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Spooner M, Reinhardt C, Boland F, McConkey S, Pawlikowska T. Risky business: medical students' feedback-seeking behaviours: a mixed methods study. MEDICAL EDUCATION ONLINE 2024; 29:2330259. [PMID: 38529848 DOI: 10.1080/10872981.2024.2330259] [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: 08/14/2023] [Accepted: 03/08/2024] [Indexed: 03/27/2024]
Abstract
There are differing views on how learners' feedback-seeking behaviours (FSB) develop during training. With globalisation has come medical student migration and programme internationalisation. Western-derived educational practices may prove challenging for diverse learner populations. Exploring undergraduate activity using a model of FSB may give insight into how FSB evolves and the influence of situational factors, such as nationality and site of study. Our findings seek to inform medical school processes that support feedback literacy. Using a mixed methods approach, we collected questionnaire and interview data from final-year medical students in Ireland, Bahrain, and Malaysia. A validated questionnaire investigated relationships with FSB and goal orientation, leadership style preference, and perceived costs and benefits. Interviews with the same student population explored their FSB experiences in clinical practice, qualitatively, enriching this data. The data were integrated using the 'following the thread' technique. Three hundred and twenty-five of a total of 514 completed questionnaires and 57 interviews were analysed. Learning goal orientation (LGO), instrumental leadership and supportive leadership related positively to perceived feedback benefits (0.23, 0.2, and 0.31, respectively, p < 0.05). Perceived feedback benefits are related positively to feedback monitoring and inquiry (0.13 and 0.38, respectively, p < 0.05). The personal cost of feedback is unsupported in quantitative data, but was a strong theme in interviews, as was feedback avoidance, peer feedback, and unsupportive learning environment. No differences were observed across sub-groups based on gender, study site, or student nationality. Integrated analysis describes FSB: avoiding 'unsafe' feedback (first, do no harm) and overcoming barriers (beat the system) and goal-centred curation (shop around) to optimise benefits. Diverse medical students across three continents undertake FSB with careful navigation, as a valued but risky business, that is highly contextualised. Promoting a constructive FSB is complex. Overcoming outdated theory and practices on the wards remains a challenge to psychologically safe, learner-centred feedback.
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Affiliation(s)
- Muirne Spooner
- Health Professions Education Centre, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Ciarán Reinhardt
- Department of Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Samuel McConkey
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Teresa Pawlikowska
- Health Professions Education Centre, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
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Grau Canét-Wittkampf C, Trippenzee M, Jaarsma D, Diemers A. Candid insights and overlooked facets: what medical students write about patient-centeredness in diaries on longitudinal patient contacts. MEDICAL EDUCATION ONLINE 2024; 29:2363611. [PMID: 38861676 PMCID: PMC11168331 DOI: 10.1080/10872981.2024.2363611] [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: 11/03/2023] [Accepted: 05/30/2024] [Indexed: 06/13/2024]
Abstract
Despite students' exposure to patient-centered care principles, their dedication to patient-centeredness often experiences a wane throughout their academic journey. The process of learning patient-centeredness is complex and not yet fully understood. Therefore, in our study, we sought to explore what aspects of patient-centeredness students spontaneously document in their diaries during interactions with actual patients. This investigation will help to identify gaps in the current educational practices and better prepare future clinicians to deliver patient-centered healthcare. We analyzed 92 diaries of 28 third-year undergraduate medical students at UMC Utrecht in the Netherlands who participated in an educational intervention, following four patients each as companions over a two-year period early in their clerkships. We conducted thematic analysis, using inductive and deductive coding, within a social-constructionist paradigm. We identified four key themes: communication, the person behind the patient, collaboration and organization in healthcare, and students' professional development. Within these themes, we observed that students spontaneously documented 9 of 15 dimensions of patient-centeredness as outlined in the model of Scholl : 'clinician-patient communication', 'patient as unique person', 'biopsychological perspective', 'essential characteristics of the clinician', 'clinician-patient relationship', 'involvement of family and friends', 'patient-information', 'emotional support' and 'coordination and continuity of care' (mainly principles of patient-centeredness). Conversely, we noted that students underreported six other dimensions (enablers and activities): 'access to care', 'integration of medical and non-medical care', 'teamwork and teambuilding', 'patient involvement in care', 'patient empowerment' and 'physical support'. Throughout their longitudinal journey of following patients as non-medical companions, students spontaneously documented some aspects of patient-centeredness in their diaries. Additionally, students reflected on their own professional development. Our findings suggest that incorporating education on the broadness of the concept of patient-centeredness coupled with enhanced guidance, could potentially enable students to learn about the complete spectrum of patient-centeredness within their medical education.
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Affiliation(s)
- Christel Grau Canét-Wittkampf
- Wenckebach Institute for Education and Training, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Miranda Trippenzee
- Department of Health Psychology, Health Sciences, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Debbie Jaarsma
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- LEARN (Lifelong Learning, Education and Assessment), University Medical Center Groningen, Groningen, The Netherlands
| | - Agnes Diemers
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- LEARN (Lifelong Learning, Education and Assessment), University Medical Center Groningen, Groningen, The Netherlands
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Peters AC, Larsson DGJ, Laxminarayan R, Munthe C. Barriers and pathways to environmental surveillance of antibiotic resistance in middle- and low-income settings: a qualitative exploratory key expert study. Glob Health Action 2024; 17:2343318. [PMID: 38813982 PMCID: PMC11141306 DOI: 10.1080/16549716.2024.2343318] [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: 07/04/2023] [Accepted: 04/11/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Local and global surveillance of antibiotic resistance (ABR) has proven a challenge to implement effectively in low- and middleincome (LMI) settings. Environmental surveillance solutions are increasingly highlighted as a strategy to help overcome such problems, and thus to promote global health as well as the local management of ABR in LMI countries. While technical and scientific aspects of such solutions are being probed continuously, no study has investigated their practical feasibility. OBJECTIVE Explore practical barriers for environmental surveillance of ABR in LMI countries, and pathways for surveillance experts to manage these. METHODS To start charting this unknown territory, we conducted an explorative, qualitative interview study with key informants, applying a constructivist grounded theory approach to analyze the results. RESULTS Barriers were identified across infrastructural, institutional and social dimensions, and pathways to manage them were mostly counterproductive from an ABR management perspective, including avoiding entire regions, applying substandard methods and failing to include local collaborators. CONCLUSION The research community as well as international agencies, organizations and states have key roles and responsibilities for improving the prospects of feasible environmental ABR surveillance in LMI-settings.
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Affiliation(s)
- Ann-Christin Peters
- Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research in Gothenburg (CARe), Gothenburg, Sweden
| | - D. G. Joakim Larsson
- Centre for Antibiotic Resistance Research in Gothenburg (CARe), Gothenburg, Sweden
- Department of Infectious Diseases, Institute for Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Ramanan Laxminarayan
- One Health Trust, Washington, DC, USA
- One Health Trust, Bangalore, India
- High Meadows Environmental Institute, Princeton University, Princeton, NJ, USA
| | - Christian Munthe
- Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research in Gothenburg (CARe), Gothenburg, Sweden
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He Q, Lei J, Chong D, Luk P, Chan E, Shen X, Tipoe GL, Chan L, Manio MM, Dizon JIWT, Ganotice FA. Unpacking the perceptions and experiences of student facilitators in interprofessional education: a qualitative study. MEDICAL EDUCATION ONLINE 2024; 29:2330257. [PMID: 38493489 PMCID: PMC10946269 DOI: 10.1080/10872981.2024.2330257] [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: 10/16/2023] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
Enhancing health professional students' effective learning and collaborative practice requires a deep understanding of strategies for facilitating interprofessional learning. While faculty members and clinical preceptors are recognized as facilitators in interprofessional education (IPE), there is limited knowledge about the impact of student facilitators' engagement in IPE. Accordingly, this study aims to explore the perceptions and experiences of student facilitators in IPE. Thirteen student facilitators were recruited to lead an interprofessional learning program, and they were subsequently invited to participate in one-on-one interviews. An interview guide was developed to explore their motivations, expectations, engagement, effectiveness, and achievements in IPE facilitation. Thematic analysis was conducted using MAXQDA software to analyze the student facilitators' experiences and perceptions. Eight interviewees from various disciplines, including Medicine, Nursing, Pharmacy, Speech and Hearing Sciences, and Social Work, took part in the study. The findings revealed that student facilitators highly valued their IPE facilitation experience, which aligned with their expectations and led to the creation of social networks, increased confidence, improved understanding of other professions, and the development of lifelong skills. Furthermore, the student facilitators demonstrated cognitive and social congruence by establishing a relaxed learning environment, displaying empathetic and supportive behaviors, and using inclusive language to engage IPE learners in group discussions. This study provides a comprehensive understanding of the role of student facilitators in IPE, contributing to the evolving literature on IPE. A conceptual framework was developed to explore the entire facilitation experience, encompassing the motivations and expectations of student facilitators, their engagement and effectiveness, and the observed achievements. These findings can inform the development of peer teaching training in IPE and stimulate further research in identifying relevant facilitator competencies for optimal delivery of IPE.
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Affiliation(s)
- Qing He
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Junru Lei
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Doris Chong
- Department of Physiotherapy, School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Pauline Luk
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Medical Ethic and Humanities Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Enoch Chan
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xiaoai Shen
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - George Lim Tipoe
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Linda Chan
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Family Medicine and Primary Care, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Michael M. Manio
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - John Ian Wilzon T. Dizon
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Fraide A. Ganotice
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Jiang Q, Horta H, Yuen M. High- and low-achieving international medical students' perceptions of the factors influencing their academic performance at Chinese universities. MEDICAL EDUCATION ONLINE 2024; 29:2300194. [PMID: 38166562 PMCID: PMC10769138 DOI: 10.1080/10872981.2023.2300194] [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: 07/18/2023] [Accepted: 12/22/2023] [Indexed: 01/04/2024]
Abstract
China has become an attractive destination for international medical students, particularly those from developing countries in Asia and Africa. These students are known to face difficulties in adapting to Chinese medical universities and they tend to score poorly on subsequent examinations to enter the medical profession in their home or in a third country. To date, limited research concerning the factors that affect the academic performance of this group of students in China has been conducted. In particular, there have been very few comparisons between high and low achievers to identify the factors that high- and low-achieving international medical students in all years of study perceive as affecting their academic performance. A qualitative research approach was implemented at two medical universities. Semi-structured interviews were conducted with 18 high achievers and 22 low achievers in their second, third, fourth, fifth, sixth, and post-graduation years. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach.A few key overlapping factors were identified: social support, learning motivation and interest, exam preparation and strategies, time management, and coping. The high achievers manipulated these strategies successfully while the low achievers did not. The high achievers demonstrated efficient learning methods (efficient use of class time, good note-taking habits, preview and review strategies, expanded learning, self-study and group learning, deep learning, choosing an appropriate study location, and focusing on basics and concepts). They also achieved a good balance between studying and leisure. The low achievers mentioned learning challenges, health issues, English language barriers, and problems with online classes. This study allowed us to identify important factors that international medical students at Chinese institutions perceive to influence their performance. The findings contribute to the literature on the topic and provide a solid basis for practice and policy development.
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Affiliation(s)
- Qinxu Jiang
- School of anesthesiology, Xuzhou Medical University, Xuzhou, China
- Social Contexts and Policies of Education, Faculty of Education, The University of Hong Kong, Hong Kong SAR, China
| | - Hugo Horta
- Social Contexts and Policies of Education, Faculty of Education, The University of Hong Kong, Hong Kong SAR, China
| | - Mantak Yuen
- Center for Advancement and Inclusive and Special Education, Faculty of Education, The University of Hong Kong, Hong Kong, China
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Sim CSL, Asharani PV, Subramaniam M, Yi H. Roles and Dynamics within Community Mental Health Systems During the COVID-19 Pandemic: A Qualitative Systematic Review and Meta-Ethnography. Health Syst Reform 2024; 10:2314525. [PMID: 38598726 DOI: 10.1080/23288604.2024.2314525] [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: 09/27/2023] [Accepted: 02/01/2024] [Indexed: 04/12/2024] Open
Abstract
Globally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare's approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users' needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries' disaster mental health response and to invest in quality care, particularly for marginalized groups.
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Affiliation(s)
- Cheryl Su Ling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - P V Asharani
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
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Nechaeva E, Kharkova O, Postoev V, Grjibovski AM, Darj E, Odland JØ. Awareness of postpartum depression among midwives and pregnant women in Arkhangelsk, Arctic Russia. Glob Health Action 2024; 17:2354008. [PMID: 38828500 PMCID: PMC11149570 DOI: 10.1080/16549716.2024.2354008] [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: 05/10/2023] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Postpartum depression (PPD) affects approximately 17% of the women worldwide with nearly half of all cases going undetected. More research on maternal mental health, particularly among healthcare professionals and pregnant mothers, could help identify PPD risks and reduce its prevalence. OBJECTIVE Given that awareness of PPD is a crucial preventive factor, we studied PPD awareness among midwives and pregnant women in Arkhangelsk, Arctic Russia. METHODS A qualitative study was conducted using in-depth semi-structured interviews. Midwives and pregnant women were recruited from the women's clinic of the Arkhangelsk municipal polyclinic. Seven midwives and 12 pregnant mothers were interviewed. RESULTS Midwives described limited time for psychological counselling of pregnant women; they reported that their primary focus was on the physiological well-being of women. Pregnant women have expressed a desire for their families to share responsibilities. The participants considered PPD as a mix of psychological and physiological symptoms, and they also highlighted a discrepancy between the expectations of pregnant women and the reality of motherhood. The present study underscored the limited understanding of PPD identification. CONCLUSIONS The findings suggest that there is a need for increased awareness among midwives and pregnant women regarding PPD. Prevention programs targeting PPD with a specific emphasis on enhancing maternal mental health knowledge are warranted.
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Affiliation(s)
- Elena Nechaeva
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Olga Kharkova
- Department of Pedagogy and Psychology, Northern State Medical University, Arkhangelsk, Russia
| | - Vitaly Postoev
- Department of Public Health, Health Care and Social Work, Northern State Medical University, Arkhangelsk, Russia
| | - Andrej M. Grjibovski
- Department of Health Policy and Management, Al-Farabi Kazakh National University, Almaty, Kazakhstan
- Department of Epidemiology and Modern Vaccination Technologies, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
| | - Elisabeth Darj
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Jon Øyvind Odland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of General Hygiene, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Amoakoh HB, De Kok BC, Yevoo LL, Olde Loohuis KM, Srofenyoh EK, Arhinful DK, Koi-Larbi K, Adu-Bonsaffoh K, Amoakoh-Coleman M, Browne JL. Co-creation of a toolkit to assist risk communication and clinical decision-making in severe preeclampsia: SPOT-Impact study design. Glob Health Action 2024; 17:2336314. [PMID: 38717819 PMCID: PMC11080670 DOI: 10.1080/16549716.2024.2336314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/25/2024] [Indexed: 05/12/2024] Open
Abstract
Globally, the incidence of hypertensive disorders of pregnancy, especially preeclampsia, remains high, particularly in low- and middle-income countries. The burden of adverse maternal and perinatal outcomes is particularly high for women who develop a hypertensive disorder remote from term (<34 weeks). In parallel, many women have a suboptimal experience of care. To improve the quality of care in terms of provision and experience, there is a need to support the communication of risks and making of treatment decision in ways that promote respectful maternity care. Our study objective is to co-create a tool(kit) to support clinical decision-making, communication of risks and shared decision-making in preeclampsia with relevant stakeholders, incorporating respectful maternity care, justice, and equity principles. This qualitative study detailing the exploratory phase of co-creation takes place over 17 months (Nov 2021-March 2024) in the Greater Accra and Eastern Regions of Ghana. Informed by ethnographic observations of care interactions, in-depth interviews and focus group and group discussions, the tool(kit) will be developed with survivors and women with hypertensive disorders of pregnancy and their families, health professionals, policy makers, and researchers. The tool(kit) will consist of three components: quantitative predicted risk (based on external validated risk models or absolute risk of adverse outcomes), risk communication, and shared decision-making support. We expect to co-create a user-friendly tool(kit) to improve the quality of care for women with preeclampsia remote from term which will contribute to better maternal and perinatal health outcomes as well as better maternity care experience for women in Ghana.
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Affiliation(s)
- Hannah Brown Amoakoh
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Bregje C. De Kok
- Anthropology Department, University of Amsterdam, Amsterdam, Netherlands
| | - Linda Lucy Yevoo
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Department of Obstetrics and Gynaecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Klaartje M. Olde Loohuis
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Emmanuel K. Srofenyoh
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Obstetrics and Gynaecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Daniel K. Arhinful
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Kwame Adu-Bonsaffoh
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana
| | - Mary Amoakoh-Coleman
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joyce L. Browne
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
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Rich A, Viney R, Silkens M, Griffin A, Medisauskaite A. The experiences of students with mental health difficulties at medical school: a qualitative interview study. MEDICAL EDUCATION ONLINE 2024; 29:2366557. [PMID: 38870397 DOI: 10.1080/10872981.2024.2366557] [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: 06/01/2023] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND High rates of burnout, anxiety, and depression in medical students are widespread, yet we have limited knowledge of the medical school experiences of students with mental health issues. The aim of the study is to understand the impact of mental health issues on students' experience and training at medical school by adopting a qualitative approach. METHODS Qualitative study using in-depth semi-structured interviews with 20 students with mental health issues from eight UK medical schools of varying size and location. Students were purposefully sampled to gain variety in the type of mental health issue experienced and demographic characteristics. Reflexive thematic analysis was employed using NVivo software. RESULTS Three themes were identified. 1) Culture of medicine: medical culture contributed to causing mental ill-health through study demands, competitiveness with peers, a 'suck it up' mentality where the expectation is that medical school is tough and medical students must push through, and stigma towards mental ill-health. 2) Help-seeking: students feared others discovering their difficulties and thus initially tried to cope alone, hiding symptoms until they were severe. There were multiple barriers to help-seeking including stigma and fear of damage to their career. 3) Impact on academic life: mental health issues had a detrimental impact on academic commitments, with students' unable to keep up with their studies and some needing to take time out from medical school. CONCLUSION This study provides insight into how medical culture contributes both to the cause of mental health difficulties and the reluctance of medical students to seek help. Mental health issues had a considerable negative impact on medical students' ability to learn and progress through their degree. Addressing the medical culture factors that contribute to the cause of mental health issues and the barriers to help-seeking must be a priority to ensure a healthier medical workforce.
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Affiliation(s)
- Antonia Rich
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Rowena Viney
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Milou Silkens
- Centre for Healthcare Innovation Research, Department of Health Services Research and Management, School of Health and Psychological Sciences, City University of London, London, UK
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Ann Griffin
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Asta Medisauskaite
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
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Liu Y, Liu T, Yao M, Kou Z, Li R. Exploring barriers to influenza vaccine uptake and recommendation among healthcare providers in the community in China: A qualitative study. Hum Vaccin Immunother 2024; 20:2352916. [PMID: 38744298 PMCID: PMC11095569 DOI: 10.1080/21645515.2024.2352916] [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: 03/18/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024] Open
Abstract
Healthcare providers (HCPs) are recommended for priority influenza vaccination due to their high risk of contracting influenza. HCPs greatly aid in targeted population immunization campaigns. Therefore, understanding the factors that influence HCPs' decisions to get vaccinated and to recommend influenza vaccination is essential. However, there currently needs to be more evidence on this topic in China. Qualitative interviews using a semi-structured interview method were conducted with 180 HCPs from urban community hospitals and town hospitals in four cities in Shandong Province during August 2023. The interview content was analyzed using thematic analysis to identify the variables impacting the vaccination and recommendation practices of HCPs, as well as their suggestions for improving vaccination services. The results will help support the future development of precise intervention measures as well as focused education and training.
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Affiliation(s)
- Yuwei Liu
- College of Public Health, Shandong Second Medical University, Weifang, China
| | - Ti Liu
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, China
| | - Mingxiao Yao
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, China
| | - Zengqiang Kou
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, China
| | - Renpeng Li
- Shandong Provincial Center for Health Science & Technology and Talents Development, Shandong, China
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George S, Regan J, Awan A, O’Connor M, Foster A, Raymond K, Gorfinkel I, McNeil SA. Attitudes, barriers, and facilitators to adherent completion of the recombinant zoster vaccine regimen in Canada: Qualitative interviews with healthcare providers and patients. Hum Vaccin Immunother 2024; 20:2317595. [PMID: 38502342 PMCID: PMC10956622 DOI: 10.1080/21645515.2024.2317595] [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: 10/09/2023] [Accepted: 02/08/2024] [Indexed: 03/21/2024] Open
Abstract
This qualitative, cross-sectional study aimed to understand the barriers and facilitators related to the adherence and completion of the recombinant zoster vaccine (RZV) two-dose series in Canada, as perceived by healthcare providers (HCPs) and patients. Data collection occurred via 60-minute concept elicitation interviews with 12 HCPs (4 physicians, 2 nurse practitioners, 6 pharmacists) who had prescribed and/or administered RZV in Canada, and 21 patients aged ≥50 years who had received ≥1 dose of RZV. Patients were categorized as adherent (received both doses within the recommended 2-to-6-month timeframe; n = 11) or non-adherent (received only one dose or second dose outside the recommended timeframe; n = 10). Interview transcripts were coded and analyzed using a two-part thematic analysis approach. HCP-identified barriers to RZV adherence included high out-of-pocket cost, inconsistent/lack of health plan coverage, inconvenient processes for accessing RZV, and patient forgetfulness. HCP-identified facilitators included desire for shingles protection, HCP encouragement, and reminders. Barriers to RZV adherence identified by patients included lack of HCP knowledge/experience with RZV, receiving unreliable/confusing information, having unpleasant/severe side effects following the first dose, high out-of-pocket cost, lack of insurance coverage, and forgetfulness. Patient-identified facilitators included self-motivation, financial support, convenient processes for obtaining RZV, and reminders. In conclusion, many factors can influence RZV series completion and adherence among adults in Canada, including cost, insurance coverage, HCP knowledge and encouragement, and reminders. Awareness of these factors may inform HCPs in helping patients overcome barriers and identify opportunities for future consideration, facilitating protection against herpes zoster.
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Affiliation(s)
| | | | | | | | | | | | | | - Shelly A. McNeil
- Canadian Center for Vaccinology, IWK Health and Nova Scotia Health, Dalhousie University, Halifax, NS, Canada
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12
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Li X, Bai Y, Weng L, Bai Y, Gong W. COVID-19 vaccine hesitancy among the Chinese elderly: A multi-stakeholder qualitative study. Hum Vaccin Immunother 2024; 20:2315663. [PMID: 38439589 PMCID: PMC10936594 DOI: 10.1080/21645515.2024.2315663] [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: 11/27/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024] Open
Abstract
The United Nations reported that the mortality risk of Corona Virus Disease 2019 (COVID-19) is five times higher in the elderly than the global average. Although the COVID-19 vaccine effectively prevents infections and reduce mortality among the elderly, vaccine hesitancy among the Chinese elderly poses a significant threat. This study, utilizing the "Confidence, Convenience and Complacency (3 Cs)" vaccine hesitancy model, aimed to explore factors contributing to vaccine hesitancy among the Chinese elderly and assess national countermeasures and potential improvement approaches. Thirteen elderly with vaccine hesitancy and eleven vaccine-related staff participated in semi-structured interviews. Thematic analysis revealed three key determinants of vaccine hesitancy among the elderly: perceived low threat of COVID-19, lack of confidence in COVID-19 vaccine, and poor accessibility to vaccination. China has implemented strategies, including advocacy through diverse channels, joint multi-sectoral promotion vaccination, and enhancing ongoing vaccination services. Recommendations from the vaccine-related staff emphasize improving vaccine awareness among the elderly, and prioritizing the vaccination environment and process. The study underscores the importance of targeted vaccination promotion programs addressing hesitation reasons to improve vaccination rates. Furthermore, existing countermeasures can serve as a foundation for enhancing vaccination strategies, including improved publicity, administration, and management approaches.
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Affiliation(s)
- Xiaoyu Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yanping Bai
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Lijun Weng
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yunshan Bai
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
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Charania NA, Tonumaipe'a D, Barbarich-Unasa TW, Iusitini L, Davis G, Pacheco G, Wilson D. Exploring the impact of the COVID-19 pandemic on perceptions of national scheduled childhood vaccines among Māori and Pacific caregivers, whānau, and healthcare professionals in Aotearoa New Zealand. Hum Vaccin Immunother 2024; 20:2301626. [PMID: 38205779 DOI: 10.1080/21645515.2023.2301626] [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: 09/28/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
In Aotearoa New Zealand, there has been a marked decrease in the uptake of routine childhood vaccinations since the onset of the COVID-19 pandemic, particularly among Māori and Pacific children. This Māori and Pacific-centered research used an interpretive description methodology. We undertook culturally informed interviews and discussions with Māori and Pacific caregivers (n = 24) and healthcare professionals (n = 13) to understand their perceptions of routine childhood vaccines. Data were analyzed using reflexive thematic analysis and privileged respective Māori and Pacific worldviews. Four themes were constructed. "We go with the norm" reflected how social norms, health personnel and institutions promoted (and sometimes coerced) participants' acceptance of routine vaccines before the pandemic. "Everything became difficult" explains how the pandemic added challenges to the daily struggles of whānau (extended family networks) and healthcare professionals. Participants noted how information sources influenced disease and vaccine perceptions and health behaviors. "It needed to have an ethnic-specific approach" highlighted the inappropriateness of Western-centric strategies that dominated during the initial pandemic response that did not meet the needs of Māori and Pacific communities. Participants advocated for whānau-centric vaccination efforts. "People are now finding their voice" expressed renewed agency among whānau about vaccination following the immense pressure to receive COVID-19 vaccines. The pandemic created an opportune time to support informed parental vaccine decision-making in a manner that enhances the mana (authority, control) of whānau. Māori and Pacific-led vaccination strategies should be embedded in immunization service delivery to improve uptake and immunization experiences for whānau.
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Affiliation(s)
- Nadia A Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - Daysha Tonumaipe'a
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Te Wai Barbarich-Unasa
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Leon Iusitini
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Georgina Davis
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Gail Pacheco
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Wilson
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
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14
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Pereira TLB, Ang E, Aayisha, Naidu KNC, Chan YH, Shorey S. Ontological coaching among nursing undergraduates: a pilot randomized controlled (OCEAN) trial. MEDICAL EDUCATION ONLINE 2024; 29:2379109. [PMID: 39033532 PMCID: PMC11262227 DOI: 10.1080/10872981.2024.2379109] [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: 01/12/2024] [Accepted: 07/08/2024] [Indexed: 07/23/2024]
Abstract
To develop and assess the preliminary effectiveness of Ontological Coaching Intervention for nursing undergraduates. Design: A pilot randomized controlled trial with a two-group pre-test and post-test followed by process-evaluation qualitative interviews. An Ontological Coaching Intervention was developed through an integration of prior literature and the collective the research team's experience, consisting of 4-6 sessions over 6-months, each lasting 30-60 minutes. Sessions encompassed exploring ontological coaching concepts, empowering nursing undergraduates to choose topics, and tailoring sessions to individual needs. Sixty undergraduates were recruited; ten were excluded for not completing the baseline questionnaires. Twenty-one nursing undergraduates were randomly assigned to the intervention group and twenty-nine undergraduates to the control group (standard academic support only). Primary (psychological well-being) and secondary (social support quantity and satisfaction, goal-setting, resilience) outcomes were measured at baseline, 3-months, and 6-months. Semi-structured interviews captured post-intervention experiences. Between-group analyses revealed a significant difference in goal-setting scores at 3-months (U = 325.5, p = 0.013), favoring the intervention group (median = 70.50, IQR = 64.25, 76.75). At 6-months, a significant difference in social support satisfaction scores (U = 114.5, p = 0.028) was found between the intervention (median = 33.00, IQR = 29.50, 35.25) and control (median = 30.00, IQR = 30.00, 35.00) groups. However, no significant between-group differences were noted in other outcome measures. Significant within-group differences were found in goal-setting scores at 3- and 6-months in the intervention group and social support quantity scores at 3- and 6-months in the control group. However, no significant within-group differences were noted in other outcome measures. Three themes were identified: Enhanced Holistic Development, Keys to Successful Coaching, and Future Directions for Successful Coaching. There is urgent need to advance research on Ontological Coaching Intervention, particularly, enhancing study rigor, broadening examinations to diverse healthcare student populations and cultural contexts, and addressing identified limitations.
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Affiliation(s)
- Travis Lanz-Brian Pereira
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Emily Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Aayisha
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kuhanesan N. C. Naidu
- Department of Psychological Medicine, National University Health System, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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15
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Felber SJ, Zambrano SC, Guffi T, Schmitz FM, Brem BG, Schnabel KP, Guttormsen S, Eychmüller S. How to talk about dying? The development of an evidence-based model for communication with patients in their last days of life and their family caregivers. PEC INNOVATION 2024; 5:100309. [PMID: 39027227 PMCID: PMC11254737 DOI: 10.1016/j.pecinn.2024.100309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 06/06/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024]
Abstract
Objective To help healthcare professionals (HCP) act with more confidence when communicating about approaching death, we sought to develop a communication model for HCP to facilitate conversations with dying patients and family caregivers (FC) in nonemergency situations. Methods We used a four-phase integrative approach: (1) creation of a preliminary model based on a systematic literature review and expert knowledge, (2) review of the model draft by international palliative care experts, (3) review by key stakeholders, and (4) final appraisal by communication experts. Results After the clinical recognition of dying, the communication model provides a structure and practical communication aids for navigating the conversation based on three phases. It describes the content and relational level as core dimensions of effective conversations about approaching death and highlights the importance of HCP self-awareness and self-care when caring for the dying. Conclusion Based on systematic involvement of key stakeholders, the model supports clinicians navigating challenging conversations about approaching death with dying patients and their FC successfully and with more confidence. Innovation This study expands the theoretical basis for communication about approaching death and offers a pragmatic model for educational interventions and clinical use.
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Affiliation(s)
- Sibylle J. Felber
- University Centre for Palliative Care (UZP), Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sofia C. Zambrano
- University Centre for Palliative Care (UZP), Bern University Hospital, University of Bern, Bern, Switzerland
- Institute for Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Tommaso Guffi
- Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Felix M. Schmitz
- Institute for Medical Education (IML), University of Bern, Bern, Switzerland
| | - Beate G. Brem
- Institute for Medical Education (IML), University of Bern, Bern, Switzerland
| | - Kai P. Schnabel
- Institute for Medical Education (IML), University of Bern, Bern, Switzerland
| | - Sissel Guttormsen
- Institute for Medical Education (IML), University of Bern, Bern, Switzerland
| | - Steffen Eychmüller
- University Centre for Palliative Care (UZP), Bern University Hospital, University of Bern, Bern, Switzerland
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16
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Brune C, Agerholm J, Burström B, Liljas A. Experience of moral distress among doctors at emergency departments in Stockholm during the Covid-19 pandemic: a qualitative interview study. Int J Qual Stud Health Well-being 2024; 19:2300151. [PMID: 38258523 PMCID: PMC10810614 DOI: 10.1080/17482631.2023.2300151] [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: 07/12/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
PURPOSE The COVID-19 pandemic and consequent strain on healthcare globally shed light on the concept of moral distress among healthcare workers, albeit to a smaller extent among doctors at emergency departments. This study aimed to examine moral distress as perceived by medical doctors working at emergency departments in Stockholm during the pandemic, with the purpose of investigating causes of moral distress and methods to manage moral distress. METHODS Semi-structured interviews were conducted with twelve doctors working at two emergency departments. A questionnaire was developed based on previous research and the interviews were analysed qualitatively through thematic analysis. RESULTS The themes "The factors that precipitated moral distress", "Experience of workplace support" and "Coping strategies" as well as seven subthemes and 15 codes were identified. The informants reported on various situations with different causes of moral distress. Common causes were resource depletion, such as hospital bed shortages, and following stricter triage criteria. Informants reported varying ways of managing moral distress. CONCLUSIONS Informants experienced moral distress when faced with challenges such as resource depletion, rules and regulations, and colleagues' decisions. The informants who chose to seek support received it from their workplace, which helped them cope with their experiences. Some informants chose to not seek support.
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Affiliation(s)
- Clara Brune
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Janne Agerholm
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Bo Burström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ann Liljas
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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17
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Kwegyir Tsiboe A, Raghuraman S, Marshall TC. Caught between two worlds: mental health literacy and stigma among bicultural youth. Int J Qual Stud Health Well-being 2024; 19:2321644. [PMID: 38431901 PMCID: PMC10911255 DOI: 10.1080/17482631.2024.2321644] [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: 04/10/2023] [Accepted: 02/18/2024] [Indexed: 03/05/2024] Open
Abstract
PURPOSE Bicultural youths are at higher risk of mental health problems and are less likely to utilize mental health services, yet our knowledge of their mental health literacy and help-seeking behaviours remains limited. METHODS To fill this gap, the current study explored bicultural youths' mental health literacy and stigma by conducting semi-structured interviews with 14 Canadian university students in 2021. RESULTS Our analysis revealed that bicultural youths may be torn between two worlds: intergenerational tensions between participants assimilated into individualistic Canadian culture and their more collectivist parents meant that they had different cultural perceptions of mental health literacy and stigma. While being caught between these two worlds may be detrimental for bicultural youth, our results also suggested that a trans-cultural factor-celebrities' mental health journeys-may promote help-seeking behaviour across participants. Furthermore, our study speaks to the ways that unprecedented events such as the COVID-19 pandemic impact mental health literacy among bicultural youth. Our findings might be used by university mental health services to encourage help-seeking among bicultural students. CONCLUSION The acculturation of mental health literacy, stigma, and associated intergenerational differences needs to be considered by university wellness services.
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Affiliation(s)
| | - Shruthi Raghuraman
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
| | - Tara C. Marshall
- Department of Health, Aging & Society, McMaster University, Hamilton, Canada
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18
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Goedeke S, Gamble H. Donor-linking provisions in New Zealand: counselling roles, concerns and needs. HUM FERTIL 2024; 27:2343718. [PMID: 38661133 DOI: 10.1080/14647273.2024.2343718] [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: 10/20/2023] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
Donor-linking where those genetically related through donor conception (e.g. donor-conceived persons (DCP), donors and siblings), or recipient parents, search for and connect with each other, is increasingly common, both in identity-release jurisdictions where donors' identifying information may be released to DCP, usually when they become adults - and in anonymous jurisdictions, e.g. as a result of direct-to-consumer DNA testing. In this paper, we explore New Zealand fertility clinic counsellors' views regarding their donor-linking roles and their concerns and needs in relation to current and anticipated service provision. Counsellors believed that fertility service providers had a longer-term responsibility to offer donor-linking services to ensure the wellbeing of all parties affected by donor conception. They perceived their role as complex and multifaceted, encompassing psychoeducation, mediation, advocacy, facilitation, relationship counselling, and therapeutic intervention. They identified significant service provision challenges however, including inadequate staffing, training, time and prioritisation of donor-linking, and inadequate legislative provisions to support practice. Counsellors called for clarity in legislation addressing different contexts of donation and providing measures to ensure the recording of and access to identifying information. They expressed a need for comprehensive, funded donor-linking services, therefore facilitating choice, and services staffed by professionally trained and supported staff.
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Affiliation(s)
- Sonja Goedeke
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Heather Gamble
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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19
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Hollmann E, Farrell E, Le Roux C, Nadglowski J, McGillicuddy D. "Treated as second class citizens" - the lived experience of obesity-related stigma: an IMI2 SOPHIA study. Int J Qual Stud Health Well-being 2024; 19:2344232. [PMID: 38662641 PMCID: PMC11047216 DOI: 10.1080/17482631.2024.2344232] [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: 11/24/2023] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
PURPOSE Obesity-related stigma impacts on and shapes the physical and psychosocial wellbeing of individuals living with obesity. Often absent from the literature in the field is the voice(s) of those living with obesity capturing the nuances of the lived experiences of obesity-related stigma. METHODS This study adopted a qualitative approach encompassing individual (n = 15) and photovoice method (n = 12), with a purposeful sample of patients accessing treatment for obesity within the healthcare setting during 2021. Analysis was undertaken using thematic analysis. RESULTS Key themes developed from the analysis related to experiencing obesity-related stigma as exposure to external judgement, societal exclusion and felt environmental stigmatization. Exposure to external judgement was described as judgemental comments resulting in hypervigilance to societal judgement. Participants reported how being overlooked and ignored by others had various negative effects and compounded obesity-related stigma through societal exclusion. Public spaces lacking suitable equipment further made obesity-related stigma visible through felt environmental stigmatization when pursuing hobbies and in everyday life. CONCLUSIONS Obesity-related stigma had a profoundly negative impact on participants in this study, particularly in shaping social interaction, limiting life experiences and impacting psychosocial wellbeing.
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Affiliation(s)
- Eva Hollmann
- School of Education, University College Dublin, Belfield, Dublin, Ireland
| | - Emma Farrell
- School of Education, University College Dublin, Belfield, Dublin, Ireland
| | - Carel Le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Joe Nadglowski
- Governance and Financials, President/CEO Obesity Action Coalition, Tampa, FL, USA
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20
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Hoffman KA, Graves C, Rowe K, Worth J, Pertl K, Laidler J, Korthuis P, McCarty D. Engaging the Great Circle: a qualitative study of the Confederated Tribes of Grand Ronde’s mobile medication unit. Ann Med 2024; 56:2306492. [PMID: 38271558 PMCID: PMC10812851 DOI: 10.1080/07853890.2024.2306492] [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: 09/11/2023] [Accepted: 01/12/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The Confederated Tribes of the Grand Ronde Community of Oregon began a Mobile Medication Unit (MMU) as part of their Great Circle Recovery Opioid Treatment Program (OTP) to address elevated rates of opioid use disorder (OUD) among American Indians and Alaska Natives in Oregon. The MMU provides methadone or buprenorphine for individuals with OUD, enrolled in the OTP, who are living either on the reservation or in surrounding rural communities. An implementation study describes the service through document review and qualitatively assesses patient and staff experiences and the perceived barriers and facilitators to mobile services. METHODS Semi-structured qualitative interviews with patients (n = 11), MMU staff (n = 5), and the state opioid treatment authority (n = 1) gathered details on the initiative's development and operations. Provider interviews probed implementation experiences. Patient interviews focused on their experiences with the MMU and staff, changes in quality of life and recommendations for enhancing treatment. Interviews were transcribed and analysed using a Thematic Analysis approach. RESULTS Staff themes identified two driving forces (i.e. staff desire for an inclusive approach to wellness that is accessible to all community members; the catalysts for the MMU), two steps toward MMU development (i.e. Tribal approvals and support; the construction and maintenance of community relationships) and two perspectives on MMU implementation and impact (i.e. initial implementation barriers; facilitators and observations of how the MMU reduced stigma associated with agonist therapy). Patients' themes noted the MMU's professional and 'caring' environment, accessible rural locations and general suggestions including culturally responsive ancillary services. CONCLUSION The Great Circle MMU enhanced access to opioid agonist therapy for people with OUD (i.e. American Indians/Alaska Natives, and non-natives) living in rural communities. The Confederated Tribes of Grand Ronde operates the first Tribally owned OTP MMU, grounded in cultural humility and committed to Tribal members and the great circle of the larger community.
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Affiliation(s)
- Kim A. Hoffman
- Department of Medicine, OR Health and Science University, Portland, OR, USA
| | - Chantell Graves
- Grand Ronde Great Circle Opioid Treatment Program, Grand Ronde Oregon, OR, USA
| | - Kelly Rowe
- Grand Ronde Great Circle Opioid Treatment Program, Grand Ronde Oregon, OR, USA
| | - Jennifer Worth
- Grand Ronde Great Circle Opioid Treatment Program, Grand Ronde Oregon, OR, USA
| | - Kellie Pertl
- Department of Medicine, OR Health and Science University, Portland, OR, USA
| | - James Laidler
- Grand Ronde Great Circle Opioid Treatment Program, Grand Ronde Oregon, OR, USA
| | - P. Todd Korthuis
- Department of Medicine, OR Health and Science University, Portland, OR, USA
| | - Dennis McCarty
- Department of Medicine, OR Health and Science University, Portland, OR, USA
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21
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Pisolkar V, Dena I, Green KL, Palmer-Clarke Y, Hinz T, Muhajarine N. See us, hear us! children, adolescents and families in Saskatchewan coping with mental health during the COVID-19 pandemic. Int J Qual Stud Health Well-being 2024; 19:2361494. [PMID: 38824661 PMCID: PMC11146264 DOI: 10.1080/17482631.2024.2361494] [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: 01/30/2024] [Accepted: 05/24/2024] [Indexed: 06/04/2024] Open
Abstract
PURPOSE To examine the lived experiences of children and adolescents coping with mental health issues and seeking mental health services in Saskatchewan during the COVID-19 pandemic. METHODS In our descriptive phenomenological qualitative study, we interviewed forty-six individuals, including children aged 8-15 and their parents. Thematic analysis was applied to interpret the interview data. RESULTS Our analysis identified three key themes: pyscho-behavioural impact, academic impact, and social impact. The pandemic adversely affected children due to factors like changes in behaviours such as increased screen time and decreased physical activity, limited access to mental health services, and disruptions to schooling and social interactions. Coping mechanisms varied, ranging from the utilization of available mental health supports and services to individual and family-based strategies. Disparities in timely access to mental health services were evident, with financially stable families accessing private services, while others struggled, particularly in rural areas. Families demonstrated resilience through parental efforts to seek balance and prioritize safety amidst COVID-19 challenges. CONCLUSIONS Social connectedness served as a crucial buffer against pandemic-induced stress. Children faced difficulty in accessing timely mental health services and supports. Echoing participant experiences, our findings emphasize the urgency of targeted interventions and policy adjustments to address existing gaps in mental health service accessibility and availability.
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Affiliation(s)
- Vaidehi Pisolkar
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Isabelle Dena
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kathryn L. Green
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yolanda Palmer-Clarke
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), Saskatoon, SK, Canada
| | - Tamara Hinz
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), Saskatoon, SK, Canada
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22
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Lavesen M, Paine M, Bove DG. In a Strained Healthcare System, Patients with Advanced COPD Struggle to Access the Needed Support from the Healthcare Professionals - A Qualitative Study. COPD 2024; 21:2361669. [PMID: 38863257 DOI: 10.1080/15412555.2024.2361669] [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: 01/25/2024] [Accepted: 05/24/2024] [Indexed: 06/13/2024]
Abstract
This study aimed to explore the self-management strategies of Danish patients living with advanced Chronic Obstructive Pulmonary Disease (COPD), with a particular focus on their daily life and their interactions with the respiratory outpatient clinic. Data were collected through semi-structured interviews with 11 patients with COPD affiliated with a Danish respiratory outpatient clinic. The data were thematically analyzed as suggested by Braun & Clarke. The analysis revealed one overarching theme, three main themes, and six subthemes. The overarching theme 'In a strained healthcare system patients with COPD struggle to access needed support to be able to self-manage their disease' revolved around the challenges that patients face in an overburdened healthcare system as they seek support to effectively self-manage their condition. The three main themes were: (1) Only physical symptoms provide legal access to the respiratory outpatient clinic, (2) For patients, the measurements serve as indicators of their health status and overall well-being, (3) Healthcare professionals' skills and not the mode of contact matters to the patients. Healthcare professionals should be aware that the rhetoric surrounding a busy healthcare system with a stressed-out staff also affects patients. Patients with COPD may be particularly sensitive to this message and try to avoid burdening the healthcare system further by setting aside their own needs. However, this approach can lead to neglecting symptoms of deterioration and mental symptoms, which increase the risk of disease progression and subsequent risk of hospital admission.
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Affiliation(s)
- M Lavesen
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M Paine
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - D G Bove
- Centre for Nursing, University College Absalon, Roskilde, Denmark
- Department for People and Technology, Roskilde University, Roskilde, Denmark
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Dundas I, Binder PE. Being able to think when caught in the maelstrom - how adolescents used mindfulness when facing exams. Int J Qual Stud Health Well-being 2024; 19:2375660. [PMID: 38967618 PMCID: PMC11229735 DOI: 10.1080/17482631.2024.2375660] [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: 05/01/2024] [Accepted: 06/29/2024] [Indexed: 07/06/2024] Open
Abstract
PURPOSE Research indicates that exam anxiety may decline with mindfulness-based interventions but there is a lack of research on adolescents' accounts of the processes involved. We explored high-school students' descriptions of how they perceived and applied mindfulness in managing anxiety-inducing thoughts related to academic performance following an 8-week Mindfulness-Based Stress Reduction (MBSR) course. METHOD Post-course individual semi-structured interviews with 22 high school students (2 males, mean age 17.8 years) were transcribed verbatim and analysed using reflexive thematic analysis. RESULTS The analyses identified six themes: (1) Noticing and attending to the attention-binding "maelstrom" of anxious thoughts and feelings (2) Attending to the breath to cope with the maelstrom, (3) "removing" and "getting rid of" anxious thoughts (4) Being able to "think" (5) awareness of more helpful thoughts, and (6) Agency and control. The findings are discussed in light of the Buddhist notion of "unwholesome thoughts" and the distinction between thought suppression and the use of breathing as a benign distraction. We propose that mindfulness encompasses both a receptive, nonjudgmental awareness and an active, intentional redirection of attention. CONCLUSION Mindfulness training aided participants by enhancing their capacity to disengage from fear-engaging thoughts, thereby maintaining them within their window of tolerance and facilitating cognitive processing.
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Affiliation(s)
- Ingrid Dundas
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Per-Einar Binder
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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Neller SA, Hebdon MT, Wickens E, Scammon DL, Utz RL, Dassel KB, Terrill AL, Ellington L, Kirby AV. Family caregiver experiences and needs across health conditions, relationships, and the lifespan: a Qualitative analysis. Int J Qual Stud Health Well-being 2024; 19:2296694. [PMID: 38213230 PMCID: PMC10791097 DOI: 10.1080/17482631.2023.2296694] [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: 08/21/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024] Open
Abstract
PURPOSE The purpose of this study was to understand the lived experiences of family caregivers who provide care to individuals across a broad range of ages, caregiving relationships, and health conditions and/or disabilities. Family caregiver research is typically siloed by health condition or by caregiving relationship, leaving gaps in understanding similarities and differences among caregivers. METHODS We hosted three virtual focus groups with diverse family caregivers (n = 26) caring for an individual with a long-term disability and/or health condition(s). We conducted a qualitative thematic analysis using an iterative, inductive process. RESULTS Participants primarily expressed shared experiences, despite having unique caregiving situations. We identified themes among a) caregiver experiences: Trying to Do It All, Balancing Complex Emotions, Managing Expectations, and Adjusting to Changes Over Time and b) caregiver needs: Longing for Breaks and Self-Care; Lacking Help, Support and Resources; and Desiring Understanding and Recognition. CONCLUSIONS These findings emphasize that many elements of the caregiving experience transcend care recipient age, condition, and relationship and are applicable to clinicians, researchers, and policy makers. The evidence of shared caregiver experiences can guide efficiencies in policy and practice (e.g., pooling of existing resources, expansion of interventions) to meet the needs of a broader population of caregivers.
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Affiliation(s)
- Sarah A. Neller
- College of Nursing, University of Tennessee, Knoxville, TN, USA
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Emily Wickens
- College of Social and Behavioral Sciences, University of Utah, Salt Lake City, UT, USA
| | - Debra L. Scammon
- David Eccles School of Business, University of Utah, Salt Lake City, UT, USA
| | - Rebecca L. Utz
- College of Social and Behavioral Sciences, University of Utah, Salt Lake City, UT, USA
| | - Kara B. Dassel
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Anne V. Kirby
- College of Health, University of Utah, Salt Lake City, UT, USA
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Taladay-Carter C. Making end-of-life health disparities in the U.S. visible through family bereavement narratives. PEC INNOVATION 2024; 4:100276. [PMID: 38576418 PMCID: PMC10992982 DOI: 10.1016/j.pecinn.2024.100276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024]
Abstract
Objective End-of-life experiences can have important implications for the meaning-making and communication of bereaved family members, particularly due to (in)access to formal healthcare services (i.e., palliative care and hospice). Grounded in Communicated Narrative Sense-Making theory, this study extends knowledge about how the stories told about end-of-life by bereaved family members affect and reflect their sense-making, well-being and importantly, potential disparities in end-of-life care. Methods Semi-structured interviews with 25 bereaved individuals were conducted regarding their experiences with the terminal illness and death of an immediate family member. Using a framework of family bereavement narratives, a cross-case data analysis demonstrated qualitative patterns between (in)access to end-of-life care and how participants framed bereavement stories. Results Four themes illustrated the continuum of communication that families engaged in when making sense of end-of-life experiences, including reflections on silence, tempered frustrations, comfort with care, and support from beyond. Innovation This innovative qualitative connection between family members' bereavement stories and end-of-life care emphasizes the importance of employing a health equity lens within hospice and palliative care, especially in addressing the important aim of comprehensively supporting families even when illness ends. This study demonstrates that access to, quality of, and imagining beyond current structures for EOL may be vital factors for facilitating effective sense-making for the dying and their family systems. Conclusion These findings illustrate the potential interconnections between (in)access to end-of-life care, sense-making, and communication for individuals and families experiencing terminal illness and bereavement.
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Affiliation(s)
- Cassidy Taladay-Carter
- Department of Communication Studies, University of Nebraska—Lincoln, 356 Louise Pound Hall, Lincoln, NE 68588, USA
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26
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Flierman M, Bossen D, de Boer R, Vriend E, van Nes F, van Kaam A, Engelbert R, Jeukens-Visser M. Parents' information needs during the first year at home with their very premature born child; a qualitative study. PEC INNOVATION 2024; 4:100270. [PMID: 38495319 PMCID: PMC10940942 DOI: 10.1016/j.pecinn.2024.100270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024]
Abstract
Objective To obtain insights into parents' information needs during the first year at home with their very preterm (VP) born infant. Methods We conducted semi-structured interviews with parents of VP infants participating in a post-discharge responsive parenting intervention (TOP program). Online interviews were audiotaped and transcribed verbatim. Inductive thematic analysis was performed by two independent coders. Results Ten participants were interviewed and had various and changing information needs during the developmental trajectory of their infant. Three main themes emerged; (1) Help me understand and cope, (2) Be fully responsible for my baby, and (3) Teach me to do it myself. Available and used sources, such as the Internet, did not meet their information needs. Participants preferred their available and knowledgeable healthcare professionals for reassurance, tailored information, and practical guidance. Conclusion This study identified parents' information needs during the first year at home with their VP infant and uncovered underlying re-appearing needs to gain confidence in child-caring abilities and autonomy in decision-making about their infants' care. Innovation This study provides valuable information for healthcare professionals and eHealth developers to support parental self-efficacy during the first year after preterm birth.
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Affiliation(s)
- Monique Flierman
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Daniel Bossen
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Rosa de Boer
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Eline Vriend
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Fenna van Nes
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Anton van Kaam
- Department of Neonatology, Emma Children's Hospital, Amsterdam University Medical center, Amsterdam, the Netherlands
| | - Raoul Engelbert
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Martine Jeukens-Visser
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Wilmont I, Loeffen M, Hoogeboom T. A qualitative study on the facilitators and barriers to adopting the N-of-1 trial methodology as part of clinical practice: potential versus implementation challenges. Int J Qual Stud Health Well-being 2024; 19:2318810. [PMID: 38417032 PMCID: PMC10903748 DOI: 10.1080/17482631.2024.2318810] [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: 11/07/2023] [Accepted: 02/10/2024] [Indexed: 03/01/2024] Open
Abstract
PURPOSE To investigate opinions among healthcare stakeholders whether implementation of the N-of-1 trial approach in clinical practice is a feasible way to optimize evidence-based treatment results for unique patients. METHODS We interviewed clinicians, researchers, and a patient advocate (n = 13) with an interest in or experience with N-of-1 trials on the following topics: experience with N-of-1, measurement, validity and reliability, informally gathered data usability, and influence on physician-patient relationship. Interviews were analysed using qualitative, thematic analysis. RESULTS The N-of-1 approach has the potential to shift the current healthcare system towards embracing personalized medicine. However, its application in clinical practice carries significant challenges in terms of logistics, time investment and acceptability. New skills will be required from patients and healthcare providers, which may alter the patient-physician relationship. The rise of consumer technology enabling self-measurement may leverage the uptake of N-of-1 approaches in clinical practice. CONCLUSIONS There is a strong belief that the N-of-1 approach has the potential to play a prominent role in transitioning the current healthcare system towards embracing personalized medicine. However, there are many barriers deeply ingrained in our healthcare system that hamper the uptake of the N-of-1 approach, making it momentarily only interesting for research purposes.
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Affiliation(s)
- Ilona Wilmont
- Data & Knowledge Engineering, HAN University of Applied Sciences, Arnhem, the Netherlands
- Institute for Computing and Information Sciences, Data Science, Radboud University Nijmegen, Nijmegen, the Netherlands
| | | | - Thomas Hoogeboom
- IQ healthcare, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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Blomberg M, Ryding J, Hertting K. Higher education as a pathway for female immigrants' establishment and well-being in Sweden. Int J Qual Stud Health Well-being 2024; 19:2365443. [PMID: 38870406 DOI: 10.1080/17482631.2024.2365443] [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: 11/15/2023] [Accepted: 06/04/2024] [Indexed: 06/15/2024] Open
Abstract
PURPOSE This study focuses on higher education as a pathway to establishment in a new society for female immigrants and its role in well-being. Building on previous research that highlights social capital and empowerment as significant factors for successful establishment in a new society, and experiencing well-being, this study aims to explore if higher education can promote female immigrants' establishment in Swedish society. METHODS Interviews were used to explore female immigrants' experiences of higher education and establishment in Swedish society. Thematic analysis was used to analyse the empirical material, generating a nuanced understanding of the studied topic. RESULTS Higher education was found to promote establishment in Swedish society, ultimately leading to an experience of well-being. Pursuing higher education was perceived as a means of achieving personal fulfilment and success while fostering new social connections. Important factors in pursuing higher education included favourable living conditions, personal motivation, and a positive educational attitude. CONCLUSION The study provides insights into female immigrants' higher education experiences in a context that promotes establishment in Swedish society and well-being. However, more research is needed to fully investigate the driving factors for female immigrants pursuing higher education, considering their migrant background and living conditions.
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Affiliation(s)
- My Blomberg
- School of Health & Welfare, Halmstad University, Halmstad, Sweden
| | - Jennie Ryding
- Department of Social and Behavioural Studies, University West, Trollhättan, Sweden
| | - Krister Hertting
- School of Health & Welfare, Halmstad University, Halmstad, Sweden
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Bonus CG, Hatcher D, Northall T, Montayre J. Using a co-design methodological approach to optimize perioperative nursing care for older adult patients from ethnically diverse backgrounds: a study protocol. Int J Qual Stud Health Well-being 2024; 19:2349438. [PMID: 38709958 PMCID: PMC11075656 DOI: 10.1080/17482631.2024.2349438] [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: 10/24/2023] [Accepted: 04/26/2024] [Indexed: 05/08/2024] Open
Abstract
This article outlines the use of a co-design methodological approach aimed at optimizing perioperative care experiences for ethnically diverse older adults and their family carers. The research involved three phases. In Phase 1, the foundation was established with the formation of a Core Advisory Group comprising key informants, including health consumers. This initial phase focused on forming relationships and conducting a literature review to inform subsequent stages of the research. Phase 2 progressed to data collection, where a qualitative survey on perioperative experiences was conducted. Semi-structured interviews were held with patients, their family carers, and perioperative staff. Phase 3 advanced the co-design process through a workshop involving patients, family carers, perioperative staff, and key stakeholders. Workshop participants collaborated on potential practice changes, proposing strategies for future clinical implementation. While data analysis and reporting for Phases 2 and 3 are forthcoming, the continued involvement of the Core Advisory Group ensures ongoing consensus-building on health consumer needs. This methodology article adopts a prospective stance, with findings to be presented in subsequent scholarly works. Use of this methodology will help to determine how the use of a co-design approach may impact the development of culturally responsive perioperative nursing care for those from ethnically diverse communities.
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Affiliation(s)
- Charmaine G. Bonus
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Blacktown, NSW, Australia
| | - Deborah Hatcher
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Tiffany Northall
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR
- WHO Collaborating Centre for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR
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Håkansson T, Svensson H, Karlsson S. Living with a person with young onset dementia - spousal experience. Int J Qual Stud Health Well-being 2024; 19:2330233. [PMID: 38493492 PMCID: PMC10946261 DOI: 10.1080/17482631.2024.2330233] [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: 04/26/2023] [Accepted: 03/11/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE Being of working age while at the same time needing to help a partner with young onset dementia has specific consequences for spouses. Research to date has been sparse concerning this particular group of spouses. The aim of the study was to explore spouses' everyday experiences when living with a person with young onset dementia. METHOD The study had a descriptive qualitative design with semi-structured interviews with nine spouses. The interviews were analysed using content analysis. RESULT The interviewed spouses experienced emotions that varied from feelings of loneliness, frustration, and worry to peace of mind. They said that they used coping strategies, which included adopting a positive mindset, adapting to inabilities, adopting an avoidant approach, and finding ways to recharge. Spouses also felt that they could use more support, both formal and informal. CONCLUSION The spouse of a person with young onset dementia has a range of emotional experiences and has resourceful ways of handling everyday life. Various types of support are offered to spouses, however, they seemed to desire more from health care services.
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Affiliation(s)
- Tania Håkansson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Hilda Svensson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Staffan Karlsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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Lindkvist RM, Eckerström J, Landgren K, Westling S. Brief admission by self-referral for individuals with self-harm and suicidal ideation: a qualitative study based on focus groups exploring relatives' experiences. Int J Qual Stud Health Well-being 2024; 19:2353460. [PMID: 38739443 PMCID: PMC11095277 DOI: 10.1080/17482631.2024.2353460] [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: 01/30/2024] [Accepted: 05/07/2024] [Indexed: 05/14/2024] Open
Abstract
PURPOSE Brief Admission by self-referral (BA) is a standardized crisis-management intervention for individuals with self-harm and risk for suicide. This study explored relatives' experiences of BA. Relatives' perspectives may contribute to an increased understanding of the effects of BA given the relatives' role as support and informal caregivers as well as being co-sufferers. METHODS Fourteen relatives to adults with access to BA within one Swedish region participated in focus groups analysed with reflexive thematic analysis. RESULTS We generated themes evolving around three meaning-based concepts: access (A low threshold to a safe back-up is crucial and obstacles may easily break faith), independence (Trust in their ability with care and respect), and recovery (The rest and relational recovery we all get are needed and invaluable). CONCLUSIONS BA brings considerable value to users and relatives, by supporting them to take care of themselves and each other. Communication and involvement of relatives may enhance users' ability to overcome obstacles to accessing BA. Implementation and adherence may be strengthened by supervision of BA staff and education of emergency care staff. Resources are needed to improve access. Mapping hurdles to BA, support through peers and targeted psychoeducation may improve recovery for BA users and their relatives.
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Affiliation(s)
- Rose-Marie Lindkvist
- Department of Clinical Sciences Malmö, Psychiatry, Lund University, Lund, Sweden
| | - Joachim Eckerström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Kajsa Landgren
- Department of Clinical Sciences Malmö, Psychiatry, Lund University, Lund, Sweden
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, Lund, Sweden
| | - Sofie Westling
- Department of Clinical Sciences Malmö, Psychiatry, Lund University, Lund, Sweden
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, Lund, Sweden
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Avraham R, Simon-Tuval T, Van Dijk D. Determinants of physical activity habit formation: a theory-based qualitative study among young adults. Int J Qual Stud Health Well-being 2024; 19:2341984. [PMID: 38605587 PMCID: PMC11018029 DOI: 10.1080/17482631.2024.2341984] [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: 02/11/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE Engagement in physical activity significantly contributes to reducing the onset and severity of chronic diseases. Nonetheless, establishing habits around this behaviour remains a persistent challenge. This research endeavours to discern the determinants influencing the formation of physical activity habit among young adults in Israel, drawing upon a socio-ecological model. METHODS A qualitative approach with phenomenological-hermeneutical method was used. In-depth interviews were carried to cover four levels of the socio-ecological model. RESULTS Interviewees were categorized into three subgroups according to their physical activity habit strength: Habitually physically active (n = 8), Variably physically active (n = 11), and physically inactive (n = 6). The content analysis yielded four overarching themes associated with physical activity habit formation. Intrapersonal determinants encompassed personal traits, perceptions and attitudes, perceived benefits, and emotional responses related to physical activity. Interpersonal determinants encompassed social support, modelling support, and peer pressure. Community determinants pertained to social norms, resource availability, and accessibility. Finally, public policy considerations encompassed educational policies as well as workplace policies and cultural influences. CONCLUSIONS This study highlights the unique determinants contributing to the formation of physical activity habit. As intrapersonal and interpersonal factors are significant determinants, interventions should focus on these elements in order to promote this behaviour among young adults.
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Affiliation(s)
- Rinat Avraham
- Department of Nursing, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Tzahit Simon-Tuval
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dina Van Dijk
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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van Zijl AC, Obermann-Borst SA, Hogeveen M, Verweij EJ, de Vries WB, Geurtzen R, Labrie NH. Mind the gap: Comparing parents' information needs about impending preterm birth to current clinical practices using a mixed methods approach. PEC INNOVATION 2024; 4:100297. [PMID: 38962499 PMCID: PMC11219962 DOI: 10.1016/j.pecinn.2024.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/16/2024] [Accepted: 05/29/2024] [Indexed: 07/05/2024]
Abstract
Objective To identify parents' information needs about impending very preterm birth and compare these needs to current information practices in the Netherlands. Methods Step 1: We surveyed N = 203 parents of preterm infants to assess their information needs. Data were analyzed using inductive thematic analysis. Step 2a: We collected information resources from hospitals (N = 9 NICUs) and via an online search. These materials were analyzed using deductive thematic analysis. Step 2b: We compared findings from Steps 1-2a. Results We identified four themes pertaining to parents' information needs: (1) participation in care, (2) emotional wellbeing, (3) experience/success stories, and (4) practical information about prematurity. Clinicians' communicative skills and time were considered prerequisites for optimal information-provision. Notably, hospital resources provided mainly medical information about prematurity with some emphasis on participation in care, while parent associations mainly focused on emotional wellbeing and experience/success stories. Conclusion While parents demonstrate clear information needs about impending very preterm birth, current information resources satisfy these partially. Innovation Our multidisciplinary research team included both scholars and veteran NICU parents. As such, we identified parents' information needs bottom-up. These parent-driven insights will be used to design an innovative, tailored information platform for parents about impending very preterm birth.
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Affiliation(s)
- Angela C.M. van Zijl
- Department of Neonatology, Wilhelmina Children's Hospital, Lundlaan 6, 3582 EA Utrecht, the Netherlands
| | - Sylvia A. Obermann-Borst
- Care4Neo, Neonatal Patient and Parent Advocacy Organization, Marshallweg 13 (unit 2), 3068 JN Rotterdam, the Netherlands
| | - Marije Hogeveen
- Department of Neonatology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - E.J.T. Joanne Verweij
- Department of Obstetrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Willem B. de Vries
- Department of Pediatrics, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Rosa Geurtzen
- Department of Neonatology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Nanon H.M. Labrie
- Department of Language, Literature & Communication, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
- Department of Pediatrics|Neonatology, OLVG Amsterdam, Jan Tooropstraat 164, 1061 AE Amsterdam, the Netherlands
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Jerala N, Petek D. Enhancing LGBT + primary healthcare in Slovenia: A national qualitative study of experiences and expectations of LGBT + people and family doctors. Eur J Gen Pract 2024; 30:2373121. [PMID: 38979662 DOI: 10.1080/13814788.2024.2373121] [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: 11/25/2023] [Revised: 03/30/2024] [Accepted: 06/11/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Despite growing acceptance of LGBT + individuals, an underlying stigma persists even in healthcare, resulting in substandard care and worse healthcare outcomes for LGBT + individuals. OBJECTIVES To examine and compare the experiences and expectations regarding primary healthcare among LGBT + individuals and general practitioners (GPs) in Slovenia. METHODS We conducted an online national qualitative study using open-ended questions. To reach LGBT + population snowball method of recruitment was employed by sharing the questionnaire through LGBT + organisations, while GPs were invited by email of Association of family doctors in Slovenia. Anonymous data was collected from October to December 2021 and the questionnaires of 25 GPs and 90 LGBT + individuals of various ages, backgrounds, gender identities and sexual orientations were reviewed using thematic analysis. RESULTS Both LGBT + participants and GPs expressed a desire for equal treatment. However, while all GPs claimed to treat all patients equally, LGBT + participants reported more varied experiences. Specific knowledge, especially on LGBT + terminology and healthcare, was perceived as lacking among GPs, leading LGBT + individuals to seek advice from specialists or community counselling. Systemic barriers, including societal stigmatisation and limited formal education on LGBT + issues, were identified, highlighting the need for designated safe spaces and improved GP training. Safety emerged as a central theme, crucial for fostering trust and disclosure between patients and healthcare providers. CONCLUSION The study underscores the significance of a sense of safety in the patient-doctor relationship and highlights the need for improved training and attitudes to provide inclusive and affirming healthcare for LGBT + individuals.
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Affiliation(s)
- Nina Jerala
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Davorina Petek
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Almegewly WH, Karavasileiadou S, Alotaibi TS. Exploring the experiences of female undergraduate nursing students in providing home healthcare to older adults. Int J Qual Stud Health Well-being 2024; 19:2291838. [PMID: 38055792 DOI: 10.1080/17482631.2023.2291838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/03/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND In light of the growing ageing population in Saudi Arabia and Saudi nurses' hesitation to work with the older population, it is important to understand the experiences of nursing students on their clinical placement in home healthcare. METHODS This study is a descriptive qualitative study based on five focus groups of 3-5 students each. Data were collected from female senior baccalaureate nursing students at a female governmental university in Saudi Arabia, and during their placement in home healthcare. Data were analysed using thematic analysis. RESULTS Five main themes emerged : struggling with their own family; struggling with cultural and social beliefs; struggling during clinical training; struggling with domestic caregivers; and reflections for the future were considered important impressions in clinical experience. CONCLUSION The culture of Saudi Arabian society is an important factor in shaping the training experience of female nursing students either positively or negatively, specifically in the context of home healthcare nursing for older patients. The results of this study show how important it is for students to be prepared for the clinical environment, the nature of the work, and the role of the home healthcare nurse in order to improve their clinical learning.
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Affiliation(s)
- Wafa Hamad Almegewly
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Taghreed Samel Alotaibi
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Micheline P, Vanrie J, Petermans A, Smetcoren AS. Exploring older migrants' meaning-making of 'happiness': " The main thing is health. Young people might say otherwise.". Int J Qual Stud Health Well-being 2024; 19:2300873. [PMID: 38184797 PMCID: PMC10773646 DOI: 10.1080/17482631.2023.2300873] [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: 10/09/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024] Open
Abstract
PURPOSE As our ageing population is growing and diversifying, it is important to gain insight into the well-being of older migrants. However, the meanings of happiness can vary cross-culturally. Therefore, prior to exploring older migrants' happiness, their meaning-making of "happiness" should be explored. This way, cultural or individual variations can be considered when analysing older migrants' happiness. Not only migration background but also age could influence the meaning of well-being. For example, the meaning of well-being can change as people grow older. Therefore, both migration background and age are considered in exploring older migrants' meaning-making of happiness. METHODS To do so, in-depth interviews with older migrants (n = 22) from various ethnicities were conducted in which their meaning-making of happiness was questioned via a semi-structured interview guide. RESULTS After analysing the results via thematic analysis, three overarching themes are discussed: (1) happiness associations, (2) happiness-pursuing strategies, and (3) happiness obstructions. The analysis then further focuses on the role of migration background and ageing on the meaning-making of happiness. CONCLUSIONS Participants' meaning-making of happiness seems strongly imbued with age-related references. On the contrary, the impact of migration background is rather limited. To explain this difference, the value of incorporating participants' life course experiences emerged.
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Affiliation(s)
- Phlix Micheline
- Architecture and Arts, UHasselt – Hasselt University, Diepenbeek, Belgium
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Brussels, Belgium
| | - Jan Vanrie
- Architecture and Arts, UHasselt – Hasselt University, Diepenbeek, Belgium
| | - Ann Petermans
- Architecture and Arts, UHasselt – Hasselt University, Diepenbeek, Belgium
| | - An-Sofie Smetcoren
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Brussels, Belgium
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Stoor JPA, Sedholm O, San Sebastián M, Nilsson LM. Sámi community perspectives on the COVID-19 pandemic: a mixed methods case study in Arctic Sweden. Int J Circumpolar Health 2024; 83:2372123. [PMID: 38917207 PMCID: PMC11207918 DOI: 10.1080/22423982.2024.2372123] [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: 08/29/2023] [Accepted: 06/20/2024] [Indexed: 06/27/2024] Open
Abstract
The COVID-19 pandemic posed a grave threat not only to Indigenous people's health and well-being, but also to Indigenous communities and societies. This applies also to the Indigenous peoples of the Arctic, where unintentional effects of public health actions to mitigate the spread of virus may have long-lasting effects on vulnerable communities. This study aim was to identify and describe Sámi perspectives on how the Sámi society in Sweden was specifically affected by the pandemic and associated public health actions during 2020-2021. A mixed-method qualitative case study approach was employed, including a media scoping review and stakeholder interviews. The media scoping review included 93 articles, published online or in print, from January 2020 to 1 September 2021, in Swedish or Norwegian, regarding the pandemic-related impacts on Sámi society in Sweden. The review informed a purposeful selection of 15 stakeholder qualitative interviews. Thematic analysis of the articles and interview transcripts generated five subthemes and two main themes: "weathering the storm" and "stressing Sámi culture and society". These reflect social dynamics which highlight stressors towards, and resilience within, the Sámi society during the pandemic. The results may be useful when evaluating and developing public health crisis response plans concerning or affecting the Sámi society in Sweden.
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Affiliation(s)
- Jon Petter A. Stoor
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
- Centre for Sami Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Oscar Sedholm
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
| | - Miguel San Sebastián
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
| | - Lena Maria Nilsson
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
- Arctic Centre, Umeå University, Umeå, Sweden
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Pouls KPM, Mastebroek M, Ligthart SJ, Assendelft WJJ, Leusink GL, Koks-Leensen MCJ. Primary mental healthcare for adults with mild intellectual disabilities: Patients' perspectives. Eur J Gen Pract 2024; 30:2354414. [PMID: 38757401 PMCID: PMC11104687 DOI: 10.1080/13814788.2024.2354414] [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: 09/12/2023] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND People with mild intellectual disabilities (MID) experience more mental health (MH) problems than the general population but often do not receive appropriate primary MH care. Primary MH care is essential in integrative MH care and, therefore, demands high quality. To improve primary MH care for this patient group, account must be taken of the experiences of people with MID. So far, their perspectives have been largely absent from primary MH care research. OBJECTIVES To explore patients' experiences, needs, and suggestions for improvement regarding primary MH care for people with MID. METHODS Qualitative study among adults with MID who visited their GP with MH problems in the previous 12 months. Semi-structured interviews were conducted using a guide based on Person-Centred Primary Care Measures. Transcripts were analysed thematically. RESULTS The 11 interviews that we conducted revealed four themes. The first theme, cumulative vulnerability, describes the vulnerability - instigated by the MID and reinforced by MH problems - experienced on a GP visit. The other themes (needs regarding the GP, needs regarding the network, self-determination) arise from this vulnerability. CONCLUSION People with both MID and MH problems are extra vulnerable in primary care but desire self-determination regarding their MH care trajectory. This requires investment in a good GP-patient relationship and the organisation of additional support to meet these patients' needs, for which collaborative care with the patient, the patient's network, and other (care) professionals is of utmost importance.
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Affiliation(s)
- Katrien PM. Pouls
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mathilde Mastebroek
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Suzanne J. Ligthart
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Willem JJ. Assendelft
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Geraline L. Leusink
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Monique CJ. Koks-Leensen
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
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Velgan M, Uibu A, Õunap E, Kangasniemi MK, Michels NR, Kalda R. Early-career general practitioners' career intentions in Estonia: A qualitative study. Eur J Gen Pract 2024; 30:2368557. [PMID: 38958064 PMCID: PMC11225626 DOI: 10.1080/13814788.2024.2368557] [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: 06/07/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The shortage of general practitioners (GPs) is a worsening problem in many countries and poses a threat to the services provided by primary care and by extension for the entire healthcare system. Issues with GP workforce recruitment and retention can be reasons for this shortage. OBJECTIVES To describe GP trainees and newly qualified GPs experiences and perceptions on how their training and early experiences of work influence their career intentions in primary care in Estonia. METHODS A qualitative study with GP trainees (n = 12) and newly qualified GPs (n = 13) using semi-structured group interviews (n = 6) was conducted. Interviews were conducted from October until November 2020. Data were analysed using thematic analysis with NVivo Software. RESULTS Although early-career GPs in Estonia envision their future roles as GP practice owners with patient list, this is often postponed due to various reasons. Early-career GPs expressed a sense of unpreparedness to fill all the roles of GPs' and found the process of establishing a GP practice and taking on a patient lists very complicated. They value work-life balance and prefer workplaces, which offer flexible working conditions. CONCLUSION Potential strategies were identified to enhance the willingness of early-career GPs to continue their career as GP practice owners with patient list: improving the GP training program by placing more emphasis on managing skills and making the process of establishing GP practice and taking on a patient list less bureaucratic and more accessible.
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Affiliation(s)
- Marta Velgan
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Anett Uibu
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Elinor Õunap
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | | | | | - Ruth Kalda
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
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Wang X, Chen D, Zou P, Zhang H, Qiu X, Xu L, Lee G. Understanding adaptive tasks in cardiac rehabilitation among patients with acute myocardial infarction: a qualitative study. Ann Med 2024; 56:2311227. [PMID: 38306095 PMCID: PMC10840589 DOI: 10.1080/07853890.2024.2311227] [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: 07/22/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND While Cardiac Rehabilitation (CR) programs have shown effectiveness in improving cardiac outcomes, there is limited understanding of how patients perceive and adapt to these interventions. Furthermore, alternative modes of delivering CR that have received positive evaluations from participants remain underexplored, yet they have the potential to enhance CR uptake. OBJECTIVES To explore the patient experience in CR programmes following Acute Myocardial Infarction (AMI) and describe their adaptive processing. PATIENTS AND METHODS This qualitative study was conducted at a nationally certified centre in China between July 2021 and September 2022, encompassing three stages: in-hospital, centre-based, and home-based CR programs. Purposive sampling was used to select eligible AMI patients for in-depth semi-structured interviews. The interview outline and analytical framework were aligned with the key concepts derived from the middle-range theory of adaptation to chronic illness and the normalization process theory. The findings were reported following the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS Forty AMI patients were recruited. Four main themes describing the process of AMI patients normalizing CR intervention were identified, including (1) experiencing CR service driving by role's responsibilities, (2) engaging in collaborative relationship based on interpersonal trust, (3) exploring a personalized rehabilitation plan by complex integration, and (4) expecting a promised outcome to shape decision-making. CONCLUSION Integrated care interventions for AMI patients could benefit from a collaborative co-designed approach to ensure that CR interventions are normalized and fit into patients' daily lives. Organizational-level CR services should align with the rehabilitation needs and expectations of patients.
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Affiliation(s)
- Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Dandan Chen
- School of Nursing, Zhejiang University School of Medicine, Zhejiang, China
| | - Ping Zou
- School of Nursing, Nipissing University, Toronto, Ontario, Canada
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People’s Hospital, Guizhou, China
| | - Xunhan Qiu
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Xu
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Geraldine Lee
- Catherine McAuley School of Nursing & Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
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Buttazzoni A, Pham J, Nelson Ferguson K, Fabri E, Clark A, Tobin D, Frisbee N, Gilliland J. Supporting children's participation in active travel: developing an online road safety intervention through a collaborative integrated knowledge translation approach. Int J Qual Stud Health Well-being 2024; 19:2320183. [PMID: 38431847 PMCID: PMC10911243 DOI: 10.1080/17482631.2024.2320183] [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: 09/18/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024] Open
Abstract
Even though regular engagement in physical activity (PA) among children can support their development and encourage the adoption of healthy lifelong habits, most do not achieve their recommended guidelines. Active travel (AT), or any form of human-powered travel (e.g., walking), can be a relatively accessible, manageable, and sustainable way to promote children's PA. One common barrier to children's engagement in AT, however, is a reported lack of education and training. To support children's participation in AT, this paper presents the development of a comprehensive 4-module online road safety education intervention designed to improve children's knowledge and confidence regarding AT. Using a qualitative integrated knowledge translation (iKT) approach undertaken with community collaborators (n = 50) containing expertise in health promotion, public safety, school administration, and transportation planning, our inductive thematic analysis generated fourth themes which constituted the foundation of the intervention modules: Active Travel Knowledge: Awareness of Benefits and Participation; Pedestrian Safety and Skills: Roles, Responsibilities, and Rules; Signs and Infrastructure: Identification, Literacy, and Behaviour; Wheeling Safety and Skills: Technical Training and Personal Maneuvers. Each theme/module was then linked to an explicit learning objective and connected to complementary knowledge activities, resources, and skill development exercises. Implications for research and practice are discussed.
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Affiliation(s)
- Adrian Buttazzoni
- School of Planning, University of Waterloo, Waterloo, ON, Canada
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
| | - Julia Pham
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Kendra Nelson Ferguson
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Emma Fabri
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Andrew Clark
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Danielle Tobin
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Nathaniel Frisbee
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Jason Gilliland
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada
- School of Health Studies, University of Western Ontario, London, Ontario, Canada
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de Korte AM, de Rooij BH, Boll D, van Loon I, Vincent N, Hoedjes M, Lammens CRM, Mols F, van der Lee ML, Vos MC, Ezendam NPM. Barriers and facilitators for healthy lifestyle and recommendations for counseling in endometrial cancer follow-up care: a qualitative study. J Psychosom Obstet Gynaecol 2024; 45:2340465. [PMID: 38622864 DOI: 10.1080/0167482x.2024.2340465] [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: 02/15/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVES Lifestyle promotion during follow-up consultations may improve long-term health and quality of life in endometrial cancer patients. This study aimed to identify barriers and facilitators to improve and sustain a healthy lifestyle that can be translated to behavioral methods and strategies for lifestyle counseling. METHODS Endometrial cancer patients from three hospitals were recruited to participate in a semi-structured interview. The data were transcribed and coded. Thematic analysis was applied to identify themes and the behavior change wheel was used as a theoretical framework. Data saturation was confirmed after 18 interviews. RESULTS Barriers included knowledge gaps as well as lack of motivation and environmental opportunities to engage in health-promoting behavior. Facilitators included applying incremental lifestyle changes, social support, positive reinforcements, and the ability to overcome setbacks. CONCLUSIONS We propose the following intervention functions: education, persuasion, training, environmental restructuring, and enablement. Suitable behavior change techniques to deliver the intervention functions include information about the consequences of certain behavior, feedback on behavior, credible source, graded tasks, habit formation, restructuring of the environment, prompts/cues, goal setting, action planning, and social support. Including these recommendations in lifestyle counseling could aid lasting lifestyle change since it suits the needs and preferences of patients.
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Affiliation(s)
- Anne M de Korte
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Belle H de Rooij
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Dorry Boll
- Department of Gynecology, Catharina Hospital, Eindhoven, The Netherlands
| | - Ingrid van Loon
- Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands
| | - Noor Vincent
- Department of Gynecology, Catharina Hospital, Eindhoven, The Netherlands
| | - Meeke Hoedjes
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | | | - Floor Mols
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Marije L van der Lee
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Bilthoven, The Netherlands
| | - M Caroline Vos
- Department of Obstetrics and Gynecology, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, The Netherlands
| | - Nicole P M Ezendam
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
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Wheeler PB, Miller-Roenigk B, Jester J, Stevens-Watkins D. Knowledge, experiences, and perceptions of medications for opioid use disorder among Black Kentuckians. Ann Med 2024; 56:2322051. [PMID: 38442301 PMCID: PMC10916927 DOI: 10.1080/07853890.2024.2322051] [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: 10/20/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Opioid overdoses have continued to increase at higher rates among Black Americans compared to people from other racial groups. Despite demonstrated effectiveness of MOUD in reducing risk of opioid overdose, Black Americans face decreased access to and uptake of MOUD. The current study aimed to examine the knowledge, perceptions, and experiences with MOUD among a sample of Black adults who use prescription opioids nonmedically in order to inform tailored efforts to improve MOUD uptake. METHODS Data were derived from a larger study assessing cultural and structural influences on drug use and drug treatment among people who use prescription opioids nonmedically. Semi-structured qualitative interviews were conducted with 34 Black men and women across four generational cohorts: born 1955-1969; 1970-1979; 1980-1994; and 1995-2001. Participant responses were analyzed using thematic analysis. RESULTS Nearly half of participants (44.1%) reported no knowledge or experience with MOUD. Among participants who had any knowledge about MOUD, four major themes regarding their perceptions emerged: MOUD Helps with Recovery; Not Needed for Level of Drug Use; Side Effects and Withdrawal; Equivalence with Illicit Drug Use. The majority reported negative perceptions of MOUD (52.6%), and the youngest cohort (born 1995-2001) had a higher proportion of negative perceptions (80%) relative to other age cohorts (born 1980-1994: 50%; 1970-1979: 75%; 1955-1969: 16.6%). DISCUSSION Findings indicate a significant knowledge gap and clear points of intervention for improving MOUD uptake. Interventions to improve communication of health information in ways that are culturally relevant and tailored by age group can be used in conjunction with efforts to improve MOUD access among Black individuals who use opioids nonmedically.
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Affiliation(s)
- Paris B. Wheeler
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Brittany Miller-Roenigk
- Department of Educational, School, and Counseling Psychology, University of KY, Lexington, KY, USA
| | - Jasmine Jester
- Department of Educational, School, and Counseling Psychology, University of KY, Lexington, KY, USA
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, University of KY, Lexington, KY, USA
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Subu MA, Dias JM, Mottershead R, Ahmed FR, Narulita S, Maryuni M, Zakiyah Z, Nurbaeti I, Mohamed Al Marzouqi A, Al-Yateem N. Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2327103. [PMID: 38465669 DOI: 10.1080/17482631.2024.2327103] [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: 11/02/2023] [Accepted: 03/03/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals. AIMS This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia. METHODS This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis. RESULTS Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns. CONCLUSIONS The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.
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Affiliation(s)
- Muhammad Arsyad Subu
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Jacqueline Maria Dias
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Richard Mottershead
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Fatma Refaat Ahmed
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
| | - Sari Narulita
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Maryuni Maryuni
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Zakiyah Zakiyah
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
| | - Irma Nurbaeti
- Faculty of Health Sciences, UIN Syarif Hidayatullah, Jakarta, Indonesia
| | - Alounoud Mohamed Al Marzouqi
- Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nabeel Al-Yateem
- Nursing department, College of Health Sciences University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Nursing and Midwifery, University of Binawan, Jakarta, Indonesia
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Smith SM, Kranenburg LW, da Conceicao D, Lambregtse-van den Berg MP, Steegers-Theunissen RPM, Ismaili M’hamdi H. Maternal health agency in women with a low socioeconomic status: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2367844. [PMID: 38912882 PMCID: PMC11198117 DOI: 10.1080/17482631.2024.2367844] [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: 02/15/2024] [Accepted: 06/10/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Health agency refers to one's capacity to form health-related goals, experience control, and possess the means to pursue them. Low socioeconomic status (SES) is linked to impaired health agency and increased risk of adverse pregnancy outcomes, potentially due to a reduced tendency to seek care. Better healthcare availability may not improve their pregnancy outcomes, and therefore improved understanding of maternal health agency is paramount. METHODS Semi-structured interviews were conducted with 15 participants who either had children or desired to have them. Low SES was determined by neighborhood median income and educational attainment. A thematic content analyses was conducted. RESULTS Two themes emerged: 1) Origin and development of personal goals, and 2) Awareness and competence. Participant's goals stemmed from cultural norms, personal narratives, and intuition. Integrated goals were those participants valued highly, were aware of, and strived for. Four subthemes were identified in goal-awareness and competence. Internal conflict due to discrepancies between goals and behavior resulted in the need to balance the burdens and benefits of behavior change. CONCLUSION Maternal health agency is a modifiable outcome dependent on goal-awareness and various factors. Impaired agency seemed to stem from lack of goal-awareness rather than an inability to meet established pillars.
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Affiliation(s)
- Sharissa Mandy Smith
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | | | - Mijke Pietertje Lambregtse-van den Berg
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | | | - Hafez Ismaili M’hamdi
- Department of Medical Ethics, Philosophy and History of Medicine, Leiden University Medical Centre, Rotterdam, The Netherlands
- Department of Health, Ethics & Society, Maastricht University, Maastricht, the Netherlands
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Zelko A, Skoumalova I, Kravcova D, Dankulincova Veselska Z, Rosenberger J, Madarasova Geckova A, van Dijk JP, Reijneveld SA. Perceptions of healthcare providers on benefits, risks and barriers regarding intradialytic exercise among haemodialysis patients. Int J Qual Stud Health Well-being 2024; 19:2287597. [PMID: 38055756 DOI: 10.1080/17482631.2023.2287597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE Clinical guidelines call for the inclusion of exercise interventions in every patient's dialysis session, but these recommendations are rarely adopted. Healthcare providers play a key role in this. Therefore, the aim of this study was to explore how healthcare providers perceive the benefits, risks and barriers of intradialytic exercise (IDE). METHODS We conducted 21 individual, semi-structured interviews with 11 nurses, 5 nephrologists, 3 training assistants and 2 managers from two dialysis centres in Slovakia. Verbatim transcripts of digitally recorded interviews were thematically analysed using MAXQDA®. RESULTS Participants reported the benefits of IDE as improvements in patients' physical and psychosocial functioning, independence and self-efficacy, clinical profile and quality of therapy. As risks of IDE, they most frequently reported exercise-related damage to vascular access, insufficient individualization of training and musculoskeletal injuries. The presence of psychological problems among patients was reported as a major barrier for initiating and maintaining patients' exercise. Other reported barriers included limitations in financial and personnel resources of haemodialysis care. CONCLUSIONS Safe and sustainable implementation of IDE, which might improve a patient's well-being, need to be prescribed in alignment with the patient's clinical profile, be delivered individually according to the patient's characteristics and requires adjustments in the available resources.
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Affiliation(s)
- Aurel Zelko
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Denisa Kravcova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
- 2nd Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Fresenius Medical Care - Dialysis Services Kosice, Kosice, Slovakia
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University in Bratislava, Bratislava, Slovakia
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Sijmen A Reijneveld
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Vuori J, Määttänen I. "It takes a lot of sisu to get through it"- managerial experiences of facing adversities during pandemic. Int J Qual Stud Health Well-being 2024; 19:2291242. [PMID: 38055783 DOI: 10.1080/17482631.2023.2291242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE Sisu refers to extraordinary internal strength in the face of adversities. Although originally a Finnish concept, it can be a universally useful concept for studying managerial well-being and performance during difficult or even emergency periods. Previous research on sisu categorizes it into beneficial and harmful sisu and suggests that these two dimensions of sisu are useful when studying determination and resoluteness in crisis situations. This study applies the concept of sisu to examine managers' well-being in times of crisis. METHODOLOGY Interviews were conducted with 15 managers in the hotel, manufacturing and retail industries in Finland. RESULTS The beneficial effects of sisu seem to dissolve when it is used too often. The study also highlighted the paradoxical tension involved in the decision to stop or continue actions in a difficult situation and contributes to sisu research by discussing collective sisu. CONCLUSION The results of this study suggest that beneficial sisu helps to overcome adversity, while harmful sisu causes distortions in thinking that are detrimental to managers. Understanding one's own tendency towards beneficial or harmful sisu in difficult situations can help in managerial work. Collective sisu is an excellent resource for overcoming difficult situations in workplaces.
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Affiliation(s)
- Johanna Vuori
- Research area of entrepreneurship and business transformation, Haaga-Helia University of Applied Sciences, Helsinki, Finland
| | - Ilmari Määttänen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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Dengsø KE, Berg A, Hansen CP, Burgdorf SK, Krohn PS, Sillesen M, Spiegelhauer N, Bach MT, Melton M, Nielsen B, Christensen BM, Finderup J, Hillingsø J. Have a vital end-user been overlooked? Developing a shared decision intervention for patients with potential pancreatic cancer regarding the choice of surgery. PEC INNOVATION 2024; 4:100269. [PMID: 38435237 PMCID: PMC10907832 DOI: 10.1016/j.pecinn.2024.100269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024]
Abstract
Objective To develop a patient decision aid facilitating shared decision making for patients with potential pancreatic cancer deciding about no treatment, surgical or medical treatment. Methods Based on a user-centred design by Wittemann et al., we developed a shared decision making intervention in three phases: 1) Understanding decision needs 2) Development of a patient decision aid (PtDA) based on a generic template 3) Assessment of the intervention from interviews with patients (n = 11), relatives (n = 11), nurses (n = 4) and surgeons (n = 2) analysed with thematic analysis, and measuring patients' perceptions of choice of options with the Decisional Conflict Scale. Results Results showed varying experiences with the use of the PtDA, with surgeons not finding PtDA useful as it was impractical and constraining with patients' conversations. There was no difference in patients' perceptions in choosing options for those being presented vs those patients not being presented for the PtDA. Conclusion The format and structure of the PtDA was not feasible for the surgeons as fundamental users in the present clinic. Innovation This study highlights the urgent need to consider clinical context before introducing a predefined tool and shows the importance of a multistakeholder approach. Research should focus on finding means to successful implement shared decision making.
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Affiliation(s)
- Kristine Elberg Dengsø
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Anne Berg
- Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Carsten Palnæs Hansen
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Stefan K. Burgdorf
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Paul S. Krohn
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Martin Sillesen
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Nina Spiegelhauer
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Mette Tholstrup Bach
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Marianne Melton
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Betina Nielsen
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Bo Marcel Christensen
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Jeanette Finderup
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Denmark
- Research Centre for Patient Involvement, Aarhus University & Central Region, Denmark
| | - Jens Hillingsø
- The Department of Surgical Gastroenterology and Transplantation, Center for Cancer and Organ and Disease, University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
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Kozak AT, Garber N, Uhley V. Undergraduates' knowledge, attitudes, and behaviours associated with fad diets. Int J Qual Stud Health Well-being 2024; 19:2309687. [PMID: 38290052 PMCID: PMC10829839 DOI: 10.1080/17482631.2024.2309687] [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: 05/19/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
PURPOSE We aimed to determine undergraduate students' use and knowledge of fad diets as well as examine how appealing students found these diets given the goal of rapid weight loss and/or improved health. Twenty-three students from a Midwestern university (mean age = 19.2, mean BMI = 27.35, 69.6% female) were recruited through new student orientations for this qualitative study. Approximately 52% of participants identified as White, 30% as Black, 13% as Asian, and 4% as multi-racial. METHODS Knowledge and opinions about fad diets were collected via focus groups and individual interviews. Coding of transcripts was conducted by hand using the constant comparative method and data were analysed based on grounded theory. RESULTS Two primary themes emerged: very negative views of fad diets and the importance of healthy eating. Although few participants had tried fad diets, they thought these diets: 1) did not lead to sustained weight loss, 2) were associated with disappointment and health issues, and 3) were money-making schemes delivered heavily through social media. Participants also valued healthy eating. CONCLUSION Experimental studies are needed to examine how healthy eating among university students can be supported through credible sources, accurate information, and established connections via innovative social media platforms.
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Affiliation(s)
- Andrea T. Kozak
- Department of Psychology, Oakland University, Rochester, MI, USA
| | - Noah Garber
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Virginia Uhley
- Department of Foundational Medical Studies and Family Medicine & Community Health, Oakland University, Rochester, MI, USA
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Kring L, Iversen E, Ibsen B, Fehsenfeld M. Exploring the impact of stressful life events on quality of life: meaning making and narrative reconstruction. Int J Qual Stud Health Well-being 2024; 19:2330117. [PMID: 38525819 DOI: 10.1080/17482631.2024.2330117] [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: 10/26/2023] [Accepted: 03/08/2024] [Indexed: 03/26/2024] Open
Abstract
PURPOSE Stressful life events have the capacity to disrupt an individual's worldview and life goals, leading to existential questions and identity loss. The subjective perception of identity is intricately linked with quality of life (QoL), and how individuals derive meaning from these stressful life events significantly influences their well-being. This article explored the impact of stressful life events on individuals' QoL, and examined the potential for enhancing QoL through meaning making and narrative reconstruction. METHODS Qualitative interviews were conducted with 11 individuals reporting diminished QoL and analysed using thematic analysis. RESULTS The study reveals that stressful life events confront interviewees with the vulnerability of their values in life and the limits of their control, leading them to question their own beliefs and purpose in life. Consequently, these events prompt individuals to reconstruction their narratives to adapt to new life circumstances. CONCLUSIONS The study suggests that "securing the base," including strong social relations and security in economic and housing conditions, is a prerequisite for enhancing QoL. The insights on "the base" have profound implications for QoL. Recognizing their fundamental importance, policymakers, healthcare professionals, and social service providers can support mechanisms to enhance these foundations, improving overall well-being for individuals and communities.
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Affiliation(s)
- Lotte Kring
- The Faculty of Health Sciences, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Evald Iversen
- Centre for Sports, Health and Civil Society (CISC), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Bjarne Ibsen
- Centre for Sports, Health and Civil Society (CISC), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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