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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] [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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Al Haddad A, Arber A, Cox A, Gallagher A. The Challenges Experienced by ICU Nurses in Kuwait during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100226. [PMID: 39155969 PMCID: PMC11327471 DOI: 10.1016/j.ijnsa.2024.100226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/05/2024] [Accepted: 07/13/2024] [Indexed: 08/20/2024] Open
Abstract
Background The coronavirus (COVID-19) pandemic presented unprecedented challenges to healthcare systems worldwide, with intensive care unit (ICU) nurses at the forefront of patient care. To date, there is limited evidence into ICU nurses'experiences of the pandemic in Kuwait. Research question/aims/objectives To elucidate the challenges faced by ICU nurses in Kuwait during the pandemic, by considering two research questions: "What contributed to intensified pressure for the ICU nurses?" and "How were the nurses affected?". Research design This was a qualitative study which utilised semi-structured interviews. Interviews were conducted between January 2021 and June 2022 with ICU nurses who worked during the COVID-19 pandemic. The data were analysed using Charmaz's grounded theory methodology. Participants and research context 25 nurses from three ICUs in Kuwait. Ethical considerations The study was approved by the University Ethics Committee and by the Ministry of Health in Kuwait. Findings/Results The analysis identified two themes (the factors contributing to intensified pressure in the ICU, and the impact on the nurses) and seven sub-themes. The pressure in the ICU intensified due to the rise in the number of patients, staff shortages, and the requirement to adhere to unrealistic new procedures for infection control. Restricted and cancelled leave, as well as impaired autonomy at work, impeded the nurses' ability to recover from stress. The heightened stress also contributed to a worsening in interpersonal relationships between the nurses and their colleagues. The nurses' care was compromised by these challenges, leading to moral distress and a range of mental health symptoms (e.g., stress, anxiety, emotional exhaustion). Conclusions The study accords with other research conducted during the pandemic in revealing a significant mental health toll among healthcare workers during the pandemic. The stressors were similar to those which have been reported in other studies, although there were also context-specific effects relating to the environment of the ICU and the Kuwaiti context.
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Longhini J, Ambrosi E, Filippi M, Evilio L, Canzan F. How do undergraduate nursing students learn to care for families and informal caregivers? A qualitative study with a grounded theory approach. NURSE EDUCATION TODAY 2024; 141:106332. [PMID: 39102767 DOI: 10.1016/j.nedt.2024.106332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/18/2024] [Accepted: 07/31/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Nurses play a crucial role in caring for families of ill individuals in care, requiring high-quality relational and communication skills to care for them. Yet these skills remain underutilized, leading to reported issues of inadequate inclusion and communication. Education is crucial to enhance nurses' competencies in caring for families and informal caregivers. AIM To explore the learning process of undergraduate nursing students to care for families and informal caregivers. DESIGN Qualitative study with a grounded theory approach. SETTINGS Bachelor's degree in nursing from two off-sites of a university and four local health units collaborating with the university in North Italy. PARTICIPANTS 15 undergraduate nursing students, 10 nurse preceptors, and 10 nurse clinical teachers. METHODS We adopted initial and theoretical sampling and conducted semi-structured interviews from December 2023 to January 2024, lasting 16 to 62 min. The interviews were audio-recorded, transcribed verbatim, and analysed through open, selective, and theoretical coding. RESULTS We developed a theory of learning for undergraduate nursing students in caring for families and informal caregivers, comprising two themes, "Learning areas" and "Learning antecedents," and nine categories. Learning areas involve five stages of learning to care for families and informal caregivers and the most frequent opportunities to interact with families and informal caregivers. The five stages are "Seeing and considering families and informal caregivers", "Assessing the families' and informal caregivers' needs and resources", "Preparing for and planning intervention with families and informal caregivers", "Acting with families and informal caregivers", "Reflecting on the intervention with families and informal caregivers". Learning antecedents encompass student characteristics, interpersonal relationships, and the clinical training setting. CONCLUSIONS In this study, we delineate a five-stage learning process for undergraduate nursing students to care for families and informal caregivers, influenced by individual, interpersonal, and contextual factors. We emphasised the importance of relational skill development, tailored learning experiences, and supportive mentorship in enhancing students' preparedness to engage with and support families in healthcare settings. The developed theory provides a foundational framework for designing educational interventions to optimise nursing students' capacities in this domain.
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Campbell JA, Egede LE. Contextualizing risk, pathways, and solutions for the relationship between adverse childhood experiences (ACEs) and type 2 diabetes among inner-city African Americans: A qualitative analysis and development of a theoretical framework. J Affect Disord 2024; 361:522-527. [PMID: 38917888 PMCID: PMC11328455 DOI: 10.1016/j.jad.2024.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/29/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024]
Abstract
PURPOSE Adverse childhood experiences (ACEs) confer significant risk for diabetes in adulthood. The purpose of this study was to explore perceptions about risk, potential pathways leading to diabetes, and solutions based on the lived experience. METHODS Three focus groups were conducted. A semi-structured interview guide was used to explore prevalence and causes of ACEs, pathways to diabetes, and possible solutions. Grounded theory was used for analysis. Constant comparisons resulted in emergent themes that were indexed and compared with the rest of the data to establish analytical categories. Analytical categories were further refined as additional data was collected until groups of key themes or categories were identified and used to construct a theoretical framework. RESULTS Participants totaled 23 across 3 groups. All participants were African American. Average age was 49, average number of years living with diabetes was 13 years. Participants included both men and women. Participants experienced one or more occasions of sexual abuse, physical and verbal abuse, and neglect. The major themes can be classified as A. Cause, B. Pathway, and C. Treatment/solution. LIMITATIONS Findings may not generalize to the overall population with ACEs and diabetes. CONCLUSIONS Three major themes were identified: family instability and financial hardship as risks for ACEs, maladaptive coping leading to diabetes, and social structure as a potential solution. Future research is needed to examine quantitatively, pathways to inform prevention at the primary, secondary, and tertiary levels of care for both the prevention of ACEs, mitigating risk for diabetes, and improving overall health.
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Xu Z, Liu L, Meng Z. What are the key factors influencing scientific data sharing? A combined application of grounded theory and fuzzy-DEMATEL approach. Heliyon 2024; 10:e35034. [PMID: 39145008 PMCID: PMC11320435 DOI: 10.1016/j.heliyon.2024.e35034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/02/2024] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
Scientific data sharing (SDS) has become essential for scientific progress, technological innovation and socioeconomic development. Identifying the key influencing factors of SDS can effectively promote SDS programmes and give full play to the critical role of scientific data. This study used grounded theory and information ecology theory to construct an SDS influencing factor model that encompassed five dimensions and 28 influencing factors and followed the fuzzy decision-making trial and evaluation laboratory (fuzzy-DEMATEL) approach to measure and analyse the degree of influence of each influencing factor and identify the key factors. The results show that (1) there are interactions and mutual interactions between the various influencing factors of SDS, which can form a complex network system. (2) 16 influencing factors, such as data-sharing policies, data-sharing regulations and data-sharing standards, comprise the key influencing factors in SDS. (3) The optimisation path of SDS is 'Scientific Researchers' → 'Scientific Data' → 'Policy Environment' → 'Research Organisations → 'Information Technologies'. In this regard, we proposed the following management suggestions to promote the development of SDS programmes in China: focusing on researchers' subjective willingness to share, enhancing the integrated governance of scientific data, fulfilling the role of policy support and guidance, strengthening the support of research organisations and improving SDS platforms with information technology.
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Azimi H, Rezapour-Nasrabad R, Borhani F, Sadat-Hoseini AS, Momeni M. The model of solving ethical challenges with nursing based on faith in God: a new model for nurses to care during epidemics. BMC Nurs 2024; 23:538. [PMID: 39112997 PMCID: PMC11304786 DOI: 10.1186/s12912-024-02207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/26/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The existence of various ethical challenges, the inability to resolve ethical conflicts, and, as a result, the low quality of care and the occurrence of dissatisfaction in patients and nurses have been discussed for years. By creating new ethical challenges, the Covid-19pandemic has played an important role in making the process of care for these patients more difficult and complicated. This study was conducted with the aim of designing a prescriptive model to help provide ethical-care and resolve ethical conflicts during the Covid-19pandemic. METHODS In this two-stage qualitative study, a grounded theory research method was used in the first stage, and data were collected through semi-structured interviews. Sampling started purposefully and continued theoretically. In the second step, the appropriate model was designed using the three-step method proposed by Walker and Avant. RESULTS The core concept was "behavior based on faith in God", based on which the grounded theory of "faithful nursing" and then "model of solving ethical challenges with nursing based on faith in God" were presented. The strategies of the model in three parts are strengthening the beliefs of nurse, strengthening environmental facilitators to help nurse, and strengthening situational analysis in duty diagnosis in nurse were presented. CONCLUSIONS According to this model, nurses' beliefs play a key role, and the strengthening of environmental factors play a secondary role in ethical-care.
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Liu Z, Zhang W. A qualitative analysis of Chinese higher education students' intentions and influencing factors in using ChatGPT: a grounded theory approach. Sci Rep 2024; 14:18100. [PMID: 39103453 DOI: 10.1038/s41598-024-65226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/18/2024] [Indexed: 08/07/2024] Open
Abstract
The emergence of ChatGPT has significantly impacted the field of education. While much of the existing research has predominantly examined the theoretical implications of ChatGPT, there is a notable absence of empirical studies substantiating these claims. As pivotal stakeholders in education and primary users of ChatGPT, exploring the willingness and influencing factors of higher education students to use ChatGPT can offer valuable insights into the real-world needs of student users. This, in turn, can serve as a foundation for empowering education with intelligent technologies in the future. This study focuses specifically on the demographic of students in Chinese higher education who have utilized ChatGPT. Using semi-structured interviews and grounded theory methodology, we aim to comprehensively understand the extent to which students embrace new technologies. Our objective is to elucidate the behavioral inclinations and influencing factors of student users. The findings of this study will contribute practical insights for refining policy frameworks, expanding the dissemination of quality resources, optimizing and upgrading products for an enhanced user experience, and fostering higher-order thinking skills to adeptly navigate evolving technological landscapes. In conclusion, this research endeavors to bridge the gap between theoretical discussions and practical applications.
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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; 24:1485-1494. [PMID: 38556219 DOI: 10.1016/j.spinee.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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Mao A, Van IK, Cheong PL, Tam HL. "This is part of the body" - Student nurses' de-sexualisation of intimate care for patients. NURSE EDUCATION TODAY 2024; 139:106209. [PMID: 38663054 DOI: 10.1016/j.nedt.2024.106209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/25/2024] [Accepted: 04/07/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Effective intimate care can significantly impact the clinical outcomes of patients. However, conducting intimate care, which involves exposing and touching sexually sensitive areas of the body, presents challenges and anxieties for student nurses, particularly when providing care for patients of the opposite sex. OBJECTIVES This study aims to identify the challenges and struggles encountered by student nurses when providing intimate care for patients of the opposite sex, as well as to explore the coping strategies employed by the students. DESIGN A constructivist grounded theory research approach. SETTINGS The study was conducted in Macau, a Special Administrative Region of China. PARTICIPANTS Twenty-six student nurses across various stages of their education, and three clinical mentors. METHODS Purposive and theoretical sampling techniques were utilized to recruit participants. Semi-structured interviews were conducted. The data analysis was in line with the principles of constructivist grounded theory research. RESULTS A two-stage adaptation model was established, demonstrating a dynamic pathway of student nurses toward intimate care. The first stage 'gendered confinement in intimate care' was characterized by student nurses' negative feelings and lack of nurse-patient interactions; the second stage 'emancipation to gendered confinement' was characterized by the development of constructive therapeutic nurse-patient relationships. The successful transfer was achieved through students' reconstructing the meaning of intimate care and nursing profession in three interplayed types: objectification of patients' body, moral authority of nursing care, and legitimisation of nursing profession. While the transfer process involved the students' intentional efforts to de-sexualize intimate care, clinical mentors facilitated the process. CONCLUSION Student nurses' adaption to intimate care is a dynamic process which enhances the construction of the nursing professional identity. Support from nursing educators can facilitate student nurses' coping with intimate care-related challenges.
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Li J, Li X. The growth of nursing professional values - A grounded theory. Nurs Ethics 2024:9697330241266772. [PMID: 39045912 DOI: 10.1177/09697330241266772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
BACKGROUND The formation of nursing professional values is crucial to the development of the nursing profession, but it is influenced by various factors. The process of shaping nursing professional values in different growth contexts has been overlooked. In order to establish professional values in the context of Chinese nursing, it is necessary to investigate the evolution of nursing professional values throughout history. PURPOSE To develop a theory of professional values growth from a nursing context. Design: This study adopted a grounded theory approach from Strauss and Corbin. PARTICIPANTS From November 2021 to March 2022, a total of 33 participants were included. METHODS Data were collected using a semi-structured interview over telephone or online or face to face and were analysed using open, axial, and selective coding, with the help of MAXQDA 2020. ETHICAL CONSIDERATIONS The research was approved by the Ethics Committee of the China Medical University. All participants signed the informed consent and agreed to be interviewed before the study. FINDINGS The study has developed a theoretical construct of nursing professional values growth that consists of five dimensions: key aspects, decisive opportunities, drivers, embodiment, and shaping outcomes. And key aspects include four subcategories (the initial stage, the consciousness stage, the core stage, and the action stage). Decisive opportunities come from organisations and individuals. Drivers consist of social culture and self-trait, and embodiment covers two subcategories (humanism and ethical emotions). The last dimension is shaping outcomes, which consists of three subcategories (maintaining the original intention, professionalism, and instilling professional values). DISCUSSION The theory demonstrates the individual development process of nursing professional values in different interactive contexts, the context of its interaction with social and personal values is revealed, and the dynamics and mechanisms of the formation of personal psychological qualities in professional values from a nursing context are discovered. CONCLUSIONS This theory reveals the mechanisms that shape nursing professional values and can provide guidance for the growth of nursing students' professional values.
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Liu G, Xin H, Lin J, Li X, Zhang Y, Wang X, Liao J, Hu R. Analysis of the survival journey and post-traumatic growth process of children and their families following paediatric intensive care unit admission: A grounded theory study. Aust Crit Care 2024:S1036-7314(24)00116-4. [PMID: 38969541 DOI: 10.1016/j.aucc.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 06/04/2024] [Accepted: 06/10/2024] [Indexed: 07/07/2024] Open
Abstract
OBJECTIVES Advances in critical care technology have lowered mortality rates among critically ill individuals. Nonetheless, survivors and their families may develop new physical, mental, cognitive, and social challenges due to paediatric intensive care unit (PICU) treatments, impacting their quality of life. The aim of this study was to investigate the survival journey and post-traumatic growth process of children and their families following PICU admission within the Chinese cultural context. METHODS Twenty-six children who have been or are currently admitted to the PICU, alongside their parents and three PICU nurses, were chosen through purposive and theoretical sampling. Data collection involved face-to-face interviews and observations, with data analysis conducted through continuous comparison, open coding, and selective coding techniques. FINDINGS A model outlining the survival journey and post-traumatic growth process of critically ill children and their families post PICU admission has been established. This model encompasses two central trajectories: an upward trajectory consisting of confusion, charging, action, and sublimation phases and a downward trajectory comprising confusion, doubt and fear, inhibition (including confrontation and avoidance), and drowning phases. CONCLUSIONS Critically ill children and their families encounter diverse survival experiences and psychological journeys following traumatic events in the PICU. The survival experience has alternative upwards or downwards trajectories that are flexible/adaptable. Hence, offering timely psychological support can alter their developmental trajectories and foster post-traumatic growth.
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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; 37:606-613. [PMID: 38360471 DOI: 10.1016/j.aucc.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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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 EDUCATION 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] [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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Wang Z, Luo Y, Cao X, Jiang J. The twisted path to sacredness: a grounded theory study of irrational religious orientation and its psycho-sociological implications. BMC Psychol 2024; 12:360. [PMID: 38902805 PMCID: PMC11191207 DOI: 10.1186/s40359-024-01858-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
This research delves into the nuances, origins, and societal effects of irrational religious orientations within China's Generation Z, employing grounded theory methodology for a comprehensive analysis. The focus is on those born between 1995 and 2010, a demographic raised amidst rapid information technology growth and significantly influenced by digitalization and globalization. The study identifies three primary dimensions of irrational religious orientations in Generation Z: religious spiritual dependence, religious instrumental tendency, and religious uniqueness identity. These are shaped by factors such as the overwhelming influx of information via digital media, societal pressures and psychological dilemmas, conflicts in values and identity crises, as well as feelings of social isolation and the need for group belonging. To address these trends, the study suggests several interventions: enhancing multicultural and values education, implementing stricter online information regulation and literacy programs, boosting mental health awareness and support, and fostering engagement in social and cultural activities. These recommendations are essential for comprehensively understanding and effectively responding to the irrational religious orientations of Generation Z, ultimately contributing to their overall well-being and healthy development.
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Yin J, Feng J, Jia M. Research on rural tourism environment perception based on grounded theory A case study of Beishan Village, Zhuhai City, Guangdong Province, China. Heliyon 2024; 10:e32373. [PMID: 38947429 PMCID: PMC11214496 DOI: 10.1016/j.heliyon.2024.e32373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 07/02/2024] Open
Abstract
Drawing upon its regional culture, natural landscapes, and architectural features, Beishan Village in Zhuhai City, Guangdong Province, has forged a distinctive rural development model that combines an industrial park with tourism. While this approach has catalyzed rural progress, it also encounters numerous complex practical challenges. Utilizing the grounded theory method, this study employs participatory observation, in-depth interviews, and network data analysis to investigate the perspectives of three key stakeholder groups: villagers, tourists, and resident merchants. A model is constructed to capture their environmental perceptions of rural tourism. Based on an analysis of network and interview textual data, as well as the influencing factors identified through the theoretical model, this study proposes several optimization strategies. These include enhancing infrastructure development, cultivating a regional brand culture, strengthening the institutional management framework, establishing a rural sharing economy platform, and introducing digital tours. These strategies are designed to refine and enhance Beishan Village's development model, offering insights for similar villages and advancing the integration of beautiful China initiatives with urban and rural development efforts.
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Mohan M, Thangaraj JWV, Pandey S, Sri Lakshmi Priya G, Arunachalam S, Sharma R, Shewade HD, Aishwarya B, Afeeq K, Khatoon A, Gokulvijay B, Sireesha G, Chandra K, Nandhakumar S, Samuel P, Nanditha Viswanathan C, Shanmugasundaram D, Rao R, Murhekar MV, Jeyashree K. Need for operational simplicity and timely disbursal of benefits-a qualitative exploration of the implementation of a direct benefit transfer scheme for persons with tuberculosis in India. Infect Dis Poverty 2024; 13:36. [PMID: 38783334 PMCID: PMC11112885 DOI: 10.1186/s40249-024-01206-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Ni-kshay Poshan Yojana (NPY) is a direct benefit transfer scheme of the Government of India introduced in 2018 to support the additional nutritional requirements of persons with TB (PwTB). Our recent nationwide evaluation of implementation and utilization of NPY using programmatic data of PwTB from nine randomly selected Indian states, reported a 70% coverage and high median delay in benefit credit. We undertook a qualitative study between January and July 2023, to understand the detailed implementation process of NPY and explore the enablers and barriers to effective implementation and utilization of the NPY scheme. METHODS We followed a grounded theory approach to inductively develop theoretical explanations for social phenomena through data generated from multiple sources. We conducted 36 in-depth interviews of national, district and field-level staff of the National Tuberculosis Elimination Programme (NTEP) and NPY beneficiaries from 30 districts across nine states of India, selected using theoretical sampling. An analytical framework developed through inductive coding of a set of six interviews, guided the coding of the subsequent interviews. Categories and themes emerged through constant comparison and the data collection continued until theoretical saturation. RESULTS Stakeholders perceived NPY as a beneficial initiative. Strong political commitment from the state administration, mainstreaming of NTEP work with the district public healthcare delivery system, availability of good geographic and internet connectivity and state-specific grievance redressal mechanisms and innovations were identified as enablers of implementation. However, the complex, multi-level benefit approval process, difficulties in accessing banking services, perceived inadequacy of benefits and overworked human resources in the NTEP were identified as barriers to implementation and utilization. CONCLUSION The optimal utilization of NPY is enabled by strong political commitment and challenged by its lengthy implementation process and delayed disbursal of benefits. We recommend greater operational simplicity in NPY implementation, integrating NTEP activities with the public health system to reduce the burden on the program staff, and revising the benefit amount more equitably.
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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] [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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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] [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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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] [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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Farrell SJ, Mills TA, Lavender T. Maternity care for women from ethnic minority backgrounds in North-West England: A grounded theory study. SEXUAL & REPRODUCTIVE HEALTHCARE 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] [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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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] [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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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] [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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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] [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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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] [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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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] [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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