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Obeng C, Amissah-Essel S, Jackson F, Obeng-Gyasi E. Preschool Environment: Teacher Experiences during the COVID-19 Pandemic in Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127286. [PMID: 35742535 PMCID: PMC9224162 DOI: 10.3390/ijerph19127286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022]
Abstract
Background: In Ghana, the COVID-19 pandemic led to the government’s decision to shut down schools for nearly nine months. This study explores the experiences of preschool teachers in Ghana during the COVID-19 pandemic. Methods: The study was carried out using the Qualitative Description approach and aspects of Albert Bandura’s Social Learning Theory. Twenty-five teachers agreed to carry out face-to-face interviews with the researchers. An audio recorder device was used to record the interviews, with each interview lasting between 35–55 min. The analysis was carried out by two researchers who served as coders, and MAXQDA 2022 (VERBI Software GmbH) was used to do the analysis. Results: All twenty-five participants indicated their awareness of COVID-19. Participants said they were so “Scared” when they heard about COVID-19 that it could spell the doom for all humanity. Participants also talked about the extra workload that came upon them as a result of the pandemic and the “financial challenges” that they went through during the pandemic because they had no income since they were not teaching. Study participants indicated that one benefit of the pandemic was the heightened awareness of the need to practice hygienic behavior in their classroom. Conclusion: Participants’ beliefs about the virus being lethal led to mask wearing and the practice of hygienic behavior. Thus, although the COVID-19 pandemic negatively impacted the emotional and financial status of the studied participants, a positive outcome was the participants’ awareness of the need to practice positive health behavior, which will contribute to the overall health and safety of everyone in the preschool environment.
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Affiliation(s)
- Cecilia Obeng
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA;
- Correspondence: ; Tel.: +1-812-856-0502
| | - Salome Amissah-Essel
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast TF0494, Ghana;
| | - Frederica Jackson
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA;
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA;
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
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Henderson ER, Sang JM, Louth-Marquez W, Egan JE, Espelage D, Friedman M, Coulter RWS. "Words Aren't Supposed to Hurt, But They Do": Sexual and Gender Minority Youth's Bullying Experiences. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP8747-NP8766. [PMID: 33300412 PMCID: PMC10910491 DOI: 10.1177/0886260520978199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Sexual and gender minority youth (SGMY) are more likely to experience bullying and violence compared to the youth who do not identify as SGMY, leading to increased risk of poor mental and physical health outcomes, and poor academic performance. Few studies explore the entire range of bullying experienced by sexual and gender minority youth (SGMY). The purpose of this study was to qualitatively describe the ways in which SGMY experience bullying victimization. We conducted semi-structured interviews with a diverse sample of 20 SGMY aged 14-18 years (median age 16 years) recruited from online social media. The sample included 10 participants who identified as cisgender girls, 4 who identified as cisgender boys, 2 who identified as transgender, and 4 who identified as another gender identity. Ten participants identified as bisexual, six identified as lesbian, and four identified as gay. Findings indicated six common experiences of bullying among the participants: (a) verbal harassment; (b) gender policing; (c) physical violence; (d) sexual harassment; (e) treated as sexual perpetrators and deviants; and (f) and social exclusion. SGMY described how bullying victimization ranged from overt to concealed attitudes and behaviors, and they articulated how several forms of bullying are likely not experienced by heterosexual and cisgender youth. These results support findings from prior qualitative studies and suggest that efforts to address school-based bullying may benefit from a more complete awareness of the range of bullying victimization experienced by SGMY. Development of multi-item scales of bullying that reflect the six common experiences of bullying presented in this study would allow researchers to quantitatively explore the range of bullying behaviors experienced by SGMY, and would aid in the conceptualization and successful implementation of anti-bullying interventions.
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103
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Hoque S, Luther J, Mizrahi R, Gerald LB, Phipatanakul W, Lemon SC, Rosal MC, Byatt N, Pbert L, Trivedi M. School Nurse Perspectives on School-Supervised Asthma Therapy: A Qualitative Study. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2022; 35:65-73. [PMID: 35723660 PMCID: PMC9247674 DOI: 10.1089/ped.2022.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background: School-supervised asthma therapy improves asthma outcomes for children, yet this strategy is not widely utilized. School nurses play a vital role in this intervention, yet their perspectives on school-supervised asthma therapy have not been thoroughly examined. Objectives: To examine the perspectives of school nurses participating in school-supervised asthma therapy and identify key facilitators, barriers, and proposed solutions that will facilitate the uptake of this strategy. Methods: We used purposeful sampling to recruit 12 school nurses participating in Asthma Link, a real-world application of school-supervised asthma therapy, between 2017 and 2019. We performed semistructured interviews with school nurses to elicit their perspectives on the facilitators, barriers, and proposed solutions to barriers to Asthma Link implementation. Interview transcripts were analyzed using qualitative descriptive methodology to identify major themes. Results: School nurses identified facilitators for Asthma Link adoption, including the ease of integrating supervised therapy into school nurse routines, recognition of benefits for families with limited resources, and satisfaction participating in preventive care. School nurses identified barriers, including communication challenges with families and providers, families not reliably bringing medication to school, limited nursing staff in schools, and increased school nurse turnover. School nurses proposed specific solutions to these barriers, including appointing Asthma Link liaisons within pediatric practices, incentivizing families to bring medicine to school, and partnering new school nurses with those experienced in delivering Asthma Link to overcome staffing issues and promote program fidelity. Conclusions: School nurse perspectives on the facilitators, barriers, and solutions to barriers are important for understanding how to promote real-world implementation of school-supervised asthma therapy. The themes identified in this study will be utilized to refine our protocol for Asthma Link to facilitate real-world adoption of this evidence-based strategy.
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Affiliation(s)
- Shushmita Hoque
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Address correspondence to: Shushmita Hoque, MD, MS, Department of Medicine, University of Massachusetts Chan Medical School, 55 North Lake Avenue, Worcester, MA 01655, USA
| | - Janki Luther
- Department of Internal Medicine, Washington University, St. Louis, Missouri, USA
| | - Raphael Mizrahi
- Department of Pediatric Pulmonology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Lynn B. Gerald
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Wanda Phipatanakul
- Department of Asthma, Allergy, and Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Stephenie C. Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Milagros C. Rosal
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Nancy Byatt
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Lori Pbert
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Michelle Trivedi
- Department of Internal Medicine, Washington University, St. Louis, Missouri, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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Pauly B, Sullivan G, Inglis D, Cameron F, Phillips J, Rosen C, Bullock B, Cartwright J, Hainstock T, Trytten C, Urbanoski K. Applicability of a national strategy for patient-oriented research to people who use(d) substances: a Canadian experience. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:22. [PMID: 35610726 PMCID: PMC9127478 DOI: 10.1186/s40900-022-00351-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 04/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Europe and North America are in the grips of a devastating overdose crisis. People who use substances often feel unsafe to access healthcare due to fears of stigma, blame, judgement, poor treatment, or other repercussions. As a result, they often avoid, delay, or leave care, resulting in premature death and missed opportunities for care. Internationally, there have been concerted efforts to move towards patient-engaged research to enhance the quality of health care systems and services. In Canada, the Canadian Institutes of Health Research (CIHR) Strategy for Patient-Oriented Research (SPOR) initiative promotes engagement of patients as active partners in health care research. As part of a community based patient oriented research project, we critically analyze the SPOR framework to provide insights into what constitutes safer research with people who use(d) substances. METHODS We undertook a two-stage process that began with a review of community based research principles and the SPOR framework. At the second stage, we undertook a qualitative descriptive study employing focus groups to generate description of the adequacy and appropriateness of the SPOR framework for guiding research with people who use(d) substances on four key dimensions (patient engagement, guiding principles, core areas of engagement and benefits). The data were analyzed using qualitative content analysis to identify key issues and insights. RESULTS While the SPOR framework includes a range of patient roles, principles and areas for engagement, there are issues and gaps related to essential elements of safe patient-oriented research for people who use substances. These include an individualized focus on patients as partners, lack of recognition of community benefits, power imbalances and distrust due to systemic stigma, engagement as one way capacity building and learning, and lack of accountability for taking action on research findings. CONCLUSIONS Given the extent of stigma in health care and the ongoing illicit drug policy crisis, strategies for enhancing equitable Patient-Oriented Research (POR) include shifting language from patient partners to community researchers, recognizing power inequities and adding trust and equity as core POR principles including pay equity. Employing community based participatory research as a POR methodology allows the lead researchers to fully engage community throughout the research process, enhances community benefits and accountability for action.
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Affiliation(s)
- Bernadette Pauly
- University of Victoria School of Nursing, Canadian Institute for Substance Use Research, Victoria, Canada.
| | - Ginger Sullivan
- University of Victoria School of Nursing, Canadian Institute for Substance Use Research, Victoria, Canada
| | - Dakota Inglis
- University of Victoria, Canadian Institute for Substance Use Research, Victoria, Canada
| | | | | | - Conor Rosen
- Umbrella Society for Addictions and Mental Health, Victoria, Canada
| | - Bill Bullock
- Victoria Division of Family Practice, Victoria, Canada
| | - Jennifer Cartwright
- BC Support Unit, Advancing Patient Oriented Research, Vancouver Island Regional Centre, Victoria, Canada
| | - Taylor Hainstock
- BC Support Unit, Advancing Patient Oriented Research, Vancouver Island Regional Centre, Victoria, Canada
| | | | - Karen Urbanoski
- University of Victoria, Canadian Institute for Substance Use Research, Victoria, Canada
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105
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Newton A, Awuviry‐Newton K, Oppong Nkansah J, Abekah‐Carter K. Understanding older adults' functioning and health-seeking behaviour during the COVID-19 pandemic in Ghana: A descriptive qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e823-e831. [PMID: 34032345 PMCID: PMC8239829 DOI: 10.1111/hsc.13452] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 04/04/2021] [Accepted: 05/04/2021] [Indexed: 05/06/2023]
Abstract
Little research has been conducted to explore the functional status of community-dwelling older adults in sub-Saharan Africa, including Ghana, especially during the COVID-19 pandemic. This study investigated the functional status and the health-seeking behaviour of older adults during the COVID-19 pandemic in Ghana. Utilising a descriptive qualitative approach, semi-structured interviews were used to collect data from 12 eligible older adults from southern Ghana. With the use of NVivo (v12), descriptive and focused coding techniques were employed to analyse the data. The following five themes were identified after the data analysis: (a) older adults' health status during COVID-19 pandemic, (b) feeling limited, (c) feeling of unhappiness for being inactive, (d) striving to be active and (e) seeking healthcare during COVID-19 pandemic. This study revealed the unique health and social-related needs of Ghanaian older adults during the COVID-19 pandemic. This study's findings draw attention to the urgent need for the state to devise practical health and social-related initiatives to support older adults during and after the COVID-19 pandemic.
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Affiliation(s)
- Abraham Newton
- Department of Social StudiesUniversity of EducationWinnebaGhana
| | - Kofi Awuviry‐Newton
- African Health and Ageing Research Centre (AHARC)WinnebaGhana
- Priority Research Centre for Generational Health and AgeingDepartment of Public Health and MedicineThe University of NewcastleCallaghanNSWAustralia
| | | | - Kwamina Abekah‐Carter
- African Health and Ageing Research Centre (AHARC)WinnebaGhana
- Department of Social WorkUniversity of GhanaLegonGhana
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Cianelli R, Villegas N, Oliveira GD, Sailsman S, Montano NP, Martinez AS, Toledo C, Sandalaula M, Sanchez H. Exploring the Psychosocial Impact of Living With HIV on Minority Older Women. J Am Psychiatr Nurses Assoc 2022; 28:216-224. [PMID: 32469282 DOI: 10.1177/1078390320927462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Among older adults, minority older women will account for 60% of the new HIV diagnoses. The psychosocial impact of living with HIV among this vulnerable population narrated by their own voices has been understudied. AIMS: The purpose of this study was to explore the psychosocial impact of living with HIV on minority older women. METHODS: In-depth interviews were conducted with 28 minority older women living with HIV at an Ambulatory Care Center HIV Clinic in South Florida. All interviews were audio-recorded and transcribed verbatim. Conventional content analysis was used to identify and define the major themes that emerged from the interviews. Questions included those concerning description of life after the HIV diagnosis, most challenging aspects of life after the diagnosis, and daily activities since the diagnosis. RESULTS: The analysis of the interview data led to five main themes: (I) Social Impact of HIV, (II) Threats to Health and Well-Being, (III) HIV as a Death Sentence, (IV) Spirituality, and (V) HIV Treatment Adherence. In their narratives, women described a myriad of psychosocial issues such as depressed mood, isolation, economic challenges, stigma, anhedonia of interest, fear of death, among others. CONCLUSIONS: There is a compelling empirical need for rapid implementation of a culturally tailored, holistic, low-cost, multistrategy intervention to early screen and reduce the psychosocial impact of HIV among minority older women.
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Affiliation(s)
- Rosina Cianelli
- Rosina Cianelli, PhD, MPH, RN, IBCLC, FAAN, University of Miami, Coral Gables, FL, USA
| | - Natalia Villegas
- Natalia Villegas, PhD, MSN, RN, IBCLC, University of Miami, Coral Gables, FL, USA
| | - Giovanna De Oliveira
- Giovanna De Oliveira, PhD, MSN, RN, ANP-C, PMHNP-BC, University of Miami, Coral Gables, FL, USA
| | - Sonique Sailsman
- Sonique Sailsman, PhD, RN, Barry University, Miami Shores, FL, USA
| | - Nilda Peragallo Montano
- Nilda Peragallo Montano, DrPH, RN, FAAN, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Angel Solorzano Martinez
- Angel Solorzano Martinez DNP, MSN, MBA, RN, CNS, PMHNP-BC, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Christine Toledo
- Christine Toledo, PhD, MSN, RN, University of Miami, Coral Gables, FL, USA
| | - Muheriwha Sandalaula
- Muheriwha Sandalaula, PhDc, MScMid, RN, University of Miami, Coral Gables, FL, USA
| | - Heather Sanchez
- Heather Sanchez, RN, University of Miami, Coral Gables, FL, USA
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Dickson VV, Blustein J, Weinstein B, Goldfeld K, Radcliffe K, Burlingame M, Grudzen CR, Sherman SE, Smilowitz J, Chodosh J. Providing Hearing Assistance to Veterans in the Emergency Department: A Qualitative Study. J Emerg Nurs 2022; 48:266-277. [PMID: 35172928 DOI: 10.1016/j.jen.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Effective communication is essential to good health care, and hearing loss disrupts patient-provider communication. For the more than 2 million veterans with severe hearing loss, communication is particularly challenging in noisy health care environments such as emergency departments. The purpose of this qualitative study was to describe patient and provider perspectives of feasibility and potential benefit of providing a hearing assistance device, a personal amplifier, during visits to an emergency department in an urban setting affiliated with the Department of Veterans Affairs. METHODS This qualitative descriptive study was conducted in parallel with a randomized controlled study. We completed a semistructured interview with 11 veterans and 10 health care providers to elicit their previous experiences with patient-provider communication in the ED setting and their perspectives on hearing screening and using the personal amplifier in the emergency department. Interview data were analyzed using content analysis and Atlas.ti V8.4 software (Scientific Software Development GmbH, Berlin, Germany). RESULTS The veteran sample (n = 11) had a mean age of 80.3 years (SD = 10.2). The provider sample included 7 nurses and 3 physicians. In the ED setting, hearing loss disrupts patient-provider communication. Screening for hearing loss in the emergency department was feasible except in urgent/emergent cases. The use of the personal amplifier made communication more effective and less effortful for both veterans and providers. DISCUSSION Providing the personal amplifier improved the ED experience for veterans and offers a promising intervention that could improve health care quality and safety for ED patient populations.
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Brennan DJ, Charest M, Turpin A, Griffiths D, Adam BD, Maxwell J, McCrady K, Ahmed R. "It's a win for the clinic, it's a win for the frontline, but, most importantly, it's a win for the client": Task Shifting HIV Prevention Services from Clinicians to Community Health Workers in Ontario, Canada. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 20:780-792. [PMID: 35505827 PMCID: PMC9049009 DOI: 10.1007/s13178-022-00721-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 05/28/2023]
Abstract
Introduction Despite strong evidence from low- and middle-income countries supporting the use of task shifting to provide quality, cost-effective HIV-related health services, this strategy has been adopted less widely in high-income countries such as Canada. Methods In 2020, we conducted semi-structured interviews with 19 clinicians (e.g., psychologists, nurses, physicians) and 14 community health workers (CHWs) in Ontario to examine their perspectives on the prospect of shifting HIV/STBBI testing services and PrEP in Ontario, Canada. Interviews were transcribed and then analyzed using content analysis. A community consultation with key stakeholders was also performed to assess the validity of the findings. Results There was substantial agreement between clinicians and CHWs with respect to shifting specific tasks related to HIV/STBBI testing and PrEP. In particular, most participants felt that rapid HIV testing could and should be provided by CHWs and that ASOs could be ideal sites for clients to obtain and use self-testing kits for STBBIs. Most respondents agreed that CHWs have the skills and expertise required to perform most non-clinical services related to PrEP (e.g., pre-counselling, follow-up, case management). The co-location of clinicians and CHWs could help support the development of task shifting initiatives. Conclusion Findings indicate that there is enthusiasm among both clinicians and CHWs with respect to shifting HIV prevention services. Creative solutions are required to have a meaningful impact on HIV incidence in this population. Policy Implications With adequate training and supervision, non-regulated CHWs should be allowed to provide certain HIV prevention services such as rapid HIV testing. A provincial, publicly funded program for PrEP is recommended.
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Affiliation(s)
- David J. Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W, Toronto, ON M5S 1V4 Canada
| | - Maxime Charest
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W, Toronto, ON M5S 1V4 Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
| | - Aaron Turpin
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W, Toronto, ON M5S 1V4 Canada
| | | | - Barry D. Adam
- Departments of Sociology, Anthropology and Criminology, University of Windsor, Windsor, ON Canada
- Ontario HIV Treatment Network, Toronto, ON Canada
| | | | - Keith McCrady
- 2-Spirited Peoples of the 1st Nations, Toronto, ON Canada
| | - Robbie Ahmed
- Alliance for South Asian AIDS Prevention, Toronto, ON Canada
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Scheunemann L, White JS, Prinjha S, Eaton TL, Hamm M, Girard TD, Reynolds C, Leland N, Skidmore ER. Barriers and facilitators to resuming meaningful daily activities among critical illness survivors in the UK: a qualitative content analysis. BMJ Open 2022; 12:e050592. [PMID: 35473739 PMCID: PMC9045053 DOI: 10.1136/bmjopen-2021-050592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To identify critical illness survivors' perceived barriers and facilitators to resuming performance of meaningful activities when transitioning from hospital to home. DESIGN Secondary content analysis of semistructured interviews about patients' experiences of intensive care (primary analysis disseminated on the patient-facing website www.healthtalk.org). Two coders characterised patient-perceived barriers and facilitators to resuming meaningful activities. To facilitate clinical application, we mapped the codes onto the Person-Task-Environment model of performance, a patient-centred rehabilitation model that characterises complex interactions among the person, task and environment when performing activities. SETTING United Kingdom, 2005-2006. PARTICIPANTS 39 adult critical illness survivors, sampled for variation among demographics and illness experiences. RESULTS Person-related barriers included negative mood or affect, perceived setbacks; weakness or limited endurance; pain or discomfort; inadequate nutrition or hydration; poor concentration/confusion; disordered sleep/hallucinations/nightmares; mistrust of people or information; and altered appearance. Task-related barriers included miscommunication and managing conflicting priorities. Environment-related barriers included non-supportive health services and policies; challenging social attitudes; incompatible patient-family coping (emotional trauma and physical disability); equipment problems; overstimulation; understimulation; and environmental inaccessibility. Person-related facilitators included motivation or attitude; experiencing progress; and religion or spirituality. Task-related facilitators included communication. Environment-related facilitators included support from family, friends or healthcare providers; supportive health services and policies; equipment; community resources; medications; and accessible housing. Barriers decreased and facilitators increased over time. Six barrier-facilitator domains dominated based on frequency and emphasis across all performance goals: mood/motivation, setbacks/progress, fatiguability/strength; mis/communication; lack/community support; lack/health services and policies. CONCLUSIONS Critical illness survivors described a comprehensive inventory of 18 barriers and 11 facilitators that align with the Person-Task-Environment model of performance. Six dominant barrier-facilitator domains seem strong targets for impactful interventions. These results verify previous knowledge and offer novel opportunities for optimising patient-centred care and reducing disability after critical illness.
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Affiliation(s)
- Leslie Scheunemann
- Division of Geriatric Medicine and Gerontology in the Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Division of Pulmonary, Allergy, and Critical Care Medicine in the Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jennifer S White
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Suman Prinjha
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Tammy L Eaton
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Critical Illness Recovery Center (CIRC), UPMC Mercy, Pittsburgh, Pennsylvania, USA
| | - Megan Hamm
- Division of General Medicine in the Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Timothy D Girard
- Clinical Research, Investigation, and Systems Modeling of Acute illness (CRISMA) Center in the Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Charles Reynolds
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Natalie Leland
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Algeo N, Bennett K, Connolly D. Breast cancer survivorship and employment in Ireland: Legislative systems and the return to work of women with breast cancer. Work 2022; 71:927-939. [DOI: 10.3233/wor-205044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Breast cancer is the most common invasive cancer in females worldwide. While work is important for well-being, 84% of women in Ireland temporarily or permanently cease working up to six months post-breast cancer diagnosis. Under Irish law, there is a right to reasonable work accommodations, however paid sick leave has only recently been state-mandated. Legislation internationally varies across nations. OBJECTIVE: The aim of this study was to explore the experiences of women who have had breast cancer returning to, and/or remaining in work, in the context of employment legislation. METHODS: Fifteen women with breast cancer, fifteen healthcare professionals, and nine employers nationwide participated in a qualitative-descriptive design, using semi-structured interviews. Interviews were audio-recorded, transcribed, and data analysed using thematic analysis. RESULTS: Thirty-nine participants were recruited. A prominent theme from interviews was that most women with breast cancer and healthcare professional cohorts were not aware of employment rights in the context of cancer diagnoses. This is in contrast to employers. Experiences of sick leave and pay entitlements varied amongst women with breast cancer with financial pressure and expediated the return to work evident for some participants. Most women did not report any discrimination on returning to the workplace, although there were examples of indirect discrimination where unfair expectations were being placed on women by colleagues. CONCLUSIONS: Education and awareness on employment rights and entitlements during and after cancer treatment is warranted. This could be incorporated into work-focused interventions to support those living with and beyond cancer to transition back into the workplace.
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Affiliation(s)
- Naomi Algeo
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Bennett
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
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Lou J, Pourkazemi F, Mackenzie L. Exploring the experiences of individuals living with persistent pain using a visual art diary. Br J Occup Ther 2022. [DOI: 10.1177/03080226221079239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Persistent pain significantly impacts daily living. Visual arts interventions can have positive outcomes, but little is known about benefits for people with persistent pain. This study aimed to explore participant experiences of utilising visual art in expressing and managing their persistent pain experience through a visual diary. Method As part of a small exploratory study nested in a larger project, participants with a history of persistent pain were recruited from a local pain management clinic. Six participants with persistent pain attended five weekly intervention sessions involving art observation, creation and discussion, at the Art Gallery of NSW. Participants explored their ideas about their pain experience through artmaking using visual and written data from self-reported pain diaries. Thematic analysis was used. Results Analysis of five diaries was conducted. Visual and written expressions of the pain experience varied. Colour was used by participants to represent ideas and emotions. Capital letters were used to convey tone, or emphasis. Three main themes emerged from the written and visual data: ‘The lived experience of pain’, ‘The powerful drive for growth beyond change itself’ and ‘Personal values and perceptions guiding daily living and decision-making’. Conclusion This study provides insights into the potential benefits of using visual arts to help manage persistent pain experiences and improve health outcomes.
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Affiliation(s)
- Jasmine Lou
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Fereshteh Pourkazemi
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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Rashoka FN, Kelley MS, Choi JK, Garcia MA, Chai W, Rashawka HN. “Many people have no idea”: a qualitative analysis of healthcare barriers among Yazidi refugees in the Midwestern United States. Int J Equity Health 2022; 21:48. [PMID: 35410348 PMCID: PMC8995685 DOI: 10.1186/s12939-022-01654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background The COVID-19 pandemic has shed new light on inequities in healthcare access faced by immigrant and refugee communities. To address ongoing disparities, there is an urgent need for ecological approaches to better understand the barriers that hinder and resources that facilitate access to healthcare. This study investigates barriers to healthcare system access faced by Yazidi refugees in the Midwestern United States. Methods Informed by the Interpretative Phenomenological Approach, three focus group meetings with a community advisory board were conducted between September 2019 and January 2020. The nine-member focus group included social workers, healthcare providers, and members of the Yazidi community. Meeting recordings were transcribed into English, coded for themes, and validated. Results We describe themes related to specific barriers to healthcare access; analyze the influence of relational dynamics in the focus group; explore experiential themes related to healthcare access in the Yazidi community, and finally interpret our findings through a social-ecological lens. Conclusion Community agencies, healthcare organizations, policymakers, and other stakeholders must work together to develop strategies to reduce systemic barriers to equitable care. Community representation in priority-setting and decision-making is essential to ensure relevance, acceptability, and utilization of developed strategies.
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Bush EJ, Krueger BI, Cody M, Clapp JD, Novak VD. Considerations for Voice and Communication Training Software for Transgender and Nonbinary People. J Voice 2022:S0892-1997(22)00068-6. [PMID: 35382956 DOI: 10.1016/j.jvoice.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/22/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
Transgender and gender diverse people often experience voice-gender incongruence, which is inversely correlated with health and quality of life. Such incongruence could be reduced with voice and communication training, but expert-administered training is often inaccessible while self-guided training is difficult and potentially risky. Training could alternatively be provided through software (eg, smartphone apps), but such software is at an early stage. This qualitatively driven mixed-methods study thus includes surveys and interviews with 21 transfeminine, transmasculine and nonbinary people to identify general views of voice and communication training software as well as most desirable features of such software. Participants were positive about the general idea and described ways to effectively implement four critical features: feedback, accountability, automated goal setting, and training characteristics other than pitch. They also discussed optional or undesirable features. These findings may inform development of voice and communication training software, thus improving health and quality of life for gender minorities.
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Affiliation(s)
| | | | - Mel Cody
- University of Wyoming, Laramie, Wyoming.
| | | | - Vesna Dominika Novak
- University of Wyoming, Laramie, Wyoming; University of Cincinnati, Cincinnati, Ohio.
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GRADE summary of findings tables Enhanced Understanding of Values and Preferences Evidence. J Clin Epidemiol 2022; 147:60-68. [PMID: 35364232 DOI: 10.1016/j.jclinepi.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 03/08/2022] [Accepted: 03/20/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We conceptualize patient values and preferences as the relative importance of health outcomes (RIO) which are often obtained through utility elicitation research. A transparent and structured approach to present synthesized RIO evidence and the certainty of this evidence is needed. This study aims to adapt the summary of findings (SoF) table to describe the RIO. STUDY DESIGN AND SETTING We performed three interactive workshops with a protype version of the SoF table for RIO evidence adapted from the SoF table for intervention effects. We then tested the new format through semi-structured interviews with professionals who interpret RIO evidence (e.g., systematic review authors and guideline developers). RESULTS We adapted the SoF table for the presentation of RIO evidence. This SoF table may be easy to use but bears one risk: some participants misunderstood the utility information and the variability around the RIO. We added a visual analogue scale to clarify the concept of utilities. CONCLUSION Through a multi-stage process including brainstorming sessions and interviews, we adapted the SoF table to present RIO evidence. This table may enhance understanding of evidence synthesis of values and preferences, facilitating the incorporation of this type of evidence in decision making.
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Factors Impacting Primary Care Engagement in a New Approach to Integrating Care in Ontario, Canada. Int J Integr Care 2022; 22:20. [PMID: 35340350 PMCID: PMC8896242 DOI: 10.5334/ijic.5704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/19/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction: In 2019, Ontario’s Ministry of Health (the Ministry) introduced Ontario Health Teams (OHTs) to provide population-based integrated healthcare. Primary care was foundational to this approach. We sought to identify factors that impacted primary care engagement during OHT formation from different perspectives. Methods: Interviews with 111 participants (administrators n = 80; primary care providers n = 17; patient family advisors = 14) from 11 OHTs were conducted following a semi-structured guide. Interviews were transcribed, coded, and thematically analyzed. Results: Participants felt that primary care engagement was an ongoing, continuous cycle. Four themes were identified: 1) ‘A low rules environment’: limited direction from the Ministry (system-level), 2) ‘They’re at different starting points’: impact of local context (initiative-level); 3) ‘We want primary care to be actively involved’: engagement efforts made by OHTs (initiative-level); 4) ‘Waiting to hear a little bit more’: primary care concerns about the OHT approach (sector-level). Thirteen factors impacting primary care engagement were identified across the four themes. Discussion and Conclusion: The 13 factors influencing primary care engagement were interconnected and operated at health system, integrated care initiative, and sector levels. Future research should focus on integrated care initiatives as they mature, to address potential gaps in the involvement of primary care physicians.
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Ries NM, Johnston B, Jansen J. A qualitative interview study of Australian physicians on defensive practice and low value care: "it's easier to talk about our fear of lawyers than to talk about our fear of looking bad in front of each other". BMC Med Ethics 2022; 23:16. [PMID: 35246129 PMCID: PMC8895622 DOI: 10.1186/s12910-022-00755-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 02/18/2022] [Indexed: 12/27/2022] Open
Abstract
Background Defensive practice occurs when physicians provide services, such as tests, treatments and referrals, mainly to reduce their perceived legal or reputational risks, rather than to advance patient care. This behaviour is counter to physicians’ ethical responsibilities, yet is widely reported in surveys of doctors in various countries. There is a lack of qualitative research on the drivers of defensive practice, which is needed to inform strategies to prevent this ethically problematic behaviour. Methods A qualitative interview study investigated the views and experiences of physicians in Australia on defensive practice and its contribution to low value care. Interviewees were recruited based on interest in medico-legal issues or experience in a health service involved in ‘Choosing Wisely’ initiatives. Semi-structured interviews averaged 60 min in length. Data were coded using the Theoretical Domains Framework, which encapsulates theories of behaviour and behaviour change. Results All participants (n = 17) perceived defensive practice as a problem and a contributor to low value care. Behavioural drivers of defensive practice spanned seven domains in the TDF: knowledge, focused on inadequate knowledge of the law and the risks of low value care; skills, emphasising patient communication and clinical decision-making skills; professional role and identity, particularly clinicians’ perception of patient expectations and concern for their professional reputation; beliefs about consequences, especially perceptions of the beneficial and harmful consequences of defensive practice; environmental context and resources, including processes for handling patient complaints; social influences, focused on group norms that encourage or discourage defensive behaviour; and emotions, especially fear of missing a diagnosis. Overall, defensive practice is motivated by physicians’ desire to avoid criticism or scrutiny from a range of sources, and censure from their professional peers can be a more potent driver than perceived legal consequences. Conclusions The findings call for strengthening knowledge and skills, for example, to improve clinicians’ understanding of the law and their awareness of the risks of low value care and using effective communication strategies with patients. Importantly, supportive cultures of practice and organisational environments are needed to create conditions in which clinicians feel confident in avoiding defensive practice and other forms of low value care. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-022-00755-2.
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Affiliation(s)
- Nola M Ries
- Faculty of Law, University of Technology Sydney, PO Box 123, Sydney, NSW, 2007, Australia.
| | - Briony Johnston
- Faculty of Law, University of Technology Sydney, PO Box 123, Sydney, NSW, 2007, Australia
| | - Jesse Jansen
- School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Chui A, Dainty KN, Kirsh B, Dawson DR, Colquhoun H. Hope for “Continued Vitality”: Qualitative Study of Adults With Traumatic Brain Injury and Low Mood on Their Rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:848575. [PMID: 36189039 PMCID: PMC9397807 DOI: 10.3389/fresc.2022.848575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/27/2022] [Indexed: 11/13/2022]
Abstract
Objective Depression is highly comorbid with traumatic brain injury (TBI) with often complex and interacting symptomology that contributes to the experience of disability. Comorbid depression results in poorer TBI rehabilitation and downstream participation outcomes yet perspectives of this group regarding person-centered care is unknown. Purpose This study aimed to explicate the perspectives of persons with TBI and depression on their values, preferences, and desired outcomes for optimal rehabilitation. Methods A qualitative descriptive approach was taken. Thirteen adults [mean age: 40.5 (standard deviation 9.8)] diagnosed with TBI and with self-reported low mood were recruited through convenience sampling. Participants were predominantly female (n = 12) with concussion/mild TBI and at least 6 months post-injury. One-on-one, semi-structured interviews were conducted by phone with Canadian participants (March-May 2020). Interviews were transcribed; data were analyzed thematically by two researchers and the thematic map refined by the research team. Results Three themes were identified on values, preferences, and desired outcomes in person-centered care. Participants valued “validation” from healthcare providers and the health system to feel seen and believed about their conditions and concerns. They preferred for healthcare providers to “share the burden of managing care” through improved interactions and better access to concussion care. Participants expressed that “meaningful outcomes” were to be symptom free, to resume valued life activities, and to be able to adapt/be resilient. The latter indicated hope for “continued vitality” for life participation despite past and ongoing challenges. Conclusions Many adults with TBI and self-identified low mood expressed rehabilitation experiences that were invalidating. Their identified values, preferences, and desired outcomes provide directions for better person-centered care by healthcare providers and health systems to support participation.
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Affiliation(s)
- Adora Chui
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Toronto, ON, Canada
- *Correspondence: Adora Chui
| | - Katie N. Dainty
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- North York General Hospital, Toronto, ON, Canada
| | - Bonnie Kirsh
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Deirdre R. Dawson
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Heather Colquhoun
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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The Impact of COVID-19 on Public/Third-Sector Collaboration in the Italian Context. SUSTAINABILITY 2022. [DOI: 10.3390/su14042228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The extent of the effects produced by the ongoing COVID-19 pandemic on the collaboration between public administrations and the third sector is currently unclear. Undoubtedly, as in any other organizations, social enterprises and non-profit organizations have been severely affected by the spread of COVID-19, especially regarding their relationship with the public sector. Based on an analysis of 563 Italian third sector entities (ETSs) that responded to an online survey launched in March 2020, this study aims to explore the current state and extent of the potential change in the collaboration between organizations belonging to the third sector and the Italian public administration system in response to the COVID-19 emergency. The results have shown that only approximately one-third of the organizations have been asked to jointly contribute with the public sector to contain the negative effects of the pandemic. In other cases, spontaneous support initiatives have been undertaken to manage the crisis. The findings have also revealed that the COVID-19 pandemic has affected the internal operating and functioning mechanisms of the organizations operating in the third sector. The study concludes with a forecast of the potential exacerbation of the difficulties currently faced by the third sector and with the provision of future strategic paths to contain the health, social and economic effects of the pandemic.
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119
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Liddell JL, Lilly JM. Healthcare experiences of uninsured and under-insured American Indian women in the United States. Glob Health Res Policy 2022; 7:5. [PMID: 35148788 PMCID: PMC8832673 DOI: 10.1186/s41256-022-00236-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Extensive health disparities exist for American Indian groups throughout the United States. Although insurance status is linked to important healthcare outcomes, this topic has infrequently been explored for American Indian tribes. For state-recognized tribes, who do not receive healthcare services through the Indian Health Service, this topic has yet to be explored. The purpose of this study is to explore how having limited access to health insurance (being uninsured or under-insured) impact American Indian women's healthcare experiences?. METHODS In partnership with a community advisory board, this study used a qualitative description approach to conduct thirty-one semi-structured life-course interviews with American Indian women who are members of a state-recognized tribe in the Gulf Coast (United States) to explore their Western healthcare experiences. Interview were conducted at community centers, participant homes, and other locations identified by participants. Interviews were transcribed verbatim and findings were analyzed in NVivo using conventional content analysis. Findings were presented at tribal council meetings and to participants for member checking. RESULTS Themes identified by participants included: (a) lack of insurance as a barrier to healthcare; (b) pre-paying for childbirth when uninsured; and (c) access to public health insurance coverage. Twenty-four women mentioned the role or importance of insurance in discussing their healthcare experiences, which was referenced a total of 59 times. CONCLUSION These findings begin to fill an important gap in the literature about the health insurance experiences of American Indian tribal members. Not having insurance was an important concern for participants, particularly for elderly and pregnant tribal members. Not having insurance also kept tribal members from seeking healthcare services, and from getting needed prescriptions. In addition to promoting knowledge about, and expanding insurance options and enrollment, increased sovereignty and resources for state-recognized tribes is needed to address the health disparities experienced by American Indian groups.
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Affiliation(s)
- Jessica L Liddell
- University of Montana School of Social Work, Jeannette Rankin Hall 004, 32 Campus Dr, Missoula, MT, 59812, USA.
| | - Jenn M Lilly
- Fordham University Graduate School of Social Service, New York, NY, USA
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Cothran FA, Paun O, Strayhorn S, Barnes LL. 'Walk a mile in my shoes:' African American caregiver perceptions of caregiving and self-care. ETHNICITY & HEALTH 2022; 27:435-452. [PMID: 32116006 PMCID: PMC9137429 DOI: 10.1080/13557858.2020.1734777] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
African American Alzheimer's disease and related dementia (ADRD) family caregivers are understudied in intervention research with discrepant evidence existing on their mental and physical health outcomes. The stress toll of ADRD caregiving, coupled with the well-documented health disparities for African Americans, place these caregivers at higher risk for morbidity and mortality.Objectives: The purpose of this study was to explore African American ADRD family caregivers' perceptions of caregiving and self-care.Design: Qualitative descriptive study based on individual, one-time, semi-structured interviews from a purposeful sample of current/former African American ADRD community-dwelling family caregivers. Participants agreed to either face-to-face or telephonic interviews between 60 and 90 minutes in length.Results: Twenty-one caregiver interviews were conducted with primarily adult children (mean age = 62.61 (SD = 12.88); 81% completed college; 57% women). Content analysis yielded three major themes: Stressors, Resources, and Coping. The results demonstrate a complex interaction of sociocultural and environmental stressors and perceptions of resources that influence the coping strategies adopted by caregivers to navigate their caregiving experience.Conclusions: These findings suggest a broadened perspective to further inform the development and testing of interventions to address the health outcomes and caregiving needs of African American ADRD caregivers.
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Affiliation(s)
- Fawn A Cothran
- Department of Adult Health and Gerontological Nursing, College of Nursing, Chicago, IL, USA
| | - Olimpia Paun
- Department of Community, Systems and Mental Health Nursing, College of Nursing, Rush University, Chicago, IL, USA
| | - Shaila Strayhorn
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, USA
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush Alzheimer's Disease Center, Chicago, IL, USA
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121
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Sinclair J, Armour S, Akowuah JA, Proudfoot A, Armour M. "Should I Inhale?"-Perceptions, Barriers, and Drivers for Medicinal Cannabis Use amongst Australian Women with Primary Dysmenorrhoea: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031536. [PMID: 35162564 PMCID: PMC8835209 DOI: 10.3390/ijerph19031536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 01/27/2023]
Abstract
Objective: This study sought to investigate the perceptions, barriers, and drivers associated with medicinal cannabis use among Australian women with primary dysmenorrhea. A qualitative study via virtual focus groups involving 26 women experiencing regular, moderate, or greater menstrual pain explored categories including cost, associated stigma, current drug driving laws, community and workplace ethics, and geographical isolation within the context of patient access under current Australian laws and regulations. Results: A qualitative descriptive analysis identified that dissatisfaction with current management strategies such as over-the-counter analgesic usage was the key driver for wanting to use medicinal cannabis. A number of significant barriers to use were identified including patient access to medical prescribers, medical practitioner bias, current drug driving laws, geographic location, and cost. Community and cultural factors such as the history of cannabis as an illicit drug and the resulting stigma, even when prescribed by a medical doctor, still existed and was of concern to our participants. Conclusion: Whilst medicinal cannabis is legal in all states and territories within Australia, several barriers to access exist that require government regulatory attention to assist in increasing patient adoption, including possible subsidisation of cost. The high cost of legal, medicinal cannabis was a key factor in women’s choice to use illicit cannabis. Overall, the concerns raised by our participants are consistent with the broader findings of a recent Australian Senate inquiry report into barriers to patient access to medicinal cannabis in Australia, suggesting many of the issues are systematic rather than disease-specific. Given the interest in use of medicinal cannabis amongst women with primary dysmenorrhea, clinical trials in this area are urgently needed.
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Affiliation(s)
- Justin Sinclair
- NICM Health Research Institute, Western Sydney University, Penrith 2571, Australia; (S.A.); (A.P.)
- Correspondence: (J.S.); (M.A.); Tel.: +61-414679635 (J.S.)
| | - Susanne Armour
- NICM Health Research Institute, Western Sydney University, Penrith 2571, Australia; (S.A.); (A.P.)
| | - Jones Asafo Akowuah
- Agricultural Economics, Agribusiness and Extension, Kwame Nkrumah University of Science and Technology, Kumasi 0233, Ghana;
| | - Andrew Proudfoot
- NICM Health Research Institute, Western Sydney University, Penrith 2571, Australia; (S.A.); (A.P.)
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith 2571, Australia; (S.A.); (A.P.)
- Translational Health Research Institute, Western Sydney University, Penrith 2571, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington 6012, New Zealand
- Correspondence: (J.S.); (M.A.); Tel.: +61-414679635 (J.S.)
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Pedersen M, Harris KJ, Brown B, Grant M, Kleinmeyer C, Glass A, Graham N, King DK. Physical Activity Intervention Adaptation: Recommendations from Rural American Indian Older Adults. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1067-1077. [PMID: 35092521 DOI: 10.1007/s11121-022-01342-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 12/11/2022]
Abstract
Preventive interventions are critical to improving health equity among American Indian (AI) populations, yet interventions that promote physical activity (PA) among AI populations are scarce. This research addresses the research-to-practice gap by informing the adaption and implementation process of evidence-based interventions (EBIs) among rural AI older adults. We used a community-based approach and an Indigenous-focused adaptation theoretical framework. Qualitative, semi-structured interviews elicited detailed information on preferences for PA intervention among rural AI older adults. We applied a collaborative directed content analysis strategy, and established trustworthiness and relevance using an inter-rater reliability process and member checking. We conducted 21 interviews, all participants identified as AI, the mean age was 66 years (SD = 7.6), and 57% were female. Themes characterized contextual and cultural intervention considerations for adapting and implementing evidence-based PA interventions in rural AI older adults. Key findings included an emphasis on social and community interaction, strategies for targeted engagement, preference for group format, pairing PA sessions with shared meals, and inclusiveness in the PA intervention across ability levels and age groups. This study identified opportunities for adaptation of PA-focused EBIs among rural AI older adults. Findings can be applied to support the adaptation and implementation of effective and relevant PA-focused preventive interventions among this population which is at high risk for chronic disease and health disparities.
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Affiliation(s)
- Maja Pedersen
- Stanford Prevention Research Center, Stanford School of Medicine, Stanford University, Stanford, USA.
| | - Kari Jo Harris
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Blakely Brown
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Mattea Grant
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Chelsea Kleinmeyer
- Community Health Division, Confederated Salish and Kootenai Tribal Health Department, Saint Ignatius, Montana, USA
| | - Ashley Glass
- Community Health Division, Confederated Salish and Kootenai Tribal Health Department, Saint Ignatius, Montana, USA
| | - Niki Graham
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Diane K King
- Center for Behavioral Health Research and Services, Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, USA
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Nathania J, Woo BFY, Cher BP, Toh KY, Chia WYA, Lim YW, Vrijhoef HJM, Lim TW. Patient perspectives of the Self-management and Educational Technology tool for Atrial Fibrillation (SETAF): A mixed-methods study in Singapore. PLoS One 2022; 17:e0262033. [PMID: 35061749 PMCID: PMC8782297 DOI: 10.1371/journal.pone.0262033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common arrythmia and is associated with costly morbidity such as stroke and heart failure. Mobile health (mHealth) has potential to help bridge the gaps of traditional healthcare models that may be poorly suited to the sporadic nature of AF. The Self-management and Educational technology support Tool for AF patients (SETAF) was designed based on the preferences and needs of AF patients but more study is required to assess the acceptance of this novel tool. OBJECTIVE Explore the usability and acceptance of SETAF among AF patients in Singapore. METHODS A mixed methods study was conducted with AF patients who were purposively sampled from an outpatient cardiology clinic in Singapore. After 6 weeks of using SETAF, semi-structured interviews were performed, and data were analyzed inductively following a thematic analysis approach. Results from a short 4-item survey and application usage data were also analyzed descriptively. Both qualitative and quantitative results were organized and presented following the Technology Acceptance Model (TAM) framework. RESULTS A total of 37 patients participated in the study and 19 were interviewed. Participants perceived SETAF as useful for improving AF knowledge, self-management and access to healthcare providers and was easy to use due to the guided tutorial and user-friendly interface. They also identified the need for better personalization of content, psychosocial support features and reduction of language barriers. Application usage data revealed preference for AF related content and decreased interaction with the motivational message component of SETAF over time. Overall, most of the participants would continue using SETAF and were willing to pay for it. CONCLUSIONS AF patients in Singapore found SETAF useful and acceptable as a tool for AF management. The insights from this study not only support the potential of mHealth but may also inform the design and implementation of future mHealth tools for AF patients.
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Affiliation(s)
- Jennifer Nathania
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Brigitte Fong Yeong Woo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Boon Piang Cher
- Centre for Health Services and Policy Research, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Kai Yee Toh
- Centre for Health Services and Policy Research, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Wei-Yan Aloysius Chia
- Centre for Health Services and Policy Research, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Yee Wei Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hubertus J. M. Vrijhoef
- Panaxea, Amsterdam, The Netherlands
- Department of Patient and Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Toon Wei Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Hospital, Singapore, Singapore
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Bruce MM, Ulrich CM, Webster J, Richmond TS. Injured black men's perceptions of the recovery environment. Soc Sci Med 2022; 292:114608. [PMID: 34861572 PMCID: PMC8748408 DOI: 10.1016/j.socscimed.2021.114608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/23/2021] [Accepted: 11/24/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Black men are disproportionately impacted by injuries in the United States. This disparity is glaring given that injury is one of the top ten causes of death. Injured Black men from disadvantaged neighborhoods experience higher injury mortality, years of life-expectancy loss, and psychological symptoms that persist after initial wounds have been treated. These injured men are typically transported to a hospital where they are medically stabilized and soon after are returned to the community. Black men are less likely to be discharged to comprehensive rehabilitation facilities, magnifying disparities in recovery from injury. While much research has examined individual characteristics that predict poor recovery from injury, fewer studies have focused on social and physical features of the environment and how they may impact the recovery of injury survivors. PURPOSE The purpose of this study was to describe Black men's perceptions of how characteristics of their environment affect their recovery following serious injury. METHODS This was a secondary analysis of an existing data set consisting of semi-structured, qualitative interviews of 43 injured Black men in a northeastern city. The interviews were conducted three months following discharge from a large urban trauma center, and were audiotaped, transcribed verbatim, and de-identified. Thematic analysis consistent with the qualitative paradigm was used to identify themes. RESULTS Four themes were identified in injured men's narratives: challenges to recovery, feeling unsafe, efforts to increase safety, and resources for recovery. CONCLUSIONS Our findings emphasize the importance of the role of community resources that can support injured men's recovery within their neighborhoods. Additional resources should be directed to survivors who return to disadvantaged communities after injury in order to minimize adverse emotional experiences that detract from recovery.
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Affiliation(s)
- Marta M Bruce
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA; Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Connie M Ulrich
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Department of Medical Ethics and Health Policy, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Jessica Webster
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Therese S Richmond
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Mayr HL, Kelly JT, Macdonald GA, Russell AW, Hickman IJ. Clinician perspectives of barriers and enablers to implementing the Mediterranean dietary pattern in routine care for coronary heart disease and type 2 diabetes: A qualitative interview study. J Acad Nutr Diet 2022; 122:1263-1282. [DOI: 10.1016/j.jand.2022.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 11/25/2022]
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O’Connor D, Lynch H, Boyle B. A qualitative study of child participation in decision-making: Exploring rights-based approaches in pediatric occupational therapy. PLoS One 2021; 16:e0260975. [PMID: 34914778 PMCID: PMC8675724 DOI: 10.1371/journal.pone.0260975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background According to Article 12 of the United Nations Convention on the Rights of the Child, therapists are duty-bound to include children in decisions that impact them. Although occupational therapists champion client-centred, collaborative practice, there remains a paucity of studies detailing children’s rights and experiences of decision-making in pediatric occupational therapy. Purpose This qualitative study described the decision-making experiences of children, parents and therapists in occupational therapy. Methods Semi-structured interviews were conducted with 17 participants (six children, five parents and six occupational therapists), and data analysed using thematic analysis. Findings Three themes emerged: 1) Goal-setting experiences; 2) Adults: child-rights gatekeepers or defenders? and 3) Decision-making in context. Findings suggest that decision-making is mostly adult directed, and children’s voices are subsumed by adult-led services, priorities, and agendas. Implications Children’s rights need to be embedded as an aspect of best practice in providing services that are child-centred in occupational therapy practices and education.
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Affiliation(s)
- Deirdre O’Connor
- Department of Occupational Science and Occupational Therapy, University College Cork, Cork, Ireland
- * E-mail:
| | - Helen Lynch
- Department of Occupational Science and Occupational Therapy, University College Cork, Cork, Ireland
| | - Bryan Boyle
- Department of Occupational Science and Occupational Therapy, University College Cork, Cork, Ireland
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Pool D, Elliott C, Willis C, Thornton A. The Experience of Locomotor Training From the Perspectives of Therapists and Parents of Children With Cerebral Palsy. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:740426. [PMID: 36188854 PMCID: PMC9397752 DOI: 10.3389/fresc.2021.740426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022]
Abstract
Objective: The objective of this study was to explore the experiences of intensive locomotor training from the perspective of therapists and parents of children with cerebral palsy.Design: A qualitative study using semi-structured interviews was employed to capture perspectives following an intensive locomotor training intervention. Data were analyzed thematically, systematically coding and interpreted by grouping information into themes and sub-theme categories.Participants: Five therapists and seven parents of children with high daily physical assistance and equipment needs participated in the study.Setting: A pediatric tertiary hospital.Results: Experiences of locomotor training were described with relation to the suitability of locomotor training with sub-themes of intervention length and time, engagement within sessions, the importance of support, and the utility of locomotor training beyond a research context. Motivation for participating in locomotor training was described in relation to the enjoyment of movement and for increasing activity level. The barriers and facilitators who participated in locomotor training provided environmental and personal factor subthemes. Finally, the outcomes from the intervention were related to improvements in physical health, sleep, affect and emotion, and ambulation in daily activities.Conclusion: The experience of intensive locomotor training from the perspectives of parents of children who have high physical assistance and equipment needs and the therapists providing the intervention was described. Future studies should consider outcome measures beyond motor capacity to quantify the perceived outcomes of interventions that are meaningful to families.
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Affiliation(s)
- Dayna Pool
- School of Allied Health, Curtin University, Perth, WA, Australia
- The Healthy Strides Foundation, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
- *Correspondence: Dayna Pool ; orcid.org/0000-0001-8313-5661
| | - Catherine Elliott
- School of Allied Health, Curtin University, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
- Perth Children's Hospital, Perth, WA, Australia
| | - Claire Willis
- School of of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Ashleigh Thornton
- Perth Children's Hospital, Perth, WA, Australia
- UWA Medical School, The University of Western Australia, Perth, WA, Australia
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Ungpakorn R, Sehmbi K, MacLaine K. Taking advanced clinical practice to the streets: an evaluation of the benefits and challenges in homeless health care. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:1184-1188. [PMID: 34761981 DOI: 10.12968/bjon.2021.30.20.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Homelessness in the UK continues to rise. People who are homeless are more likely to have poor health and die early, and face multiple barriers to accessing health care. Ten years have passed since the Marmot review recommended action on these disparities. In the context of significant health inequalities, advanced clinical practitioners (ACPs) offer a different approach to homeless health care, providing complete episodes of care in complex situations and leading in integrating multiple agencies, service development and strategic advocacy. ACPs can use their expertise in this specialty to deliver education that raises awareness and reduces prejudice. Their research skills can identify gaps and expand the evidence base to improve practice at local and national levels. However, ACPs must promote their own roles, work closely with people with lived experience and be supported by their employers to embrace all four pillars of advanced clinical practice for the full benefits to be realised.
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Affiliation(s)
- Rosa Ungpakorn
- Homeless Health Nurse Practitioner, Central London Community Healthcare NHS Trust, London
| | - Kirit Sehmbi
- Homeless Health Nurse Practitioner, Guy's & St Thomas' NHS Foundation Trust, London
| | - Katrina MacLaine
- Associate Professor Advanced Practice, Institute of Health & Social Care, London South Bank University
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129
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Cui N, Qiu R, Zhang Y, Chen D, Zhang H, Rao H, Jin J. Why are physical restraints still in use? A qualitative descriptive study from Chinese critical care clinicians' perspectives. BMJ Open 2021; 11:e055073. [PMID: 34732505 PMCID: PMC8572407 DOI: 10.1136/bmjopen-2021-055073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To understand why critical care clinicians still implement physical restraints, to prevent unplanned extubation and to explore the driving factors influencing the decision-making of physical restraints use. DESIGN A qualitative descriptive design was used. The data were collected through one-to-one, semistructured interviews and analysed through the framework of thematic analysis. PARTICIPANTS AND SETTING The study was conducted from December 2019 to May 2020 at one general intensive care unit (ICU) and one emergency ICU in a general tertiary hospital with 3200 beds in Hangzhou, China. The sampling strategy was combined maximum variation sampling and criterion sampling. RESULTS A total of 14 clinicians participated in the study. The reason why critical care clinicians implemented physical restraints to prevent unplanned extubation was that the tense healthcare climate was caused by family members' rejection of mismatched expectations. As unplanned extubation was highly likely to create medical disputes, hospitals placed excessive emphasis on unplanned extubation, which resulted in a lack of analysis of the cause of unplanned extubation and strict measures for dealing with unplanned extubation. The shortage of nursing human resources, unsuitable ward environments, intensivists' attitudes, timely extubation for intensivists, nurse experiences and the patient's possibility of unplanned extubation all contributed to the decision-making resulting in the use of physical restraints. CONCLUSIONS Although nurses played a crucial role in the decision-making process of using physical restraints, changing the healthcare climate and the hospital management mode for unplanned extubation are fundamental measures to reduce physical restraints use.
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Affiliation(s)
- Nianqi Cui
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Hangzhou, Zhejiang, China
| | - Ruolin Qiu
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuping Zhang
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Hangzhou, Zhejiang, China
| | - Dandan Chen
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hui Zhang
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hongyu Rao
- Faculty of Nursing, Yunnan University of Business Management, Kunming, Yunnan, China
| | - Jingfen Jin
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Hangzhou, Zhejiang, China
- Changxing Branch Hospital, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Huzhou, Zhejiang, China
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Jun J, Rosemberg MAS. I Am a Nurse, Not a Martyr: Qualitative Investigation of Nurses' Experiences During Onset of the Coronavirus Pandemic. Policy Polit Nurs Pract 2021; 23:48-55. [PMID: 34704859 DOI: 10.1177/15271544211054435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nurses have always played an essential role during epidemics, risking their lives caring for sick and dying patients. However, the unprecedented nature of the novel coronavirus disease 2019 (COVID-19) has left organizations and healthcare professionals ill-prepared and under-equipped to manage the severity, manifestations, and acute and long-term implications. While COVID-19 has presented profound physical and mental health implications for nurses, we know little about nurses' professional experiences within their organizational context. Thus, this qualitative descriptive study fills that gap through in-depth exploration of nurses' shared professional experiences working in hospitals during the first surge of COVID-19 in the United States. Twenty-two nurses were interviewed via telephone during April and May 2020. Through thematic analysis four main themes emerged: (1) fear, (2) collective resilience through shared trauma, (3) uncharted territory, and (4) perceived disposability. Nurses felt ill-praepared for the rapid changes wrought by COVID-19; yet they also felt proud with a renewed sense of meaning in their work. While unit colleagues were a great source of strength, nurses still reported disappointment, even feeling abandoned by their organizations. Our study indicates that nurses relied on one another to cope and find meaning. These findings are invaluable for policy development and the establishment of preventive and early intervention strategies. Done right, such efforts could better support nurses by encouraging team building, protection, and rewards to maintain nurses' wellbeing during such outbreaks and in their aftermath. Organizations also ought to make nurses' health and wellbeing a priority by streamlining communication, transparency, and leadership visibility.
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Affiliation(s)
- Jin Jun
- Center for Healthy Aging, Self-Management and Complex Care, 2647The Ohio State University, College of Nursing, Columbus, OH, USA
| | - Marie-Anne S Rosemberg
- Department of Systems, Populations and Leadership, 1259University of Michigan, School of Nursing, Ann Arbor, MI, USA
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131
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Garpenhag L, Dahlman D. Perceived healthcare stigma among patients in opioid substitution treatment: a qualitative study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:81. [PMID: 34702338 PMCID: PMC8549326 DOI: 10.1186/s13011-021-00417-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 12/02/2022]
Abstract
Background People with substance use disorders (SUD) including patients in opioid substitution treatment (OST) are subject to stigma, and have generally poor health and barriers towards seeking healthcare. Experience of stigma might negatively affect healthcare seeking, but this topic is sparsely investigated. The aim of this study was to explore OST patients’ past and present experiences of substance use stigma in healthcare settings, in order to provide insight into the challenges that people with opioid use disorder may face when using health services, and the strategies they use to cope with them. Methods Six focus groups with 23 OST patients were moderated by OST staff, and conducted with a questioning route focusing on health literacy. Experiences associated with stigma and its consequences that were spontaneously brought up by participants were assessed in a secondary analysis using a thematic approach. Results Experiences of stigma from a wide range of healthcare settings were reported. Medical records and patients’ oral information regarding substance use, OST medication or hepatitis C infection were identified as circumstances bringing unwanted attention to the SUD. Participants reported various forms of poor treatment, believed to reflect views of people with SUD as morally culpable, intimidating, curious, untrustworthy and less valuable than other patients, sometimes with tangible effects on the quality of healthcare. Stigma in healthcare settings affected healthcare seeking behaviors, and could result in patients concealing their OST status or substance use history. Conclusion This study highlights several aspects of perceived healthcare stigma that can shed light on difficulties that OST patients might experience when navigating the healthcare system. The results implicate a need to investigate attitudes towards OST patients, and the aptitude to deal with patients with SUD, among healthcare professionals, as well as a need for interventions addressing knowledge deficits and issues tied to values and patient reception among healthcare staff. Supplementary Information The online version contains supplementary material available at 10.1186/s13011-021-00417-3.
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Affiliation(s)
- Lars Garpenhag
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University/Region Skåne, Sweden, Box, 503 22, Malmö, Sweden
| | - Disa Dahlman
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University/Region Skåne, Sweden, Box, 503 22, Malmö, Sweden. .,Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.
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132
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Ismail S, Ridlo M, Rochana N. A Qualitative Description of Nurses’ Psychological Responses in Caring for COVID-19 Patients: An Indonesian Context. Open Nurs J 2021. [DOI: 10.2174/1874434602115010136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
COVID-19 is a dangerous, infectious disease that has affected the whole world in the past year. In Indonesia, many nurses were not only infected by the virus but also experienced varying psychological responses in providing treatment and performing their tasks. In other words, they faced the daunting responsibility of fighting the disease while taking care of COVID-19 patients.
Objective:
The study aimed to describe nurses’ psychological responses in caring for COVID-19 patients in Indonesia.
Methods:
This was a qualitative descriptive study involving 13 nurses. Using purposive sampling, the participants were selected from three public hospitals in Semarang, Indonesia. These nurses were assigned to take care of COVID-19 patients in the isolation room. The participants underwent face-to-face interviews, either by video calls or through an online application, using semi-structured and in-depth guidelines. The collected data were analyzed using Ello and Kyngas inductive content analysis.
Results:
During the pandemic, the nurses had the following psychological responses in caring for COVID-19 patients in Indonesia: 1) being constantly stressed in carrying out their duties; 2) having no choice but happy to help patients recover at the same time, and 3) getting closer to God as a form of spiritual relief.
Conclusion:
This study provides fundamental data related to further psychological interventions for nurses who experience psychological problems during the COVID-19 pandemic.
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Haldane V, Zhang Z, Ma Q, Yin T, Zhang B, Li Y, Pan Q, Dainty KN, Rea E, Pasang P, Wei X, Hu J. A qualitative study of perspectives on access to tuberculosis health services in Xigaze, China. Infect Dis Poverty 2021; 10:120. [PMID: 34544492 PMCID: PMC8451167 DOI: 10.1186/s40249-021-00906-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background Tuberculosis (TB) is a major global health threat and the leading infectious disease cause of death worldwide. Access to and retention in TB care remains a challenge for patients, particularly those living in rural and remote settings. This qualitative study explored barriers and facilitators to accessing and maintaining contact with TB care services in communities in Xigaze (Shigatse) prefecture, Xizang Autonomous Region (Tibet Autonomous Region), China from the perspective of persons impacted by TB. Methods We conduced in-depth interviews with 23 participants impacted by TB in four rural districts in Xigaze prefecture, Xizang Autonomous Region, China between April 2019 and November 2020. Interviews were conducted in Tibetan and Mandarin, transcribed in Mandarin and translated into English. Transcripts were checked against recordings by native Tibetan and Mandarin speakers. QSR NVivo12 software was used for framework analysis guided by an access to care conceptual framework by Levesque et al. Results Overall patients reported low awareness of and an indifferent attitude towards TB, although all reported understanding the need to adhere to treatment. Participants reported complex pathways to care, often requiring visits to multiple healthcare facilities. Some participants reported visiting traditional Tibetan medicine (TTM) providers. Participants reported various barriers to accessing care including challenges physically reaching care, out-of-pocket payments for tests, diagnostics and transport. Barriers to maintaining care included medication side effects and worry about treatment effectiveness. Enablers to accessing care identified included knowledge or past experience with TB, integrated models of TTM and western care, supportive village doctors who conducted home visits, free TB treatment and other subsidies, as well as having family support with care and social support as barriers and facilitators to maintaining treatment. Conclusions We identified barriers and facilitators to accessing services in rural communities in Xigaze from the perspective of persons impacted by TB. Challenges include complex pathways to care, travel distances, wait times and low awareness. Tuberculosis care in the region could be strengthened by ongoing culturally tailored educational campaigns to increase awareness, partnerships with TTM providers, providing comprehensive treatment subsidies and strengthening the role of family members in comprehensive TB care. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00906-4.
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Affiliation(s)
- Victoria Haldane
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St., Toronto, ON, M5T 3M6, Canada
| | - Zhitong Zhang
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, M5T 3M7, Canada
| | - Qi Ma
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St., Toronto, ON, M5T 3M6, Canada
| | - Tingting Yin
- Weifang Medical College, Weifang, Shandong, China
| | - Bei Zhang
- Weifang Medical College, Weifang, Shandong, China
| | - Yinlong Li
- Jining Medical University, Jining, Shandong, China
| | - Qiuyu Pan
- North Sichuan Medical College, Nanchong, Sichuan, China
| | - Katie N Dainty
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St., Toronto, ON, M5T 3M6, Canada
| | - Elizabeth Rea
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, M5T 3M7, Canada
| | - Pande Pasang
- Xigaze Centre for Disease Control and Prevention, 7 Keji Road, Sangzhuzi District, Xigaze, Xizang, China
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, M5T 3M7, Canada.
| | - Jun Hu
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China.
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Ann Cutler N, Halcomb E, Sim J. Using naturalistic inquiry to inform qualitative description. Nurse Res 2021; 29:29-33. [PMID: 33855820 DOI: 10.7748/nr.2021.e1788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Choosing how to answer a research question requires an understanding of philosophical and theoretical assumptions and how these inform a study's methodology and methods. This can be a challenge for all researchers, but for novice researchers, such as doctoral candidates, this can feel like an overwhelming task. Ensuring there is clear alignment between philosophy, theory, methodology and methods is an essential part of the research process, that enables research to be undertaken with clarity and integrity. This alignment must be a good fit for the research aim, and to ensure the researcher's intrinsic values and beliefs do not affect the analysis undertaken. AIM To describe the alignment between qualitative description and naturalistic inquiry and how it was applied to a doctoral candidate's exploration of the meaning of safety for people with experience of admission to an acute mental health unit. DISCUSSION Understanding the alignment between qualitative descriptive methodology and naturalistic inquiry provided a clear pathway for the doctoral candidate. CONCLUSION The assumptions that underpin a methodological approach need to be unpacked to understand how to answer a research question effectively. IMPLICATIONS FOR PRACTICE Qualitative description, informed by naturalistic inquiry, offers a practical way to explore and answer research questions.
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Affiliation(s)
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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Cui N, Qiu R, Zhang Y, Jin J. "Patient Comfort Can Be Sacrificed for Patient Safety"-Perception and Practice Reported by Critical Care Nurses Toward Physical Restraints: A Qualitative Descriptive Study. Front Med (Lausanne) 2021; 8:573601. [PMID: 34368171 PMCID: PMC8342939 DOI: 10.3389/fmed.2021.573601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 06/25/2021] [Indexed: 12/30/2022] Open
Abstract
Aim: The aim of the study was to explore the perception and practice of physical restraints used by critical care nurses. Design: A qualitative descriptive design was used. Method: From December 2019 to May 2020, a one-to-one, semi-structured in-depth interview with 10 critical care nurses from two intensive care units in a tertiary general hospital with 3,200 beds in China was conducted using the method of purposeful sampling. The data were analyzed using inductive thematic analysis. Findings: The perception of physical restraints among critical care nurses was that patient comfort can be sacrificed for patient safety. Physical restraints protected patient safety by preventing patients from unplanned extubation but influenced patient comfort. Physical restraints were common practice of critical care nurses. Relative physical restraints provided patients with more freedom of movement and rationalization of physical restraints which were the practical strategies. Conclusion: The study identified problems in critical care nurses' perception and practice on physical restraints. Critical care nurses are confident that physical restraints can protect patient safety, and the influence of physical restraints on patient comfort is just like the side effect. Although physical restraints were common practice, critical care nurses still faced dilemmas in the implementation of physical restraints. Relative physical restraints and rationalization of physical restraints help critical care nurses cope with the “bad feelings,” which may also be the cause of unplanned extubation. It is necessary for the adaptation of clinical practice guidelines about physical restraints for critically ill patients in the Chinese context, to change the perception and practice of critical care nurses and deliver safe and high-quality patient care.
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Affiliation(s)
- Nianqi Cui
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China
| | - Ruolin Qiu
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuping Zhang
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China
| | - Jingfen Jin
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China.,Changxing Branch Hospital of SAHZU, Huzhou, China
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Montesanti S, Fitzpatrick K, Azimi T, McGee T, Fayant B, Albert L. Exploring Indigenous Ways of Coping After a Wildfire Disaster in Northern Alberta, Canada. QUALITATIVE HEALTH RESEARCH 2021; 31:1472-1485. [PMID: 33971774 PMCID: PMC8278559 DOI: 10.1177/10497323211009194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In May 2016, a wildfire devastated a northern region of Alberta, Canada, resulting in negative consequences on physical and mental stress, social relationships, and overall resilience among Indigenous residents. Research on coping and managing stress following a disaster has failed to incorporate unique characteristics from Indigenous perspectives. Sharing circles were held in urban and rural community settings to capture: (a) Indigenous perspectives of coping, (b) individual and collective strengths that helped Indigenous residents and communities to cope during and after the wildfire, and (c) intergenerational experiences of coping from stress among Indigenous residents. Indigenous residents' experience with coping from the wildfire was shaped by: (a) heightened physical and emotional stress, (b) existing structural inequities, and (c) strong community cohesion and connection to culture. An unexpected outcome of this research was the therapeutic value of the sharing circles for participants to share their experience.
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Affiliation(s)
| | - Kayla Fitzpatrick
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Tara Azimi
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Tara McGee
- Department of Earth and Atmospheric Sciences, Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - Bryan Fayant
- McMurray Métis Local 1935, Fort McMurray, Alberta, Canada
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Marrocco AM, El-Masri MM. Exploring the Application of Interpretive Description in Chronic Illness: A Scoping Review. Res Theory Nurs Pract 2021; 35:RTNP-D-20-00022. [PMID: 34162757 DOI: 10.1891/rtnp-d-20-00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Chronic illness is a complex condition that affects over one billion people. To develop a deeper insight of the needs of this patient population, interpretive description uses disciplinary knowledge as the source of understanding. This methodology is a pragmatic approach to research without focusing on a strict methodological directive. The aims of this scoping review are twofold, (a) to describe the findings of studies that have used Thorne's interpretive description to research chronic illness and (b) to discuss the application of interpretive description in clinical research. Thereby, showing interpretive description as a valuable tool to advance nursing knowledge and patient care. METHODS The methodological framework for this review was based on the Johanna Briggs Institute guidelines for scoping reviews. RESULTS To develop an understanding of interpretive description, it is essential to examine the results of studies which have applied the methodology. Our scoping review showed that researchers utilizing interpretive description identified four common challenges experienced by individuals living with chronic illness: symptom management, education and knowledge, supportive care, and cultural disadvantages. By demonstrating how interpretive description is applied, it shows how it can be used to understand and interpret clinical phenomena to improve practice. IMPLICATION FOR PRACTICE This scoping review demonstrates how interpretive description was used to develop knowledge about chronic illness. The premise of interpretive description is that disciplinary knowledge offers a sufficient foundation to develop meaningful research to support health practices. By approaching research from a disciplinary perspective, new knowledge can be discovered to complex health problems.
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Affiliation(s)
- Anna M Marrocco
- Cardiovascular Intensive Care, Henry Ford Health System, Detroit, MI
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Klinedinst TC, Swink LA, Atler KE, Chard CA, Malcolm MP. The experience of type 2 diabetes: Application of the Model of Human Occupation. Br J Occup Ther 2021. [DOI: 10.1177/03080226211026545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction Integrating type 2 diabetes (T2DM) self-care behaviors into daily life is complex and poorly understood. Occupational therapists, as experts in life context, habits, roles, and routines, can foster new ways of understanding and promoting daily engagement in T2DM self-care. The Model of Human Occupation (MOHO), a conceptual practice model, may have applicability to better understanding the experience of living with T2DM and engaging in necessary self-care behaviors. Methods We conducted focus group interviews with individuals with T2DM ( n = 10). We applied the MOHO to understand the experience of living with T2DM and engaging in related self-care behaviors. Findings Participants discussed each element of MOHO and how it related to living with and managing type 2 diabetes. Participants identified obtaining skills for self-advocacy with family, individualized/adapted exercise, stable health-promoting environments and routines, and problem-solving skills for disruptions to routine as critical needs for managing T2DM. These intervention strategies are well-aligned with MOHO and occupational therapy practice. Conclusion We found that MOHO was a useful tool for exploring the experience and daily management of T2DM.
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Affiliation(s)
- Tara C Klinedinst
- Health Policy Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Laura A Swink
- Veterans Administration Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain VA Medical Center, Aurora, Colorado, USA
| | - Karen E Atler
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
| | - Christine A Chard
- Colorado School of Public Health, Fort Collins, Colorado, USA
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Matt P Malcolm
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
- Colorado School of Public Health, Fort Collins, Colorado, USA
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Scholtz S. The balancing act: A qualitative study on remote work and childcare during the COVID-19 lockdown in South Africa. F1000Res 2021. [DOI: 10.12688/f1000research.53579.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted many employees' world by forcing some to remote work whilst also caring for children. Methods: This study explored the remote working experiences of child caregivers in balancing work and childcare during the South African COVID-19 lockdown period (from 26 March 2020 to 31 December 2020). A qualitative descriptive design was employed to collect data through an online qualitative questionnaire with semi-structured questions. A final sample of 22 participants was included using purposive and snowball sampling. Results: Findings indicate that employees experienced difficulty balancing work and childcare, which prompted them to use personal and organisational resources to restore work-life balance. These resources included people, spaces and time. Conclusions: This study provides insight for employers and healthcare workers into how remote workers balanced work and childcare and can promote conversations or interventions on improving employee remote work experiences - especially in the unique South African context.
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Foust Winton RE, Draucker CB, Von Ah D. Pain Management Experiences Among Hospitalized Postcraniotomy Brain Tumor Patients. Cancer Nurs 2021; 44:E170-E180. [PMID: 32657900 PMCID: PMC7794082 DOI: 10.1097/ncc.0000000000000851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Brain tumors account for the majority of central nervous system tumors, and most are removed by craniotomies. Many postcraniotomy patients experience moderate or severe pain after surgery, but patient perspectives on their experiences with pain management in the hospital have not been well described. OBJECTIVE The aim of this study was to describe how patients who have undergone a craniotomy for brain tumor removal experience pain management while hospitalized. METHODS Qualitative descriptive methods using semistructured interviews were conducted with patients on a neurological step-down unit in an urban teaching hospital in the Midwest United States. Interviews focused on how patients experienced postcraniotomy pain and how it was managed. Narratives were analyzed with standard content analytic procedures. RESULTS Twenty-seven participants (median age, 58.5 years; interquartile range, 26-41 years; range, 21-83 years) were interviewed. The majority were white (n = 25) and female (n = 15) and had an anterior craniotomy (n = 25) with sedation (n = 17). Their pain experiences varied on 2 dimensions: salience of pain during recovery and complexity of pain management. Based on these dimensions, 3 distinct types of pain management experiences were identified: (1) pain-as-nonsalient, routine pain management experience; (2) pain-as-salient, routine pain management experience; and (3) pain-as-salient, complex pain management experience. CONCLUSIONS Many postcraniotomy patients experience their pain as tolerable and/or pain management as satisfying and effective; others experience pain and pain management as challenging. IMPLICATIONS FOR PRACTICE Clinicians should be attuned to needs of patients with complex pain management experiences and should incorporate good patient/clinician communication.
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Affiliation(s)
- Rebecca E Foust Winton
- Author Affiliation: Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis
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A qualitative study to identify factors that influence patients' decisions to call Emergency Medical Services for syncope. CAN J EMERG MED 2021; 23:195-205. [PMID: 33709359 DOI: 10.1007/s43678-020-00045-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/14/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Protocols that support paramedics to assess, treat and refer low-risk syncope (fainting) may allow for ED transport of only high-risk patients. The development and uptake of such protocols is limited by a dearth of information about factors patients consider when deciding to seek EMS care following syncope. OBJECTIVE We explored decision-making processes of individuals with syncope regarding whether (or not) to call EMS after fainting as a starting point in the development of prehospital risk-stratification protocols for syncope. METHODS Twenty-five Canadian adults (aged 18-65 years) with a history of ≥ 1 syncopal episode were recruited. Individual semi-structured interviews were conducted, recorded, and transcribed. Straussian grounded theory methods were used to identify common themes and a core (overarching) category. RESULTS Four themes were identified: (a) previous experiences with the healthcare system (e.g., feeling dismissed), (b) individual patient factors (e.g., age, medical history), (c) attitudes and beliefs (e.g., burdening the health care system, syncope is "not serious"), and (d) contextual factors (e.g., influence of important others, symptom severity). Perceived judgement, including judgement from EMS and negative self-evaluations, was identified as the core category that influenced patients' decisions to seek care. CONCLUSION We theorize that, while patients consider many factors in deciding to contact EMS for syncope, previous experiences of feeling judged and unfavorable beliefs about syncope may interfere with patients' receptiveness to traditional EMS protocols for syncope. The findings highlight potential patient needs that program developers may wish to consider in the development of prehospital protocols to improve care and satisfaction among patients with syncope.
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Smith BG, Whiffin CJ, Esene IN, Karekezi C, Bashford T, Mukhtar Khan M, Fontoura Solla DJ, Indira Devi B, Hutchinson PJ, Kolias AG, Figaji A, Rubiano AM. Neurotrauma clinicians' perspectives on the contextual challenges associated with long-term follow-up following traumatic brain injury in low-income and middle-income countries: a qualitative study protocol. BMJ Open 2021; 11:e041442. [PMID: 33664068 PMCID: PMC7934765 DOI: 10.1136/bmjopen-2020-041442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) is a global public health concern; however, low/middle-income countries (LMICs) face the greatest burden. The WHO recognises the significant differences between patient outcomes following injuries in high-income countries versus those in LMICs. Outcome data are not reliably recorded in LMICs and despite improved injury surveillance data, data on disability and long-term functional outcomes remain poorly recorded. Therefore, the full picture of outcome post-TBI in LMICs is largely unknown. METHODS AND ANALYSIS This is a cross-sectional pragmatic qualitative study using individual semistructured interviews with clinicians who have experience of neurotrauma in LMICs. The aim of this study is to understand the contextual challenges associated with long-term follow-up of patients following TBI in LMICs. For the purpose of the study, we define 'long-term' as any data collected following discharge from hospital. We aim to conduct individual semistructured interviews with 24-48 neurosurgeons, beginning February 2020. Interviews will be recorded and transcribed verbatim. A reflexive thematic analysis will be conducted supported by NVivo software. ETHICS AND DISSEMINATION The University of Cambridge Psychology Research Ethics Committee approved this study in February 2020. Ethical issues within this study include consent, confidentiality and anonymity, and data protection. Participants will provide informed consent and their contributions will be kept confidential. Participants will be free to withdraw at any time without penalty; however, their interview data can only be withdrawn up to 1 week after data collection. Findings generated from the study will be shared with relevant stakeholders such as the World Federation of Neurosurgical Societies and disseminated in conference presentations and journal publications.
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Affiliation(s)
- Brandon George Smith
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Charlotte Jane Whiffin
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- College of Health of Social Care, University of Derby, Derby, UK
| | - Ignatius N Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Northwest Region, Cameroon
| | - Claire Karekezi
- Department of Neurosurgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Tom Bashford
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Muhammad Mukhtar Khan
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Department of Neurosurgery, Northwest General Hospital and Research Center, Peshawar, Pakistan
| | - Davi Jorge Fontoura Solla
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Department of Neurosciences and Behaviour Sciences, University of São Paulo, Ribeirao Preto, Brazil
| | - Bhagavatula Indira Devi
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Peter John Hutchinson
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Angelos G Kolias
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Anthony Figaji
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Division of Neurosurgery, University of Cape Town, Rondebosch, South Africa
| | - Andres M Rubiano
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Neurosciences Institute, Department of Neurosurgery, El Bosque University, Bogota, Colombia
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Fawole OA, Reed MV, Harris JG, Hersh A, Rodriguez M, Onel K, Lawson E, Rubinstein T, Ardalan K, Morgan E, Paul A, Barlin J, Daly RP, Dave M, Malloy S, Hume S, Schrandt S, Marrow L, Chapson A, Napoli D, Napoli M, Moyer M, Delgaizo V, Danguecan A, von Scheven E, Knight A. Engaging patients and parents to improve mental health intervention for youth with rheumatological disease. Pediatr Rheumatol Online J 2021; 19:19. [PMID: 33622346 PMCID: PMC7901209 DOI: 10.1186/s12969-021-00503-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health disorders are common in youth with rheumatological disease yet optimal intervention strategies are understudied in this population. We examined patient and parent perspectives on mental health intervention for youth with rheumatological disease. METHODS We conducted a mixed methods cross-sectional study, via anonymous online survey, developed by researchers together with patient/parent partners, to quantitatively and qualitatively examine youth experiences with mental health services and resources in North America. Patients ages 14-24 years with juvenile idiopathic arthritis, juvenile dermatomyositis, or systemic lupus erythematous, and parents of patients ages 8-24 with these diseases were eligible (not required to participate in pairs). Participants self-reported mental health problems (categorized into clinician-diagnosed disorders vs self-diagnosed symptoms) and treatments (e.g. therapy, medications) received for the youth. Multivariate linear regression models compared patient and parent mean Likert ratings for level of: i) comfort with mental health providers, and ii) barriers to seeking mental health services, adjusting for potential confounders (patient age, gender, disease duration, and patient/parent visual analog score for disease-related health). Participants indicated usefulness of mental health resources; text responses describing these experiences were analyzed by qualitative description. RESULTS Participants included 123 patients and 324 parents. Patients reported clinician-diagnosed anxiety (39%) and depression (35%); another 27 and 18% endorsed self-diagnosed symptoms of these disorders, respectively. 80% of patients with clinician-diagnosed disorders reported receiving treatment, while 11% of those with self-diagnosed symptoms reported any treatment. Patients were less comfortable than parents with all mental health providers. The top two barriers to treatment for patients and parents were concerns about mental health providers not understanding the rheumatological disease, and inadequate insurance coverage. Over 60% had used patient mental health resources, and over 60% of these participants found them to be helpful, although text responses identified a desire for resources tailored to patients with rheumatological disease. CONCLUSION Self-reported mental health problems are prevalent for youth in this sample with rheumatological disease, and obstacles to mental health treatment include disease-related and logistic factors. Strategies are needed to improve acceptance and accessibility of mental health intervention, including routine mental health screening and availability of disease-specific mental health resources.
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Affiliation(s)
- Oluwatunmise A Fawole
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
- New York University Grossman School of Medicine, New York, NY, USA
| | | | - Julia G Harris
- University of Missouri-Kansas City, Children's Mercy Kansas City, Kansas City, MO, USA
| | | | - Martha Rodriguez
- Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
| | - Karen Onel
- Hospital for Special Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Erica Lawson
- University of California San Francisco, San Francisco, CA, USA
| | - Tamar Rubinstein
- Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Kaveh Ardalan
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Duke University Medical Center, Durham, NC, USA
| | - Esi Morgan
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Anne Paul
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Judy Barlin
- Lupus Foundation of America, Washington, D.C, USA
| | - R Paola Daly
- Lupus Foundation of America, Washington, D.C, USA
| | | | | | | | | | | | - Angela Chapson
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Donna Napoli
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael Napoli
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Miranda Moyer
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Vincent Delgaizo
- Patient-Centered Outcomes Research Institute, Washington, D.C, USA
- The Childhood Arthritis and Rheumatology Research Alliance, Milwaukee, WI, USA
| | - Ashley Danguecan
- Division of Rheumatology, Hospital for Sick Children, Toronto, ON, M5G1X8, Canada
| | | | - Andrea Knight
- Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- University of Pennsylvania, Philadelphia, PA, USA.
- Division of Rheumatology, Hospital for Sick Children, Toronto, ON, M5G1X8, Canada.
- University of Toronto Faculty of Medicine, Toronto, ON, Canada.
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Integrating Technology Into Clinical Practice for the Assessment of Balance and Mobility: Perspectives of Exercise Professionals Practicing in Retirement and Long-term Care. Arch Rehabil Res Clin Transl 2021; 2:100041. [PMID: 33543070 PMCID: PMC7853342 DOI: 10.1016/j.arrct.2020.100041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To explore exercise professionals’ perspectives on technology integration for balance and mobility assessment practices in retirement and long-term care. Setting A private residential care organization in Ontario, Canada, with 18 sites providing accommodation and services for older adults. Design A qualitative descriptive approach was used including semistructured focus group interviews. Open-ended questions explored perceptions of technology integration along with factors influencing its adoption. Analysis involved preliminary coding based on research questions, review and discussion of emerging themes, and final, resultant coding for each category. Participants Exercise professionals (kinesiologists and exercise therapists) (N=18). Interventions Not applicable. Main Outcome Measures Not applicable. Results All participants felt that technology could enhance their practice by supporting programming, communication, and/or information management. Potential barriers to technology integration related primarily to the need to accommodate the broad range of complex health conditions present among clients, which would impact (1) their ability to engage with the technology and (2) relevance of technology-derived outcomes. Specific concerns related to individuals with significant cognitive and/or functional impairment. Solutions to these barriers emphasized the need for flexible technology and appropriate normative data to maximize the potential for uptake. Conclusions The participating exercise professionals working in a retirement and long-term care setting saw technology as a potentially effective addition to current clinical practice. To increase the likelihood for clinical uptake, technology must be maximize flexibility in order to accommodate a wide range of physical and cognitive abilities and meet specific needs related to setting and job responsibilities. The findings emphasize the need for continuous dialogue between technology producers and end users for successful development and implementation.
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Jefferson UT, Bloom TL, Lewis KR. Infant Feeding Exposure and Personal Experiences of African American Mothers. Breastfeed Med 2021; 16:124-130. [PMID: 32865430 DOI: 10.1089/bfm.2020.0073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Although exposure and personal experiences can guide breastfeeding decisions, the extant research on African American mothers is limited regarding the influence of infant feeding exposure. The persistent race-based breastfeeding disparities also underscore the lack of effective interventions to support breastfeeding among African Americans. Objective: To describe infant feeding exposure and personal experiences of African American mothers in the Midwestern United States with regard to decision making about breastfeeding behavior. Materials and Methods: Thirty individual qualitative interviews using a semistructured interview guide were conducted with African American mothers ≥18 years old with an infant 1-6 months of age. Interviews addressed participants' breastfeeding and formula feeding decisions. Data were coded line by line using thematic analysis. Results: Positive exposure to breastfeeding and health care providers' prenatal advice influenced nearly all participants to try breastfeeding. However, breastfeeding experiences were unexpected, they did not know how to handle challenges, and nearly half did not continue. Five central themes important to their decision-making processes were identified in the data including contact with breastfeeding mothers, guidance from health care providers, navigating the demands of breastfeeding, making the switch to formula, and my own research. Conclusion: Our findings support the importance of both prenatal and postnatal education, the influence of health care providers, and the impact of close social role models. Appropriate education about realistic breastfeeding information is needed to support African American mothers in their breastfeeding decision making. The high use of the Internet to access information also emphasizes the potential opportunity for breastfeeding interventions delivered through technology.
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Affiliation(s)
- Urmeka T Jefferson
- Department of Women, Children, and Family Nursing, Rush University, College of Nursing, Chicago, Illinois, USA
| | - Tina L Bloom
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
| | - Kaleea R Lewis
- School of Health Professions, University of Missouri, Columbia, Missouri, USA
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Burnette CE, Liddell J, Roh S, Lee YS, Lee HY. American Indian women cancer survivors' perceptions and experiences with conventional and non-conventional mental health care for depressive symptoms. ETHNICITY & HEALTH 2021; 26:186-205. [PMID: 29962228 PMCID: PMC6314900 DOI: 10.1080/13557858.2018.1493439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/06/2018] [Indexed: 05/12/2023]
Abstract
Background: Despite cancer and depression being disproportionately high for American Indian and Alaska Native (AI/AN) women, such cancer survivors' help-seeking practices and perceptions related to depression are absent in extant research. A broader context of historical oppression has set the stage for unequal health outcomes and access to quality services. The purpose of this article was to explore AI women cancer survivors' experiences with conventional mental health services and informal and tribally-based assistance, as well as barriers related to mental health service utilization.Methods: A qualitative descriptive study methodology, with qualitative content analysis, was used to examine the experiences of AI women cancer survivors as they related to help-seeking experiences for depressive symptoms. The sample included 43 AI women cancer survivors (n = 14 breast cancer, n = 14 cervical cancer, and n = 15 colon and other types of cancer survivors).Results: Since receiving a cancer diagnosis, 26 (62%) participants indicated they had feelings of depression. Some participants (n = 13) described mixed perceptions of the mental health service system. Generally, participants viewed families and informal support systems as primary forms of assistance, whereas conventional services were reported as a supplementary or 'as needed' forms of support, particularly when the informal support system was lacking. Participants received help in the forms of psychotropic medications and psychotherapy, as well as help from family and AI-specific healing modalities (e.g. sweat lodges and healing ceremonies). Stigma and confidentiality concerns were primary barriers to utilizing conventional services as described by 12 (29%) participants.Discussion: Participants' help primarily came from family and tribally-based entities, with conventional mental health care being more salient when informal supports were lacking. The mixed perceptions espoused by participants may be related to a broader context of historical oppression; family and social support and tribally-based services may be protective factors for cancer survivors with depression.
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Affiliation(s)
- Catherine E. Burnette
- School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Jessica Liddell
- City, Community, and Culture PhD Program, School of Social Work, Tulane University, 127 Elk Place, #8906, New Orleans, LA 70112, Phone: 504-862-3495,
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, 365 Health Science Center, 1400 West 22 Street, Sioux Falls, SD 57105, Phone: 605-357-1593,
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132, Phone: 415-405-0944,
| | - Hee Yun Lee
- School of Social work, The University of Alabama, 1022 Little Hall, Box 870314, Tuscaloosa, AL 35487, Phone: 205-348-6553,
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Post-Intensive Care Unit Care. A Qualitative Analysis of Patient Priorities and Implications for Redesign. Ann Am Thorac Soc 2021; 17:221-228. [PMID: 31726016 DOI: 10.1513/annalsats.201904-332oc] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Rationale: Although survival during critical illness is improving, little evidence exists to guide post-intensive care unit (ICU) care. Understanding patients' needs and priorities is fundamental to improving care quality.Objectives: To describe the evolution of patients' priorities for recovery across the spectrum of post-ICU care.Methods: This was a secondary analysis of 39 semistructured interviews conducted from 2005 to 2006 in participants' homes 19 days to 11 years after hospital discharge after critical illness. Adult critical illness survivors (N = 39) aged 20 years or older from multiple ICUs across the United Kingdom were purposively selected to maximize diversity with respect to time since diagnosis, disease severity, sex, age, ethnicity, socioeconomic group/status, region. age, ICU admitting diagnoses, and length of stay. We used the method of qualitative description to characterize patients' priorities for recovery and their evolution within and between individual patients across three post-ICU periods: ICU transition to wards, early period (approximately the first 2 mo) after discharge to home, and late period (>2 mo) after discharge to home.Results: The analysis revealed 12 core patient priorities during recovery: feeling safe, being comfortable, engaging in mobility, participating in self-care, asserting personhood, connecting with people, ensuring family well-being, going home, restoring psychological health, restoring physical health, resuming previous roles and routines, and seeking new life experiences. In general, priorities evolved from those pertaining to basic survival during the stay on wards to being broader and more aspirational by the late postdischarge period.Conclusions: Understanding patients' priorities for post-ICU care is critical for developing stakeholder-driven clinical guidelines. Engaging other stakeholders (e.g., family members, healthcare providers, and institutionalized and frail older adults) to inform the development of clinical guidelines for post-ICU care, together with the barriers and facilitators faced in achieving patient- and family-centered care, is an important next step.
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The Role of Research in Guiding Treatment for Women's Health: A Qualitative Study of Traditional Chinese Medicine Acupuncturists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020834. [PMID: 33478105 PMCID: PMC7835913 DOI: 10.3390/ijerph18020834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 02/07/2023]
Abstract
Background: Surveys of acupuncture practitioners worldwide have shown an increase in the use of acupuncture to treat women’s health conditions over the last ten years. Published studies have explored the effectiveness of acupuncture for various conditions such as period pain, fertility, and labor induction. However, it is unclear what role, if any, peer-reviewed research plays in guiding practice. Methods: Acupuncturists with a significant women’s health caseload were interviewed online in three small groups to explore factors that contribute to acupuncturists’ clinical decision made around treatment approaches and research. Results: Eleven practitioners participated in the focus groups. The overarching theme that emerged was one of ‘Not mainstream but a stream.’ This captured two themes relating to acupuncture as a distinct practice: ‘working with what you’ve got’ as well as ‘finding the right lens’, illustrating practitioners’ perception of research needing to be more relevant to clinical practice. Conclusions: Acupuncture practitioners treating women’s health conditions reported a disconnect between their clinical practice and the design of clinical trials, predominantly due to what they perceived as a lack of individualization of treatment. Case histories were popular as a learning tool and could be used to support increasing research literacy.
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Haidar H, Le Clerc-Blain J, Vanstone M, Laberge AM, Bibeau G, Ghulmiyyah L, Ravitsky V. A qualitative study of women and partners from Lebanon and Quebec regarding an expanded scope of noninvasive prenatal testing. BMC Pregnancy Childbirth 2021; 21:54. [PMID: 33441113 PMCID: PMC7805222 DOI: 10.1186/s12884-020-03538-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 12/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background In the near future, developments in non-invasive prenatal testing (NIPT) may offer couples the opportunity to expand the range of genetic conditions tested with this technology. This possibility raises a host of ethical and social concerns, such as the type of information (medical vs. non-medical information) that couples might be exposed to and how this might complicate their informed decision-making. Currently, only limited research, mainly carried out in western countries, was conducted on women’s and partners’ views regarding the potential expansion of NIPT. Methods This study used semi-structured interviews with pregnant women and their partners to explore their views on future potential NIPT applications such as non-medical sex selection and non-medical traits, paternity testing, and NIPT use for fetal whole genome sequencing (FWGS). It was conducted in Lebanon and Quebec, as case studies to explore the impact of cultural differences on these views. Results We found no differences and many similarities when comparing the perceptions of participants in both contexts. While couples in both settings disapproved of the use of NIPT for non-medical sex selection and non-medical traits such as physical characteristics, they were near-unanimous about their support for its use for paternity testing in specific cases, such as legal doubts or conflicts related to the identity of the father. Participants were more ambivalent about NIPT for Fetal Whole Genome Sequencing. They supported this use to detect conditions that would express at birth or early childhood, while objecting to testing for adult-onset conditions. Conclusions These results can further inform the debate on the future uses of NIPT and future policy related its implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03538-y.
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Affiliation(s)
- Hazar Haidar
- Institute for Health and Social Policy, McGill University, Montreal, Canada.
| | - Jessica Le Clerc-Blain
- Medical Genetics, Department of Pediatrics, and Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Anne-Marie Laberge
- Medical Genetics, Department of Pediatrics, and Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada.,Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal, Montreal, Canada
| | - Gilles Bibeau
- Department of Anthropology, Faculty of Arts and Sciences, Université de Montréal, Montreal, Canada
| | - Labib Ghulmiyyah
- Department of Obstetrics and Gynecology, American University of Beirut, Beirut, Lebanon
| | - Vardit Ravitsky
- Bioethics Program, Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Canada
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Mohsen K, Kildea J, Lambert SD, Laizner AM. Exploring Cancer Patients' Perceptions of Accessing and Experience with Using the Educational Material in the Opal Patient Portal. Support Care Cancer 2021; 29:4365-4374. [PMID: 33415366 DOI: 10.1007/s00520-020-05900-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Opal is a new patient-centered mobile application that gives cancer patients access to their real time medical data in conjunction with disease- and treatment-specific patient education material. Few studies have focused on patients' experiences with such mobile applications. This study's objectives were to (1) explore cancer patients' perceptions of accessing the educational materials through Opal and (2) explore their experiences using these educational materials. METHODS A qualitative descriptive design was used. Patients were invited to participate in the study via Opal itself. Semi-structured individual interviews were done in person or over the phone, transcribed verbatim and analyzed using qualitative content analysis. RESULTS Nine women were interviewed. Three themes were identified as participants spoke about their perceptions of and experiences with Opal. First, Opal makes me feel like I have more control, conveying how learning more about their diagnosis and treatments allowed patients to advocate for themselves and plan their care. Second, Opal tends to reassure me, illustrating that having access to information was reassuring. Lastly, Opal is just starting to have information which could help meet my needs, reflecting patients' belief Opal is on the right track but could provide more of their medical record, treating team contact information and education material. CONCLUSION Patients can feel more empowered when using patient-centered mobile applications, and mobile applications have potential for improving collaboration with healthcare professionals and care coordination. Healthcare professionals, including oncologists and nurses, should support patients' use of mobile applications and integrate them in their patient interactions.
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Affiliation(s)
- Katherine Mohsen
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - John Kildea
- Medical Physics Unit - Gerald Bronfman, Department of Oncology, McGill University, Montréal, Québec, Canada
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
- St. Mary's Research Centre, Montréal, Québec, Canada
| | - Andréa M Laizner
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada.
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
- Nursing Directorate, McGill University Health Centre, Montréal, Québec, Canada.
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