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Kosman BA, Castro de Jong D, Knight-Agarwal CR, Chipchase LS, Etxebarria N. The benefits of virtual learning abroad programs for higher education students: A phenomenological research study. Nurse Educ Today 2024; 136:106133. [PMID: 38387211 DOI: 10.1016/j.nedt.2024.106133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/28/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Higher education institutions offer in-country learning abroad programs to provide healthcare students with the opportunity to gain the intercultural and global competencies they need to work in a globally interconnected world. During the Covid-19 pandemic, institutions offered virtual learning abroad programs as an alternative to the in-country programs, however, little is known about whether they provide comparable benefits to students. OBJECTIVES The purpose of this study was to investigate, and identify, the benefits gained by higher education healthcare students through their participation in a virtual learning abroad program. DESIGN/METHODS This research implemented a qualitative approach, conducting semi-structured interviews with four higher education students enrolled in the final year of their healthcare studies. Data were analyzed using interpretative phenomenological analysis. RESULTS The results revealed that virtual programs provide a range of benefits students can use in their future careers. They also provide students with a positive learning experience and an opportunity for personal growth. However, although the benefits students gain from virtual learning abroad programs are similar to those they gain from in-country programs, they are not identical. While virtual learning abroad programs are a viable alternative for in-country programs and offer many benefits, they fail to replicate the intercultural and global competencies that in-country programs offer to students. CONCLUSION This study focusses on virtual learning abroad programs and whether the benefits healthcare students gain from them are comparable to the traditional in-country programs. Students gain personal and professional benefits from these programs without the risks and costs associated with international travel. However, the identified lack of increased global awareness has implications for how the benefits of virtual learning abroad programs should be promoted to students.
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Affiliation(s)
- Bronwyn A Kosman
- Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia.
| | - Daniela Castro de Jong
- Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia.
| | | | - Lucy S Chipchase
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Naroa Etxebarria
- Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia.
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Halsall T, Daley M, Hawke LD, Henderson J, Wilson A, Matheson K. "I Think Peer Support Helps to Demystify People Who Have Mental Health Issues and Helps to Remove That Stigma": Exploring the Defining Characteristics and Related Challenges of Youth Peer Support Through Participatory Research. Community Ment Health J 2024; 60:784-795. [PMID: 38430287 DOI: 10.1007/s10597-024-01235-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/09/2024] [Indexed: 03/03/2024]
Abstract
Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming.
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Affiliation(s)
- Tanya Halsall
- University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada.
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
| | - Mardi Daley
- LOFT Community Services, 721 Bloor St. W Suite 301, Toronto, ON, M6G 1L5, Canada
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1L8, Canada
| | - Jo Henderson
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1L8, Canada
| | - Anne Wilson
- LOFT Community Services, 721 Bloor St. W Suite 301, Toronto, ON, M6G 1L5, Canada
| | - Kimberly Matheson
- University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
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Keeton VF, Soleimanpour S, Geierstanger S, Schapiro NA. Case Management for Social Needs of Youth and Families in School-Based Health Centers. J Sch Health 2024; 94:462-468. [PMID: 38234257 PMCID: PMC10987258 DOI: 10.1111/josh.13432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND School-based health centers (SBHCs) are ideal settings to address social needs of youth and families. Case managers can play a vital role in social care interventions. METHODS We piloted a program to incorporate a Case Manager into the care team of 1 SBHC serving 2 local schools with over 900 students and their surrounding communities. This project's purpose was to evaluate program feasibility, utilization, and acceptability. Our mixed-methods evaluation included analyses of data from electronic health records, client satisfaction surveys, and staff interviews. RESULTS During the 6-month pilot, the Case Manager served 133 clients (about one third of all SBHC clients served) through 593 contacts. Most contacts included referrals to support services (90%) and 37% addressed newcomer immigrant adjustment. All 37 respondents to the satisfaction survey during the 3-month administration period (44% response rate) reported that the Case Manager made them feel comfortable asking for help; 95% reported getting the help they needed. The 7 SBHC staff interviewed shared many program benefits, including increased time for clinical services. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Inequities in children's health and educational achievement are influenced by structural factors. Results from our pilot program demonstrate that SBHCs may be well-positioned to deliver social care interventions and that case managers enhance the ability to deliver quality care. CONCLUSIONS School-based programs to address unmet social needs are critical to supporting learning and wellness for all youth. Robust studies are needed to further test the impacts of case management in SBHCs.
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Affiliation(s)
- Victoria F Keeton
- Department of Obstetrics, Gynecology, and Reproductive Sciences, CA Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA
| | - Samira Soleimanpour
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
| | - Sara Geierstanger
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
| | - Naomi A Schapiro
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA
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104
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Grace KT, Glass NE, Miller E, Alexander KA, Holliday CN, Decker MR. Birth Control Sabotage Motivation and Measurement: A Mixed-Methods Analysis among Latina Women. Violence Against Women 2024; 30:1634-1655. [PMID: 36567608 PMCID: PMC10290727 DOI: 10.1177/10778012221145292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Reproductive coercion (RC) is a type of intimate partner violence that includes birth control sabotage (BCS). We explored the perceived intent behind BCS to refine RC measurement, using a mixed-methods design with a clinic-based sample of Latina women (13 interviews; 482 surveys). Women perceived partners used BCS for reasons beyond pregnancy promotion. Specifically, 16.8% of participants reported any past-year RC; this decreased to 9.5% when asked if their partner used BCS with the sole intent of getting them pregnant. RC measures and assessment should separate behavior from intent in BCS questions to not underestimate the prevalence and to guide clinical response.
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Affiliation(s)
- Karen Trister Grace
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nancy E Glass
- Johns Hopkins University, School of Nursing, Baltimore, MD, USA
| | - Elizabeth Miller
- Division of Adolescent Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | | | | | - Michele R Decker
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
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105
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Redburn J, Hayes B. Facilitators and barriers to "Positive Outcomes" from cognitive-behavioral therapy, according to young people: A thematic synthesis. J Clin Psychol 2024; 80:968-1002. [PMID: 38328892 DOI: 10.1002/jclp.23653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 07/18/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE This qualitative review sought to explore how young people (YP) conceptualize positive outcomes from cognitive-behavioral therapy (CBT) and what YP perceive to be the facilitators and barriers to positive outcomes. METHODS A systematic literature search was conducted in June 2021 using six online databases. Studies were included if qualitative data were collected from participants who were aged up to 25, had internalizing mental health difficulties, and had received in-person CBT from trained practitioners. RESULTS Nineteen studies were included. The Gough Weight of Evidence framework was used to assess methodological and topical quality and relevance. A thematic synthesis identified 34 conceptualizations of positive outcomes, 57 facilitators, and 49 barriers. Descriptive and analytical themes were identified. In line with the review's pragmatic perspective, the latter were worded as practice recommendations: acknowledge YP's perspectives on outcomes, teach tangible CBT techniques, balance autonomy and support, frame CBT as "upskilling," explore nuanced barriers to engagement, and consider the power of group dynamics. CONCLUSIONS This review established the range of YP's views about positive outcomes from CBT, as well as facilitators and barriers to achieving these. Findings should prompt CBT practitioners to reflect and consider how their practice might be shaped through reports from YP as experts by experience.
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Affiliation(s)
- James Redburn
- Clinical Educational and Health Psychology, University College London, London, UK
| | - Ben Hayes
- Clinical Educational and Health Psychology, University College London, London, UK
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106
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Smiddy MP, Burton E, Kingston L, Poovelikunnel TT, Moyo M, Flores A. Identifying research priorities for infection prevention and control. A mixed methods study with a convergent design. J Infect Prev 2024; 25:59-65. [PMID: 38584713 PMCID: PMC10998549 DOI: 10.1177/17571774241230676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 04/09/2024] Open
Abstract
Background Meaningful research creates evidence for Infection Prevention and Control (IPC) practice. Aim To establish Infection Prevention Society (IPS) members' research priorities to support future research projects. Methods A mixed methods convergent parallel design incorporating a cross-sectional survey of IPS members (2022-2023), and focus group findings from the IPS Consultative Committee, (October 2022). Quantitative data were analysed using descriptive statistics. Qualitative data were transcribed verbatim, entered into NVivo 12, and analysed using a thematic analysis approach. Findings/Results 132 IPS members responded to the survey, including 120 (90.9%) nurses. The three most prevalent priorities were: Quality Improvement and Patient Safety (n = 84, 16.1%); IPC Training and Education (n = 77, 14.8%); and IPC Evidence-based Guidelines (n = 76, 14.6%). Analysis of the focus group transcripts identified six emergent themes 'Patient Centred Care', 'Training and Education', 'IPC Role and Identity', 'IPC Leadership', 'IPC is Everyone's Responsibility', and 'Research Activity'. Triangulation of findings demonstrated concordance between quantitative and qualitative findings with Quality Improvement and Patient Safety (QIPS) and Training and Education identified as priority research areas. Discussion This study highlights the necessity of developing support systems and incorporating research priorities in QIPS, as well as Training and Education. The findings of this study align with the recommended core competencies and components for effective infection prevention and control programs, making them relevant to QIPS initiatives. The outcomes of the study will serve as a valuable resource to guide the IPS Research and Development Committee in delivering practical support to IPS members.
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Affiliation(s)
- MP Smiddy
- School of Public Health, University College Cork, Cork, Ireland
| | - E Burton
- School of Public Health, University College Cork, Cork, Ireland
- Pharmacy Department, Bon Secours Hospital, Cork, Ireland
| | - L Kingston
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - T Thomas Poovelikunnel
- Office of the National Director Health Protection, HSE - Health Protection Surveillance Centre, Dublin, Ireland
- Faculty of Nursing and Midwifery, RCSI, Dublin
| | - M Moyo
- Department of Social Sciences and Nursing, Solent University, Southampton, UK
| | - A Flores
- Infection Prevention and Control Department, Kings College Hospitals Foundation NHS Trust, London, UK
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107
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Ozturk B, Nelson-Gardell D. From Lived Experience: Listening to Stories of Healing From Middle Eastern Immigrant IPV Survivors. Violence Against Women 2024; 30:1708-1725. [PMID: 36788412 DOI: 10.1177/10778012231155166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Intimate partner violence (IPV) affects all communities, but immigrant communities can be distinctively more vulnerable. This study explores the coping strategies of 10 immigrant Middle Eastern Immigrant Survivors of IPV in the United States. A phenomenological design was utilized to explore Middle Eastern immigrant IPV survivors coping strategies. The study participants had similar and different experiences with formal resources and informal help-seeking behaviors. These study results recommended that there is a considerable need for future research to extend the study of this population as well as an urgent need to increase accessible resources to empower immigrant IPV survivors.
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Affiliation(s)
- Burcu Ozturk
- School of Social Work, Wichita State University, Wichita, USA
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108
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Ali Y, Wright N, Charnock D, Henshaw H, Morris H, Hoare DJ. Applications of Grounded Theory Methodology to Investigate Hearing Loss: A Methodological Qualitative Systematic Review With Developed Guidelines. Ear Hear 2024; 45:550-562. [PMID: 38608196 PMCID: PMC11008453 DOI: 10.1097/aud.0000000000001459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 11/23/2023] [Indexed: 04/14/2024]
Abstract
OBJECTIVES Qualitative methodologies are commonly adopted in hearing loss research. Grounded theory methodology is increasingly used to establish novel theories explaining experiences related to hearing loss. Establishing and improving the quality of grounded theory studies has been emphasized as critical to ensuring theoretical trustworthiness. Thus, the primary aim of the present study was to systematically review hearing loss research studies that have applied grounded theory methodology and assess the methodological quality of those grounded theory applications. Secondarily aims were to (i) explore how grounded theory methodology has been applied to investigate hearing loss, and (ii) use the findings of the review to develop a set of guidelines to aid the future high-quality application of grounded theory methodology to hearing loss research. DESIGN Original peer-reviewed studies applying grounded theory methodology and published in English were identified through systematic searches in 10 databases; Applied Social Sciences Index and Abstracts, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, EBSCO, Global Health, MEDLINE (OvidSP), PsycINFO, PubMed, Scopus, and Web of Science. The quality of studies was assessed according to 12 grounded theory principles using the Guideline for Reporting, Evaluating, and applying the core principles of Grounded Theory studies (GUREGT) tool. Data were analyzed using qualitative inductive thematic analysis. RESULTS After the removal of duplicates, 155 articles were retrieved. Of those, 39 met the criteria for inclusion in the systematic review. An increase in the adoption of grounded theory methodology to investigate hearing loss was identified with the number of published studies tripling in the last 5 years. Critical appraisal using the GUREGT tool identified four studies as high-quality. Most included studies were of moderate study quality (n = 25), and 10 were classified as being of low study quality. Using inductive thematic analysis, the included studies investigated one of four areas relating to hearing loss: (a) Living with hearing loss, (b) Identity and hearing loss, (c) Coping strategies for hearing loss, and (d) Audiological counseling and rehabilitation. Analysis also identified four main grounded theory factors frequently overlooked in hearing loss research: the different schools of grounded theory, sampling strategy, sample size, and the depth of grounded theory application. CONCLUSIONS Use of grounded theory methodology is increasing at a rapid rate in hearing loss research. Despite this, studies conducted in the field to date do not meet and apply the full spectrum of grounded theory principles, as outlined by the GUREGT tool. To improve methodological rigor in future studies using grounded theory, we propose a set of guidelines that address the most commonly overlooked methodological considerations in hearing loss studies to date. The guidelines are designed to aid researchers to achieve high methodological quality in any field, improve qualitative rigor, and promote theoretical credibility.
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Affiliation(s)
- Yasmin Ali
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Nicola Wright
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - David Charnock
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Helen Henshaw
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Haley Morris
- Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, United Kingdom
| | - Derek J Hoare
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Dahm MR, Raine SE, Slade D, Chien LJ, Kennard A, Walters G, Spinks T, Talaulikar G. Older patients and dialysis shared decision-making. Insights from an ethnographic discourse analysis of interviews and clinical interactions. Patient Educ Couns 2024; 122:108124. [PMID: 38232671 DOI: 10.1016/j.pec.2023.108124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVE To describe and analyse the perspectives and communication practices of kidney clinicians and older patients (aged 60 +) during collaborative education and decision-making about dialysis. METHODS This qualitative study drew on pluralistic data sources and analytical approaches investigating elicited semi-structured interviews (n = 31) with doctors (n = 8), nurses (n = 8) and patients (n = 15), combined with ethnographic observations, written artefacts and audio-recorded naturally-occurring interactions (n = 23, education sessions n = 4; consultations n = 19) in a tertiary Australian kidney outpatient clinic. Data were analysed for themes and linguistic discourse features. RESULTS Five themes were identified across all data sources: 1) lost opportunity in education; 2) persistent disease knowledge gaps; 3) putting up with dialysis; 4) perceived and real involvement in decision-making and 5) complex role of family as decision-making brokers. CONCLUSION As the first study to complement interviews with evidence from naturally-occurring kidney interactions, this study balances the perspectives of how older patients and their clinicians view chronic kidney disease education, with how decision-making about dialysis is reflected in practice. PRACTICE IMPLICATIONS The study provides suggestions for contextualized, multi-perspectives formal and informal training for improving decision-making about dialysis, spanning from indications to boost communication efficiency, to reducing unexplained jargon, incorporating patient navigators and exploring different dialysis modalities.
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Affiliation(s)
- Maria R Dahm
- Institute for Communication in Health Care (ICH), College of Arts and Social Sciences, Australian National University, Canberra, Australia.
| | - Suzanne Eggins Raine
- Institute for Communication in Health Care (ICH), College of Arts and Social Sciences, Australian National University, Canberra, Australia
| | - Diana Slade
- Institute for Communication in Health Care (ICH), College of Arts and Social Sciences, Australian National University, Canberra, Australia
| | - Laura J Chien
- Institute for Communication in Health Care (ICH), College of Arts and Social Sciences, Australian National University, Canberra, Australia
| | - Alice Kennard
- Canberra Hospital Renal Service, Canberra, Australia; College of Health and Medicine, Australian National University, Canberra, Australia
| | - Giles Walters
- Canberra Hospital Renal Service, Canberra, Australia; College of Health and Medicine, Australian National University, Canberra, Australia
| | - Tony Spinks
- Canberra Hospital Renal Service, Canberra, Australia
| | - Girish Talaulikar
- Canberra Hospital Renal Service, Canberra, Australia; College of Health and Medicine, Australian National University, Canberra, Australia
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Hansen KL, Guldin MB, Fosgerau CF. Grief participation rights and the social support hierarchy: Exploring the communicative role of the bereaved in a social support interaction. Death Stud 2024; 48:465-477. [PMID: 37471460 DOI: 10.1080/07481187.2023.2235582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
This article explores how bereaved individuals co-construct social support and social norms in the social interaction of 14 bereavement group meetings in Denmark. To study this, we used a discourse analytical approach focusing on how the participants position their social supporters. The results show that the participants designate, uphold, and presuppose two hierarchical positions to bereaved and non-bereaved supporters with different abilities to understand them. Based on this finding, the concepts of "grief participation rights" and "social support hierarchy" are proposed to supplement existing notions of "rights to grieve" and "grief hierarchy." These concepts suggest that non-bereaved supporters are not accorded the same participatory rights in social support conversations as bereaved individuals who have suffered a similar loss as the speaker. The concepts are discussed in relation to effective social support and in the context of research on social disconnection in grief.
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Affiliation(s)
- Kathrine Lund Hansen
- Department of Nordic Studies and Linguistics, Copenhagen University, Copenhagen, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
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Turgeon S, MacKenzie A, Batcho CS, D'Amour J. Making physical activity fun and accessible to adults with intellectual disabilities: A pilot study of a gamification intervention. J Appl Res Intellect Disabil 2024; 37:e13213. [PMID: 38404069 DOI: 10.1111/jar.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Only about 9% of individuals with intellectual disabilities reach the government's physical activity (PA) recommendations. Combining gamification and technology seems particularly promising in overcoming personal and environmental barriers to PA participation. METHOD Eighteen adults with varying levels of intellectual disabilities completed a pilot study to assess the initial effects of a cycling gamification intervention on levels of PA, fitness, psychosocial outcomes, and challenging behaviours. The study comprised three designs: pre-post single group, AB single-case, and qualitative. Social validity, implementation barriers and facilitators were also explored. RESULTS Nearly all 18 participants cycled daily. Time and distance cycled daily increase during the intervention while a decrease in stereotyped behaviours was observed. Participants and staff found the intervention enjoyable and socially valid. CONCLUSIONS Results of the multiple-design study suggest that gamification interventions may be a suitable, enjoyable, and promising way to contribute to PA participation of adults with intellectual disabilities.
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Affiliation(s)
- Stéphanie Turgeon
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Alexandra MacKenzie
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Charles Sebiyo Batcho
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec, Canada
| | - Jason D'Amour
- Département de psychologie, Université du Québec à Trois Rivières, Quebec, Canada
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112
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Nyhagen R, Egerod I, Rustøen T, Lerdal A, Kirkevold M. Family Members' Engagement in Symptom Communication, Assessment, and Management in the Intensive Care Unit: A Qualitative Study. Dimens Crit Care Nurs 2024; 43:111-122. [PMID: 38564453 DOI: 10.1097/dcc.0000000000000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Opportunities for communication and participation in decision making are limited for critically ill patients, but family members serving as surrogates enable empowerment of these patients. OBJECTIVE The aim of this study was to explore family members' engagement in symptom communication in the intensive care unit. METHODS A qualitative descriptive design using fieldwork methodology with triangulation of participant observation and individual interviews was conducted. Nine mechanically ventilated patients were observed in interaction with family members and clinicians in the intensive care unit. Six of the observed patients, 6 family members, and 9 clinicians were interviewed after participant observation. Field notes and transcripts were analyzed using Braun and Clarke's method of thematic analysis. RESULTS Family members engaged actively in symptom communication, assessment, and management, and there were barriers and facilitators to family engagement. Three main themes and 9 subthemes describing family engagement emerged: (1) intermediary role (recognize and report symptoms, provide patient information, and assist in communication), (2) independent role (provide familiarity, manage symptoms, and promote patient communication), and (3) conditions for family engagement (intensive care unit environment, relationship with the patient, and patient preferences). DISCUSSION Family members have unique knowledge of the patient that differs from and complement the competence of the staff, and might contribute to improved symptom communication. Future research should examine how family members can contribute to symptom communication, assessment, and management.
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113
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Postma A, Ketelaar M, van Nispen Tot Sevenaer J, Downs Z, van Rappard D, Jongmans M, Zinkstok J. Exploring individual parent-to-parent support interventions for parents caring for children with brain-based developmental disabilities: A scoping review. Child Care Health Dev 2024; 50:e13255. [PMID: 38587275 DOI: 10.1111/cch.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/21/2024] [Accepted: 03/08/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Brain-based developmental disabilities (BBDDs) comprise a large and heterogeneous group of disorders including autism, intellectual disability, cerebral palsy or genetic and neurodevelopmental disorders. Parents caring for a child with BBDD face multiple challenges that cause increased stress and high risk of mental health problems. Peer-based support by fellow parents for a various range of patient groups has shown potential to provide emotional, psychological and practical support. Here, we aim to explore existing literature on individual peer-to-peer support (iP2PS) interventions for parents caring for children with BBDD with a view to (1) explore the impact of iP2PS interventions on parents and (2) identify challenges and facilitators of iP2PS. METHOD An extensive literature search (January 2023) was performed, and a thematic analysis was conducted to synthesize findings. RESULTS Fourteen relevant articles revealed three major themes regarding the impact of iP2PS on parents: (1) emotional and psychological well-being, (2) quality of life and (3) practical issues. Four themes were identified describing challenges and facilitators of iP2PS: (1) benefits and burden of giving support, (2) matching parent-pairs, (3) logistic challenges and solutions and (4) training and supervision of parents providing peer support. CONCLUSIONS This review revealed that iP2PS has a positive impact on the emotional and psychological well-being of parents, as well as the overall quality of life for families caring for a child with a BBDD. Individual P2PS offers peer-parents an opportunity to support others who are facing challenges similar to those they have experienced themselves. However, many questions still need to be addressed regarding benefits of different iP2PS styles, methods of tailoring support to individual needs and necessity of training and supervision for peer support providers. Future research should focus on defining these components and evaluating benefits to establish effective iP2PS that can be provided as standard care practice for parents.
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Affiliation(s)
- Amber Postma
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Department of Rehabilitation, Physical Therapy and Sports; Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- De Hoogstraat, Rehabilitation, Utrecht, The Netherlands
| | | | - Zahra Downs
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Diane van Rappard
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marian Jongmans
- Department of Pedagogical and Educational Sciences, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Janneke Zinkstok
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry Nijmegen, Nijmegen, The Netherlands
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Hore K, Hoi Tan M, Kehoe A, Beegan A, Mason S, Al Mane N, Hughes D, Kelly C, Wells J, Magner C. Cybersecurity and critical care staff: A mixed methods study. Int J Med Inform 2024; 185:105412. [PMID: 38492407 DOI: 10.1016/j.ijmedinf.2024.105412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/19/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Cyberattacks on healthcare organisations are becoming increasingly common and represent a growing threat to patient safety. The majority of breaches in cybersecurity have been attributed to human error. Intensive care departments are particularly vulnerable to cyberattacks. The aim of this study was to investigate cybersecurity awareness, knowledge and behaviours among critical care staff. METHODS This was a multi-site cross-sectional survey study administered to critical care staff. Cybersecurity awareness was evaluated using the validated HAIS-Q instrument. Knowledge and behaviours were evaluated by direct questioning and scenario-based multiple-choice questions. Free text options were also offered to respondents. Thematic analysis was performed on free text sections. RESULTS Median scores of 12-15 in each of the HAIS-Q focus areas were achieved, indicating high levels of cybersecurity awareness among critical care staff. However, self-reported confidence in cybersecurity practices, especially identifying signs of cybersecurity breaches and reporting cybersecurity incidents, were relatively low. Participants responses to the scenarios demonstrated a lack of knowledge and awareness of some of the mechanisms of cyberattacks. Barriers to safe cybersecurity practices among staff that emerged from the qualitative analysis included: a lack of training and education; heavy workloads and staff fatigue; perceived lack of IT support and poor IT infrastructure. CONCLUSION Critical care staff appear to have a high-level cybersecurity awareness. However, in practice safe cybersecurity practices are not always followed. ICU departments and hospitals must invest in the human aspect of cybersecurity to strength their cyber-defences and to protect patients.
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Affiliation(s)
- Kevin Hore
- Paediatric Intensive Care Unit, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Mong Hoi Tan
- Paediatric Intensive Care Unit, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Anne Kehoe
- Department of Psychology, Children's Health Ireland at Crumlin, Dublin Ireland
| | - Aidan Beegan
- Department of Research & Innovation, Children's Health Ireland, Dublin, Ireland
| | - Sabina Mason
- Intensive Care Unit, Tallaght University Hospital, Dublin, Ireland
| | - Nader Al Mane
- Intensive Care Unit, Naas General Hospital, Naas, Ireland
| | - Deirdre Hughes
- Paediatric Intensive Care Unit, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Caroline Kelly
- Department of Nursing, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - John Wells
- Department of Nursing, School of Health Sciences, South East Technological University, Waterford, Ireland
| | - Claire Magner
- School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
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Nunes AR. Resilience: conceptualisations and challenges for effective heatwave public health planning. Public Health 2024; 230:113-121. [PMID: 38531233 DOI: 10.1016/j.puhe.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/02/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES This article examines diverse perspectives on heatwave resilience in public health planning, interviewing stakeholders from various sectors. It identifies challenges, including operational, political, economic, and cultural aspects, hindering effective strategies. The study advocates for a holistic approach to heatwave resilience, emphasising interdisciplinary research and collaboration for targeted interventions. Enhancing resilience is crucial to mitigating adverse health impacts and safeguarding vulnerable populations during heatwaves. Conceptualisations of resilience related to heatwave public health planning and heatwave resilience vary significantly. There is a need to unveil the multifaceted nature of resilience in the context of heatwaves and identify key challenges that hinder effective public health planning efforts. STUDY DESIGN Qualitative study to explore key stakeholders' conceptualisations of resilience and highlight challenges and opportunities needed for greater heatwave resilience and public health planning. METHODS Interviews were conducted with a diverse group of key stakeholders involved in local, regional, and national heatwave planning, academics, civil sector and private sector representatives. RESULTS The findings of this study highlight diverse conceptualisations of resilience. Conceptualisations of resilience mainly differ on the following: 'whom'; 'what'; 'how'; 'when'; and 'why'. This analysis shows that the concept of resilience is well understood but has different functions. The analysis of challenges revealed several key problems, such as operational and technical; political and governance; organisational and institutional; economic; linguistic; cultural, social, and behavioural; and communication, information, and awareness. These significantly hinder effective heatwave public health planning strategies. CONCLUSIONS The study emphasises the need for a holistic and integrated approach to heatwave resilience. Addressing these challenges is crucial for enhancing heatwave public health planning. This study provides valuable insights into the complexities of heatwave resilience, offering guidance for different sectors of society to develop targeted interventions and strategies. The development of new resilience interdisciplinary and intersectoral research, practice, and governance will prove crucial to ongoing efforts to strengthen national heatwave resilience public health planning. By fostering resilience, societies can mitigate the adverse impacts of heatwaves and safeguard the health and well-being of vulnerable populations.
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Affiliation(s)
- Ana Raquel Nunes
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom.
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Ilarda E, McIlveen P, Tynan A, Senz A. Emergency department staff experiences of the Bröset Violence Checklist. J Adv Nurs 2024; 80:2027-2037. [PMID: 37975436 DOI: 10.1111/jan.15961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/22/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
AIM Work-related violence is a significant problem in healthcare settings and emergency departments are one of the highest at-risk locations. There have been significant challenges in identifying successful risk-mitigation strategies to reduce the incidence and impact of work-related violence in this setting. This research explores the perspectives of clinical staff who routinely use violence risk assessment to provide recommendations for improvements. DESIGN This qualitative research used interviews of staff who routinely use of the Bröset Violence Checklist in an emergency department. The study was conducted in April 2022. METHOD Interview transcripts were subjected to Thematic Analysis to explore participants' clinical experiences and judgements about the utility of the Bröset Violence Checklist. RESULTS Eleven staff participated in semi-structured interviews. Participants described themes about the benefits of routine violence risk assessment and the influence of the subjective opinion of the scorer with respect to the emergency department patient cohort. Four categories of violence risk factors were identified: historical, clinical, behavioural and situational. Situational risks were considered important for tailoring the tool for context-specificity. Limitations of the BVC were identified, with recommendations for context-specific indicators. CONCLUSION Routine violence risk assessment using the Bröset Violence Checklist was deemed useful for emergency departments, however, it has limitations. IMPACT This study's findings offer potential solutions to reduce violence affecting front-line workers and practical processes that organizations can apply to increase staff safety. IMPLICATIONS The findings produced recommendations for future research and development to enhance utility of the Bröset Violence Checklist. REPORTING METHOD EQUATOR guidelines were adhered to and COREQ was used. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was involved in this study.
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Affiliation(s)
- Elisa Ilarda
- School of Education, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Peter McIlveen
- School of Education, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Anna Tynan
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- Research Support Unit, Darling Downs Health, Toowoomba, Queensland, Australia
| | - Ainslie Senz
- Department of Emergency Medicine, Footscray Hospital, Western Health, Footscray, Victoria, Australia
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Nizza IE, Smith JA, Kirkham JA. Picturing oneself over time: a multi-modal interpretative phenomenological analysis of pain management trajectories. Eur J Pain 2024; 28:741-753. [PMID: 38102753 DOI: 10.1002/ejp.2214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/06/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Chronic pain (CP) can be a disabling condition with impacts that affect the sense of identity of those who live with it. This article idiographically describes the longitudinal evolution of the sense of self of participants following their referral to a pain management service and participation in a pain management programme (PMP). METHODS Participants were interviewed three times: before they attended a PMP, and 1 and 6 months after the PMP. Data included the drawings of themselves that participants created at each interview and the transcripts of the interviews guided by the drawings, analysed longitudinally using interpretative phenomenological analysis. RESULTS This paper describes in detail the cases of four participants: two who experienced a positive albeit troubled trajectory following their PMP and two who did not experience any positive change. The results provide a nuanced account of how the impacts of CP on identity can evolve, with different people engaging with different aspects of a PMP and some people not engaging at all, and how pain self-management strategies enable those that do engage to cope in times of difficulty. CONCLUSIONS Participant responses to PMP participation are idiosyncratic and interviews with drawings of self analysed longitudinally can help illustrate processes of change. SIGNIFICANCE Not enough is understood about why some people get limited benefits from pain services. This idiographic longitudinal study illustrates how the impact of CP on identity can evolve when people are introduced to pain self-management, with some embracing change and others resisting it. For clinicians, this study describes four detailed CP individual paths, showing the interaction between contextual and idiosyncratic aspects. This is also the first study to use multiple drawings of self to explore the impacts of illness on identity longitudinally. In a person-centred approach to treatment, the drawings of self could also be adopted as a tool in clinician-patient conversations to gain a deeper understanding of the impacts of living with CP.
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Affiliation(s)
- I E Nizza
- Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - J A Smith
- Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - J A Kirkham
- Kent Community Health NHS Trust, Ashford, UK
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Day S, Tahlil KM, Shah SJ, Fidelak L, Wilson EC, Shah SK, Nwaozuru U, Chima K, Obiezu-Umeh C, Chikwari CD, Mwaturura T, Phiri N, Babatunde AO, Gbajabiamila T, Rennie S, Iwelunmor J, Ezechi O, Tucker JD. The HI V O pen Call on I nformed C onsent and E thics in Research (VOICE) for Adolescents and Young Adults: A Digital Crowdsourcing Open Call in Low- and Middle-Income Countries. Sex Transm Dis 2024; 51:359-366. [PMID: 38346417 PMCID: PMC11018461 DOI: 10.1097/olq.0000000000001949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND Many adolescents and young adults (AYAs; 10-24 years old) are excluded from HIV research because of social, ethical, and legal challenges with informed consent, resulting in limited AYA-focused data. We use a participatory approach to identify strategies for improving AYA consent processes in HIV research in low- and middle-income countries (LMICs). METHODS We conducted a digital crowdsourcing open call for ideas to improve AYA consent to HIV research in LMICs. Crowdsourcing involves engaging a group of people in problem-solving, then sharing emergent solutions. Submissions were evaluated by 3 independent judges using predefined criteria, with exceptional strategies receiving prizes. Demographic data were collected, and textual data were qualitatively analyzed for emergent themes in barriers and facilitators for improving AYA consent in HIV research, guided by a socioecological model. RESULTS We received 110 strategies total; 65 were eligible for evaluation, 25 of which were identified as finalists. Fifty-eight participants from 10 LMICs submitted the 65 eligible submissions, of which 30 (52%) were 18 to 24 years old. Thematic analysis identified 10 barriers to AYA consent, including HIV stigma, limited education, and legal/regulatory barriers. Strategies for improving AYA consent processes revealed 7 potential facilitators: enhancing AYA engagement in research, involving parents/guardians, improving education/awareness, improving institutional practices/policy, making research participation more AYA-friendly, enhancing engagement of other key communities of interest, and empowering AYA. CONCLUSIONS Diverse communities of interest in LMICs developed compelling strategies to enhance informed consent that may improve AYA inclusion in HIV research. These data will be used to develop practical guidance on improving AYA consent processes.
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Affiliation(s)
- Suzanne Day
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kadija M. Tahlil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sonam J. Shah
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lauren Fidelak
- Current undergraduate student (degree not yet granted) in the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin C. Wilson
- San Francisco Department of Public Health, San Francisco, California, USA
| | - Seema K. Shah
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Ucheoma Nwaozuru
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Kelechi Chima
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Chisom Obiezu-Umeh
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri, USA
| | - Chido Dziva Chikwari
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | - Nomsa Phiri
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | | | - Titilola Gbajabiamila
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri, USA
| | - Stuart Rennie
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- UNC Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Juliet Iwelunmor
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri, USA
| | - Oliver Ezechi
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Joseph D. Tucker
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Austin EE, Blakely B, Salmon P, Braithwaite J, Clay-Williams R. Eadem Sed Aliter. Validating an emergency department work domain analysis across three hospital configurations. Appl Ergon 2024; 117:104240. [PMID: 38286045 DOI: 10.1016/j.apergo.2024.104240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 01/31/2024]
Abstract
Work Domain Analysis (WDA), the foundational phase in the Cognitive Work Analysis Framework (CWA), provides a platform for understanding and designing complex systems. Though it has been used extensively, there are few applications in healthcare, and model validation for different contexts is not always undertaken. The current study aimed to validate an Emergency Department (ED) WDA across three metropolitan hospitals that differ in the type and nature of services they provide, including the ED in which the original ED WDA was developed. A facilitated workshop was conducted at the first ED and interviews at two subsequent EDs to refine and validate the ED WDA. ED subject matter experts (SMEs) including nurses, doctors, administration, and allied health personnel provided feedback on the model. SME feedback resulted in modifications to the original ED WDA model including combining nodes to reduce duplication and amending five labels for clarity. The resulting WDA provides a valid representation of the EDs found in metropolitan districts within an Australian state and can be used by roles such as frontline ED clinicians, hospital managers, and policy developers to facilitate the design, testing, and sharing of solutions to local and shared problems. The findings also demonstrate the importance of validating WDA models across different contexts.
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Affiliation(s)
- Elizabeth E Austin
- Australian Insititute of Health Innovation, Macquarie University, NSW, Australia.
| | - Brette Blakely
- Australian Insititute of Health Innovation, Macquarie University, NSW, Australia.
| | - Paul Salmon
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, QLD, Australia.
| | - Jeffrey Braithwaite
- Australian Insititute of Health Innovation, Macquarie University, NSW, Australia.
| | - Robyn Clay-Williams
- Australian Insititute of Health Innovation, Macquarie University, NSW, Australia.
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Hartman AG, Caspero K, Bodison SC, Soehner A, Akcakaya M, DeAlmeida D, Bendixen R. Pediatric Occupational Therapists' Perspectives on Sleep: A Qualitative Descriptive Study. Am J Occup Ther 2024; 78:7803205010. [PMID: 38512128 DOI: 10.5014/ajot.2024.050352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
IMPORTANCE Insufficient sleep is common among children seeking occupational therapy services but is rarely a focus of therapy despite sleep's critical impact on health. OBJECTIVE To examine pediatric occupational therapists' experiences, views, and confidence in addressing sleep concerns in their practice as well as barriers to and supports for doing so. DESIGN A qualitative descriptive study with thematic analysis of data from 1-hr virtual interviews. Rapport building, multiple-coder analysis, and member checking were used to ensure reliability and validity. SETTING Interviews were conducted remotely at each participant's preferred time and location. PARTICIPANTS Pediatric occupational therapists (N = 20) practicing across multiple settings in the United States were recruited through emails directed to their place of work and social media posts. A goal of 20 participants was set a priori with the goal of thematic saturation. OUTCOMES AND MEASURES A semistructured interview guide. RESULTS Participants were predominately cisgender (95%), female (85%), and White, non-Hispanic (90%). Overall, they voiced the importance of sleep but reported almost never writing sleep-related goals. Reported barriers that affected the participants' ability to fully address sleep in practice included therapists' lack of confidence and knowledge and low caregiver buy-in. CONCLUSIONS AND RELEVANCE The findings identify themes on the basis of which actionable steps toward promoting occupational therapists as sleep champions can be developed. Future implications include increasing sleep education opportunities, enhancing awareness of sleep health's impact on goal areas, and facilitating discussions about occupational therapy's role within the medical system and family system in supporting sleep. Plain-Language Summary: This qualitative study identifies what helps and hinders occupational therapists in addressing the sleep health concerns of their clients. We give occupational therapy clinicians and educators key supports to seek out or barriers to address.
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Affiliation(s)
- Amy G Hartman
- Amy G. Hartman, PhD, OTR/L, is Postdoctoral Fellow, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA;
| | - Kaitlyn Caspero
- Kaitlyn Caspero, MS, OTR/L, is Occupational Therapist and Founder, OT Graphically, Frederick, MD
| | - Stefanie C Bodison
- Stefanie C. Bodison, OTD, OTR/L, FAOTA, is Assistant Professor, Department of Occupational Therapy, University of Florida, Gainesville
| | - Adriane Soehner
- Adriane Soehner, PhD, is Assistant Professor, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Murat Akcakaya
- Murat Akcakaya, PhD, is Associate Professor, Department of Engineering, University of Pittsburgh, Pittsburgh, PA
| | - Dilhari DeAlmeida
- Dilhari DeAlmeida, PhD, is Associate Professor and Program Director, Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA
| | - Roxanna Bendixen
- Roxanna Bendixen, PhD, OTR/L, FAOTA, is Associate Professor and Division Director, Department of Occupational Therapy, Medical University of South Carolina, Charleston
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van Dieën MSH, Paans W, Mariani MA, Dieperink W, Blokzijl F. A qualitative study of the experiences and perceptions of older patients and relatives prior to cardiac surgery. Heart Lung 2024; 65:40-46. [PMID: 38395007 DOI: 10.1016/j.hrtlng.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Shared decision-making plays an important role in ensuring value-based healthcare in cardiac surgery. However, the personal situations of patients in cardiac care have not been widely explored, and thus, little is known about the decision-making experiences of patients and their relatives before surgery. OBJECTIVE To explore the perceptions of patients indicated for cardiac surgery and their relatives during the decision-making process, as well as their experiences of a conversation aimed at achieving shared decision-making in the treatment trajectory. METHODS The data were collected through semi-structured in-depth interviews with patients aged ≥70 years who were indicated for cardiac surgery and their relatives until theme saturation. Both inductive and deductive analysis were conducted based on the principles of reflexive thematic analysis. RESULTS Interviews with 16 patients and 10 relatives provided in-depth insights into the experiences of patients and their relatives in terms of a shared decision-making process prior to surgery. Overall, 15 subthemes were identified, and these were divided into three themes. In general, the patients' experiences and perceptions were influenced by their (1) general daily functioning. The relatives were more concerned about (2) social expectations and (3) existential uncertainty. CONCLUSIONS Patients eligible for cardiac surgery and their families have unique experiences and perceptions during the process of shared decision-making. The subthemes emerging from this study, such as the overestimation of potential medical outcomes by patients and their relatives, who experience fear about the current health situation of their loved one, require careful attention from healthcare professionals during decision-making conversations.
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Affiliation(s)
- Milou S H van Dieën
- Hanze University of Applied Sciences, School of Nursing, Research Group Nursing Diagnostics, Petrus Driessenstraat 3 9714 CA Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Cardiothoracic Surgery, Hanzeplein 1 9713 GZ Groningen, The Netherlands.
| | - Wolter Paans
- Hanze University of Applied Sciences, School of Nursing, Research Group Nursing Diagnostics, Petrus Driessenstraat 3 9714 CA Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Critical Care, Hanzeplein 1 9713 GZ Groningen, The Netherlands
| | - Massimo A Mariani
- University of Groningen, University Medical Center Groningen, Department of Cardiothoracic Surgery, Hanzeplein 1 9713 GZ Groningen, The Netherlands
| | - Willem Dieperink
- Hanze University of Applied Sciences, School of Nursing, Research Group Nursing Diagnostics, Petrus Driessenstraat 3 9714 CA Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Critical Care, Hanzeplein 1 9713 GZ Groningen, The Netherlands
| | - Fredrike Blokzijl
- Hanze University of Applied Sciences, School of Nursing, Research Group Nursing Diagnostics, Petrus Driessenstraat 3 9714 CA Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Critical Care, Hanzeplein 1 9713 GZ Groningen, The Netherlands
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Webermann AR, Holland KJ, Murphy CM. Student Experiences Reporting Sexual and Gender-Based Misconduct to the Title IX Office at a Public State University. Violence Against Women 2024; 30:1564-1585. [PMID: 36635951 DOI: 10.1177/10778012221150274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Twenty-five survivors completed anonymous surveys about reporting sexual and gender-based misconduct to their public university's Title IX office, including case characteristics, perceptions of the reporting and response process (e.g., helpfulness, respect), and experiences of institutional betrayal and support. Measures and open-ended responses described varied misconduct incidents, reporting behaviors, case outcomes, process issues, and negative process consequences. Additionally, process perceptions correlated with institutional betrayal and support. Findings illuminate how survivors' Title IX process perceptions relate to experiencing harm or support from larger institutions, and offer insights into developing a Title IX process which maintains student rights and dignity regardless of outcome.
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Affiliation(s)
- Aliya R Webermann
- VA Connecticut Healthcare System, West Haven, CT, USA
- University of Maryland, Baltimore County, Baltimore, MD, USA
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Al Wattar BH, Teh JJ, Clarke S, Abbara A, Morman R, Wilcox A, Talaulikar V. Healthcare and research priorities for women with polycystic ovary syndrome in the UK National Health Service: A modified Delphi method. Clin Endocrinol (Oxf) 2024; 100:459-465. [PMID: 38420872 DOI: 10.1111/cen.15038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is a chronic lifelong condition affecting up to 20% of women worldwide. There is limited input from affected women to guide the provision of healthcare services and future research needs. Our objective was to scope the healthcare and research priorities of women with PCOS in the United Kingdom. DESIGN A three-staged modified Delphi method, consisting of two questionnaires and a consensus meeting involving lay representatives and healthcare professionals. PATIENTS AND MEASUREMENTS Lay patient representatives of women with PCOS. Participants were asked to identify and rank healthcare and research priorities for their importance. RESULTS Six hundred and twenty-four lay participants took part in our Delphi method. Over 98% were diagnosed with PCOS (614/624, 98.4%). More than half experienced difficulties to receive a PCOS diagnosis (375/624, 60%), and the majority found it difficult to access specialised PCOS health services in the NHS (594/624, 95%). The top two healthcare priorities included better education for health professionals on the diagnosis and management of PCOS (238/273, 87.1%) and the need to set up specialist PCOS services (234/273, 85.7%). The top two research priorities focused on identifying better treatments for irregular periods (233/273, 85.3%) followed by better tests for early PCOS diagnosis (230/273, 84.2%). CONCLUSIONS We identified 13 healthcare and 14 research priorities that reflect the current health needs of women with PCOS in the United Kingdom. Adopting these priorities in future healthcare and research planning will help to optimise the health of women with PCOS and increase patient satisfaction.
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Affiliation(s)
- Bassel H Al Wattar
- Beginnings Assisted Conception Unit, Epsom and St Helier University Hospitals, London, UK
- Comprehensive Clinical Trials Unit, Institute for Clinical Trials and Methodology, University College London, London, UK
| | - Jhia Jiat Teh
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Sophie Clarke
- Reproductive Medicine Unit, University College London Hospitals, London, UK
| | - Ali Abbara
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Division of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | | | | | - Vikram Talaulikar
- Reproductive Medicine Unit, University College London Hospitals, London, UK
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Sigad LI, Gosen NB, Golan L, Lusky-Weisrose E, Shaibe J, Tener D, Moshon-Cohen TE, Roe D. 'A kindergarten teacher must have 100 eyes and 100 ears!': Kindergarten teachers' experiences coping with child sexual abuse and problematic sexual behavior. Child Abuse Negl 2024; 151:106713. [PMID: 38447239 DOI: 10.1016/j.chiabu.2024.106713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/24/2024] [Accepted: 02/18/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Child sexual abuse (CSA) and problematic sexual behavior (PSB) are worldwide phenomena that occur across all ages. Kindergarten teachers' proactive involvement can be crucial to the prevention, disclosure and intervention of CSA and PSB. However, research on their experiences of contending with CSA and PSB remains limited. OBJECTIVE This study examines kindergarten teachers' experiences in Israel with the CSA and PSB of their students. PARTICIPANTS AND SETTING Semi-structured interviews were conducted with 31 teachers: 11 secular Jewish, seven religious Jewish, nine Druze Arab, and four Muslim Arab. METHODS A qualitative analysis was conducted using the interview transcripts as data. RESULTS The analysis revealed three themes illustrating teachers' professional transformations regarding their knowledge of these phenomena: 1) initial shock, uncertainty and sense of responsibility when exposed to CSA and PSB due to missing knowledge, 2) implementation of prevention and intervention strategies regarding CSA and PSB, and 3) embracing a social role to disseminate CSA and PSB knowledge. The findings indicated that the majority of the teachers went from overwhelming shock and fear due to a lack of knowledge in coping with CSA and PSB to a sense of responsibility as a community leader. CONCLUSIONS The fragmentation of the Israeli education system isolates kindergartens, and the lack of training and education for the teachers left them alone when contending with the CSA and PSB of their students. Nevertheless, the participants exhibited remarkable agency and resourcefulness, gaining the necessary knowledge and acting as knowledge agents within their communities.
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125
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Nielson SA, Khosa DK, Verbrugghe A, Clow KM. Talking treats: A qualitative study to understand the importance of treats in the pet-caregiver relationship. Prev Vet Med 2024; 226:106163. [PMID: 38461702 DOI: 10.1016/j.prevetmed.2024.106163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/12/2024]
Abstract
Treats are a prevalent aspect of pet care, frequently given by dog and cat caregivers for varying reasons. However, recommendations of reducing or eliminating treat feeding poses a common challenge, leading to potential non-adherence surrounding weight management practices. To explore caregivers' perceptions and experiences surrounding treat feeding, we conducted five online focus groups with 24 dog and cat caregivers, recruited via an infographic shared on social media using snowball sampling. NVivo12© was used to organize and analyze verbatim transcripts using inductive thematic analysis. Outcomes illustrated three major themes: 1) the role of treats as an important tool for caregivers; 2) considerations for treat selection and provision; and 3) caregivers' need for more and better information and support related to treats. Participants emphasized the importance of treats for managing behaviours, health-related activities, and enhancing the pet-caregiver relationship. Results suggest that the diverse and valued applications of treats, caregivers' satisfaction associated with treat-giving, and perceived lack of guidance surrounding treats may present challenges for caregivers in reducing treat feeding with their pets. Findings highlight opportunities to enhance the available resources that can empower both veterinary professionals and caregivers to make well-informed decisions and foster sustainable changes in treat feeding practices to support weight management and overall health. Such considerations can improve client compliance with veterinary recommendations, to promote companion animal health and well-being while fostering the human-animal bond.
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Affiliation(s)
- Shelby A Nielson
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Guelph, Ontario N1G 2W1, Canada.
| | - Deep K Khosa
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Guelph, Ontario N1G 2W1, Canada
| | - Adronie Verbrugghe
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Guelph, Ontario N1G 2W1, Canada
| | - Katie M Clow
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Rd E, Guelph, Ontario N1G 2W1, Canada
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126
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Fisher G, Quel de Oliveira C, Stubbs PW, Power E, Checketts M, Porter-Armstrong A, Kennedy DS. Spatial Neglect: An Exploration of Clinical Assessment Behaviour in Stroke Rehabilitation. Clin Rehabil 2024; 38:688-699. [PMID: 38347746 PMCID: PMC11005297 DOI: 10.1177/02692155241230270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/08/2023] [Indexed: 04/10/2024]
Abstract
OBJECTIVE There is a large gap between evidence-based recommendations for spatial neglect assessment and clinical practice in stroke rehabilitation. We aimed to describe factors that may contribute to this gap, clinician perceptions of an ideal assessment tool, and potential implementation strategies to change clinical practice in this area. DESIGN Qualitative focus group investigation. Focus group questions were mapped to the Theoretical Domains Framework and asked participants to describe their experiences and perceptions of spatial neglect assessment. SETTING Online stroke rehabilitation educational bootcamp. PARTICIPANTS A sample of 23 occupational therapists, three physiotherapists, and one orthoptist that attended the bootcamp. INTERVENTION Prior to their focus group, participants watched an hour-long educational session about spatial neglect. MAIN MEASURES A deductive analysis with the Theoretical Domains Framework was used to describe perceived determinants of clinical spatial neglect assessment. An inductive thematic analysis was used to describe perceptions of an ideal assessment tool and practice-change strategies in this area. RESULTS Participants reported that their choice of spatial neglect assessment was influenced by a belief that it would positively impact the function of people with stroke. However, a lack of knowledge about spatial neglect assessment appeared to drive low clinical use of standardised functional assessments. Participants recommended open-source online education involving a multidisciplinary team, with live-skill practice for the implementation of spatial neglect assessment tools. CONCLUSIONS Our results suggest that clinicians prefer functional assessments of spatial neglect, but multiple factors such as knowledge, training, and policy change are required to enable their translation to clinical practice.
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Affiliation(s)
- Georgia Fisher
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Camila Quel de Oliveira
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Peter W. Stubbs
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Emma Power
- Discipline of Speech Pathology, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Matthew Checketts
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alison Porter-Armstrong
- Healthcare Technology Innovation and Assessment in the School of Health and Social Care, Edinburgh Napier University, Scotland, UK
| | - David S. Kennedy
- Motion and Mobility Rehabilitation Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada
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127
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Cannon CJ, Barry RA. Associations Between Family Caregiving and Romantic Relationships: An Exploratory Study With Nondistressed Couples Caring for an Outside Family Member. Gerontologist 2024; 64:gnad104. [PMID: 37504794 DOI: 10.1093/geront/gnad104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Family caregiving-providing emotional and physical health care for a family member or friend with an illness or disability-can result in many outcomes, including stress and beneficial experiences. Both romantic and caregiving relationships are complex and varied. Nevertheless, little research has examined how caregiving and romantic relationships influence one another. The purpose of this study was to understand ways romantic partners who care for a family member outside of their romantic relationship perceive that their romantic relationship and caregiving experiences influence one another. RESEARCH DESIGN AND METHODS A qualitative study using thematic analysis was conducted. A sample of 5 couples where one or both partners were caring for a relative with dementia participated in interviews about their experiences in family caregiving and in their romantic relationship, as well as how the 2 roles interacted with each other. Couple members were interviewed separately and together. RESULTS From these interviews, themes reflecting ways that caregiving influences romantic relationships, as well as ways romantic relationships influence caregiving emerged. Themes about caregiving influencing romantic relationships were caregiver stress interacting in the romantic relationship, the romantic relationship becoming less of a priority, and benefits experienced in the romantic relationship due to caregiving. Themes about romantic relationships influencing caregiving were partners improving the caregiving experience, and workload inequality. DISCUSSION AND IMPLICATIONS These findings broaden our understanding of how dyadic coping affects family caregiving and may suggest ways that the mutual influences caregivers experience between romantic relationships and caregiving benefits and challenges.
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Affiliation(s)
| | - Robin A Barry
- Department of Family Sciences, University of Toledo Medical Center, Toledo, Ohio, USA
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128
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Söyünmez S, Seki Öz H. Childhood Traumatic Experiences and Happiness of Nursing Students: A Mixed Methods Study. Child Maltreat 2024; 29:322-339. [PMID: 36460482 DOI: 10.1177/10775595221143530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The aim of this study was to examine the childhood trauma experiences and current happiness levels of nursing students. The quantitative part of the study was carried out with 349 student nurses and the qualitative part with 25 student nurses. An explanatory-sequential mixed methods design was used. Data were collected using Demographic Information Form, Childhood Trauma Questionnaire-Short Form, Oxford Happiness Questionnaire-Short Form and semi-structured Interview Form between November 2020 and September 2021. Quantitative data were analysed using descriptive statistics with the SAS 9.4 package program. Transcribed qualitative data were analysed using Braun and Clarke's six stage thematic analysis approach, and this was performed with the MAXQDA 2020 package program. In the quantitative section, it was determined that as the participants' childhood traumatic experiences increased, their happiness levels decreased. In the qualitative section six themes were formed (Childhood Trauma, Effects of Childhood Trauma, Coping with Childhood Trauma, Growing Up After Trauma, Perceptions of Future Parenting, Empowerment Through Nursing Education). It was determined that participants had various childhood traumatic experiences and mostly been exposed to emotional neglect. Some of the participants' childhood traumas continued to affect them in adulthood, and nursing education contributed to coping with trauma and raising awareness about it.
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Affiliation(s)
- Selin Söyünmez
- Department of Nursing, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Hilal Seki Öz
- Department of Nursing, Kırşehir Ahi Evran University, Kırşehir, Turkey
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129
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Hay CA, Packham J, Prior JA, Mallen CD, Ryan S. Barriers and facilitators in diagnosing axial spondyloarthritis: a qualitative study. Rheumatol Int 2024; 44:863-884. [PMID: 38472441 PMCID: PMC10980652 DOI: 10.1007/s00296-024-05554-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/31/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Diagnosis of axial spondyloarthritis (axSpA) is frequently delayed for years after symptom onset. However, little is known about patient and healthcare professional (HCP) perspectives on barriers and facilitators in axSpA diagnosis. This study explored the experiences and perceptions of both groups regarding the factors affecting the timely diagnosis of axSpA. METHOD Semi-structured interviews with patients with axSpA and axSpA-interested HCPs from the United Kingdom (UK) were performed by telephone or Microsoft Teams and focussed on the individuals' perspective of the diagnostic journey for axSpA. Interview transcripts were thematically analysed. RESULTS Fourteen patients with axSpA (10 female, 4 male) and 14 UK based HCPs were recruited, the latter comprising of 5 physiotherapists, 4 General Practitioners, 3 rheumatologists, a nurse, and an occupational therapist. Barriers to diagnosis identified by patients and HCPs were: difficult to diagnose, a lack of awareness, unclear referral pathways, patient behaviour and patient/HCP communication. Patient-identified facilitators of diagnosis were patient advocacy, clear referral processes and pathways, increased awareness, and serendipity. HCPs identified promoting awareness as a facilitator of diagnosis, along with symptom recognition, improvements to healthcare practice and patient/HCP communications. CONCLUSION Poor communication and a lack of understanding of axSpA in the professional and public spheres undermine progress towards timely diagnosis of axSpA. Improving communication and awareness for patients and HCPs, along with systemic changes in healthcare (such as improved referral pathways) could reduce diagnostic delay.
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Affiliation(s)
| | - Jon Packham
- School of Medicine, Keele University, Keele, UK
- Academic Unit of Population and Lifespan Sciences, University of Nottingham, Nottingham, UK
- Midlands Partnership University NHS Foundation Trust, Stafford, UK
| | - James A Prior
- School of Medicine, Keele University, Keele, UK
- Midlands Partnership University NHS Foundation Trust, Stafford, UK
| | - Christian D Mallen
- School of Medicine, Keele University, Keele, UK
- Midlands Partnership University NHS Foundation Trust, Stafford, UK
| | - Sarah Ryan
- Midlands Partnership University NHS Foundation Trust, Stafford, UK
- School of Nursing and Midwifery, Keele University, Keele, UK
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130
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Najmabadi L, Agénor M, Tendulkar S. "Pouring From an Empty Cup": Manifestations, Drivers, and Protective Factors of Occupational Stress Among Healthcare Providers of Trauma-Informed Care. J Interpers Violence 2024; 39:2041-2075. [PMID: 38059411 DOI: 10.1177/08862605231215028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
In the United States alone, 10 million people are affected by family and domestic violence (DV). DV survivors experience many forms of victimization, including physical, psychological, and sexual abuse resulting in trauma. The DV workforce, including healthcare providers, social workers, advocates, and other providers, utilize trauma-informed care in a variety of settings to help DV survivors heal and recover from their traumatic experiences. Given the intensity of DV work and occupational stressors associated with navigating complex survivor cases and systems of care, health and mental health professionals can experience burnout, compassion fatigue, and secondary traumatic stress. The purpose of this qualitative study was to explore how professionals in the DV workforce, including healthcare and mental health professionals, experience and mitigate occupational stress. Twenty in-depth interviews were conducted with DV professionals, who worked in medical settings like urban hospitals as well as DV shelters and rape crisis centers in Boston, MA. A semistructured interview guide was developed, and pilot tested and addressed the following topics including experiences of occupational stress, and mitigators of occupational stress. The interviews were audio recorded, transcribed, and analyzed using a thematic analysis approach. Codes were organized into themes and subthemes, which were reviewed and refined during research team discussions. Risk factors of occupational stress included caseload quantity and intensity, workplace isolation, and length of time in the field. Protective factors spanned individual, interpersonal, and organizational level factors. Participants described various strategies for mitigating occupational stress, including training, supervision, and self-care. Findings from this study have the potential to inform policies and practices among healthcare organizations that support professionals in the DV workforce who work with DV survivors.
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Affiliation(s)
| | - Madina Agénor
- Brown University School of Public Health, Providence, RI, USA
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131
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Pymer S, Harwood AE, Ibeggazene S, McGregor G, Huang C, Nicholls AR, Ingle L, Long J, Rooms M, Chetter IC, Twiddy M. High INtensity Interval Training in pATiEnts with Intermittent Claudication: A Qualitative Acceptability Study. Ann Vasc Surg 2024; 102:17-24. [PMID: 38301846 DOI: 10.1016/j.avsg.2023.11.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND A novel high-intensity interval training (HIIT) program has demonstrated feasibility for patients with intermittent claudication (IC). The aim of this study was to explore patient perspectives of the HIIT program to inform refinement and future research. METHODS All patients screened and eligible for the 'high intensity interval training in patients with intermittent claudication (INITIATE)' study were eligible to take part in a semistructured interview. A convenience subsample of patients was selected from 3 distinct groups: 1) those who completed the HIIT program, 2) those who prematurely discontinued the HIIT program, and 3) those who declined the HIIT program. Interviews considered patients views of the program and experiences of undertaking and/or being invited to undertake it. Interviews were audio recorded, transcribed verbatim, and analyzed via thematic analysis. RESULTS Eleven out of 31 participants who completed the program and 12 out of 38 decliners were interviewed. No participants who withdrew from the program agreed to interview. The 3 key themes were; personal reflections of the program; program facilitators and barriers; and perceived benefits. Completers enjoyed taking part, reported symptomatic improvement and would complete it again. Practical and psychological barriers exist, such as transport and motivation. Changes to the program were suggested. CONCLUSIONS Findings support the acceptability of this novel HIIT program, which in combination with the feasibility findings, suggest that a fully powered randomized controlled trial, comparing HIIT to usual-care supervised exercise programs is warranted.
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Affiliation(s)
- Sean Pymer
- Academic Vascular Surgical Unit, Hull York Medical School, Hull, UK.
| | - Amy E Harwood
- Department of Cardiac Rehabilitation, Centre for Exercise & Health, University Hospital, Coventry, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Saïd Ibeggazene
- Academic Vascular Surgical Unit, Hull York Medical School, Hull, UK
| | - Gordon McGregor
- Department of Cardiac Rehabilitation, Centre for Exercise & Health, University Hospital, Coventry, UK; Centre for Sport Exercise & Life Sciences, Coventry University, Coventry, UK; Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Chao Huang
- Department of Sport, Health & Exercise Science, University of Hull, Hull, UK
| | - Adam R Nicholls
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Lee Ingle
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Judith Long
- Department of Cardiology, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Marjorie Rooms
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Ian C Chetter
- Academic Vascular Surgical Unit, Hull York Medical School, Hull, UK
| | - Maureen Twiddy
- Department of Sport, Health & Exercise Science, University of Hull, Hull, UK
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132
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Denton J, Evans D, Qunyan X, Vernon R. Supporting older nurses and midwives in the Australian healthcare workplace-A qualitative descriptive study. J Adv Nurs 2024; 80:2065-2079. [PMID: 38012825 DOI: 10.1111/jan.15965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/29/2023]
Abstract
AIM To explore support strategies for older nurses and midwives in Australian healthcare workplaces. DESIGN A qualitative descriptive study. METHOD Participants were 50 older nurses and midwives and 20 healthcare managers recruited from a broad range of Australian healthcare settings. Data were collected using semi-structured interviews from November 2018 to April 2021. The interviews were recorded, transcribed and thematically analysed. RESULTS The limited number of identified sedentary roles and inequitable distribution of workload responsibilities were identified as constraints that impact the provision of workplace support for older nurses and midwives in healthcare settings. Three major themes were identified: Workplace support, Personal support and Doing more. A small number of participants reported support was available at work, but most said there was not. Of the reported strategies some were offered exclusively to a cohort that met an age criterion, while others were open to all staff regardless of age. Personal support strategies were employed outside of the workplace while others used strategies during working hours. Doing more related to suggestions about how organizations could do more to support older nurses and midwives at work. CONCLUSION Support mechanisms like adjustments in workload, employment fraction, practice location, upskilling and wellness programs in workplaces are limited. To facilitate retention and support older nurses and midwives in the workforce, health workplaces should consider implementing support mechanisms that can be tailored to the individual needs of the nurse or midwife over the life course of their career. IMPACT The findings of this study highlight the lack of support for many older nurses and midwives in Australian healthcare workplaces, emphasizing the need for further research into innovative practices on how to better support healthcare staff as they age. REPORTING METHOD This study adhered to the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Julie Denton
- Clinical and Health Sciences, The University of South Australia, Adelaide, South Australia, Australia
| | - David Evans
- Clinical and Health Sciences, The University of South Australia, Adelaide, South Australia, Australia
| | - Xu Qunyan
- Clinical and Health Sciences, The University of South Australia, Adelaide, South Australia, Australia
| | - Rachael Vernon
- Clinical and Health Sciences, The University of South Australia, Adelaide, South Australia, Australia
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133
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Dolu İ, Hayter M, Serrant L, Lee A. 'Hearing silences': Exploring culturally safe transitional care: A qualitative study among Turkish-speaking migrant frail older adults. J Adv Nurs 2024; 80:1997-2017. [PMID: 37950376 DOI: 10.1111/jan.15955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
AIMS This study aimed to investigate the experiences and transitional care needs of Turkish frail older adults living in the UK and determine how this information can be utilized to improve the provision of culturally sensitive care during the transitional period. DESIGN Qualitative descriptive research with semi-structured individual interviews. METHODS "The 'Silences' Framework guided the research design, from conceptualizing the research question to structuring the report of final outputs. For this study, semi-structured, in-depth interviews were conducted with sixteen older adults living with frailty and five family caregivers between January and May of 2023 in the United Kingdom. RESULTS Major themes that were identified included: (i) information and communication, (ii) care and support, (iii) the role of culture and (iv) trust and satisfaction. Further analysis, through discussion and immersion in the data, revealed that care transition periods were presented alongside three phases of transitional care: pre-transition (during hospitalization), early-transition (the period between discharge and the 7th day after discharge) and late transition (the period between the 8th day and 12th month after discharge). CONCLUSIONS Our study revealed that the communication and informational needs of frail older individuals change during the transition period. While Turkish older adults and family caregivers expressed satisfaction with healthcare services in the UK, many struggled due to a lack of knowledge on how to access them. IMPACT The support of family caregivers is a crucial component in facilitating transitional care for frail older patients, as they help in accessing healthcare services and using technological devices or platforms. It should be noted that family caregivers often hold the same level of authority as their elderly Turkish counterparts. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- İlknur Dolu
- Department of Nursing, Faculty of Health Science, Bartın University, Bartın, Turkey
| | - Mark Hayter
- Department of Nursing, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Laura Serrant
- Health Education England (North East & Yorkshire), Sheffield, UK
| | - Amanda Lee
- Department of Nursing, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
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134
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Steenekamp BL, Barker SL. Exploring the Experiences of Compassion Fatigue Amongst Peer Support Workers in Homelessness Services. Community Ment Health J 2024; 60:772-783. [PMID: 38285087 PMCID: PMC11001661 DOI: 10.1007/s10597-024-01234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
Peer support workers have lived experiences of the challenges their clients face. While research has shown peer work can benefit recovery, the negative consequences have not been clearly addressed. This study aimed to explore the experiences of compassion fatigue amongst peer support workers in homelessness services, and the coping strategies used. An explorative qualitative design was adopted. Six peer support workers, in homelessness services, were recruited via snowball sampling. Data was collected using semi-structured interviews and analysed using thematic analysis. Five themes were identified: relentless nature of working in homelessness services, change, making meaning of past experiences, organisational support, and personal coping strategies. There were two novel findings: (1) multiple clients recounting traumatic experiences, and (2) being unfairly blamed for lack of progress, exacerbating compassion fatigue. The findings of this study furthers limited research on compassion fatigue and can be used to develop protocols and practices for organisations that utilise peer support.
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135
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Capper T, Ferguson B, Muurlink O. Health professionals' experiences of whistleblowing in maternal and newborn healthcare settings: A scoping review and thematic analysis. Women Birth 2024; 37:101593. [PMID: 38423844 DOI: 10.1016/j.wombi.2024.101593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/29/2024] [Accepted: 02/18/2024] [Indexed: 03/02/2024]
Abstract
PROBLEM Whistleblowing, which involves raising concerns about wrongdoing, carries risks yet can be crucial to ensuring the safety of health service users in maternal and newborn healthcare settings. Understanding of the experiences of health care professionals that enact whistleblowing in this context is currently limited. BACKGROUND Notable inquiries involving maternity services such as those reported upon by Ockenden and Kirkup and the Lucy Letby case in the United Kingdom have shone an international spotlight on whistleblowing failures. AIM To identify and synthesise available literature addressing the experiences of healthcare professionals enacting whistleblowing in maternal and newborn care settings. METHODS This scoping review followed Arksey and O'Malley's framework. Five academic databases were systematically searched for documents published between January 2013 and October 2023 with additional searches of Google Scholar and related reference lists. FINDINGS Whilst 35 papers from international sources were identified, the majority originated from the United Kingdom, where recent high-profile incidents have occurred. Thematic analysis identified three main themes: 'Structural Power', 'Perfectionism' and 'Bravery, Hope and Disappointment', each with sub-themes. DISCUSSION Whistleblowing is frequently an altruistic act in a hierarchical system. It exposes poor practices and disrupts power dynamics, especially in challenging workplace cultures. Open disclosure, however, requires psychological safety. Obstacles persist, emphasising the need for a culture of trust and transparency led by individuals who embody the desired values. CONCLUSION Primary research on whistleblowing in maternal and newborn healthcare settings is limited. This study sheds light on power dynamics and factors that affect whistleblowing.
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Affiliation(s)
- Tanya Capper
- Australian Catholic University, 1100 Nudgee Rd, Banyo, QLD 4014, Australia.
| | - Bridget Ferguson
- CQUniversity Australia, 554/700 Yaamba Rd, Norman Gardens, Rockhampton, North QLD 4701, Australia
| | - Olav Muurlink
- CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
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136
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Chandanabhumma PP, Ratakonda S, Panko T, Cuculick J, Hauser P, Paasche-Orlow MK, Fetters MD, McKee MM. Examining the differences of perceptions and experience with online health information accessibility between deaf and hearing individuals: A qualitative study. Patient Educ Couns 2024; 122:108169. [PMID: 38325209 DOI: 10.1016/j.pec.2024.108169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/06/2023] [Accepted: 01/21/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Describe and compare the experiences and preferences of Deaf and hearing individuals with different levels of health literacy in accessing, interpreting, and acting upon online health information. METHODS We conducted semi-structured interviews with 17 Deaf and 10 hearing participants with high and low health literacy from three healthcare sites. We conducted thematic analysis of the transcripts to explore information navigation experiences, information sources and dissemination preferences. RESULTS We found thematic differences between Deaf and hearing participants with high and low health literacy in terms of information needs, information search experiences, information search perceptions, and preferred information dissemination approaches. Relative to hearing counterparts, Deaf participants were more likely to encounter challenges in accessing and understanding online information. Deaf participants with low health literacy were more likely to rely on visual graphics to support their understanding of the information than those with high health literacy. Deaf participants advocated for tailored approaches to disseminate health information to Deaf communities. CONCLUSION Our findings suggest that differences in online health information navigation experiences and accessibility may inform disparities in health literacy outcomes between Deaf and hearing individuals. PRACTICE IMPLICATIONS Online health information should be presented in a manner accessible to Deaf community members.
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Affiliation(s)
| | | | - Tiffany Panko
- National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, NY, USA
| | - Jessica Cuculick
- National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, NY, USA
| | - Peter Hauser
- National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, NY, USA
| | | | - Michael D Fetters
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Michael M McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
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137
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De Veer AJE, Voss H, Francke AL, de Man Y. Improvement of palliative care for people with intellectual disabilities: A multi-site evaluation. J Appl Res Intellect Disabil 2024; 37:e13223. [PMID: 38469929 DOI: 10.1111/jar.13223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/23/2023] [Accepted: 02/20/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND To improve the quality of palliative care, six evidence-based tools were implemented in 10 care services specialised in care for people with intellectual disabilities. Contextual differences were taken into account by using a participatory action research approach. METHOD The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) structured the evaluation. Data sources were online questionnaires completed by 299 professionals at baseline (response 45.2%) and 250 professionals after 2.5 years (35.1%), 11 semi-structured group interviews with 43 professionals, field notes and implementation plans. RESULTS A total of 767 professionals and 43 teams were reached. The effectiveness of the intervention was demonstrated in an improved knowledge of palliative care policy and increased competences among professionals. 79% of the professionals adopted tools in the toolbox. The participatory action research method was perceived as valuable in driving change. CONCLUSIONS Improving palliative care needs a context-specific, flexible approach, with involvement of all stakeholders.
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Affiliation(s)
- Anke J E De Veer
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Hille Voss
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Anneke L Francke
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, APH Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Expertise Centre Palliative Care Amsterdam UMC, Amsterdam, The Netherlands
| | - Y de Man
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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138
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Neve KL, Coleman P, Hawkes C, Vogel C, Isaacs A. What shapes parental feeding decisions over the first 18 months of parenting: Insights into drivers towards commercial and home-prepared foods among different socioeconomic groups in the UK. Appetite 2024; 196:107260. [PMID: 38403201 DOI: 10.1016/j.appet.2024.107260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024]
Abstract
Infants born into families experiencing socioeconomic disadvantage follow a high-risk trajectory for obesity and poor health in later life. Differences in early childhood food experiences may be contributing to these inequalities. This study aimed to explore the factors that influence parental decisions on when, how and what food to introduce over the first 18 months of their child's life and identify differences according to families' social position. Particular attention was given to social and environmental determinants within and outside the home. This research utilised a longitudinal qualitative methodology, with interviews and photo-elicitation exercises completed by participants when their children were 4-6; 10-12 and 16-18 months of age. Participants were parents (61 mothers; 1 father), distributed across low, medium and high socioeconomic position (SEP). During analysis, observable differences in factors directing parents to home-prepared or commercial foods were identified. Factors that undermined the provision of home-prepared meals included lack of time after returning to work, insufficient support from partners, uncertainty around infant and young child feeding (defined as the introduction and provision of solids) and an implicit trust in the messaging on branded products. These factors directed parents towards commercial foods and were most persistent among families experiencing socioeconomic disadvantage due to barriers accessing formal childcare, less flexible working conditions and fathers being less involved in infant feeding. To facilitate an enabling environment for healthy infant and young child feeding practices and address dietary inequalities, immediate steps that policy makers and healthcare providers can take include: i) changing the eligibility criteria for shared parental leave, ii) aligning claims on commercial infant food labels with international best practices, and iii) improving access to formal childcare.
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Affiliation(s)
- Kimberley L Neve
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK.
| | - Paul Coleman
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Corinna Hawkes
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Christina Vogel
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Anna Isaacs
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
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139
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Yang CF, Gau BS, Lee YH, Hsieh HL, Wang SY. Exploring clinical judgment ability in second-degree baccalaureate of science nursing students: A mixed methods study. Nurse Educ Today 2024; 136:106146. [PMID: 38412583 DOI: 10.1016/j.nedt.2024.106146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/06/2024] [Accepted: 02/23/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND As they have not yet embarked on clinical practice, most students who already have a bachelor's degree but require a bachelor's degree in nursing occasionally perceive the educator's instruction on clinical situations as abstract and challenging for making accurate clinical judgments. OBJECTIVES This study aims to implement a clinical judgment model and case scenarios in classroom teaching to evaluate improvements in students' clinical judgment and critical thinking abilities. DESIGN A mixed-method design. SETTING A second-degree Bachelor of Science in Nursing at a university in Taiwan. PARTICIPANTS First-year undergraduate nursing students. METHODS This mixed-methods study featured a survey at the beginning and end of a course, followed by one-on-one online interviews. A purposive sample of sophomore nursing students was recruited from a university in northern Taiwan between March 2020 and May 2021. Semi-structured interviews were conducted after a preliminary analysis of the collected quantitative data. RESULTS In total, 48 participants completed the study questionnaire, and 20 were interviewed. The results show that the students' ability to make clinical judgment and identify individual health problems from case scenarios significantly improved after completing the course. However, critical thinking did not differ significantly after the course. Qualitative data analysis revealed three key themes relevant to the participants' learning experiences: (1) establishing the context of clinical judgment, (2) building a bridge between basic medical science and clinical nursing, and (3) having a broader perspective. CONCLUSIONS Incorporating clinical judgment measurement model and case scenarios in the curriculum may benefit second-degree Bachelor of Science in Nursing students who have not yet begun their clinical practice. Additionally, the result provides educators with valuable learning goals and evaluation strategies in the classroom and clinical practice.
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Affiliation(s)
- Cheng-Fang Yang
- Second-Degree Bachelor of Science in Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
| | - Bih-Shya Gau
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Yun-Hsiang Lee
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui-Ling Hsieh
- Second-Degree Bachelor of Science in Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
| | - Shu-Yi Wang
- College of Nursing, University of Colorado Anschutz Medical Campus, USA.
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140
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Cavanagh DE, Northway R, Todd S. Annual health checks for people with intellectual disabilities: An exploration of experiences, follow-up and self-management of health conditions. J Appl Res Intellect Disabil 2024; 37:e13233. [PMID: 38561873 DOI: 10.1111/jar.13233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 01/29/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Little is known about how health issues identified at the annual health check (AHC) are followed up and addressed, how participants self-manage their health in between AHCs, and what support they receive. This research aimed to explore this. METHODS People with intellectual disabilities (n = 12), and/or their supporters residing in Wales, were interviewed following their AHC and again at 6 and 11 months. A recurrent cross-sectional thematic analysis was undertaken. RESULTS Five main themes emerged from interview one: going for a health check, issues identified, and actions taken, supporting the self-management of health, the personal context, and addressing health inequities. Four main themes emerged from follow-up interviews: follow-up, supporting the self-management of health, the need for reasonably adjusted health services, and going for another health check. CONCLUSION A broader system of support around the AHC is required if people are to achieve or maintain the best possible health.
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Affiliation(s)
- Dawn E Cavanagh
- Unit for Development in Intellectual and Developmental Disabilities, University of South Wales, Lower Glyntaff Campus, Pontypridd, South Wales, UK
| | - Ruth Northway
- Unit for Development in Intellectual and Developmental Disabilities, University of South Wales, Lower Glyntaff Campus, Pontypridd, South Wales, UK
| | - Stuart Todd
- Unit for Development in Intellectual and Developmental Disabilities, University of South Wales, Lower Glyntaff Campus, Pontypridd, South Wales, UK
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141
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Coman IA, Bazaa U, Guidry JPD, Miller CA. #EndtheSTIgma: An Exploratory Analysis of the 2019 HPV Awareness Day Conversation on Twitter & Instagram. Health Commun 2024; 39:927-936. [PMID: 37041687 DOI: 10.1080/10410236.2023.2196466] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The current study explores the risk communication conversations on Twitter and Instagram in the context of the 2019 HPV Awareness Day, through the theoretical lenses of the stigma associated with HPV, HPV-related cancer, and the HPV vaccine. Our findings reveal that: 1) self and enacted stigma are present in these social media conversations, via nonprofits and official ambassadors, and via regular people; 2) other categories related to stigma, which can be seen as reactions to stigma and appeals to better individuals and society (i.e. stopping stereotypes) also emerged in these conversations, via official and not official sources, pro and against vaccine discourses; and 3) the same categories emerged from the data via both platforms, but differences exist in terms of narratives and messaging. Practical implications are discussed.
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Affiliation(s)
- Ioana A Coman
- College of Media and Communication, Texas Tech University
| | - Uyanga Bazaa
- Department of Communication, Mississippi State University
| | | | - Carrie A Miller
- Public Relations/STEM Translational Communication Center, College of Journalism and Communications, UF Health Cancer Center, University of Florida
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142
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Goodman-Williams R, Volz J, Fishwick K. Reasons for Not Reporting Among Sexual Assault Survivors Who Seek Medical Forensic Exams: A Qualitative Analysis. J Interpers Violence 2024; 39:1905-1925. [PMID: 37970805 PMCID: PMC10993628 DOI: 10.1177/08862605231211926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
After a sexual assault, survivors have the option of seeking a medical forensic exam, which includes medical evaluation and treatment, as well as forensic evidence collection. Forensic evidence is collected in a sexual assault evidence kit (SAEK) and typically released to police to aid in the investigation and potential prosecution of the assault. However, 20% to 25% of survivors who have a SAEK collected do not report their assault to police at that time and choose instead to have their SAEK stored for possible future use. This study sought to understand the reasons for not reporting among this group of survivors. We examined medical records of 296 individuals aged 18 and older who had documented their reasons for not reporting to police in their medical record and used a non-theory-driven coding framework to conduct a reflexive thematic analysis based on that data. We identified four themes: Reporting Won't Help, Reporting Will Harm, Not Now, and Not What I'm Here For. These data illustrate that survivors are making an active choice which, for many, was based on concerns that reporting would not meaningfully help their situation or may even make their situations worse. For some survivors, the decision to have forensic evidence collected without a police report was based on their needs at that moment, whereas for other survivors it was based on their desire to move on from the assault more permanently. Practice and policy recommendations are discussed, including the importance of providing survivors information about what police reporting would look like in specific circumstances as well as ensuring that financial concerns are not a barrier to survivors receiving post-assault medical care without forensic evidence collection.
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Affiliation(s)
| | - Jessica Volz
- Adventist HealthCare Shady Grove Medical Center, Rockville, MD, USA
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143
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Venetis MK, Bontempo AC, Catona D, Buckley de Meritens A, Devine KA, Greene K. Dilemmas and Strategy When Companion Participation During Appointments Differs from Patient and Companion Expectations. Health Commun 2024; 39:876-887. [PMID: 36941532 DOI: 10.1080/10410236.2023.2190244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Cancer patients often attend medical interactions with at least one companion. The degree to which companions participate varies, ranging from passive observer to active advocate. However, the structure of the medical interaction often promotes dyadic rather than triadic communication, creating ambiguity about to the degree to which companions can and should participate. Participants (N = 34, 16 dyads) included gynecologic cancer patients who were undergoing chemotherapy treatment (n = 18) and their companions (n = 16); all participants were separately interviewed. Interviews included discussion of dyadic communication patterns within medical interactions. The normative rhetorical theory (Goldsmith, 2019) was applied as a guiding framework. Patients discussed the dilemma they experience when companions are expected but absent. Patients and companions provided positive reports of companion communication when behavior aligned with expectations. Alternatively, patients and companions experience dilemmas when companions participate more than or differently from how patients and/or companions had expected. Companions provided one strategy for managing the dilemma of how to participate in medical interactions. Implications and limitations are discussed.
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Affiliation(s)
| | | | | | | | - Katie A Devine
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey
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144
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Harmer MJ, Stewart DJ, Prasad P, Veligratli F, Pickles C, Kim JS, Raja M. Unilateral Multicystic Dysplastic Kidney Management: A National Survey. Clin Pediatr (Phila) 2024; 63:482-487. [PMID: 37278332 DOI: 10.1177/00099228231177808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Risks of contralateral kidney abnormalities and chronic kidney disease necessitate follow-up for unilateral multicystic dysplastic kidneys (MCDK). A nationwide survey of senior UK pediatricians was conducted. Of the 60 responses obtained, 62% routinely perform a dimercaptosuccinic acid scan to confirm diagnosis. Eight percent routinely perform a cystogram to investigate contralateral vesicoureteric reflux. Sixty-two percent would routinely measure renal function (frequency ranging from once only to "every 2 years"). Twenty-five percent recalled MCDK nephrectomy being performed within the previous 5 years. Respondents voiced concerns that national guidance may result in an overcautious approach but could balance consensus and safe variation, and offer families choice and reassurance. The mean estimated cost of follow-up from birth to 18 years ranged from £258 to £3854. Results demonstrate significant variation in management, highlighting the need for a clear pathway to decrease unwanted variability and to ensure those at high risk of renal sequelae are recognized early, without undue investigatory burden.
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Affiliation(s)
- Matthew J Harmer
- Department of Paediatric Nephrology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- University of Southampton, Southampton, UK
| | - Douglas J Stewart
- Department of Paediatric Nephrology, Royal Hospital for Children, NHS Greater Glasgow and Clyde, Glasgow, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Pallavi Prasad
- Department of Paediatric Nephrology, Alder Hey Children's Hospital, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Faidra Veligratli
- Department of Paediatric Nephrology, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Charles Pickles
- Department of Paediatric Nephrology, Great North Children's Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Victoria Wing, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Ji Soo Kim
- Department of Paediatric Nephrology, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Maduri Raja
- Department of Paediatric Nephrology, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, UK
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145
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Quarshie ENB, Oppong Asante K, Andoh-Arthur J, Akotia CS, Osafo J. To Keep the Law or to Repeal It: Views of Parliamentarians On the Call to Decriminalise Attempted Suicide in Ghana. Omega (Westport) 2024; 89:39-56. [PMID: 34967674 PMCID: PMC11017692 DOI: 10.1177/00302228211066683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We explored the views of members of parliament (MPs) in Ghana on the call to decriminalise attempted suicide. We applied reflexive thematic analysis to Parliamentary Hansards (2017-2020) on calls to decriminalise attempted suicide in Ghana. 11 MPs shared their stance for or against the call. We developed three major themes that entailed, often, opposing views: (1) deterrent effect of the law (against: the law punishes and deters to protect life; for: the law is insensitive and has ironic effects), (2) enforcement of the law (against: leave things as they are, the law is not enforced, anyway; for: crime is not self-inflicted) and (3) prioritisation of suicide prevention (against: focus on more pressing issues, but resource support systems; for: the law and legitimate support systems cannot co-exist). The findings indicate two needs: to extend suicide literacy to Ghanaian MPs, and to initiate a public/private member's bill on attempted suicide decriminalisation.
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Affiliation(s)
- Emmanuel Nii-Boye Quarshie
- School of Psychology, University of Leeds, Leeds, UK
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
| | - Johnny Andoh-Arthur
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Charity Sylvia Akotia
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
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146
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Eckman MH, Wise R, Knochelmann C, Mardis R, Leonard AC, Wright S, Gummadi A, Dixon E, Becker RC, Schauer DP, Flaherty ML, Costea A, Kleindorfer D, Ireton R, Baker P, Harnett BM, Adejare A, Sucharew H, Arduser L, Kues J. Can a best practice advisory improve anticoagulation prescribing to reduce stroke risk in patients with atrial fibrillation? J Cardiol 2024; 83:285-290. [PMID: 37579873 DOI: 10.1016/j.jjcc.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a risk factor for stroke. Randomized trials have demonstrated that anticoagulation can reduce strokes in AF patients. Yet, widespread underutilization of this therapy continues. To address this practice gap, we designed a study to implement and evaluate the effectiveness of a best practice advisory (BPA) for an Atrial Fibrillation Decision Support Tool (AFDST) embedded within our electronic health record. METHODS Our intervention is provider-facing, focused on decision support. Clinical setting is ambulatory patients being seen by primary care physicians. We prospectively enrolled 608 patients in our health system who are currently receiving less than optimal anticoagulation therapy as determined by the AFDST and randomized them to one of two arms - 1) usual care, in which the AFDST is available for use; or 2) addition of a BPA to the AFDST notifying clinicians that their patient stands to gain significant benefit from a change in current therapy. Primary outcome was effectiveness of the BPA measured by change to "appropriate thromboprophylaxis" based on the AFDST recommendation at 3 months post-enrollment. Secondary endpoints included Reach and Adoption from the RE-AIM (Reach, Effectiveness, Adoption, Implementation, & Maintenance) framework for implementation studies. RESULTS Among 562 patients with a minimum follow-up of 3 months, addition of a BPA to the AFDST resulted in significant improvement in anticoagulation therapy, 5 % (12/248) versus 11 % (33/314) p = 0.02, odds ratio 2.31 (95 % CI, 1.17-4.87). CONCLUSIONS A BPA added to an AF decision support tool improved anticoagulation therapy among AF patients in a primary care academic health system setting.
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Affiliation(s)
- Mark H Eckman
- Division of General Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Ruth Wise
- Division of General Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Carol Knochelmann
- Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Rachael Mardis
- Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Anthony C Leonard
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sharon Wright
- Department of Pharmacy, University Hospital, Cincinnati, OH, USA
| | - Ashish Gummadi
- Division of General Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Estrelita Dixon
- Division of General Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Richard C Becker
- Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Daniel P Schauer
- Division of General Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Matthew L Flaherty
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Dawn Kleindorfer
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Rob Ireton
- Center for Health Informatics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Pete Baker
- Center for Health Informatics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Brett M Harnett
- Center for Health Informatics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Heidi Sucharew
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Lora Arduser
- Department of English, University of Cincinnati, Cincinnati, OH, USA
| | - John Kues
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Hu N, Yang Z, Wang A. Early Post-Transplant Adaptation Experience in Young and Middle-Aged People With Kidney Transplant in China: A Qualitative Study. West J Nurs Res 2024; 46:356-365. [PMID: 38500353 DOI: 10.1177/01939459241238683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Successful adaptation to post-transplantation life in patients who have undergone kidney transplants is crucial. The psychosocial needs of people with kidney transplants are closely related to the health of the transplanted kidney. If transplant recipients cannot adapt to the effects of the transplant, their physical and mental health will be seriously impaired. OBJECTIVE The purpose of this study was to explore the early post-transplant adaptation experience of young and middle-aged persons with kidney transplants in China based on the Roy adaptation model. METHODS A qualitative descriptive study was conducted using semi-structured interviews. Fifteen young and middle-aged persons with kidney transplant were recruited from a tertiary hospital in China between September 2022 and March 2023 through purposive sampling. Data were analyzed using a thematic analysis approach. RESULTS This study identified 4 themes: (1) "two-sided" changes in physiological functioning, (2) "dawn and darkness" (conflicting perceived emotions about the future), (3) role functioning adaptation conflict and impairment, and (4) social isolation and the challenges of coping. CONCLUSIONS This study found that early post-transplant adaptation in young and middle-aged people with kidney transplant included both positive and negative experiences, and these findings can provide new insights into research related to successful post-operative adaptation.
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Affiliation(s)
- Na Hu
- Department of Transplantation, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhen Yang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Aiping Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, China
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148
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Andina-Díaz E, Welch L, Siles-González J, Serrano-Fuentes N, Gutiérrez-García AI, Solano-Ruiz MC. Photovoice: An active learning tool with community nursing students. Public Health Nurs 2024; 41:392-402. [PMID: 38311870 DOI: 10.1111/phn.13285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/01/2023] [Accepted: 01/11/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVE To assess nursing students' experiences of using photovoice as a pedagogical approach to active learning in the community. METHODS A descriptive design with a cross-sectional mixed-method questionnaire was used with 108 students following an educational activity, in which their communities were photographed and the impact of the pandemic on vulnerable populations was reflected. Descriptive statistics and thematic analysis were used to analyze the data. RESULTS Seventy eight percent of the students felt that photovoice was an interesting and useful tool for nurses, 89% affirmed it helped stimulate reflection on social and health inequities in times of pandemic, 82% described that it developed many emotions and feelings and 86% would like to disseminate their photographs directly to stakeholders, citizens, and politicians. Three themes were identified in the data: "stimulate critical reflection", "develop emotional skills", and "encourage action". CONCLUSIONS Photovoice is a successful active learning pedagogical approach that engages nursing students to develop critical awareness while connecting with their communities, with the real world. It fosters students' sensitivity and motivation and encourages them to take action. Teachers need to introduce new scaffolds for active learning, such as photovoice, to provide innovative academic support that nurtures and develops the next generation of nurses appropriately.
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Affiliation(s)
- Elena Andina-Díaz
- Department of Nursing and Physiotherapy, University of León, Vegazana Campus, Leon, Spain
- SALBIS Research Group, University of León, León, Spain
- EYCC Research Group, University of Alicante, Alacant, Spain
| | - Lindsay Welch
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- University Hospitals Dorset NHS Foundation Trust, Bournemouth University, Bournemouth, UK
| | - José Siles-González
- EYCC Research Group, University of Alicante, Alacant, Spain
- Department of Nursing, University of Alicante, Carretera San Vicente del Raspeig, s/n, San Vicente del Raspeig, Spain
| | - Nestor Serrano-Fuentes
- SALBIS Research Group, University of León, León, Spain
- NIHR ARC Wessex, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Ana Isabel Gutiérrez-García
- EYCC Research Group, University of Alicante, Alacant, Spain
- Department of Nursing, University of Alicante, Carretera San Vicente del Raspeig, s/n, San Vicente del Raspeig, Spain
| | - MCarmen Solano-Ruiz
- EYCC Research Group, University of Alicante, Alacant, Spain
- Department of Nursing, University of Alicante, Carretera San Vicente del Raspeig, s/n, San Vicente del Raspeig, Spain
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149
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Harrison A, Konstantara E, Zaremba N, Brown J, Allan J, Pillay D, Hopkins D, Treasure J, Ismail K, Stadler M. A cognitive behavioural model of the bidirectional relationship between disordered eating and diabetes self care in adult men with Type 1 diabetes mellitus. Diabet Med 2024; 41:e15287. [PMID: 38379243 DOI: 10.1111/dme.15287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/11/2023] [Accepted: 01/09/2024] [Indexed: 02/22/2024]
Abstract
AIMS This qualitative study aimed to develop the first cognitive behavioural (CBT) model outlining the development and maintenance of disordered eating in adult men living with Type 1 diabetes to improve on previous theoretical models of Type 1 diabetes and disordered eating and to draw comparisons to women with Type 1 diabetes and disordered eating. METHODS Twenty-seven men (n = 16 with Type 1 diabetes and disordered eating, n = 11 with Type 1 diabetes without disordered eating) participated in semi-structured interviews. Data were analysed using thematic analysis and individual CBT formulations were developed for each participant to inform the model. RESULTS Men with Type 1 diabetes and disordered eating experience negative thoughts about food, insulin, weight/shape and diabetes itself, which cause negative emotions such as fear and vulnerability and difficulties with diabetes self care such as problems with hyper and hypoglycaemia and problems accessing structured education and technology result in men feeling more dissatisfied about their body weight/shape. CONCLUSIONS This CBT model of disordered eating in men with Type 1 diabetes can guide new interventions.
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Affiliation(s)
- Amy Harrison
- Department of Psychological Medicine, Diabetes, Psychology and Psychiatry Research Group, King's College London, London, UK
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
- Department of Psychology and Human Development, Institute of Psychiatry, University College London, London, UK
| | - Emmanouela Konstantara
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - Natalie Zaremba
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - Jennie Brown
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
- Diabetes Centre, King's College Hospital, London, UK
| | - Jacqueline Allan
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - Divina Pillay
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
| | - David Hopkins
- Diabetes Centre, King's College Hospital, London, UK
| | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Khalida Ismail
- Department of Psychological Medicine, Diabetes, Psychology and Psychiatry Research Group, King's College London, London, UK
- Diabetes Centre, King's College Hospital, London, UK
| | - Marietta Stadler
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, London, UK
- Diabetes Centre, King's College Hospital, London, UK
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150
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Kokorelias KM, Nadesar N, Bak K, Boger J, Nygård L, Mäki-Petäjä-Leinonen A, Nedlund AC, Astell A. The impact on employment and education of caregiving for a family member with young onset dementia: A scoping review. Dementia (London) 2024:14713012241247339. [PMID: 38623057 DOI: 10.1177/14713012241247339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Young-onset dementia (YOD) affects individuals under 65 years of age, often leading to loss of employment and independence. Families provide increasing levels of care to family members with YOD, resulting in changes to their daily lives, including their occupational pursuits. This review examines evidence of the occupational implications for family members who provide care to a family with YOD to identify: (i) the influence and impact caregiving tasks and responsibilities have on employment, volunteering, and education, and (ii) caregiver, and caregiving situation factors associated with changes in employment, volunteering, and education. A scoping review was performed using eight electronic databases. Included articles were narratively synthesized using a thematic analysis. Sixteen studies met the inclusion criteria and were included for review. The over-arching (main) theme of 'decision-making' was identified, with family members required to make choices about their own occupational goals and roles to be able to provide care to family living with YOD. The outcomes of these decisions are dynamic and changeable across the caregiving trajectory. Three caregiving factors influence decision-making: (1) Implications of Combining Caregiving and Occupations, (2) Altered Identity (3) Strategies to Support Caregivers of Individuals Living with YOD. A fourth theme was also identified 'Guidance for Researchers To Support Caregivers'. There is a scarce body of literature examining the influence caregiving has on occupational outcomes for the YOD caregiver population. Much of this work is descriptive and lacks focus on the implications, particularly long-term impacts. This review provides a foundational guide for future research and practices to support YOD family caregivers to obtain and sustain occupations.
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Affiliation(s)
- Kristina M Kokorelias
- Sinai Health System, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Nirusa Nadesar
- University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Katherine Bak
- University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Jennifer Boger
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
- UBC-Okanagan, Kelowna, BC, Canada
| | - Louise Nygård
- Division of occupational therapy, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Arlene Astell
- University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- University of Reading, Reading, UK
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