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Ayres L, Pelkowitz L, Simon P, Thompson SC. Necessity as the Catalyst of Change: Exploring Client and Provider Perspectives of Accelerated Implementation of Telehealth by a Regional Australian Community Service Organisation during COVID-19 Restrictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11433. [PMID: 34769949 PMCID: PMC8583583 DOI: 10.3390/ijerph182111433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 12/17/2022]
Abstract
Community services have played a significant role in supporting the psychosocial health and well-being of vulnerable populations during the SARS-CoV-2 (COVID-19) pandemic. To meet increased community needs, organisations were required to rapidly modify service provision, often using remote delivery systems. This in-depth study, undertaken early in the pandemic, explored staff and clients' experiences of adapting to using telehealth to provide and access services in one regional social services agency. Semi-structured interviews from 15 staff and 11 clients from a regional not-for-profit agency in Western Australia were recorded and transcribed. Inductive coding, and thematic analysis identified eight subthemes, with experiences and perceptions of telehealth varying substantially among staff and client groups. Distinct benefits and challenges were associated with telehealth. Participants highlighted tensions and complexities and commented on the place of telehealth in the community service sector. Clients expressed the importance of relationships and communication. This study provides in-depth insights into the contextualised experiences of staff and clients during a time at which change was both enabled and necessary. The findings highlight the need for tailored service delivery; choice; client collaboration; ongoing staff training relating to telehealth; and guidelines specific to telehealth in the community service sector.
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Affiliation(s)
- Leah Ayres
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6530, Australia; (L.P.); (S.C.T.)
| | - Lindi Pelkowitz
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6530, Australia; (L.P.); (S.C.T.)
| | - Perlin Simon
- Centacare Family Services, Geraldton, WA 6530, Australia;
| | - Sandra C. Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6530, Australia; (L.P.); (S.C.T.)
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402
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Rony MKK, Bala SD, Rahman MM, Dola AJ, Kayesh I, Islam MT, Tama IJ, Shafi EH, Rahman S. Experiences of front-line nurses caring for patients with COVID-19 in Bangladesh: A qualitative study. BELITUNG NURSING JOURNAL 2021; 7:380-386. [PMID: 37496501 PMCID: PMC10367993 DOI: 10.33546/bnj.1680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/12/2021] [Accepted: 09/13/2021] [Indexed: 07/28/2023] Open
Abstract
Background As the incidence of COVID-19 is increasing, the Bangladesh government has announced a countrywide shutdown instead of a lockdown. Consequently, front-line healthcare workers, particularly nurses, are confronting more challenging situations at work. Objective This study aimed to explore front-line nurses' experiences caring for patients with COVID-19 in Dhaka, Bangladesh. Methods A qualitative descriptive study was conducted among front-line nurses caring for patients with COVID-19. Twenty nurses were purposively chosen from January to March 2021 to participate in semi-structured online interviews. Interviews on audio and video were collected, analyzed, interpreted, transcribed verbatim, and verified by experts. Thematic analysis was used. Results Nine themes emerged and were grouped into negative and positive experiences. The themes of negative experiences include lack of necessary medical equipment, use of non-standard personal protective equipment, work overload, long working hours, poor working environment, and lack of quality of nursing care. The positive experiences include feeling self in a patient position, nurses' coping strategy in COVID-19 patient care, and establishing emotional control. Conclusion The study results encourage national and international health care professionals to cope with adverse working environments. Also, the findings provide nurses with techniques for dealing with any critical situation, controlling patients' emotions, and how empathy increases self-confidence and patient care. The research should also be used to enhance government policy, nursing council policy, ministry of health policy, and other healthcare agencies.
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Affiliation(s)
- Moustaq Karim Khan Rony
- College of Nursing, International University of Business Agriculture and Technology, Dhaka, Bangladesh
- Master of Public Health, Bangladesh Open University, Bangladesh
| | - Shuvashish Das Bala
- College of Nursing, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | | | | | - Ibne Kayesh
- MRM Hospital & Nursing Institute, Bancharampur, Brahmmanbaria, Bangladesh
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403
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Robbins T, Hanlon C, Kelly AH, Gidiri MF, Musiyiwa M, Silverio SA, Shennan AH, Sandall J. Pills and prayers: a comparative qualitative study of community conceptualisations of pre-eclampsia and pluralistic care in Ethiopia, Haiti and Zimbabwe. BMC Pregnancy Childbirth 2021; 21:716. [PMID: 34702209 PMCID: PMC8547033 DOI: 10.1186/s12884-021-04186-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/24/2021] [Indexed: 11/11/2022] Open
Abstract
Background Pre-eclampsia is a leading cause of preventable maternal and perinatal deaths globally. While health inequities remain stark, removing financial or structural barriers to care does not necessarily improve uptake of life-saving treatment. Building on existing literature elaborating the sociocultural contexts that shape behaviours around pregnancy and childbirth can identify nuanced influences relating to pre-eclampsia care. Methods We conducted a cross-cultural comparative study exploring lived experiences and understanding of pre-eclampsia in Ethiopia, Haiti and Zimbabwe. Our primary objective was to examine what local understandings of pre-eclampsia might be shared between these three under-resourced settings despite their considerable sociocultural differences. Between August 2018 and January 2020, we conducted 89 in-depth interviews with individuals and 17 focus group discussions (n = 106). We purposively sampled perinatal women, survivors of pre-eclampsia, families of deceased women, partners, older male and female decision-makers, traditional birth attendants, religious and traditional healers, community health workers and facility-based health professionals. Template analysis was conducted to facilitate cross-country comparison drawing on Social Learning Theory and the Health Belief Model. Results Survivors of pre-eclampsia spoke of their uncertainty regarding symptoms and diagnosis. A lack of shared language challenged coherence in interpretations of illness related to pre-eclampsia. Across settings, raised blood pressure in pregnancy was often attributed to psychosocial distress and dietary factors, and eclampsia linked to spiritual manifestations. Pluralistic care was driven by attribution of causes, social norms and expectations relating to alternative care and trust in biomedicine across all three settings. Divergence across the contexts centred around nuances in religious or traditional practices relating to maternal health and pregnancy. Conclusions Engaging faith and traditional caregivers and the wider community offers opportunities to move towards coherent conceptualisations of pre-eclampsia, and hence greater access to potentially life-saving care. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04186-6.
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Affiliation(s)
- Tanya Robbins
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, St Thomas' Hospital, 10th Floor, North Wing, Westminster Bridge Road, London, SE1 7EH, UK.
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, and WHO Collaborating Centre for Mental Health Research and Training, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ann H Kelly
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Muchabayiwa Francis Gidiri
- Department of Obstetrics and Gynaecology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Mickias Musiyiwa
- Department of History, Heritage and Knowledge Systems, Faculty of Arts and Humanities, University of Zimbabwe, Harare, Zimbabwe
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, St Thomas' Hospital, 10th Floor, North Wing, Westminster Bridge Road, London, SE1 7EH, UK
| | - Andrew H Shennan
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, St Thomas' Hospital, 10th Floor, North Wing, Westminster Bridge Road, London, SE1 7EH, UK
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, St Thomas' Hospital, 10th Floor, North Wing, Westminster Bridge Road, London, SE1 7EH, UK
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404
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Bond J, Robotham D, Kenny A, Pinfold V, Kabir T, Andleeb H, Larkin M, Martin JL, Brown S, Bergin AD, Petit A, Rosebrock L, Lambe S, Freeman D, Waite F. Automated Virtual Reality Cognitive Therapy for People With Psychosis: Protocol for a Qualitative Investigation Using Peer Research Methods. JMIR Res Protoc 2021; 10:e31742. [PMID: 34694236 PMCID: PMC8576557 DOI: 10.2196/31742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/20/2022] Open
Abstract
Background Many people with psychosis experience difficulties in everyday social situations. Anxiety can make life challenging, leading to withdrawal. Cognitive therapy, using active in vivo learning, enables people to overcome fears. These treatments are not readily available to people with psychosis. Automated virtual reality (VR) therapy is a potential route to increase accessibility. The gameChange automated VR cognitive therapy is designed to help people overcome anxious avoidance and build confidence in everyday social situations. A virtual coach guides the person through the treatment. Understanding user experience is key to facilitating future implementation. Peer research methods, in which people with lived experience of the issues being studied are involved in collecting and analyzing data, may be useful in developing this understanding. This encourages researchers to draw on their lived experience to explore participant perspectives and co-create knowledge. Objective The primary objective is to use a peer research approach to explore the participant experience of a novel automated VR therapy for anxious social avoidance. This includes understanding (1) the experience of anxious social avoidance in people with psychosis, (2) the experience of the gameChange automated VR cognitive therapy, and (3) any potential impact of the therapy in people’s lives. This will inform future implementation strategies. The secondary objective is to explore how peer research can be used to co-create knowledge. Methods Semistructured interviews will be conducted with approximately 25 people with psychosis participating in the gameChange trial (ISRCTN17308399). Participants will be recruited from the five trial centers based in National Health Service mental health trusts across England. Interviews will be conducted by two researchers. One is a peer researcher with similar lived experience to the trial participants. The other has lived experiences of mental health issues that do not directly overlap with those of the trial participants. Interview questions will focus on an individual’s experience of anxious social avoidance, experiences of participating in the gameChange VR therapy, and any changes or impact following therapy. The interview schedule was developed in collaboration with the gameChange Lived Experience Advisory Panel (LEAP), comprising 10 project advisors with lived experience of psychosis. Interpretative phenomenological analysis and template analysis will be used to explore individual accounts. The LEAP will contribute to the analysis. Results Data collection will be conducted from April to September 2021, and analysis will be conducted from June to October 2021. As of September 28, 2021, 20 participants had been interviewed, and coding is underway. Conclusions The study, employing a peer research approach, may provide a unique insight into the experiences of anxious social avoidance in people with psychosis and its treatment using automated VR therapy. This will inform potential future implementation of VR automated therapies in mental health services. International Registered Report Identifier (IRRID) DERR1-10.2196/31742
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Affiliation(s)
| | | | | | | | | | - Humma Andleeb
- Research Department of Clinical, Educational and Health Psychology, Psychology and Language Sciences, Faculty of Brain Sciences, UCL, London, United Kingdom
| | - Michael Larkin
- School of Psychology, Aston University, Birmingham, United Kingdom
| | - Jennifer L Martin
- School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom.,National Institute for Health Research Mindtech Co-operative, Nottingham, United Kingdom
| | - Susan Brown
- School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom.,National Institute for Health Research Mindtech Co-operative, Nottingham, United Kingdom
| | - Aislinn D Bergin
- School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom.,National Institute for Health Research Mindtech Co-operative, Nottingham, United Kingdom
| | - Ariane Petit
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom.,National Institute for Health Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Laina Rosebrock
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom.,National Institute for Health Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Sinéad Lambe
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom.,National Institute for Health Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom.,National Institute for Health Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom.,National Institute for Health Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom
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405
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Dakin E, Levy DL, Williams KA. Religious and spiritual journeys of LGBT older adults in rural Southern Appalachia. JOURNAL OF RELIGION, SPIRITUALITY & AGING 2021. [DOI: 10.1080/15528030.2021.1985035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Emily Dakin
- Department of Social Work, Appalachian State University
| | - Denise L Levy
- Beaver College of Health Sciences, Appalachian State University
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406
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Malik FS, Lind C, Duncan S, Mitrovich C, Pascual M, Yi-Frazier JP. Augmenting Traditional Support Groups for Adolescents With Type 1 Diabetes Using Instagram: Mixed Methods Feasibility Study. JMIR Diabetes 2021; 6:e21405. [PMID: 34673527 PMCID: PMC8569531 DOI: 10.2196/21405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/12/2020] [Accepted: 06/04/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In-person support groups have been shown to benefit adolescents with type 1 diabetes (T1D) by helping to decrease perceived diabetes burden and improving knowledge related to chronic disease management. However, barriers exist to participation in traditional support groups, including the timing and location of meetings and resources needed to attend. Adolescents are increasingly utilizing online support groups, which may provide solutions to some of the challenges faced when implementing in-person support groups. OBJECTIVE The purpose of this study was to assess the feasibility and acceptability of a hybrid support group model where traditional in-person support groups were augmented with Instagram participation between monthly support group sessions for adolescents with T1D. METHODS Participants (13-18 years old with T1D for ≥6 months) were asked to post photos each week for 3 months based on predetermined topics related to diabetes management. At the end of each month, participants attended an in-person support group to discuss their photos using the Photovoice method. Feasibility was assessed through enrollment and retention, number of Instagram posts, poststudy questionnaire, and a template analysis of the focus groups. RESULTS Of 24 eligible participants, 16 (67%) enrolled in the study, with 3 dropping out prior to support group participation. The number of photos posted over 3 months ranged from 14 to 41. Among the 11 participants who completed a follow-up questionnaire, the majority of participants (6/11, 55%) reported that they very much enjoyed participating in the hybrid support group, and more than three-quarters (9/11, 82%) of participants reported that they "related to the photos posted." Over half of participants (8/11, 73%) reported "learning something new from the photos posted," which arose from sharing knowledge and experiences related to navigating the common challenges of diabetes management. Additionally, the use of Instagram posts helped facilitate peer discussions during the in-person support groups. CONCLUSIONS The novel combination of using Instagram to augment traditional in-person support groups was feasible and acceptable to adolescents with T1D. The overall satisfaction with the hybrid support group model, combined with the observed engagement with peers between support group sessions over social media, suggests that a hybrid support group model may have the potential to provide more pronounced benefits to adolescents than in-person meetings alone. Future research should investigate the use of social media as part of the support group model and examine the potential improvement of self-esteem, benefit-finding, and social support using validated tools in adolescents with diabetes.
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Affiliation(s)
- Faisal S Malik
- Department of Pediatrics, University of Washington, Seattle, WA, United States.,Seattle Children's Research Institute, Seattle, WA, United States
| | - Cara Lind
- Seattle Children's Research Institute, Seattle, WA, United States
| | - Sarah Duncan
- Seattle Children's Research Institute, Seattle, WA, United States
| | - Connor Mitrovich
- Seattle Children's Research Institute, Seattle, WA, United States
| | - Michael Pascual
- Seattle Children's Research Institute, Seattle, WA, United States
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407
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Marshal M, Niranjan V, Spain E, MacDonagh J, O'Doherty J, O'Connor R, O'Regan A. 'Doctors can't be doctors all of the time': a qualitative study of how general practitioners and medical students negotiate public-professional and private-personal realms using social media. BMJ Open 2021; 11:e047991. [PMID: 34667001 PMCID: PMC8527115 DOI: 10.1136/bmjopen-2020-047991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The objective of this study is to explore the experiences and perspectives of general practitioners' and medical students' use of, and behaviour on, social media and to understand how they negotiate threats to professional and personal life on social media. DESIGN A two-phase qualitative design was used, consisting of semistructured interviews and follow-up vignettes, where participants were asked to respond to vignettes that involved varying degrees of unprofessional behaviour. Data were analysed using template analysis. SETTING AND PARTICIPANTS Participants were general practitioner tutors and third year medical students who had just completed placement on the University of Limerick longitudinal integrated clerkship. Five students and three general practitioners affiliated with the medical school were invited to participate in one-to-one interviews. RESULTS Three overarching themes, each containing subthemes were reported. 'Staying in contact and up to date' outlines how social media platforms provide useful resources and illustrates the potential risks of social media. 'Online persona' considers how social media has contributed to changing the nature of interpersonal relationships. 'Towards standards and safety' raises the matter of how to protect patients, doctors and the medical profession. CONCLUSION Guidance is required for students and medical practitioners on how to establish reasonable boundaries between their personal and professional presence on social media and in their private life so that poorly judged use of social media does not negatively affect career prospects and professional efficacy.
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Affiliation(s)
- Megan Marshal
- School of Medicine, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Vikram Niranjan
- School of Pulbic Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Eimear Spain
- School of Medicine, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Joe MacDonagh
- School of Business and Humanities, Technical University Dublin, Dublin, Ireland
| | - Jane O'Doherty
- School of Medicine, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Raymond O'Connor
- School of Medicine, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Andrew O'Regan
- School of Medicine, Health Research Institute, University of Limerick, Limerick, Ireland
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408
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Chau JPC, Lo SHS, Lee VWY, Lui GCY, Butt L, Chan KM, Kwok CY, Lau AYL. Multistakeholder knowledge levels and perspectives of human papillomavirus and its vaccination: An exploratory qualitative study. Eur J Cancer Care (Engl) 2021; 30:e13511. [PMID: 34622502 DOI: 10.1111/ecc.13511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/03/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This qualitative study was an integral part in the development of a multidisciplinary team-led school-based human papillomavirus vaccination health-promotion programme (MDL-SHPVP) aiming to increase HPV vaccine uptake in Hong Kong. Study findings will inform the design of the MDL-SHPVP by drawing on interview data regarding the expectations and needs of key stakeholders and potential programme users. METHODS Eight mother-daughter dyads, four secondary school teachers, two school principals, three social workers and one school nurse were interviewed. All interviews were audio-recorded and transcribed verbatim for thematic analysis. RESULTS Most participants had misconceptions about HPV and the vaccine. Alhough there was no immediate perceived need for the vaccination, most participants had favourable attitudes towards HPV inoculation and vaccines in general. Factors affecting vaccine uptake included perceptions about risk of infection, vaccine availability, and cost. Participants were largely open to suggested MDL-SHPVP components (videos, digital game, and group discussions). CONCLUSION Findings have highlighted knowledge gaps among potential users and key stakeholders and will be used to inform the design of the MDL-SHPVP to ensure that their needs and expectations are addressed. Study findings may also aid future HPV vaccine promotion efforts and boost HPV vaccine uptake among youth in the city.
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Affiliation(s)
- Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vivian Wing Yan Lee
- Centre for Learning Enhancement and Research, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Grace Chun Yan Lui
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Laveeza Butt
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kam Ming Chan
- Department of Paediatrics & Adolescent Medicine, United Christian Hospital, Hong Kong
| | - Chiu Yin Kwok
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Alexander Yuk Lun Lau
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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409
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Krishan Aggarwal N. Analyzing predisposing, precipitating, and perpetuating factors of militancy through declassified interrogation summaries: A case study. Transcult Psychiatry 2021; 58:683-696. [PMID: 32364043 DOI: 10.1177/1363461520919317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Researchers and policymakers have supported a public health approach to countering violent extremism throughout the War on Terror. However, barriers to obtaining primary data include concerns from minority groups about stigmatization, the ethics of harming research subjects by exposing them to violent content, and restrictions on researchers from institutions and governments. Textual analyses of declassified documents from government agencies may overcome these barriers. This article contributes a method for analyzing the predisposing, precipitating, and perpetuating factors of terrorism through open source texts. This method is applied to FBI interrogation summaries of Al Qaeda terrorist Umar Farouk Abdulmutallab who attempted an attack aboard an airplane in 2009. This analysis shows that consuming militant content online led him to narrow his social relationships offline to extremists and foster identifications with subjugated Muslims around the world. After deciding to wage militancy, loyalty to Al Qaeda members, swearing allegiance to and obeying group leaders, and interpreting religious texts militantly perpetuated violent activities. Such work can advance empirical work on militant behavior to develop interventions.
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410
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Torre D, Rice NE, Ryan A, Bok H, Dawson LJ, Bierer B, Wilkinson TJ, Tait GR, Laughlin T, Veerapen K, Heeneman S, Freeman A, van der Vleuten C. Ottawa 2020 consensus statements for programmatic assessment - 2. Implementation and practice. MEDICAL TEACHER 2021; 43:1149-1160. [PMID: 34330202 DOI: 10.1080/0142159x.2021.1956681] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Programmatic assessment is a longitudinal, developmental approach that fosters and harnesses the learning function of assessment. Yet the implementation, a critical step to translate theory into practice, can be challenging. As part of the Ottawa 2020 consensus statement on programmatic assessment, we sought to provide descriptions of the implementation of the 12 principles of programmatic assessment and to gain insight into enablers and barriers across different institutions and contexts. METHODS After the 2020 Ottawa conference, we surveyed 15 Health Profession Education programmes from six different countries about the implementation of the 12 principles of programmatic assessment. Survey responses were analysed using a deductive thematic analysis. RESULTS AND DISCUSSION A wide range of implementations were reported although the principles remained, for the most part, faithful to the original enunciation and rationale. Enablers included strong leadership support, ongoing faculty development, providing students with clear expectations about assessment, simultaneous curriculum renewal and organisational commitment to change. Most barriers were related to the need for a paradigm shift in the culture of assessment. Descriptions of implementations in relation to the theoretical principles, across multiple educational contexts, coupled with explanations of enablers and barriers, provided new insights and a clearer understanding of the strategic and operational considerations in the implementation of programmatic assessment. Future research is needed to further explore how contextual and cultural factors affect implementation.
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Affiliation(s)
- Dario Torre
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Neil E Rice
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Anna Ryan
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Harold Bok
- Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Luke J Dawson
- School of Dentistry, University of Liverpool, Liverpool, UK
| | - Beth Bierer
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Tim J Wilkinson
- Education unit, University of Otago, Christchurch, New Zealand
| | - Glendon R Tait
- MD Program, Dept. of Psychiatry, and The Wilson Centre, University of Toronto, Toronto, Canada
| | - Tom Laughlin
- Department of Family Medicine, Dalhousie University, Halifax, Canada
| | - Kiran Veerapen
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sylvia Heeneman
- Department of Educational Development and Research, School of Health Profession Education, Maastricht University, Maastricht, The Netherlands
| | - Adrian Freeman
- College of Medicine and Health, University of Exeter Medical School, Exeter, UK
| | - Cees van der Vleuten
- Department of Educational Development and Research, School of Health Profession Education, Maastricht University, Maastricht, The Netherlands
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411
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Schwartz R, Dubey M, Blanch-Hartigan D, Sanders JJ, Hall JA. Physician empathy according to physicians: A multi-specialty qualitative analysis. PATIENT EDUCATION AND COUNSELING 2021; 104:2425-2431. [PMID: 34330597 DOI: 10.1016/j.pec.2021.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To explore how physicians in neurology, family medicine, internal medicine, and emergency medicine characterize clinical empathy. METHODS Physicians (N = 94) were asked to describe up to 10 examples of empathic physician behavior. Data were analyzed using template analysis. RESULTS Physicians' descriptions of clinical empathy patterned into three themes: Clinical Performance and Professionalism, Interpersonal Communication, and Clinician Orientation. Clinical Performance and Professionalism subthemes included physician competency and accessibility; intersection with institutional resources; and spending/making/taking time with patients. Interpersonal Communication subthemes involved information sharing; verbal and nonverbal approaches; interpersonal sensitivity; physician self-disclosure; and attention to emotion. Clinician Orientation encompassed general physician demeanor and internal thoughts and feelings that might be unobservable by patients. Physicians varied widely in the themes they mentioned in their definition of empathy. CONCLUSION Physicians hold diverse notions of clinical empathy. These extend beyond traditional affective and cognitive empathy definitions to include structural elements like team-based care and accessibility after hours. Communication behaviors were perceived as important for demonstrating empathy. Some physician descriptions of empathy may not be perceptible to patients. PRACTICE IMPLICATIONS Training physicians to engage in behaviors that both they and patients perceive as empathic may lead to higher patient and physician satisfaction.
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Affiliation(s)
| | - Manisha Dubey
- University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA.
| | | | - Justin J Sanders
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Ariadne Labs, Boston, MA, USA.
| | - Judith A Hall
- Department of Psychology, Northeastern University, Boston, MA, USA.
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412
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Jackson K, Rosenberg J, Jansen E, Mallan KM. Qualitative Exploration of Dimensions of Restrictive Feeding With Australian Mothers of 6-Year-Olds. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:858-869. [PMID: 34257029 DOI: 10.1016/j.jneb.2021.04.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 04/18/2021] [Accepted: 04/24/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Explore the nature and dimensions of restrictive feeding with mothers of 6-year-olds. DESIGN Semistructured interviews with mothers. Conversations were audio-recorded and transcribed verbatim. SETTING Brisbane and Adelaide, Australia. PARTICIPANTS Twenty-nine mothers of 6-year-olds. PHENOMENON OF INTEREST Mothers' restrictive feeding practices. ANALYSIS Qualitative thematic analysis. RESULTS This study revealed 6 key themes relating to the restrictive feeding phenomenon: restriction of specific foods and drinks; restrictive feeding practices; mothers' motivation; mothers' preferences for restricted foods; patterns over time; and relationships with other controlling feeding practices. Parents' restrictive feeding practices are likely to be inherently inconsistent, with mothers reportedly varying their practices across different restricted foods, contexts, day to day, and as children age. Mothers intended to either totally restrict or restrict a food/drink in moderation, and these intentions presented qualitatively distinct characteristics across themes. Mothers commonly referred to foods/drinks restricted in moderation as treats, and their liking for these restricted foods/drinks was related to higher child access. CONCLUSIONS AND IMPLICATIONS This study provides insights into the nature and dimensions of restrictive feeding. Further research is proposed to clarify these findings and examine the effects of child access, types of restrictive feeding practices, and parent communication on child preferences for restricted foods and drinks across a range of cultural groups.
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Affiliation(s)
- Kim Jackson
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - John Rosenberg
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Elena Jansen
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kimberley M Mallan
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
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413
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Versteeg M, Bressers G, Wijnen-Meijer M, Ommering BWC, de Beaufort AJ, Steendijk P. What Were You Thinking? Medical Students' Metacognition and Perceptions of Self-Regulated Learning. TEACHING AND LEARNING IN MEDICINE 2021; 33:473-482. [PMID: 33722115 DOI: 10.1080/10401334.2021.1889559] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PHENOMENON As a component of self-regulated learning, metacognition is gaining attention in the medical education research community. Metacognition, simply put, is thinking about one's thinking. Having a metacognitive habit of mind is essential for healthcare professionals. This study identified the metacognitive competencies of medical students as they completed a conceptual learning task, and provided insight into students' perceptions of self-regulated learning in their curriculum. Approach: Eleven third-year medical students from a Dutch University were purposively sampled to participate in this qualitative study. The study design included a think-aloud assignment followed by a semi-structured interview. During the assignment, participants were instructed to think aloud while solving questions about medical physiological concepts such as blood flow, pressure, and resistance. Think-aloud data were collected through audiotaping and used to identify participants' metacognitive competencies. The assignment also served as a prompt for an interview in which participants were questioned about metacognitive knowledge, monitoring, experiences, and perceptions of self-regulated learning in their curriculum. All data were transcribed verbatim and analyzed iteratively using a template analysis. Findings: Students differed in their use of metacognitive skills, with an overall focus on monitoring and, to a lesser extent, on planning and evaluation. Additionally, differences were found in students' metacognitive knowledge and metacognitive experiences. There was apparent use of inefficient, superficial predictive cues. Regarding perceptions of self-regulated learning skills, some students felt no need to develop such skills as they perceived medical education as an exercise in memorizing facts. Others emphasized the need for more insight into their actual level of knowledge and competence. Insights: Pre-clinical medical students require explicit teaching of metacognitive skills to facilitate self-regulated learning. Educators should aim to integrate metacognition in the everyday discourse of the classroom to foster an environment in which students discuss their own learning. UNLABELLED Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.1889559.
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Affiliation(s)
- Marjolein Versteeg
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Guusje Bressers
- Eindhoven School of Education, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Marjo Wijnen-Meijer
- TUM School of Medicine, TUM Medical Education Center, Technical University of Munich, Munich, Germany
| | - Belinda W C Ommering
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
| | - Arnout Jan de Beaufort
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul Steendijk
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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414
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Johnson EE, MacGeorge C, King KL, Andrews AL, Teufel RJ, Kruis R, Hale KC, Ford DW, Sterba KR. Facilitators and Barriers to Implementation of School-Based Telehealth Asthma Care: Program Champion Perspectives. Acad Pediatr 2021; 21:1262-1272. [PMID: 33940203 DOI: 10.1016/j.acap.2021.04.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/13/2021] [Accepted: 04/25/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Asthma is one of the most common chronic conditions of childhood, conferring an immense burden on children and their caregivers. School-based telehealth approaches for asthma care provide the opportunity to deliver convenient, cost-effective care to more children in the school setting. Our study objective was to characterize school-based telehealth asthma program delivery experiences and examine barriers and facilitators to telehealth program implementation. METHODS Interviews were conducted with telehealth program staff and school stakeholders in nine schools engaged in a school-based telehealth asthma program. A structured interview guide was designed using the Exploration, Adoption/Preparation, Implementation, Sustainment (EPIS) framework. A template analysis qualitative approach was used to identify themes related to implementation processes. RESULTS Interviews identified key telehealth implementation strategies including building relationships, marketing and provision of technical assistance, education and support to aid program delivery. Key facilitators to successful program implementation included strong partnerships between the telehealth and school teams, a shared commitment to enhancing access to asthma care for children, and strong nurse leadership. Primary barriers to implementation included lack of family/caregiver involvement and competing demands for nurses. CONCLUSIONS This study identified barriers and facilitators to implementing a school-based telehealth asthma program that can be used to guide education, training and support strategies to enhance program delivery. Recommended implementation strategies include building strong program-school partnerships, creating a shared vision to improve access to care, and building engagement in families and communities while supporting nurse leaders and family involvement with training and resources. These results can help guide future telehealth interventions.
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Affiliation(s)
- Emily E Johnson
- Medical University of South Carolina (MUSC), College of Nursing (EE Johnson), Charleston, SC.
| | - Claire MacGeorge
- MUSC, Department of Pediatrics (C MacGeorge, AL Andrews, RJ Teufel), Charleston, SC
| | - Kathryn L King
- Center of Telehealth, MUSC (KL King, KC Hale, DW Ford), Charleston, SC
| | - Annie L Andrews
- MUSC, Department of Pediatrics (C MacGeorge, AL Andrews, RJ Teufel), Charleston, SC
| | - Ronald J Teufel
- MUSC, Department of Pediatrics (C MacGeorge, AL Andrews, RJ Teufel), Charleston, SC
| | | | - Kathryn C Hale
- Center of Telehealth, MUSC (KL King, KC Hale, DW Ford), Charleston, SC
| | - Dee W Ford
- Center of Telehealth, MUSC (KL King, KC Hale, DW Ford), Charleston, SC
| | - Katherine R Sterba
- Medical University of South Carolina, Department of Public Health Sciences (KR Sterba), Charleston, SC
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415
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Mitchell JW, Gamarel KE, Kam KK, Pennington JT. Perceived facilitators of decision-making and usage of biomedical HIV prevention strategies: findings from an online, qualitative study with same-gender male couples in the United States. AIDS Care 2021; 33:1209-1217. [PMID: 32844670 PMCID: PMC7907248 DOI: 10.1080/09540121.2020.1808158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 08/04/2020] [Indexed: 12/30/2022]
Abstract
The early stages of gay and bisexual men's relationships are a critical period for communicating about HIV prevention strategies. This study sought to: (1) explore facilitators to decision-making to use prevention strategies and (2) describe the prevention strategies being used by same-gender male couples in new relationships. Individual interviews were conducted with 76 partnered men, representing 37 couples and 2 individuals. Couples had been together for one year or less, and varied by U.S. geographical region of residence and HIV serostatus: 8 seroconcordant positive, 17 seroconcordant negative, and 13 serodiscordant couples. Two overarching qualitative themes emerged: (1) communication and (2) information and resources. Notably, few couples had both partners mention the same facilitator. The most commonly used HIV prevention strategies were treatment as prevention for partners in seroconcordant positive and serodiscordant couple relationships, and HIV/STI testing for partners of seroconcordant negative couples. Compared to the other two couple groups, fewer seroconcrdant negative couples were aware of each other's use of strategies. Study findings suggest these facilitators are important to include in future interventions. Efforts are also needed to improve within-dyad awareness about which strategies partners are using and how they may best support one another toward their sexual health goals.
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Affiliation(s)
- Jason W. Mitchell
- Office of Public Health Studies, University of Hawai’i at Mānoa, Honolulu, Hawai’i
| | - Kristi E. Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
- Center for Sexuality and Health Disparities, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Kasey K. Kam
- Office of Public Health Studies, University of Hawai’i at Mānoa, Honolulu, Hawai’i
| | - Jacob T. Pennington
- Office of Public Health Studies, University of Hawai’i at Mānoa, Honolulu, Hawai’i
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416
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Groves S, Brooks J. What do young women below national screening age in England think about cervical cancer and cervical screening? A qualitative study. J Clin Nurs 2021; 31:1588-1597. [PMID: 34418192 DOI: 10.1111/jocn.16012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore what women aged below the national screening age in the UK know and think about cervical cancer and cervical screening. BACKGROUND The efficacy of cervical cancer screening is well established. However, cervical screening attendance in the United Kingdom has decreased, with especially low rates at the first screening opportunity at age 25. Research has not yet explored knowledge and beliefs underpinning young women's intention to screen before first screening invitation. DESIGN Qualitative exploratory study. METHODS Qualitative email interviews were undertaken with 16 participants, using questions derived from the Health Belief Model. Data were analysed using template analysis. The COREQ were followed. RESULTS Analysis generated three themes; (1) Learning about cervical cancer and cervical screening: sources of information and (missed) opportunities; (2) Young women know screening is important - but they don't always know why; (3) Screening intentions: a cost/benefit analysis of the available information. CONCLUSIONS Young women had varied knowledge and beliefs about cervical cancer and screening which were underpinned by several sources of information available to them. Most women expressed an intention to attend screening when invited; however, some participants were unsure, with low screening-based knowledge and low perceived susceptibility of cervical cancer identified as key barriers. Social media, familial interactions and interventions within education were highlighted as being suited to interventions aimed at increasing cervical cancer- and screening-based knowledge in young women. RELEVANCE TO CLINICAL PRACTICE Findings suggest that women below screening age could be better informed about cervical cancer and screening. Tailored interventions addressing common concerns and misconceptions around screening may be acceptable to young women and could help to promote screening attendance at first invitation.
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Affiliation(s)
- Samantha Groves
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, England
| | - Joanna Brooks
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, England
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417
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Sivagurunathan M, Walton DM, Packham T, Booth R, MacDermid J. "Punched in the Balls": Male Intimate Partner Violence Disclosures and Replies on Reddit. Am J Mens Health 2021; 15:15579883211039666. [PMID: 34414824 PMCID: PMC8396797 DOI: 10.1177/15579883211039666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Research on male intimate partner violence (IPV) survivors is limited. The sparse
research on male IPV disclosure suggest males receive more negative and less
helpful responses from potential sources of formal or informal support. Males
may seek support on social networking sites (SNSs), hence, it is important to
understand their emerging experiences of virtual disclosures. This study
examined the nature and content of responses to IPV disclosures by male IPV
survivors on a popular SNS (reddit.com). Search of Reddit submissions related to
male IPV were carried out using three IPV related keywords for the calendar
month of February 2019, resulting in 917 submissions. Twelve submissions that
focused on male IPV disclosure were examined in detail. The 12 submissions were
analyzed using quantitative content analysis while associated comments
(n = 569) were analyzed using qualitative approach.
Two-thirds of the disclosures (8/12) were of personal IPV experiences. All
disclosure narratives identified the sex of perpetrator, most stated the types
of abuse (7/12), and some revealed the outcomes of past disclosures (4/12). Six
major themes were developed through qualitative analysis of the associated
comments: (1) Informational Support, (2) Nurturant Support, (3) Tangible Aid,
(4) Negative Response (5) Self-Defence, and (6) Reciprocal Disclosure. Overall,
males experienced a majority of supportive responses to IPV disclosures and some
negative responses including criticism and minimizing the abuse. Males take
risks in disclosure of IPV in person and online.
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Affiliation(s)
- Marudan Sivagurunathan
- Department of Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - David M Walton
- Department of Health and Rehabilitation Sciences, Western University, London, ON, Canada.,Department of Physical Therapy, Western University, London, ON, Canada
| | - Tara Packham
- The School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Richard Booth
- Health Information Sciences, Western University, London, ON, Canada
| | - Joy MacDermid
- Department of Physical Therapy, Western University, London, ON, Canada.,The School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.,Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, London, ON, Canada
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418
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Halliday JA, Speight J, Russell-Green S, O E, Hagger V, Morris A, Sturt J, Hendrieckx C. Developing a novel diabetes distress e-learning program for diabetes educators: an intervention mapping approach. Transl Behav Med 2021; 11:1264-1273. [PMID: 33677509 DOI: 10.1093/tbm/ibaa144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Diabetes distress is a common negative emotional response to the ongoing burden of living with diabetes. Elevated diabetes distress is associated with impaired diabetes self-management and quality of life yet rarely identified and addressed in clinical practice. Health professionals report numerous barriers to the provision of care for diabetes distress, including lack of skills and confidence, but few diabetes distress training opportunities exist. The purpose of this paper is to describe how we utilized Intervention Mapping to plan the development, implementation, and evaluation of a novel diabetes distress e-learning program for diabetes educators, to meet a well-documented need and significant gap in diabetes care. A multidisciplinary team (combining expertise in research, health and clinical psychology, diabetes education, nursing, tertiary education, and website architecture) developed a diabetes distress e-learning program. We followed a six-step process (logic model of the problem, program outcomes and objectives, program design, program production, program implementation plan, and evaluation plan) known as Intervention Mapping. The program is underpinned by educational and psychological theory, including Bloom's Taxonomy of Educational Objectives and social cognitive theory. We developed a short (estimated 4 h) e-learning program for diabetes educators, which draws on the content of the Diabetes and Emotional Health handbook and toolkit. It integrates a 7As model, which provides a stepwise approach to identifying and addressing diabetes distress. Our diabetes distress e-learning program has been developed systematically, guided by an Intervention Mapping approach. In the next phase of the project, we will trial the e-learning.
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Affiliation(s)
- Jennifer A Halliday
- School of Psychology, Deakin University, Geelong, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Sienna Russell-Green
- School of Psychology, Deakin University, Geelong, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Eric O
- Faculty of Health, Deakin University, Geelong, Australia
| | | | - Ann Morris
- AMCON Diabetes Management Service, Warrnambool, Australia
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, London, UK
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
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419
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Heerden A, Ntinga X, Lippman SA, Leslie HH, Steward WT. Understanding the Factors that Impact Effective Uptake and Integration of Health Programs in South African Primary Health Care Clinics. RESEARCH SQUARE 2021:rs.3.rs-783631. [PMID: 34426806 PMCID: PMC8382126 DOI: 10.21203/rs.3.rs-783631/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction : There is an increasingly urgent gap in knowledge regarding the translation of effective HIV prevention and care programming into scaled clinical policy and practice. Challenges limiting the translation of efficacious programming into national policy include both the paucity of proven efficacious programs that are reasonable for clinics to implement and the difficulty in moving a successful program from research trial to scaled programming. This study aims to bridge the divide between science and practice by exploring health care providers’ views on what is needed to integrate of HIV programming into clinic systems. Methods : We conducted 20 in-depth interviews with clinic managers and clinic program implementing staff and 5 key informant interviews with district health managers overseeing programming in the uMgungundlovu District of KwaZulu-Natal Province, South Africa. Qualitative data were analyzed using a template approach. A priori themes were used to construct templates of relevance including current care context for HIV and past predictors of successful implementation. Data were coded and analyzed in accordance with these templates. Results : Heath care providers identified three main factors that impact integration of HIV programming into general clinical care: perceived benefits, resource availability, and clear communication. The perceived benefits of HIV programs hinged on the social validation of the program by early adopters. Wide program availability and improved convenience for providers and patients increased perceived benefit. Limited staffing capacity and a shortage of space were noted as resource constraints. Programs that specifically tackled these constraints through, for example clinic decongestion, were reported as being the most successful. Clear communication with all entities involved in clinic-based programs, some of which include external partners, was noted as central to maximizing program function and provider uptake. Conclusions : Amid the COVID-19 pandemic, new programs are already being developed for implementation at the primary health care level. A better understanding of the factors which both facilitate and prevent programmatic success will improve public health outcomes. Implementation is likely to be most successful when programs capitalize on endorsements from early adopters, tackle resource constraints, and foster greater communication among partners responsible for implementation.
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420
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Buchanan K, Newnham E, Ireson D, Davison C, Bayes S. Does midwifery-led care demonstrate care ethics: A template analysis. Nurs Ethics 2021; 29:245-257. [PMID: 34396811 DOI: 10.1177/09697330211008638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ethical care in maternity is fundamental to providing care that both prevents harm and does good, and yet, there is growing acknowledgement that disrespect and abuse routinely occur in this context, which indicates that current ethical frameworks are not adequate. Care ethics offers an alternative to the traditional biomedical ethical principles. RESEARCH AIM The aim of the study was to determine whether a correlation exists between midwifery-led care and care ethics as an important first step in an action research project. RESEARCH DESIGN Template analysis was chosen for this part of the action research. Template analysis is a design that tests theory against empirical data, which requires pre-set codes. PARTICIPANTS AND CONTEXT A priori codes that represent midwifery-led care were generated by a stakeholder consultative group of nine childbearing women using nominal group technique, collected in Perth, Western Australia. The a priori codes were applied to a predesigned template with four domains of care ethics. ETHICAL CONSIDERATIONS Ethics approval was granted by the Edith Cowan University research ethics committee REMS no. 2019-00296-Buchanan. FINDINGS The participants generated eight a priori codes representing ethical midwifery care, such as: 1.1 Relationship with Midwife; 1.2 Woman-centred care; 2.1 Trust women's bodies and abilities; 2.2. Protect normal physiological birth; 3.1. Information provision; 3.2. Respect autonomy; 4.1. Birth culture of fear (midwifery-led care counter-cultural) and 4.2. Recognition of rite of passage. The a priori codes were mapped to the care ethics template. The template analysis found that midwifery-led care does indeed demonstrate care ethics. DISCUSSION Care ethics takes into consideration what principle-based bioethics have previously overlooked: relationship, context and power. CONCLUSION Midwifery-led care has been determined in this study to demonstrate care ethics, which suggest that further research is defensible with the view that it could be incorporated into the ethical codes and conduct for the midwifery profession.
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Affiliation(s)
| | | | | | | | - Sara Bayes
- Edith Cowan University, Australia; Australian Catholic University, Australia
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421
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Evans S, Villegas V, Dowding C, Druitt M, O'Hara R, Mikocka-Walus A. Treatment use and satisfaction in Australian women with endometriosis: A mixed-methods study. Intern Med J 2021; 52:2096-2106. [PMID: 34396651 DOI: 10.1111/imj.15494] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022]
Abstract
AIMS This study aimed to document the frequency of conventional and complementary treatments used by Australian women with endometriosis and the perceived efficacy of these treatments; and to qualitatively explore women's treatment satisfaction. METHODS Using a mixed-methods design, 532 women with self-reported endometriosis were recruited from the community. METHOD Participants were asked about their medication, complementary and self-care treatment use, as well as perceived efficacy on a 0 (not effective) - 10 (extremely effective) numeric rating scale (NRS), and open-ended qualitative survey items about treatment satisfaction. RESULTS 97% of women used medication for pain relief (mean perceived efficacy = 5.05) and 89% used complementary/ self-care strategies (mean perceived efficacy = 3.70), with medication rated as significantly more effective (p <.001). Content analysis of the qualitative data identified that 36% of women were dissatisfied with treatment, 34% were somewhat satisfied, and 24% were satisfied. We identified qualitative themes relating to: 1) Barriers to treatment, which included lack of access, stigma, and disappointment with medical professionals who were perceived as uncaring, unhelpful and in some cases, psychologically damaging; 2) The need for holistic, interdisciplinary care; and 3) Patient knowledge, advocacy and resilience in endometriosis management. CONCLUSIONS Our findings reveal important limitations in the current Australian healthcare model, including the need for patient-centred interdisciplinary care that treats the biopsychosocial needs of people with endometriosis; and widespread pain education, spanning medical training to community awareness. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Subhadra Evans
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia
| | - Valeria Villegas
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia
| | - Charlotte Dowding
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia
| | - Marilla Druitt
- University Hospital, Geelong, Australia.,Deakin University, Geelong, Australia
| | - Rebecca O'Hara
- Robinson Research Institute, University of Adelaide, South Australia, Australia
| | - Antonina Mikocka-Walus
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Victoria, Australia
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422
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Front-Line Hospice Staff Perceptions of Barriers and Opportunities to Discussing Advance Care Planning With Hospice Patients and Their Families. J Am Med Dir Assoc 2021; 23:1205-1214.e2. [PMID: 34391713 DOI: 10.1016/j.jamda.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/20/2021] [Accepted: 07/14/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To understand the facilitators and barriers to hospice staff engagement of patients and surrogates in advance care planning (ACP) conversations. DESIGN Qualitative study conducted with purposive sampling and semistructured interviews using ATLAS.ti software to assist with template analysis. SETTINGS AND PARTICIPANTS Participants included 51 hospice professionals (31 clinicians, 13 leaders, and 7 quality improvement administrators) from 4 geographically distinct nonprofit US hospices serving more than 2700 people. MEASURES Interview domains were derived from the implementation science framework of Capability, Opportunity, Motivation, and Behavior (COM-B), with additional questions soliciting recommendations for behavior change. Differences in themes were reconciled by consensus. The facilitator, barrier, and recommendation themes were organized within the COM-B framework. RESULTS Capability was facilitated by interdisciplinary teamwork and specified clinical staff roles and inhibited by lack of self-perceived skill in engaging in ACP conversations. Opportunities for ACP occurred during admission to hospice, acute changes, or deterioration in patient condition. Opportunity-related environmental barriers included time constraints such as short patient stay in hospice and workload expectations that prevented clinicians from spending more time with patients and families. Motivation to discuss ACP was facilitated by the employee's goal of providing personalized, patient-centered care. Implicit assumptions about patients' and families' preferences reduced staff's motivation to engage in ACP. Hospice staff made recommendations to improve ACP discussions, including training and modeling practice sessions, earlier introduction of ACP concepts by clinicians in prehospice settings, and increasing workforce diversity to reflect the patient populations the organizations want to reach and cultural competency. CONCLUSIONS AND IMPLICATIONS Even hospice staff can be uncomfortable discussing death and dying. Yet staff were able to identify what worked well. Solutions to increase behavior of ACP engagement included staff training and modeling practice sessions, introducing ACP prior to hospice, and increasing workforce diversity to improve cultural competency.
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423
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Turner M, King N, Mojtahedi D, Burr V, Gall V, Gibbs GR, Hudspith LF, Leadley CB, Walker T. Well-being programmes in prisons in England and Wales: a mixed-methods study. Int J Prison Health 2021; 18:259-274. [PMID: 34382757 DOI: 10.1108/ijph-03-2021-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE In the past decade, there has been growing awareness of well-being and its importance and an increase in the development of activities or programmes aimed at improving well-being. The purpose of this study is to investigate what well-being programmes were being offered to prisoners in England and Wales and what benefits and other outcomes were experienced. DESIGN/METHODOLOGY/APPROACH The study used a mixed-methods exploratory design in two phases. Phase 1 was a questionnaire survey of all adult prisons in England and Wales, completed by prison staff. In Phase 2, a sample of survey respondents took part in in-depth interviews. FINDINGS The programmes identified in Phase 1 included physical activities, creative arts, mindfulness, horticulture, reading and animal-assisted activities. Prison staff reported a range of universally positive outcomes shared by all programmes, including enthusiasm from prisoners, enjoyment of the activities and being able to do something different from the usual prison routine. However, in Phase 2, interviewees rarely mentioned direct health and well-being benefits. The impetus for programmes was varied and there was little reference to national policy on health and well-being; this reflected the ad hoc way in which programmes are developed, with a key role being played by the Well-being Officer, where these were funded. ORIGINALITY/VALUE The literature on well-being programmes in prisons is limited and tends to focus on specific types of initiatives, often in a single prison. This study contributes by highlighting the range of activities across prisons and elucidating the perspectives of those involved in running such programmes.
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Affiliation(s)
- Mary Turner
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Nigel King
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Dara Mojtahedi
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Viv Burr
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Victoria Gall
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Graham R Gibbs
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Lara Flynn Hudspith
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | | | - Tammi Walker
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
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Mikocka-Walus A, Druitt M, O'Shea M, Skvarc D, Watts JJ, Esterman A, Tsaltas J, Knowles S, Harris J, Dowding C, Parigi E, Evans S. Yoga, cognitive-behavioural therapy versus education to improve quality of life and reduce healthcare costs in people with endometriosis: a randomised controlled trial. BMJ Open 2021; 11:e046603. [PMID: 34373298 PMCID: PMC8354255 DOI: 10.1136/bmjopen-2020-046603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Endometriosis is a debilitating chronic inflammatory condition highly burdensome to the healthcare system. The present trial will establish the efficacy of (1) yoga and (2) cognitive-behavioural therapy (CBT), above (3) education, on quality of life, biopsychosocial outcomes and cost-effectiveness. METHODS AND ANALYSIS This study is a parallel randomised controlled trial. Participants will be randomly allocated to yoga, CBT or education. Participants will be English-speaking adults, have a diagnosis of endometriosis by a qualified physician, with pain for at least 6 months, and access to internet. Participants will attend 8 weekly group CBT sessions of 120 min; or 8 weekly group yoga sessions of 60 min; or receive weekly educational handouts on endometriosis. The primary outcome measure is quality of life. The analysis will include mixed-effects analysis of variance and linear models, cost-utility analysis from a societal and health system perspective and qualitative thematic analysis. ETHICS AND DISSEMINATION Enrolment in the study is voluntary and participants can withdraw at any time. Participants will be given the option to discuss the study with their next of kin/treating physician. Findings will be disseminated via publications, conferences and briefs to professional organisations. The University's media team will also be used to further disseminate via lay person articles and media releases. TRIAL REGISTRATION NUMBER ACTRN12620000756921p; Pre-results.
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Affiliation(s)
- Antonina Mikocka-Walus
- School of Psychology, Deakin University Geelong, Geelong and Burwood, Victoria, Australia
| | - Marilla Druitt
- Department of Obstetrics and Gynaecology, University Hospital Geelong, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Melissa O'Shea
- School of Psychology, Deakin University Geelong, Geelong and Burwood, Victoria, Australia
| | - David Skvarc
- School of Psychology, Deakin University Geelong, Geelong and Burwood, Victoria, Australia
| | - Jennifer J Watts
- School of Health & Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Adrian Esterman
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
| | - Jim Tsaltas
- Department of Gynaecology, Epworth Freemasons Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics & Gynaecology, Monash Health, Clayton, Victoria, Australia
| | - Simon Knowles
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jill Harris
- Kyo Yoga & Healing, Ocean Grove, Victoria, Australia
| | - Charlotte Dowding
- School of Psychology, Deakin University Geelong, Geelong and Burwood, Victoria, Australia
| | - Elesha Parigi
- School of Psychology, Deakin University Geelong, Geelong and Burwood, Victoria, Australia
| | - Subhadra Evans
- School of Psychology, Deakin University Geelong, Geelong and Burwood, Victoria, Australia
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425
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Silverio SA, De Backer K, Easter A, von Dadelszen P, Magee LA, Sandall J. Women's experiences of maternity service reconfiguration during the COVID-19 pandemic: A qualitative investigation. Midwifery 2021; 102:103116. [PMID: 34399382 DOI: 10.1016/j.midw.2021.103116] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/19/2021] [Accepted: 08/02/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To explore women's experiences of maternity service reconfiguration during the first wave of the SARS-CoV-2 (COVID-19) pandemic. DESIGN Qualitative interview study. SETTING South London, United Kingdom. PARTICIPANTS Women (N=23) who gave birth between March and August 2020 in one of the ten South London maternity hospitals. METHODS Semi-structured interviews were conducted (N=23), via video-conferencing software. Transcribed interviews were analysed 'by hand' using Microsoft Word. Template analysis was selected to code, analyse, and interpret data, according to the findings of a recently-published national survey of maternity service reconfiguration across the UK in response to COVID-19. FINDINGS Three main themes emerged through analysis: (i) Disruption to In-Person Care and Increased Virtual Care Provision, (ii) Changes to Labour and Birth Preferences and Plans, (iii) Advice for Navigating Maternity Services During a Pandemic. KEY CONCLUSIONS Women reported mixed views on the reduction in scheduled in-person appointments. The increase in remote care, especially via telephone, was not well endorsed by women. Furthermore, women reported an under-reliance on healthcare professionals for support, rather turning to family. IMPLICATIONS FOR PRACTICE We provide insight into the experiences of women who received antenatal, intrapartum, and postnatal care during the first wave of the COVID-19 pandemic. Our findings should inform healthcare policy to build back better maternity care services after the pandemic.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK.; Elizabeth Garrett Anderson Institute for Women's Health, Faculty of Population Health Sciences, School of Life and Medical Sciences, University College London, Medical School Building, 74 Huntley Street, London, Bloomsbury, WC1E 6AU, UK..
| | - Kaat De Backer
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK.; Kingfisher Mother and Baby Unit, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Drayton High Road, Norwich, Norfolk, NR6 5BE, UK
| | - Abigail Easter
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Peter von Dadelszen
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Laura A Magee
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
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426
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How do female engineers conceptualise career advancement in engineering: a template analysis. CAREER DEVELOPMENT INTERNATIONAL 2021. [DOI: 10.1108/cdi-01-2021-0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeExisting research has established that women drop out of engineering careers in part because of a dissatisfaction with their career development, but women's understanding of career development in engineering has been as yet largely unexplored. This paper aims to explore female engineers' experiences of navigating their careers and their perceptions of barriers to career development, through the lens of the intelligent career framework (ICF).Design/methodology/approachThe in-depth interviews of this study were conducted with female engineers in the UK and analysed using template analysis.FindingsThe authors identified three structural barriers that participants felt hinder women's career development in engineering: (1) promotions are more likely to be given to people who are widely known – more often men; (2) promotions are more likely to be given to people on whom high status is conferred in this context – more often men and (3) promotions are more likely to be given to people who conform to the ideal worker ideology – more often men. The women also offered a series of counter-narratives in which they reframed the behaviour they witnessed as something other than sexism.Originality/valueThe findings highlight the significant and systemic bias against women's career development through gender stereotypes in workplaces and an implicitly gendered organisation that hinders the development of the three competencies needed for career advancement. The authors describe a range of counter-narratives that the participants use to help them to make sense of their experiences. Finally, the authors illustrate the application of the intelligent career framework (ICF) as a lens to view the career development culture of an organisation.
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427
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Stefancic A, Bochicchio L, Svehaug K, Alvi T, Cabassa LJ. "We Die 25 Years Sooner:" Addressing Physical Health Among Persons with Serious Mental Illness in Supportive Housing. Community Ment Health J 2021; 57:1195-1207. [PMID: 33385266 DOI: 10.1007/s10597-020-00752-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
People diagnosed with serious mental illness (SMI) experience significant health disparities, including high rates of premature mortality. Supportive housing may serve as a critical service setting for addressing physical health, but comprehensive health-related services within these programs remain an exception. This study sought to identify barriers, and potential solutions, to addressing the physical health needs of people with SMI within supportive housing. Semi-structured interviews and focus groups were conducted with multiple stakeholders (clients, peer specialists, non-peer staff, leadership) across three supportive housing agencies. There was general consensus regarding multiple barriers at the individual, organizational, policy/system, and community levels. Nevertheless, stakeholders also identified strategies in domains such as staffing, organizational culture, partnerships, communication, and infrastructure for addressing barriers. These findings can inform planning for implementation of health initiatives within supportive housing while also highlighting the need for broader community, systems, and policy change.Trial Registration Number: NCT02175641.
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Affiliation(s)
- Ana Stefancic
- Department of Psychiatry, Columbia University, 1051 Riverside Dr, New York, NY, 10032, USA.
| | | | - Katy Svehaug
- Department of Psychiatry, Columbia University, 1051 Riverside Dr, New York, NY, 10032, USA
| | - Talha Alvi
- Southern Methodist University, 6116 North Central Expressway, PO Box 750442, Dallas, TX, 75206, USA
| | - Leopoldo J Cabassa
- Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
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428
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Thornton M, Harcourt D, Deave T, Kiff J, Williamson H. "Have We Done Enough?" A Cross-condition Exploration of the Experiences of Parents Caring for A Child with an Appearance-affecting Condition or Injury. Dev Neurorehabil 2021; 24:418-428. [PMID: 33852812 DOI: 10.1080/17518423.2021.1901150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Children and young people (CYP) with appearance-affecting conditions/injuries report common pervasive psychosocial difficulties, regardless of cause, nature or extent of their visible differences. Parents or carers can also experience psychosocial difficulties and challenges specific to having CYP with a visible difference. Current literature is confined to exploring condition-specific concerns of parents, typically in more prevalent appearance-affecting conditions/injuries, whilst the experiences of parents of CYP with other visible differences are unknown. Thirty-one interviews (parents n = 20, health and support professionals n = 11) and 4 parent focus groups (n = 25) were conducted. Three overarching themes were constructed: "Appearance does(n't) matter" describes the impact of having a child with a socially undesirable appearance; "Being 'battle' ready" reflects parents' desire to arm their child with resources to manage challenges, whilst "Walking the tightrope" reflects parents' lack of clarity about how best to approach this. Findings highlight shared and common cross-condition psychosocial difficulties among parents and carers.
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Affiliation(s)
- Maia Thornton
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Diana Harcourt
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Toity Deave
- Nursing and Midwifery, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - James Kiff
- Outlook Service, Southmead Hospital, Bristol, UK
| | - Heidi Williamson
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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429
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Skeva R, Gregg L, Jay C, Pettifer S. Assessment of virtual environments for alcohol Relapse Prevention in a less immersive and cost-effective setup: A qualitative study. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2021. [DOI: 10.1016/j.chbr.2021.100120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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430
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Lee CB, Huang NC, Kung SF, Hu SC. Opportunity for HiAP through a Healthy Cities initiative in Taiwan: a multiple streams analysis. Health Promot Int 2021; 36:78-88. [PMID: 32285099 DOI: 10.1093/heapro/daaa037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Health in All Policies (HiAP) is an effective approach to promote population health through addressing comprehensive social determinants of health. In 1997, the World Health Organization designed a 20-step protocol for developing a Healthy Cities (HC) project to build healthy public policies. Taiwan adopted the concept of HC in 2002 and established the first demonstration project in Tainan City in 2003. This study explores the impact of the HC initiative on the development of HiAP, as well as how a window of opportunities for HiAP was opened through the HC movement, using Tainan City as an example. Tainan was selected as the case for this study because of its relative maturity in the development of an HC initiative. A theory-driven thematic analysis was conducted in the study with archived documents between 2003 and 2010. We first adopted a Multiple Streams Approach to examine how the city government opened a window for HiAP through the HC initiative and then drew on the Maturity Model to evaluate the stage of HiAP in the Tainan HC project. After analyzing all related documents, we concluded that HiAP in the Tainan HC project had reached Stage V Institutionalization after 7 years. Key contexts, factors, challenges and strategies were identified. This study suggests that the HC initiative can indeed contribute to the development of HiAP and that the window was opened for HiAP through a concurrence of the three streams of problem, policy and politics along with the HC movement process.
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Affiliation(s)
- Chiachi Bonnie Lee
- Department of Health Services Administration, China Medical University, Taichung 404, Taiwan
| | - Nuan-Ching Huang
- Department of Urban Planning, College of Planning and Design, National Cheng Kung University, Tainan 701, Taiwan
- Healthy Cities Research Center, Research and Services Headquarter, National Cheng Kung University, Tainan 701, Taiwan
| | - Shiann-Far Kung
- Department of Urban Planning, College of Planning and Design, National Cheng Kung University, Tainan 701, Taiwan
- Healthy Cities Research Center, Research and Services Headquarter, National Cheng Kung University, Tainan 701, Taiwan
| | - Susan C Hu
- Healthy Cities Research Center, Research and Services Headquarter, National Cheng Kung University, Tainan 701, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
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431
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Robertson MC, Cox-Martin E, Liao Y, Flores SA, Shegog R, Markham CM, Fujimoto K, Durand CP, Brewster A, Lyons EJ, Basen-Engquist KM. Acceptance- and mindfulness-based techniques for physical activity promotion in breast cancer survivors: a qualitative study. Support Care Cancer 2021; 30:465-473. [PMID: 34313858 PMCID: PMC8314027 DOI: 10.1007/s00520-021-06428-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/11/2021] [Indexed: 11/08/2022]
Abstract
Purpose The purpose of this study was to develop and characterize the relevance and potential utility of an electronically delivered acceptance- and mindfulness-based approaches to physical activity promotion for insufficiently active breast cancer survivors. Methods The acceptance- and mindfulness-based physical activity intervention was delivered to participants electronically over the course of 4–8 weeks. It consisted of didactic videos, experiential exercises, and workbook-type activities that targeted principles from acceptance and commitment therapy (ACT). We conducted semi-structured, in-depth interviews with participants after they completed the intervention. Three coders conducted qualitative data analysis on interview transcripts to identify overarching themes and subthemes. Results We recruited 30 participants. Of those, 16 engaged in an individual interview. The mean age of the sample was 58.4 years (SD = 13.8). The sample was relatively well educated (50.0% college graduates) and mostly overweight or obese (58.8%). We identified two overarching themes from interviews. They were centered on (1) internal and external barriers to physical activity adherence and (2) the utility of targeting core ACT processes (acceptance and defusion, mindfulness, and values clarification) for physical activity promotion. Conclusion Intervention content was perceived to be acceptable, relevant, and to fulfill important needs related to healthy living. Findings suggest that this approach to physical activity promotion can be delivered effectively online. Electronically delivered acceptance- and mindfulness-based approaches hold promise for helping insufficiently active breast cancer survivors increase physical activity.
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Affiliation(s)
- Michael C Robertson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA. .,Health Promotion & Behavioral Sciences, The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA. .,Division of Rehabilitation Science, The University of Texas Medical Branch At Galveston, 301 University Boulevard, Galveston, TX, 77555, USA.
| | - Emily Cox-Martin
- VA Puget Sound Health Care System, 9600 Veterans Dr SW, Tacoma, WA, USA
| | - Yue Liao
- College of Nursing and Health Innovation, The University of Texas At Arlington, 411 S Nedderman Dr, Arlington, TX, 76010, USA
| | - Sara A Flores
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, 77843, USA
| | - Ross Shegog
- Health Promotion & Behavioral Sciences, The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Christine M Markham
- Health Promotion & Behavioral Sciences, The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Kayo Fujimoto
- Health Promotion & Behavioral Sciences, The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Casey P Durand
- Health Promotion & Behavioral Sciences, The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Abenaa Brewster
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Elizabeth J Lyons
- Department of Nutrition and Metabolism, Medical Branch At Galveston, The University of Texas, 301 University Boulevard, Galveston, TX, 77555, USA
| | - Karen M Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
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432
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Dangaltcheva A, Booth C, Moretti MM. Transforming Connections: A Trauma-Informed and Attachment-Based Program to Promote Sensitive Parenting of Trans and Gender Non-conforming Youth. Front Psychol 2021; 12:643823. [PMID: 34381395 PMCID: PMC8350507 DOI: 10.3389/fpsyg.2021.643823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Gender non-conforming and trans youth experience high rates of bullying and victimization, placing them at risk for serious mental health challenges. Parent support is one of the most significant protective factors in this population, and yet few programs are specifically developed to promote parenting sensitivity, understanding, and acceptance. Connect, a trauma-informed and attachment-based group program for caregivers of at-risk adolescents, has been shown to reduce parent stress and depressed mood, increase parents' sense of efficacy and satisfaction, and reduce parent-teen conflict. Teens benefit from increased attachment security and improved mental health and well-being. Treatment effects have been documented to continue for up to 2 years post-treatment. This paper describes the adaptation of the Connect program to create a new program, Transforming Connections, for caregivers of transgender and gender non-conforming youth. Participants in the first three groups were 20 parents of 16 gender non-conforming youth (ages 12-18). Common themes in group discussions related to gender included: coming out, connecting with peers, affirming pronouns/names, medical transition, parental reactions (e.g., confusion, isolation, grief, acceptance), and concerns about safety and mental health. All parents completed the full program, attending on average 9 of 10 sessions. Caregivers reported feeling respected, safe, and welcomed in the program and indicated that learning about attachment enhanced their understanding of their teen and their gender journey as well as themselves as a parent. Additionally, all parents reported applying the ideas discussed in the group frequently (60%) or somewhat frequently (40%). The majority indicated that their relationship with their teen had improved somewhat (65%) or a great deal (20%). Findings provide positive preliminary evidence of the fit and value of Transforming Connections for these families.
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Affiliation(s)
| | - Chris Booth
- Maples Adolescent Treatment Centre, Vancouver, BC, Canada
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433
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van der Zanden V, van der Zaag-Loonen HJ, Paarlberg KM, Meijer WJ, Mourits MJE, van Munster BC. PREsurgery thoughts - thoughts on prehabilitation in oncologic gynecologic surgery, a qualitative template analysis in older adults and their healthcare professionals. Disabil Rehabil 2021; 44:5930-5940. [PMID: 34283686 DOI: 10.1080/09638288.2021.1952319] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aimed to reveal information that can be used for composing a prehabilitation program tailored to elderly gynecological oncological patients and is applicable to healthcare professionals. We investigated possible content and indications for prehabilitation, and what potential barriers might exist. MATERIALS AND METHODS Because of the primary exploratory study aim, inductive thematic template analysis on semi-structured interviews with gynecologic oncological patients aged ≥60 years and healthcare professionals were used. RESULTS 16 patients and 20 healthcare professionals were interviewed. Three themes important for prehabilitation were found: (1) "Motivation," (2) "Practical issues and facilitators," and (3) "Patient-related factors." A short time interval between diagnosis and surgery was reported as a potential barrier for prehabilitation. Given components for a tailor-made prehabilitation program are: (1) The first contact with a nurse who screens the patients, gives tailor-made advice on prehabilitation and keeps patients motivated and supports them mentally; (2) If patients are referred to a more extensive/supervised program, this should preferably be arranged close to a patients' home. CONCLUSION Based on our findings, an outline of a patient-tailored prehabilitation program was developed. The main important themes for prehabilitation were "Motivation," "Practical issues and facilitators," and "Patient-related factors."IMPLICATIONS FOR REHABILITATIONPatients and healthcare professionals are positive about prehabilitation.Main themes for designing a prehabilitation program are "Motivation," "Practical issues and facilitators," and "Patient-related factors."Nursing staff can play a key role in prehabilitation.It is important to screen patients for specific impairments to obtain a tailor-made prehabilitation program.For some patients, general advice on prehabilitation might be sufficient, while others may need more supervision.The time interval between diagnosis and surgery is often short and is perceived as a potentially significant barrier for an effective prehabilitation program.
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Affiliation(s)
- Vera van der Zanden
- Department of Obstetrics and Gynecology, Gelre Hospitals, Apeldoorn, The Netherlands.,Department Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hester J van der Zaag-Loonen
- Department Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - K Marieke Paarlberg
- Department of Obstetrics and Gynecology, Gelre Hospitals, Apeldoorn, The Netherlands
| | - Wouter J Meijer
- Department of Obstetrics and Gynecology, Gelre Hospitals, Apeldoorn, The Netherlands
| | - Marian J E Mourits
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara C van Munster
- Department Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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434
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Behrens CC, Driessen EW, Dolmans DH, Gormley GJ. 'A roller coaster of emotions': a phenomenological study on medical students lived experiences of emotions in complex simulation. Adv Simul (Lond) 2021; 6:24. [PMID: 34217370 PMCID: PMC8254235 DOI: 10.1186/s41077-021-00177-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Simulation-based education can induce intense learner emotions. The interplay between emotions and learning is less well understood. Gaining greater insights into learner emotions has potential to guide how best we manage emotions and optimise learning. This study aimed to understand learners' lived emotional experiences in complex simulation and the perceived impact on learning. METHODS Eight final-year medical students participated in the study. Wearing video-glasses, participants took part in a ward-based simulation. Video-footage was used to elicitate exploratory interviews and analysed using Template Analysis reflexively. RESULTS Analysis yielded four main themes: 'nervous anticipation': encapsulating the fear, anxiety and uncertainty experienced by learners prior to simulation; 'shock and awe': feelings of anxiousness and being overwhelmed at the start of a simulation; 'in the moment: flowing or buffeting with the emotions': experiencing fear of being judged as incompetent, but also experiencing positive emotions such as satisfaction; 'safe-landing?': whilst debriefing aimed to encourage more positive emotions, negative emotions about the simulation could persist even with debriefing. CONCLUSIONS Complex simulation can evoke intense emotions in students. If students experienced a positive progression, they reported positive emotions and felt competent which was perceived to have a positive impact on learning. If students experienced failure, they reported strong negative emotions which made them question about their future performance and was perceived as negative for learning. Bringing to the surface these complex emotional dynamics, could permit educators to be aware of and adapt the emotional climate within simulation in order to optimise learning.
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Affiliation(s)
- Claudia C Behrens
- Medical Education Unit, Universidad Católica del Norte, Coquimbo, Larrondo 1281, Coquimbo, Chile.
| | - Erik W Driessen
- School of Health Professions Education, Maastricht University, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Diana H Dolmans
- School of Health Professions Education, Maastricht University, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Gerard J Gormley
- Centre for Medical Education, Queen's University Belfast, University Road Belfast, BT7 1NN, Belfast, Northern Ireland
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435
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Ribeiro DL, Costa M, Helmich E, Jaarsma D, de Carvalho‐Filho MA. 'I found myself a despicable being!': Medical students face disturbing moral dilemmas. MEDICAL EDUCATION 2021; 55:857-871. [PMID: 33386638 PMCID: PMC8248051 DOI: 10.1111/medu.14447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/05/2020] [Accepted: 12/26/2020] [Indexed: 06/12/2023]
Abstract
CONTEXT The psychological realm of medical students' moral experiences is explored tangentially in medical education literature, often in the context of ethics or professionalism education. This study deepens our understanding by (a) investigating the nature of moral dilemmas experienced at the onset of clinical practice, (b) exploring students' emotional response to these dilemmas, and (c) examining how students perceive the influence of these dilemmas on their professional development. METHODS This is a cross-sectional qualitative study carried out in 2017 that applied thematic template analysis to individual interviews performed with last-year medical students. The interviews followed the drawing of a Rich Picture representing moral dilemmas experienced by medical students at the onset of clinical practice. RESULTS Moral dilemmas have four intertwined dimensions. The first relates to students' struggle to prioritise, balance and apply conflicting moral values; the second comprises the clash between students' inner motivation and the external constraints that limit the moral action; the third refers to the conflict between students' current attitudes with the desired/idealised attitudes of the doctor they intend to become; and the fourth corresponds to weighting conflicting ethical principles during the moral decision. Students' emotional responses are intense and long-lasting, and with a remarkable residue effect, particularly when the moral decision does not align with their moral beliefs. Moral dilemmas are impactful experiences that affect the professional development of medical students and can culminate in both detachment and growth in moral courage. CONCLUSION Moral dilemmas are memorable, complex and emotionally intense experiences that impact the professional development of medical students. Understanding students' moral dilemmas can help educators to devise pedagogical activities to anticipate and reflect on these experiences. These activities should happen under the guidance of a non-judgemental facilitator, capable of listening and legitimating students' thoughts and feelings while providing insights to nurture their professional development.
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Affiliation(s)
- Diego Lima Ribeiro
- Department of Ethics and Emergency MedicineUniversity of CampinasCampinasBrazil
| | - Marcos Costa
- University Medical Center AmsterdamAmsterdamThe Netherlands
| | - Esther Helmich
- Center for Education Development and Research in Health ProfessionsUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Debbie Jaarsma
- Center for Education Development and Research in Health ProfessionsUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Marco Antonio de Carvalho‐Filho
- Center for Education Development and Research in Health ProfessionsUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
- ICVS ‐ Life and Health Sciences Research InstituteUniversity of MinhoBragaPortugal
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436
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Smid AMC, Inberg PHJ, de Jong S, Sinclair S, von Keyserlingk MAG, Weary DM, Barkema HW. Perspectives of Western Canadian dairy farmers on providing outdoor access for dairy cows. J Dairy Sci 2021; 104:10158-10170. [PMID: 34218920 DOI: 10.3168/jds.2021-20342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/20/2021] [Indexed: 11/19/2022]
Abstract
Dairy cows are highly motivated to access pasture, especially at night in summer. When pasture is not available, dairy cows show a partial preference for alternative types of outdoor access, spending half the night outside in summer on an outdoor sand or wood chip pack. However, many dairy farms do not provide cows outside access. To better understand reasons why dairy farmers choose to provide or not provide outdoor access, we studied the perspectives of dairy farmers located in the 4 Western Canadian provinces: British Columbia, Alberta, Saskatchewan, and Manitoba. Data were collected via (1) 11 focus group discussions with a total of 50 Western Canadian dairy farmers, and (2) semi-structured individual interviews with 6 dairy farmers of Hutterite colonies. Transcripts were analyzed using template analysis. Reasons to not provide outdoor access fell into 5 main themes: (1) adverse climate conditions, (2) negative implications of outdoor access for cow welfare including concerns about udder health, (3) concerns regarding decreases in profitability, (4) farm infrastructure not set up for outdoor access, and (5) higher ability to manage animals kept indoors. Reasons to provide outdoor access fell into the 5 main themes: (1) local climate conditions conducive for outdoor access, (2) beneficial effects of outdoor access on cow welfare including lower lameness prevalence, (3) increased profitability due to a premium milk price provided to farmers that allow pasture access to their cows, (4) farm infrastructure that is set up for outdoor access, and (5) easier management of animals outdoors. We conclude that the decision to provide outdoor access depends on how farmers weigh these factors given the constraints on their farm, as well as their personal beliefs and values.
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Affiliation(s)
- Anne-Marieke C Smid
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada.
| | - Pauline H J Inberg
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Saskia de Jong
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Shane Sinclair
- Faculty of Nursing and Department of Oncology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Marina A G von Keyserlingk
- Animal Welfare Program, Faculty of Land and Food Systems, University of British Columbia, 2357 Main Mall, Vancouver, BC, V6T 1Z6, Canada
| | - Daniel M Weary
- Animal Welfare Program, Faculty of Land and Food Systems, University of British Columbia, 2357 Main Mall, Vancouver, BC, V6T 1Z6, Canada
| | - Herman W Barkema
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada
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437
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Evans S, Dowding C, Druitt M, Mikocka-Walus A. "I'm in iso all the time anyway": A mixed methods study on the impact of COVID-19 on women with endometriosis. J Psychosom Res 2021; 146:110508. [PMID: 33993063 PMCID: PMC8101001 DOI: 10.1016/j.jpsychores.2021.110508] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has resulted in restrictions and social isolation measures, which carry mental health risks. Cancellation of surgery and appointments, medication shortages and fear of the virus itself may have further challenged wellbeing. We aimed to understand how COVID-19 has affected people with endometriosis. METHODS Using a mixed methods design, we examined; 1) the impact of COVID-19 on endometriosis related healthcare, symptoms and functioning; and 2) the relationship between a measure of fear of COVID-19 and qualitative impact in 162 women with endometriosis. RESULTS We found that 60% of women reported impact of the pandemic upon healthcare, with sub-themes documenting the difficulty of cancelled and delayed treatment, specific COVID-19 barriers, and the advantages and disadvantages of telehealth. Only 23% reported negative impact on symptoms, specifically stress; 76% reported impact on daily functioning, with sub-themes related to compromised work, social life and healthy living. A 'hidden benefits' theme revealed ways that COVID-19 had improved some women's lives, including working from home, and the opportunity for healthy lifestyle choices. Logistic regressions revealed that fear of COVID-19 significantly predicted impact themes (healthcare odds ratio = 0.93, 95% confidence interval: 0.87-0.98; symptoms odds ratio = 0.88, 95% confidence interval: 0.82-0.95; functioning odds ratio = 0.92, 95% confidence interval: 0.85-0.99). CONCLUSION Our findings indicate the need to provide patients with supportive care during pandemic restrictions that leverage self-management strategies.
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Affiliation(s)
- Subhadra Evans
- School of Psychology, Deakin University, Geelong, Australia; Faculty of Health, The Centre for Social and Early Emotional Development, Australia.
| | | | - Marilla Druitt
- School of Psychology, Deakin University, Geelong, Australia,University Hospital Geelong, Australia
| | - Antonina Mikocka-Walus
- School of Psychology, Deakin University, Geelong, Australia,Faculty of Health, The Centre for Social and Early Emotional Development, Australia
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438
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Girerd L, Verniers C, Bonnot V. Neoliberal Ideology in France: A Qualitative Inquiry. Front Psychol 2021; 12:686391. [PMID: 34267709 PMCID: PMC8276107 DOI: 10.3389/fpsyg.2021.686391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
This article adds to the existing literature on neoliberal ideology by investigating its content and contours in a context historically marked by statism. Very few studies in social psychology have looked at how neoliberal ideology transpires out of people's discourses and none have done so in such contexts. Yet, this appears necessary in order to better understand its actual influence and how it interacts with localized norms. Relying on a qualitative analysis of 32 semi-structured interviews and on the existing literature, we identified five central themes of neoliberal ideology in France: State prerogatives, competition, abstraction from institutional and social contexts, the entrepreneurial self and emotional management. Results suggest that the influence of neoliberal ideology transpires in the way people envision competition as something natural and motivating, in the way they distance themselves from their immediate and distant contexts, and in the way they value and engage in self-regulation while pursuing happiness and self-optimization. We also found that, in the French context, neoliberal ideology was not necessarily associated to the willingness to see the State step back and to the rationalization of all types of inequalities. Indeed, in the eyes of participants, the State largely remains the guarantor of public services and should ensure an equality of opportunity. This study highlights the value of relying on a qualitative approach to provide a rich and complex account of social realities such as ideologies.
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Affiliation(s)
- Lola Girerd
- Laboratoire de Psychologie Sociale, Université de Paris, Paris, France
| | | | - Virginie Bonnot
- Laboratoire de Psychologie Sociale, Université de Paris, Paris, France
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439
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Lecours A, St-Hilaire F, Daneau P. Moving toward an integrated prevention approach for mental health at work: Promoting workers' involvement through concrete actions. Work 2021; 69:295-306. [PMID: 33998589 DOI: 10.3233/wor-213478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Work-related mental health problems are a primary cause of disability and lead to the absence of 500,000 workers each week in Canada. There is a growing body of literature suggesting integrated approaches of prevention are necessary to improve mental health at work. The involvement of numerous stakeholders inclusive of government agents, employers, and workers is recommended. However, only minimal information is available to suggest actions workers may adopt toward an integrated approach of prevention to improve mental health at work. OBJECTIVE The aim of the study was to identify behaviors workers may adopt to foster mental health at work. METHODS Following a descriptive qualitative research design, semi-structured interviews were conducted with researchers, professionals, and workers. Data were analyzed using a template analysis strategy. RESULTS A total of 49 concrete behaviors were identified, grouped into ten sub-themes, and three broad themes. These main themes identify those behaviors that appear to be useful throughout the prevention continuum: 1) adopting a reflexive practice, 2) acting for one's own mental health, and 3) acting for mental health of others. CONCLUSIONS In harmony with the integrated prevention approach, this study offers a framework to organize workers' concrete actions contributing to mental health.
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Affiliation(s)
- Alexandra Lecours
- Équipe sur les organisations en santé, École de gestion, Université de Sherbrooke, Sherbrooke, Canada.,Département d'ergothérapie, Université du Québec à Trois-Rivières, Québec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Université Laval, Québec, Canada
| | - France St-Hilaire
- Équipe sur les organisations en santé, École de gestion, Université de Sherbrooke, Sherbrooke, Canada.,Département de management et gestion des ressources humaines, École de gestion, Université de Sherbrooke, Sherbrooke, Canada
| | - Patrice Daneau
- Équipe sur les organisations en santé, École de gestion, Université de Sherbrooke, Sherbrooke, Canada.,Département de management et gestion des ressources humaines, École de gestion, Université de Sherbrooke, Sherbrooke, Canada
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440
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Anderson MA, Buffo C, Ketcher D, Nguyen H, MacKenzie JJ, Reblin M, Terrill AL. Applying the RISE Model of Resilience in Partners Post-Stroke: A Qualitative Analysis. Ann Behav Med 2021; 56:270-281. [PMID: 34228090 DOI: 10.1093/abm/kaab053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Resilience is dynamic and influenced by internal and external factors. In persons with chronic illness and/or disability, resilience is viewed as the ability to adapt to new life circumstances. Existing models of resilience typically focus on the absence of deficit and pathology in the individual, overlooking resources, well-being, and broader social impacts. Our proposed novel Relational, Intrapersonal, Social and Environmental (RISE) Model of resilience incorporates and describes the interconnection and influence of constructs that impact resilience and affect the quality of life. PURPOSE The purpose of this study is to examine the fit of the RISE Model against original interview data obtained from persons with stroke and their partners. METHODS This study is a secondary analysis of qualitative data collected from post-intervention interviews that were part of an intervention pilot study designed to promote resilience in couples coping with stroke. Interviews were coded to examine relationships between RISE Model constructs. RESULTS The study included 36 interviews from 18 cohabitating couples; mean participant age was 53.33 years (SD ±14.70). Examples of each construct within the RISE Model appeared in transcribed interviews and common patterns of co-occurring constructs were identified. CONCLUSION The constructs within the RISE Model were supported by the interviews. The impact of disability does not remain confined to a single individual and instead branches out into the broader social context, including close interpersonal relationships. A deeper understanding of resilience and its relationship with intrapersonal, interpersonal and socio-ecological constructs would add value to our understanding and fostering of resilience in persons with disabilities and/or chronic illness. CLINICAL TRIAL INFORMATION NCT03335358.
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Affiliation(s)
- Miranda A Anderson
- Department of Occupational & Recreational Therapies, University of Utah, Salt Lake City, USA
| | - Corinne Buffo
- Department of Occupational & Recreational Therapies, University of Utah, Salt Lake City, USA
| | - Dana Ketcher
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Hop Nguyen
- Department of Occupational & Recreational Therapies, University of Utah, Salt Lake City, USA
| | - Justin J MacKenzie
- Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, USA
| | - Maija Reblin
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Alexandra L Terrill
- Department of Occupational & Recreational Therapies, University of Utah, Salt Lake City, USA
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441
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Creagh NS, Zammit C, Brotherton JM, Saville M, McDermott T, Nightingale C, Kelaher M. Self-collection cervical screening in the renewed National Cervical Screening Program: a qualitative study. Med J Aust 2021; 215:354-358. [PMID: 34145591 DOI: 10.5694/mja2.51137] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the implementation and acceptability of the self-collection cervical screening pathway since commencement of the renewed National Cervical Screening Program (rNCSP), from the perspectives of screening participants and primary care practitioners. DESIGN, SETTING, PARTICIPANTS Qualitative study; individual semi-structured interviews with 45 screening participants and 18 primary care practitioners in Victoria who had engaged with the self-collection pathway during the first 17 months of the rNCSP (1 December 2017 - 30 April 2019). RESULTS The self-collection pathway was highly acceptable as an alternative cervical screening pathway for most participating screening participants and practitioners. Some screening participants indicated that they would not have been screened had the pathway not been available. Acceptability was lower among those who had tested positive for HPV types not 16/18, a result that requires additional testing of a clinician-collected cervical sample. Use of the self-collection pathway is driven more by practitioners than their patients. Interpretations of the self-collection guidelines varied between practices. Barriers to expanding promotion of the pathway by practitioners included difficulties with identifying eligible participants. CONCLUSIONS Increasing the accessibility of the self-collection pathway to under- and never screened women could reduce inequities in cervical cancer outcomes for those not participating in the main screening pathway. Practitioners should be provided resources to integrate self-collection into routine practice and to efficiently implement the entire self-collection pathway, in order to maximise its use and to optimise the experience for screening participants.
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Affiliation(s)
- Nicola S Creagh
- Centre for Health Policy, School of Population and Global Health, the University of Melbourne, Melbourne, VIC
| | - Claire Zammit
- Centre for Health Policy, School of Population and Global Health, the University of Melbourne, Melbourne, VIC.,VCS Foundation, Melbourne, VIC
| | - Julia Ml Brotherton
- Centre for Health Policy, School of Population and Global Health, the University of Melbourne, Melbourne, VIC.,VCS Foundation, Melbourne, VIC
| | - Marion Saville
- VCS Foundation, Melbourne, VIC.,The University of Melbourne, Melbourne, VIC
| | | | - Claire Nightingale
- Centre for Health Policy, School of Population and Global Health, the University of Melbourne, Melbourne, VIC.,Monash University, Bendigo, VIC
| | - Margaret Kelaher
- Centre for Health Policy, School of Population and Global Health, the University of Melbourne, Melbourne, VIC
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442
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Lecours A, Major MÈ, Vincent C, Lederer V, Lamontagne MÈ. Integrated Prevention at Work: Protocol for a Concept Analysis. JMIR Res Protoc 2021; 10:e29869. [PMID: 34137727 PMCID: PMC8277315 DOI: 10.2196/29869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background Integrated prevention at work promises to eliminate the boundaries between primary, secondary, and tertiary prevention actions taken by stakeholders in the world of work. It is receiving increasing attention from the scientific community because of its concerted and harmonized approach, which promotes employment access, return, and healthy long-term continuation. Although promising, integrated prevention is not yet well-defined, which makes it difficult to operationalize. Objective This manuscript exposes the protocol of a study aiming to conceptualize integrated prevention at work on the basis of scientific and experiential knowledge. Methods Using a concept analysis research design, data collection has been planned in 2 parts. A meta-narrative literature review will first be conducted to document how integrated prevention has been defined in the literature. Then, phone interviews will be conducted with key informers (ie, managers, workers, ergonomists, occupational therapists, psychologists, physiotherapists, union and insurance representatives) to document their viewpoints and understanding of integrated prevention at work. Qualitative data gathered during these 2 parts of research will be analyzed using template analysis, which allows data from literature and empirical collection to be analyzed simultaneously. The analysis will bring out the points of convergence, divergence, and complementarity between the information gleaned from literature and key informers’ experiences to arrive at a conceptualization of integrated prevention at work by identifying its uses, attributes, antecedents, and consequences. As a final step, validation and interpretation with a TRIAGE (Technique for Research of Information by Animation of a Group of Experts) group will be carried out in collaboration with the key informers to identify the tools for the implementation of integrated prevention at work and promote workers’ health and safety. Results This study is expected to offer a contemporary conceptualization of integrated prevention at work that clearly lays out the variables of this concept and elicits the viewpoints of the different stakeholders. Conclusions This study will contribute to the advancement of knowledge about the professional injury prevention continuum. The clear identification of the uses, attributes, antecedents, and consequences of integrated prevention at work will offer concrete tools to stakeholders to implement innovative and promising approaches to integrated prevention at work. International Registered Report Identifier (IRRID) PRR1-10.2196/29869
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Affiliation(s)
- Alexandra Lecours
- Département d'ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada
| | - Marie-Ève Major
- Faculté des sciences de l'activité physique, Université de Sherbrooke, Sherbrooke, QC, Canada.,Centre de recherche interdisciplinaire sur le bien-être, la santé, la société et l'environnement, Université du Québec à Montréal, Montreal, QC, Canada
| | - Claude Vincent
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada.,Département de réadaptation, Université Laval, Québec, QC, Canada
| | - Valérie Lederer
- Département des relations industrielles, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Marie-Ève Lamontagne
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada.,Département de réadaptation, Université Laval, Québec, QC, Canada
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443
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Kamp A, Bood Z, Scherer-Rath M, Weeseman Y, Christophe N, Dörr H, Sanders J, Sprangers M, Helmich E, Timmermans L, van Wolde E, van Laarhoven HWM. Narrative recognition and identification: a qualitative pilot study into reading literary texts with advanced cancer patients. J Cancer Surviv 2021; 16:531-541. [PMID: 34129212 PMCID: PMC9142438 DOI: 10.1007/s11764-021-01048-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
Purpose Patients with advanced cancer can experience their disease as a contingent life event. The sudden interruption of their life stories can obscure life goals and disrupt meaning making. In the context of the research project “In search of stories,” we aim to investigate the reading and discussion of selected stories which present ways of dealing with a contingent life event. In addition, we examine the use of a newly developed guide for reading these exemplary texts together with advanced cancer patients. Methods This qualitative study describes the experiences of five patients with advanced cancer who participated in a guided reading and discussion about selected literary texts. The intervention consisted of reading a selected story, after which each patient was interviewed, using the reading guide as a conversation template. The interviews were then thematically analyzed for their conceptual content using a template analysis. Results All five conversations showed some form of recognition in reaction to the chosen text, which led to personal identification of experiences of contingency, such as loss of life goals, impending death, or feelings of uncertainty. Besides the important role of identification, revealed by the responses to the questions in the reading guide, the discussion of the text helped them articulate their own experience and sources of meaning. Diverse worldviews came to the fore and concepts of meaning such as fate, life goals, quality of life, and death. Conclusions First experiences with our newly developed reading guide designed to support a structured reading of stories containing experiences of contingency suggest that it may help patients to express their own experiences of contingency and to reflect on these experiences. Implications for Cancer Survivors The intervention tested in this study may contribute to supportive care for survivors with advanced cancer, but further research is needed to evaluate its effect on quality of life.
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Affiliation(s)
- Albert Kamp
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | - Zarah Bood
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | - Yvonne Weeseman
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | | | - Henny Dörr
- HKU University of the Arts Utrecht, Utrecht, The Netherlands
| | - José Sanders
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | - Mirjam Sprangers
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Esther Helmich
- Amsta Healthcare Organisation, Amsterdam, The Netherlands
| | - Liesbeth Timmermans
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ellen van Wolde
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
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444
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Patient and Family Preferences on Health System-Led Direct Contact for Cascade Screening. J Pers Med 2021; 11:jpm11060538. [PMID: 34200550 PMCID: PMC8230217 DOI: 10.3390/jpm11060538] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 12/16/2022] Open
Abstract
Health benefits to relatives of people at known genetic risk for hereditary cancer syndromes is key to realizing the promise of precision medicine. We conducted a qualitative study to design a patient- and family-centered program for direct contact of relatives to recommend cascade genetic testing. We conducted two rounds of data collection using focus groups followed by individual interviews with patients with HBOC or Lynch syndrome and a separate sample of people with a family history of hereditary cancers. Results indicate that U.S.-based health system-led direct contact of relatives is acceptable to patients and families, should take a programmatic approach, include consent of relatives before proband testing, complement to existing patient-mediated disclosure, and allow for relative control of information. Our findings suggest a set of requirements for U.S.-based direct contact programs that could ultimately benefit more relatives than current approaches.
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445
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Higgins JM, Arnold SR, Weise J, Pellicano E, Trollor JN. Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2356-2369. [PMID: 34088219 DOI: 10.1177/13623613211019858] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Autistic burnout has been commonly described in social media by autistic people. There is little mention of autistic burnout in the academic literature. Only one recent study has used interviews and reviews of social media descriptions to try to understand autistic burnout. Anecdotally, autistic burnout is a very debilitating condition that reduced people's daily living skills and can lead to suicide attempts. It is suggested that autistic burnout is caused by the stress of masking and living in an unaccommodating neurotypical world. We wanted to create a definition of autistic burnout that could be used by clinicians and the autism community. We used the Grounded Delphi method, which allowed autistic voice to lead the study. Autistic adults who had experienced autistic burnout were considered as experts on the topic, in the co-production of this definition. The definition describes autistic burnout as a condition involving exhaustion, withdrawal, problems with thinking, reduced daily living skills and increases in the manifestation of autistic traits. It is important for future research that there is a specific description of the condition. In practice, it is important for clinicians to be aware that autistic burnout is different from depression. Psychological treatments for depression potentially could make autistic burnout worse. Further awareness of autistic burnout is needed, as well as further research to prove this condition is separate from depression, chronic fatigue and non-autistic burnout.
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Affiliation(s)
- Julianne M Higgins
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Samuel Rc Arnold
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Janelle Weise
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia
| | - Elizabeth Pellicano
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.,Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, New South Wales, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
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Erickson M, Wattiaux MA, Marks D, Karcher EL. Brief, Written Reflections Improve Interest of Introductory Animal Science Undergraduates. CBE LIFE SCIENCES EDUCATION 2021; 20:ar28. [PMID: 33938765 PMCID: PMC8734397 DOI: 10.1187/cbe.20-08-0164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/11/2021] [Accepted: 04/01/2021] [Indexed: 06/08/2023]
Abstract
In addition to stimulating interest through experiential means, educators can support interest development through structured reflection. Our randomized controlled intervention study assessed the effectiveness of 10-minute written utility-value reflections designed to enhance the interest of introductory animal science students. During the Spring 2019 semester, we randomly assigned participating students into two blocks, utility-value reflection (n = 39) and control (n = 34), at the beginning of the course. In week 6 during the 16-week semester, students completed corresponding tasks: either written reflections on the personal value of course laboratory material or a control picture-summarization task. Results showed that the utility-value reflection intervention tended to improve situational interest and was most effective for students with low pretest individual interest. Neither the intervention nor the interest variable predicted course performance. In utility-value reflection responses, we catalogued themes aligned with a range of task-value components beyond utility-value. Our results reinforce previous work indicating that utility-value reflections support low individual interest students in developing academic motivation.
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Affiliation(s)
- MaryGrace Erickson
- Department of Animal & Dairy Sciences, University of Wisconsin–Madison, Madison, WI 53703
| | - Michel A. Wattiaux
- Department of Animal & Dairy Sciences, University of Wisconsin–Madison, Madison, WI 53703
| | - Danielle Marks
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
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447
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Lam H, Quinn M, Cipriano-Steffens T, Jayaprakash M, Koebnick E, Randal F, Liebovitz D, Polite B, Kim K. Identifying actionable strategies: using Consolidated Framework for Implementation Research (CFIR)-informed interviews to evaluate the implementation of a multilevel intervention to improve colorectal cancer screening. Implement Sci Commun 2021; 2:57. [PMID: 34059156 PMCID: PMC8167995 DOI: 10.1186/s43058-021-00150-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 04/28/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Many evidence-based interventions (EBIs) found to be effective in research studies often fail to translate into meaningful patient outcomes in practice. The purpose of this study was to identify facilitators and barriers that affect the implementation of three EBIs to improve colorectal cancer (CRC) screening in an urban federally qualified health center (FQHC) and offer actionable recommendations to improve future implementation efforts. METHODS We conducted 16 semi-structured interviews guided by the Consolidation Framework for Implementation Research (CFIR) to describe diverse stakeholders' implementation experience. The interviews were conducted in the participant's clinic, audio-taped, and professionally transcribed for analysis. RESULTS We used the five CFIR domains and 39 constructs and subconstructs as a coding template to conduct a template analysis. Based on experiences with the implementation of three EBIs, stakeholders described barriers and facilitators related to the intervention characteristics, outer setting, and inner setting. Implementation barriers included (1) perceived burden and provider fatigue with EHR (Electronic Health Record) provider reminders, (2) unreliable and ineffectual EHR provider reminders, (3) challenges to providing health care services to diverse patient populations, (4) lack of awareness about CRC screening among patients, (5) absence of CRC screening goals, (6) poor communication on goals and performance, and (7) absence of printed materials for frontline implementers to educate patients. Implementation facilitators included (1) quarterly provider assessment and feedback reports provided real-time data to motivate change, (2) integration with workflow processes, (3) pressure from funding requirement to report quality measures, (4) peer pressure to achieve high performance, and (5) a culture of teamwork and patient-centered mentality. CONCLUSIONS The CFIR can be used to conduct a post-implementation formative evaluation to identify barriers and facilitators that influenced the implementation. Furthermore, the CFIR can provide a template to organize research data and synthesize findings. With its clear terminology and meta-theoretical framework, the CFIR has the potential to promote knowledge-building for implementation. By identifying the contextual determinants, we can then determine implementation strategies to facilitate adoption and move EBIs to daily practice.
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Affiliation(s)
- Helen Lam
- Center for Asian Health Equity, University of Chicago, 5841 S Maryland Ave, Rm S406, MC 1140, Chicago, IL, 60637, USA.
| | - Michael Quinn
- Department of Internal Medicine Section of General Internal Medicine, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA
| | - Toni Cipriano-Steffens
- University of Chicago Medicine, 5841 S. Maryland Ave, MC 2115, Suite G109, Chicago, IL, 60637, USA
| | - Manasi Jayaprakash
- Center for Asian Health Equity, University of Chicago, 5841 S Maryland Ave, Rm S406, MC 1140, Chicago, IL, 60637, USA
| | - Emily Koebnick
- Center for Asian Health Equity, University of Chicago, 5841 S Maryland Ave, Rm S406, MC 1140, Chicago, IL, 60637, USA
| | - Fornessa Randal
- Center for Asian Health Equity, University of Chicago, 5841 S Maryland Ave, Rm S406, MC 1140, Chicago, IL, 60637, USA
| | - David Liebovitz
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr., 10th Floor, Chicago, IL, 60611, USA
| | - Blasé Polite
- University of Chicago Medicine Hematology and Oncology, 5841 S Maryland Ave, Chicago, IL, 60637, USA
| | - Karen Kim
- Center for Asian Health Equity, University of Chicago, 5841 S Maryland Ave, Rm S406, MC 1140, Chicago, IL, 60637, USA
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448
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Pieters J, Verstegen DML, Dolmans DHJM, Warmenhoven FC, van den Beuken-van Everdingen MHJ. Design and evaluation of a learning assignment in the undergraduate medical curricula on the four dimensions of care: a mixed method study. BMC MEDICAL EDUCATION 2021; 21:309. [PMID: 34059030 PMCID: PMC8165949 DOI: 10.1186/s12909-021-02681-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Chronic and palliative care are rapidly gaining importance within the physician's range of duties. In this context, it is important to address the four dimensions of care: physical, psychological, social, and spiritual. Medical students, however, feel inadequately equipped to discuss these dimensions with the patient. To bridge this gap, a new assignment was developed and implemented, in which students talked to a chronic or palliative patient about the four dimensions of care during an internship. This study, reports the evaluation of this assignment by students and teachers using a design-based approach. METHODS Mixed methods were used, including a) student questionnaires, b) student focus groups, c) teacher interviews, and d) student's written reflections. Two researchers performed analyses of the qualitative data from the focus groups, interviews, and written reflections using qualitative research software (ALTLAS.TI). Descriptive statistics were computed for the quantitative data using SPSS 21.0. RESULTS Students and teachers valued talking to an actual patient about the four dimensions of care. Reading and providing peer feedback on each other's reports was considered valuable, especially when it came to the diversity of illnesses, the way that patients cope and communication techniques. The students considered reflection useful, especially in the group and provided it was not too frequent. All the dimensions were addressed in the interviews, however the spiritual dimension was found to be the most difficult to discuss. The analysis of the written reflections revealed an overlap between the social and spiritual dimensions. Students pay a lot of attention to the relationship between the illness and the patient's daily life, but the reflections do often not show insight in the potential relationship between the four dimensions and decisions in patient care. CONCLUSIONS During internships, medical students can practice talking about four dimensions of care with a chronically ill or palliative patient. Due to the format, it can be implemented across existing internships with relatively little extra time and effort. Reflection, peer feedback, and group discussion under the guidance of a teacher are important additions.
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Affiliation(s)
- Jolien Pieters
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229, ER, Maastricht, The Netherlands.
| | - Daniëlle M L Verstegen
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229, ER, Maastricht, The Netherlands
| | - Diana H J M Dolmans
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229, ER, Maastricht, The Netherlands
| | - Franca C Warmenhoven
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229, ER, Maastricht, The Netherlands
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449
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Smith C, Burr V. Retrospective accounts of emotional experiences during personal development groups in qualified counsellors and psychotherapists. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Carole Smith
- Department of Psychology School of Human and Health Sciences University of Huddersfield Huddersfield UK
| | - Viv Burr
- Department of Psychology School of Human and Health Sciences University of Huddersfield Huddersfield UK
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450
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Saggers A, Wand BM, Bulsara C, Truter P. 'I'm not in GP pain, I'm in hospital pain': Qualitative study regarding patient decision-making factors in seeking care in the emergency department with non-specific low back pain. Emerg Med Australas 2021; 33:1013-1020. [PMID: 33960124 DOI: 10.1111/1742-6723.13792] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate factors contributing to the decision for a working age adult experiencing non-specific low back pain (NSLBP) to seek care at an Australian metropolitan tertiary ED. METHODS Participants triaged with NSLBP were recruited from one metropolitan tertiary Australian ED. We employed a qualitative descriptive methodology using semi-structured interviews to collect data. The short-form Orebro musculoskeletal pain screening questionnaire was administered pre-interview and used to inform discussion of psychosocial factors in the interview. RESULTS Patient perception and interpretation of their low back pain symptoms was the most important participant decision-making factor. This was part of the care-seeking decision for all participants. Convenience of care accessed in the ED was also important with many participants aiming to avoid multiple appointments in primary care settings while in pain or attending ED because it was close to home. Participants expected high-quality care in the ED and often did not identify an alternative in primary care they believed could provide an equivalent standard of care. Few participants were advised to attend ED by a GP or physiotherapist, but when given, this advice was a critical factor. CONCLUSIONS Patient beliefs about NSLBP are important drivers of ED care seeking. Evidence-based guidelines recommend screening for red flags and then addressing pain and disability through engagement with patient concerns and providing a management plan/pathway. In the ED setting, addressing the anxieties of these patients and re-interpreting the significance of their pain may be a path to providing time efficient high-value care.
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Affiliation(s)
- Annabel Saggers
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Benedict M Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Caroline Bulsara
- School of Nursing, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Piers Truter
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.,Emergency Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
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