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Dawson T, Pahlke S, Carrasco-Labra A, Polk D. Patient Values and Preferences for Managing Acute Dental Pain Elicited through Online Deliberation. JDR Clin Trans Res 2024; 9:104-113. [PMID: 37542374 PMCID: PMC10871022 DOI: 10.1177/23800844231174398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Abstract
INTRODUCTION Patient values and preferences (PVP) are among multiple sources of information panelists synthesize when developing clinical practice guidelines (CPG). Patient and public involvement (PPI) can be critical for learning PVP; however, the methodology for engaging patients in CPG development is lacking. Deliberative engagement is effective for obtaining public views on complex topics that require people to consider ethics, values, and competing perspectives. OBJECTIVE Elicit comprehensive understanding of PVP concerning oral analgesics for managing acute dental pain consecutive to toothache and simple and surgical dental extractions, with consideration of associated outcomes, both desirable and undesirable. METHODS Multistage engagement involving 2 electronic surveys and a 90-min online small group deliberative engagement. Adults who have experienced acute dental pain deliberated about 3 hypothetical scenarios stratified according to expected pain intensity, completed a postdeliberation survey, and validated a PVP statement developed by researchers based on review of qualitative data from deliberations and quantitative data from surveys. RESULTS Participants affirmed the PVP statement reflected their small group deliberations and their individual views. Most indicated that pain relief is critical to deciding which pain relief medicine they would want regardless of expected pain level. Most also identify as critical concerns about substance abuse or misuse, although many believe it unlikely that they will experience these outcomes over the brief prescription timeframe for acute dental pain. Participants identified agency in decision-making, consultation including "better communication" of options, and treatment actions tailored to life circumstances as key values. CONCLUSIONS Participants preferred nonprescription and nonopioid pain relief options. As expected pain levels increased, more participants expressed willingness to accept opioids, but more also mentioned rescue analgesia as a third outcome critical to decision-making. Online deliberative method provided opportunities for obtaining informed perspectives. Guideline developers and policymakers may find online deliberations useful for eliciting PVP related to health outcomes. KNOWLEDGE TRANSFER STATEMENT Study results informed the US Food and Drug Administration-funded clinical practice guideline on the management of acute dental pain. Findings may be a resource for clinicians in decision-making conversations with patients regarding expectations for pain relief and positive and negative outcomes of differing pain relief medications. Further research should pursue applicability of online deliberative engagement as a method to elicit patient values and preferences.
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Affiliation(s)
- T. Dawson
- The Art of Democracy, LLC, Pittsburgh, PA, USA
| | - S. Pahlke
- Infectious Diseases Society of America, Arlington, VA, USA
| | - A. Carrasco-Labra
- Department of Preventive and Restorative Sciences and Center for Integrative Global Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - D. Polk
- University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
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152
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Arter J, Bunge SS. Perceived Impacts of Partners' Other Relationships on Oneself in Consensual Nonmonogamy. Arch Sex Behav 2024; 53:1415-1429. [PMID: 38438814 PMCID: PMC10954970 DOI: 10.1007/s10508-024-02823-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 01/12/2024] [Accepted: 01/25/2024] [Indexed: 03/06/2024]
Abstract
Existing research suggests a number of both costs and benefits to oneself that can occur as a result of partners' other relationships in consensual nonmonogamy (CNM), but such costs and benefits have not previously been systematically cataloged. Using reflexive thematic analysis, we present themes derived from semi-structured interviews with 51 individuals (63% white, 55% nonbinary/genderqueer/non-cisgendered, and 77% LGBQ) who have practiced CNM, describing the costs and benefits to themselves that they perceive as a result of their partners' other relationships. Themes describing costs include experiencing difficult feelings (e.g., jealousy), having less with a partner (e.g., less of a partner's time) than one would like, difficulties or conflict within one's own relationship, and difficulties or conflict as a result of interactions between metamours (individuals who share a partner). Themes describing benefits include experiencing positive feelings (e.g., compersion), benefiting from a partner getting needs met in other relationships, strengthening of or pleasurable interactions within one's own relationship, enjoyable or beneficial relationships or interactions between metamours, and personal growth as a result of sharing partners with others. We note that these costs and benefits roughly mirror each other, suggesting that they may reflect the positive and negative sides of some fundamental aspects of CNM. Each of our themes also contains a rich range of elements that suggest avenues for future research. Our results suggest that CNM relationships are complex and multi-faceted, and that further research could fruitfully examine the circumstances that influence whether individuals experience their partners' other relationships positively or negatively.
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Affiliation(s)
- Jennifer Arter
- Psychology Department, San Francisco State University, San Francisco, CA, 94132, USA.
| | - Sacha S Bunge
- Psychology Department, San Francisco State University, San Francisco, CA, 94132, USA
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153
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Liu J, Meyer K, Glassner A, Gonzales M, Bartlett Ellis RJ, Park H, Song L, Patel N, Wang J. Thematic Analysis of Alzheimer's Medication Management Discussion in a Non-Moderated Online Forum. West J Nurs Res 2024; 46:307-314. [PMID: 38456477 PMCID: PMC10955786 DOI: 10.1177/01939459241237671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Managing medications for Alzheimer's disease and related dementias is challenging for caregivers. Information about caregivers' strategies to manage these challenges is needed to inform intervention development. OBJECTIVE This study aimed to understand caregivers' medication management experiences by analyzing online community discussions. METHODS Posts were extracted from the ALZConnected® Forum using keywords "medication" and "drug" via web scraping. The researchers applied thematic analysis. RESULTS Four major themes emerged: (1) role transition of medication management responsibilities, (2) caregivers' uncertainty about medication purpose and values, (3) conflicts between the care recipients and caregivers, and (4) difficulty accessing and affording medications. CONCLUSIONS The experiences shared on a non-moderated, unstructured online forum indicate that medication management is challenging and overwhelming for caregivers of people living with Alzheimer's disease and related dementias. Since this is a progressive disease with various stages and changing needs, caregivers' strategies vary and are often limited by available resources and support. Health care providers should offer training and support for caregivers to navigate the transfer of medication management responsibilities and changing care needs as the disease progresses.
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Affiliation(s)
- Jia Liu
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Kylie Meyer
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Ashlie Glassner
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mitzi Gonzales
- Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Hyejin Park
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Lixin Song
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Neela Patel
- Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jing Wang
- College of Nursing, Florida State University, Tallahassee, FL, USA
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154
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Khan A, Adil A. Development and validation of Unsuccessful Disengagement Aging Scale (UDAS) for older adults. J Gen Psychol 2024; 151:186-208. [PMID: 37545159 DOI: 10.1080/00221309.2023.2241951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 07/20/2023] [Indexed: 08/08/2023]
Abstract
The present study aimed to develop a precise and reliable measure of unsuccessful disengagement among older adults, defined as involuntary withdrawal from societal roles and norms due to familial or societal pressure, resulting in the transfer of responsibilities to the younger generation. High scores on the Unsuccessful Disengagement Aging Scale (UDAS) were indicative of a greater degree of unsuccessful disengagement. The study was conducted in two parts: Study I involved a purposive sample of 200 participants, whereas Study II involved a purposive sample of 500 occupationally retired older adults aged between 65 and 85 years. The constructs of the study were measured using the UDAS, Depression Anxiety and Stress Scale, and Identity and Experiences Scale. In Study I, the UDAS was subjected to an Exploratory Factor Analysis, which revealed a clear four-factor solution with high factor loadings and internally consistent factors. This factor structure was confirmed through Confirmatory Factor Analysis in Study II. Construct validity was established through the UDAS's significant positive correlation with depression and non-significant correlation with assimilation identity style. Furthermore, the mean UDAS score of older adults suffering from chronic physical ailments such as hypertension, diabetes, cardiac problems, hepatitis, ulcers, liver problems, arthritis, and joint pain was significantly higher than that of healthy older adults, indicating the concurrent validity of the UDAS in distinguishing between ill and healthy older adults. Overall, the results indicated that the UDAS was a reliable and valid instrument for measuring unsuccessful disengagement in older adults.
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155
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DeVito NJ, Morley J, Goldacre B. Barriers and best practices to improving clinical trials transparency at UK public research institutions: A qualitative interview study. Health Policy 2024; 142:104991. [PMID: 38417375 DOI: 10.1016/j.healthpol.2024.104991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 12/22/2023] [Accepted: 01/08/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVES Since 2017, the UK government has made concerted efforts to ensure the dissemination of clinical trials conducted at public research institutions. This study aims to understand how stakeholders within these institutions responded to these pressures and modified internal policies and processes while identifying best practices and barriers to improved transparency practice. METHODS Research governance and trial management staff from UK public research institutions (i.e., Universities and NHS Trusts) in England, Scotland and Wales participated in semi-structured interviews. Interviews were analysed using thematic analysis, aided by the framework method. RESULTS Between November 2020 and July 2021, 14 individual participants were recruited from 11 different institutions. They worked in research governance, administration, and management. Almost universally, new policies and procedures have been established to ensure investigators are aware of, and supported in, fulfilling their transparency commitments, however challenges remain. Trials of medicinal products, as the most closely regulated research, consequently received the most attention. National professional networks aid in sharing knowledge and best practice within this community. CONCLUSIONS Investment in the institutional governance of transparency is essential to achieving optimal transparency practices. Universities and hospitals share responsibility for ensuring research is performed and reported to regulatory standards. Facing political pressure, public research institutions in the UK have made efforts to improve their transparency practice which can provide key insights for similar efforts elsewhere.
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Affiliation(s)
- Nicholas J DeVito
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom.
| | - Jessica Morley
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
| | - Ben Goldacre
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
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156
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Akhavan AR, Kontrick AV, Egan H, Balint SA, Kane BG, House JB, Graffeo CS, Courtney DM, Lu DW. "Cold feet": A qualitative study of medical students who seriously considered emergency medicine but chose another specialty. AEM Educ Train 2024; 8:e10967. [PMID: 38525364 PMCID: PMC10955612 DOI: 10.1002/aet2.10967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/26/2024]
Abstract
Introduction Emergency medicine (EM) has historically been among the most competitive specialties in the United States. However, in 2022 and 2023, 219 of 2921 and 554 of 3010 respective National Resident Matching Program positions were initially unfilled. Medical students' selection of a medical specialty is a complex process. To better understand recent trends in the EM residency match, this qualitative study explored through one-on-one interviews the rationale of senior medical students who seriously considered EM but ultimately pursued another specialty. Methods A convenience sample of senior medical students from across the United States was recruited via multiple mechanisms after the 2023 match. Participant characteristics were collected via an online survey. Qualitative data were generated through a series of one-on-one semistructured interviews and thematic analysis of the data was performed using a constant comparative approach. Results Sixteen senior medical students from 12 different institutions participated in the study. Thematic saturation was reached after 12 interviews but data from all 16 interviews were included for qualitative analyses. Five major themes emerged as important in students' consideration but ultimate rejection of EM as a career: (1) innate features of EM attracted or dissuaded students, (2) widespread awareness of a recent workforce report, (3) burnout in EM, (4) their perception of EM's standing in the health care landscape, and (5) early EM experience and exposure. Conclusions This qualitative study identified five major themes in the career decisions of senior medical students who seriously considered EM but chose another specialty. These findings may help inform the perceptions of students and guide future EM recruitment efforts.
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Affiliation(s)
- Arvin R. Akhavan
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Amy V. Kontrick
- Department of Emergency MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Haley Egan
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Bryan G. Kane
- Emergency MedicineLehigh Valley HospitalBethlehemPennsylvaniaUSA
| | - Joseph B. House
- Department of Emergency MedicineUniversity of MichiganAnn ArborMichiganUSA
| | | | | | - Dave W. Lu
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
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157
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Caretta‐Weyer HA, Sebok‐Syer SS, Morris AM, Schnapp BH, Fant AL, Scott KR, Pirotte M, Gisondi MA, Yarris LM. Better together: A multistakeholder approach to developing specialty-wide entrustable professional activities in emergency medicine. AEM Educ Train 2024; 8:e10974. [PMID: 38532740 PMCID: PMC10962124 DOI: 10.1002/aet2.10974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
Purpose Entrustable professional activities (EPAs) are a widely used framework for curriculum and assessment, yet the variability in emergency medicine (EM) training programs mandates the development of EPAs that meet the needs of the specialty as a whole. This requires eliciting and incorporating the perspectives of multiple stakeholders (i.e., faculty, residents, and patients) in the development of EPAs. Without a shared understanding of what a resident must be able to do upon graduation, we run the risk of advancing ill-prepared residents that may provide inconsistent care. Methods In an effort to address these challenges, beginning in February 2020, the authors assembled an advisory board of 25 EM faculty to draft and reach consensus on a final list of EPAs that can be used across all training programs within the specialty of EM. Using modified Delphi methodology, the authors came to consensus on an initial list of 22 EPAs. The authors presented these EPAs to faculty supervisors, residents, and patients for refinement. The authors collated and analyzed feedback from focus groups of residents and patients using thematic analysis. The EPAs were subsequently refined based on this feedback. Results Stakeholders in EM residency training endorsed a final revised list of 22 EPAs. Stakeholder focus groups highlighted two main thematic considerations that helped shape the finalized list of EM EPAs: attention to the meaningful nuances of EPA language and contextualizing the EPAs and viewing them developmentally. Conclusions To foreground all key stakeholders within the EPA process for EM, the authors chose within the development process to draft; come to consensus; and refine EPAs for EM in collaboration with relevant faculty, patient, and resident stakeholders. Each stakeholder group contributed meaningfully to the content and intended implementation of the EPAs. This process may serve as a model for others in developing stakeholder-responsive EPAs.
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Affiliation(s)
- Holly A. Caretta‐Weyer
- Department of Emergency MedicineStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Stefanie S. Sebok‐Syer
- Department of Emergency MedicineStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Amanda M. Morris
- Department of Emergency MedicineStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Benjamin H. Schnapp
- Berbee Walsh Department of Emergency MedicineUniversity of WisconsinMadisonWisconsinUSA
| | - Abra L. Fant
- Department of Emergency Medicine, Northwestern University Feinberg School of MedicineMcGaw Medical Center at Northwestern UniversityChicagoIllinoisUSA
| | - Kevin R. Scott
- Department of Emergency MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Matthew Pirotte
- Department of Emergency MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Michael A. Gisondi
- Department of Emergency MedicineStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Lalena M. Yarris
- Department of Emergency MedicineOregon Health & Science UniversityPortlandOregonUSA
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158
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Hoetger C, White A, Bono RS, Hall CJ, Hood KB, Everhart RS, Nana-Sinkam P, Barnes AJ, Cobb CO. Perceptions of African American Youth and Adults Regarding Tobacco Use-Related Factors in Their Community: A Mixed-Methods Approach in Richmond, Virginia. Fam Community Health 2024; 47:176-190. [PMID: 38372334 PMCID: PMC10878718 DOI: 10.1097/fch.0000000000000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
INTRODUCTION The US Food and Drug Administration is poised to restrict the availability of menthol cigarettes and flavored cigars, products disproportionately used by Black/African American (B/AA) individuals. We examined B/AA youth and adult perceptions regarding factors contributing to tobacco use, as well as prevention/cessation resources. METHODS In 2 mixed-methods studies in Richmond, Virginia, we conducted cross-sectional surveys among youth (n = 201) and adult (n = 212) individuals who were primarily B/AA and reported past 30-day cigar smoking or nontobacco use, followed by focus groups with a subset (youth: n = 30; adults: n = 24). Focus groups were analyzed using a thematic analysis framework, and descriptive survey data provided context to themes. RESULTS Among focus group participants, 20% of youth and 75% of adults reported current cigar smoking. Six themes emerged across the groups: advertising/brands, sensory experiences, costs, social factors, youth-related factors, and dependence/cessation. Youth and adults perceived cigars as popular; cigar use was attributed to targeted advertising, flavors, affordability, and accessibility. While adults expressed concern regarding youth tobacco use, youth did not perceive tobacco prevention programs as helpful. Adults and youth reported limited access to community tobacco prevention/cessation programs. DISCUSSION Expanded tobacco prevention and cessation resources for B/AA people who smoke could leverage federal regulatory actions to ban tobacco products targeted toward this group and decrease disparities in tobacco-related morbidity and mortality.
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Affiliation(s)
- Cosima Hoetger
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Universitat of Witten/Herdecke, Institute for Integrative Health Care and Health Promotion, Witten, Germany
| | - Augustus White
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Rose S. Bono
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Calvin J. Hall
- Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | | | | | - Andrew J. Barnes
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Caroline O. Cobb
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Psychology, Virginia Commonwealth University, Richmond, VA, USA
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159
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Demedis J, Reedy J, Chow EJ, Dorsey Holliman B, Peterson PN, Studts CR. Provider perspectives and recommendations on standardized sexual function screening intervention in adolescent/young adult oncology patients. Pediatr Blood Cancer 2024; 71:e30872. [PMID: 38233999 DOI: 10.1002/pbc.30872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/13/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Sexual function (SF) concerns are common among adolescent and young adult (AYA) cancer survivors, are underrecognized and undertreated. This study sought AYA oncology provider input on the implementation of an SF screening tool to address this unmet need. PROCEDURE Semi-structured interviews were completed with oncology providers (n = 25) who care for AYAs at a single institution. Interviews sought to understand barriers to addressing SF, elicit perspectives on use of an established screening tool, and obtain recommendations for SF screening intervention development and implementation. Interviews were developed using the Consolidated Framework for Implementation Research (CFIR); thematic analysis-guided interpretation. RESULTS AYA oncology providers were in favor of using an SF screening tool, but confirmed previously identified barriers and implementation considerations within multiple CFIR domains, including concerns about privacy, patient comfort, provider buy-in, provider knowledge, resource needs, and workflow/capacity constraints. They identified numerous strategies to address barriers through screening intervention design and implementation approaches. For example, provider buy-in could be optimized through education, availability of clinical resources, creation of a dedicated sexual healthcare team, provider engagement in intervention development, and leadership involvement. CONCLUSIONS Development and implementation of an effective SF screening intervention is necessary to improve diagnosis and treatment of sexual dysfunction, with the ultimate goal of improving sexual health-related quality of life in AYA cancer survivors. AYA oncology providers identified numerous intervention and implementation design strategies for the development and implementation of an SF screening intervention, which must be integrated with patient recommendations.
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Affiliation(s)
- Jenna Demedis
- Adult & Child Center for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Julia Reedy
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, Colorado, USA
| | - Eric J Chow
- Clinical Research and Public Health Sciences Divisions, Fred Hutchinson Cancer Center, Washington, USA
| | - Brooke Dorsey Holliman
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Pamela N Peterson
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Denver Health Medical Center, Denver, Colorado, USA
| | - Christina R Studts
- Adult & Child Center for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, Colorado, USA
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160
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Williamson FA, Lester JN, Woods C, Kaye EC. Questions to promote child-centered care in racially discordant interactions in pediatric oncology. Patient Educ Couns 2024; 121:108106. [PMID: 38123375 DOI: 10.1016/j.pec.2023.108106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To examine questioning practices in racially discordant interactions and describe how these practices engendered child-centered care. METHODS We used applied conversation analysis to analyze a collection of 300 questions directed to children across 10 cases involving children of color and their families in disease reevaluation appointments in pediatric oncology. RESULTS Our analysis generated two patterns: 1) both the pediatric oncologists' and caregivers built upon one another's talk to enable the child's conversational turn, and 2) the oncologists' reformulated requests as questions to invite the child's permission and cooperation for completing exams and understanding symptoms. CONCLUSION Children, pediatric oncologists, and caregivers coordinated their actions to enable children to participate as recipients of and respondents to questions. The analysis of real-time interactions illuminates practices for centering children in clinical encounters and the benefits of doing so. PRACTICAL IMPLICATIONS This study's findings have implications for defining competencies and practices for fostering child-centered communication, creating training materials based on real-time encounters, and identifying strategies for humanizing pediatric patient experiences.
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Affiliation(s)
| | - Jessica Nina Lester
- Department of Counseling Education and Psychology, Indiana University, Bloomington, USA
| | - Cameka Woods
- St. Jude's Children's Research Hospital, Memphis, USA
| | - Erica C Kaye
- St. Jude's Children's Research Hospital, Memphis, USA
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161
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Houweling KP, Mallam SC, van de Merwe K, Nordby K. The effects of Augmented Reality on operator Situation Awareness and Head-Down Time. Appl Ergon 2024; 116:104213. [PMID: 38154227 DOI: 10.1016/j.apergo.2023.104213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/30/2023]
Abstract
A lack of navigator's Situation Awareness (SA) is one of the leading causes of maritime accidents. Visually observing the area surrounding a vessel continues to be a critical aspect and best practice of safe navigation to establish and maintain SA. Augmented Reality (AR) allows the placement of information in a user's field of view, which can encourage navigators to spend more time looking up at their external environment whilst still having access to operational data. However, empirical evidence on the impact of AR on maritime operations is limited. This paper investigates the effects of AR on navigator SA & Head-Down Time (HDT) using a within-group quasi-experimental design. Seventeen licensed navigators and nautical students analysed twelve navigation scenarios: six non-AR (control) and six AR (experimental) scenarios using a maritime training simulator. SA was measured via SAGAT scores for each scenario and the SA-SWORD to compare preferences. Each scenario was video recorded and analysed for participant's total amount of HDT and head-down occurrences in each scenario. Results found that the addition of AR significantly reduced participant HDT (by a factor of 2.67) and head-down occurrences (by 62%) in comparison to navigation scenarios without AR. Furthermore, AR did not significantly improve mean SA. This study contributes to the limited empirical data on the effects of AR on operator performance, demonstrating the potential value of AR for improving SA and facilitating increased head-up time during maritime navigation, which in turn could improve safety at sea.
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Affiliation(s)
- Koen Pieter Houweling
- Department of Maritime Operations, University of South-Eastern Norway, Borre, Norway; Group Research and Development, DNV, Høvik, Norway
| | - Steven C Mallam
- Department of Maritime Operations, University of South-Eastern Norway, Borre, Norway; Fisheries & Marine Institute, Memorial University of Newfoundland, St. John's, Canada.
| | - Koen van de Merwe
- Department of Maritime Operations, University of South-Eastern Norway, Borre, Norway; Group Research and Development, DNV, Høvik, Norway
| | - Kjetil Nordby
- Institute of Design, The Oslo School of Architecture and Design, Oslo, Norway
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Christanti JV, Setiadi AP, Setiawan E, Presley B, Halim SV, Wardhani SA, Sunderland B, Wibowo YI. Community-Based Approach to Promote Rational Use of Antibiotics in Indonesia: The Development and Assessment of an Education Program for Cadres. Community Health Equity Res Policy 2024; 44:281-293. [PMID: 37393556 DOI: 10.1177/2752535x231184029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND Cadres play an important part in providing community-based education. This study developed and assessed an education program for cadres in Malang, Indonesia, as 'change agents' to promote rational antibiotic use. METHODS In-depth-interviews with stakeholders (N = 55) and a subsequent group discussion with key personnel (N = 5) were conducted to develop a relevant education tool for cadres. This was followed with a pilot study with cadres (N = 40) to assess the effectiveness and acceptability of the new tool. RESULTS Consensus was reached on the education tool media: an audio-recording (containing full information) with a pocketbook (containing key information) as a supplement. A pilot study on the new tool reported its effectiveness in improving knowledge (p < 0.001) and demonstrated a high acceptability (all respondents stated 'Strongly Agree' or 'Agree' on all statements). CONCLUSION This study has created a model for an education tool which can potentially be implemented for cadres to educate their communities about antibiotics in the Indonesian context.
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Affiliation(s)
- J V Christanti
- Master of Pharmacy Program, Faculty of Pharmacy, Universitas Surabaya, Surabaya, Indonesia
| | - A P Setiadi
- Master of Pharmacy Program, Faculty of Pharmacy, Universitas Surabaya, Surabaya, Indonesia
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, Indonesia
| | - E Setiawan
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, Indonesia
| | - B Presley
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, Indonesia
| | - S V Halim
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, Indonesia
| | - S A Wardhani
- East Java Provincial Health Office, Ministry of Health, Republic of Indonesia, Surabaya, Indonesia
| | - B Sunderland
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Y I Wibowo
- Centre for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, Universitas Surabaya, Surabaya, Indonesia
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Abstract
Consensually non-monogamous (CNM) romantic and sexual relationships tend to be stigmatized. The present research examined this stigma across two studies. First, we qualitatively explored the specific ways that people in CNM relationships report experiencing stigma using thematic analysis and identified the following four themes: Expressions of discomfort/disapproval of CNM, Loss of resources/threatening behaviors, Character devaluation, and Relationship devaluation (Study 1; N = 372). Second, we examined the relationship between experienced stigma and psychological well-being for people in CNM relationships, using the framework of minority stress theory. We found that experienced stigma was positively associated with psychological distress and that this association was partially statistically mediated by anticipated stigma and internalized stigma (Study 2; N = 383). Overall, this research strives to achieve a better understanding of the processes and potential consequences of stigma toward CNM relationships and individuals.
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Dahlawi N, Milnes L, Swallow V. Children's behavioural and emotional reactions towards living with congenital heart disease in Saudi Arabia: A grounded theory study. Health Expect 2024; 27:e13959. [PMID: 38411365 PMCID: PMC10897868 DOI: 10.1111/hex.13959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND A high incidence of children with congenital heart disease (CHD) was found in Saudi Arabia (SA). International literature reports that children with CHD exhibit behavioural and emotional issues due to experiencing hospitalisation and clinical treatments combined with a dearth of qualitative understanding of the experiences of younger children with CHD. Therefore, the aim was to explore the behaviour and emotions of 4-10-year-olds with CHD in SA through children's accounts of their own experiences and parental proxy reports of children's behaviour and emotions. METHODS Charmaz's constructivist grounded theory (GT) approach was used. Twenty single semi-structured interviews of 10 child/parent dyads were undertaken at a hospital clinic in SA. Children's interviews were combined with an arts-based approach using drawings, pictures and faces of emotions (emojis). Constant comparison analysis was undertaken. Consolidated Criteria for Reporting Qualitative Research guidelines was followed in reporting this study. FINDINGS A substantive GT: children's behavioural and emotional reactions towards stressors related to living with CHD was developed and provides new insights into children's and parents' perceptions of the children's behavioural and emotional reactions to living with CHD in SA. The theory proposes that children's reactions to living with CHD relate to medical treatment stressors, sociocultural stressors and physical change stressors. Several further factors influenced children's responses to these stressors. CONCLUSION Children and parents in SA contributed to a new understanding of the relationship between CHD and children's behavioural and emotional reactions. In addition, findings support the need for early assessment of behaviour and emotions among children with CHD and the application of preventative and supportive measures for the children and their families in SA. PATIENT OR PUBLIC CONTRIBUTION Before the research commenced, the developmental appropriateness of the proposed arts-based data collection tools was tested with three healthy children aged 6-9 years old; the tools were then revised accordingly before the interviews were undertaken.
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Affiliation(s)
- Nada Dahlawi
- Nursing Faculty, King Abdulaziz University, Jeddah, Saudi Arabia
- School of Healthcare, University of Leeds, Leeds, UK
| | - Linda Milnes
- School of Healthcare, University of Leeds, Leeds, UK
| | - Veronica Swallow
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
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165
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Mailer J, Ward K, Aspinall C. The impact of visiting restrictions in intensive care units for families during the COVID-19 pandemic: An integrative review. J Adv Nurs 2024; 80:1355-1369. [PMID: 37897120 DOI: 10.1111/jan.15915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/28/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023]
Abstract
AIM To synthesize current evidence about the impact visiting restrictions in adult intensive care units have on family members during the COVID-19 pandemic. DESIGN Integrative literature review. METHODS A total of 104 articles were retrieved. Screening yielded a total of 23 articles which were appraised for quality. Reflexive thematic analysis was applied to synthesize findings and extract themes. DATA SOURCES CINAHL Plus, Ovid MEDLINE, PubMed and ProQuest databases were searched for articles between January 2020 and November 2022. RESULTS The findings were grouped into two main themes with six subthemes. Theme 1: not being present at the bedside, and Theme 2: altered communication added to family members' distress. Findings indicate that visiting restrictions imposed during the COVID-19 pandemic had negative consequences for family members. CONCLUSION The patient and their family are inherently connected, prioritizing family presence with the return of flexible, open visitation policies in ICU must be a priority to mitigate further harm and adverse outcomes for all. REPORTING METHOD The review complies with the PRISMA guidelines for reporting systematic reviews. IMPLICATIONS FOR PROFESSION Nursing leaders must be included in the development of future pandemic policies that advocate family-centred care. NO PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was included in this review.
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Affiliation(s)
- Jackie Mailer
- Te Whatu Ora Waikato, Hamilton, Waikato, New Zealand
| | - Kim Ward
- University of Auckland, Auckland, New Zealand
| | - Cathleen Aspinall
- University of Auckland, Te Whatu Ora Counties Manukau, Auckland, New Zealand
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166
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Lim YX, Quah ELY, Chua KZY, Lin Ronggui CK, Govindasamy R, Ong SM, Ong EK, Phua GLG, Krishna LKR. A Systematic Scoping Review on Dignity Assessment Tools. J Pain Symptom Manage 2024; 67:e263-e284. [PMID: 38092260 DOI: 10.1016/j.jpainsymman.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 01/15/2024]
Abstract
CONTEXT The provision of person-centered dignity-conserving care is central to palliative care. It is important to reevaluate current methods of assessing dignity as the concept of dignity is multifaceted. OBJECTIVES The aim of this study is to understand the tools which are used to assess a patient's dignity and the elements of dignity evaluated in these tools. METHODS Two independent and concurrent Systematic Evidence-Based Approach guided systematic scoping reviews (SSR in SEBA) on existing dignity assessment tools and on accounts of assessments of dignity were carried out. The SSR in SEBA on dignity assessment tools involving PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Scopus, and CINAHL databases saw 22 full-text articles included from the 645 articles reviewed. The SSR in SEBA on accounts of assessments of dignity featured in the PubMed database identified 102 full-text articles which saw 46 articles included. RESULTS The domains identified were factors affecting patients' definition of dignity; elements of dignity-conserving care; and components of effective tools. CONCLUSION Current accounts to assess dignity and assessment tools fail to capture shifting self-concepts of dignity holistically. A portfolio-like appraisal of dignity is proposed to achieve assessments that are timely, longitudinal, and patient-specific. Portfolio-based assessments by members of the multidisciplinary team will better direct timely evaluations of relevant aspects of changing concepts of dignity, without losing the patient's holistic perception of dignity.
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Affiliation(s)
- Yun Xue Lim
- Yong Loo Lin School of Medicine (Y.X.L., E.L-Y.Q., K.Z-Y.C., S.M.O., L.K.R.R), National University of Singapore, Singapore; Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore
| | - Elaine Li Ying Quah
- Yong Loo Lin School of Medicine (Y.X.L., E.L-Y.Q., K.Z-Y.C., S.M.O., L.K.R.R), National University of Singapore, Singapore; Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine (Y.X.L., E.L-Y.Q., K.Z-Y.C., S.M.O., L.K.R.R), National University of Singapore, Singapore; Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore
| | - Casper Keegan Lin Ronggui
- Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore; Centre for Biomedical Ethics (C.K.L.R., L.K.R.R), National University of Singapore, Singapore; Department of Pharmacy (C.K.L.R.), National Cancer Center Singapore, Singapore; Division of Cancer Education (C.K.L.R., R.G., E.K.O., L.K.R.R.), National Cancer Centre Singapore, Singapore
| | - Ranitha Govindasamy
- Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore; Division of Cancer Education (C.K.L.R., R.G., E.K.O., L.K.R.R.), National Cancer Centre Singapore, Singapore; Department of Psychosocial Oncology (R.G.), National Cancer Center Singapore, Singapore
| | - Simone Meiqi Ong
- Yong Loo Lin School of Medicine (Y.X.L., E.L-Y.Q., K.Z-Y.C., S.M.O., L.K.R.R), National University of Singapore, Singapore; Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore; Division of Cancer Education (C.K.L.R., R.G., E.K.O., L.K.R.R.), National Cancer Centre Singapore, Singapore; Duke-NUS Medical School (E.K.O., L.K.R.R.), Singapore; Assisi Hospice (E.K.O.), Singapore
| | - Gillian Li Gek Phua
- Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore; Lien Centre for Palliative Care (G.L.G.P.), Duke-NUS Medical School, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine (Y.X.L., E.L-Y.Q., K.Z-Y.C., S.M.O., L.K.R.R), National University of Singapore, Singapore; Division of Supportive and Palliative Care (Y.X.L., E.L-Y.Q., K.Z-Y.C., C.K.L.R., S.M.O., E.K.O., G.L.K.P., L.K.R.R), National Cancer Centre Singapore, Singapore; Centre for Biomedical Ethics (C.K.L.R., L.K.R.R), National University of Singapore, Singapore; Division of Cancer Education (C.K.L.R., R.G., E.K.O., L.K.R.R.), National Cancer Centre Singapore, Singapore; Duke-NUS Medical School (E.K.O., L.K.R.R.), Singapore; Palliative Care Institute Liverpool (L.K.R.R.), Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom; PalC (L.K.R.R.), The Palliative Care Centre for Excellence in Research and Education, Singapore.
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167
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Millington PM, Snaith B, Edwards L, Carus CA. Factors that influence the quality of the clinical supervision experience in a first contact physiotherapy (FCP) role - The perspectives of supervisors and supervisees - A qualitative analysis. Musculoskelet Sci Pract 2024; 70:102921. [PMID: 38354619 DOI: 10.1016/j.msksp.2024.102921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/08/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE First contact practitioner (FCP) roles have been developed to supplement the primary care workforce in managing the burden of musculoskeletal conditions. In order to quality assure and standardise capability of these clinicians an educational framework was developed by NHS England. The Roadmap to Practice (2020) was the curriculum designed to support and develop capability for FCP roles. This secondary analysis of a broader research project aimed to understand the factors affecting the supervisory experience from both a supervisor and supervisee perspective. METHODS A qualitative design using group interviews and an online survey was utilised to examine the experiences of these clinicians on their journey navigating and supporting the Roadmap to Practice portfolio process. FINDINGS Three principal themes were identified that affected the supervisory process; preparation of both supervisors and supervisee; the person (supervisor) and the practicalities associated with supervision. CONCLUSION There were numerous factors influencing the quality of clinical supervision. Adequate preparation of the supervisor and supervisee is critical to success. The attributes of the supervisor were important in the enhancing the quality of supervisory process. Time afforded to undertake supervision and access to appropriate supervisors need to be adequate and accounted for in workforce planning. A paradigm shift in workplace culture is required so clinical supervision is seen as an integral component in maintaining quality and assuring patient safety.
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Affiliation(s)
- P M Millington
- School of Allied Health Professions & Midwifery, Faculty of Health Studies, University of Bradford, Bradford, UK.
| | - B Snaith
- School of Allied Health Professions & Midwifery, Faculty of Health Studies, University of Bradford, Bradford, UK; The Mid Yorkshire Teaching NHS Trust, Wakefield, UK
| | - L Edwards
- School of Allied Health Professions & Midwifery, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - C A Carus
- School of Allied Health Professions & Midwifery, Faculty of Health Studies, University of Bradford, Bradford, UK
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168
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Lawrence AL, Willis GM. Facilitators and Barriers to Understanding and Accepting People with a Sexual Interest in Children: A Thematic Analysis. Arch Sex Behav 2024; 53:1361-1375. [PMID: 38110846 DOI: 10.1007/s10508-023-02757-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023]
Abstract
The widespread conflation between having a sexual interest in children and engaging in sexually abusive behavior contributes significantly to elevated levels of stigma targeted at people living with a sexual interest in children. Stigmatization and societal punitiveness surrounding people living with these interests can impact their well-being, obstruct help-seeking, and potentially increase risk of offending behavior. Recent quantitative research employing stigma intervention strategies has produced encouraging results in reducing stigmatizing attitudes toward this population. The current study sought to expand on quantitative research findings to explore qualitatively the facilitators and barriers to understanding and accepting people living with sexual interest in children. Thirty participants were interviewed following completion of an online stigma intervention study. Participants were asked about their attitudinal responses to the earlier study and how personal and professional experiences contributed to shaping their attitudes surrounding people living with a sexual interest in children. Reflexive inductive thematic analysis was used to explore what factors promote understanding and what factors act as barriers to understanding people with sexual interest in children. The significance of experiences which challenged the dominant social narrative was identified across several themes which facilitated understanding and acceptance of people who have a sexual interest in children. Themes which reflected barriers to understanding included difficulty comprehending alternate narratives, parental concern, and reinforcement of current stereotypes. Implications for developing stigma-reduction interventions and future research are discussed.
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Affiliation(s)
- Amy L Lawrence
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Gwenda M Willis
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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169
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Martin A. Experiences of junior doctors who shielded during the COVID-19 pandemic. Clin Teach 2024; 21:e13685. [PMID: 37888496 DOI: 10.1111/tct.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Shielding was introduced to protect clinically extremely vulnerable people during the COVID-19 pandemic. For junior doctors who had to shield, this meant pausing in-person clinical duties to protect their health. There is limited literature regarding this, and the available evidence is predominantly surveys or blogs that describe mainly negative experiences including guilt, isolation, inadequate support and Return To Work (RTW) concerns. Exploring the experiences of this group is valuable to understand the impact on them, and their support needs moving forward. METHODS This was a qualitative study using individual semi-structured interviews. Three junior doctors were recruited using volunteer and snowball sampling. Interview transcripts were analysed using thematic analysis. FINDINGS Seven themes were finalised: (1) Professional value, (2) Threatened autonomy, (3) Self-motivated, (4) Educational impact, (5) Mental health, (6) Inadequate support and (7) Return To Work concerns. DISCUSSION Participant experiences largely reflected the evidence base including increased skill and knowledge acquisition, alongside guilt, isolation and inadequate support whilst shielding and upon RTW. These findings add valuable qualitative data to a scarcity of literature. However, caution should be applied when transferring these findings to other junior doctors, noting the small sample and regional setting. A small research grant has been secured for further research with a larger sample size incorporating the supervisor perspective. CONCLUSION These findings demonstrate that shielding was a challenging experience for these junior doctors including impacts on mental health and insufficient support. This lack of support requires further attention to refine and strengthen available support structures.
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Affiliation(s)
- Amy Martin
- University of Glasgow, Glasgow, UK
- University of York, York, UK
- Leeds Teaching Hospital Trust, Leeds, UK
- University of Leeds, Leeds, UK
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170
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Nowland LA. Exploring Physical Educators' Self-Efficacy to Teach Students With Disabilities in General Physical Education. Adapt Phys Activ Q 2024; 41:247-267. [PMID: 37917958 DOI: 10.1123/apaq.2023-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
The purpose of this study was to explore the ways in which in-service physical education teachers construct their self-efficacy beliefs toward teaching students with disabilities in general physical education classes. Using a qualitative descriptive approach situated within self-efficacy theory, data were collected via semistructured audio-recorded interviews with 16 in-service physical educators. Three interrelated themes were constructed: (a) The more I do it, the better I feel: the importance of professional experiences; (b) I've learned from others: the influence of colleagues; and (c) Being in the general educational setting is a challenge: the impact of contextual factors. Findings supported the influence of the four sources of self-efficacy (i.e., mastery experience, vicarious experience, social persuasion, and affective and physiological state), in addition to potential contextual factors (i.e., class sizes and availability of hands-on support), impacting participants' self-efficacy to teach students with disabilities in general physical education classes.
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Affiliation(s)
- Lindsey A Nowland
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA
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171
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Edwards-Callaway L, Mijares S, Okoren C, Rogers C, Sullivan P, Davis M, Cramer C, Román-Muñiz N. Developing a model to promote caretaker confidence and communication in treatment decisions for dairy cattle through case studies. J Dairy Sci 2024; 107:2321-2331. [PMID: 37944803 DOI: 10.3168/jds.2023-23698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/29/2023] [Indexed: 11/12/2023]
Abstract
The significant role of dairy caretakers in maintaining animal welfare on dairy farms emphasizes the necessity of appropriate training and education to ensure the implementation of practices that promote good animal welfare. This study explored the potential of case-based learning as a novel approach to training for dairy caretakers by investigating dairy caretakers' perspectives on case study discussions. Additionally, this study sought to understand thoughts and feelings of caretakers during case study discussions to help identify information that caretakers use to evaluate cases and make decisions. Two case studies were developed and presented to participants, and thematic analysis of case study discussion transcripts was performed. Pre- and post-training questionnaires for 21 caretakers (n = 21) were summarized. The study found that caretaker reactions to case studies were generally positive. Thematic analysis revealed that caretakers use previous knowledge to make treatment decisions for cattle, and valued discussion with coworkers. The results of this study suggest the need for further investigation into the use of case studies and other activities that provide opportunities for critical thinking as training opportunities on dairy farms.
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Affiliation(s)
- Lily Edwards-Callaway
- Department of Animal Sciences, Colorado State University, College of Agricultural Sciences, Fort Collins, CO 80523.
| | - Sage Mijares
- Department of Animal Sciences, Colorado State University, College of Agricultural Sciences, Fort Collins, CO 80523
| | - Claire Okoren
- Department of Animal Sciences, Colorado State University, College of Agricultural Sciences, Fort Collins, CO 80523
| | - Corley Rogers
- Department of Animal Sciences, Colorado State University, College of Agricultural Sciences, Fort Collins, CO 80523
| | - Paxton Sullivan
- Department of Animal Sciences, Colorado State University, College of Agricultural Sciences, Fort Collins, CO 80523
| | - Melissa Davis
- Department of Animal Sciences, Colorado State University, College of Agricultural Sciences, Fort Collins, CO 80523
| | - Catie Cramer
- Department of Animal Sciences, Colorado State University, College of Agricultural Sciences, Fort Collins, CO 80523
| | - Noa Román-Muñiz
- Department of Animal Sciences, Colorado State University, College of Agricultural Sciences, Fort Collins, CO 80523
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King JJ, Badger TA, Segrin C, Thomson CA. Loneliness, Spirituality, and Health-Related Quality of Life in Hispanic English-Speaking Cancer Caregivers: A Qualitative Approach. J Relig Health 2024; 63:1433-1456. [PMID: 37665415 DOI: 10.1007/s10943-023-01880-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 09/05/2023]
Abstract
Hispanic caregivers experiencing higher caregiving burden than their non-Hispanic cohorts, due in part to contextual factors, such as barriers to accessing health care, challenging employment environments, low education and income, immigration issues, and minority stress. Spirituality may serve as a coping strategy for Hispanic caregivers that influences health-related quality of life (HRQoL), possibly by modifying loneliness associated with caregiving. We explored these concepts using semi-structured interviews (N = 10 Hispanic caregivers). Participants shared perceptions of loneliness, spirituality, and how these factors related to HRQoL. Five themes emerged: caregiver experience, coping strategies, loneliness, religion and spirituality to gain strength. Findings suggested that spirituality and religion improved HRQoL partially by reducing loneliness. Future programs to improve HRQoL in Hispanic English-speaking cancer caregivers should address spirituality.
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Affiliation(s)
- Jennifer J King
- University of Arizona Cancer Center, University of Arizona, 1295 N. Martin Ave., Drachman Hall, A260, PO Box 245209, Tucson, AZ, 85719, USA.
| | - Terry A Badger
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Chris Segrin
- College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, USA
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, The University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
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Murvartian L, Matías-García JA, Saavedra-Macías FJ, Crowe A. A Systematic Review of Public Stigmatization Toward Women Victims of Intimate Partner Violence in Low- and Middle-Income Countries. Trauma Violence Abuse 2024; 25:1349-1364. [PMID: 37309621 DOI: 10.1177/15248380231178756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Public stigmatization of women victims of intimate partner violence (IPV) has begun to be studied because of its negative impact on recovery from violence. This systematic review aimed to analyze such stigmatization in low- and middle-income countries (LAMIC) by identifying social norms and perceptions linked to public stigmatizing responses, such responses, negative consequences of those responses on victims, and other factors associated with public stigma. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five databases were searched using "stigma" and multiple synonyms of IPV as keywords. Selected articles were empirical, written in English, published in peer-reviewed journals, and reported findings on public stigma toward women victims of IPV that had occurred in LAMIC. Nineteen articles met the inclusion criteria. Patriarchal gender roles, normalization of IPV and the consideration of violence as a private matter were the most prevalent social norms among the studies. These led to blaming, isolating, and discriminating against the victim, making her feel ashamed, considering her less valuable than before suffering IPV, and dismissing or denying the abuse. Many negative consequences were identified. Anticipated public stigma, associated with not disclosing the abuse and not seeking help, was the most popular. Public stigmatization was stronger when other public stigmas intersected and in the case of disadvantaged social circumstances. Consequences were diminished by protective factors such as informal support and gender-based violence support services. This review provides a global vision for future research in each specific sociocultural context and is a first step in the design of anti-stigma programs in LAMIC.
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Havilla S, Alanazi FK, Boon B, Patton D, Ho YC, Molloy L. Exploring the impact of a multilevel intervention focused on reducing the practices of seclusion and restraint in acute mental health units in an Australian mental health service. Int J Ment Health Nurs 2024; 33:442-451. [PMID: 37964469 DOI: 10.1111/inm.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
Reducing and eliminating seclusion and restraint in inpatient settings has been a key area of focus in mental health policy and research for many years. To address this issue, numerous programmes aimed at minimising the use of these practices have been developed over the past two decades, with varying degrees of success. This article reports on research focused on the implementation of a localised, multilevel complex intervention that targeted both organisational and individual factors related to the use of seclusion and restraint. The researchers followed the impact of the intervention by interviewing medical, nursing and allied health staff who worked within the service (N = 12) and analysing the rates of seclusion and restraint over an 18-month period. Post-adoption, participants identified that there were clear changes in practice culture. Seclusion clearly became a practice of last resort and other options became prominent in staff's practice. Participants identified that there was a sense of shared purpose across the multidisciplinary team. The clinical environment was viewed as being more therapeutic for service users and less frightening for staff. There was a significant difference in the total number of seclusion events between pre- (Mean = 6.22, SD = 5.82) and post-implementation (Mean = 2.55, SD = 2.44, p = 0.002, d = 0.94), demonstrating a significantly lower number of seclusions was observed after the intervention. Similarly, a significant difference in restraint events between pre- (Mean = 5.50, SD = 3.77) and post-implementations (Mean = 3.38, SD = 3.21, p = 0.037, d = 0.62) was observed.
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Affiliation(s)
- Sizwile Havilla
- Illawarra Shoalhaven Local Health District Mental Health Service, Shellharbour, New South Wales, Australia
| | | | - Brad Boon
- Illawarra Shoalhaven Local Health District Mental Health Service, Shellharbour, New South Wales, Australia
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Yen-Chung Ho
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan ROC
| | - Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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175
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Honda A, Liu Y, Ono M, Nishida T, Tsukigi T, Fauth EB, Honda S. Impact of visitation restrictions on the mental health of family caregivers during the COVID-19 pandemic: A mixed methods study. J Adv Nurs 2024; 80:1652-1665. [PMID: 37902113 DOI: 10.1111/jan.15918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 09/15/2023] [Accepted: 10/15/2023] [Indexed: 10/31/2023]
Abstract
AIM To examine the mental health conditions of family caregivers residing away from their loved ones who experienced visitation restrictions during the coronavirus disease 2019 pandemic. DESIGN A mixed-methods design applying the Kessler Scale-10 for the quantitative measurement of psychological distress and an open-ended question for qualitative analysis. METHODS The participants were recruited from care facilities between February and September 2021. This cross-sectional study included 197 family caregivers who were utilizing formal residential care services for their loved ones. Using thematic analyses, open-ended responses regarding the impact of visitation restrictions were coded. These themes were then examined to determine thematic patterns across caregiver characteristics. RESULTS Thirteen themes were identified regarding the impact of visitation restrictions. Many participants reported primary harmful effects as follows: 'inability to confirm the type of care and lifestyle assistance provided to an older relative' and 'difficulty communicating with an older relative because of the inability to converse face-to-face'. Younger age, being employed, poor sleep, poor relationship quality with the care recipient and experiencing harmful effects from the visitation restrictions were associated with psychological distress. CONCLUSION Our findings suggest that to maintain positive mental health after a care transition, it is important for family caregivers to take part in the care of their loved ones and ensure information sharing between the care recipient's family and institution. IMPACT These findings suggest that both residents and family caregivers living outside facilities may feel distressed due to separation. Therefore, institutional care staff needs to consider how to adjust facility procedures or communication with family caregivers. PATIENT OR PUBLIC CONTRIBUTION The comments obtained from the participants in this survey helped to shape the study design and are expected to contribute to the further development of quality facility care.
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Affiliation(s)
- Ayumi Honda
- Department of Nursing, St. Mary's College, Fukuoka, Japan
| | - Yin Liu
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Mayo Ono
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Nishida
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tatsuya Tsukigi
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Elizabeth B Fauth
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Sumihisa Honda
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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176
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Gajaria A, Greenblatt A, Prebeg M, Relihan J, Peter Szatmari, Courtney DB. Talking 'Bout Better outcomes for Adolescent Depression: Youth and Caregiver Perspectives on an Integrated Care Pathway for Depression. Clin Child Psychol Psychiatry 2024; 29:453-465. [PMID: 37394898 DOI: 10.1177/13591045231184916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND Depression is a common condition among adolescents, with rates continuing to rise. A gap exists between evidence-based recommendations for the treatment of depression and clinical practice. Integrated Care Pathways (ICPs) can help address this gap, but to date no study has examined how young people and their caregivers experience ICPs and whether these pathways are an acceptable form of care. This study used focus groups with adolescents, caregivers, and service providers to examine experiences of an ICP. METHODS Six individual interviews with service providers, four focus groups with youth, and two focus groups with caregivers were completed. Data was analyzed consistent with Braun & Clarke's Thematic Analysis Framework within an interpretivist paradigm. RESULTS AND CONCLUSION The study demonstrated that ICPs are acceptable to youth and their caregivers and that ICPs facilitate shared decision making between youth/caregivers and care providers. Findings also indicated that youth are willing to engage with ICPs particularly when there is a trusted clinician involved who helps interpret and tailor the ICP to the young person's experience. Further questions include how to best integrate these into the overall system and how to further tailor these pathways to support youth with diagnostic complexity and treatment resistance.
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Affiliation(s)
- Amy Gajaria
- Margaret and Wallace McCain Centre for Child, Youth, & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Andrea Greenblatt
- Child Health Evaluative Sciences, Sick Kids Research Institute, Toronto, ON, Canada
| | - Matthew Prebeg
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Darren B Courtney
- Margaret and Wallace McCain Centre for Child, Youth, & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
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177
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Jonathan GK, Abitante G, McBride A, Bernstein-Sandler M, Babington P, Dopke CA, Rossom RC, Mohr DC, Goulding EH. LiveWell, a smartphone-based self-management intervention for bipolar disorder: Intervention participation and usability analysis. J Affect Disord 2024; 350:926-936. [PMID: 38246280 PMCID: PMC10947155 DOI: 10.1016/j.jad.2024.01.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Understanding how individuals utilize and perceive digital mental health interventions may improve engagement and effectiveness. To support intervention improvement, participant feedback was obtained and app use patterns were examined for a randomized clinical trial evaluating a smartphone-based intervention for individuals with bipolar disorder. METHODS App use and coaching engagement were examined (n = 124). Feedback was obtained via exit questionnaires (week 16, n = 81) and exit interviews (week 48, n = 17). RESULTS On average, over 48 weeks, participants used the app for 4.4 h and engaged with the coach for 3.9 h. Participants spent the most time monitoring target behaviors and receiving adaptive feedback and the least time viewing self-assessments and skills. Participants reported that the daily check in helped increase awareness of target behaviors but expressed frustration with repetitiveness of monitoring and feedback content. Participants liked personalizing their wellness plan, but its use did not facilitate skills practice. App use declined over time which participants attributed to clinical stability, content mastery, and time commitment. Participants found the coaching supportive and motivating for app use. LIMITATIONS App engagement based on viewing time may overestimate engagement. The delay between intervention delivery and the exit interviews and low exit interview participation may introduce bias. CONCLUSION Utilization patterns and feedback suggest that digital mental health engagement and efficacy may benefit from adaptive personalization of targets monitored combined with adaptive monitoring and feedback to support skills practice and development. Increasing engagement with supports may also be beneficial.
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Affiliation(s)
- Geneva K Jonathan
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - George Abitante
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, United States of America
| | - Alyssa McBride
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, United States of America
| | - Mary Bernstein-Sandler
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, United States of America
| | - Pamela Babington
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, United States of America
| | - Cynthia A Dopke
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, United States of America
| | - Rebecca C Rossom
- HealthPartners Institute, Minneapolis, MN, United States of America
| | - David C Mohr
- Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, United States of America
| | - Evan H Goulding
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, United States of America.
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178
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Zhang W, He Y, Gu Q, Zhang Y, Zha Q, Feng Q, Zhang S, He Y, Kang L, Xue M, Jing F, Li J, Mao Y, Zhu W. Optimal timing for awake prone positioning in Covid-19 patients: Insights from an observational study from two centers. Int J Nurs Stud 2024; 152:104707. [PMID: 38368846 DOI: 10.1016/j.ijnurstu.2024.104707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 01/15/2024] [Accepted: 01/28/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND The widespread application and interest in awake prone positioning stems from its ease and availability and its ability to enhance patients' oxygenation. Nevertheless, due to the absence of consensus over the regimen of awake prone positioning, the efficacy of awake prone positioning remains uncertain. OBJECTIVE To explore the optimal regimen for awake prone positioning, including the timing of initiation, ideal daily duration, and strategies for improving patient comfort and encouraging adherence. DESIGN Retrospective observational study. SETTING(S) Two university-affiliated hospitals in Shanghai. PARTICIPANTS Between December 2022 and February 2023, a total of 475 patients with COVID-19-related pneumonia who received awake prone positioning were observed. METHODS The data were collected from the hospital's electronic medical record system. The differentiation efficiency of peripheral blood oxygen saturation [SpO2]:fractional oxygen concentration in inspired air [FiO2] ratio at first awake prone positioning for different outcomes was tested by the area under the receiver operating characteristic curve. The Cox proportional hazard regression model was used to analyze the relationship between time to occurrence of 28-day outcomes and collected variables. Kaplan-Meier curves were plotted with the percentage of 28-day outcomes according to the SpO2:FiO2 ratio at first awake prone positioning after controlling covariates through Cox regression. RESULTS The best efficiency in predicting patient outcomes was achieved when the cutoff SpO2:FiO2 ratio at first awake prone positioning was 200. Patients with a reduced SpO2:FiO2 ratio (≤200) experienced more adverse respiratory outcomes (RR = 5.42, 95%CI [3.35, 8.76], p < 0·001) and higher mortality (RR = 16.64, 95%CI [5.53, 50.13], p < 0.001). Patients with a SpO2:FiO2 ratio of ≥200 at first awake prone positioning, longer duration between first awake prone positioning and admission, more awake prone positioning days, and better awake prone positioning completion were significantly protected from 28-day adverse respiratory outcomes and mortality. CONCLUSIONS Initiating awake prone positioning with a SpO2:FiO2 ratio exceeding 200, increasing the number of awake prone positioning days, prolonging the time between first awake prone positioning and admission, and achieving better completion of awake prone positioning were found to be significantly associated with reduced adverse respiratory outcomes and mortality. REGISTRATION ClinicalTrials.gov; No.: NCT05795751; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Weiqing Zhang
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Yan He
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Shanghai, China
| | - Qiuying Gu
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yin Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinghua Zha
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Feng
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shiyu Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang He
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Kang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Xue
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Jing
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinling Li
- Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Shanghai, China
| | - Yanjun Mao
- Department of Nursing, Shanghai Pulmonary Hospital, Shanghai, China.
| | - Weiyi Zhu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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179
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Elshahat S, Moffat T, Iqbal BK, Newbold KB, Gagnon O, Alkhawaldeh H, Morshed M, Madani K, Gehani M, Zhu T, Garabedian L, Belahlou Y, Curtay SAH, Zhu IHC, Chan C, Duzenli D, Rajapaksege N, Shafiq B, Zaidi A. 'I thought we would be nourished here': The complexity of nutrition/food and its relationship to mental health among Arab immigrants/refugees in Canada: The CAN-HEAL study. Appetite 2024; 195:107226. [PMID: 38266714 DOI: 10.1016/j.appet.2024.107226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/12/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
Nutritional psychiatry suggests that diet quality impacts one's mental health (MH). The relationship between food/nutrition and MH may be particularly salient for immigrants/refugees who often experience high risk for household food insecurity and MH challenges. An innovative collaborative community-based participatory research and integrated knowledge translation approach was adopted to explore food/nutrition needs as they relate to MH among Arab immigrants/refuges (AIR) in Ontario, Canada. The goal was to co-identify areas that require social change and co-produce applicable knowledge for service improvement. The CAN-HEAL study used a multi-methodological approach, employing qualitative interviews, photovoice and a questionnaire survey. A combination of three sampling approaches (convenience, snowball and purposive) was used to recruit sixty socio-demographically-diverse adult AIR participants. The research was guided by an integrated bio-psycho-socio-cultural framework. Participants reported various socio-economic and structural barriers to nutritious eating. Food quality/safety was a significant concern and source of anxiety among AIR; food mislabeling, the widespread presence of genetically/chemically modified foods and expired/rotten food products were associated with negative MH. Participants experienced an alarming prevalence of food insecurity (65%), which was associated with negative MH. Intersections among age, gender, religion, socio-economic status, parenthood, disability, and place of residence played a considerable role in how nutrition, food security, and dietary intake impacted AIR's MH and caused substantial disparities within the AIR community. The food/nutrition-MH relationship among AIR is multi-faceted, and various psycho-socio-cultural pathways/processes were found to shape MH. Intersectoral collaboration between health and non-health sectors is needed to implement a co-proposed socio-political and community-level action plan to achieve nutrition and health equity for AIR and other similar marginalized groups.
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Affiliation(s)
- Sarah Elshahat
- Department of Anthropology, Faculty of Social Sciences, McMaster University, Hamilton, ON, L8S 4L9, Canada.
| | - Tina Moffat
- Department of Anthropology, Faculty of Social Sciences, McMaster University, Hamilton, ON, L8S 4L9, Canada
| | - Basit Kareem Iqbal
- Department of Anthropology, Faculty of Social Sciences, McMaster University, Hamilton, ON, L8S 4L9, Canada
| | - K Bruce Newbold
- School of Earth, Environment & Society, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Olivia Gagnon
- Department of Neuroscience, Faculty of Science, Carleton University, Ottawa, ON, K1S 5B6, Canada
| | - Haneen Alkhawaldeh
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Mahira Morshed
- Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Keon Madani
- Integrated Biomedical Engineering and Health Sciences Faculty, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Mafaz Gehani
- Department of Psychological and Health Sciences, University of Toronto, Scarborough, ON, M1C 1A4, Canada
| | - Tony Zhu
- Department of Criminology & Sociolegal Studies, Faculty of Arts and Science, University of Toronto, Toronto, ON, M5S 1A1, Canada
| | - Lucy Garabedian
- Department of Biomedical and Molecular Sciences, Faculty of Arts and Science, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Yasmine Belahlou
- Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Sarah A H Curtay
- School of Nursing, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Irene Hui-Chen Zhu
- School of Food and Nutritional Sciences, University of Western Ontario, Brescia University College, London, ON, N6A 3K7, Canada
| | - Charlotte Chan
- School of Food and Nutritional Sciences, University of Western Ontario, Brescia University College, London, ON, N6A 3K7, Canada
| | - Deniz Duzenli
- Department of Biology, Faculty of Science, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | | | - Bisma Shafiq
- School of Food and Nutritional Sciences, University of Western Ontario, Brescia University College, London, ON, N6A 3K7, Canada
| | - Amna Zaidi
- Department of Political Science, Faculty of Social Sciences, McMaster University, Hamilton, ON, L8S 4L8, Canada
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180
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Clark MTR, Manuel J, Lacey C, Pitama S, Cunningham R, Jordan J. 'E koekoe te Tūī, e ketekete te Kākā, e kuku te Kererū, The Tūī chatters, the Kākā cackles, and the Kererū coos': Insights into explanatory factors, treatment experiences and recovery for Māori with eating disorders - A qualitative study. Aust N Z J Psychiatry 2024; 58:365-372. [PMID: 37888910 DOI: 10.1177/00048674231207583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
BACKGROUND Eating disorders are as common in Māori, the Indigenous people of Aotearoa-New Zealand, as they are in non-Māori; however, research has focused on the experiences of non-Māori. This paper will describe explanatory factors, treatment experiences and what helps with recovery for Māori. METHODS Kaupapa Māori research methodology informed the methods and analysis. Fifteen semi-structured interviews comprised thirteen Māori participants with eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder) and two whānau (support network) members. A thematic analysis was undertaken by a first cycle of coding that used deductive structural coding to identify data describing participants' perceived causes of eating disorders, their experience of treatment and recovery. A second cycle of coding used inductive analysis with descriptive and pattern coding. RESULTS Three overarching themes were antecedents (cumulative exposure), treatment (a system of complexities) and recovery (resource empowerment). Antecedents comprised cumulative exposure to body and sporting ideals and adversity as causal factors of eating disorders. In the treatment theme, a system of complexities critiqued rural settings for generalised mental health services, allocation of Māori cultural support, the economic burden of treatment, culturally incongruent treatment (methods, values) and a weight-focused discharge criterion. Recovery (resource empowerment) found appropriate health information, self-determination and connection to Māori culture and whānau aspirations helped with recovery. CONCLUSION The diversity of birdcalls reminds us of the individuality of eating disorders. Health practitioners are reminded that just as the Tūī, Kākā and Kererū possess their own unique birdcalls, so do Māori with eating disorders and their whānau have their own experiences, needs and required treatment responses.
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Affiliation(s)
- Mau Te Rangimarie Clark
- Department of Māori/Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
| | - Jenni Manuel
- Department of Māori/Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Māori/Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Suzanne Pitama
- Department of Māori/Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
- Te Whatu Ora - Health New Zealand Waitaha/Canterbury, Specialist Mental Health Clinical Research Unit, Christchurch, New Zealand
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181
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Bever A, Dunne J, Reynolds J, Waserman S, Kaplan AG, O'Keefe A, McNeilly S, Szabo SM. Exploring Perceptions of Biologic Therapies: A Qualitative Study Among Canadians Living with Severe Asthma. Adv Ther 2024; 41:1401-1418. [PMID: 38349560 DOI: 10.1007/s12325-024-02803-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/25/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION Biologic therapies have demonstrated benefits for individuals with severe asthma, including reduced daily symptoms and severe exacerbations. However, data describing patient perspectives on these treatments are limited. This study sought to understand the preferences and priorities of Canadians with severe asthma in the context of novel biologic treatment options. METHODS Semi-structured, qualitative interviews were conducted among Canadians with severe asthma from July to August 2022. Purposeful sampling included individuals with and without biologic therapy experience. All participants described daily life with severe asthma, experiences and priorities related to asthma treatment and their impressions of biologics. Reflexive thematic analysis was used to explore patterns in the data. RESULTS Among 18 individuals included, 10 were currently taking or had prior experience with biologic treatment for asthma. Those who had never been treated with biologics were unfamiliar with them, considering treatment, or believed that they may not be eligible. Four themes were developed to convey the perspectives of participants on biologics: (1) life-changing benefits, but not for all; (2) navigating barriers to being prescribed and remaining adherent to biologic treatments; (3) treatment administration preferences are not only about convenience; (4) concerns about safety and the unknown as a source of treatment hesitancy. CONCLUSIONS Findings suggest that the clinical benefits of biologics align with patient perceptions of achieving good asthma control. However, treatment gaps persist among individuals who do not experience a meaningful improvement in their asthma symptoms and those who face barriers accessing biologics. People with severe asthma attributed importance to greater availability of at-home treatment options, improved access to financial support to cover treatment costs and support to address safety concerns. This research provides insight into patient-based treatment priorities and preferences for biologics, which may help inform decision-making related to emerging therapies for severe asthma.
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Affiliation(s)
- Andrea Bever
- Broadstreet HEOR, 201-343 Railway St, Vancouver, BC, Canada
| | - Jessica Dunne
- Broadstreet HEOR, 201-343 Railway St, Vancouver, BC, Canada
| | | | - Susan Waserman
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Alan G Kaplan
- Family Physician Airways Group of Canada, Respiratory Effectiveness Group, Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Andrew O'Keefe
- Department of Pediatrics, Faculty of Medicine, Memorial University, St. John's, NL, Canada
| | | | - Shelagh M Szabo
- Broadstreet HEOR, 201-343 Railway St, Vancouver, BC, Canada.
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182
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Zeng Y, Pan T, He Y, Sun M. Stigma of nursing students towards people with mental illness: Protocol of a mixed-method systematic review. Heliyon 2024; 10:e27899. [PMID: 38500990 PMCID: PMC10945256 DOI: 10.1016/j.heliyon.2024.e27899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/03/2024] [Accepted: 03/07/2024] [Indexed: 03/20/2024] Open
Abstract
Aims To synthesize the influencing factors of the stigma of nursing students towards people with mental illness (PMI). Background The stigma of nursing students towards PMI may affect their career choices and negatively impact people seeking health services. While many studies have examined the educational aspects of mental health, they often overlook the multiple dimensions of possible factors influencing nursing students' perceptions. Design A mixed-method systematic review using the Framework Integrating Normative Influences on Stigma (FINIS). Methods We will search six databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and PsycINFO. The reference list of the included literature will be thoroughly examined to identify if any additional studies meet the criteria. Two authors will independently screen all titles, abstracts, full text and extract data. The Mixed-method Appraisal Tool will be used to assess quality. The extracted data will be disposed to different levels, including micro (demographic characteristics, disease characteristics), meso (social networks, treatment systems) and macro (media images, national context) to comply with the FINIS. Expected results This systematic review aims to comprehensively analyze the influencing factors of the stigma of nursing students towards PMI, providing a reference basis for anti-stigma intervention measures.Prospero registration number: CRD42022374419.
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Affiliation(s)
- Yi Zeng
- Xiangya School of Nursing, Central South University, Changsha, 410013, China
| | - Ting Pan
- Xiangya School of Nursing, Central South University, Changsha, 410013, China
| | - Yuqing He
- Xiangya School of Nursing, Central South University, Changsha, 410013, China
| | - Mei Sun
- School of Nursing, Xinjiang Medical University, Urumqi 830054, China
- Xiangya School of Nursing, Central South University, Changsha, 410013, China
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Mekonen LD, Kumsa DM, Adamu Amanu A. Social media use, effects, and parental mediation among school adolescents in a developing country. Heliyon 2024; 10:e27855. [PMID: 38515715 PMCID: PMC10955317 DOI: 10.1016/j.heliyon.2024.e27855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 03/01/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024] Open
Abstract
Social media use among adolescents is becoming increasingly common worldwide. While social media use has many benefits for everyone, it can also pose risks especially for adolescents, depending on how and why they use it. Therefore, it is an important research and public agenda, especially in developing countries like Ethiopia where there is an increasingly growing social media use among adolescents in these days. This study aimed to assess social media use, effects, and parental mediation among school adolescents in Ethiopia. The study employed concurrent triangulation cross-sectional study design. Simple random sampling and purposive sampling were used to select 227 participants, including adolescents and parents. Descriptive statistics were used to present, analyze, and interpret the quantitative data using SPSS software version 20.0. Thematic analysis was used to analyze the qualitative data. The findings were then triangulated. The study found that the majority (86.3%) of the respondents were widely using various social media platforms for different purposes. Both adolescents and parents reported that adolescents were experiencing both positive and negative effects from social media use, including academic, mental, social, and health related aspects. However, adolescents emphasized the positive effects, while parents stressed the negative effects more. The study also found that many parents were supportive of their children's social media use for educational purposes, but most do not have control over or do not supervise their children's social media usage. The study recommends that the government, schools, parents, and other concerned bodies work together to improve understanding of and promote safe social media usage among adolescents.
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Affiliation(s)
| | | | - A. Adamu Amanu
- Department of Sociology, Jimma University, Jimma, Oromia, Ethiopia
- Health, Behavior, And Society Department, Jimma University, Jimma, Oromia, Ethiopia
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184
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Swierad EM, Rausch JC, Sawyer V, Drucker G, Williams O. "The Design and Acceptability of a Hip Hop Themed Integrated Nutrition Math Curriculum for Minoritized 5th Grade Students Using the Multisensory Multilevel Health Education Model". Health Promot Pract 2024:15248399241240431. [PMID: 38533745 DOI: 10.1177/15248399241240431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Digital technology creates new opportunities to design multisensory learning experiences. Evidence suggests that digital innovation can greatly benefit health education, including nutrition programs. The COVID-19 pandemic disrupted the education sector, forcing schools to modify standard practices from exclusively in-person delivery to online or blended learning. Digitalized curriculums became particularly useful as an Emergency Remote Teaching tool. This article focuses on developing and implementing a multimedia, multisensory, and scalable Hip-Hop Healthy Eating and Living in Schools (H.E.A.L.S.) Nutrition-Math Curriculum (NMC). NMC comprises 20 lessons-music-based multimedia resources used in the classroom or at home. Fourteen lessons represent self-directed online modules (asynchronous learning) hosted on a Learning Management System (LMS) called "Gooru." The remaining six lessons are teacher-facilitated (in person or using Zoom) review sessions (synchronous learning). The article discusses (1) the development of NMC through the lens of the Multisensory Multilevel Health Education Model (MMHEM), (2) the high acceptability of NMC evaluated using a mixed-methods design among minoritized fifth-grade students attending an after-school program, and (3) the students' completion and mastery rates of the NMC modules based on LMS data. Multimedia nutrition education programs integrated with common core curriculum content, such as NMC, may be a promising avenue for disseminating health education to minoritized children living in New York City and similar high fast-food density cities.
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Affiliation(s)
| | - John C Rausch
- Columbia University Irving Medical Center, New York, NY, USA
| | - Vanessa Sawyer
- Columbia University Irving Medical Center, New York, NY, USA
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185
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Ahmed Pihlgren S, Johansson L, Holmes EA, Kanstrup M. Exploring healthcare workers' experiences of a simple intervention to reduce their intrusive memories of psychological trauma: an interpretative phenomenological analysis. Eur J Psychotraumatol 2024; 15:2328956. [PMID: 38533843 DOI: 10.1080/20008066.2024.2328956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/02/2024] [Indexed: 03/28/2024] Open
Abstract
ABSTRACTBackground: Many healthcare workers (HCWs) endured psychologically traumatic events at work during the coronavirus disease 2019 (COVID-19) pandemic. For some, these events are re-experienced as unwanted, recurrent, and distressing intrusive memories. Simple psychological support measures are needed to reduce such symptoms of post-traumatic stress in this population. A novel intervention to target intrusive memories, called an imagery-competing task intervention (ICTI), has been developed from the laboratory. The intervention includes a brief memory reminder cue, then a visuospatial task (Tetris® gameplay using mental rotation instructions for approximately 20 min) thought to interfere with the traumatic memory image and reduce its intrusiveness. The intervention has been adapted and evaluated in a randomized controlled trial (RCT) with Swedish HCWs (ClinicalTrials.gov identifier: NCT04460014).Objective: We aimed to explore how HCWs who worked during the COVID-19 pandemic experienced the use of a brief intervention to reduce their intrusive memories of work-related trauma.Method: Interpretative phenomenological analysis was used for in-depth understanding of the lived experiences of HCWs who used the intervention. Seven participants from the RCT were interviewed by an independent researcher without prior knowledge of the intervention. Interviews were conducted via telephone and transcribed verbatim.Results: Four general themes were generated: 'Triggers and troublesome images', 'Five Ws regarding support - what, when, why, by/with who, for whom', 'Receiving it, believing it, and doing it' and 'The intervention - a different kind of help'; the last two included two subthemes each. The results reflect participants' similarities and differences in their lived experiences of intrusive memories, support measures, and intervention impressions and effects.Conclusion: HCWs' experiences of the novel ICTI reflect a promising appraisal of the intervention as a potential help measure for reducing intrusive memories after trauma, and gives us a detailed understanding of HCWs' needs, with suggestions for its adaption for future implementation.Trial registration: ClinicalTrials.gov identifier: NCT04460014.
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Affiliation(s)
- Sara Ahmed Pihlgren
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Johansson
- The Neurosurgical Intensive Care Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emily A Holmes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marie Kanstrup
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Theme Women's Health and Allied Health Professionals, Medical Unit for Medical Psychology, Karolinska University Hospital, Solna, Sweden
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186
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Siu C, Aoude M, Andersen J, Adams KD. The lived experiences of play and the perspectives of disabled children and their parents surrounding brain-computer interfaces. Disabil Rehabil Assist Technol 2024:1-10. [PMID: 38533741 DOI: 10.1080/17483107.2024.2333884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
Brain-computer interfaces (BCI) offer promise to the play of children with significant physical impairments, as BCI technology can enable disabled children to control computer devices, toys, and robots using only their brain signals. However, there is little research on the unique needs of disabled children when it comes to BCI-enabled play. Thus, this paper explored the lived experiences of play for children with significant physical impairments and examined how BCI could potentially be implemented into disabled children's play experiences by applying a social model of childhood disability. Descriptive qualitative methodology was employed by conducting four semi-structured interviews with two children with significant physical impairments and their parents. We found that disabled children's play can be interpreted as passive or active depending on one's definition and perceptions surrounding play. Moreover, disabled children continue to face physical, economic, and technological barriers in their play, as well as play restrictions from physical impairments. We urge that future research should strive to directly hear from disabled children themselves, as their perspectives may differ from their parents' views. Also, future BCI development should strive to incorporate video games, recreational and entertainment applications/platforms, toys and switch-adapted toys, and power wheelchairs to better support the play of children with significant physical impairments.Implications for RehabilitationAssistive technology research should strive to examine the social, infrastructural, and environmental barriers that continue to disable and restrict participation for disabled children and their families through applying a social model of childhood disability and other holistic frameworks that look beyond individual factorsFuture research that examines the needs and lives of disabled children should strive to directly seek the opinions and perspectives of disabled children themselvesBrain-computer interface development should strive to incorporate video games, recreational and entertainment applications/platforms, toys and switch-adapted toys, and power wheelchairs to better support the play of children with significant physical impairments.
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Affiliation(s)
- Carina Siu
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Manar Aoude
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - John Andersen
- Glenrose Rehabilitation Hospital, Edmonton, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Kim D Adams
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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187
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Pillay S, Duncan M, de Vries PJ. 'We wait and we wait'-caregiver perspectives on autism spectrum disorder services in the Western Cape Province of South Africa. Child Adolesc Ment Health 2024. [PMID: 38533770 DOI: 10.1111/camh.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION Caregivers of children with autism face significant challenges in navigating health, education and other systems of care to ensure appropriate services for their children. In South Africa, for example, many children with autism are reported to be out of schools and waiting long periods for specialist school placements thus adding to the burden of care for caregivers and raising many questions about equity, diversity and inclusion. METHODS Here we performed a qualitative study using focus groups to collect data on the perspectives of caregivers of children with autism waiting for school placement in the Western Cape Province of South Africa. We asked families about their experiences of current autism services and for suggestions to improve service delivery. RESULTS The main theme that emerged was 'We wait and we wait'. Caregivers expressed high levels of frustration with existing autism educational and other services. Perspectives about services were captured under three categories. The first category, 'The costs of waiting' describes the socioemotional, financial and time costs associated with having a child with autism wait for educational services. The second category 'Barriers while waiting' describes the attitudinal, structural, process and communication barriers experienced by caregivers while seeking services for their children. The final category 'Expecting action' describes attitudinal, service and policy expectations that caregivers felt could improve service delivery. Caregivers provided 10 recommendations for autism service improvements. CONCLUSION Caregivers of children with autism waiting for educational services in the Western Cape Province of South Africa expressed dissatisfaction with existing services. Efforts to find solutions to providing services and support to children with autism waiting for educational services and their caregivers should be prioritized.
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Affiliation(s)
- Sarosha Pillay
- Department of Health and Rehabilitation Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Madeleine Duncan
- Department of Health and Rehabilitation Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Petrus J de Vries
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
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188
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Libster N, Harwood R, Meacham K, Kasari C. "I do my best to do right by her": Autistic motherhood and the experience of raising a non-autistic adolescent daughter. Autism 2024:13623613241241577. [PMID: 38529855 DOI: 10.1177/13623613241241577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
LAY ABSTRACT Little is known about the parenting experiences of autistic mothers, especially those who have daughters who are not on the autism spectrum. In this study, we interviewed seven autistic mothers who have raised or are currently raising non-autistic teenage daughters. Mothers were asked to describe what parenting was/is like during their daughters' teenage years. We analyzed the transcripts of the interviews and found several common themes. Mothers described their relationships with their daughters to be loving, safe, and empathetic. Mothers described several strengths when it came to parenting, such as helping their daughters solve problems and using positive strategies to handle conflict with their daughters. Mothers also described challenges they faced when interacting with other non-autistic people and when trying to form relationships with them. Mothers tried to build their daughters' social skills so that they would not experience the same challenges. This study shows that autistic mothers have close, loving relationships with their non-autistic teenage daughters but have trouble forming relationships with other non-autistic people. It is, therefore, important that non-autistic parents are more understanding and welcoming of autistic mothers.
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189
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Mwakawanga DL, Massae AF, Kohli N, Lukumay GG, Rohloff CT, Mushy SE, Mgopa LR, Mkoka DA, Mkonyi E, Trent M, Ross MW, Rosser BRS, Connor J. The need for and acceptability of a curriculum to train nursing and medical students in the sexual healthcare of clients with female genital mutilation/cutting in Tanzania. BMC Womens Health 2024; 24:198. [PMID: 38532377 DOI: 10.1186/s12905-024-03034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Female genital mutilation/cutting (FGM/C) is tied to one of the most conservative cultures in the Mediterranean and Sub-Saharan Africa. More than 200 million girls and women in 30 African, Asian and the middle Eastern countries have undergone FGM/C. However, healthcare professionals are not adequately trained to prevent and manage FGM/C-related complications including sexual health problems. This study aimed to assess the need and acceptability of a curriculum to train nursing and medical students in the sexual healthcare of clients with FGM/C in Tanzania. METHODS We used a descriptive and cross sectional study design to collect and analyse information from 271 medical and 137 nursing students in Tanzania. A Qualtrics online survey was used to obtain quantitative data on training interest, previous training received, and the curriculum delivery method. Open-ended questions were used to explore their insights on significance to obtain the necessary competencies to treat and prevent FGM/C. Descriptive statistics were used to analyze quantitative data while qualitative data were analyzed using a thematic approach. RESULTS Almost half of the participants reported they had little to no training in sexual healthcare for women with FGM/C (47%). In all, 82.4% reported the training to be acceptable. Following thematic analysis of open-ended questions, participants expressed a desire to improve their competencies to meet the current and future sexual and psychological health needs of women and girls who have undergone FGM/C. CONCLUSION It is a necessary and acceptable to develop a curriculum to train healthcare students to diagnose, treat and prevent sexual health complications related to FGM/C. In our study, designing a culturally sensitive curriculum and its delivery method, that includes practical sessions with simulated patients, was considered the most beneficial and favorable.
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Affiliation(s)
- Dorkasi L Mwakawanga
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Agnes F Massae
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Nidhi Kohli
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Gift Gadiel Lukumay
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Corissa T Rohloff
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Stella Emmanuel Mushy
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Lucy R Mgopa
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Dickson Ally Mkoka
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Ever Mkonyi
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Maria Trent
- Johns Hopkins University, 200 N. Wolfe Street, Baltimore, MD, 21287, USA
| | - Michael W Ross
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - B R Simon Rosser
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA.
| | - Jennifer Connor
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
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190
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Perry A, Gardener C, Shieh J, Hồ QT, Doan A, Bhui K. Investigating the acceptability of a culturally adapted acceptance and commitment therapy group for UK Vietnamese communities: A practice-based feasibility study. Transcult Psychiatry 2024:13634615241228071. [PMID: 38529626 DOI: 10.1177/13634615241228071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Acceptance and Commitment Therapy (ACT) is an empirically supported psychotherapy that offers promise for the mental health of minoritised ethnic populations. Given the diversity of those presenting to inner-city services and barriers to accessing appropriate mental healthcare, we sought to develop a culturally syntonic ACT intervention for UK Vietnamese refugee communities in a practice-based partnership project between a National Health Service and local third-sector service in East London. The aim was to explore the feasibility, acceptability and impact of the adapted intervention to inform culturally inclusive clinical practice and future research. We outline key aspects of Vietnamese belief systems and culture, and consider how these might influence the optimisation of group-based ACT. We then present a mixed-method evaluation of the seven-session adapted ACT group for 11 participants (9 male and 5 female, aged between 44 and 73 years). Individual-level change analyses indicated clinically significant improvements in psychological flexibility for the minority of participants and a mixed pattern for impact on well-being. A thematic analysis and descriptive approach examined acceptability, feasibility and narratives of impact. Participants reported positive feedback on group experience, relevance and usefulness, and emergent themes indicate that the group facilitated key acceptance, commitment and behaviour-change processes, promoted social connections and increased engagement in meaningful life activities in relation to new perspectives and values-based action. Limitations are outlined, but overall, findings suggest preliminary support for the potential beneficial effect of the adapted ACT group as a feasible, culturally acceptable therapeutic approach for UK Vietnamese communities that is worthy of further investigation.
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Affiliation(s)
| | | | | | | | | | - Kamaldeep Bhui
- East London NHS Foundation Trust
- University of Oxford
- World Psychiatric Association Collaborating Centre (Research, Training, Policy) Oxford
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191
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Yussof I, Mohamed Shah N, Ab Muin NF, Abd Rahim S, Hatah E, Mohd Tahir NA, Loganathan K, Munisamy M. Challenges in Obtaining and Seeking Information Among Breast Cancer Survivors in an Asian Country: a Qualitative Study. J Cancer Educ 2024:10.1007/s13187-024-02421-0. [PMID: 38530598 DOI: 10.1007/s13187-024-02421-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/28/2024]
Abstract
Breast cancer survivors on adjuvant endocrine therapy (AET) have distinct information-seeking experience compared to those in the diagnosis and intensive treatment phase. This study aimed to understand the challenges in obtaining and seeking information among Malaysian breast cancer survivors. We conducted semi-structured, one-to-one interviews among patients using AET from two hospitals and a local cancer organization. Interviews were conducted until theme saturation was achieved (N = 25). Interviews were de-identified, transcribed verbatim, and analysed using thematic analysis. To ensure rigor, coding was conducted through regular discussions between two researchers and the findings were shared with several participants after analysis was completed. Three main themes were identified: limitations in the healthcare system, pitfalls of seeking information online, and limited information from local sources. The participants perceived that their information needs were not met by their healthcare providers and sought information on the Internet to complement their information needs. However, they were faced with risks of misinformation, information overload, and unethical promotion of health products. Those with limited English proficiency had difficulties in accessing quality information, and suggested that there should be more content created by local health advocates in local languages, with information that is tailored for local cultures. As the Internet has become an important medium of health education, healthcare providers and patients should be equipped with the skills to share and search for information online. Digital health literacy needs to be incorporated in patient education modules to create a more informed and empowered patient community.
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Affiliation(s)
- Izzati Yussof
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
- Pharmaceutical Services Division, Kuala Lumpur & Putrajaya Health Department, Ministry of Health, Kuala Lumpur, Malaysia
| | - Noraida Mohamed Shah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | - Nur Fa'izah Ab Muin
- Radiotherapy and Oncology Department, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Ernieda Hatah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Asyikin Mohd Tahir
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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192
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Kovalenko AG, Fenton RA. Bystander Intervention in Football and Sports. A Quasi-Experimental Feasibility Study of a Bystander Violence Prevention Program in the United Kingdom. J Interpers Violence 2024:8862605241239452. [PMID: 38529918 DOI: 10.1177/08862605241239452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
In recent years, social campaigns and high-profile cases have brought increased attention to violence against women. Athletes can be role models, shaping both prosocial and antisocial attitudes. Their engagement in violence prevention could be an effective tool to tackle violence against women through bystander intervention. This part of a mixed-method feasibility study reports on the quantitative evaluation of an evidence-led bystander program, Football Onside, implemented at a football club in South West England in June 2018 to February 2020. The study employed a quasi-experimental design with intervention and control groups. Football coaches and club members (n = 50) completed measures of rape and domestic abuse myths, bystander intent and efficacy, self-reported bystander behaviors, readiness for change, perceptions of peer helping and myth acceptance, law knowledge, and program evaluation. Fidelity was also assessed. The analysis compared between- and within-group differences in mean changes over time using mixed-effects models. Participant ratings of learning outcomes were high, and fidelity was maintained throughout the intervention. Between-group comparison revealed mixed results, with greater improvements in the intervention group for bystander intent and efficacy at post-test and follow-up, domestic abuse myths at post-test, and rape myth acceptance at follow-up. Model contrasts for within intervention group revealed improvements in rape and domestic abuse myth acceptance, bystander intent and efficacy, perceived law knowledge at both time points, and perceived peer myths and helping at post-test. At follow-up, intervention participants reported significantly higher engagement in bystander behaviors. No significant effects were found for perceived importance of legal knowledge. Our research highlights the potential efficacy of a bystander program tailored for football club members. Cluster-randomized control trials are now required to examine bystander attitudes and behavior change processes among professional athletes.
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193
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Wiik AB, Doupe MB, Bakken MS, Kittang BR, Jacobsen FF, Førland O. Areas of consensus on unwarranted and warranted transfers between nursing homes and emergency care facilities in Norway: a Delphi study. BMC Health Serv Res 2024; 24:374. [PMID: 38532452 DOI: 10.1186/s12913-024-10879-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Transferring residents from nursing homes (NHs) to emergency care facilities (ECFs) is often questioned as many are terminally ill and have access to onsite care. While some NH to ECF transfers have merit, avoiding other transfers may benefit residents and reduce healthcare system costs and provider burden. Despite many years of research in this area, differentiating warranted (i.e., appropriate) from unwarranted NH to ECF transfers remains challenging. In this article, we report consensus on warranted and unwarranted NH to ECF transfers scenarios. METHODS A Delphi study was used to identify consensus regarding warranted and unwarranted NH to ECF transfers. Delphi participants included nurses (RNs) and medical doctors (MDs) from NHs, out-of-hours primary care clinics (OOHs), and hospital-based emergency departments. A list of 12 scenarios and 11 medical conditions was generated from the existing literature on causes and medical conditions leading to transfers, and pilot tested and refined prior to conducting the study. Three Delphi rounds were conducted, and data were analyzed using descriptive and comparative statistics. RESULTS Seventy-nine experts consented to participate, of whom 56 (71%) completed all three Delphi rounds. Participants reached high or very high consensus on when to not transfer residents, except for scenarios regarding delirium, where only moderate consensus was attained. Conversely, except when pain relieving surgery was required, participants reached low agreement on scenarios depicting warranted NH to ECF transfers. Consensus opinions differ significantly between health professionals, participant gender, and rurality, for seven of the 23 transfer scenarios and medical conditions. CONCLUSIONS Transfers from nursing homes to emergency care facilities can be defined as warranted, discretionary, and unwarranted. These categories are based on the areas of consensus found in this Delphi study and are intended to operationalize the terms warranted and unwarranted transfers between nursing homes and emergency care facilities.
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Affiliation(s)
- Arne Bastian Wiik
- Centre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway.
| | - Malcolm Bray Doupe
- Centre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Marit Stordal Bakken
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Bård Reiakvam Kittang
- University of Bergen, Bergen, Norway
- Department of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Frode Fadnes Jacobsen
- Centre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway
| | - Oddvar Førland
- Centre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway
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194
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Tuinman MA, Nuver J, de Boer A, Looijmans A, Hagedoorn M. Lifestyle changes after cancer treatment in patients and their partners: a qualitative study. Support Care Cancer 2024; 32:248. [PMID: 38528283 DOI: 10.1007/s00520-024-08447-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE Oncologists nowadays promote healthy lifestyle choices more often, focusing on diet, physical activity, smoking, alcohol consumption, and sleep, but the question is whether this is enough to establish actual change. As patients will have to achieve a healthy lifestyle at home in daily life, it is important to understand barriers and facilitators for lifestyle change for both patients and their partners. METHODS A qualitative interview study was done among patients who received chemotherapy for testicular (n = 10) or breast cancer (n = 7) and their partners (n = 17). The interview focused on how much they remembered the lifestyle advice given in hospital, whether and what they had adapted since diagnosis, and what they deemed as facilitators and barriers in maintaining lifestyle change. RESULTS Results showed that many patients and partners recalled that some advice was given in hospital but experienced this as too general and only at the start of treatment. Social contacts and the entire cancer experience helped facilitate change but were also seen as barriers. Other barriers were not considering healthy behaviors a priority or experiencing unhealthy choices as something nice after a trying time. CONCLUSIONS Oncologists and hospitals that provide lifestyle advice should provide cancer- and person-specific lifestyle advice, should offer this advice repeatedly into survivorship, and include the partner, as they are dedicated to improving lifestyle as well. IMPLICATION FOR CANCER SURVIVORS Staying healthy after cancer is important to both patients and their partners, and both experience their own facilitators and barriers to achieving this. Seeing a healthy lifestyle as a joint goal might facilitate change.
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Affiliation(s)
- Marrit Annika Tuinman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Anke de Boer
- Department of Psychology, Patyna Elderly Care, Harste 15, 8602 JX, Sneek, The Netherlands
| | - Anne Looijmans
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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195
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Rainbow C, Tatnell R, Blashki G, Melvin GA. Recognizing and coping with suicidal thoughts: A mixed-methods investigation of digital safety plan content. Br J Clin Psychol 2024. [PMID: 38532233 DOI: 10.1111/bjc.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 02/29/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES Suicide safety plans are a personalized means of documenting how a person at risk of suicide recognizes and intends to cope with emerging suicidal thoughts. This study aimed to understand how users of digital suicide safety plans describe their warning signs, methods of coping and any relationships between these that may emerge. METHODS A sample comprising 150 users of the Australian suicide safety planning smartphone app Beyond Now consented to share the content of their safety plans. Reflexive thematic analysis was used to identify themes in overall plan content. Most participants identified as women (61%), had a history of at least one suicide attempt (61%) and completed their plans by themselves (84%). RESULTS Three major themes emerged: (1) interpersonal challenges and complexity; (2) matching coping strategies to warning signs; and (3) helpful and harmful digital technology use. Most plans appeared to demonstrate high self-awareness of warning signs and available supports. CONCLUSIONS Safety plan content provides a window into the thought process underlying the recognition of suicidal thoughts and the attempts to manage them. An opportunity exists for practitioners and support persons to use this content when collaboratively supporting a safety plan user to improve their coping strategies and support networks.
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Affiliation(s)
- Christopher Rainbow
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Ruth Tatnell
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Grant Blashki
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Glenn A Melvin
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Melbourne, Victoria, Australia
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196
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Seeratan DD, van Schuylenburch RG, van Lonkhuijzen LRCW, Aarts JWM. Patient-reported outcome measures (PROMs) to personalise follow-up care of ovarian cancer: what do patients think? A qualitative interview study. Support Care Cancer 2024; 32:247. [PMID: 38528152 DOI: 10.1007/s00520-024-08436-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/12/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE The purpose of this study was to explore ovarian cancer patients' preferences regarding follow-up care and, in particular, the use of patient-reported outcome measures (PROMs) as an approach to personalise follow-up care. METHODS Between May and June 2021, semi-structured interviews were conducted with ovarian cancer patients, who had finished their primary treatment at least 6 months prior and were receiving follow-up care at our centre. Interviews were transcribed verbatim and analysed using an inductive thematic approach. A thematic flow chart was created describing interacting themes. RESULTS Seventeen patients were interviewed, of which 11 were familiar with PROMs. Two key themes emerged from the data: the need for reassurance and the wish for personalised care. A follow-up scheme using PROMs was identified as a separate theme with the potential to personalise care. Several barriers and facilitators of PROMs were mentioned. CONCLUSIONS Ovarian cancer patients have a desire for personalised follow-up care and seek reassurance. PROMs may be able to support both of these needs. Future research is needed to determine the most effective, patient-centred way to implement them. IMPLICATIONS FOR CANCER SURVIVORS By understanding what patients' preferences are regarding follow-up care, more initiatives can be set up to personalise follow-up care, through which patient anxiety and dissatisfaction can be reduced.
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Affiliation(s)
- Dachel D Seeratan
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Department of Gynaecological Oncology, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - Robin G van Schuylenburch
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Luc R C W van Lonkhuijzen
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Department of Gynaecological Oncology, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - Johanna W M Aarts
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
- Department of Gynaecological Oncology, Cancer Centre Amsterdam, Amsterdam, the Netherlands.
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197
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Creasy SL, Sweet S, Myers JJ, Shumway M, Tolou-Shams M, McCaffrey N, Dauria EF. eHealth-Enhanced Peer Navigation for Substance Use Treatment and HIV Prevention Service Linkage for Young Adults Surveilled by the Criminal Legal System: Protocol for a Pilot Randomized Trial Study. JMIR Res Protoc 2024; 13:e54815. [PMID: 38530335 DOI: 10.2196/54815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/02/2024] [Accepted: 02/22/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND In the United States, the proportion of criminal legal-involved (CLI) adults with a substance use disorder reaches 72%, and ~150,000 persons with HIV pass through a carceral setting annually, which represents 16% of the HIV-infected population nationally. Despite the high need for substance use treatment and HIV prevention services, few carceral settings successfully link CLI individuals to treatment upon release. Young adults represent 41.9% of the adults incarcerated in the United States and have the highest HIV incidence rates nationally. Peer patient navigation has successfully increased community-based care linkage for people living with HIV leaving jail; yet, peer-led navigation for HIV prevention among HIV-negative CLI populations is undeveloped and untested. eHealth approaches to substance use and HIV prevention services hold promise because they improve access to effective intervention services, particularly for younger people. OBJECTIVE This paper describes a protocol for a pilot randomized controlled trial that aims to improve linkage to substance use treatment and HIV prevention services using peer navigation and a codeveloped eHealth technology adjunct. METHODS The three aims of this study are to (1) adapt an existing evidence-based navigator model and incorporate codeveloped eHealth technology to refer and link young adults (18 to 29 years) surveilled by the criminal legal system to substance use and pre-exposure prophylaxis (PrEP) services; (2) refine and test the intervention with criminal legal-involved young adults (CLI-YAs); and (3) assess the feasibility, acceptability, and impact of the intervention. Data to inform the intervention will be collected via system partner interviews (n=4) and focus groups with CLI-YAs (n=24). Next, an open trial (n=10) will be conducted. The intervention will be refined via interviews with participants and facilitators, and a randomized pilot trial (n=75) will be conducted to assess the feasibility, acceptability, and preliminary impact of the eHealth-enhanced navigation on substance use and PrEP services linkage. Exit interviews conducted with a subsample of intervention participants (n=10), the navigator (n=1), and system partners (n=4) will assess intervention acceptability and suggestions for improvement. A community of practice, a group of system partners with an interest in working toward solutions to common problems, will inform each phase of the study. RESULTS The project is currently ongoing. The project was funded in September 2022. Internal review board approval was received on March 21, 2022. The first results from early study aims are expected to be published in 2025. CONCLUSIONS This study provides an opportunity to reduce HIV acquisition and improve access to substance use treatment in a systemically marginalized group: young CLI-YAs. The results will contribute to the development and testing of a future multilevel randomized controlled trial. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54815.
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Affiliation(s)
- Stephanie L Creasy
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sheridan Sweet
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Janet J Myers
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, CA, United States
| | - Martha Shumway
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, United States
| | - Marina Tolou-Shams
- Department of Psychiatry, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, CA, United States
| | - Nicole McCaffrey
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Emily F Dauria
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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198
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Skov SS, Berg ME, Andersen JR, Schou-Juul F, Jensen AMB, Folker AP, Lauridsen S. 'We had conversations we wouldn't have had otherwise'-Exploring home-dwelling people with dementia and family members' experiences of deliberating on ethical issues in a literature-based intervention. J Clin Nurs 2024. [PMID: 38528439 DOI: 10.1111/jocn.17138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/07/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Abstract
AIM To explore home-dwelling people with dementia and family members' perceptions of the feasibility and acceptability of an intervention using dementia-related literature excerpts to facilitate conversations on ethical issues related to living with dementia. BACKGROUND Ethical issues in dementia care emerge throughout the illness. In the early stages, they may involve decisions about disclosing the illness to the family, shifting roles and responsibilities, and considerations of transitioning to a nursing home. Addressing ethical issues and providing adequate support to home-dwelling people with dementia and their families are often lacking. DESIGN An exploratory-descriptive qualitative study. METHODS We conducted eight interviews with 14 home-dwelling persons with dementia and their family caregivers. Six were dyadic interviews, and two were individual interviews with family caregivers. We analysed the interview data using template analysis. We adhered to the COREQ checklist in reporting this study. RESULTS Using excerpts from dementia-related literature was a feasible and acceptable way of initiating discussions on ethical issues among home-dwelling persons with dementia and family caregivers. However, engaging the families of newly diagnosed individuals was challenging due to emotional distress. The intervention provided peer support, including identifying with others and sharing experiences. Moreover, participating couples found intimacy and relational attunement through shared reflections. CONCLUSION Based on the findings, it appears that the participants in this study felt that using excerpts from dementia-related literature to deliberate on ethical issues was feasible and acceptable. Deliberating on ethical issues with peers and family caregivers offers valuable social support and opportunities for strengthening relationships. IMPLICATIONS FOR PATIENT CARE This study makes an important contribution by providing valuable insights into how ethical issues related to living with dementia can be addressed using related literature and suggests how the intervention can be integrated into existing care initiatives for home-dwelling people with dementia and their families. REPORTING METHOD We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION A healthcare professional working as a so-called dementia coordinator (a title used in the Danish context) was involved in the conduct of this study by being responsible for the recruitment of home-dwelling people with dementia and their family members. Moreover, she had joint responsibility for facilitating the intervention along with the first author.
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Affiliation(s)
- Sofie Smedegaard Skov
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Marie Eva Berg
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Frederik Schou-Juul
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anja M B Jensen
- Section for Health Services Research, Center for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sigurd Lauridsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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199
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Giesen J, Timmerman I, Bakker-Jacobs A, Berings M, Huisman-de Waal G, Van Vught A, Vermeulen H. What can nurses learn from patient's needs and wishes when developing an evidence-based quality improvement learning culture? A qualitative study. Scand J Caring Sci 2024. [PMID: 38525853 DOI: 10.1111/scs.13252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/02/2024] [Accepted: 02/24/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patient participation is fundamental in nursing care and has yielded benefits for patient outcomes. However, despite their compassionate care approach, nurses do not always incorporate patients' needs and wish into evidence-based practice, quality improvement or learning activities. Therefore, a shift to continuous quality improvement based on evidence-based practice is necessary to enhance the quality of care. The patient's opinion is an essential part of this process. To establish a more sustainable learning culture for evidence-based quality improvement, it is crucial that nurses learn alongside their patients. However, to promote this, nurses require a deeper understanding of patients' care preferences. OBJECTIVE To explore patients' needs and wishes towards being involved in care processes that nurses can use in developing an evidence-based quality improvement learning culture. METHODS A qualitative study was conducted in two hospital departments and one community care team. In total, 18 patients were purposefully selected for individual semi-structured interviews with an average of 15 min. A framework analysis based on the fundamental of care framework was utilised to analyse the data deductively. In addition, inductive codes were added to patients' experiences beyond the framework. For reporting this study, the SRQR guideline was used. RESULTS Participants needed a compassionate nurse who established and sustained a trusting relationship. They wanted nurses to be present and actively involved during the care delivery. Shared decision-making improved when nurses offered fair, clear and tailored information. Mistrust or a disrupted nurse-patient relationship was found to be time-consuming and challenging to restore. CONCLUSIONS Results confirmed the importance of a durable nurse-patient relationship and showed the consequences of nurses' communication on shared decision-making. Insights into patients' care preferences are essential to stimulate the development of an evidence-based quality improvement learning culture within nursing teams and for successful implementation processes.
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Affiliation(s)
- Jeltje Giesen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse Timmerman
- Psychiatry Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Annick Bakker-Jacobs
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolein Berings
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Surgical Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anneke Van Vught
- Department on Health and Vitality, HAN University of Applied Sciences, School of Allied Health, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Department on Health and Vitality, HAN University of Applied Sciences, School of Allied Health, Nijmegen, The Netherlands
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200
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Middleton G, Johnson BJ, Dutch D, Trost SG, Byrne R, Christian HE, Henry A, Terranova CO, Williams KE, Chai LK, Brookes DSK, Simon K, Golley RK. A great way to bring up health behaviour topics at playgroup: a qualitative evaluation of the Healthy Conversations @ Playgroup program. BMC Public Health 2024; 24:890. [PMID: 38528500 DOI: 10.1186/s12889-024-17703-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/08/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The early years is a critical stage to establish optimal nutrition and movement behaviours. Community playgroups are a relaxed environment for parents with a focus on social connection and supporting parents in their role as 'First Teachers'. Playgroups are therefore an opportunistic setting to promote health behaviours in the early years. To support parents with young children around healthy lifestyle behaviours, the Healthy Conversations @ Playgroup program was delivered in urban and regional areas, across three Australian jurisdictions between 2021-2023. OBJECTIVE This qualitative evaluation aimed to understand how the Healthy Conversations @ Playgroup program was experienced by parents, playgroup coordinators and peer facilitators. DESIGN Semi-structured virtual interviews and focus groups were conducted with parents, playgroup coordinators (i.e., person responsible for coordinating the playgroup) and peer facilitators (i.e., trained facilitator for the program) that participated in the Healthy Conversations @ Playgroup study. Transcripts were analysed following a thematic analysis approach. RESULTS Twenty-eight playgroup parents, coordinators or peer facilitators participated in one of 8 focus groups or 5 interviews. Four themes were developed: Program strengths and challenges; Setting strengths and challenges; Factors that impact program delivery; Participant's suggestions for future program delivery. CONCLUSIONS The Healthy Conversations @ Playgroup program was valued by parents, providing validation and normalisation of parenting practices, and fostering a shared experience of parenting. Playgroups are a convenient setting for families to attend. The dynamic and distracting nature of the playgroup setting were carefully considered when designing the program. Strategies to further enhance program engagement could include use of coordinator or parent champions, tailored delivery, and extending the reach to other family members. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12621000055808, registered 22 January 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380890.
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Affiliation(s)
- Georgia Middleton
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia
| | - Brittany J Johnson
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia.
| | - Dimity Dutch
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland Australia, Brisbane, QLD, Australia
| | - Rebecca Byrne
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hayley E Christian
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Anna Henry
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Caroline O Terranova
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kate E Williams
- Centre for Child and Family Studies, School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, QLD, Australia
| | - Li Kheng Chai
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
- Health and Wellbeing Queensland, Queensland Government, Brisbane, QLD, Australia
| | - Denise S K Brookes
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kate Simon
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rebecca K Golley
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA, Australia.
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