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Rahban A, Ghahramani A, Yusefzadeh H, Harirchi I, Alinia C. Price transparency in Iranian healthcare market. Health Policy Open 2024; 6:100120. [PMID: 38706778 PMCID: PMC11070242 DOI: 10.1016/j.hpopen.2024.100120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/24/2023] [Accepted: 04/25/2024] [Indexed: 05/07/2024] Open
Abstract
Insufficient price transparency has emerged as a pivotal contributor to patient dissatisfaction, escalating costs, and diminished productivity within Iran's health system. This study aims to delineate and elucidate a definition of price transparency, identify suitable strategies, and present the outcomes associated with establishing a health system that embraces transparent pricing while also addressing the challenges ahead. Employing a quantitative-qualitative research design, data were extracted from a semi-structured interviews with stakeholders. A purposive sampling method, encompassing sequential and snowball techniques, was employed to capture the perspectives of all stakeholders involved in the issue of price transparency in Iran. The interview data were analyzed using the grounded theory approach was classified into three categories: price transparency before, during, and after the receipt of healthcare services. Our findings reveal the causes of low price transparency, strategies to address the issue, and the consequences associated with increased levels of transparency. Ultimately, we contend that health systems can significantly enhance efficiency, patient satisfaction, and the performance of health insurance by adopting transparent pricing for health services, thus obviating the need for resource-intensive restructuring efforts.
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Affiliation(s)
- Ameneh Rahban
- Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Abolfazl Ghahramani
- Department of Occupational Health and Safety at Work Engineering, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Hasan Yusefzadeh
- Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Iraj Harirchi
- Department of Cardiology, School of Medicine, Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Cyrus Alinia
- Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
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Bourke SL, McKenna L, Cooper S, Lam L. Contextual determinants impacting final year nursing students' emergency team communication during deteriorating patient simulations: A grounded theory study. Nurse Educ Today 2024; 138:106183. [PMID: 38554566 DOI: 10.1016/j.nedt.2024.106183] [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: 02/10/2023] [Revised: 03/07/2024] [Accepted: 03/21/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND Ability to focus on development of students' team communication and non-technical skills may be reduced in content saturated nursing curricula. Even when communication and simulation-based education is provided, students' utilisation of non-technical skills remains challenging. Although simulation is a recognised means to learn communication skills, little is known about nursing students' team communication in simulated settings. OBJECTIVE To understand the process by which final year undergraduate nursing students communicate in simulated team emergencies. DESIGN Using constructivist grounded theory, data was collected using semi-structured interviews and student observations and analysed using constant comparative analysis. SETTING Simulation laboratories in one university nursing school in Australia. PARTICIPANTS 21 final year nursing students in seven teams. METHODS Data were gathered from interviews and video observations of final year nursing students during simulated team emergencies. RESULTS Interview data and observations of video-recordings revealed contextual determinants that influence communication within teams: the simulation context, the student context and the team context. Team member characteristics, such as cultural and linguistic background, life experiences, gender and age, the ability to shift from leadership to followership as well as environmental factors such as mask wearing and simulation fidelity, contributed to uncertainty in communicating that nursing team effectiveness. CONCLUSIONS Improvement of contextual conditions necessitates implementation of supportive strategies. These include development of educational initiatives, and further research in experiential learning as a modality for learners to experience team communication. Further, simulation context, student context and team context are important considerations. Meeting clinical communication learning needs of students allows better preparation to care for deteriorating patients as graduates.
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Affiliation(s)
- Sharon L Bourke
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia.
| | - Simon Cooper
- The Health Innovation and Transformation Centre (HITC), Institute of Health and Wellbeing, Federation University Australia, Berwick Campus, Clyde Road, Berwick, Victoria, Australia.
| | - Louisa Lam
- School of Nursing, Midwifery and Paramedicine (VIC), Faculty of Health Sciences, Australian Catholic University, Victoria Parade, Fitzroy, VIC 3065, Australia.
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Qi Y, Han J, Lu X, Wang Z, Ren H, Zhang X. A study on satisfaction evaluation of Chinese mainstream short video platforms based on grounded theory and CRITIC-VIKOR. Heliyon 2024; 10:e30050. [PMID: 38707463 PMCID: PMC11068598 DOI: 10.1016/j.heliyon.2024.e30050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
In recent years, Chinese short video platforms have experienced vigorous development, accompanied by increasing expectations and demands from users. This study aims to explore the factors influencing user satisfaction on mainstream Chinese short video platforms and provide a scientific and objective evaluation framework to support the enhancement of user satisfaction and the development of short video platforms. Through a combination of qualitative and quantitative research methods, multiple mainstream Chinese short video platforms were evaluated and analyzed. Firstly, semi-structured interviews with users were conducted using Grounded Theory to delve into the key factors shaping users' expectations, needs, and satisfaction towards short video platforms. Secondly, the CRITIC-VIKOR method was employed to assign comprehensive weights to various factors and to evaluate the satisfaction levels of the mainstream platforms. The study revealed that the core categories affecting user satisfaction include content quality and interaction, trust and values, and user experience. The weighted values of the main categories are as follows: interface and interaction design 0.124, personalized experience 0.115, platform stability and performance 0.075, privacy and security 0.133, user service and communication 0.060, social impact and values 0.124, content quality and diversity 0.088, social interaction 0.094, and advertising experience 0.186. Furthermore, the satisfaction evaluation of mainstream short video platforms indicated that bilibili platform garnered the highest user satisfaction among surveyed users. This study provides specific directions for improving user experience and enhancing user satisfaction for short video platforms, while also offering a evaluation framework based on Grounded Theory and CRITIC-VIKOR method for similar studies, thus expanding the theoretical and practical fields of user satisfaction research.
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Affiliation(s)
- YuZhe Qi
- School of Industrial Design, Silla University, Sasang-Gu, Busan, South Korea
| | - JiangYue Han
- Fashion Design Institute, Chengdu Vocational University of the Arts, Chengdu, Sichuan, China
| | - XiaoNing Lu
- School of Industrial Design, Silla University, Sasang-Gu, Busan, South Korea
| | - ZiXiang Wang
- School of Industrial Design, Silla University, Sasang-Gu, Busan, South Korea
| | - HongYan Ren
- Fashion Design Institute, Chengdu Vocational University of the Arts, Chengdu, Sichuan, China
| | - Xiang Zhang
- School of Industrial Design, Silla University, Sasang-Gu, Busan, South Korea
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Hing N, Thorne H, Lole L, Sproston K, Hodge N, Rockloff M. 'Getting addicted to it and losing a lot of money… it's just like a hole.' A grounded theory model of how social determinants shape adolescents' choices to not gamble. BMC Public Health 2024; 24:1270. [PMID: 38724892 PMCID: PMC11084133 DOI: 10.1186/s12889-024-18286-3] [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: 07/15/2023] [Accepted: 03/05/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Gambling abstinence when underage lowers the risk of harmful gambling in later life. However, little research has examined why many young people refrain from gambling, even though this knowledge can inform protective strategies and lower risk factors to reduce underage gambling and subsequent harm. This study draws on the lived experience of adolescent non-gamblers to explore how social determinants while growing up have shaped their reasons and choices to not gamble. METHODS Fourteen Australian non-gamblers, aged 12-17 years, participated in an in-depth individual interview (4 girls, 3 boys) or online community (4 girls, 3 boys). Questions in each condition differed, but both explored participants' gambling-related experiences while growing up, including exposure, attitudes and behaviours of parents and peers, advertising, simulated gambling and motivations for not gambling. The analysis used adaptive grounded theory methods. RESULTS The grounded theory model identifies several reasons for not gambling, including not being interested, being below the legal gambling age, discouragement from parent and peers, concern about gambling addiction and harm, not wanting to risk money on a low chance of winning, and moral objections. These reasons were underpinned by several social determinants, including individual, parental, peer and environmental factors that can interact to deter young people from underage gambling. Key protective factors were parental role modelling and guidance, friendship groups who avoided gambling, critical thinking, rational gambling beliefs, financial literacy and having other hobbies and interests. CONCLUSIONS Choices to not gamble emanated from multiple layers of influence, implying that multi-layered interventions, aligned with a public health response, are needed to deter underage gambling. At the environmental level, better age-gating for monetary and simulated gambling, countering cultural pressures, and less exposure to promotional gambling messages, may assist young people to resist these influences. Interventions that support parents to provide appropriate role modelling and guidance for their children are also important. Youth education could include cautionary tales from people with lived experience of gambling harm, and education to increase young people's financial literacy, ability to recognise marketing tactics, awareness of the risks and harms of gambling, and how to resist peer and other normalising gambling influences.
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Affiliation(s)
- Nerilee Hing
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, University Drive, 4670, Bundaberg, QLD, Australia.
| | - Hannah Thorne
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Adelaide, South Australia, Australia
| | - Lisa Lole
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, University Drive, 4670, Bundaberg, QLD, Australia
| | | | | | - Matthew Rockloff
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, University Drive, 4670, Bundaberg, QLD, Australia
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Laepple M, Beil-Hildebrand MB. Community Nurses' Perspectives on Conceptual Challenges Related to the Need for Nursing Care in Germany: A Constructivist Grounded Theory Study. Policy Polit Nurs Pract 2024; 25:119-126. [PMID: 38263677 DOI: 10.1177/15271544241228507] [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] [Indexed: 01/25/2024]
Abstract
In Germany, a person's need for nursing care is assessed by evaluators according to the federal legal definition of the statutory long-term care insurance (LTCI). This definition and the associated standardized assessment tool constitute the conditions for providing nursing care in a community care setting in Germany. Furthermore, the community care setting is regulated by state law and negotiations between long-term care funds and associations of providers of nursing care. During nursing care, nurses engage in a variety of interactions with people. The extent to which the legal definition of the need for nursing care leads to challenges in these interactions is unclear. To address this knowledge gap, we conducted 22 problem-centered interviews with nurses in the community and analyzed the data using the constructivist grounded theory. The results revealed that the negotiation processes are settled within professional-family relationships and vary between the constructs of closeness and distance, advocacy and submission of responsibility, and ethos and technocracy; these are the central challenges nurses encounter in this setting. We discuss the implications and questions that arise from the findings for the nursing profession regarding its own current and future role as well as the design of nursing support in the community, to nurture more advanced nurse practitioners and community health nurses.
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Affiliation(s)
- Miriam Laepple
- University of Koblenz - Faculty 1: Educational Sciences, Institute of Nursing Science, Koblenz, Rhineland-Palatinate, Germany
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Farrell SJ, Mills TA, Lavender T. Maternity care for women from ethnic minority backgrounds in North-West England: A grounded theory study. Sex Reprod Healthc 2024; 40:100978. [PMID: 38703456 DOI: 10.1016/j.srhc.2024.100978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/02/2024] [Accepted: 04/28/2024] [Indexed: 05/06/2024]
Abstract
AIM To understand the maternity experiences of women from minority ethnic groups who had given birth in an NHS trust in the North-West of England, and experiences of midwives caring for them. BACKGROUND Women from minority ethnic groups have poorer maternity outcomes compared with other women. Research about maternity experiences of women from minority ethnic groups is limited but suggests that they have poorer experiences. METHOD Constructivist grounded theory was used as the framework for the study. Thirteen women and sixteen midwives were interviewed to elicit views and maternity experiences of women from minority ethnic groups. Interviews were transcribed, analysed, and focused codes developed into theoretical codes resulting in an emergent grounded theory. FINDINGS Four sub-categories emerged: 'I was feeling protected', 'it is just literally empowering them, 'it will affect them more', and 'if people speak out it will help other people'. These sub-categories generated a substantive theory: 'striving towards equity and women centred care'. DISCUSSION Culturally sensitive, relational care made women feel safe and trust their care providers. Information provision led to reassurance and enabled women to make choices about their care. Midwives' workload compromised care provision and disproportionally affected women from minority ethnic groups, especially those who do not speak English. Women from minority groups are less likely to complain and be represented in feedback. CONCLUSION Culturally sensitive care is meeting the individual needs of many women; however, non- English speakers are disproportionally and negatively affected by midwives' workload, attitudes, or service challenges, reducing their reassurance and choice.
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Affiliation(s)
- Sarah J Farrell
- Centre for Childbirth, Women's and Newborn Health, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK; Research and Development, Liverpool Women's Hospital NHS Trust, Crown St, Liverpool, L8 7SS, UK.
| | - Tracey A Mills
- Centre for Childbirth, Women's and Newborn Health, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tina Lavender
- Centre for Childbirth, Women's and Newborn Health, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Marques FRDM, Laranjeira C, Carreira L, Gallo AM, Baccon WC, Goes HDF, Salci MA. Managing long COVID symptoms and accessing health services in Brazil: A grounded theory analysis. Heliyon 2024; 10:e28369. [PMID: 38571660 PMCID: PMC10988007 DOI: 10.1016/j.heliyon.2024.e28369] [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: 10/30/2023] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
Background The worldwide community has shown significant interest in researching the management of Long COVID. However, there is scarce evidence about the daily experiences of people living with Long COVID and their insights into the healthcare services provided to them. Aims This study aims to understand the experience of Long COVID sufferers with their symptoms and in accessing health services. Method We employed Charmaz's grounded theory methodology, informed by constructivism, and applied the COREQ guidelines for qualitative research. Sixty-six Brazilians living with Long COVID participated in the study. The data was collected using semi-structured telephone interviews and analyzed using a constant comparative process. Findings The findings refer firstly to the consequences of persistent Long COVID symptoms. Secondly, they describe how the disease trajectory required Long COVID sufferers to reorganize their routines and develop adaptive strategies. Lastly, they reflect a diverse array of both positive and negative interactions inside the healthcare system conveyed by individuals suffering from Long COVID. These elements converge towards the core category of the study: "The limbo of Long COVID sufferers: between the persistence of symptoms and access to health services". Conclusions Long COVID is characterized by its varied nature, including a range of physical and emotional repercussions experienced by individuals. There is a need for enhanced comprehension and discourse about Long COVID across several domains, including the general public, policy-making entities, and healthcare professionals. In this sense, the development of specialized services or the reinforcement of existing services to support long COVID sufferers is imperative.
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Affiliation(s)
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801, Évora, Portugal
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Herbert de Freitas Goes
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
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Azmoude E, Zagami SE, Hooshmand E, Taheri E, Shoorab NJ. Exploring the decision-making process of female genital cosmetic procedures in Iranian women and constructing and validating a results-based logic model for a healthy public policy: a study protocol. Reprod Health 2024; 21:46. [PMID: 38589866 PMCID: PMC11000343 DOI: 10.1186/s12978-024-01788-z] [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: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Female genital cosmetic procedures have grown rapidly in most parts of the world. Professional organizations have issued warnings about the complications and long-term consequences of these practices. To be able to adopt the right health policies, it is necessary to know why women decide to perform these procedures. Therefore, the present study will be aim to discover the decision-making process involved in performing female genital cosmetic procedures for Iranian women and construct and validate a results-based logic model for healthy public policy. METHODS The present study was conducted in three phases. In the initial phase, a qualitative study will be conducted with the Corbin and Strauss ground theory approach. The participants in the study will be healthy women who desire or have undergone female genital cosmetic procedures without medical indications. In this phase, purposive and theoretical sampling will guide recruitment and data collection. The data will be collected via semi-structured interviews, field notes and observations of individual interactions. The data will be analysed using the approach of Corbin and Strauss (2015). MAXQDA 2007 software was used for managing the process of data analysis. In the second phase, the development of a results-based logic model for a healthy public policy is performed based on the findings of the first phase of the study, interviews with key informants and a review of the results of the literature in this field. Finally, validation of the designed program will be performed by the nominal group technique with the presence of a group of experts in the third phase. DISCUSSION The findings of this study, by identifying women's main concerns related to the studied phenomenon, the existing context, participants' reactions and the consequences of the adopted reactions, can be very important in designing a program that fits Iran's cultural characteristics. In this research, a program using a logical model will be presented that is suitable for policymakers, planners and healthcare service providers to be implemented in the social-cultural context of the study.
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Affiliation(s)
- Elham Azmoude
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Ebrahimzadeh Zagami
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Hooshmand
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Taheri
- Department of Clinical Psychology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Jahani Shoorab
- Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Wang F, Zhou J, Fan C. Exploring the factors influencing public intention for spectator sports consumption based on grounded theory. Sci Rep 2024; 14:8221. [PMID: 38589500 PMCID: PMC11001854 DOI: 10.1038/s41598-024-59049-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/05/2024] [Indexed: 04/10/2024] Open
Abstract
Spectator sports consumption serves as a vital component in the development of the sports industry. However, numerous challenges exist in fostering public engagement in this domain. Therefore, in order to explore the factors that influence public participation in spectator sport consumption, this study analyzes the intention to participate in spectator sports consumption from the perspective of consumers. On this basis, Semi-structured interviews were conducted with a sample of 25 members of the public, and three levels of coding were analyzed using the qualitative research method of procedural rooting theory and establish a model on the influence of public intention to participate in spectator sports consumption, and on this basis, we reveal the influence of crucial elements. The results of the study indicate that: Firstly, personal and psychological factors are significant internal drivers, while external drivers cover product and contextual factors. Secondly, the key to filling the attitudinal and behavioral gaps is the depth of perception individually, which is of great importance in increasing public participation. Thirdly, external contextual factors impacting consumer support primarily consist of external incentives, social influences, and urban contextual variables, which also serve a moderating role in the integration model. The results suggest that guiding the public to actively participate in spectator sport consumption should be based on an understanding of individual perceptions, emotions as well as attitudes. This paper develops a model examining public motivation to engage in spectator sports locally in China, pinpoints the primary influencing factors and mechanisms, and presents novel concepts for the sustainable growth of the sports sector.
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Affiliation(s)
- Fenghao Wang
- School of Physical Education, Ludong University, Yantai, China
| | - Junhua Zhou
- School of Physical Education, Ludong University, Yantai, China.
| | - Chenyu Fan
- School of Foreign Languages, Ludong University, Yantai, China
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McPoland P, Grossoehme DH, Sheehan DC, Stephenson P, Downing J, Deshommes T, Gassant PYH, Friebert S. Children's understanding of dying and death: A multinational grounded theory study. Palliat Support Care 2024; 22:213-220. [PMID: 36960605 DOI: 10.1017/s1478951523000287] [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] [Indexed: 03/25/2023]
Abstract
OBJECTIVES The ways in which children understand dying and death remain poorly understood; most studies have been carried out with samples other than persons with an illness. The objective of this study was to understand the process by which children directly involved with life-limiting conditions understand dying and death. METHODS This qualitative study obtained interview data from N = 44 5-18-year-old children in the USA, Haiti, and Uganda who were pediatric palliative care patients or siblings of patients. Of these, 32 were children with a serious condition and 12 were siblings of a child with a serious condition. Interviews were recorded, transcribed, verified, and analyzed using grounded theory methodology. RESULTS Loss of normalcy and of relationships emerged as central themes described by both ill children and siblings. Resilience, altruism, and spirituality had a bidirectional relationship with loss, being strategies to manage both losses and anticipated death, but also being affected by losses. Resiliency and spirituality, but not altruism, had a bidirectional relationship with anticipating death. Themes were consistent across the 3 samples, although the beliefs and behaviors expressing them varied by country. SIGNIFICANCE OF RESULTS This study partially fills an identified gap in research knowledge about ways in which children in 3 nations understand dying and death. While children often lack an adult vocabulary to express thoughts about dying and death, results show that they are thinking about these topics. A proactive approach to address issues is warranted, and the data identify themes of concern to children.
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Affiliation(s)
- Paula McPoland
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Daniel H Grossoehme
- Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH, USA
- College of Public Health, Kent State University, Kent, OH, USA
| | | | | | - Julia Downing
- International Children's Palliative Care Network, Assagay, South Africa
- Makerere/Mulago Palliative Care Unit, Kampala, Uganda
| | - Theony Deshommes
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | - Pascale Y H Gassant
- Department of Pediatric Oncology, Saint-Damien Pediatric Hospital, Tabarre, Haiti
| | - Sarah Friebert
- Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH, USA
- Department of Pediatrics, Northeast Ohio Medical University, Rootstown, OH, USA
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Du J, Zhu X, Li X, Ünal E. What drives the green development behavior of local governments? A perspective of grounded theory. Heliyon 2024; 10:e27744. [PMID: 38509992 PMCID: PMC10951574 DOI: 10.1016/j.heliyon.2024.e27744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/10/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024] Open
Abstract
Although the elements that lead local governments to adopt sustainable development behaviors have been examined, the underlying processes that local governments adopt to accomplish green development behavior (GDB) lack systematic theoretical analysis. This study aims to investigate the determinants influencing local governments' implementation of GDB from the organizational internal and external perspectives. This study employed grounded theory to analyze the data and develop an influencing factor model of local government green development behavior (GDB-LG) after interviewing 53 Chinese local officials. Additionally, through integrating process organization research with new institutional theory, the mechanism that explains how these elements influence GDB was investigated. The results of the study demonstrate that the influencing factors model could give municipal governments clear guidance when creating sensible green development policies, further enhancing the efficacy of GDB.
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Affiliation(s)
- Jianguo Du
- School of Management, Jiangsu University, Zhenjiang, 212013, China
| | - Xiaowen Zhu
- School of Management, Jiangsu University, Zhenjiang, 212013, China
- Centre for Design Engineering, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - Xingwei Li
- College of Architecture and Urban-Rural Planning, Sichuan Agricultural University, Chengdu, 611830, China
| | - Enes Ünal
- Centre for Design Engineering, Cranfield University, Bedfordshire, MK43 0AL, UK
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Jin L, Jowsey T, Yin M. Medical students' perceptions of prosocial behaviors: a grounded theory study in China. BMC Med Educ 2024; 24:353. [PMID: 38553677 PMCID: PMC10981338 DOI: 10.1186/s12909-024-05335-z] [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] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/21/2024] [Indexed: 04/01/2024]
Abstract
INTRODUCTION Prosocial behavior has been shown to be protective against burnout. Yet, we know little about prosocial behavior in medical students. We wanted to know what are chinese medical students' understanding of prosocial behavior and which factors influence their participation in it? METHODS We undertook a grounded theory study, following Corbin & Strauss. We used convenience sampling and conducted semi-structured individual interviews. We analyzed data using open, axial, and selective coding techniques. Next, we grouped data into concepts. We noticed these concepts aligned with three existing social theories, so we developed our theory in concert with these: the Theory of Planned Behavior, Self-Determination Theory, and Social Support Theory. RESULTS Twenty-eight medical students participated in this study. Medical students hold especial views on the roles of medical physicians, and most of these views align with students' core values, including the value of prosocial behavior. Students are intrinsically motivated to engage in prosocial behaviors that align with their core values. Personal values, personality traits, perceived self-competence, career motivation, environmental factors, and family influences are the core factors influencing medically positive prosocial behavior. CONCLUSIONS This study supports a focus on prosocial behavior instead of altruistic behavior in medical education. We anticipate that promoting prosocial behavior through medical curricula will reduce moral distress and burnout among medical students.
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Affiliation(s)
- Linya Jin
- School of Medical Humanity, Harbin Medical University, Nangang District, Heilongjiang Province, Harbin, China
| | - Tanisha Jowsey
- School of Medicine, Bond University, 14 University Drive, Robina, Gold Coast, QLD, 4226, Australia
| | - Mei Yin
- School of Medical Humanity, Harbin Medical University, Nangang District, Heilongjiang Province, Harbin, China.
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Debono B, Lonjon G, Guillain A, Moncany AH, Hamel O, Challier V, Diebo B. Spine surgeons facing second opinions: a qualitative study. Spine J 2024:S1529-9430(24)00155-4. [PMID: 38556219 DOI: 10.1016/j.spinee.2024.03.013] [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: 10/31/2023] [Revised: 03/04/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND CONTEXT The social and technological mutation of our contemporary period disrupts the traditional dyad that prevails in the relationship between physicians and patients. PURPOSE The solicitation of a second opinion by the patient may potentially alter this dyad and degrade the mutual trust between the stakeholders concerned. The doctor-patient relationship has often been studied from the patient's perspective, but data are scarce from the spine surgeon's point of view. STUDY DESIGN/SETTING This qualitative study used the grounded theory approach, an inductive methodology emphasizing field data and rejecting predetermined assumptions. PATIENT SAMPLE We interviewed spine surgeons of different ages, experiences, and practice locations. We initially contacted 30 practitioners, but the final number (24 interviews; 11 orthopedists and 13 neurosurgeons) was determined by data saturation (the point at which no new topics appeared). OUTCOME MEASURES Themes and subthemes were analyzed using semistructured interviews until saturation was reached. METHODS Data were collected through individual interviews, independently analyzed thematically using specialized software, and triangulated by three researchers (an anthropologist, psychiatrist, and neurosurgeon). RESULTS Index surgeons were defined when their patients went for a second opinion and recourse surgeons were defined as surgeons who were asked for a second opinion. Data analysis identified five overarching themes based on recurring elements in the interviews: (1) analysis of the patient's motivations for seeking a second opinion; (2) impaired trust and disloyalty; (3) ego, authority, and surgeon image; (4) management of a consultation recourse (measurement and ethics); and (5) the second opinion as an avoidance strategy. Despite the inherent asymmetry in the doctor-patient relationship, surgeons and patients share two symmetrical continua according to their perspective (professional or consumerist), involving power and control on the one hand and loyalty and autonomy on the other. These shared elements can be found in index consultations (seeking high-level care/respecting trust/closing the loyalty gap/managing disengagement) and referral consultations (objective and independent advice/trusting of the index advice/avoiding negative and anxiety-provoking situations). CONCLUSIONS The second opinion often has a negative connotation with spine surgeons, who see it as a breach of loyalty and trust, without neglecting ego injury in their relationship with the patient. A paradigm shift would allow the second opinion to be perceived as a valuable resource that broadens the physician-patient relationship and optimizes the shared surgical decision-making process.
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Affiliation(s)
- Bertrand Debono
- Paris-Versailles Spine Center (Centre Francilien du Dos), Paris, France; Ramsay Santé-Hôpital Privé de Versailles, Versailles, France.
| | - Guillaume Lonjon
- Department of Orthopedic Surgery, Orthosud, Clinique St-Jean- Sud de France, Santecite Group. St Jean de Vedas, Montpellier Metropole, France
| | - Antoine Guillain
- AMADES (Medical Anthropology, Development and Health), Centre de la Vieille Charité, Marseille, France
| | - Anne-Hélène Moncany
- Department of Psychiatry and Addictive Behaviour, Gerard Marchant Hospital Center, Toulouse, France
| | - Olivier Hamel
- Department of Neurosurgery, Ramsay Santé-Clinique des Cèdres, Cornebarrieu, France
| | - Vincent Challier
- Department of Orthopedic Surgery, Hôpital privé du dos Francheville, Périgueux, France
| | - Bassel Diebo
- Department of Orthopedic surgery, Brown University Warren Alpert Medical School, East Providence, RI, USA
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Paganini A, Westesson LM, Hansson E, Karlsson SA. Women's decision process when actively choosing to 'go flat' after breast cancer: a constructivist grounded theory study. BMC Womens Health 2024; 24:178. [PMID: 38491353 PMCID: PMC10941362 DOI: 10.1186/s12905-024-03015-0] [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: 11/09/2023] [Accepted: 03/06/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE This study aims to describe a conceptual model that could illuminate the decision process women go through when choosing to go flat on one or both sides due to breast cancer. METHODS A qualitative design, with constructivist grounded theory was used. Eighteen women were individually interviewed, digitally or by telephone, until saturation was reached. Data were analysed using a constant comparative iterative method in accordance with grounded theory. By examining the text data to identify the decision process for going flat and rejecting reconstructive surgery open coding was obtained. As the study proceeded patterns were explored and categories developed into a core category. RESULTS The overall decision process for women choosing to go flat on one or both sides emerged in three phases: Phase 1, where the women are forced to "Face the cancer", Phase 2 comprising "Reflections on health and motivation" and Phase 3, described as "Hobson's choice". The fundament of the decision process was found in the core category "Establishing and safeguarding the chosen self". CONCLUSIONS The decision process involved in actively going flat and rejecting reconstructive surgery is founded in the individual woman's motivations, such as view of femininity and apprehensions about the offered reconstructive surgery.
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Affiliation(s)
- Anna Paganini
- Region Västra Götaland, Department of Plastic and Reconstructive Surgery, Sahlgrenska University hospital, Gothenburg, Sweden.
- Sahlgrenska Academy, Institution for Health and Care Sciences at Gothenburg University, Gothenburg, Sweden.
- Sahlgrenska Academy, Institution for Clinical Sciences at Gothenburg University, Gothenburg, Sweden.
| | - Linda Myrin Westesson
- Sahlgrenska Academy, Institution for Health and Care Sciences at Gothenburg University, Gothenburg, Sweden
- Region Västra Götaland, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Emma Hansson
- Region Västra Götaland, Department of Plastic and Reconstructive Surgery, Sahlgrenska University hospital, Gothenburg, Sweden
- Sahlgrenska Academy, Institution for Clinical Sciences at Gothenburg University, Gothenburg, Sweden
| | - Susanne Ahlstedt Karlsson
- Sahlgrenska Academy, Institution for Health and Care Sciences at Gothenburg University, Gothenburg, Sweden
- Region Västra Götaland, Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
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de Vries AJ, Hoeve YT, Jaarsma DADC, Pols J, van Raay JJAM. Developing a model describing voluntary residency attrition: a qualitative study. BMC Med Educ 2024; 24:221. [PMID: 38429755 PMCID: PMC10908006 DOI: 10.1186/s12909-024-05223-6] [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] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Many factors influencing residency attrition are identified in the literature, but what role these factors play and how they influence each other remains unclear. Understanding more about the interaction between these factors can provide background to put the available evidence into perspective and provide tools to reduce attrition. The aim of this study was therefore to develop a model that describes voluntary residency attrition. METHODS Semi-structured interviews were held with a convenient sample of orthopaedic surgery residents in the Netherlands who dropped out of training between 2000 and 2018. Transcripts were analysed using a constructivist grounded theory approach. Concepts and themes were identified by iterative constant comparison. RESULTS Seventeen interviews with former residents were analysed and showed that reasons for voluntary attrition were different for each individual and often a result of a cumulative effect. Individual expectations and needs determine residents' experiences with the content of the profession, the professional culture and the learning climate. Personal factors like previous clinical experiences, personal circumstances and personal characteristics influence expectations and needs. Specific aspects of the residency programme contributing to attrition were type of patient care, required skills for the profession, work-life balance and interpersonal interaction. CONCLUSIONS This study provides a model for voluntary resident attrition showing the factors involved and how they interact. This model places previous research into perspective, gives implications for practice on the (im)possibilities of preventing attrition and opens possibilities for further research into resident attrition.
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Affiliation(s)
- Astrid J de Vries
- Department of Orthopaedic Surgery, Martini Hospital Groningen, Groningen, The Netherlands.
| | - Yvonne Ten Hoeve
- Health Sciences - Nursing Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | | | - Jan Pols
- Center for Education Development and Research in Health Professions (CEDAR), Lifelong Learning, Education and Assessment Research Network (LEARN), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jos J A M van Raay
- Department of Orthopaedic Surgery, Martini Hospital Groningen, Groningen, The Netherlands
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Longhurst P, Aspell J, Todd J, Swami V. "There's No Separating My View of My Body from My Autism": A qualitative study of positive body image in autistic individuals. Body Image 2024; 48:101655. [PMID: 38042087 DOI: 10.1016/j.bodyim.2023.101655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/11/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023]
Abstract
While scholars have investigated positive body image across diverse populations, extant theory largely excludes those with differing socio-cognitive experiences, such as autistic individuals. Using constructivist grounded theory, this study sought to develop a grounded theory of positive body image in autistic individuals. One-to-one interviews with photo-elicitation were conducted with 20 autistic adults (7 women, 8 men, 5 non-binary/agender; aged 18-53 years) from the United Kingdom. Through a process of open, axial, and focused coding, a grounded theory was developed around a core category of positive body image in autistic adults and was found to comprise six themes: body connection, body acceptance, appreciating body functionality and neurodivergent strengths, having a body-positive protective filter, taking care of the body, and body and appearance neutrality. Our findings suggest that some aspects of positive body image in autistic individuals are consistent with those found in neurotypical adults. However, positive body image in autistic individuals further encompasses both the sensory (i.e., how the body is felt) and aesthetic (i.e., how the body is seen) body. These findings may stimulate research aimed at improving positive body image in autistic populations.
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Affiliation(s)
- Phaedra Longhurst
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom.
| | - Jane Aspell
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Jennifer Todd
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
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Jordan SP. Compelling care: A grounded theory of transmasculine self-defense and collective protection at the clinic. Soc Sci Med 2024; 345:116638. [PMID: 38364718 DOI: 10.1016/j.socscimed.2024.116638] [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: 09/01/2023] [Revised: 12/12/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024]
Abstract
Despite formidable inequities in health care systems, transgender people are accessing clinical services in record numbers and gaining recognition as a patient population. This article examines how transgender people are negotiating their care and, in so doing, challenging patterns of marginalization and exclusion. Interviews with twenty-six transmasculine adults were collected and analyzed in the context of a community-led initiative foregrounding low-income people and people of color in Los Angeles County using a constructivist grounded theory approach. Participants gained agency in clinical settings by compelling care, a grounded theory that explains how patients contest medical authority and shift power through everyday acts to defend themselves and future patients. Histories of mistreatment and unequal social power drive patients to engage with health care providers judiciously and with a sense of social responsibility. In tracing seemingly decentralized acts of self-defense (e.g., vetting providers, disrupting gender norms, directing treatment), the study shows how patients rely on community resources and marshal collective protection. The theory recasts patients as constitutive actors in a changing landscape of care and as integral to, and one of many fronts of, collective struggle. In turn, the study lends theoretical insights to anti-racist understandings of medical mistrust andoffers a depathologized framework toward the development of community-building health equity interventions.
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Affiliation(s)
- Sid P Jordan
- Portland State University, School of Social Work, 1800 SW 6th Ave, Portland, OR, 97201, USA.
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Senette CL, Dingley C, Doolen J, Gordon H. Fluctuating cohesion: A grounded theory study of nursing students engaged in a combined debriefing format. Nurse Educ Pract 2024; 76:103943. [PMID: 38554617 DOI: 10.1016/j.nepr.2024.103943] [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: 12/20/2023] [Revised: 02/25/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
AIM This study explored the social processes enacted by nursing students when they engage in a combined format of structured peer debriefing followed by instructor-led debriefing after in-person simulation. The aim was to gain insight into nursing students' perceptions and how peer processes influenced reflection and learning. BACKGROUND Debriefing, a key component of clinical simulation, promotes development of nursing students' reflective processes and enhances learning. In-person group-debriefing led by faculty/instructors is the most used debriefing format in healthcare simulation education. Yet, recent studies indicate instructor-led formats may increase students' anxiety and limit their capacity for reflection, a crucial step in clinical reasoning and decision making. Investigations into learner-centered formats support peer debriefing as a reasonable alternative to traditional instructor-led debriefing. However, current peer debriefing studies provide little insight into the social interactions and processes supporting reflection and learning; and little theoretical basis exists for the integration of alternatives to instructor-led debriefing formats (such as peer debriefing) into simulation-based education. DESIGN This qualitative study used a Straussian grounded theory design. METHODS Senior-level baccalaureate and associate degree nursing students from an U.S. public university with first-hand experience using the combined format of peer debriefing followed by instructor-led debriefing were recruited to participate in focus-group interviews. Data gathered from semi structured interviews were analysed using the iterative process of constant comparison. Theory building was aided using memoing, theoretical sampling and conceptual diagramming. RESULTS The sample consisted of 34 students. Study findings revealed the core category of the constructed theory, 'Fluctuating cohesion', involved students' pervasive sense of going back and forth between a sense of unity (we-ness) and separatism (me-ness) while engaged in the combined debriefing format. The theory integrated five related categories: discovering the process, normalizing experiences, developing mutuality, dynamic balancing and engaging informal social connections. Findings illustrated the processes students enacted to take ownership for learning and proactively discuss their clinical decision-making with the instructor. In turn, reflection was enhanced by increased receptiveness to subsequent expert feedback. CONCLUSIONS The study findings demonstrated that augmenting instructor-led debriefing with peer debriefing leveraged the beneficial nature of peer interactions, promoted psychological safety, facilitated nascent team behaviors and enhanced reflective thinking. The resultant theory that was generated from the findings and grounded in participants' experience, provides a meaningful framework that may inform future learner-centered debriefing formats aimed at optimizing debriefing effectiveness.
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Affiliation(s)
- Carol Lynn Senette
- University of Nevada, Las Vegas School of Nursing, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA; University of Alaska Anchorage School of Nursing, Health Sciences Building, 3795 Piper St, Anchorage, AK 99508, USA.
| | - Catherine Dingley
- University of Nevada, Las Vegas School of Nursing, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA
| | - Jessica Doolen
- University of Nevada, Las Vegas School of Nursing, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA.
| | - Howard Gordon
- University of Nevada, Las Vegas School of Nursing, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA
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Cui J, Yu S, Xu M, Ma J, Cui W, Cao X, He Q, Luo W, Huang H, Lin X. Construction and enhancement of government capacity for international communication and promotion of Chinese Wushu. Heliyon 2024; 10:e25695. [PMID: 38390092 PMCID: PMC10881557 DOI: 10.1016/j.heliyon.2024.e25695] [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: 11/08/2022] [Revised: 01/17/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND In the process of international communication in Chinese Wushu (ICCW), the government controls the orientation, scale, pace. However, the ICCW currently lacks a standardised government capacity structural system, and a detailed study of framework construction may be required to ensure the smooth development of the ICCW. OBJECTIVES This study aims to clarify these elements and construct a framework for a governmental capacity system for ICCW. METHODS For this purpose, an expert interview outline was designed, and in-depth interviews were conducted with 61 experts. Using grounded theory in the qualitative research method, NVivo 12 software was used to conduct a three-level coding analysis of the interview text for data processing and analysis. RESULTS We extracted 58 opening codes and 11 tree nodes and categorised them into three core categories: supply side government capacity, environment-side government capacity, and demand-side government capacity, accounting for 62.36 %, 24.76 %, and 12.86 % of the total, respectively, which jointly constructed the framework structure system of the governmental capacity system for the ICCW. CONCLUSIONS This study found that these three-dimensional government capacities have synergistic effects and that multiple measures work together. The government should ensure the supply side's direct promotion effect; the environmental side's indirect influencing effect; and the demand side's internal driving effect to promote ICCW. Meanwhile, a closed-loop systematic study of communication processes should be conducted in combination with communication organisations and individuals.
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Affiliation(s)
- Jianhua Cui
- College of Education, Zhejiang University, Hangzhou 310063, China
| | - Songting Yu
- College of International Education, Shandong University, Jinan 250100, China
| | - Man Xu
- College of Education, Zhejiang University, Hangzhou 310063, China
| | - Juncheng Ma
- Department of Basic Education, Zhejiang Conservatory of Music, Hangzhou 310024, China
| | - Wenjuan Cui
- Department of Public Sports, Zhejiang International Studies University, Hangzhou 310023, China
| | - Xueying Cao
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Qingshan He
- Department of Public Sports, Ningbo University of Finance & Economics, Ningbo 315175, China
| | - Wenxiao Luo
- Department of Physical Education, Hangzhou Culture, Radio, Television, Tourism and Sports Office, Hangzhou 310015, China
| | - Haiyun Huang
- Department of Basic Education, Shanghai Lida University, Shanghai 201608, China
| | - Xiaomei Lin
- College of Education, Zhejiang University, Hangzhou 310063, China
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Bäckström D, Alvinius A. Physicians' challenges when working in the prehospital environment - a qualitative study using grounded theory. Int J Emerg Med 2024; 17:28. [PMID: 38413854 PMCID: PMC10900586 DOI: 10.1186/s12245-024-00599-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND In the rapid development in prehospital medicine the awareness of the many challenges in prehospital care is important as it highlights which areas need improvement and where special attention during education and training should be focused. The purpose of this study is to identify challenges that physicians face when working in the prehospital environment. The research question is thus; what challenges do physicians face when working in prehospital care? METHOD This is a qualitative study with an inductive approach and is based on individual interviews. The interviews were analyzed using the Classic Grounded Theory (GT) method as an approach. The interviews were conducted as semi-structured interviews via the digital platform Zoom during winter / early spring 2022. RESULTS Challenges for prehospital physicians can be understood as a process that involves a balancing act between different factors linked to the extreme environment in which they operate. This environment creates unique challenges not usually encountered in routine hospital practice, which results in trade-offs that they would not otherwise be faced with. Their individual situation needs to be balanced against organizational conditions, which means, among other things, that their medical decisions must be made based on limited information as a result of the constraints that exist in the prehospital environment. They must, both as individuals and as part of a team, manoeuvre in time and space for decision-making and practical tasks. This theory of balancing different entities is based on four themes; thus the theory is the relation between the four themes: leadership, environment, emotion management and organization. CONCLUSIONS With the help of previous studies and what we have found, it is reasonable to review what training is needed before starting to work prehospital as a physician. This should include components of the themes we have described: organization, environment, leadership and emotional management.
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Affiliation(s)
- Denise Bäckström
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, 581 83, Sweden.
| | - Aida Alvinius
- Department of Leadership and Command & Control, Swedish Defence University, Våxnäsgatan 10, Karlstad, 651 80, Sweden
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Valerius K, von Eitzen L, Göbel M, Ohlbrecht H, van den Berg N, Völzke H, Grabe HJ, Schomerus G, Speerforck S. Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience. BMC Psychiatry 2024; 24:153. [PMID: 38388350 PMCID: PMC10885433 DOI: 10.1186/s12888-024-05521-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Seeking help for severe depressive symptoms remains a major obstacle for particular groups within the general population. Value-related attitudes might contribute to this treatment gap, particularly in rural regions with a low density of psychiatric-psychotherapeutic services. We aimed to investigate narratives of socialization, value systems, and barriers of help-seeking to better understand social milieus at increased risk for underuse of psychiatric-psychotherapeutic services in a rural area in East Germany. This could complement the explanatory power of classical socio-demographic determinants and provide guidance for possible interventions. METHOD Based on results of an analysis of a population-based German cohort study (SHIP-TREND-1), 20 individual semi-structured interviews were conducted with participants who met criteria for having been moderately or severely depressed at least once in their life. Qualitative analyses of interview data were guided by grounded theory methodology. RESULTS Participants with severe symptoms of depression were more frequent among non-responders of this study. We identified key aspects that influence help-seeking for mental health problems and seem to be characteristic for rural regions: family doctors serve as initial contact points for mental health problems and are considered as alternatives for mental health professionals; norms of traditional masculinity such as being more rational than emotional, needing to endure hardships, embodying strength, and being independent were frequently mentioned as inhibiting help-seeking by middle-aged men; anticipated adverse side-effects of therapy such as worsening of symptoms; a frequently expressed desire for less pathologically perceived treatment options. CONCLUSIONS Our results suggest that barriers regarding help-seeking in rural regions are multifaceted and seem to be influenced by traditional norms of masculinity. We believe it is critical to strengthen existing and already utilized services such as family doctors and to implement and evaluate tailored interventions targeting the needs of the rural milieu.
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Affiliation(s)
- Karsten Valerius
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
| | - Linnéa von Eitzen
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Mirjam Göbel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Heike Ohlbrecht
- Department for Social Sciences, Otto-von-Guericke University, Magdeburg, Germany
| | - Neeltje van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sven Speerforck
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
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Safa A, Adib-Hajbaghery M, Rezaei M. A model for older adults' coping with the death of their child: a grounded theory study. BMC Psychiatry 2024; 24:150. [PMID: 38383337 PMCID: PMC10882903 DOI: 10.1186/s12888-024-05597-3] [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: 06/20/2023] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Losing a child at an old age while also facing health problems and physical limitations can have significant negative impacts on parents' lives such as anxiety, depression, and impairment in social functions. The process of coping with the death of a child is particularly unknown among older adults. Therefore, this study aimed to explore how older adults cope with the death of their child. METHOD This qualitative study was conducted in 2020-2021, using Corbin and Strauss (2015) approach to the grounded theory method. The sampling began purposefully and continued theoretically until theoretical saturation was achieved. Semi-structured interviews were conducted to collect data from Iranian older adults who had experienced the death of their child. To ensure data trustworthiness, the Guba and Lincoln (1985) criteria were utilized. A qualitative data analysis software, MAXQDA2020, was used to manage the data. FINDINGS The results of this study were obtained from 27 participants. The main concern of older adults was the fear of their lives collapsing following the death of their child. Participants utilized three main strategies to address their concerns: attempting to rebuild themselves, connecting to a higher power, and searching for positivity amidst grief. The central category that emerged from the analysis was "improving physical, mental, and spiritual capacities," resulting in personal growth and improved social relationships. CONCLUSIONS Through the use of the three aforementioned strategies, older adults were able to overcome their primary concern of the fear of their lives collapsing following the death of their child. Further development of the theory is suggested in order to design a model that can facilitate older adults' coping with this difficult life event.
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Affiliation(s)
- Azade Safa
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Mahboubeh Rezaei
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Hu H, Lu H. Revisiting tourism in the post-pandemic era: An evaluation study of China's 5A-Class scenic spots. Heliyon 2024; 10:e25411. [PMID: 38352753 PMCID: PMC10861982 DOI: 10.1016/j.heliyon.2024.e25411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
The emergence of the COVID-19 in 2019 has unquestionably had a profound and transformative effect on the tourism industry. Following the easing of COVID-19 prevention and control measures in China, there has been a significant increase in travel demand. Representing the epitome of excellence in Chinese scenic spots, 5A-class scenic areas are primary destinations for travelers. The assessment of these scenic spots plays a crucial role in shaping their tourism reputation. Currently, there is a regional focus in research on the evaluation of 5A-class scenic spots exhibits regional characteristics, with limited attention given to a nationwide assessment. In this study, we collected over 410,000 online comments were gathered from 256 scenic spots classified as 5A-class. Employing the Latent Dirichlet Allocation (LDA) topic model, this study conducted a thematic exploration and applied Grounded Theory for qualitative analysis of evaluation themes. This study focused on analyzing scenic spot evaluations by examining three dimensions: the scenic spot itself, the surrounding facilities, and the perspective of tourists. Study findings reveal: (1)Tourist evaluations of 5A-class scenic spots by tourists undergo changes from the inception of the journey to its conclusion. (2)Tourist assessments of these scenic spots are not confined solely to the attractions themselves, the quality of peripheral amenities also has a significant impact on their assessments. This study differentiates itself from traditional regional analysis and perceptual image perspective analysis by employing a process-oriented approach from the perspective of the tourist. The utilization of text-mining techniques enables the identification of coexisting universal and regional tourism evaluation indicators. The present study makes a valuable contribution to the existing body of knowledge by providing insights into the intricate nature of the tourist evaluation process and the interrelationships among different factors.
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Affiliation(s)
- Hanqing Hu
- School of Economics and Management, Beijing Information Science & Technology University, Beijing, 10092, China
| | - Hao Lu
- School of Economics and Management, Beijing Information Science & Technology University, Beijing, 10092, China
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Kappes M, Romero-Garcia M, Sanchez M, Delgado-Hito P. Coping trajectories of intensive care nurses as second victims: A grounded theory. Aust Crit Care 2024:S1036-7314(24)00006-7. [PMID: 38360471 DOI: 10.1016/j.aucc.2024.01.001] [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: 11/21/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024] Open
Abstract
A qualitative study that provides evidence of the institutional support required by intensive care unit (ICU) nurses as second victims of adverse events (AEs). BACKGROUND The phenomenon of second victims of AE in healthcare professionals can seriously impact professional confidence and contribute to the ongoing occurrence of AEs in hospitals. OBJECTIVES The objective of this study was to describe the coping trajectories of second victims among nurses working in ICUs in public hospitals in Chile. METHODS Conducting qualitative research through the grounded theory method, this study focused on high-complexity hospitals in Chile, using theoretical sampling. The participants consisted of 11 nurses working in ICUs. Techniques used included in-depth interviews conducted between March and May 2023, as well as a focus group interview. Analysis, following the grounded theory approach proposed by Strauss and Corbin, involved constant comparison of data. Open, axial, and selective coding were applied until theoretical data saturation was achieved. The study adhered to reliability and authenticity criteria, incorporating a reflexive process throughout the research. Ethical approval was obtained from the ethics committee, and the study adhered to the consolidated criteria for reporting qualitative research. RESULTS From the interviews, 29 codes were identified, forming six categories: perception of support when facing an AE, perception of helplessness when facing an AE, initiators of AE, responses when facing an AE, professional responsibility, and perception of AE. The perception of support when facing an AE emerged as the main category, determining whether the outcome was stagnation or overcoming of the phenomenon after the AE. CONCLUSIONS For the coping process of ICU nurses following an AE, the most crucial factor is the support from colleagues and supervisors.
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Affiliation(s)
- Maria Kappes
- Faculty of Health Care Sciences, Universidad San Sebastian, Puerto Montt, Chile.
| | - Marta Romero-Garcia
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain; IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain; International Research Project: HU-CI Project, Collado Villalba, Spain.
| | - Maria Sanchez
- Faculty of Health Care Sciences, Universidad San Sebastian, Puerto Montt, Chile.
| | - Pilar Delgado-Hito
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain; IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain; International Research Project: HU-CI Project, Collado Villalba, Spain.
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Asadi M, Ahmadi F, Mohammadi E, Vaismoradi M. A grounded theory of the implementation of medical orders by clinical nurses. BMC Nurs 2024; 23:113. [PMID: 38347548 PMCID: PMC10863222 DOI: 10.1186/s12912-024-01775-6] [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: 06/13/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To explore the process of implementing medical orders by clinical nurses, and identify specific areas of concern in the implementation process, and uncover strategies to address these concerns. BACKGROUND The implementation of medical orders is a crucial responsibility for clinical nurses, as they bear legal accountability for the precise implementation of directives issued by medical practitioners. The accurate implementation of these orders not only shapes the quality and safety of healthcare services but also presents numerous challenges that demand careful consideration. METHOD This study employed a qualitative design using a grounded theory approach to construct a comprehensive theoretical framework grounded in the insights and experiences of nurses operating within the hospital settings of Iran. The study encompassed 20 participants, comprising 16 clinical nurses, two nurse managers, and two specialist doctors working in hospital settings. The selection process involved purposeful and theoretical sampling methods to ensure diverse perspectives. Data collection unfolded through in-depth, individual, semi-structured interviews, persisting until data saturation was achieved. The analytical framework proposed by Corbin and Strauss (2015) guided the process, leading to the development of a coherent theory encapsulating the essence of the study phenomenon. FINDINGS The primary finding of the study underscores the significance of 'legal threat and job prestige' highlighting diverse repercussions in case of errors in the implementation of medical orders. At the core of the investigation, the central variable and the theory of the study was the 'selective and tasteful implementation of orders to avoid legal and organizational accountability.' This indicated a set of strategies employed by the nurses in the implementation of medical orders, encapsulated through three fundamental concepts: 'accuracy in controlling medical orders,' 'untruth documentation,' and 'concealment of events. The formidable influence of legal threats and job prestige was further compounded by factors such as heavy workloads, the doctor's non-compliance with legal instructions for giving verbal orders, the addition of orders by the doctor without informing nurses, and pressure by nursing managers to complete documentation. The resultant psychological distress experienced by nurses not only jeopardized patient safety but also underscored the intricate interplay between legal implications and professional standing within the healthcare framework. CONCLUSION Alleviating staff shortages, enhancing the professional rapport between doctors and nurses, offering legal support to nursing staff, implementing measures such as recording departmental phone conversations to deter the non-acceptance of verbal orders, fostering an organizational culture that embraces nurse fallibility and encourages improvement, and upgrading equipment can ameliorate nurses' apprehensions and contribute to the safe implementation of medical orders.
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Affiliation(s)
- Monireh Asadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran.
| | - Easa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14155-4838, Tehran, Iran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
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Fritz H, Chase S, Morgan L, Cutchin MP. Managing Complexity: Black Older Adults With Multimorbidity. Gerontologist 2024; 64:gnad066. [PMID: 37350763 PMCID: PMC10825832 DOI: 10.1093/geront/gnad066] [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: 02/02/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Black older adults have higher rates of multimorbidity and receive less effective multimorbidity support than their white counterparts. Yet little is known about the experiences of Black older adults with multimorbidity that may be at the heart of those disparities and which are central to interventions and improving care for this population. In this study, we aimed to conceptualize the multimorbidity management (MM) experience for Black older adults. RESEARCH DESIGN AND METHODS As part of a larger study on Black older adults' multimorbidity and physician empathy, we conducted in-depth qualitative interviews with 30 Black older adults living in a large midwestern city in the United States aged 65 years and older with self-reported multimorbidity. We used grounded theory analysis to distill findings into a core conceptual category as well as component domains and dimensions. RESULTS "Managing complexity" emerged as the core category to describe MM in our sample. Managing complexity included domains of "social context," "daily logistics," "care time," and "care roles." DISCUSSION AND IMPLICATIONS We discuss how managing complexity is distinct from patient complexity and how it is related to cumulative inequality and precarity. Study findings have potential implications for intervention around provider education and empathy as well as for enabling agency of Black older adults with MM.
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Affiliation(s)
- Heather Fritz
- School of Occupational Therapy, Pacific Northwest University of Health Sciences, Yakima, Washington, USA
| | - Sage Chase
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, Washington, USA
| | - Lauren Morgan
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, Washington, USA
| | - Malcolm P Cutchin
- School of Occupational Therapy, Pacific Northwest University of Health Sciences, Yakima, Washington, USA
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Leinemann V, Krutter S. 'The last bridge'- How patients experience the CAR T-cell therapy. A qualitative study. Eur J Oncol Nurs 2024; 68:102494. [PMID: 38184925 DOI: 10.1016/j.ejon.2023.102494] [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: 04/06/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024]
Abstract
PURPOSE CAR T-cell therapy gives patients new hope, who are diagnosed with relapsed or refractory B-cell lymphoma or B-cell leukaemia. To date, there is no scientific knowledge about the experiences of patients with CAR T-cell therapy, their process of treatment decision making or how they handle potential side effects. The study aims at deepening the understanding of the patient's experiences, indicating how to improve nursing care for this patient population. METHOD A qualitative study was carried out. Episodic guideline-based interviews were conducted with 14 patients who had received CAR T-cell therapy. The data analysis was performed according to the Grounded Theory. The study took place at a German university hospital. RESULTS Data analysis showed five sequential phases including the following concepts: 'living with cancer recurrence', 'deciding on CAR T-cell therapy', 'waiting for the reinfusion of the CAR T-cells', 'experiencing CAR T-cell therapy' and 'recovering and staying healthy'. The decision for CAR T-cell therapy was characterised by the lack of alternatives and uncertainty about the outcome and side effects. CONCLUSIONS Before, during and after CAR T-cell therapy, patients are faced with major challenges for which they need nursing support and guidance. These include preparation for CAR T-cell therapy, handling of side effects and preparation for discharge home.
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Affiliation(s)
- Verena Leinemann
- Institute for Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria.
| | - Simon Krutter
- Institute for Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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Hosseinzadegan F, Habibzadeh H, Jasemi M. The contribution of the nursing profession to the establishment of social justice: A grounded theory study. Nurs Ethics 2024:9697330231200566. [PMID: 38297879 DOI: 10.1177/09697330231200566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND Social inequities in the healthcare system threaten global health. Efforts to establish equity in healthcare is a key goal of healthcare systems worldwide. Social justice is a basic value of the nursing profession that always merits attention. OBJECTIVE This study aimed to identify and explain the processes of the nursing profession's participation in establishing social justice in healthcare system. RESEARCH DESIGN AND METHODS This qualitative study was conducted using the grounded theory method. PARTICIPANTS AND RESEARCH CONTEXT Data were collected through in-depth, semi-structured, individual interviews with 26 participants, 23 of whom were members of the nursing profession. Sampling started purposefully and, then, continued with theoretical sampling. Field notes were also taken for data collection. Data analysis was performed using Corbin and Strauss' 2015 method. ETHICAL CONSIDERATIONS The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran. FINDINGS The "Professional Dynamics in the Path of Justice" was the study's core category. This theory is the result of nine main categories: "inefficient professional authority," "social justice, a neglected component in education," "clinical concerns, barriers to nurses' presence in society," "individual input reserves to facilitate social justice," "inadequate maturity of the profession in the path of equity in health," "promoting justice in clinical practice," "a tendency to community-oriented profession," "use of personal approaches for justice promotion," and "emerging justice-expanding nursing." These categories cover the underlying factors, strategies, and outcomes of the nursing profession's participation in establishing social justice process in healthcare. CONCLUSION The theory of professional dynamics in the path of justice can be used as a practical guide to describe the role of nurses in establishing social justice. Further studies with a quantitative approach to applying this theory are recommended.
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Källstrand J, Lindgren EC, Carlsson IM. Perpetuating ability to live life as usual: a grounded theory study of persons living with age-related macular degeneration. BMC Geriatr 2024; 24:82. [PMID: 38254006 PMCID: PMC10804715 DOI: 10.1186/s12877-024-04689-9] [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: 05/08/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Age-Related Macular Degeneration (AMD) is an eye disease associated with age that causes progressive and irreversible loss of central vision, while the peripheral visual ability remains. The occurrence of and especially late AMD is estimated to increase extensively to 2040 among persons aged ≥ 65 in Scandinavia, due to an increasing aging population. OBJECTIVES The present study explored what it means to live with AMD through the eyes of those living with the condition. METHODS This is an explorative interview study. People who were ≥ 65 years old, living in their own homes, and diagnosed with advanced dry AMD in one or both eyes, causing a visual acuity of no more than 0.3 or worse in the best eye, were invited to participate in the study. The method chosen was the constructivist grounded theory, where reality is seen as fundamentally social and processual and a way of accessing the participants' experiences, thoughts, and feelings. RESULTS In total, 12 interviews were conducted. Living with dry AMD confronted different problems and challenges. The substantive theory, Perpetuating ability to live life as usual, is characterised by a desire to continue life as usual, which requires an acceptance of the disease's progress, self-acceptance of the new me, and an acceptance that the new life needs to be lived a little more carefully. Moreover, the participants used three strategies to resolve their main concern by maintaining an everyday life 1) Navigating the new normal, 2) Trusting own ability, and 3) Interdepending. CONCLUSION Maintaining an everyday life is the primary concern among people with AMD. In supporting self-care, gaining information about the subjective experience to support their everyday living is of the utmost importance. This grounded theory captures valuable knowledge of how the older adults resolved their main concern "you got to keep on" despite their affected vision by "facing the fact" live life as usual since since life goes on. Our study also gives rise both to implications for research and practice in order to strengthen older people with AMD facing their future challenges. TRIAL REGISTRATION The Swedish Ethical Review Authority (EPN 2021/02877).
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Affiliation(s)
- J Källstrand
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.
| | - E-C Lindgren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - I M Carlsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Nysaeter TM, Olsson C, Sandsdalen T, Hov R, Larsson M. Family caregivers' preferences for support when caring for a family member with cancer in late palliative phase who wish to die at home - a grounded theory study. BMC Palliat Care 2024; 23:15. [PMID: 38212707 PMCID: PMC10782637 DOI: 10.1186/s12904-024-01350-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/09/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Family caregivers are essential in end-of-life care for cancer patients who wish to die at home. The knowledge is still limited regarding family caregivers needs and preferences for support and whether the preferences change during the patient's illness trajectory. Therefore, the aim was to explore family caregivers' preferences for support from home care services over time when caring for a family member with cancer at the end of life who wished to die at home. METHODS A qualitative method was applied according to Grounded Theory. Data was collected longitudinally over the illness trajectory by means of repeated individual interviews (n = 22) with adult family caregivers (n = 11). Sampling, data collection and data analysis were undertaken simultaneously in line with the constant comparative method. RESULTS The findings are captured in the core category "hold out in duty and love". The categories "having control and readiness for action" and "being involved in care" describe the family caregivers' preferences for being prepared and able to handle procedures, medical treatment and care, and to be involved by the healthcare personnel in the patient's care and decision making. The categories "being seen and confirmed" and "having a respite" describe family caregivers' preferences for support according to their own needs to be able to persevere in the situation. CONCLUSION Despite deterioration in the patient's illness and the increasing responsibility family caregiver struggle to hold out and focus on being in the present. Over time together with deterioration in the patient's illness and changes in the situation, they expressed a need for more intense and extensive support from the home care services. To meet the family caregivers' preferences for support a systematic implementation of a person-centred care model and multicomponent psycho- educational interventions performed by nurses can be proposed. Moreover, we suggest developing a tool based on the conceptual model generated in this study to identify and map family caregivers' needs and preferences for support. Such a tool can facilitate communication and ensure person-centred interventions.
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Affiliation(s)
- Toril Merete Nysaeter
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway.
| | - Cecilia Olsson
- Department of Health Sciences, Karlstad University SE, Karlstad, Sweden
- Department of Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
| | - Tuva Sandsdalen
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway
| | - Reidun Hov
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway
- Centre for Development of Institutional and Home Care Services (USHT), Inland (Hedmark), Hamar, Norway
| | - Maria Larsson
- Department of Health Sciences, Karlstad University SE, Karlstad, Sweden
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Ruan J, Liu C, Yang Z, Kuang Y, Yuan X, Qiu J, Tang L, Xing W. Suffering and adjustment: a grounded theory of the process of coping with financial toxicity among young women with breast cancer. Support Care Cancer 2024; 32:96. [PMID: 38197967 DOI: 10.1007/s00520-024-08305-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
PURPOSE To explore the process of coping with financial toxicity among young women with breast cancer and formulate a grounded theory that serves as a foundation for creating intervention strategies aimed at supporting cancer survivors. METHODS A qualitative study using the Corbin and Strauss variant of grounded theory. A series of in-depth interviews were carried out with young women with breast cancer (n = 29) using the theoretical sampling method. We analyzed data by coding core categories in the patients' coping processes and developing theory around these categories. Data collection and analysis were performed simultaneously. RESULTS A substantial theory of the process of coping with financial toxicity among young female breast cancer survivors was constructed. Two core concepts, suffering and adjustment, were identified. Young women with breast cancer suffered from financial toxicity, which was related to risk factors, coping resources, and unmet needs. To overcome financial toxicity, young women with breast cancer adjusted by reshaping consumption concept, re-dividing of family functions, re-planning of occupation career, and rebuilding life confidence. CONCLUSION This qualitative study constructed a theory delineating the coping strategies employed by young women with breast cancer in response to financial toxicity, offering profound insights into the intricacies of cancer-related financial toxicity. Identifying risk factors, enhancing coping resources, and meeting unmet needs would be helpful to patients' adjustment to financial stress.
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Affiliation(s)
- Junyi Ruan
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Cheng Liu
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Zhongfang Yang
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Yi Kuang
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Xiaoyi Yuan
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Jiajia Qiu
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, 270 Dongan Rd, Shanghai, 200032, China
| | - Lichen Tang
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, 270 Dongan Rd, Shanghai, 200032, China.
| | - Weijie Xing
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China.
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Wu Y, Xue Y, Zhao X, Han S, Wu W. Unravelling the veil of appearance anxiety: exploring social media use among Chinese young people. BMC Psychol 2024; 12:9. [PMID: 38167566 PMCID: PMC10759542 DOI: 10.1186/s40359-023-01495-7] [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: 06/29/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
The purpose of this study is to explore the relationship between appearance anxiety and social media use among Chinese adolescents. Using a grounded theory approach, the study conducted two-round online interviews with ten Chinese university students and subsequently constructed a theoretical model of social media appearance anxiety among Chinese young people. The results of the study indicate that social media has a dual impact on appearance anxiety. On one hand, increased social media engagement amplifies appearance anxiety by shaping aesthetic standards and fostering comparative environments. On the other hand, diverse aesthetic perspectives and authentic presentations on social media partially alleviate appearance anxiety by promoting acceptance of unique appearances and boosting self-confidence. It is emphasized in this study that there should be an in-depth understanding of the dual impact and complicated relationship of social media on the daily lives of Chinese adolescents to further develop relevant strategies that promote healthy social media behavior among youth. Furthermore, this study calls for efforts to actively promote the healthy image and psychological well-being of adolescents while alleviating the negative impact of appearance anxiety and overall mental health. Such efforts are needed to ensure a positive and healthy development for the younger generation.
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Affiliation(s)
- Yihan Wu
- School of Social Development, Nanjing Normal University, Nanjing, China.
| | - Ying Xue
- School of Social Development, Nanjing Normal University, Nanjing, China
| | - Xiaohan Zhao
- School of Social Development, Nanjing Normal University, Nanjing, China
| | - Sijia Han
- School of Social Development, Nanjing Normal University, Nanjing, China
| | - Weiyun Wu
- School of Social Development, Nanjing Normal University, Nanjing, China
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Wang F, Wang L. Communication model in Chinese online medical consultations: Insights and implications. Patient Educ Couns 2024; 118:108031. [PMID: 37924743 DOI: 10.1016/j.pec.2023.108031] [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: 01/10/2023] [Revised: 09/09/2023] [Accepted: 10/16/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE To comprehensively analyze and further enhance the established E4 communication model for online medical counseling in Chinese settings, by proposing the novel E5 model. Additionally, it aims to evaluate the performance of Chinese doctors in fulfilling the E5 model. METHODS Through thematic analysis and grounded theory of 500 online medical consultations in China, we developed the extended E5 model from the E4 model. We identified four dimensions of patient attitudes and behaviors using Stanford Topic Modeling Toolbox, then employed Chi-square analysis to investigate their influence on doctors' performance of E5 model. RESULTS Our study illustrates that the extended E5 model, with its operable strategies, accurately mirrors the nuanced dynamics of online medical counseling in China, significantly varying in doctors' execution in response to the four identified dimensions of patient attitudes and behaviors. CONCLUSION The extended E5 model, coupled with insights into patient attitudes and behaviors, provides a comprehensive framework for understanding and enhancing communication in China's online healthcare context. PRACTICE IMPLICATIONS The findings highlight the necessity for doctor training in the E5 model for effective online communication. Furthermore, fostering conducive relationship between patients and doctors could potentially boost doctors' E5 performance.
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Affiliation(s)
- Fan Wang
- School of Foreign Languages, Shanghai Normal University, China
| | - Li Wang
- School of Foreign Languages, Shanghai Normal University, 100 Guilin Road, Xuhui, Shanghai, China.
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Weinschreider J, Tenzek K, Foltz-Ramos K, Jungquist C, Livingston JA. Electronic health record competency in graduate nurses: A grounded theory study. Nurse Educ Today 2024; 132:105987. [PMID: 37890193 DOI: 10.1016/j.nedt.2023.105987] [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: 04/02/2023] [Revised: 09/18/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The use of electronic health records is ubiquitous in healthcare settings, yet newly graduated nurses struggle with developing electronic health record competency prior to entry into nursing practice. Insufficient electronic health record knowledge, skills, and attitudes among newly graduated nurses are contributing to patient harm, clinical burn-out, and unsafe practices. In this study, we interviewed electronic health record educators to identify how newly graduated nurses develop electronic health record competency characteristics and to learn about their educational approaches for teaching electronic health record proficiency. METHOD This study used a constructive grounded theory approach to develop a theoretical model to make sense of electronic health record educators' experiences working with newly graduated nurses during electronic health record education and training sessions. FINDINGS Electronic health record educators found that in the newly graduated nurse population, practicing builds competency in electronic health record knowledge, skills, and attitudes. The research revealed that it is the combination of teaching through modeling, working hard as a new graduate, and understanding charting to standards requirements that impacts the development of electronic health record competency characteristics. CONCLUSION Electronic health record competency characteristics are developed when an educator is modeling documentation knowledge, skills, and attitudes, the newly graduated nurse is working hard to learn, and there is clarity by nursing leadership related to charting to standards requirements. It is the success or failure in these core areas that impacts a newly graduated nurse's ability to achieve electronic health record competency. A level of competency and proficiency in electronic health record is required to provide care that is safe and patient centered.
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Affiliation(s)
- Joanne Weinschreider
- University at Buffalo, graduated Fall 22, Saint John Fisher University, School of Nursing, Director of Experiential Learning, 3690 East Ave, Rochester, NY 14618, United States of America.
| | - Kelly Tenzek
- University at Buffalo, State University of New York, 323 Baldy Hall, Buffalo, NY 14260-1020, United States of America
| | - Kelly Foltz-Ramos
- School of Nursing, University at Buffalo, State University of New York, 211 Wende Hall, Buffalo, NY 14214-3079, United States of America
| | - Carla Jungquist
- School of Nursing, University at Buffalo, State University of New York, 211 Wende Hall, Buffalo, NY 14214-3079, United States of America
| | - Jennifer A Livingston
- School of Nursing, University at Buffalo, State University of New York, 211 Wende Hall, Buffalo, NY 14214-3079, United States of America
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Silverio SA, Varman N, Barry Z, Khazaezadeh N, Rajasingam D, Magee LA, Matthew J. Inside the 'imperfect mosaic': Minority ethnic women's qualitative experiences of race and ethnicity during pregnancy, childbirth, and maternity care in the United Kingdom. BMC Public Health 2023; 23:2555. [PMID: 38129856 PMCID: PMC10734065 DOI: 10.1186/s12889-023-17505-7] [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: 04/25/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Persistent, high rates of maternal mortality amongst ethnic minorities is one of the UK's starkest examples of racial disparity. With greater risks of adverse outcomes during maternity care, ethnic minority women are subjected to embedded, structural and systemic discrimination throughout the healthcare service. METHODS Fourteen semi-structured interviews were undertaken with minority ethnic women who had recent experience of UK maternity care. Data pertaining to ethnicity and race were subject to iterative, inductive coding, and constant comparison through Grounded Theory Analysis to test a previously established theory: The 'Imperfect Mosaic'. ANALYSIS & FINDINGS A related theory emerged, comprising four themes: 'Stopping Short of Agentic Birth'; 'Silenced and Stigmatised through Tick-Box Care'; 'Anticipating Discrimination and the Need for Advocacy'; and 'Navigating Cultural Differences'. The new theory: Inside the 'Imperfect Mosaic', demonstrates experiences of those who received maternity care which directly mirrors experiences of those who provide care, as seen in the previous theory we set-out to test. However, the current theory is based on more traditional and familiar notions of racial discrimination, rather than the nuanced, subtleties of socio-demographic-based micro-aggressions experienced by healthcare professionals. CONCLUSIONS Our findings suggest the need for the following actions: Prioritisation of bodily autonomy and agency in perinatal physical and mental healthcare; expand awareness of social and cultural issues (i.e., moral injury; cultural safety) within the NHS; and undertake diversity training and support, and follow-up of translation of the training into practice, across (maternal) health services.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, Addison House, Great Maze Pond, Southwark, London, SE1 1UL, UK.
| | - Nila Varman
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, Addison House, Great Maze Pond, Southwark, London, SE1 1UL, UK
| | - Zenab Barry
- National Maternity Voices, London, UK
- National Institute of Health and Care Research Applied Research Collaboration [NIHR ARC] South London, King's College Hospital NHS Foundation Trust, Lambeth, London, SE5 9RS, UK
| | - Nina Khazaezadeh
- Chief Midwifery Office, NHS England, Wellington House, 133-155 Waterloo Road, Southwark, London, SE1 8UG, UK
| | - Daghni Rajasingam
- Maternity Services, St. Thomas' Hospital, Guy's and St. Thomas' NHS Foundation Trust, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Laura A Magee
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, Addison House, Great Maze Pond, Southwark, London, SE1 1UL, UK
| | - Jacqueline Matthew
- Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, Faculty of Life Sciences & Medicine, King's College London, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
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Yoosefi Lebni J, Irandoost SF, Ziapour A, Ahmadi A, Mehedi N, Azizi SA. Identification of causes and consequences of Kolberi among Iranian Kurdish women: a grounded theory study. BMC Womens Health 2023; 23:648. [PMID: 38053054 PMCID: PMC10696815 DOI: 10.1186/s12905-023-02791-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 11/19/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Women turn to Kolberi for various reasons, which cause numerous challenges for them. Thus, it is imperative to identify these causes and problems. Since no study has ever been undertaken to deal with this participant, the present research aims to identify the causes and consequences of Kolberi among Kurdish women in Iran. METHOD The present research uses the grounded theory approach to investigate 28 female Kurdish Kolbers. To achieve several participants, purposive, snowball, and theoretical sampling methods were used, while face-to-face semi-structured interviews were used to gather data. The process of data collection and analysis took 10 months, from April to December 2022. The data were analyzed using the Strauss and Corbin method and MAXQDA-20018 software. The Guba and Lincoln criteria were also met to increase the trustworthiness of the results. FINDINGS Analysis of the data led to 143 initial codes, 31 subcategories, and 9 main categories: Causal condition (individual characteristics and economic factors); predisposing conditions (social and cultural factors, familial factors); intervening conditions (advantages and characteristics of Kolberi); strategies (strengthening compatibility with Kolberi); and consequences (individual problems, social problems and positive consequences). CONCLUSION Measures such as training occupational skills for women and providing employment conditions for them, increasing social, financial, and mental support for women without guardians, creating border markets, and expanding women's handicrafts can help prevent female Kolberi.
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Affiliation(s)
- Javad Yoosefi Lebni
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Seyed Fahim Irandoost
- Department of Community Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahmad Ahmadi
- Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Nafiul Mehedi
- Department of Social Work, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Seyyed Amar Azizi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Rochette C, Mériade L, Cassière F. A grounded theory-based qualitative approach for examining local implementation of public health policies during crises. MethodsX 2023; 11:102439. [PMID: 38023318 PMCID: PMC10630630 DOI: 10.1016/j.mex.2023.102439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background COVID-19's emergence questions the agility of health policy deployment in a context of urgency. This exceptional pandemic offers a unique Implementation Science study opportunity. It reveals how actors adapt, coordinate, and mitigate an unknown global threat to safeguard populations from an initially mysterious virus. Limited research has explored how involved players act and adapt their practices to fulfil health protection missions during a global health crisis. Bridging the gap between public policy expectations and achievements requires a methodology for stakeholder identification and implementation practice description. Objective Focusing on COVID-19 management in France's second-largest region, we investigate ministerial recommendation implementation and the emergence of new links, coordination modes, and practices. Methods Due to the novel subject, we adopted grounded theory. Initial documentary data collection identifies stakeholders for subsequent interviews. Open-ended coding of collected discourse enables content analysis. Results Findings reveal a crisis-driven re-evaluation of stakeholder relationships. This research identifies three levels of implementation of health policies at the local level (administrative, organizational and operational) and reveals different types of coordination specific to each of these levels. Our results provide insights on how to better coordinate and implement healthcare policies in a period of crisis. Recommendations include real-life simulations of large-scale crises. Conclusion Our work establishes a methodological foundation for analysing coordination dynamics. Future research could compare these findings with other unpredictable health emergencies, such as episiotomic veterinary health crises.•The first step of the method is to analyse the guidelines of health policy implementation during the Covid-19 crisis and to identify the main stakeholders in charge of the local health policy implementation.•The second step consists of interviewing these stakeholders using a co-constructed sample and structural coding of their speech to reveal the forms of coordination between stakeholders.
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Affiliation(s)
- Corinne Rochette
- IAE Clermont Auvergne – ClerMa, Research Chair "Santé et Territoires" University Clermont Auvergne, 11 Boulevard Charles de Gaulle, Clermont-Ferrand 63 000, France
| | - Laurent Mériade
- IAE Clermont Auvergne – ClerMa, Research Chair "Santé et Territoires" University Clermont Auvergne, 11 Boulevard Charles de Gaulle, Clermont-Ferrand 63 000, France
| | - François Cassière
- IAE Clermont Auvergne – ClerMa, Research Chair "Santé et Territoires" University Clermont Auvergne, 11 Boulevard Charles de Gaulle, Clermont-Ferrand 63 000, France
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Zhou Q, Zhang J, Wang Q, Zhong J. Grounded theory-based analysis of occupational health and safety management modes in supply chain by core enterprises --evidence from China. Heliyon 2023; 9:e23044. [PMID: 38144277 PMCID: PMC10746419 DOI: 10.1016/j.heliyon.2023.e23044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/26/2023] Open
Abstract
The implementation of occupational health and safety management in the supply chain by core enterprises is a significant step towards improving the working conditions of their suppliers. To guide core enterprises to adopt active and effective management modes, it is crucial to identify the characteristics of different management modes and classify them accordingly. This paper employs the grounded theory method to conduct an in-depth analysis of occupational health and safety management modes within the supply chain of core enterprises. This research mainly adopts semi-structured interview method. A total of 16 person-times are interviewed, and 210,000 words of in-depth interview scripts are obtained. After three coding process of the grounded theory,the evolution model of occupational health and safety management modes in supply chain by core enterprises was established. The research results indicate that core enterprises currently employ three modes of occupational health and safety management for their suppliers: defensive mode, passive mode, and strategic mode. Different modes have distinct characteristics in four dimensions of cognition, motivation, strategy and result. This research may provide strategic guidelines for core enterprises to evolve from the defensive mode to the strategic mode.
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Affiliation(s)
- Qiaomei Zhou
- School of Intellectual Property, Jiangsu University, PR China
| | | | - Qiwei Wang
- School of Economics and Management, Zhengzhou University of Light Industry, PR China
| | - Jingjing Zhong
- School of Economics and Management, Changzhou Institute of Technology, PR China
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Chen IJ, Chen Z. A study of the mechanism for intergenerational transmission of gender roles in single-parent families. Heliyon 2023; 9:e22952. [PMID: 38058454 PMCID: PMC10696254 DOI: 10.1016/j.heliyon.2023.e22952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/02/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023] Open
Abstract
The divorce rate in China is rising yearly, and the concept of marriage is changing, triggering many social topics related to single parents. Among them, gender-awareness education for children in single-parent families is particularly worthy of attention, as there has been insufficient exploration of how parents transfer their gender role concepts to their children. This study conducted in-depth interviews with 58 single parents and children from 29 families in Suzhou and constructed the mechanism for intergenerational transmission of gender roles in single-parent families based on grounded theory. It found that single parents' gender stereotypes, the starting point of the intergenerational transmission mechanism, have been diluted. It affords them a more enlightened attitude towards child-rearing style, and they expect more equality in the gender role of their offspring. However, in some parents' actual parenting process, when the children's sexualization behaviours exceed their acceptance range, they will communicate with children in an authoritative and didactic way to "correct" the children's behaviour. In addition to direct verbal instruction, parents' expectations of their children's gender roles will be implicitly conveyed through various parent-child interactions in daily life to affect the formation of their children's gender roles. In the intergenerational transmission of gender roles, external people (such as grandparents, teachers and peer groups) have horizontal socialisation effects on children to modify or strengthen the results of gender education from their parents. Under the comprehensive influence of the above factors, the children's gender roles are finally determined. These studies expand previous theories and studies and have significant theoretical and practical implications.
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Affiliation(s)
- I-Jun Chen
- School of Education, Soochow University, Dushuhu Campus, No. 1, Wenjing Road, Suzhou Industrial Park (SIP), Suzhou, 215123, China
| | - Zisong Chen
- School of Education, Soochow University, Dushuhu Campus, No. 1, Wenjing Road, Suzhou Industrial Park (SIP), Suzhou, 215123, China
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Lönn A, Weurlander M, Seeberger A, Hult H, Thornberg R, Wernerson A. The impact of emotionally challenging situations on medical students' professional identity formation. Adv Health Sci Educ Theory Pract 2023; 28:1557-1578. [PMID: 37184676 PMCID: PMC10184105 DOI: 10.1007/s10459-023-10229-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 04/09/2023] [Indexed: 05/16/2023]
Abstract
In their interactions with patients and health care professionals during work-based learning, medical students are known to experience emotionally challenging situations that can evoke negative feelings. Students have to manage these emotions. Students learn and develop their professional identity formation through interactions with patients and members of the healthcare teams. Earlier studies have highlighted the issues involved with processing emotionally challenging situations, although studies concerning learning and professional identity formation in response to these experiences are rare. In this study, we explored medical students' experiences of emotionally challenging situations in work-based learning, and the impact these experiences had on forming medical students' professional identities. We conducted an analysis of narrative data (n = 85), using a constructivist grounded theory approach. The narratives were made up of medical students' reflective essays at the end of their education (tenth term). The analysis showed that students' main concern when facing emotionally challenging situations during their work-based education was the struggle to achieve and maintain a professional approach. They reported different strategies for managing their feelings and how these strategies led to diverse consequences. In the process, students also described arriving at insights into their own personal needs and shortcomings. We consider this development of self-awareness and resulting self-knowledge to be an important part of the continuously ongoing socialization process of forming a professional identity. Thus, experiencing emotionally challenging situations can be considered a unique and invaluable opportunity, as well as a catalyst for students' development. We believe that highlighting the impact of emotions in medical education can constitute an important contribution to knowledge about the process of professional identity formation. This knowledge can enable faculty to provide students with more effective and sufficient support, facilitating their journey in becoming physicians.
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Affiliation(s)
- Annalena Lönn
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden.
| | - Maria Weurlander
- Department of Education, Stockholm University, Stockholm, Sweden
| | - Astrid Seeberger
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
| | - Håkan Hult
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
| | - Robert Thornberg
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Annika Wernerson
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Huddinge, Stockholm, Sweden
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Ganson KT, Nguyen L, Ali ARH, Nagata JM, Rodgers RF, Murray SB, Alaggia R. "Eat more protein, build more muscle": A grounded theory study of muscle-building behaviors among Canadian adolescents and young adults. Body Image 2023; 47:101635. [PMID: 37806066 DOI: 10.1016/j.bodyim.2023.101635] [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: 06/09/2023] [Revised: 09/11/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
Unique risk factors for the development of muscle dissatisfaction and engagement in muscle-building behaviors have been described by theoretical frameworks and supported by empirical research. What remains unknown are the unique processes, including catalysts and facilitators, which underpin engagement in muscle-building behaviors. Therefore, this study used a grounded theory methodology to elucidate the process of engagement in muscle-building behaviors. Thirty-three individual semi-structured interviews with Canadian adolescents and young adults ages 16-30 years were conducted. Transcripts were analyzed using initial and focused coding to identify themes that explained the grounded theory. The core theme underpinning the grounded theory was balancing aesthetic, health, and functional goals in relation to participants' engagement in muscle-building behaviors. Participants described experiences that encompassed several unique phases of muscle-building engagement, including the initiation phase, beginner phase, preservation phase, and intensification phase. Participants also described unique methods of gathering information on muscle-building behaviors, and their own analysis and decision-making processes driving their behaviors. Findings from this study extend prior theory and research by conceptualizing a novel process theory of engagement in muscle-building behaviors among adolescent and young adults, resulting in important implications for research and practice.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Lynn Nguyen
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ali Raza Hasan Ali
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Linlin W, Wanyu H, Yuting L, Huimin Q, Zhi L, Qinchen J, Tingting W, Fan W, Minghao P, Wei Z. Research on the mechanism of short video information interaction behavior of college students with psychological disorders based on grounded theory. BMC Public Health 2023; 23:2256. [PMID: 37974096 PMCID: PMC10652505 DOI: 10.1186/s12889-023-17211-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The utilization of short videos by individuals often leads to the emergence of information exchange behavior. Previous studies have shown that certain students with psychological disorders exhibit addictive tendencies towards short video-related software. Therefore, it is essential to address the psychology and behavior of college students with psychological disorders while engaging with short videos. This study aims to explore the mechanism of short video information interaction behavior among college students with psychological disorders. METHODS We conducted semi-structured interviews with 30 college students afflicted by psychological disorders in a prefecture-level city in Henan Province, China from September to December 2022. Based on the Grounded theory, we encoded 30 text materials across three levels to explore the mechanism of short video information interaction behavior among college students with psychological disorders, and subsequently build a model framework. RESULTS The findings of this study suggest that college students with psychological disorders exhibit negative cognition tendencies that can lead to strongly negative emotions, excacerbated by a lack of social support. These adverse factors collectively drive the consumption of short video content in this demographic, providing a virtual environment where they can fulfill their unmet social needs. Therefore, the mechanism governing short video messages interaction among college students with psychological disorders encompasses negative cognitive tendencies, negative emotions, lack of social support, post-video-watching behaviors, and the gratification of social needs within the confines of a virtual environment. CONCLUSIONS This study comprehensively analyzes the motivation and complexity of college students with psychological disorders in short video interaction. Although short videos provide this group with some ways of self-expression and emotional support, they still have a negative impact on their physical and mental health. The short video interaction of college students with psychological disorders is affected by many factors, including their negative cognitive tendencies, negative emotions, lack of social support, post-video-watching behaviors, and the gratification of social needs within the confines of a virtual environment. These findings deepened our understanding to the mechanism of short video information interaction behavior among college students with psychological disorders, also provided us with guidance on facilitating the proper use of short video and maintaining the mental health. In future researches, researchers can discuss more about intervention measures to help this demographic cope with the challenges from short video interaction.
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Affiliation(s)
- Wang Linlin
- Medical College, Xinyang Normal University, 237 Nanhu Road, Xinyang City, 464000, Henan Province, China
| | - Huang Wanyu
- School of Public Health Wuhan University, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China
| | - Li Yuting
- Hangzhou Wickham International School, Hangzhou City, 311000, Zhejiang Province, China
| | - Qiao Huimin
- Yantai Automobile Engineering Professional College, Yantai City, 265500, Shandong Province, China
| | - Li Zhi
- Xinyang Central Hospital, Xinyang City, 464000, Henan Province, China
| | - Jiang Qinchen
- Medical College, Xinyang Normal University, 237 Nanhu Road, Xinyang City, 464000, Henan Province, China
| | - Wang Tingting
- Zhoukou Normal University, Zhoukou City, 466000, Henan Province, China
| | - Wang Fan
- School of Information Management, Wuhan University, Wuhan City, 430072, Hubei Province, China
| | - Pan Minghao
- Medical College, Xinyang Normal University, 237 Nanhu Road, Xinyang City, 464000, Henan Province, China.
- School of Public Health Wuhan University, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China.
| | - Zhu Wei
- Medical College, Xinyang Normal University, 237 Nanhu Road, Xinyang City, 464000, Henan Province, China.
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Ang JY, Ooi GS, Abd Aziz F, Tong SF. Risk-taking in consumers' online purchases of health supplements and natural products: a grounded theory approach. J Pharm Policy Pract 2023; 16:134. [PMID: 37924079 PMCID: PMC10623737 DOI: 10.1186/s40545-023-00645-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Health supplements and natural products are widely used by the general public to support physical function and prevent disease. Additionally, with the advent of e-commerce, these products have become easily accessible to the general public. Although several theoretical models have been used to explain the use of health supplements and natural products, empirical evidence on how consumers make decisions to purchase online health supplements and natural products remains limited. METHODS In this study, a grounded theory approach was used to develop a substantive theoretical model with the aim of investigating the decision-making process of consumers when purchasing health supplements and natural products online. Malaysian adult consumers who had purchased these products via the Internet were either purposively or theoretically sampled. A total of 18 virtual in-depth interviews (IDIs) were conducted to elicit participants' experiences and priorities in relation to this activity. All the IDIs were audio-recorded and transcribed verbatim. The data were analysed using open coding, focus coding and theoretical coding. The analytical interpretations and theoretical concepts were recorded in research memos. RESULTS Consumers' decisions to purchase a health supplement or natural product over the Internet are based on a series of assessments regarding the perceived benefits and risks of this activity, which may be related to the product or the process. In the online marketplace, consumers attempt to choose products, online sellers, sales platforms and/or purchase mechanisms with lower perceived risk, which ultimately enhances their confidence in five elements related to the purchase: (1) product effectiveness, (2) product safety, (3) purchase convenience, (4) fair purchase and (5) online security. Consumers take an acceptable level of risk to purchase these products online, and this acceptable level is unique to each individual and is based on their perception of having control over the potential consequences if the worst-case scenario occurs. CONCLUSIONS In this study, a substantive theoretical model is developed to demonstrate how consumers decide to purchase online health supplements and natural products by accepting an acceptable level of risk associated with the product or process. The emerging model is potentially transferable to other populations in similar contexts.
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Affiliation(s)
- Ju-Ying Ang
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
- Clinical Research Centre (CRC), Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Perak, Malaysia
| | - Guat-See Ooi
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia.
| | | | - Seng-Fah Tong
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Wang F, Wang X, Liu D, Liu H. Comprehensive safety risk evaluation of fireworks production enterprises using the frequency-based ANP and BPNN. Heliyon 2023; 9:e21724. [PMID: 38027679 PMCID: PMC10658285 DOI: 10.1016/j.heliyon.2023.e21724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
The fireworks industry has long struggled with the problem of safety. Scientific, reasonable, and operable evaluation models are prerequisites of reducing risk. Based on the data from over 100 fireworks production safety accidents in China from 2010 to 2022, two evaluation models were established from the perspective of safety risk definition. Firstly, a weight calculation derivative method, the frequency-based analytic network process (ANP), was proposed creatively. This method optimized the importance ranking index calculation process in the ANP by considering the causal frequency of risk factors in the historical accident samples, thus determining how much each indicator affects the likelihood of accidents. Secondly, utilizing the historical accident samples as the dataset, a back propagation neural network (BPNN) model was developed to extract the mathematical relationship between each risk factor and the severity of accident consequence. Finally, the frequency-based ANP and BPNN models were combined to determine the safety risk level of the fireworks production enterprises. Meanwhile, the safety evaluation research samples were used as the comparison set for empirical study with historical accident samples, involving 100 fireworks production enterprises in China evaluated from 2017 to 2020. The significance result of zero shows that there is a statistically significant difference between the likelihood evaluation results of the accident and non-accident companies. Additionally, the severity evaluation model exhibits an excellent result, revealing a classification accuracy of 98.21 %, a mean square error of 8.97 × 10-4, a percent bias of 1.24 %, and a correlation coefficient and Nash-Sutcliffe efficiency coefficient both of 0.96. The frequency-based ANP and BPNN models integrate self-learning, self-adaptive, and fuzzy information processing, obtaining more accurate and objective evaluation results. This work provides a new strategy for the promotion and application of artificial intelligence in the field of safety risk evaluation, thus offering real-time safety risk evaluation and decision support of the safety management for the enterprises.
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Affiliation(s)
- Feiyue Wang
- Institute of Disaster Prevention Science and Safety Technology, School of Civil Engineering, Central South University, Changsha, 410075, Hunan, China
| | - Xinyu Wang
- Institute of Disaster Prevention Science and Safety Technology, School of Civil Engineering, Central South University, Changsha, 410075, Hunan, China
| | - Dingli Liu
- School of Traffic & Transportation Engineering, Changsha University of Science and Technology, Changsha, 410114, Hunan, China
| | - Hui Liu
- Institute of Disaster Prevention Science and Safety Technology, School of Civil Engineering, Central South University, Changsha, 410075, Hunan, China
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Gao Y, Khan AA, Khan SU, Ali MAS, Huai J. Navigating China's carbon neutrality journey: insights from policy instruments and implementation strategies across provincial regions. Environ Sci Pollut Res Int 2023; 30:115322-115336. [PMID: 37884723 DOI: 10.1007/s11356-023-30589-3] [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: 05/14/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023]
Abstract
China's critical reliance on well-crafted public policies, coupled with the effective execution of central government directives at the local level, drives the achievement of the "dual carbon" goal including the peaking of CO2 emissions and attaining carbon neutrality. Therefore, examining policy records can unveil the holistic strategy for attaining carbon neutrality during the period of peak CO2 emissions; at the same time, it can also highlight the potential obstacles in policy implementation. In this study, we adopt a policy instruments perspective to investigate data related to policies addressing peak CO2 emissions across 29 provincial administrative regions in China. We apply Nvivo12 software to conduct a quantitative literature assessment and content analysis to establish a theoretical framework for the policy process. This framework encompasses dimensions such as political feasibility, regional coordination, attributes of low-carbon initiatives, and policy refinement. Subsequently, we employ the model to carry out a retrospective analysis of policy documents pertaining to peak CO2 emissions in China. Our research findings underscore the pivotal role of political feasibility in shaping policy effectiveness, while also highlighting the facilitative influence of regional coordination, shedding light on the essential synergy between provinces and cities in achieving emissions reduction goals. Similarly, the estimated results highlight the motivating impact of specific attributes within low-carbon initiatives. Moreover, policy enhancements are identified as a critical driver in advancing the path toward carbon neutrality. Consequently, to achieve the objective of carbon neutrality, it is imperative for every province and city to sequentially reach the peak of CO2 emissions. Our research offers a comprehensive "China strategy," providing valuable insights to guide future policy formulation and accelerate progress toward sustainable environmental objectives.
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Affiliation(s)
- Yuling Gao
- College of Economics and Management, Northwest A&F University, Yangling, 712100, People's Republic of China
| | - Arshad Ahmad Khan
- College of Economics and Management, Northwest A&F University, Yangling, 712100, People's Republic of China
| | - Sufyan Ullah Khan
- Department of Economics and Finance, UiS Business School, University of Stavanger, 4036, Stavanger, Norway
| | | | - Jianjun Huai
- College of Economics and Management, Northwest A&F University, Yangling, 712100, People's Republic of China.
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Movahedi A, Sadooghiasl A, Ahmadi F, Vaismoradi M. A grounded theory study of alarm fatigue among nurses in intensive care units. Aust Crit Care 2023; 36:980-988. [PMID: 36737263 DOI: 10.1016/j.aucc.2022.12.004] [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: 09/10/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The aim of this study was to explore the process of how nurses experienced and dealt with alarm fatigue in intensive care units based on Iranian nurses' perceptions and experiences. BACKGROUND Alarm fatigue is the overstimulation of senses due to the constant ringing of alarms in intensive care units. It is associated with nurses' desensitization to critical alarms that can directly influence patient safety and quality of care. METHODS A qualitative exploratory study using the grounded theory approach by Strauss and Corbin was carried out. Participants were 20 nurses working in intensive care units. The sampling process was started purposively and continued theoretically. Data were collected using semi-structured, in-depth, and individual interviews and continued to data saturation. The constant comparative analysis approach was used consisting of the following steps: open coding, developing concepts, analysing the context, entering the process into data analysis, integrating categories. FINDINGS The participants' main concern in the exposure to alarm fatigue was 'threat to personal balance'. The core category in this research was 'trying to create a holistic balance', which reflected a set of strategies that the nurses consistently and continuously used to deal with alarm fatigue and consisted of four main categories as follows: 'smart care', 'deliberate balancing', 'conditional prioritisation', and 'negligent performance'. Threat to personal balance was strengthened by 'inappropriate circuit of individual roles', 'distortion of the organisational structure', and 'insecurity of the infrastructure'. The consequences of this process was harm to the patient, burnout among nurse, and damage to the healthcare organisation. CONCLUSIONS The research findings have practical implications for healthcare management, policymaking, nursing education, research, and clinical practice. Mitigating staff shortages, improving staff competencies, enhancing nurses' authority for responding to alarms, modifying care routines, improving the physical environment, and removing problems related to alarm equipment can prevent alarm fatigue and its unappropriated consequences.
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Affiliation(s)
- Ali Movahedi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Afsaneh Sadooghiasl
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia.
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Middleton G, Golley RK, Patterson KA, Coveney J. Barriers and enablers to the family meal across time; a grounded theory study comparing South Australian parents' perspectives. Appetite 2023; 191:107091. [PMID: 37865298 DOI: 10.1016/j.appet.2023.107091] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 10/23/2023]
Abstract
Family meals are positively associated with numerous beneficial health and social outcomes. Current discourse however claims that parents are faced with numerous barriers when trying to bring the family together to share a meal. Solutions for overcoming barriers to a positive shared family meal are often individualistic and do not address the systemic pressures and burdens families have faced for decades. The aim of this study was to explore the systemic and novel barriers and enablers to shared family meals as experienced by families across time. To achieve this, a qualitative study informed by grounded theory was conducted. Parents of South Australian families were recruited and interviewed in the 1990s, and a new sample of parents were recruited and interviewed in 2020. Transcripts were analysed using grounded theory and comparative analysis methods. Thirty-two parents from 16 families were interviewed in the 1990s, and 22 parents from 10 families in 2020. Ten factors were identified presenting as either enablers or barriers to the family meal, depending on the context they were experienced. Barriers and enablers were largely consistent across time. Scheduling and flexibility, children's disruptions and children's independence, privileges required to have family meals and motivation and commitment to the family meal were identified as persistent enablers and barriers across time. These findings indicate that parents are faced with similar challenges they have been facing for decades and are still not being adequately supported to execute family meals regularly. Recognising that factors present as either barriers or enablers to the family meal provides us with opportunities to transform barriers to enablers and support families to have regular, meaningful family meals.
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Affiliation(s)
- Georgia Middleton
- Caring Futures Institute, Flinders University, Tarntanya, Adelaide, South Australia, Australia; College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia.
| | - Rebecca K Golley
- Caring Futures Institute, Flinders University, Tarntanya, Adelaide, South Australia, Australia; College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
| | - Karen A Patterson
- College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
| | - John Coveney
- Caring Futures Institute, Flinders University, Tarntanya, Adelaide, South Australia, Australia; College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
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Røykenes K, Kvernenes M, Giske T. Endeavouring interplay: a grounded theory study of how nurse educators' work with simulation-based learning. BMC Nurs 2023; 22:377. [PMID: 37821879 PMCID: PMC10568800 DOI: 10.1186/s12912-023-01546-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Simulation-based learning is frequently used as a teaching and learning strategy in nursing and other health professions educations, and educators have a key role as facilitators. This facilitator role provides them with a particularly relevant perspective to help us understand and theorize around the essence of simulation-based learning, and how it is approached. This study aims to explore nurse educators' experiences and strategies in simulation-based learning. METHOD Data were collected in 2018-2021 using in-depth interviews with eight nurse educators. Transcripts were analysed through constant comparison using Classical Grounded Theory approach. RESULT The participants' main concern was how to Maximize students' learning-space in simulation. To resolve this, four strategies were identified: legitimizing simulation, self-development, preparing students, and tailoring simulation. Legitimisation, and self-development were found to be important prerequisites for developing the learning space and were therefore defined as the background or context of the theory. Nurse students were the focus of the two remaining categories, preparing students and tailoring simulation, and are thus defined as being in the foreground of the theory. The dynamics of these four strategies were captured in the Grounded theory of Endeavouring interplay. CONCLUSION The theory of Endeavouring interplay illustrates the complexity educators are encountering when aiming to optimize simulation as a learning space for nurse students. The strategies used are adapted to the organisational climate, available resources and context, and include striving to legitimize simulation, pursue self-development in the role as facilitator, help students prepare for simulation-based learning, and tailor the simulation to both contextual factors and individual student needs.
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Affiliation(s)
- Kari Røykenes
- Institute of Nursing, Faculty of Health Studies, VID Specialized University, Bergen, Norway
| | - Monika Kvernenes
- Center for Medical Education and Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Tove Giske
- Institute of Nursing, Faculty of Health Studies, VID Specialized University, Bergen, Norway
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Mitchell G, Stark P, Wilson CB, Tsakos G, Brocklehurst P, Lappin C, Quinn B, Holland N, McKenna G. 'Whose role is it anyway?' Experiences of community nurses in the delivery and support of oral health care for older people living at home: a grounded theory study. BMC Nurs 2023; 22:359. [PMID: 37798687 PMCID: PMC10557176 DOI: 10.1186/s12912-023-01533-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 09/25/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Older people who receive care at home are likely to require support with oral health care. Community nurses, who are also referred to as district or home care nurses, have an important role with this population. This is because they are the healthcare professionals who are most likely to encounter this population, who may also not be receiving regular dental care or oral health promotion. However, few studies have explored community nursing experiences in the delivery and support of oral healthcare for older people living at home. METHODS A grounded theory approach was used to explore experiences of community nurses in the delivery and support of oral health care for older people living at home. Fifteen practising community nurses from the United Kingdom participated in one-to-one semi-structed interviews from May 2021 to December 2021. These interviews were audio-recorded, transcribed verbatim and analysed using constant comparative analysis. Ethical approval was obtained for this study prior to data collection. RESULTS Four categories emerged from the data to support development of the core phenomena. These four categories were: (1) Education, in relation to what community nurses knew about oral health, (2) Practice, with regards to how community nurses delivered oral health care to older people in their own home, (3) Confidence, with consideration to the extent to which this supported or impeded community nurses in providing oral healthcare to older people and (4) Motivation, in terms of the extent to which community nurses thought they could or should influence future practice improvement in the area. The core category was (C) Uncertainty as it was both present and central across all four categories and related to community nursing understanding about their specific role, and the role of other professionals, with reference to oral health of their patients. CONCLUSIONS This study reveals community nurses' uncertainty in providing oral healthcare to older adults at home. Emphasising comprehensive and continuous oral health education can boost nurses' confidence in patient support. Interprofessional collaboration and clear role definitions with oral health professionals are crucial for improving oral health outcomes in this vulnerable population.
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Grants
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- HSC R&D Division, Belfast, Northern Ireland
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Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | | | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Caroline Lappin
- Department of Health, Castle Buildings, Stormont, Belfast, Northern Ireland
| | - Barry Quinn
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Nicola Holland
- Department of Health, Castle Buildings, Stormont, Belfast, Northern Ireland
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Gerry McKenna
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
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Vogel G, Joelsson-Alm E, Forinder U, Svensen C, Sandgren A. Shifting focus: A grounded theory of how family members to critically ill patients manage their situation. Intensive Crit Care Nurs 2023; 78:103478. [PMID: 37384978 DOI: 10.1016/j.iccn.2023.103478] [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: 10/28/2022] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES Critical illness is a life-threatening condition for the patient, which affects their family members as a traumatic experience. Well-known long-term consequences include impact on mental health and health-related quality of life. This study aims to develop a grounded theory to explain pattern of behaviours in family members of critically ill patients cared for in an intensive care unit, addressing the period from when the patient becomes critically ill until recovery at home. RESEARCH METHODOLOGY/DESIGN We used a classic grounded theory to explore the main concern for family members of intensive care patients. Fourteen interviews and seven observations with a total of 21 participants were analysed. Data were collected from February 2019 to June 2021. SETTING Three general intensive care units in Sweden, consisting of a university hospital and two county hospitals. FINDINGS The theory Shifting focus explains how family members' main concern, living on hold, is managed. This theory involves different strategies: decoding, sheltering and emotional processing. The theory has three different outcomes: adjusting focus, emotional resigning or remaining in focus. CONCLUSION Family members could stand in the shadow of the patients' critical illness and needs. This emotional adversity is processed through shifting focus from one's own needs and well-being to the patient's survival, needs and well-being. This theory can raise awareness of how family members of critically ill patients manage the process from critical illness until return to everyday life at home. Future research focusing on family members' need for support and information, to reduce stress in everyday life, is needed. IMPLICATIONS FOR CLINICAL PRACTICE Healthcare professionals should support family members in shifting focus by interaction, clear and honest communication, and through mediating hope.
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Affiliation(s)
- Gisela Vogel
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, SE-118 83 Stockholm, Sweden.
| | - Eva Joelsson-Alm
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, SE-118 83 Stockholm, Sweden.
| | - Ulla Forinder
- Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, SE-801 76 Gävle, Sweden.
| | - Christer Svensen
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, SE-118 83 Stockholm, Sweden.
| | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Universitetsplatsen 1, SE-352 52 Växjö, Sweden.
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