exploring and refining gerontological concepts via qualitative research with older people. J Aging Stud 2023; 65:101138. [PMID: 37268388 DOI: 10.1016/j.jaging.2023.101138] [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: 11/23/2022] [Revised: 04/18/2023] [Accepted: 04/30/2023] [Indexed: 06/04/2023]
Abstract
This article argues that a tailored version of the qualitative embedded case study method can be used to build strong conceptual and inclusive insights from qualitative research with older people, and, in doing so, advance theoretical scholarship in social and critical gerontology. Gerontology has often been described as "data-rich and theory-poor" (Birren & Bengtson, 1988). It is a field which draws heavily on post-positivist traditions of quantitative research and notions of prediction, generalization, and statistical significance. While critical qualitative approaches have gained ground through interdisciplinary scholarship in the social sciences and humanities, few attempts have been made to articulate the relationship between research questions designed to understand older people's experiences and concept- or theory-building in gerontology. This piece makes a case for engaging with the theoretical/methodological interface by drawing on an evolving approach entitled the qualitative embedded case study, as it was used in three qualitative studies on the concepts of frailty, (im)mobility, and precarity. It suggests this is an evolving approach with the potential to develop conceptually sound, meaningful research from older people's experiences, including diverse, underrepresented, and marginalized groups, and to draw on these insights to direct change.
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Affiliation(s)
- Amanda Grenier
- Norman and Honey Schipper Chair in Gerontological Social Work, Factor-Inwentash Faculty of Social Work, University of Toronto, Canada; Baycrest's Rotman Research Institute, Toronto, Canada.
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13
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Hangel N, ChoGlueck C. On the pursuitworthiness of qualitative methods in empirical philosophy of science. Stud Hist Philos Sci 2023; 98:29-39. [PMID: 36842291 DOI: 10.1016/j.shpsa.2022.12.009] [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] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 12/05/2022] [Accepted: 12/30/2022] [Indexed: 06/18/2023]
Abstract
While the pursuitworthiness of philosophical ideas has changed over time, philosophical practice and methodology have not kept pace. The worthiness of a philosophical pursuit includes not only the ideas and objectives one pursues but also the methods with which one pursues them. In this paper, we articulate how empirical approaches benefit philosophy of science, particularly advocating for the use of qualitative methods for understanding the social and normative aspects of scientific inquiry. After situating qualitative methods within empirical philosophy of science, we discuss how to adapt these traditionally sociological methods to empirically inform philosophical questions. Our aim is to normalize and legitimize qualitative methods for philosophical purposes and discuss how they can elucidate descriptive and normative components of scientific practice in a more generalizable non-idealized manner. We contend that qualitative methods are particularly well suited to philosophical interest in the social norms of science, their achievability, and their mutability. Furthermore, unlike more historical case studies in philosophy, qualitative methods enable more confidence in generalizability, albeit limited, from a concrete sample to a larger class. We conclude by addressing anxieties about the distinctness of empirical philosophy of science from social epistemology and from sociology of science.
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Affiliation(s)
- Nora Hangel
- Leibniz Center for Science and Society (LCSS), Leibniz University Hannover, Germany; Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany.
| | - Christopher ChoGlueck
- Department of Communication, Liberal Arts and Social Sciences, New Mexico Institute of Mining and Technology (New Mexico Tech), Socorro, NM, USA
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14
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Yuan Q, Zhang Y, Samari E, Jeyagurunathan A, Goveas R, Ng LL, Subramaniam M. Positive aspects of caregiving among informal caregivers of persons with dementia in the Asian context: a qualitative study. BMC Geriatr 2023; 23:51. [PMID: 36707781 PMCID: PMC9883086 DOI: 10.1186/s12877-023-03767-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/21/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Positive aspects of caregiving are important coping resources for informal caregivers of persons with dementia (PWD). However, existing studies mostly focused on caregivers from western societies and less attention was paid to the potential cultural differences. This study aims to explore positive aspects of caregiving in the Asian context. METHODS A qualitative methodology with semi-structured interviews was adopted. A total of 29 informal caregivers of PWD in Singapore were interviewed from Apr 2019 to Dec 2020. All the interviews were audio-recorded and transcribed verbatim for the analysis. Inductive thematic analysis was conducted. RESULTS The results revealed a total of three major themes with 11 sub-themes including: 1) positive aspects within self (i.e., better understanding of dementia and caregiving, personal growth, role satisfaction, and improved awareness of self-care); 2) positive aspects between caregiver and PWD (i.e., chance to demonstrate filial piety towards PWD, happiness and positive attitudes of PWD, positive interactions with PWD, and closer relationships with PWD); and 3) positive aspects between caregiver and others (i.e., empathy towards other caregivers, befriending peers, and sharing dementia and caregiving knowledge with others). DISCUSSION Findings from this study improved our understanding on positive aspects of caregiving among informal caregivers of PWD in the Asian context. In addition to similar themes across cultures such as personal growth, our study identified a few unique themes like improved awareness of self-care and chances to demonstrate filial piety. For future studies targeting Asian caregivers, it is necessary to include these cultural-specific positive aspects of caregiving.
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Affiliation(s)
- Qi Yuan
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Yunjue Zhang
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Ellaisha Samari
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Richard Goveas
- grid.414752.10000 0004 0469 9592Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- grid.413815.a0000 0004 0469 9373Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Mythily Subramaniam
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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15
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Woodard GS, Mraz A, Renn BN. Perspectives of Nonspecialists Delivering a Brief Depression Treatment in the United States: A Qualitative Investigation. BMC Psychiatry 2023; 23:32. [PMID: 36639746 PMCID: PMC9839228 DOI: 10.1186/s12888-023-04528-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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Task sharing is an implementation strategy which increases access to services by training and supporting treatment delivery by nonspecialists. Such an approach has demonstrated effectiveness for depression and other mental health outcomes; however, few studies in high-income countries have examined nonspecialist providers' (NSPs) perspectives of the acceptability, feasibility, and appropriateness of delivering mental health interventions. We examine qualitative reports of NSPs experiences delivering a brief structured behavioral intervention for depression (called "Do More, Feel Better" [DMFB]) to adults aged 55 and older. METHODS All NSPs (N = 4, 100%) who delivered DMFB participated in a focus group to probe their perceptions of the acceptability, feasibility, and appropriateness of both the intervention and their delivery experience as NSPs. Two coders analyzed the qualitative data from focus groups using codebook thematic analysis. RESULTS NSPs perceived the intervention and delivery experience to be acceptable, feasible, and appropriate. Qualitative results provided insight into specific barriers and facilitators which may be important to consider when planning to implement task sharing. Themes that emerged from qualitative data included supervision being highly acceptable and feasible, appropriateness of the intervention for NSPs, and the feasibility of tailoring the intervention to patient participants. NSPs also expressed difficulty managing emotional investment in patients' success and providing therapy during a pandemic and racial violence in the US. CONCLUSIONS Our results can inform future implementation and sustainment of task sharing interventions to expand access to care.
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Affiliation(s)
- Grace S. Woodard
- grid.26790.3a0000 0004 1936 8606Department of Psychology, University of Miami, Coral Gables, Florida USA
| | - Amanda Mraz
- grid.272362.00000 0001 0806 6926Department of Psychology, University of Nevada, Las Vegas, 4505 South Maryland Parkway, MS 5030, Las Vegas, Nevada 89154-5030 USA
| | - Brenna N. Renn
- grid.272362.00000 0001 0806 6926Department of Psychology, University of Nevada, Las Vegas, 4505 South Maryland Parkway, MS 5030, Las Vegas, Nevada 89154-5030 USA
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16
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Driscoll B, Leonard LD, Kovar A, Billings J, Tevis SE, Kim SP, Cumbler E. Surgeon Perceptions of the Integration of Patient-Reported Outcome Measures into Clinical Practice. J Surg Res 2022; 280:486-494. [PMID: 36067535 DOI: 10.1016/j.jss.2022.07.038] [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: 03/15/2022] [Revised: 07/16/2022] [Accepted: 07/29/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Patient-reported outcome measures (PROMs/PROM) are standardized, validated instruments used to measure the patient's perception of their own health status including their symptoms, functional wellbeing, and mental health. Although PROMs were initially developed as research tools, their use in clinical practice for shared decision-making and to assess the impact of disease and treatment on quality of life of individual patients has been increasing. There is a paucity of research exploring providers' perspectives on the clinical integration of PROMs. We sought to use a qualitative methodology to understand surgeons' perceptions of integrating PROMs into their clinical practices. METHODS Semistructured interviews were performed from November 2019 until August 2020. All interviews were recorded and transcribed verbatim. Thematic saturation was achieved after interviewing nine surgeons representing eight surgical specialties. Qualitative interview data were thematically analyzed using an inductive approach facilitated by Atlas.ti qualitative software. RESULTS Forty seven unique codes were identified that fit into 21 themes that revealed five novel insights. Key insights included: (1) PROM data can modify surgical practice on an individual and institutional level, (2) Surgeon's view PROM clinical integration as a potential method of advancing patient-centered care, (3) There are various institutional processes that must be in place, including strong leadership and an integrative platform, to enable successful clinical PROM integration, (4) Surgeons appreciate challenges of integrating PROMs into surgical practice including risks of incorrect use or interpretation, and (5) A PROM platform must be adaptable to the diversity within surgery and to unique physician workflows. CONCLUSIONS Surgeons perceived value from integrating PROMs into routine care to better inform patients during preoperative discussions and to help identify at-risk patients in the postoperative period. However, they also identified numerous barriers to the implementation of an integrated system for the routine use of PROMs in clinical practice and expressed concern about using PROMs to compare operative outcomes between surgeons. Based on this work, institutions that want to incorporate PROMs into surgical practice need a leadership team capable of supporting the change management necessary for effective integration and use a PROM platform that gives individual surgeons and surgical teams the ability to customize platforms for their unique practices.
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Affiliation(s)
| | - Laura D Leonard
- Department of Surgery, University of Colorado, Aurora, Colorado
| | - Alexandra Kovar
- Department of Surgery, University of Colorado, Aurora, Colorado
| | - Joshua Billings
- Department of Surgery, University of Colorado, Aurora, Colorado
| | - Sarah E Tevis
- Department of Surgery, University of Colorado, Aurora, Colorado
| | - Simon P Kim
- Department of Surgery, University of Colorado, Aurora, Colorado
| | - Ethan Cumbler
- Department of Surgery, University of Colorado, Aurora, Colorado; Department of Medicine, University of Colorado, Aurora, Colorado
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17
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Cummins MW, Brannon GE. Mothering in a Pandemic: Navigating Care Work, Intensive Motherhood, and COVID-19. Gender Issues 2022; 39:123-141. [PMID: 35261538 PMCID: PMC8893238 DOI: 10.1007/s12147-022-09295-w] [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] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Even before COVID-19, women around the world performed more unpaid domestic labor, specifically unpaid care labor, than men. COVID-19 has only exacerbated the gender gap in this domestic labor. For Western women, especially mothers in the United States of America, the normative discourse of intensive motherhood and the gendered pressure inherent in the unrealistic standards set by the discourse have only increased the amount of unpaid domestic and care labor required of mothers. Using qualitative, in-depth interviews with 18 mothers during May-June 2020, this study examines privileged mothers' perceptions of what they did well in parenting both before and during the early part of the COVID-19 pandemic. The mothers' pragmatic adaptations during the pandemic posed challenges to the norms of intensive motherhood, as did emergent ideas about integrative mothering articulated before the pandemic's onset. We find that while COVID-19 has increased expectations on mothers, it has also provided a turning point wherein expectations can be changed, as the participants suggested. Implications for intensive motherhood scholars, mothers, and communication researchers are discussed, along with future research.
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Affiliation(s)
- Molly Wiant Cummins
- Department of Communication, University of Texas Arlington, Arlington, TX USA
| | - Grace Ellen Brannon
- Department of Communication, University of Texas Arlington, Arlington, TX USA
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18
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Meier S, Kasting ML, Liu SS, DeMaria AL. Shared decision-making among non-physician healthcare professionals: Enhancing patient involvement in women's reproductive health in community healthcare settings. Patient Educ Couns 2021; 104:2304-2316. [PMID: 33685762 DOI: 10.1016/j.pec.2021.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/29/2021] [Accepted: 02/15/2021] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Shared decision-making (SDM) is an important approach to patient-centered care in women's reproductive healthcare. This study explored SDM experiences and perceptions among non-physician healthcare professionals. METHODS We completed 20 key-informant interviews with non-physician healthcare professionals (i.e., NP, RN, CNM, doula, pharmacist, chiropractor) living in Indiana (September 2019-May 2020) who provided community-based women's reproductive healthcare. Interviews were audio-recorded, transcribed, and analyzed using an expanded grounded theory framework. Constant comparative analysis identified emergent themes. RESULTS Professionals noted community-based healthcare required contextualized decision-making approaches. Results identified listening, decisional ownership, and engagement strategies that enhanced SDM involvement. Findings suggested outcome-oriented SDM concepts, including decisional ownership and investigative listening to enhance SDM. Providers redefined 'challenging' patients as engaged in their healthcare and discussed ways SDM improved healthcare experience beyond one visit. CONCLUSION Findings offered insight into actionable and practical strategies for enhancing SDM in community-based women's reproductive healthcare. The findings offer strategies to improve SDM by addressing barriers and facilitators among professionals. This extends SDM beyond the patient-physician dyad and supports broader application of SDM. PRACTICE IMPLICATIONS Incorporating professionals' experiences into SDM concepts can enhance SDM in community-based women's healthcare practice, offering opportunities to support a culture of SDM across settings.
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Affiliation(s)
- Stephanie Meier
- Division of Consumer Science, Purdue University, West Lafayette, IN, USA.
| | - Monica L Kasting
- Department of Public Health, Purdue University, West Lafayette, IN, USA.
| | - Sandra S Liu
- Department of Public Health, Purdue University, West Lafayette, IN, USA.
| | - Andrea L DeMaria
- Department of Public Health, Purdue University, West Lafayette, IN, USA.
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19
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Miroševič Š, Krajc K, Klemenc-Ketiš Z, Selič-Zupančič P. Mapping Users' Experience of a Family History and Genetic Risk Algorithm Tool in Primary Care. Public Health Genomics 2021; 25:1-10. [PMID: 34515220 DOI: 10.1159/000518086] [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: 03/04/2021] [Accepted: 06/22/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The development of a family history (FH) questionnaire (FHQ) provides an insight into a patient's familiarity of a trait and helps to identify individuals at increased risk of disease. A critical aspect of developing a new tool is exploring users' experience. OBJECTIVE The objective of this study was to examine users' experience, obstacles and challenges, and their views and concerns in the applicability of a new tool for determining genetic risk in Slovenia's primary care. METHODS We used a qualitative approach. The participants completed a risk assessment software questionnaire that calculates users' likelihood of developing familial diseases. Audio-taped semi-structured telephone interviews were conducted to evaluate their experience. There were 21 participants, and analyses using the constant comparative method were employed. RESULTS We identified 3 main themes: obstacles/key issues, suggestions for improvements, and coping. The participants were poorly satisfied with the clarity of instructions, technical usability problems, and issues with the entry of relatives' data. They expressed satisfaction with some of the characteristics of the FHQ (e.g., straightforward and friendly format, easy entry, and comprehension). They suggested simpler language, that the disease risk should be targeted toward the disease, that the FHQ should include patient-specific recommendations, and that it should be part of the electronic medical records. When discussing what would they do with the results of the FHQ, the participants used different coping strategies: active (e.g., seeking information) or passive (e.g., avoidance). DISCUSSION/CONCLUSION User experience was shown to be a synthesis of obstacles, overcoming them with suggestions for improvements, and exploration of various coping mechanisms that may emerge from dealing with the stressor of "being at risk."
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Affiliation(s)
- Špela Miroševič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Kaja Krajc
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Koper, Slovenia
| | - Zalika Klemenc-Ketiš
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Community Health Centre Ljubljana, Ljubljana, Slovenia
| | - Polona Selič-Zupančič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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20
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DeBois K, Chatfield SL. Misinformation, thin-ideal internalization, and resistance to treatment: an interpretive phenomenological analysis of the experience of orthorexia nervosa. Eat Weight Disord 2021; 26:1963-1973. [PMID: 33074459 DOI: 10.1007/s40519-020-01049-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 07/16/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Orthorexia nervosa (ON) is an emerging pattern of disordered eating which may be driven by a pathological desire to consume only highly nutritious foods, absent concern over body weight, as is noted in anorexia nervosa (AN). This study seeks to clarify the development and progression of ON and add to researchers' understanding of this potential disorder. METHOD Utilizing Interpretive Phenomenological Analysis to guide data collection and analysis, interviews were conducted with 18 individuals who self-identified as having ON. RESULTS Participants described a clear distinction between orthorexia nervosa and clinically recognized eating disorders, with which they had prior experience. In addition, they demonstrated patterns of inflexible thinking that guided their perceptions of themselves and others. As a result, participants rapidly integrated newly acquired nutritional information, which led to escalations in restriction, social isolation, and physical symptoms of malnutrition. While prior findings on the relationship between ON and weight are conflicting, previously proposed criteria for ON emphasize an absence of weight-related concerns. The results of the present study suggest that weight control is a primary motivating factor in the escalating pattern of restriction. CONCLUSION The nuanced results from this work evidence the value of interpretive qualitative approaches to improve understanding of ON. In particular, participants' described inflexible thinking with respect to eating behaviors may help inform or revise screening instruments and provide important insights for treatment of ON. LEVEL OF EVIDENCE Level V, qualitative descriptive research.
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Affiliation(s)
- Kristen DeBois
- Kent State University College of Public Health, Moulton Hall, 800 Hilltop Drive, Kent, OH, 44242, USA.
| | - Sheryl L Chatfield
- Kent State University College of Public Health, Moulton Hall, 800 Hilltop Drive, Kent, OH, 44242, USA
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Abstract
Geographical life-space is an important factor to consider when studying subjective wellbeing of older adults. The purpose of this article is twofold: to provide an in-depth understanding of 1) the geographical life-spaces in which the lives of older adults take place and 2) the relation between life-space and experienced levels of subjective wellbeing. Seventy-six older adults (aged 65 and older) participated in our qualitative study. We applied a qualitative research approach, through combining indepth-interviews with visual life-space diagrams. Our findings show that most older adults continue to experience a high level of subjective wellbeing, regardless of the extent of their life-space. We conclude that the possibility to fulfill one's needs, even in a restricted life-space, is more conducive to maintaining subjective wellbeing than the extent of life-space itself.
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Affiliation(s)
- Linden Douma
- Population Research Centre, Urban and Regional Studies Institute (URSI), Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands.
| | - Nardi Steverink
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 38, 97112, TJ, the Netherlands; Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - Louise Meijering
- Population Research Centre, Urban and Regional Studies Institute (URSI), Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands.
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22
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Alcaide Lozano V, Pérez Domínguez A, Lupresti Medina E, Almazán Sáez C. [Proposals for approaching violence against women in health care. A qualitative analysis]. Aten Primaria 2021; 53:102045. [PMID: 33930846 PMCID: PMC8102170 DOI: 10.1016/j.aprim.2021.102045] [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: 10/20/2020] [Revised: 11/24/2020] [Accepted: 12/09/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Identify improvement proposals for approaching violence against women through the evaluation of 2009s Protocol for approaching Violence Against Women in Health Care in Cataluña (PAVIM). DESIGN Qualitative ethnographic study, 2019. SETTING Public Health Care in Catalonia. PARTICIPANTS One hundred eighty one participants, of which: 104 health care professionals, 43 women's associations and/or experts in violence against women and 34 experts on health and violence against women. METHOD Intentional sampling. Eighteen focus groups and 34 semi-structured interviews. Evaluation with a gender and intersectional perspective. RESULTS Results are structured along PAVIM's phases. PREVENTION mandatory and institutionally recognized training for the whole professional team, with a gender and intersectional perspective. Detection: diagnostic code standardization for violence against women and improve coordination between primary care, emergency service, pediatrics and Assistance to Sexual and Reproductive Health. Care and recovery: territorial equity in the applied resources on cases of violence against women care (in the 9 sanitary regions of Catalonia) and improves communication between health and associative fields. CONCLUSIONS The improvement proposals identified are those that have generated a greater consensus among participants and are the most interesting to primary care. As limitations, stand out the temporality and heterogeneity of the Catalan territory.
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Affiliation(s)
| | - Alba Pérez Domínguez
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona , España
| | | | - Cari Almazán Sáez
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona , España
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23
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Doja A, Lavin Venegas C, Clarkin C, Scowcroft K, Ashton G, Hopkins L, Bould MD, Writer H, Posner G. Varying perceptions of the role of "nurse as teacher" for medical trainees: A qualitative study. Perspect Med Educ 2021; 10:88-94. [PMID: 33270186 PMCID: PMC7952473 DOI: 10.1007/s40037-020-00632-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/29/2020] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The informal curriculum-an essential complement to the formal curriculum-is delivered to medical trainees through learning outside the classroom. We sought to explore nurse-mediated aspects of trainee education in the informal curriculum in obstetrics and gynecology (OBGYN), as well as nursing perceptions of their role in medical trainee education. METHODS Naturalistic, non-participant observations (40 h) were performed on a tertiary care birthing unit (BU) to document teaching and learning interactions. Insights gleaned from observations informed subsequent semi-structured interviews with BU nurses (n = 10) and focus group discussions with third-year medical students who had completed an OBGYN rotation (n = 10). Thematic analysis was conducted across data sets. RESULTS Conceptions of nurse-mediated education differed considerably between nurses and trainees. Nurses were widely acknowledged as gatekeepers and patient advocates by both groups, although this role was sometimes perceived by trainees as impacting on learning. Interest and engagement were noted as mediators of teaching, with enhanced access to educational opportunities reported by trainees who modelled openness and enthusiasm for learning. Nurse-driven education was frequently tailored to the learner's level, with nurses feeling well positioned to share procedural knowledge or hard skills, soft skills (i.e. bedside manners), and clinical insights gained from bedside practice. DISCUSSION Nurses are instrumental in the education of medical trainees; however, divergence was noted in how this role is enacted in practice. Given the valuable teaching resource BU nurses present, more emphasis should be placed on interprofessional co-learning and the actualization of this role within the informal curriculum.
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Affiliation(s)
- Asif Doja
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
| | | | | | | | | | - Laura Hopkins
- Division of Oncology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - M Dylan Bould
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Hilary Writer
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Glenn Posner
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
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Rota-Musoll L, Brigidi S, Molina-Robles E, Oriol-Vila E, Perez-Oller L, Subirana-Casacuberta M. An intersectional gender analysis in kidney transplantation: women who donate a kidney. BMC Nephrol 2021; 22:59. [PMID: 33593306 PMCID: PMC7885450 DOI: 10.1186/s12882-021-02262-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 10/11/2020] [Accepted: 01/12/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Living-donor transplantation is the best treatment option in patients with chronic kidney failure. Global data show that women are less likely to be kidney recipients than men but are more likely to become living kidney donors. We explored the experience of women who donate a kidney to relatives with biological and socio-cultural ties and to understand the similarities and differences in their experience. METHODS A qualitative hermeneutic phenomenological study with an intersectional analysis of gender. Ten women donors accepted in the transplant evaluation period participated, all of whom donated a kidney to a pre-dialysis relative. Two categories were included: women with biological kinship ties (mothers, sisters) and women who have a socio-cultural relationship (wives) with kidney recipient. The data were collected through semi-structured in-depth interviews and analysed using thematic analysis. RESULTS Women donate their kidneys in a convinced manner, without worrying about their health, with an optimistic and positive attitude, and without believing that they are acting heroically. Women with biological kinship ties see it as a 'naturalization thing'. In contrast, wives donate conditioned by gender roles, but also as a form of empowerment and as a personal benefit: they donate in order to avoid taking on carer role for their husband and as a way of protecting their children. CONCLUSION The study's findings expand the conception of kidney donation as solely altruistic and may help professionals to pay attention to the complexity and intersectionality of features present in women who are living kidney donors.
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Affiliation(s)
- Laura Rota-Musoll
- Department of Nephrology, Consorci Hospitalari de Vic, Vic, Catalunya, Spain
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Serena Brigidi
- Department of Anthropology, Philosophy and Social Work in the University of Rovira i Virgili (URV), Tarragona, Catalunya, Spain.
| | - Esmeralda Molina-Robles
- Department of Nephrology, Consorci Hospitalari de Vic, Vic, Catalunya, Spain
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Ester Oriol-Vila
- Department of Nephrology, Consorci Hospitalari de Vic, Vic, Catalunya, Spain
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | | | - Mireia Subirana-Casacuberta
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
- Department of Nursing Management, Parc Taulí Health Corporation Consortium, Sabadell, Catalunya, Spain
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Grau-Muñoz A. [A proposal of sociological classification of Internet use in primary health care]. Gac Sanit 2021; 35:420-424. [PMID: 33518412 DOI: 10.1016/j.gaceta.2020.08.008] [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] [Received: 04/30/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To analyze and classify the communication strategies developed by primary health care professionals in the Valencian Community (Spain), in view of the use of the Internet as a source of health information by the user population through the analytical categories of power and control which, according to Basil Bernstein, characterize the communication processes of therapeutic meetings. METHOD Qualitative study through in-depth interviews with primary health care professionals of the Valencian Community (n=18). The language of description of Bernstein's theory was applied to the analysis of the speeches in order to classify the strategies developed by the professionals and to propose a typology. RESULTS A sociological typology of strategies used by professionals in the face of Internet use by the user population is provided, which classifies them according to the classification and framing modulation in rejection strategies, validation strategies, filtering strategies and opening strategies. CONCLUSIONS The different strategies developed by professionals when faced with the use of the Internet as a source of information have different implications for the power and control relationships inherent to the therapeutic encounter. Professionals should be aware of these implications in order to increase the participation of the user population in therapeutic meetings.
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Affiliation(s)
- Arantxa Grau-Muñoz
- Departament de Sociologia i Antropologia Social, Facultat de Ciències Socials, Universitat de València, València, España.
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Pandita S, Mishra HG, Chib S. Psychological impact of covid-19 crises on students through the lens of Stimulus-Organism-Response (SOR) model. Child Youth Serv Rev 2021; 120:105783. [PMID: 33518862 PMCID: PMC7834393 DOI: 10.1016/j.childyouth.2020.105783] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/27/2020] [Accepted: 11/28/2020] [Indexed: 05/23/2023]
Abstract
The present outbreak of the Covid-19 pandemic has affected 28,584,158 people world-wide as of 13th September 2020 (WHO, 2020b). This crisis has created an atmosphere of uncertainty and fear. Due to the unavailability of the evidence based medical treatment, non-pharmaceutical interventions (NPIs) are the best options at the present moment. Lockdown was one of such measures to control the spread of the Covid-19 disease. Due to lockdown measures, many countries across the globe followed the complete closure of shopping malls, transport networks, schools, universities, etc. This study aims to investigate the behavioural psychological changes among university students due to covid-19 crises and lockdown. Stimulus-Organism-Response (SOR) model has been adopted to develop a theoretical foundation for the research. Qualitative research methodology including a combination of personal interviews and focus groups has been adopted in the study to develop the themes with the help of computer-assisted qualitative data analysis software, Atlas.ti 7. It has been found that students are suffering from academic anxiety, fear, Mysophobia, etc. As far as behavioural responses are concerned following behavioural changes have been found; Panic buying, e-learning, community support, support for prime-minister, etc.
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Affiliation(s)
- Shailesh Pandita
- School of Business, Shri Mata Vaishno Devi University, Katra, J&K, India
| | - Hari Govind Mishra
- School of Business, Shri Mata Vaishno Devi University, Katra, J&K, India
| | - Shagun Chib
- Academic Associate, Indian Institute of Management, Indore, India
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Wolcott MD, Lobczowski NG, Zeeman JM, McLaughlin JE. Situational judgment test validity: an exploratory model of the participant response process using cognitive and think-aloud interviews. BMC Med Educ 2020; 20:506. [PMID: 33317517 PMCID: PMC7734708 DOI: 10.1186/s12909-020-02410-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 12/02/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Situational judgment tests (SJTs) are used in health sciences education to measure examinee knowledge using case-based scenarios. Despite their popularity, there is a significant gap in the validity research on the response process that demonstrates how SJTs measure their intended constructs. A model of SJT response processes has been proposed in the literature by Robert Ployhart; however, few studies have explored and expanded the factors. The purpose of this study was to describe the factors involved in cognitive processes that examinees use as they respond to SJT items in a health professions education context. METHODS Thirty participants-15 student pharmacists and 15 practicing pharmacists-completed a 12-item SJT designed to measure empathy. Each participant engaged in a think-aloud interview while completing the SJT, followed by a cognitive interview probing their decision-making processes. Interviews were transcribed and independently coded by three researchers to identify salient factors that contributed to response processes. RESULTS The findings suggest SJT response processes include all four stages (comprehension, retrieval, judgment, and response selection) as initially proposed by Ployhart. The study showed factors from other published research were present, including job-specific knowledge and experiences, emotional intelligence, and test-taking. The study also identified new factors not yet described, including identifying a task objective in the scenario, assumptions about the scenario, perceptions about the scenario, and the setting of the item. CONCLUSIONS This study provides additional SJT validity evidence by exploring participants' response processes through cognitive and think-aloud interviews. It also confirmed the four-stage model previously described by Ployhart and identified new factors that may influence SJT response processes. This study contributes to the literature with an expanded SJT response process model in a health professions education context and offers an approach to evaluate SJT response processes in the future.
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Affiliation(s)
- Michael D Wolcott
- The University of North Carolina Eshelman School of Pharmacy, 321 Beard Hall, Chapel Hill, NC, 27599, USA.
- The University of North Carolina Adams School of Dentistry, Chapel Hill, NC, USA.
- The University of North Carolina School of Education, Chapel Hill, NC, USA.
| | - Nikki G Lobczowski
- The University of North Carolina School of Education, Chapel Hill, NC, USA
- Carnegie Mellon University, Pittsburgh, PA, USA
| | - Jacqueline M Zeeman
- The University of North Carolina Eshelman School of Pharmacy, 321 Beard Hall, Chapel Hill, NC, 27599, USA
| | - Jacqueline E McLaughlin
- The University of North Carolina Eshelman School of Pharmacy, 321 Beard Hall, Chapel Hill, NC, 27599, USA
- The University of North Carolina School of Education, Chapel Hill, NC, USA
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Osborn E, Wittkowski A, Brooks J, Briggs PE, O'Brien PMS. Women's experiences of receiving a diagnosis of premenstrual dysphoric disorder: a qualitative investigation. BMC Womens Health 2020; 20:242. [PMID: 33115437 PMCID: PMC7594422 DOI: 10.1186/s12905-020-01100-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 10/09/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is a complex and disabling condition that affects women of reproductive age, characterised by severe physical and psychological symptoms that occur cyclically and remit following the onset of menses. As the psychological nature and consequences of PMDD often seem indistinguishable from symptoms of other mental health difficulties, this condition presents distinct diagnostic challenges for healthcare professionals. Therefore, this study aimed to explore women's experiences of both having PMDD and of receiving this diagnosis. METHODS Participant recruitment took place in the United Kingdom during 2018. Seventeen women who had been diagnosed with PMDD by a medical specialist and met the clinical criteria for PMDD on the premenstrual symptoms screening tool were interviewed. The data from these semi-structured interviews were audio-recorded, transcribed and inductively analysed using reflexive thematic analysis. RESULTS Twelve subthemes were identified and organised around four main themes: (1) A broken woman, (2) Misdiagnosis and the lost decades, (3) A life transformed and (4) Negotiating the aftermath. CONCLUSIONS The findings of this study highlight the critical importance of the accurate and timely detection of PMDD, with the aim of preventing women from experiencing severe and prolonged psychological distress. In order to achieve this, there needs to be a greater understanding and awareness of PMDD within both the medical and lay communities, alongside training for healthcare practitioners in PMDD assessment.
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Affiliation(s)
- Elizabeth Osborn
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, 2nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, 2nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. .,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
| | - Joanna Brooks
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, 2nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
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Cowden C, Mwananyanda L, Hamer DH, Coffin SE, Kapasa ML, Machona S, Szymczak JE. Healthcare worker perceptions of the implementation context surrounding an infection prevention intervention in a Zambian neonatal intensive care unit. BMC Pediatr 2020; 20:432. [PMID: 32912138 DOI: 10.1186/s12887-020-02323-2] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/27/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Infants in the neonatal intensive care unit (NICU) are particularly susceptible to healthcare-associated infections (HAIs). NICUs in low- and middle income countries face additional challenges to HAI prevention. There is a need to better understand the role of the implementation context surrounding infection prevention interventions in low- and middle income countries. AIM The aim of this study was to identify NICU healthcare worker perceptions of an intervention to reduce bloodstream infections in a large Zambian NICU. METHODS Semi-structured interviews were conducted with NICU staff during a prospective cohort study examining the impact of an infection prevention bundle on bloodstream infections. Interviews were analyzed using an integrated approach, combining inductive theme generation with an application of the Consolidated Framework for Implementation Research (CFIR). RESULTS Interviews were conducted with 17 NICU staff (5 physicians and 12 nurses). Respondents believed the bundle elements were easy to use, well-designed and facilitated improved performance. Four organizational characteristics that facilitated HAI transmission were identified - (1) lack of NICU admission protocols; (2) physical crowding; (3) understaffing; and (4) equipment shortages. Respondents suggested that NICU resource constraints reflected a societal ethos that devalued the medical care of infants. Despite the challenges, respondents were highly motivated to prevent HAIs and believed this was an achievable goal. They enthusiastically welcomed the bundle but expressed serious concern about sustainability following the study. CONCLUSIONS By eliciting healthcare worker perceptions about the context surrounding an infection prevention intervention, our study identified key organizational and societal factors to inform implementation strategies to achieve sustained improvement.
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Canada KE, Trawver KR, Barrenger S. Deciding to participate in mental health court: Exploring participant perspectives. Int J Law Psychiatry 2020; 72:101628. [PMID: 32889423 PMCID: PMC7554147 DOI: 10.1016/j.ijlp.2020.101628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 06/11/2023]
Abstract
As the number of mental health courts (MHC) expands across the United States, so does the body of research demonstrating its effectiveness in reducing criminal recidivism. While there has been considerable research conducted on MHC operations, less is known about how individuals decide to participate in MHCs. Data from in-depth interviews with 26 MHC participants from two MHCs in the United States were analyzed using grounded dimensional and thematic analyses. Results suggest that individuals participated in MHC to avoid incarceration and obtain treatment. Participants understood the court to function in four distinct ways: 1) to help through service provision, 2) to structure a judicial agreement allowing MHCs to make treatment decisions in exchange for community living, 3) to protect people from risks within the criminal justice system, and 4) to reward participants for treatment adherence. Findings can be used to guide the need for policy and practice for those referring to MHCs.
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Affiliation(s)
- Kelli E Canada
- University of Missouri, School of Social Work, 706 Clark Hall, Columbia, MO 65211, USA.
| | - Kathi R Trawver
- University of Alaska Anchorage, School of Social Work, 3211 Providence Dr., Anchorage, AK 99508, United States of America.
| | - Stacey Barrenger
- New York University, Silver School of Social Work, New York, NY, United States of America.
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Sarabia-Cobo C, Taltavull-Aparicio JM, Miguélez-Chamorro A, Fernández-Rodríguez A, Ortego-Mate C, Fernández-Peña R. Experiences of caregiving and quality of healthcare among caregivers of patients with complex chronic processes: A qualitative study. Appl Nurs Res 2020; 56:151344. [PMID: 32907769 DOI: 10.1016/j.apnr.2020.151344] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/12/2020] [Accepted: 08/22/2020] [Indexed: 11/20/2022]
Abstract
Aim To explore the perceptions of main caregivers regarding caring for chronic complex patients in two different regions of Spain. BACKGROUND Spain is a country with an ageing population and a high number of people with chronic diseases. It is well known that the role of the caregiver is important to ensure quality of life and appropriate care. METHODS Qualitative design using focus groups. Five focus groups, from two different regions, were conducted with 22 caregivers of people with chronic complex diseases to explore their personal experience, examine the quality of care received by the patient and their family and to develop strategies for the improvement of the quality of health care. The focus groups were audio and video recorded. The transcriptions of the focus group sessions were exported to qualitative software analysis MAXQDA 2018.2. The qualitative content analysis was based on different analytical cycles. RESULTS In general terms, caregivers would refer to accepting the care of their family members, but they highlight many negative aspects such as tiredness, lack of help and overload of care. They indicated general satisfaction with the health system but indicated that help was insufficient and that strategies to better address the situations of the complex chronic patient should be improved. The main categories observed were: Conclusions. Complex chronic illnesses are increasingly common at present, generating important consequences on the lives of patients and that of their caregivers. The design of any health strategy for facing the dilemma of chronic illnesses, must necessarily include the vision of the caregivers.
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Catho G, Centemero NS, Catho H, Ranzani A, Balmelli C, Landelle C, Zanichelli V, Huttner BD. Factors determining the adherence to antimicrobial guidelines and the adoption of computerised decision support systems by physicians: A qualitative study in three European hospitals. Int J Med Inform 2020; 141:104233. [PMID: 32736330 DOI: 10.1016/j.ijmedinf.2020.104233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/30/2020] [Revised: 05/07/2020] [Accepted: 07/08/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Antimicrobial stewardship (AMS) programs aim to optimize antibiotic use and reduce inappropriate prescriptions through a panel of interventions. The implementation of clinical guidelines is a core strategy of AMS programs. Nevertheless, their dissemination and application remain low. Computerised decision support systems (CDSSs) offer new opportunities for semi-automated dissemination of guidelines. This qualitative study aimed at gaining an in-depth understanding of the determinants of adherence to antimicrobial prescribing guidelines and CDSSs adoption and is part of a larger project, the COMPASS trial, which aims to assess a CDSS for antimicrobial prescription. The final objective of this qualitative study is to 1) provide insights from end-users to assist in the design of the COMPASS CDSS, and to 2) help with the interpretation of the quantitative findings of the randomised controlled trial assessing the COMPASS CDSS, once data will be analysed. METHODS We conducted semi-structured individual interviews among in-hospital physicians in two hospitals in Switzerland and one hospital in France. Physicians were recruited by convenience sampling and snowballing until data saturation was achieved. RESULTS Twenty-nine physicians were interviewed. We identified three themes related to the potential barriers to guideline adherence: 1) insufficient clarity, accessibility and applicability of guidelines, 2) need of critical thinking skills to adhere to guidelines and 3) impact of the team prescribing process and peers on physicians in training. As to the perception of CDSSs, we identified four themes that could affect their adoption: 1) CDSSs are perceived as time-consuming, 2) CDSSs could reduce physicians' critical thinking and professional autonomy and raise new medico-legal issues, 3) effective CDSSs would require specific features, such as ease of use and speed, which affect usability and 4) CDSSs could improve physicians' adherence to guidelines and patient care. DISCUSSION CDSSs have the potential to overcome several barriers for adherence to guidelines by improving accessibility and providing individualised recommendations backed by patient data. When designing CDSSs, mixed clinical and information technology teams should focus on user-friendliness, ergonomics, workflow integration and transparency of the decision-making process.
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Affiliation(s)
- Gaud Catho
- Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | | | - Heloïse Catho
- Grenoble Alpes University Hospital and Faculty of Medicine, Grenoble, France
| | - Alice Ranzani
- Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Carlo Balmelli
- Division of Infection Control and Hospital Epidemiology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Caroline Landelle
- Hospital Hygiene Unit, Grenoble Alpes University Hospital, University Grenoble Alpes/CNRS, ThEMAS TIM-C UMR 5525, Grenoble, France
| | - Veronica Zanichelli
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Benedikt David Huttner
- Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Jitnarin N, Poston WSC, Jahnke SA, Haddock CK, Kelley HN. Cancer Perceptions Among Smokeless Tobacco Users: A Qualitative Study of US Firefighters. Saf Health Work 2020; 11:284-90. [PMID: 32995053 DOI: 10.1016/j.shaw.2020.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/04/2020] [Accepted: 04/12/2020] [Indexed: 11/25/2022] Open
Abstract
Background Prevalence rates of smokeless tobacco (SLT) use among firefighters are remarkably high and substantially higher than similar occupational groups and the general U.S. population. The purpose of this study was to explore the perspectives of fire service personnel regarding cancer and its associations with tobacco and SLT use. Methods This descriptive study used a qualitative approach. Key informant interviews were conducted in 39 career firefighters and fire service administration from across the U.S. Discussion were recorded, transcribed verbatim and transferred to NVivo software for narrative analysis. Topics explored included cancer perceptions, attitudes and beliefs, and cultural factors related to SLT use behaviors. Results: Major themes that emerged among fire service personnel included concerns about cancer and its risk factors including firefighting tasks, such as fire overhaul operations, and from their lifestyle behaviors, such as alcohol and tobacco use. Firefighters also suggested a number of reasons for their increased SLT use, such as fire department tobacco-free policy and fire service culture. Conclusion The current study provides a rich foundation for future research, prevention, and intervention efforts for the fire service and research communities regarding tobacco and SLT use and cancer risk. Additional research on firefighters' cancer beliefs deserves future research in order to improve messaging about the risks of cancer due to firefighting.
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Ersson A, Östman T, Sjöström R. Perceptions of Tuberculosis Among Individuals Born in a High-Endemic Setting, Now Living in a Low-Endemic Setting. J Immigr Minor Health 2020; 21:1373-1379. [PMID: 30788679 DOI: 10.1007/s10903-019-00858-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/27/2022]
Abstract
Of all individuals diagnosed with tuberculosis (TB) in Sweden 2015 were 90% born in other countries. Early diagnosis and treatment is essential to avoid TB transmission. Lack of knowledge about TB and anticipated negative social consequences have proved to be significant contributing factors to delay in seeking health care. This study aimed to understand the perception of TB among people originating from a high-endemic region, currently living in a low-endemic region. A qualitative study design, with male and female participants from a high-endemic region divided into focus groups. A semi-structured interview guide was used to elicit their perceptions of TB. A qualitative content analysis was performed on the recorded material from the interviews. The informants noted that their attitude towards individuals with TB had changed, previously they had felt prejudiced towards them whereas now they felt supportive. It seems possible to diminish TB stigma by ensuring suitable health care is available in combination with correct information about transmission, infectiousness and treatment.
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Affiliation(s)
- Annika Ersson
- Department of infectious diseases, Östersund Hospital, Östersund, Sweden. .,Östersund hospital, Building 12, 2d Floor, 831 27, Östersund, Sweden.
| | - Terese Östman
- Department of infectious diseases, Östersund Hospital, Östersund, Sweden
| | - Rita Sjöström
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden.,Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Moura AF, Aschemann-Witzel J. A downturn or a window of opportunity? How Danish and French parents perceive changes in healthy eating in the transition to parenthood. Appetite 2020; 150:104658. [PMID: 32171779 DOI: 10.1016/j.appet.2020.104658] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 12/16/2022]
Abstract
Alarming childhood obesity rates call for research into the factors that influence a child's environment. Although parents have a large influence on children's eating behaviours, surprisingly little research has explored parental healthy eating patterns. We conducted face-to-face interviews with parents of young children (up to 4 years old) living in Denmark (n = 16) and in France (n = 14) to provide insights into how the transition to parenthood affects the perceived healthfulness of eating behaviours. A problem-centred, Life-Course approach was employed, exploring the topics of interest from the perspective of the participants, and then interpreting these on the background of Social Cognitive Theory. From a cross-cultural sample of mostly well-educated parents living in couples, we found that the transition to parenthood represents a turning point for eating behaviour. Marked differences in dietary changes were perceived across four stages: 1) pregnancy, 2) first months with the baby, 3) complementary feeding and 4) child shares family meals. The findings point to an opposite cross-country perception of the impact of parenthood on food behaviours, and to the idea of what we called an "equalizing effect" on individuals' diet, where having a child triggered "unhealthy" eaters to consider dietary improvements while it imposed challenges to "healthy" eaters to maintain their satisfactory food habits. Contrasting differences on perceived behaviour change mainly appeared in terms of food ethics concern, meat consumption, cooking enjoyment, dietary diversity and sugar consumption. The proposition that low food-health-oriented individuals become healthier and (some) more environmentally conscious, reveals an opportunity for effective strategies and public health messages targeting health and food-ethics behaviour. Nevertheless, findings point to a need to consider individualized health support, addressing parental self-care, physiological changes, stress and negative emotions of early parenthood.
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Rodríguez-Rodríguez V, Pérez-Garín D, Recio-Saboya P, Rico-Gómez A. [Financial fraud and health: a qualitative approach]. Gac Sanit 2020; 34:268-275. [PMID: 31964535 DOI: 10.1016/j.gaceta.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/13/2019] [Accepted: 11/18/2019] [Indexed: 11/18/2022]
Abstract
During the economic crisis, developed countries have experienced financial fraud, with effects on the physical and mental health of the people affected, and on social domains. Based on the theoretical framework in literature reviews and in quantitative studies, this paper aims to obtain evidence on the effects of financial fraud on health and on the family and social environments of those affected. An intentional sample of 32 people affected by abusive and multi-currency mortgages, preferred and swap stock in Madrid was approached. In-depth interviews were conducted, and the resulting data was analysed using content analysis. Fraud-affected individuals had conditions of age, sex, educational level and occupations that possibly allowed them to accumulate economic resources throughout the course of their lives and, predictably in many cases, to take out fraudulent financial products, based on trust in the financial institutions. Financial fraud has led to the emergence of various processes of anomia and adverse health effects. The consequences on health were physical ailments (symptoms and diseases in various systems and parts of the body) and mental disorders (anxiety, depression, suicidal ideation), all affecting lifestyles, behaviour and personal and social relationships, both in affected individuals and their families. The increase in the use of medical drugs and health services serves as a final corollary to the imbalances on the affected people's health. Individuals and the Spanish society demand public health policy measures to mitigate the effects on health and the recovery of their confidence in the banking and political system.
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Affiliation(s)
- Vicente Rodríguez-Rodríguez
- Instituto de Economía, Geografía y Demografía, Consejo Superior de Investigaciones Científicas, Madrid, España.
| | | | - Patricia Recio-Saboya
- Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, España
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Krouwel M, Jolly K, Greenfield S. Comparing Skype (video calling) and in-person qualitative interview modes in a study of people with irritable bowel syndrome - an exploratory comparative analysis. BMC Med Res Methodol 2019; 19:219. [PMID: 31783797 PMCID: PMC6883529 DOI: 10.1186/s12874-019-0867-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [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: 06/15/2019] [Accepted: 11/13/2019] [Indexed: 12/31/2022] Open
Abstract
Background Within qualitative research in-person interviews have the reputation for being the highest standard of interviewer-participant encounter. However, there are other approaches to interviewing such as telephone and e-mail, which may be appropriate for a variety of reasons such as cost, time and privacy. Although there has been much discussion of the relative values of different interview methods, little research has been conducted to assess what differentiates them using quantifiable measures. None of this research has addressed the video call, which is the interview mode most like the in-person interview. This study uses quantifiable measures generated by the interview to explore the relative value of in-person and video call interview modes. Methods Interview data gathered by a qualitative research study exploring the views of people with IBS about hypnotherapy for their condition were used. In-person and video call interviews using the same topic guide were compared on measures of length (time and word count), proportion of time the interviewer was dominant, the number of topics generated (codes) and the number of individual statements on which those topics were based. Results Both interview methods produced a similar number of words and a similar number of topics (codes) were discussed, however the number of statements upon which the variety of topics was based was notably larger for the in-person interviews. Conclusion These findings suggest that in in-person study interviews were marginally superior to video calls in that interviewees said more, although this was on a similar range of topics. However, the difference is sufficiently modest that time and budget constraints may justify the use of some video call interviews within a qualitative research study.
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Affiliation(s)
- Matthew Krouwel
- Institute of Applied Health Research, University of Birmingham, 80, Hawkesley Mill Lane, Northfield, Edgbaston, Birmingham, B15 2TT, UK.
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, 80, Hawkesley Mill Lane, Northfield, Edgbaston, Birmingham, B15 2TT, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, 80, Hawkesley Mill Lane, Northfield, Edgbaston, Birmingham, B15 2TT, UK
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Schraeder KE, Reid GJ, Brown JB. An Exploratory Study of Children's Mental Health Providers' Perspectives on the Transition to Adult Care for Young Adolescents in the Canadian Context. J Pediatr Nurs 2019; 49:51-59. [PMID: 31491694 DOI: 10.1016/j.pedn.2019.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 01/16/2019] [Revised: 08/16/2019] [Accepted: 08/16/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE Many youth who receive specialized children's mental health treatment might require additional treatment as young adults. Little is known about how to prepare these youth for transitions to adult care. DESIGN AND METHODS This study gained perspectives from children's mental health providers (n = 10) about the process of caring for younger adolescents (aged 12-15) with mental health problems (e.g., depression, anxiety), who might require mental health services after age 18. Providers were asked about their clients' future mental health needs and the possibility of transition to adult care. RESULTS Using Grounded Theory analysis, an over-arching theme was providers' reluctance to consider the transition process for their younger clients (<16 years old). This stemmed from uncertainty among providers about: (1) who [which youth] will need adult mental health services; (2) when this discussion would be appropriate; and (3) what adult services would be available. CONCLUSIONS AND PRACTICE IMPLICATIONS Findings indicate a lack of treatment capacity within children's mental health to routinely monitor youth as they approach the age of transfer (18 years old). In the absence of routine monitoring (post-treatment), it may be difficult to predict who will need adult care. A comprehensive evaluation of existing follow-up practices, in children's mental health and beyond, is needed to identify strategies for ensuring adolescents with recurring conditions receive optimal transition care.
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Affiliation(s)
- Kyleigh E Schraeder
- Department of Psychology, The University of Western Ontario, London, ON, Canada.
| | - Graham J Reid
- Department of Psychology, The University of Western Ontario, London, ON, Canada; Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; Lawson Health Research Institute, London, ON, Canada.; Department of Paediatrics, The University of Western Ontario, London, ON, Canada; Children's Health Research Institute, London, ON, Canada
| | - Judith Belle Brown
- Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; School of Social Work, King's University College, London, ON, Canada
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Pizarro JM, Holt K, Pelletier KR. An examination of the situated transactions of firearm homicides. J Behav Med 2019; 42:613-25. [PMID: 31367927 DOI: 10.1007/s10865-019-00050-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/24/2019] [Indexed: 10/26/2022]
Abstract
This study employs a mixed methods approach, using quantitative analysis to discuss significant patterns, and qualitative analysis to provide descriptive accounts of homicide incidents. Seven hundred and five homicides that occurred in a northeastern city between January 1999 and December 2007 are examined to answer the following research question: Do the situated transactions of firearm homicides differ from those involving other weapons? The quantitative analyses found distinct patterns in offender intent, criminogenic tendencies, and situational attributes between firearm and other weapon homicides. The qualitative analysis revealed that firearms are most often utilized in homicides that can be understood as "doing crime," where offenders and victims are engaged in a criminal lifestyle and firearms are an extension of this activity. Other weapons are associated with homicides concerned with "establishing moral order," or defending values and ideals, between individuals who are intimate. The methodological and policy implication of these findings are discussed.
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40
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Elise Radina M, Deer BL, Herriman RA, Jagpal A, Dodd MM, Kawamura KL, Clark LC. Elucidating emotional closeness within the Theory of Health-Related Family Quality of Life: evidence from breast cancer survivors. BMC Res Notes 2019; 12:312. [PMID: 31159844 PMCID: PMC6545688 DOI: 10.1186/s13104-019-4354-5] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/31/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives Due to the increasing survivorship of breast cancer, survivor’s view of their families through the process of diagnosis and treatment is essential. The Theory of Health-related Family Quality of Life (HRFQoL) guided this exploration of the ways in which breast cancer impacts family life. In this study, HRFQoL was used to explore breast cancer survivors’ perceptions of the theory’s sub-concepts of psychological and/or affectional closeness, family communication, and social support. The guiding research question was: In what ways do breast cancer survivors describe their experiences regarding changes in emotional closeness among family members following their breast cancer diagnosis? Participants (N = 22) were interviewed to discuss their experiences with breast cancer, family quality of life, decision-making, basic health information, and personal coping. Data were analyzed using NVivo 9 to conduct thematic analysis and consensual qualitative data analysis. Results Diagnosis and treatment of breast cancer improved the majority of participants’ HRFQoL. Participants who reported positive perceptions prior to diagnosis also reported positive perceptions after diagnosis. These findings elucidate the HRFQoL theory and contribute to understanding how breast cancer impacts family life. Electronic supplementary material The online version of this article (10.1186/s13104-019-4354-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Elise Radina
- Department of Family Science & Social Work, Miami University, 101 McGuffey Hall, 210 E. Spring Street, Oxford, OH, 45056, USA.
| | - Briana L Deer
- Kansas City University of Medicine and Biosciences, Kansas City, USA
| | | | - Anjana Jagpal
- Department of Psychology, DePaul University, Chicago, USA
| | | | | | - Lindsay C Clark
- College of Optometry, University of Missouri-St. Louis, St. Louis, USA
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Sprague S. A Qualitative Evaluation of the Implementation of an Intimate Partner Violence Education Program in Fracture Clinics. J Fam Violence 2019; 34:621-630. [PMID: 31929680 PMCID: PMC6936650 DOI: 10.1007/s10896-019-00052-4] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We developed an intimate partner violence educational program (EDUCATE) for health care providers which was implemented in seven fracture clinics by local IPV champions. The purpose of the program was to provide health care providers with the knowledge and skills required to comfortably identify and assist women experiencing IPV in the fracture clinic. The program consisted of an introductory video, interactive online modules, and an in-person presentation by a local IPV champion. The study aim was to qualitatively evaluate the feasibility, acceptability, and perceived value of the program. We conducted semi-structured interviews with 10 champions and 23 participants and identified themes using a qualitative descriptive approach. Champions and participants expressed a strong satisfaction with the program. Champions also described several barriers and facilitators to program implementation. Additionally, we identified themes through analysis of interview data from champions (champion training, program delivery, and perceptions about program participants' receptiveness to the training) and participants (value of the training experience, useful program content, desire for more education, and suggested program improvements). The program showed promising results, as both champions and program participants had overall positive experiences completing the program. Their suggestions for improvement have been used to refine the program, which is now publically available for educational purposes through www.IPVeducate.com.
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Affiliation(s)
- Sheila Sprague
- Department of Surgery, McMaster University, 293 Wellington St. N., Suite 110, Hamilton, ON L8L 8E7 Canada
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Sundstrom B, Smith E, Delay C, Luque JS, Davila C, Feder B, Paddock V, Poudrier J, Pierce JY, Brandt HM. A reproductive justice approach to understanding women's experiences with HPV and cervical cancer prevention. Soc Sci Med 2019; 232:289-297. [PMID: 31121439 DOI: 10.1016/j.socscimed.2019.05.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 10/05/2017] [Revised: 04/18/2019] [Accepted: 05/09/2019] [Indexed: 11/20/2022]
Abstract
Cervical cancer is a preventable disease. HPV infection has been linked to more than 90% of cervical cancers. A vaccine to prevent the acquisition of HPV has been available since 2006. The purpose of this study was to investigate women's perceptions of cervical cancer prevention, including HPV vaccination. A reproductive justice framework guided data collection and analysis. In 2016, researchers conducted 70 in-depth, semi-structured qualitative interviews with women aged 19-78 years in South Carolina. A purposive sampling approach was employed to maximize requisite variety based on social, economic, and environmental axes of inequality. Participants self-identified as white (53%), African American (33%), and Hispanic (9%). Data analysis included an inductive constant comparative method to identify patterns and themes across the interviews. Misinformation about the prevalence and risk of HPV and cervical cancer led to "othering" of women with HPV-related diagnoses based on the flawed assumption of not being at risk. Participants described a lack of knowledge about the effectiveness and safety of the HPV vaccine. Social norms influenced participants' perceptions of HPV vaccination and cervical cancer, including concerns about sexual activity and intergenerational communication. Participants' social construction of identity, including race/ethnicity, socioeconomic position, ability, age, gender, sexual orientation, and immigration status, impacted their perceptions of cervical cancer screening and the HPV vaccine. In particular, participants believed that the HPV vaccine was "only for girls" and identified gender norms that limited uptake. Participants described barriers to accessing health care and cervical cancer screening, including cost, health insurance, and life changes (e.g., pregnancy, relocating). Many participants experienced an abnormal Papanicolaou test and described follow-up care, including biopsies and treatment for cervical dysplasia. Findings from this study offer insight into women's identity and perceptions of cervical cancer prevention. Results provide practical recommendations to increase women's agency in the development of successful public health interventions.
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Affiliation(s)
- Beth Sundstrom
- Department of Communication, College of Charleston, Charleston, SC, USA.
| | - Ellie Smith
- College of Public Health and Human Sciences, Oregon State University, USA
| | - Cara Delay
- Department of History, College of Charleston, Charleston, SC, USA
| | - John S Luque
- Institute of Public Health, Florida A&M University, USA
| | - Caroline Davila
- Department of Public Health Sciences, Medical University of South Carolina, USA
| | - Bailey Feder
- Department of Communication, College of Charleston, Charleston, SC, USA
| | - Vincenza Paddock
- Department of Communication, College of Charleston, Charleston, SC, USA
| | - Jessie Poudrier
- Department of Communication, College of Charleston, Charleston, SC, USA
| | | | - Heather M Brandt
- Arnold School of Public Health, University of South Carolina, USA
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Pérez-Álvarez C, Gallego-Royo A, Marco-Gómez B, Martínez-Boyero T, Altisent R, Delgado-Marroquín MT, Astier-Peña MP. Resident Physicians as Patients: Perceptions of Residents and Their Teaching Physicians. Acad Psychiatry 2019; 43:67-70. [PMID: 30264275 DOI: 10.1007/s40596-018-0981-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study aims to broaden understanding into the process by which resident physicians deal with illness and to identify areas for improvement regarding healthcare of residents and teaching physicians training to support them adequately. METHODS A qualitative study of ten semi-structured interviews with residents who had suffered a serious illness and a focus group of teaching physicians were conducted. Analysis of the interview transcripts was performed using the grounded theory approach, with information divided into five categories: Differences between residents as patients and general patients; confidentiality; feelings and attitudes; learning from illness; and impact on work and training. RESULTS There are differences between residents and the general population: In the initial stage, diagnosis is made promptly with preferential treatment shown by colleagues. Subsequently, the lack of clear guidelines can lead to poor follow-up. They accept a loss of confidentiality in the process. One of the most serious concerns felt by residents is the impact of their illness on their training as specialists, meaning that teaching physicians are charged with the important role of guaranteeing the resident's proper recovery, return to work, and readaptation to the training program. Teaching physicians demand their own training be reinforced in these aspects. CONCLUSION There is a need to assess the great diversity observed in training-related decisions made by teaching physicians when residents fall ill. Given the differences observed, more research is required to improve the care provided to sick residents and particularly the teaching physicians training to handle them.
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Affiliation(s)
- Candela Pérez-Álvarez
- Professionalism and Clinical Ethics Department, University of Zaragoza (Spain), IIS Aragón, Zaragoza, Spain
| | - Alba Gallego-Royo
- Professionalism and Clinical Ethics Department, University of Zaragoza (Spain), IIS Aragón, Zaragoza, Spain
| | - Bárbara Marco-Gómez
- Professionalism and Clinical Ethics Department, University of Zaragoza (Spain), IIS Aragón, Zaragoza, Spain
| | - Teresa Martínez-Boyero
- Professionalism and Clinical Ethics Department, University of Zaragoza (Spain), IIS Aragón, Zaragoza, Spain
| | - Rogelio Altisent
- Professionalism and Clinical Ethics Department, University of Zaragoza (Spain), IIS Aragón, Zaragoza, Spain
| | | | - María Pilar Astier-Peña
- Professionalism and Clinical Ethics Department, University of Zaragoza (Spain), IIS Aragón, Zaragoza, Spain.
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Del Moral G, Suárez-Relinque C. [Family categorization as a technique to support the analysis process that follows the grounded theory]. Gac Sanit 2018; 34:87-90. [PMID: 30591309 DOI: 10.1016/j.gaceta.2018.09.007] [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] [Received: 06/15/2018] [Revised: 08/27/2018] [Accepted: 09/20/2018] [Indexed: 10/27/2022]
Abstract
An important aspect that requires special attention by researchers using qualitative methods is the construction of theoretical categories, or more specifically, the step between coding and categorization. One of the most structured methodological proposals used in health sciences is grounded theory. In this paper an analytical technique called "family categorization" is proposed. Its aim is to facilitate the steps of creating the initial categories, based on intra- and inter-family codes analysis.
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Affiliation(s)
- Gonzalo Del Moral
- Área de Psicología Social, Departamento de Educación y Psicología Social, Universidad Pablo de Olavide, Sevilla, España.
| | - Cristian Suárez-Relinque
- Área de Psicología Social, Departamento de Educación y Psicología Social, Universidad Pablo de Olavide, Sevilla, España
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Thille P, Gibson BE, Abrams T, McAdam LC, Mistry B, Setchell J. Enhancing the human dimensions of children's neuromuscular care: piloting a methodology for fostering team reflexivity. Adv Health Sci Educ Theory Pract 2018; 23:867-889. [PMID: 29797172 DOI: 10.1007/s10459-018-9834-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/11/2018] [Indexed: 06/08/2023]
Abstract
For those with chronic, progressive conditions, high quality clinical care requires attention to the human dimensions of illness-emotional, social, and moral aspects-which co-exist with biophysical dimensions of disease. Reflexivity brings historical, institutional, and socio-cultural influences on clinical activities to the fore, enabling consideration of new possibilities. Continuing education methodologies that encourage reflexivity may improve clinical practice and trainee learning, but are rare. We piloted a dialogical methodology with a children's rehabilitation team to foster reflexivity (patient population: young people with Duchenne's or Becker's muscular dystrophy). The methodology involved three facilitated, interactive dialogues with the clinical team. Each dialogue involved clinicians learning to apply a social theory (Mol's The Logic of Care) to ethnographic fieldnotes of clinical appointments, to make routine practice less familiar and thus open to examination. Discourse analyses that preserve group dynamics were completed to evaluate the extent to which the dialogues spurred reflexive dialogue within the team. Overall, imagining impacts of clinical care on people's lives-emphasized in the social theory applied to fieldnotes-showed promise, shifting how clinicians interpreted routine practices and spurring many plans for change. However, this reflexive orientation was not sustained throughout, particularly when examining entrenched assumptions regarding 'best practices'. Clinicians defended institutional practices by co-constructing the metaphor of balancing logics in care delivery. When invoked, the balance metaphor deflected attention from emotional, social, and moral impacts of clinical care on patients and their families. Emergent findings highlight the value of analysing reflexivity-oriented dialogues using discourse analysis methods.
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Affiliation(s)
- Patricia Thille
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada.
| | - Barbara E Gibson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Thomas Abrams
- Department of Sociology and Social Anthropology, Dalhousie University, Halifax, NS, Canada
| | - Laura C McAdam
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada
- Department of Paediatrics, Division of Developmental Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Bhavnita Mistry
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada
| | - Jenny Setchell
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Rehnström Loi U, Lindgren M, Faxelid E, Oguttu M, Klingberg-Allvin M. Decision-making preceding induced abortion: a qualitative study of women's experiences in Kisumu, Kenya. Reprod Health 2018; 15:166. [PMID: 30285768 PMCID: PMC6171301 DOI: 10.1186/s12978-018-0612-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 01/31/2018] [Accepted: 09/25/2018] [Indexed: 11/30/2022] Open
Abstract
Background Unwanted pregnancies and unsafe abortions are prevalent in regions where women and adolescent girls have unmet contraceptive needs. Globally, about 25 million unsafe abortions take place every year. In countries with restrictive abortion laws, safe abortion care is not always accessible. In Kenya, the high unwanted pregnancy rate resulting in unsafe abortions is a serious public health issue. Gaps exist in knowledge regarding women’s decision-making processes in relation to induced abortions in Kenya. Decision-making is a fundamental factor for consideration when planning and implementing contraceptive services. This study explored decision-making processes preceding induced abortion among women with unwanted pregnancy in Kisumu, Kenya. Methods Individual face-to-face in-depth interviews were conducted with nine women aged 19–32 years old. Women who had experienced induced abortion were recruited after receiving post-abortion care at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) or Kisumu East District Hospital (KDH) in Kisumu, Kenya. In total, 15 in-depth interviews using open-ended questions were conducted. All interviews were tape-recorded, transcribed and coded manually using inductive content analysis. Results Respondents described their own experiences regarding decision-making preceding induced abortion. This study shows that the main reasons for induced abortion were socio-economic stress and a lack of support from the male partner. In addition, deviance from family expectations and gender-based norms highly influenced the decision to have an abortion among the interviewed women. The principal decision maker was often the male partner who pressed for the termination of the pregnancy indirectly by declining his financial or social responsibilities or directly by demanding termination. In some cases, the male partner controlled decision-making by arranging an unsafe abortion without the woman’s consent. Strategic choices regarding whom to confide in were employed as protection against abortion stigma. This contributed to a culture of silence around abortion and unwanted pregnancy, a factor that made women more vulnerable to complications. Conclusions The findings suggest that financial, social and gender-based dependencies influence women’s agency and perceived options in decision-making regarding abortion.
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Affiliation(s)
- Ulrika Rehnström Loi
- Department of Public Health Sciences/IHCAR, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Matilda Lindgren
- Department of Public Health Sciences/IHCAR, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Elisabeth Faxelid
- Department of Public Health Sciences/IHCAR, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Monica Oguttu
- College of Health Sciences, School of Nursing Sciences, University of Nairobi, Nairobi, Kenya.,Kisumu Medical Education Trust (KMET), Kisumu, Kenya
| | - Marie Klingberg-Allvin
- Department of Women's and Children's Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,School of Education, Health and Social Studies, Dalarna University, Högskolegatan 2, 791 31, Falun, Sweden
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Voith LA, Blakey JM. Restoring and Empowering Traumatized Girls in a Philippines-Based Independent Living Program: An Exploratory Study. J Child Adolesc Trauma 2018; 11:257-268. [PMID: 32318155 PMCID: PMC7163886 DOI: 10.1007/s40653-016-0116-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Researchers have examined knowledge and skillsets that enhance successful transitions into independent living for at-risk youth residing in independent living programs; however, few studies examine programs outside of the United States. Employing focus groups and participant-observation, this exploratory study examined areas of personal development, knowledge, and skills that former graduates, staff, and administrators of a Philippines-based independent living program believed essential for the success of young women with traumatic histories. Thematic analysis revealed three themes: (1) Psycho-Emotional-Spiritual Well-Being, (2) Cultivating a Fighting Spirit, and (3) Financial Stability. Distinct from much of the literature, spiritual development, a mechanism of Psycho-Emotional-Spiritual Wellbeing, and Cultivating a Fighting Spirit, a form of empowerment, emerged as important areas of development. The focal program emphasized personal development and restoration for the survival and success of young Filipina women in their agency.
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Affiliation(s)
- Laura A. Voith
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, OH 44106-7164 USA
| | - Joan Marie Blakey
- Helen Bader School of Social Welfare, University of Wisconsin Milwaukee, Milwaukee, WI USA
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Goldthorpe J, Sanders C, Macey R, Gough L, Rogers J, Tickle M, Pretty I. Exploring implementation of an electronic referral management system and enhanced primary care service for oral surgery: perspectives of patients, providers and practitioners. BMC Health Serv Res 2018; 18:646. [PMID: 30126391 PMCID: PMC6102936 DOI: 10.1186/s12913-018-3424-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/26/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND A specialist primary care oral surgery service combined with an electronic referral management and triage system was developed in response to concerns raised around overburdened secondary care services in the UK. Whilst the system has the potential to manage conflicting demand for oral surgery services against an objective need, the new pathway represents a number of challenges to existing working practices and could compromise the sustainability of existing hospital services. The aim of this research was to carry out a qualitative exploration of implementation of a new intervention to gain insight into how these challenges have manifested and been addressed. METHODS Views were sought from stakeholders (dentists, hospital staff, commissioners and patients) at various time points over 3 years during and after implementation using semi-structured interviews. Normalization Process Theory informed a qualitative thematic analysis which was carried out using data from interview transcripts to identify important emerging issues. RESULTS Themes emerging from the data were; amenability to change and assimilation into practice (primary care dentists), compliance and governance, changing perceptions of impact (secondary care staff and commissioners) understanding change in service provision and priorities for treatment (patients). The new pathway impacted stakeholders at different stages of implementation. CONCLUSION Electronic referral management with a primary care advanced service for oral surgery was successfully implemented in a specific area of the UK. The service model evaluated has the potential to be expanded across a wider geographical footprint and to support demand management in other specialist services.
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Affiliation(s)
- Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Coupland 1 Building, Manchester, M13 9PL UK
| | - Caroline Sanders
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Williamson Building, Manchester, M13 9PL UK
| | - Richard Macey
- Division of Dentistry, University of Manchester, J R Moore Building, Manchester, M13 9PL UK
| | - Lesley Gough
- Public Health England, Cheshire and Merseyside PHE Centre 5th Floor, Rail House Lord Nelson Street, Liverpool, L1 1JF UK
| | - Jean Rogers
- NHS England North, Regatta Place, Brunswick Business Park, Summers Road, Liverpool, L3 4BL UK
| | - Martin Tickle
- Division of Dentistry, University of Manchester, J R Moore Building, Manchester, M13 9PL UK
| | - Iain Pretty
- Colgate Palmolive/ University of Manchester Dental Health Unit, Williams House, Manchester Science Park, Manchester, M15 6SE UK
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Sheiban L, Stolee P, McAiney C, Boscart V. Health care provider experiences in primary care memory clinics: a phenomenological study. BMC Fam Pract 2018; 19:68. [PMID: 29778091 PMCID: PMC5960498 DOI: 10.1186/s12875-018-0756-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 05/01/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND There is a growing need for community-based services for persons with Alzheimer's disease and related dementias (ADRD). Memory clinic (MC) teams in primary care settings have been established to provide care to people with ADRD. To consider wider adoption of these MC teams, insight is needed into the experiences of practitioners working in these models. The purpose of the current study is to explore the experiences of health care providers (HCPs) who work in primary care Memory Clinic (MC) teams to provide care to persons with Alzheimer's disease and related dementias (ADRD). METHODS This study utilized a phenomenological methodology to explore experiences of 12 HCPs in two primary care MCs. Semi-structured interviews were completed with each HCP. Interviews were recorded and transcribed verbatim. Colaizzi's steps for analyzing phenomenological data was utilized by the authors. RESULTS Three themes emerged from the analysis to describe HCP experiences: supporting patients and family members during ADRD diagnosis and treatment, working in a team setting, and personal and professional rewards of caring for people with ADRD and their family members. CONCLUSIONS Findings provide insight into current practices in primary care MCs and on the motivation of HCPs working with persons with ADRD.
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Affiliation(s)
- Linda Sheiban
- School of Public and Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.,Schlegel Centre for Advancing Seniors Care, Conestoga College, Kitchener, Ontario, Canada
| | - Paul Stolee
- School of Public and Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada. .,Schlegel-UW Research Institute for Aging, Kitchener, Ontario, Canada.
| | - Carrie McAiney
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Veronique Boscart
- School of Public and Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.,Schlegel Centre for Advancing Seniors Care, Conestoga College, Kitchener, Ontario, Canada.,Schlegel-UW Research Institute for Aging, Kitchener, Ontario, Canada
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Allard J, Ballesteros F, Anthony SJ, Dumez V, Hartell D, Knoll G, Wright L, Fortin MC. What does patient engagement mean for Canadian National Transplant Research Program Researchers? Res Involv Engagem 2018; 4:13. [PMID: 29657835 PMCID: PMC5890351 DOI: 10.1186/s40900-018-0096-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 02/20/2018] [Indexed: 05/26/2023]
Abstract
PLAIN ENGLISH SUMMARY In recent years, the importance of involving patients in research has been increasingly recognized because it increases the relevance and quality of research, facilitates recruitment, enhances public trust and allows for more effective dissemination of results. The Canadian National Transplant Research Program (CNTRP) is an interdisciplinary research team looking at a variety of issues related to organ and tissue donation and transplantation. The aim of this study was to gather the perspectives of CNTRP researchers on engaging patients in research.We conducted interviews with 10 researchers who attended a national workshop on priority-setting in organ donation and transplant research. The researchers viewed patient engagement in research as necessary and important. They also considered that patients could be engaged at every step of the research process. Participants in this study identified scientific language, time, money, power imbalance, patient selection and risk of tokenism as potential barriers to patient engagement in research. Training, adequate resources and support from the institution were identified as facilitators of patient engagement.This study showed a positive attitude among researchers in the field of organ donation and transplantation. Further studies are needed to study the implementation and impact of patient engagement in research within the CNTRP. ABSTRACT Background Involving patients in research has been acknowledged as a way to enhance the quality, relevance and transparency of medical research. No previous studies have looked at researchers' perspectives on patient engagement (PE) in organ donation and transplant research in Canada. Objective The aim of this study was to gather the perspectives of Canadian National Transplant Research Program (CNTRP) researchers on PE in research. Methods We conducted semi-structured interviews with ten researchers who attended a national workshop on priority-setting in organ donation and transplant research. The interviews were digitally recorded and transcribed verbatim, and the transcripts were subjected to qualitative thematic and content analyses. Results The researchers viewed PE in research as necessary and important. PE was a method to incorporate the voice of the patient. They also considered that patients could be engaged at every step of the research process. The following were identified as the main barriers to PE in research: (i) scientific jargon; (ii) resources (time and money); (iii) tokenism; (iv) power imbalance; and (v) patient selection. Facilitating factors included (i) training for patients and researchers, (ii) adequate resources and (iii) institutional support. Conclusion This study revealed a favourable attitude and willingness among CNTRP researchers to engage and partner with patients in research. Further studies are needed to assess the implementation of PE strategy within the CNTRP and its impact.
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Affiliation(s)
- Julie Allard
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), 900 Saint-Denis St., Room 12-454, Montréal, QC, H2X 0A9 Canada
- Canadian National Transplant Research Program, Edmonton, Canada
| | - Fabián Ballesteros
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), 900 Saint-Denis St., Room 12-454, Montréal, QC, H2X 0A9 Canada
- Canadian National Transplant Research Program, Edmonton, Canada
| | - Samantha J. Anthony
- Canadian National Transplant Research Program, Edmonton, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Vincent Dumez
- Direction collaboration et partenariat patient, Faculty of Medicine, Université de Montréal, Montréal, Canada
- Centre of Excellence on Partnership with Patients and the Public, Université de Montréal, Montréal, Canada
| | - David Hartell
- Canadian National Transplant Research Program, Edmonton, Canada
| | - Greg Knoll
- Canadian National Transplant Research Program, Edmonton, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Linda Wright
- Canadian National Transplant Research Program, Edmonton, Canada
- Department of Surgery and Joint Centre for Bioethics, University of Toronto, Toronto, Canada
| | - Marie-Chantal Fortin
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), 900 Saint-Denis St., Room 12-454, Montréal, QC, H2X 0A9 Canada
- Canadian National Transplant Research Program, Edmonton, Canada
- Université de Montréal, Montréal, Canada
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