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Matrook KA, Cowman S, Pertl M, Whitford D. Nurse-led family-based approach in primary health care for patients with type 2 diabetes mellitus: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2323060. [PMID: 38446054 PMCID: PMC10919304 DOI: 10.1080/17482631.2024.2323060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE The prevalence of Type 2 diabetes is rapidly increasing, with 537 million people estimated to have diabetes in 2021. The literature suggests that nurses can deliver effective person-centred diabetes care and that families can be essential in supporting patients. Thus, a Nurse-led Family-based (NLFB) approach may be particularly effective. This study aims to explore the perceptions of nurses, adults with type 2 diabetes, and family members regarding the NLFB intervention. METHODS Guided by the UK Medical Research Council Framework, this seminal study adopted a qualitative, descriptive approach with content analysis. Data were obtained through 16 semi-structured, in-depth interviews. Themes emerged based on an inductive process using constant comparison (Graneheim and Lundman 2004). The COREQ checklist was used in ensuring rigour. RESULTS Three main themes emerged includes: (1) nurses' experiences with current diabetes care practices, (2) stakeholders' views on the development of a NLFB approach, and (3) merging the nurse-led family aspects into the diabetes care. The key challenges are the dominant medical model, lack of specialist nurses, and time. The key facilitators are knowledge and social support. CONCLUSION The study recommends stakeholders embrace nursing empowerment strategies and involve families to enhance the nurses' advanced roles and family inclusion in healthcare.
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Affiliation(s)
- Khadija A. Matrook
- Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen, Bahrain
| | - Seamus Cowman
- School of Nursing and Midwifery, Faculty of Medicine and Health Sciences Royal College of Surgeons, Dublin 2, Ireland
| | - Maria Pertl
- Department of Health Psychology, Faculty of Medicine and Health Sciences Royal College of Surgeons, Dublin 2, Ireland
| | - David Whitford
- Department of General Practice, RCSI & UCD Malaysia Campus, George Town, Pulau Pinang, Malaysia
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Ness MM. Parent and Young Adult Perspectives About the Transition to College During the COVID-19 Pandemic. Sci Diabetes Self Manag Care 2024:26350106241276434. [PMID: 39248609 DOI: 10.1177/26350106241276434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
PURPOSE The purpose of this study was to describe the influence of COVID-19 on parents and their young adults with type 1 diabetes as they navigated the college environment during the COVID-19 pandemic. PARTICIPANTS A sample of 9 college students with type 1 diabetes and their parents were recruited to participate in interviews via purposive sampling methodology. METHODS A descriptive, qualitative study was conducted using semi-structured questions via recorded video conferencing interviews. RESULTS Three themes related to navigating type 1 diabetes at college during the pandemic emerged: (1) isolation and mental health: COVID-19-related isolation and loneliness; (2) risk and exposure to COVID-19: balancing risk of COVID-19 with type 1 diabetes; and (3) management of type 1 diabetes on campus during the pandemic: academics, university policies, and their impact on type 1 diabetes. CONCLUSIONS Students with type 1 diabetes and their parents had to navigate a complex set of concerns that extended beyond the usual challenges of diabetes management during the COVID-19 pandemic. Providers must provide additional support and incorporate education about type 1 diabetes management strategies to families affected by large-scale health crises.
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Rees L, Friis T, Woodward-Kron R, Munsie M. What is known about healthcare professional-patient communication when discussing stem cell therapies? A scoping review. PATIENT EDUCATION AND COUNSELING 2024; 130:108430. [PMID: 39265452 DOI: 10.1016/j.pec.2024.108430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 08/12/2024] [Accepted: 09/05/2024] [Indexed: 09/14/2024]
Abstract
OBJECTIVES When therapeutic options are limited, patients may invest hope in therapies proposed by healthcare professional, or those they find online. This review aims to explore how healthcare professional-patient communication is realised when discussing stem cell therapies. METHOD Four electronic databases were systematically searched for relevant studies. Twenty-six studies met the inclusion criteria. Descriptive analyses and a thematic analysis guided by a functions of medical communication framework were performed on extracted data. RESULTS Most included studies addressed communication in contexts of conventional stem cell therapies, such as bone marrow transplants for blood cancers. Few studies investigated communication in contexts of experimental stem cell therapies yet to receive regulatory approval. Two themes were identified as informational and relational aspects of communication, and a third theme being a mismatch in orientations. CONCLUSIONS Communication between healthcare professionals and patients about stem cell therapies is practised using a combination of communication approaches that do not always align with patients' needs, hopes or expectations. PRACTICE IMPLICATIONS The context of healthcare settings and health conditions are important when communicating about stem cell therapies. Acknowledging healthcare professionals' environmental and personal determinants can inform strategies to navigate complex discussions about stem cell therapies with patients.
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Affiliation(s)
- Leanne Rees
- Murdoch Children's Research Institute, Melbourne, Australia; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
| | - Tine Friis
- Medical Museion, University of Copenhagen, Copenhagen, Denmark.
| | - Robyn Woodward-Kron
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
| | - Megan Munsie
- Murdoch Children's Research Institute, Melbourne, Australia; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
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Istanboulian L, Gilding AJ, Hamilton L, Master T, Bingler S, Soldatic K, Smith KM. Reported impact and protective factors of the care partner role during persistent critical illness: a content analysis. BMC Nurs 2024; 23:625. [PMID: 39242522 PMCID: PMC11378581 DOI: 10.1186/s12912-024-02300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 08/28/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Patients with persistent critical illness experience prolonged multi-system morbidity, functional impairments, and chronic conditions. As a result, these patients have prolonged intensive care unit admissions. If discharged, they return home with long-term medical dependencies. Care partners take on a variety of physical, mental health, cognitive, and social roles to support the provision of care for these patients. There is limited evidence, however, of the impact of being a care partner for this patient population during hospitalization. METHODS A qualitative descriptive study was conducted to explore the impact care provision on care partners for patients experiencing persistent critical illness. Patients who have or have had persistent critical illness and care partners were recruited from two inpatient units in a single community academic hospital in Toronto, Canada to participate in semi-structured interviews. Data was analyzed using a team-based inductive content analysis. RESULTS Seven (43.8%) participants were patient survivors, and nine (56.3%) were care partners. Patients and care partners reported physical, socio-emotional, and social stress as impacts of care provision during persistent critical illness hospitalization. Care partners identified several protective strategies that they used to mitigate the impacts of care provision on them such as seeking external mental health support and boundary setting. Features of formalized and care partner programs were also identified and suggest that these programs can be protective of care partner values, mitigate feelings of helplessness and stress, and may improve relationships between the family members who are in the care partner role and the healthcare team. CONCLUSIONS This study identified physical, socio-emotional, and social stress related impacts of care provision on care partners of patients with persistent critical illness during hospitalization. Additionally, this study identified protective factors initiated by care partners to mitigate the reported stresses of the role, as well as protective features of a care partner program. The results provide a better understanding supportive features of care partner programs that are specific to the experiences and needs of persistent critical illness and add to the growing body of evidence about how to provide equitable access to care during and post hospitalization.
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Affiliation(s)
- Laura Istanboulian
- Daphne Cockwell School of Nursing Toronto Metropolitan University, Toronto, Canada.
- Michael Garron Hospital, Toronto, Canada.
| | - Anthony J Gilding
- Michael Garron Hospital, Toronto, Canada
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Canada
| | | | | | | | - Karen Soldatic
- School of Disability Studies, Toronto Metropolitan University, Toronto, Canada
| | - Kelly M Smith
- Michael Garron Hospital, Toronto, Canada
- Institute of Health Policy Management and Evaluation Dalla Lana School of Public, Health University of Toronto, Toronto, Canada
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Santacroce SJ, Beauchemin MP, Pelletier W, Robles JM, Ruiz J, Blazin LJ, Aristizabal P, Orjuela-Grimm M, Hall AG, Kahn J, Kline C, Seif AE, Velez MC, Winestone LE. Multilevel challenges to equitable inclusion of children in trials when parents use languages other than English: A qualitative report from Children's Oncology Group's Diversity and Health Disparities Committee Language Equity Working Group. Pediatr Blood Cancer 2024:e31321. [PMID: 39238140 DOI: 10.1002/pbc.31321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/20/2024] [Accepted: 08/28/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Increasing representation in clinical trials is a priority for the National Cancer Institute and Children's Oncology Group (COG). Our survey of COG-affiliated institutions revealed that many sites have insufficient processes and resources to enroll children whose parents use languages other than English (LOE). We describe reported barriers and facilitators to enrolling children in clinical trials when parents use LOE and propose opportunities for improvement. PROCEDURES We sent a 20-item survey to COG-affiliated institutions. Five items allowed respondents to expand on replies to questions about (a) local institutional review board (IRB) requirements regarding translation of consent documents, (b) contributors to provider discomfort consenting parents who use LOE, (c) available language services and resources, and (d) barriers to enrolling children whose parents use LOE or offer ideas about approaches to improvements. Two pairs of researchers independently coded free-text responses and compared results for concordance. RESULTS A total of 139 (N = 230; 60%) institutions returned the survey. Respondents were mainly physician principal investigators (n = 79/139; 57%) at the United States sites (n = 118/139; 85%) serving less than 100 newly diagnosed children per year (n = 99/139, 71%). They described challenges at multiple levels. Proposed approaches to improvements included centralized provision of translated materials and video educational materials in various languages, and collaborating with IRBs on regulatory processes that protect families and facilitate equitable clinical trial access. CONCLUSIONS Clinical trial consortia, such as COG, face challenges in enrolling representative samples. Further research is required to design and implement multilevel interventions to ensure equitable access for all, regardless of language used, and mitigate disparate research participation.
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Affiliation(s)
- Sheila Judge Santacroce
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | | | | | - Joanna M Robles
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jenny Ruiz
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Lindsay J Blazin
- Indiana University School of Medicine, Indianapolis, Indiana, USA
- Riley Children's Health, Indianapolis, Indiana, USA
| | - Paula Aristizabal
- University of California San Diego Moores Cancer Center/University of California San Diego Department of Pediatrics, Rady Children's Hospital San Diego, San Diego, California, USA
| | | | - Anurekha G Hall
- University of Washington, Seattle Children's Hospital, Seattle, Washington, USA
| | - Justine Kahn
- New York Presbyterian/Columbia University Medical Center, New York, New York, USA
| | - Cassie Kline
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Alix E Seif
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Maria C Velez
- Children's Hospital New Orleans/Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Lena E Winestone
- Division of Allergy, Immunology & BMT, University of California San Francisco Benioff Children's Hospitals, San Francisco, California, USA
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Davenport MH, Nesdoly A, Ray L, Khurana R, Thornton J, McHugh TLF. "Is It Realistic?": A Qualitative Study of the Experiences of Elite Women Athletes Considering Parenthood. Sports Med 2024; 54:2411-2421. [PMID: 38615294 DOI: 10.1007/s40279-024-02019-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND AND OBJECTIVE As the visibility and acceptance of athlete-mothers increase, so does the number of women athletes considering parenthood. Yet, many athletes struggle with the decision to become a parent while competing at the elite level due to the significant changes and uncertainties that have been reported by pregnant and parenting athletes. The experiences of women athletes considering parenthood are under-represented in the vast sport literature but are necessary for developing evidenced-based policies and practices that can support women's equitable participation in high-performance sport contexts. Thus, the purpose of this qualitative study was to describe the experiences of elite women athletes that are considering parenthood. METHODS Participants were ten elite North American athletes (29-36 years) who are considering becoming parents in the next 5 years. Each participant self-identified as a woman and competed at the highest level in their respective sport. Data were generated via one-on-one semi-structured interviews that were audio-recorded, transcribed verbatim, and analyzed through a process of content analysis. RESULTS The experiences of elite women athletes considering parenthood are represented by five themes: (a) calls for essential mandates and leadership, (b) how do you support yourself?, (c) hesitation of body changes, (d) age inequities, and (e) being proactive about reproductive health. Such findings support an in-depth understanding of gender-specific stressors that limit women's equitable participation in high-performance contexts. CONCLUSION This research is grounded in the voices of elite women athletes and identifies actionable steps necessary for research and culture change. Findings provide necessary evidence to inform the development of sport policies to support those athletes that are considering becoming parents.
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Affiliation(s)
- Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada.
| | - Autumn Nesdoly
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Lauren Ray
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Rshmi Khurana
- Departments of Medicine and Obstetrics and Gynecology, Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
| | - Jane Thornton
- Fowler Kennedy Sports Medicine Clinic, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Epidemiology, and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Tara-Leigh F McHugh
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada
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Ames SG, Delaney RK, Delgado-Corcoran C, Houtrow AJ, Alvey J, Watt MH, Murphy N. Impact of disability-based discrimination in healthcare on parents of children with medical complexity. Dev Med Child Neurol 2024; 66:1226-1233. [PMID: 38327250 DOI: 10.1111/dmcn.15870] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 12/26/2023] [Accepted: 01/05/2024] [Indexed: 02/09/2024]
Abstract
AIM To qualitatively assess the impact of disability-based discrimination in healthcare on the parents of children with medical complexity (CMC). METHOD In this qualitative study, we conducted in-depth, semi-structured interviews with the parents of CMC. Data collection and analysis occurred iteratively; constant comparison methods were used to identify themes describing the impact of disability-based discrimination in pediatric healthcare on the parents of CMC. RESULTS Thirty participants from 15 US states were interviewed. Four themes were developed regarding the impact of disability-based discrimination in healthcare on parents. The themes were: (1) discrimination leads to a loss of trust in healthcare providers; (2) discrimination increases the burden of caregiving; (3) discrimination impacts parental well-being; and (4) racism and poverty-based discrimination amplifies disability-based discrimination. INTERPRETATION The experience of discrimination toward their child results in loss of trust and therapeutic relationship between provider and parent, causes increased burden to the family, and contributes to decreased parental well-being. These experiences are magnified in minoritized families and in families perceived to have a lower socioeconomic status based on insurance type.
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Affiliation(s)
- Stefanie G Ames
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Rebecca K Delaney
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Amy J Houtrow
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Justin Alvey
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Melissa H Watt
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Nancy Murphy
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
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Block H, George S, Hunter SC, Bellon M. Family experiences of the management of challenging behaviours after traumatic brain injury in the acute hospital setting. Disabil Rehabil 2024; 46:4522-4531. [PMID: 37970816 DOI: 10.1080/09638288.2023.2280081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE This study explored experiences of the management of challenging behaviours after traumatic brain injury (TBI) in the acute hospital setting from the perspectives of family members. MATERIALS AND METHODS A qualitative, interpretive phenomenological approach was adopted involving semi-structured interviews with 10 family members. Interviews were transcribed and analysed using thematic analysis, with Ecological Systems Theory applied as a guiding framework to discuss findings and implications for practice. RESULTS Four primary themes were identified: 1) The hospital environment; 2) Hospital staffing; 3) Identifying and preventing triggers, and 4) Family support and information. CONCLUSIONS This qualitative study highlights the need for further information, education, and support to families of patients with TBI in the acute setting. Further research investigating the implementation of best practice approaches for managing challenging behaviours practice in acute settings is needed to overcome the barriers of the hospital environment, inexperienced and inconsistent staffing, and difficulties identifying triggers within the acute hospital setting, experienced by families. Approaches for family involvement in behaviour management strategies, and facilitation of communication for people with TBI in the acute setting requires exploration.
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Affiliation(s)
- Heather Block
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia
| | - Stacey George
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Sarah C Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Michelle Bellon
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Bulls HW, Hamm M, Wasilewski J, Olejniczak D, Bell SG, Liebschutz JM. "To prescribe or not to prescribe, that is the question": Perspectives on opioid prescribing for chronic, cancer-related pain from clinicians who treat pain in survivorship. Cancer 2024; 130:3034-3042. [PMID: 38567685 DOI: 10.1002/cncr.35299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Opioid pain management in cancer survivorship is a complex and understudied topic. METHODS The authors conducted in-depth, qualitative interviews to understand clinician approaches to opioid pain management in chronic cancer pain and to generate ideas for improvement. They used a rigorous, inductive, qualitative, descriptive approach to examine clinician (n = 20) perspectives about opioid pain management in survivorship, including oncologists (n = 5), palliative care clinicians (n = 8), primary care clinicians (n = 5), and pain management specialists (n = 2). RESULTS The findings indicated that no consistent medical home exists for chronic pain management in cancer survivors and that there are fundamental differences in how each subspecialty approaches chronic pain management in survivorship (e.g., "Do we think of this as noncancer pain or cancer pain?… This is in this limbo zone-this gray zone-because it's cancer-related pain, right?"). Simultaneously, clinicians are influenced by their peers' perceptions of their opioid prescribing decisions, sparking intraprofessional tension when disagreement occurs. In these instances, clinicians described overthinking and doubting their clinical decision-making as well as a sense of judgment, pressure, and/or shame. Finally, clinicians acknowledged a fear of consequences for opioid prescribing decisions. Specifically, participants cited conflict with patients, sometimes escalating to aggression and threats of violence, as well as potential disciplinary actions and/or legal consequences. CONCLUSIONS Participants suggested that opportunities to improve chronic cancer pain care include developing clear, systematic guidance for chronic cancer pain management, facilitating clinician communication and consultation, creating tailored survivorship care plans in partnership with patients, and developing accessible, evidence-based, complementary pain treatments.
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Affiliation(s)
- Hailey W Bulls
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Palliative Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Challenges in Managing and Preventing Pain Clinical Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Megan Hamm
- Qualitative, Evaluation, and Stakeholder Engagement Services, Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Julia Wasilewski
- Qualitative, Evaluation, and Stakeholder Engagement Services, Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Donna Olejniczak
- Division of General Internal Medicine, Department of Medicine, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah G Bell
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jane M Liebschutz
- Division of General Internal Medicine, Department of Medicine, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Arends GR, Loos NL, van Kooij YE, Tabeau K, de Ridder WA, Selles RW, Veltkamp J, Wouters RM. What are the perspectives of patients with hand and wrist conditions, chronic pain, and patients recovering from stroke on the use of patient and outcome information in everyday care? A Mixed-Methods study. Qual Life Res 2024; 33:2573-2587. [PMID: 38839681 DOI: 10.1007/s11136-024-03685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE To evaluate the patients' perspectives on the use of patient- and outcome information tools in everyday care and to investigate which characteristics affect general understanding and perceived value of patient- and outcome information. METHODS This mixed-methods study included surveys and interviews on understanding, experience, decision-support, and perceived value in patients with hand and wrist conditions and chronic pain. We synthesized our quantitative and qualitative findings using a triangulation protocol and identified factors independently associated with general understanding and perceived value of patient- and outcome information using hierarchical logistic regression. RESULTS We included 3379 patients. The data triangulation indicated that patients understand the outcome information, they find it valuable, it supports decision-making, and it improves patient-clinician interaction. The following variables were independently associated with better general understanding: having more difficulty with questionnaires (standardized odds ratio 0.34 [95%-CI 031-0.38]), having a finger condition (0.72 [0.57-0.92]), longer follow-up (0.75 [0.61-0.91]), and undergoing surgical treatment (ref: non-surgical treatment, 1.33 [1.11-1.59]). For more general value, these were: having more difficulty with questionnaires (0.40 [0.36-0.44]), having a wrist condition (0.71 [0.54-0.92]), better hand function (1.12 [1.02-1.22]), and requiring help with questionnaires (1.65 [1.33-2.05]). CONCLUSION Patients value the use of patient- and outcome information tools in daily care and find it easy to understand. The factors associated with understanding and value can be targeted to personalized and value-based healthcare. We recommend using outcome information to improve patient independence, empowerment, and involvement in decision-making.
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Affiliation(s)
- Grada R Arends
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands.
- Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Room EE-1589, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Xpert Handtherapie, Utrecht, The Netherlands.
| | - Nina L Loos
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Room EE-1589, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Yara E van Kooij
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Room EE-1589, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Xpert Handtherapie, Utrecht, The Netherlands
| | - Kasia Tabeau
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Willemijn A de Ridder
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Room EE-1589, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Xpert Handtherapie, Utrecht, The Netherlands
| | - Ruud W Selles
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Room EE-1589, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Joris Veltkamp
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Room EE-1589, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Xpert Handtherapie, Utrecht, The Netherlands
| | - Robbert M Wouters
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Room EE-1589, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Shattnawi KK, Balbaa EA. Resilience and challenges: A qualitative exploration of Jordanian Mothers' experiences with children who have cerebral palsy. J Pediatr Nurs 2024; 78:e314-e322. [PMID: 39054110 DOI: 10.1016/j.pedn.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 07/21/2024] [Accepted: 07/21/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE This study aimed to explore the experiences of Jordanian mothers of children with cerebral palsy (CP) in order to better understand the challenges they face while caring for their children. DESIGN AND METHODS A qualitative descriptive study was applied, using semi-structured face to face interviews with a purposive sample of 10 mothers of children with CP. FINDINGS Mothers caring for children with CP embark on a challenging journey. Navigating the diagnosis begins with shock and disbelief, followed by emotional struggles as they deal with the new reality. This initial phase also involves caregiving challenges and hardships. Mothers may experience societal stigma and feelings of rejection, which can contribute to social isolation. Additionally, the physical demands of care can lead to financial hardships. These financial constraints can further limit access to specialized care, creating a frustrating cycle for mothers. Throughout this process, mothers demonstrate resilience by adapting to the illness. This encompasses making changes in their lives, actively seeking support, and developing expertise in managing their child's specific needs. CONCLUSIONS The results shed light on the emotional, physical, and social challenges faced by mothers of children with CP. The findings show a narrative of adaptation, resilience, and strength, encompassing adjustments to the diagnosis, substantial life changes, seeking support, and addressing challenges such as social stigma, isolation, and various hardships. PRACTICE IMPLICATIONS Our findings lay the foundation for tailored interventions and empathic support for mothers caring for a child with CP.
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Affiliation(s)
- Khulood Kayed Shattnawi
- Maternal & Child Health Nursing Department/ Faculty of Nursing, Jordan University of Science and Technology, P.O.Box (3030), Irbid 22110, Jordan.
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Shikuku DN, Bar-Zeev S, Ladur AN, Allott H, Mwaura C, Nandikove P, Uyara A, Tallam E, Ndirangu E, Waweru L, Nyaga L, Bashir I, Bedwell C, Ameh C. Experiences, barriers and perspectives of midwifery educators, mentors and students implementing the updated emergency obstetric and newborn care-enhanced pre-service midwifery curriculum in Kenya: a nested qualitative study. BMC MEDICAL EDUCATION 2024; 24:950. [PMID: 39217305 PMCID: PMC11365191 DOI: 10.1186/s12909-024-05872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION To achieve quality midwifery education, understanding the experiences of midwifery educators and students in implementing a competency-based pre-service curriculum is critical. This study explored the experiences of and barriers to implementing a pre-service curriculum updated with emergency obstetric and newborn care (EmONC) skills by midwifery educators, students and mentors in Kenya. METHODS This was a nested qualitative study within the cluster randomised controlled trial investigating the effectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in 20 colleges in Kenya. Following the pre-service midwifery curriculum EmONC update, capacity strengthening of educators through training (in both study arms) and additional mentoring of intervention-arm educators was undertaken. Focus group discussions were used to explore the experiences of and barriers to implementing the EmONC-enhanced curriculum by 20 educators and eight mentors. Debrief/feedback sessions with 6-9 students from each of the 20 colleges were conducted and field notes were taken. Data were analysed thematically using Braun and Clarke's six step criteria. RESULTS Themes identified related to experiences were: (i) relevancy of updated EmONC-enhanced curriculum to improve practice, (ii) training and mentoring valued as continuous professional development opportunities for midwifery educators, (iii) effective teaching and learning strategies acquired - peer teaching (teacher-teacher and student-student), simulation/scenario teaching and effective feedback techniques for effective learning and, (iv) effective collaborations between school/academic institution and hospital/clinical staff promoted effective training/learning. Barriers identified were (i) midwifery faculty shortage and heavy workload vs. high student population, (ii) infrastructure gaps in simulation teaching - inadequate space for simulation and lack of equipment inventory audits for replenishment (iii) inadequate clinical support for students due to inadequate clinical sites for experience, ineffective supervision and mentoring support, lack/shortage of clinical mentors and untrained hospital/clinical staff in EmONC and (iv) limited resources to support effective learning. CONCLUSION Findings reveal an overwhelmed midwifery faculty and an urgent demand for students support in clinical settings to acquire EmONC competencies for enhanced practice. For quality midwifery education, adequate resources and regulatory/policy directives are needed in midwifery faculty staffing and development. A continuous professional development specific for educators is needed for effective student teaching and learning of a competency-based pre-service curriculum.
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Affiliation(s)
- Duncan N Shikuku
- Liverpool School of Tropical Medicine (Kenya), P.O. Box 24672-00100, Nairobi, Kenya.
- Liverpool School of Tropical Medicine (UK), Liverpool, L3 5QA, UK.
| | - Sarah Bar-Zeev
- Burnet Institute, 85 Commercial Road Prahran Victoria, Melbourne, Australia
| | | | - Helen Allott
- Liverpool School of Tropical Medicine (UK), Liverpool, L3 5QA, UK
| | - Catherine Mwaura
- Kenya Medical Training College, P.O Box 30195-00100, Nairobi, Kenya
| | - Peter Nandikove
- Masinde Muliro University of Science and Technology, P.O. Box 190-50100, Kakamega, Kenya
| | - Alphonce Uyara
- Alphonce Uyara, Maseno University, P.O. Box 3275-40100, Kisumu, Kenya
| | - Edna Tallam
- Nursing Council of Kenya, P.O. Box 20056-00200, Nairobi, Kenya
| | - Eunice Ndirangu
- Aga Khan University of East Africa, P.O Box 39340-00623, Nairobi, Kenya
| | - Lucy Waweru
- Kenya Medical Training College, P.O Box 30195-00100, Nairobi, Kenya
| | - Lucy Nyaga
- Kenya Medical Training College, P.O Box 30195-00100, Nairobi, Kenya
| | - Issak Bashir
- Department of Family Health, Ministry of Health (Kenya), P.O. Box 30016-00100, Nairobi, Kenya
| | - Carol Bedwell
- Liverpool School of Tropical Medicine (UK), Liverpool, L3 5QA, UK
| | - Charles Ameh
- Liverpool School of Tropical Medicine (UK), Liverpool, L3 5QA, UK
- University of Nairobi, P. O. Box 19676-00100, Nairobi, Kenya
- Diponegoro University, JI. Prof Sudarto No 13, Temalang, Kec, Tembalang, P. O. Box 19676-00100, Kota, Semarang, Jawa Tengah, 50275, Indonesia
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Cho H, Sefcik JS, Washington K, Parker Oliver D, Demiris G. Exploring Social Support Experiences of Caregivers of Persons Living With Dementia in Hospice Care. J Appl Gerontol 2024:7334648241275968. [PMID: 39214070 DOI: 10.1177/07334648241275968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
As the number of persons living with dementia (PLWD) enrolling in hospice care rises, caregiver support becomes increasingly crucial. While social support can help buffer caregiver stress, many caregivers report feeling isolated and having unmet needs, highlighting the limited research on this population. This qualitative descriptive study aimed to better understand caregivers' social support during the period when the PLWD is enrolled in hospice care. Analyzing qualitative data from 22 caregivers of PLWD using conventional content analysis, we identified the theme "Variations in Social Connections." This theme encompasses two subthemes: "never completely alone," indicating social support from family, friends, and neighbors, and "disappointed sometimes," reflecting instances when some individuals in the caregivers' lives couldn't provide regular support. These findings underscore the need for individualized interventions, as each caregiver experiences social support uniquely. Future research should consider the variations in social support among caregivers of PLWD to inform caregiving practices effectively.
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Affiliation(s)
- Hannah Cho
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Justine S Sefcik
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Karla Washington
- School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | | | - George Demiris
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, Philadelphia, PA, USA
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Hinga A, Ibrahim A, Vintimilla D, Jones M, Eckstein L, Rid A, Shah SK, Kamuya D. Ethical preparedness of data monitoring committees (DMCs) to oversee international clinical trials: a qualitative descriptive study. BMJ Glob Health 2024; 9:e015233. [PMID: 39182924 DOI: 10.1136/bmjgh-2024-015233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 07/31/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION A data monitoring committee (DMC) is an independent group of experts who assess the ongoing scientific and ethical integrity of a study through periodic analyses of study data. The objective of this study was to explore the extent to which the structure, membership and deliberations of DMCs enable them to address ethical issues. METHODS We conducted qualitative individual interviews (n=22) with DMC members from countries across Africa, the Americas, South Asia and the UK. We selected interview respondents through purposive sampling, managed data using NVivo (Release V.1.7) and analysed data thematically. RESULTS All respondents were highly experienced professionals; many (18/22) had received training in medicine and/or statistics. One respondent had academic qualifications in ethics, and four indicated that they served on DMCs as ethicists. While respondents generally felt DMCs should be required for studies that were high-risk or enrolled vulnerable populations, some were concerned about the overuse of DMCs. There were divergent views on the necessity of geographical and disciplinary representation in DMC membership, including about whether ethicists were helpful. Many respondents described a DMC member recruitment process that they felt was somewhat exclusive. While one respondent received DMC-specific training, most described learning on the job. Respondents generally agreed that study protocols and DMC charters were key guiding documents for addressing ethical issues and described DMC deliberations that often, but not always, involved consensus-building. CONCLUSION This study is one of the first to consider the ethical implications of DMC structure, membership and deliberations. The potential overuse of DMCs, DMC member recruitment processes that seem somewhat insular, limited training for DMC members, and divergent approaches to deliberation may limit the capacity of DMCs for addressing ethical issues. Further research on DMC structure and processes could help enhance the ethical preparedness of DMCs.
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Affiliation(s)
- Alex Hinga
- Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Akram Ibrahim
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital, Chicago, Illinois, USA
| | | | - Mickayla Jones
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital, Chicago, Illinois, USA
| | - Lisa Eckstein
- School of Law, University of Tasmania, Hobart, Tasmania, Australia
| | - Annette Rid
- Department of Bioethics, The Clinical Center & Division of International Science Policy, Planning and Evaluation, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Seema K Shah
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Dorcas Kamuya
- Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
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Bélanger M, Goguen J, Beauchamp J, Gallant F, Boucher A, Chevarie JS, DeGrâce S, Saheb Y, Gagnon M, Doré I, Sabiston CM. Identification of distinct physical activity profiles through adolescence: a longitudinal qualitative description study. Front Sports Act Living 2024; 6:1230999. [PMID: 39239476 PMCID: PMC11374625 DOI: 10.3389/fspor.2024.1230999] [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: 05/29/2023] [Accepted: 07/01/2024] [Indexed: 09/07/2024] Open
Abstract
Introduction We aimed to better understand longitudinal physical activity experiences among initially active adolescents and to identify and describe distinct physical activity profiles. Methods A sample of 23 physically active participants [52% female; mean age = 12.2 (0.6) years at study inception] were selected from the MATCH study to take part in this nested qualitative descriptive study. Participants were interviewed once a year for six years. Following individual-level analyses, profiles were identified based on similarity of longitudinal experiences. Results Four profiles captured participants' experiences: Independents (those who progressively seek activities that cater to their pursuit of autonomy); Multitaskers (those who participate in many different sports as an integral part of their lifestyle); Specialists (those who are dedicated to becoming the best they can be at one sport); Undecided (those who take part in physical activity to occupy time). Discussion The exploration of longitudinal physical activity experiences led to the identification of distinct profiles that could be targets for tailored interventions, theory development, and participation models.
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Affiliation(s)
- Mathieu Bélanger
- Department of Family and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
- Office of Research Services, Vitalité Health Network, Moncton, NB, Canada
| | - Julie Goguen
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
| | - Jacinthe Beauchamp
- Department of Family and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
| | - François Gallant
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Anika Boucher
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Sébastien Chevarie
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sara DeGrâce
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Yanis Saheb
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Maryse Gagnon
- Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Isabelle Doré
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal, Montréal, QC, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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Armini LN, Setiawati EP, Arisanti N, Hilmanto D. Patient perspective on the elimination mother-to-child transmission of HIV, syphilis, and hepatitis B in Bali, Indonesia: a qualitative study. BMC Public Health 2024; 24:2258. [PMID: 39164708 PMCID: PMC11337813 DOI: 10.1186/s12889-024-19692-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 08/05/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND This study aimed to explore the facilitators and barriers to the elimination of human immunodeficiency virus (HIV), syphilis, and hepatitis B transmission based on the perspectives of mothers living with HIV, syphilis, and hepatitis B. METHODS This study employed a descriptive, qualitative design. Semi-structured interviews were conducted with mothers living with HIV, syphilis, and/or hepatitis B virus. A total of 25 participants were included in the study. This study used a triangulation method conducted by members to enhance the validity and dependability of the findings. The study was conducted at referral hospitals and community health centers between September 2022 and February 2023. Data analysis utilized deductive content analysis and categorized themes based on a socio-ecological framework. RESULTS The findings revealed facilitators and barriers across five levels of the socio-ecological framework and 21 subcategories. The findings included the following: (1) At the policy level, facilitators were mandatory testing programs, and barriers were separating testing services from antenatal care facilities. (2) At the community level, facilitators included the involvement of non-governmental organizations (NGOs) and cross-sector support. Barriers included challenges faced by non-residents and fear of stigma and discrimination. (3) At the healthcare system level, facilitators included tracking and follow-up by midwives, positive relationships with healthcare providers, and satisfaction with healthcare services. Barriers included prolonged waiting times, insufficient information from healthcare providers, and administrative limitations. (4) At the interpersonal level, facilitators included partner and family support, open communication, and absence of stigma. Barriers included the reluctance of sexual partners to undergo screening. (5) At the individual level, facilitators included the desire for a healthy baby, adequate knowledge, self-acceptance, and commitment to a healthy lifestyle; barriers included the lack of administrative discipline. CONCLUSION Mothers living with HIV, syphilis, or hepatitis B require tailored healthcare approaches. Healthcare professionals must understand and meet the needs of mothers within a comprehensive care continuum. The findings of this study advocate for the development and implementation of integrated care models that are responsive to the specific challenges and preferences of affected mothers, aiming to improve health outcomes for both mothers and their children.
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Affiliation(s)
- Luh Nik Armini
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Sumedang, 45363, Indonesia
- Midwifery Science Program, Faculty of Medicine, Universitas Pendidikan Ganesha, Bali, 81116, Indonesia
| | - Elsa Pudji Setiawati
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia.
| | - Nita Arisanti
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Dany Hilmanto
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, 45363, Indonesia
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Sürme Y, Maraş G, Aydin Akbuğa G. Environmental sustainability, medical waste management, energy and medicine consumption of the surgical intensive care nurses: A qualitative study. Nurs Crit Care 2024. [PMID: 39145440 DOI: 10.1111/nicc.13150] [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: 12/01/2023] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND In intensive care units, it is noticeable that there is intensive use of resources in the treatment and care process, leading to a significant amount of waste generation. In addition, the demand for intensive care, increasing life expectancy and surgical interventions, complex comorbidities and ecological crisis make it necessary to make critical care more sustainable. AIM To explore the perspectives of nurses working in surgical intensive care units regarding responsible medical waste management, energy and medication consumption. STUDY DESIGN This qualitative descriptive study was conducted in surgical intensive care units of a university hospital in Turkey in November 2023. Twenty-three nurses filled in an introductory form and participated in a semi-structured interview. Data were analysed using inductive content analysis. RESULTS Three main themes were determined: environmentally sustainable intensive care, prevention of waste in intensive care; responsible consumption and recycling; suggestions for institutional and individual behavioural change regarding environmental sustainability. CONCLUSIONS The majority of nurses lack knowledge about sustainable development goals. However, in the intensive care unit, they provided effective and creative solutions for medical waste management, energy and medication consumption and individual and institutional behavioural change regarding environmental sustainability. RELEVANCE TO CLINICAL PRACTICE Sustainability strategies should be created in institutions to ensure responsible medical waste management, energy and medicine consumption and reduce carbon footprint. In accordance with this purpose, 'Green teams' including unit-based doctors, nurses and paramedics should be established. Training should be provided and awareness should be raised to reduce energy use resulting from heating, lighting, ventilation and air conditioning.
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Affiliation(s)
- Yeliz Sürme
- Surgery Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Gülseren Maraş
- Surgery Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Gökçen Aydin Akbuğa
- Surgery Nursing, Faculty of Health Sciences, Yozgat Bozok University, Yozgat, Turkey
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Tokumasu K, Obara H, Hirosawa T, Ogawa H, Otsuka F. Postgraduate Year Two Medical Residents' Awareness of Personal Development as a Physician during the Management of Inpatients: A Qualitative Study. Healthcare (Basel) 2024; 12:1621. [PMID: 39201179 PMCID: PMC11353354 DOI: 10.3390/healthcare12161621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/11/2024] [Accepted: 08/13/2024] [Indexed: 09/02/2024] Open
Abstract
Clinical experiences, helping relationships, and reflection are key factors for personal development for physicians. However, few studies have shown which experiences are important for personal growth and how medical residents specifically use their experiences for personal growth. The aim of this study was to identify from the medical residents' perspective which clinical experiences contribute to their personal development. We employed a qualitative design, conducting semi-structured interviews with ten postgraduate year two medical residents at a Japanese teaching hospital. The interviews were transcribed in interview memos, anonymized, and subjected to reflective thematic analysis to generate themes relevant to personal and professional development. Successful clinical experiences with autonomy and responsibility in clinical management were shown to be essential points for personal development as a physician. Autonomy in this study was the attitude of making one's own choices when managing patients. Responsibility was the obligation of the resident to take charge of a patient. Instructing junior trainees, appreciation received from patients, and approval granted by attending physicians reinforced their feelings of personal growth. The realization of what experiences and concepts influence medical residents' personal growth and development will make their professional development more effective.
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Affiliation(s)
- Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
- Department of General Internal Medicine, Okinawa Chubu Hospital, Uruma 904-2243, Japan
| | - Haruo Obara
- Department of General Internal Medicine, Okinawa Chubu Hospital, Uruma 904-2243, Japan
| | - Takanobu Hirosawa
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan
| | - Hiroko Ogawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
- Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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DeCoste KL, Benoit BL, Dewart GK, Johnson ST. Registered nurse lactation consultants' experiences supporting maternal mental health: A qualitative descriptive study. Midwifery 2024; 138:104145. [PMID: 39159539 DOI: 10.1016/j.midw.2024.104145] [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: 03/13/2024] [Revised: 08/02/2024] [Accepted: 08/11/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND The province of Nova Scotia has the highest rates of perinatal mental health disorders in Canada, and rates of exclusive breastfeeding fall below the Canadian national average. Exclusive breastfeeding is identified as a protective factor against the development of perinatal mental health disorders. Lactation consultant support is associated with increased rates of exclusive breastfeeding and decreased rates of perinatal mental health disorders. Despite this, little is known regarding the experiences of Registered Nurse Lactation Consultants related to supporting maternal mental health. OBJECTIVE To understand the experiences of Registered Nurse Lactation Consultants related to supporting maternal mental health. DESIGN A qualitative descriptive design using online semi-structured interviews. SETTING & PARTICIPANTS Ten Registered Nurse Lactation Consultants employed in the publicly funded healthcare system in Nova Scotia, Canada, were recruited via purposive sampling. FINDINGS Three themes emerged regarding the relational experiences of Registered Nurse Lactation Consultants while supporting maternal mental health; these included (1) Experiences supporting maternal mental health, (2) Providing maternal mental health care, and (3) Mothers need support. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Registered Nurse Lactation Consultants described positive experiences supporting maternal mental health and indicated that lactation consultant appointments were an opportune time to provide screening and support for maternal mental health. Enhancing support for maternal mental health requires collaborative and integrated approaches throughout the perinatal period. Healthcare providers, including Registered Nurse Lactation Consultants, must be provided with the support and resources to provide timely and appropriate support for maternal mental health throughout the perinatal period.
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Affiliation(s)
- Kelly L DeCoste
- St. Francis Xavier University, Rankin School of Nursing, 2340 Notre Dame Avenue, Antigonish, Nova Scotia B2G 1Z3, Canada.
| | - Britney L Benoit
- St. Francis Xavier University, Rankin School of Nursing, 2340 Notre Dame Avenue, Antigonish, Nova Scotia B2G 1Z3, Canada
| | - Georgia K Dewart
- Athabasca University, Faculty of Health Disciplines, 1 University Drive, Athabasca, Alberta T9S 3A3, Canada
| | - Steven T Johnson
- Athabasca University, Faculty of Health Disciplines, 1 University Drive, Athabasca, Alberta T9S 3A3, Canada
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McCoy MS, Ward M, Neergaard R, Joffe S, Szymczak JE. Managing institutional conflicts: Stakeholder accounts of communication between conflict of interest and technology transfer offices. PLoS One 2024; 19:e0304519. [PMID: 39110712 PMCID: PMC11305534 DOI: 10.1371/journal.pone.0304519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 05/14/2024] [Indexed: 08/10/2024] Open
Abstract
There have been repeated calls for academic institutions to develop policies and procedures to manage institutional conflicts of interest (ICOI) arising from technology transfer activities. While prior research has examined adoption of ICOI policies by medical schools and universities, little is known about how these institutions handle ICOI in practice, hindering the development of evidence-based recommendations to improve ICOI management. To address this gap, we conducted semi-structured interviews with 25 senior administrators responsible for research integrity and conflict of interest issues at academic institutions. Data were analyzed using a descriptive qualitative content analysis approach, combining flexible coding to index the interview data with close examination, interpretation, and synthesis of coded content. Participants identified communication and information sharing between conflict of interest (COI) and technology transfer (TT) offices as a critical factor in the effective management of ICOI and suggested several strategies to strengthen coordination between these offices. These findings suggest that academic research institutions could strengthen COI programs by taking measures to improve communication and information sharing between COI and TT offices.
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Affiliation(s)
- Matthew S. McCoy
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Michaela Ward
- Mixed Methods Research Lab, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Rebecca Neergaard
- Mixed Methods Research Lab, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Steven Joffe
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Julia E. Szymczak
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
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Yehualashet FA, Kessler D, Bizuneh SM, Donnelly C. The Feasibility of the Diabetes Self-Management Coaching Program in Primary Care: A Mixed-Methods Randomized Controlled Feasibility Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1032. [PMID: 39200642 PMCID: PMC11354968 DOI: 10.3390/ijerph21081032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 09/02/2024]
Abstract
BACKGROUND Diabetes mellitus, a chronic metabolic disorder associated with elevated blood sugar levels, is a significant cause of morbidity, mortality, and disability globally. The rampant rise in the prevalence of diabetes presents a public health burden and a challenge to the primary care setting. Diabetes self-management coaching is an emergent, client-centered, solution-focused approach to enhance self-efficacy and self-care behavior, control glycemia, and prevent acute and chronic complications. Currently, there is no diabetes self-management support strategy in the primary care setting in Ethiopia. Therefore, this study assessed the feasibility, acceptability, and fidelity of implementing the Diabetes Self-Management Coaching Program in primary care in Ethiopia. METHOD A single-center, single-blinded, parallel group mixed-methods feasibility randomized control design was applied to assess the feasibility, acceptability, and fidelity of the Diabetes Self-Management Coaching Program in primary care. Adult patients with type 2 diabetes with HbA1c ≥ 7%, taking diabetic medication, and living in Gondar town were included in the study. A block randomization technique with a block size of four was used to allocate participants into the treatment and control groups. The treatment group attended a 12-week Diabetes Self-Management Coaching Program in addition to undergoing usual care, while the control group received the usual care for the same period. Data were collected at baseline, at the end of the intervention, and after the follow-up period. Descriptive statistics such as the frequency, mean, median, and standard deviations were computed. Based on the normality assessment, the baseline group difference was examined using the independent sample Student's t-test, the Mann-Whitney U test, and the chi-square test. RESULT This study's eligibility, recruitment, retention, and adherence rates were 23%, 70%, 90%, and 85%, respectively. Both the qualitative and quantitative findings show that the program was feasible to implement in primary care and acceptable to the participants. The fidelity assessment of the Diabetes Self-Management Coaching Program indicates an appropriate intervention implementation. CONCLUSIONS This study demonstrated remarkable recruitment, retention, and adherence rates. The Diabetes Self-Management Coaching Program was feasible, acceptable, and implementable in primary care in Ethiopia. As a result, we recommend that a large-scale multi-center cluster randomized controlled trial with an adequate sample can be designed to evaluate the effect of the DSM Coaching Program on clinical and behavioral outcomes.
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Affiliation(s)
- Fikadu Ambaw Yehualashet
- Department of Rehabilitation Science, School of Rehabilitation Therapy, Queen’s University, 31 George St., Kingston, ON K7L 3N6, Canada; (D.K.); (C.D.)
- Department of Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Dorothy Kessler
- Department of Rehabilitation Science, School of Rehabilitation Therapy, Queen’s University, 31 George St., Kingston, ON K7L 3N6, Canada; (D.K.); (C.D.)
| | - Segenet M. Bizuneh
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar P.O. Box 196, Ethiopia;
| | - Catherine Donnelly
- Department of Rehabilitation Science, School of Rehabilitation Therapy, Queen’s University, 31 George St., Kingston, ON K7L 3N6, Canada; (D.K.); (C.D.)
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McGuire SS, Lampman MA, Smith OA, Clements CM. Impact of Workplace Violence Against Emergency Medical Services (EMS). PREHOSP EMERG CARE 2024:1-9. [PMID: 39042823 DOI: 10.1080/10903127.2024.2381218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/21/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVES The objectives of this study were to: (1) understand the personal impact of workplace violence (WPV) on staff within a large multistate emergency medical services (EMS) agency, (2) describe the impact of WPV on subsequent patient interactions, examining how experiences of violence affect the quality of care provided by EMS clinicians, (3) examine the influence of WPV on perceived workplace safety among prehospital personnel and its correlation with retention in the EMS field, and (4) solicit recommendations from staff for the prevention and mitigation of WPV in the future. METHODS We conducted virtual focus groups and individual interviews with 22 prehospital personnel using a descriptive qualitative design within a large multistate Midwest EMS agency between 4/5/2023-6/20/2023. Data were analyzed using Thematic Analysis to identify common perceptions among and across participants. RESULTS Major themes of personal impact; impact on patient interactions; influence of WPV on career longevity/sustainability; and relationship between EMS culture and WPV were identified. Overall, participants shared the perception that WPV is "part of the job", and that verbal abuse was so common that they hadn't previously considered it as violence. Participants provided several examples of WPV and described how these experiences impacted them personally (e.g., hypervigilance) and impacted their subsequent interaction with patients (e.g., quicker to use restraints, loss of empathy). Participants shared the perception that EMS is no longer valued or respected by patients or communities. Several voiced concerns for the next generation of colleagues and nearly all participants reported the need for education and training in situational awareness, de-escalation, and self-defense tactics. Participants referenced desire for more coordination and communication with law enforcement, change in culture of abuse from patients without repercussions, and improved agency mental health support and peer support/mentoring following a violent event. Despite experiences with WPV, the majority reported plans to remain in EMS. CONCLUSIONS Emergency Medical Services personnel are commonly traumatized by violence in their work and nonphysical violence is underappreciated. Despite its impact on staff and subsequent patient interactions, most participants reported plans to remain within EMS. Multi-faceted system-focused efforts are needed to shift toward and support a zero-tolerance culture for WPV.
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Affiliation(s)
- Sarayna S McGuire
- Division of Prehospital Medicine, Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michelle A Lampman
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Olivia A Smith
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Casey M Clements
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota
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Grano C. A Qualitative Study of School Nurses' Experience of Secondary Trauma. Creat Nurs 2024:10784535241268094. [PMID: 39099538 DOI: 10.1177/10784535241268094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
This qualitative descriptive study explored school nurses' experiences of exposure to reports of trauma from those in their care. Online interviews of school nurses practicing in NJ, USA, were recorded and transcribed verbatim. The study found that school nurses were exposed to reports of others' trauma to varying degrees, with those serving in urban settings reporting more stories of exposure than those in suburban settings. Reports included numerous, layered traumas at the community and individual levels, including students' poverty-related adversity and psychological distress. Qualitative content analysis revealed four categories: Health Office as Safe Haven, Challenges Working Within the School Model, Things That We Hear: Reports of Trauma, and The Ripple Effect of Trauma. School-based challenges included a lack of collaboration, misunderstanding of the school nurse's role, and workload issues such as competing demands and limited time and resources. School nurses reported focusing on the individual's immediate needs and processing the experience afterward. They acknowledged they can only do so much, and shared stories of coping and resilience. Additional education, resources, and support in addressing student trauma can enhance the provision of school nursing services and support the well-being of school nurses, students, and staff. Further research is warranted with a larger and more diverse sample of school nurses, including attention to school nurse wellness and resilience strategies.
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24
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Fakolade A, Jackson A, Cardwell KL, Finlayson M, O'Sullivan TL, Tomasone JR, Pilutti LA. DigiTRAC: Qualitative insights from knowledge users to inform the development of a Digital Toolkit for enhancing resilience among multiple sclerosis caregivers. Mult Scler Relat Disord 2024; 88:105736. [PMID: 38954857 DOI: 10.1016/j.msard.2024.105736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Resilience-promoting resources are critically needed to support positive caregiving experiences for multiple sclerosis (MS) caregivers. A digital toolkit offers a flexible way to access and use evidence-based resources that align with MS caregivers' interests and needs over time. OBJECTIVE We explored the perspectives of key knowledge users regarding content areas, features, and other considerations to inform an MS caregiver resilience digital toolkit. METHODS Twenty-two individuals completed a demographic survey as part of this study: 11 MS family caregivers, 7 representatives of organizations providing support services for people with MS and/or caregivers, and 4 clinicians. We conducted nine semi-structured individual interviews and two focus groups. Data were analyzed using content analysis. RESULTS Participants recommended that a digital toolkit should include content focused on promoting MS caregivers' understanding of the disease, its trajectory and available management options, and enhancing caregiving skills and caregivers' ability to initiate and maintain behaviours to promote their own well-being. Features that allow for tracking and documenting care recipients' and caregivers' experiences, customization of engagement, and connectivity with other sources of support were also recommended. Participants suggested a digital toolkit should be delivered through an app with web browser capabilities accessible on smartphones, tablets, or laptops. They also acknowledged the need to consider how users' previous technology experiences and issues related to accessibility, usability, privacy and security could influence toolkit usage. CONCLUSION These findings will guide future toolkit development and evaluation. More broadly, this study joins the chorus of voices calling for critical attention to the well-being of MS family caregivers.
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Affiliation(s)
- Afolasade Fakolade
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada; Providence Care Hospital, 752 King Street West, Kingston, ON, K7L 4 X 3, Canada.
| | - Alexandra Jackson
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Katherine L Cardwell
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Tracey L O'Sullivan
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada; LIFE Research Institute, Thompson Hall, 25 University Private, room 227, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, 200 Division Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road Ottawa, ON, K1H 8M5, Canada
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25
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Toohey K, Paterson C, Coltman CE. Barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. J Cancer Surviv 2024; 18:1252-1263. [PMID: 37171718 PMCID: PMC10175906 DOI: 10.1007/s11764-023-01366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/16/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Ovarian cancer is the leading cause of death among gynecological cancers, with low survival rates and a high disease burden. Despite the known benefits, most women reduce their participation in physical activity following diagnosis. Little is known about ovarian cancer survivors' experiences of physical activity. The primary aim of this study was to explore the barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. METHODS A qualitative descriptive study design was conducted via semi-structured interviews with nine women diagnosed with ovarian cancer (stages I-IV; 40-77 years). The interviews took place at the participant's home via telephone or online video conferencing software Coviu©. An inductive thematic approach was used. The organization and coding of data were completed using NVivo computer software (Version 12.6.0, QSR International Pty Ltd.). Weekly discussions occurred among the research team to ensure that themes accurately represented participant views. The consolidated criteria for reporting qualitative studies (COREQ) 32-item checklist were followed. RESULTS The main barriers to physical activity participation that emerged were (i) the lack of referral to an exercise professional within the multidisciplinary cancer team, (ii) fear of injury after surgery and during treatment, and (iii) treatment-related side effects. However, many of the participants perceived benefits of physical activity related to (i) enhanced physical and psychological health, (ii) improved cancer outcomes, and (iii) social benefits as key enablers of physical activity participation. CONCLUSIONS Physical activity interventions for women with ovarian cancer should address the modifiable barriers identified in this study. A key focus should be to streamline timely referral pathways within the multidisciplinary team, including exercise professionals, dietitians, psychologists, and specialists nurses following a diagnosis of ovarian cancer. Further research and service development are needed to optimize supported self-management through (i) education about the importance of physical activity to both healthcare professionals and women alike, (ii) enhanced symptom management for women, which was identified as a barrier to participation, and (iii) the development of shared care plans and patient center goals to address any fears or concerns. IMPLICATIONS FOR CANCER SURVIVORS People diagnosed with ovarian cancer have low participation levels of physical activity. Cancer care professionals' support could increase physical activity uptake and reduce some of the burden of an ovarian cancer diagnosis.
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Affiliation(s)
- Kellie Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia.
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Garthdee, Aberdeen, UK
- Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Canberra, Australia
| | - Celeste E Coltman
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
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Heidari O, Shah H, Bhagwat A, Ahmad NJ, Whaley S, Sherman SG, Morris M, Saloner B. Changes in opioid treatment programs and harm reduction provider services during the COVID-19 pandemic: Findings from 10 states. Psychol Serv 2024; 21:658-664. [PMID: 37824245 PMCID: PMC11009379 DOI: 10.1037/ser0000805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Harm reduction and opioid treatment programs (OTPs) modified service delivery based on rapid changes to state and federal regulations during the COVID-19 pandemic. There is little evidence on how these regulations changed the delivery of medication for opioid use disorder and harm reduction services and whether certain regulations should be made permanent. This study explores how harm reduction OTPs across the United States leveraged changes in regulations and responded to impacts of COVID-19 to continue providing services and perspectives on future legislation that regulates their practice and practice sites. The COVID Harm Reduction and Treatment programs Survey study administered a survey that included closed-ended and free-response questions to 22 sites between August 2020 and January 2021. Program demographics and responses to survey items pertaining to site and service modifications were tabulated and proportions reported. A qualitative descriptive method was used to analyze free-response questions. All (100%) surveyed providers reported the need to modify their services. The majority (68%) reported an increase or no change in client volume; 68% reported increases in naloxone services and 77% reported increases in syringe services programs. Qualitative themes included (a) flexibility in reaching clients due to regulatory changes, (b) benefits and drawbacks of telehealth, and (c) increased vulnerabilities of their clients during the pandemic. Despite difficulties during the COVID-19 pandemic, harm reduction and OTP sites found that regulatory changes provided flexibility in service delivery and that they were better able to serve their clients. Future policies should bolster these sites to continue to provide low-barrier and high-quality services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Omeid Heidari
- University of Washington, School of Nursing, Department of Child, Family, and Population Health
| | - Hridika Shah
- Department of Health, Policy, and Management, Johns Hopkins University, Bloomberg School of Public Health
| | - Atharva Bhagwat
- Department of Health, Policy, and Management, Johns Hopkins University, Bloomberg School of Public Health
| | - N. Jia Ahmad
- Harvard Affiliated Emergency Medicine Residency, Massachusetts General Hospital and Brigham and Women’s Hospital
| | - Sara Whaley
- Department of Health, Policy, and Management, Johns Hopkins University, Bloomberg School of Public Health
| | - Susan G. Sherman
- Department of Health, Behavior, and Society, Johns Hopkins University, Bloomberg School of Public Health
| | - Miles Morris
- Department of Health, Policy, and Management, Johns Hopkins University, Bloomberg School of Public Health
| | - Brendan Saloner
- Department of Health, Policy, and Management, Johns Hopkins University, Bloomberg School of Public Health
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Al-Anezi F. Interlinking FinTech and eHealth: a qualitative study. Front Public Health 2024; 12:1398136. [PMID: 39157524 PMCID: PMC11328015 DOI: 10.3389/fpubh.2024.1398136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/19/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction This study investigates the integration of financial technology (FinTech) and electronic health (eHealth) to explore the opportunities, challenges, and implications arising from their interlinkage in Saudi Arabia. Methods Utilizing qualitative semi-structured interviews with 26 participants-including physicians, patients, technical and administrative managers, and FinTech consultants-the research adopts an inductive approach to understand diverse perspectives. Results Key findings reveal significant benefits such as improved efficiency in administrative processes, enhanced access to healthcare services, increased financial inclusion, better decision-making, improved patient experience, and the promotion of innovation and sustainability. However, barriers including regulatory challenges, data privacy and security concerns, interoperability issues, the digital divide, resistance to change, and cost implications were also identified. Conclusion Overall, the integration of FinTech and eHealth holds substantial promise for advancing healthcare delivery in Saudi Arabia. Future implications include the expansion of telehealth services, an increase in startups, the integration of wearable health devices, blockchain-based systems, evolving regulatory frameworks, and heightened collaborations. Addressing the identified challenges is crucial for realizing the full potential of this integration.
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Affiliation(s)
- Fahad Al-Anezi
- Department Management Information Systems, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Faulks F, Edvardsson K, Shafiei T. Barriers and enablers to accessing perinatal health services for rural Australian women: A qualitative exploration of rural health care providers perspectives. Aust J Rural Health 2024; 32:774-788. [PMID: 38831729 DOI: 10.1111/ajr.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/15/2024] [Accepted: 05/19/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE To identify perceived barriers and enablers for rural women in accessing perinatal care within their own community from the perspective of perinatal health care providers. DESIGN A qualitative descriptive study design utilising reflexive thematic analysis, using the socioecological framework to organise and articulate findings. SETTING Victoria, Australia. PARTICIPANTS Semi-structured interviews were conducted with nine perinatal health care providers who provide care to pregnant women or new mothers in rural communities. Participants were recruited across Victoria in 2023. RESULTS Providers reported multi-level barriers and enablers that exist for rural women in accessing perinatal care within their communities. Barriers included women's personal circumstances, challenging professional relationships, inequitable service provision, ineffective collaboration between services and clinicians and government funding models and policies. Enablers included strength and resilience of rural women, social capital within rural communities, flexible care delivery and innovative practice, rural culture and continuity of care models. CONCLUSION Rural perinatal health care providers perceived that rural women face multiple barriers that are created or sustained by complex interpersonal, organisational, community and policy factors that are intrinsic to rural health care delivery. Several addressable factors were identified that create unnecessary barriers for rural women in engaging with perinatal care. These included education regarding health systems, rights and expectations, equitable distribution of perinatal services, improved interprofessional relationships and collaborative approaches to care and equity-based funding models for perinatal services regardless of geographical location.
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Affiliation(s)
- Fiona Faulks
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Kristina Edvardsson
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Touran Shafiei
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
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Piispanen N, Haavisto E, Hublin L, Ikonen R, Koivisto J. Nursing students' perceptions of interaction in a multiplayer virtual reality simulation: A qualitative descriptive study. Nurs Open 2024; 11:e2245. [PMID: 39083574 PMCID: PMC11290554 DOI: 10.1002/nop2.2245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 06/21/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024] Open
Abstract
AIM To describe nursing students' perceptions of interaction in a multiplayer virtual reality (MPVR) simulation. DESIGN A qualitative descriptive study. METHODS Second-semester nursing students (n = 24) participated in pairs in MPVR simulations and semi-structured interviews. Data were analysed deductively and inductively. RESULTS Four types of interaction in a MPVR simulation were identified: interaction between the students, interaction between the student and the virtual environment (VE), interaction between the student and the virtual patient (VP), and interaction between the student and the simulation facilitator. Interaction consisted of verbal and nonverbal interaction, as well as object manipulation and movement in the VE. The reasons for interaction were to coordinate the care, to assess the VP, and to implement VPs' care. CONCLUSIONS MPVR simulation offered nursing students an opportunity to practice nurse-to-nurse interaction and interaction related to nurses' collaboration, which are essential skills in nursing practice. Students were also able to interact with the VP, which can promote students' nurse-patient interaction skills. Therefore, MPVR simulations can be utilized as a platform to enhance interaction skills of future healthcare professionals, which could improve patient safety. PATIENT OR PUBLIC CONTRIBUTION None.
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Affiliation(s)
- Niina Piispanen
- Faculty of Social Sciences, Health SciencesTampere UniversityTampereFinland
| | - Elina Haavisto
- Faculty of Social Sciences, Health SciencesTampere UniversityTampereFinland
- Tampere University HospitalTampereFinland
| | - Linda Hublin
- Faculty of Social Sciences, Health SciencesTampere UniversityTampereFinland
| | - Riikka Ikonen
- Faculty of Social Sciences, Health SciencesTampere UniversityTampereFinland
| | - Jaana‐Maija Koivisto
- Faculty of Social Sciences, Health SciencesTampere UniversityTampereFinland
- Faculty of Medicine, Department of Public HealthUniversity of HelsinkiHelsinkiFinland
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Tanaka K, Ikeuchi S. Insights from primary care workers supporting people at risk of suicide in local communities in Japan: A qualitative descriptive study. J Adv Nurs 2024; 80:3264-3277. [PMID: 38093474 DOI: 10.1111/jan.16024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 07/13/2024]
Abstract
AIM To identify insights for supporting people at risk of suicide in the community based on primary healthcare workers' experiences. DESIGN Qualitative descriptive design. METHODS Semi-structured interviews were conducted with fifteen primary healthcare workers employed by Japanese municipalities between August and October 2019. The data were subjected to qualitative descriptive analysis. RESULTS The analysis revealed eleven subthemes, clustered under the following three themes: (1) fostering 'opportunities for discovery' for people at risk of suicide by encompassing strategies such as increasing access to services and promoting a holistic understanding of the life cycle; (2) fostering 'meaningful connections' by searching for channels to reach the heart and taking approaches from different objectives; and (3) engaging in 'risk management', by understanding and coping with real-life struggles and implementing timely crisis intervention. CONCLUSION Not only direct care targeting suicide prevention but also holistic care that includes atypical perspectives such as 'approaches from different objectives' may provide important insights for supporting people with suicide risk. IMPLICATIONS FOR PRACTICE Beyond the limitations of existing suicide risk screening methods, this study highlights the importance of a holistic approach that sees people at risk of suicide in the context of their daily lives and aims to alleviate the difficulties in their lives that have brought them to the point of considering suicide. IMPACT By describing support focused on the difficulties that people at risk of suicide face in their daily lives, this study identified insights for supporting people at risk of suicide in communities where screening and intervention are difficult. These findings will contribute to the relief of people at risk of suicide by stimulating suicide prevention measures in primary healthcare settings. REPORTING METHOD This study complied with the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Koji Tanaka
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Satomi Ikeuchi
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
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Aroua M, Chowdhury N, Lake D, Turin TC. International medical graduates as untapped resource for community health and wellness. Prev Med Rep 2024; 44:102819. [PMID: 39104569 PMCID: PMC11298929 DOI: 10.1016/j.pmedr.2024.102819] [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] [Received: 03/21/2024] [Revised: 05/26/2024] [Accepted: 07/05/2024] [Indexed: 08/07/2024] Open
Abstract
Objectives This study examines the potential of International Medical Graduates (IMG) in contributing to the health and wellness of a community, particularly through transdisciplinary knowledge engagement or mobilization in diverse settings. We aimed to gather IMGs' perspectives on potential non-physician roles to enhance community health and wellness using a qualitative descriptive approach. Methods Eight focus groups were conducted among IMGs in Canada between June and August 2020 (n = 42), followed by a thematic analysis of the verbatim transcripts. Two independent reviewers carried out inductive coding of the data. Emergent themes and sub-themes were identified. Through an iterative process incorporating insights from community partners, themes were refined to capture the lived experiences of IMGs in this context. Results We sought to engage this population in discussions to capture their perspectives on contributions to health and wellness. Participants suggested various alternative contribution pathways such as knowledge mobilization, research generation, and supportive community roles. They also identified individual and systemic challenges. Finally, strategies for change were proposed on personal, professional, and organizational levels. Conclusion The IMGs put forward various ideas and insights regarding their potential contributions to community health and wellness. They can be valuable assets in promoting health and improving health literacy. It is important to recognize that IMGs are eager to take on significant roles in the community and that they are currently an underused resource for enhancing community health and wellness.
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Affiliation(s)
- Meriem Aroua
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nashit Chowdhury
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta International Medical Graduates Association, Calgary, Alberta, Canada
| | - Deidre Lake
- Alberta International Medical Graduates Association, Calgary, Alberta, Canada
| | - Tanvir C. Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Alilyyani B, Alaidarous N, Alsaedi M, Alshomrani S, Aljuaid S, Alotaibi S, Alotaibi A, Alotaibi G. The lived experience of patients going under hyperbaric oxygen therapy in Saudi Arabia: A phenomenological study. Medicine (Baltimore) 2024; 103:e38840. [PMID: 39058885 PMCID: PMC11272284 DOI: 10.1097/md.0000000000038840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Hyperbaric oxygen therapy (HBOT) has emerged as an effective treatment or adjunct therapy for various disorders, prioritizing improving oxygen delivery to tissues. This qualitative inquiry aims to explore the psychological experiences of patients undergoing their first hyperbaric session, focusing on the emotional responses and information needs of patients. The study addresses the gap in understanding patient experiences and seeks to contribute to holistic care approaches and improved health outcomes for patients undergoing HBOT. Using a phenomenological-hermeneutical approach, this study engaged 6 participants from KAASH in Taif City who had undergone at least 1 HBOT session. Data were collected through in-person interviews using a semistructured guide, focusing on patients' initial HBOT experiences. Giorgi 4-step method was applied for data analysis, allowing for rich descriptions and thematic categorization of the participants' lived experiences. The analysis is centered around "Walking into the unknown" with emerged subthemes (feeling anxious or being calm; immediate or evolving outcomes; formal orientation and management; success stories and self-learning) organized under 2 revised categories, "Transitioning from fear to reassurance" and "Navigating the path of understanding." The study also highlighted the critical role of healthcare providers in addressing information gaps and enhancing patient preparedness. The findings revealed the importance of comprehensive patient education and effective communication by healthcare providers to alleviate initial fears and improve treatment experiences for HBOT patients. Future research should expand to other regions and include healthcare providers' perspectives to further validate these findings and enhance HBOT practices. Integrating psychological support into the treatment process may also benefit patients, promoting holistic care and improving overall health outcomes.
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Affiliation(s)
- Bayan Alilyyani
- Department of Nursing Management and Education, College of Nursing, Taif University, Taif, Saudi Arabia
| | - Nada Alaidarous
- Arthur Labatt Family School of Nursing, Western University, London, Canada
| | - Manal Alsaedi
- Department of Nursing Management and Education, College of Nursing, Taif University, Taif, Saudi Arabia
| | - Sara Alshomrani
- Department of Nursing Management and Education, College of Nursing, Taif University, Taif, Saudi Arabia
| | - Shujun Aljuaid
- Department of Nursing Management and Education, College of Nursing, Taif University, Taif, Saudi Arabia
| | - Salha Alotaibi
- Department of Nursing Management and Education, College of Nursing, Taif University, Taif, Saudi Arabia
| | - Alanoud Alotaibi
- Department of Nursing Management and Education, College of Nursing, Taif University, Taif, Saudi Arabia
| | - Ghadah Alotaibi
- Department of Nursing Management and Education, College of Nursing, Taif University, Taif, Saudi Arabia
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Kwan C, Davis S, Marjerrison S, Wahi G. Understanding experiences and perspectives in addressing unmet social needs of children and families in a paediatric weight management program: a qualitative descriptive study. BMJ Paediatr Open 2024; 8:e002739. [PMID: 39043581 DOI: 10.1136/bmjpo-2024-002739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/01/2024] [Indexed: 07/25/2024] Open
Abstract
OBJECTIVE The objective is to describe the experiences and perceptions of caregivers who participated in a community systems navigator intervention that addressed unmet social needs. DESIGN, SETTING AND PATIENTS A qualitative descriptive study with caregivers of children enrolled in a clinical trial addressing unmet social needs of families with children cared for in a tertiary pediatric weight management clinic, through community systems navigation. Participants were asked open-ended questions related to perceptions of social needs screening in clinical settings. Interviews were recorded and analysed using Braun and Clarke's six-phase approach to thematic analysis. RESULTS Ten parent participants were interviewed. Social needs screening perception and acceptability varied between participants. Social needs screening was comfortable for most but stressful for others. Participants noted that trusting relationships promote comfort with sharing social needs information, and this data should be shared on the electronic health record if accurate and purposeful. They found the online screening tool convenient but thought it could also limit opportunities to elaborate. Some participants noted the intervention of community systems navigation helpful; however, others described the need for more tailored resources. CONCLUSIONS Screening for unmet social needs in clinical settings is complex and should be family centred, including the consideration of the mode of screening, data sharing in the electronic health record and ensuing interventions. Perspectives of families should drive the design of future larger scale community navigation interventions to address unmet social needs in clinical settings.
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Affiliation(s)
- Celia Kwan
- Department of Pediatrics, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Sarah Davis
- Department of Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | - Stacey Marjerrison
- Department of Pediatrics, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Gita Wahi
- Department of Pediatrics, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton, Ontario, Canada
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Manikandan M, Kerr C, Fortune J, Walsh M, Ryan J, Walsh A. Experiences of health services for adults with cerebral palsy, their support people, and service providers. Dev Med Child Neurol 2024. [PMID: 39032015 DOI: 10.1111/dmcn.16037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/20/2024] [Accepted: 06/18/2024] [Indexed: 07/22/2024]
Abstract
AIM To explore the experiences of health services among adults with cerebral palsy (CP) in Ireland, from the perspectives of adults with CP, their support people, and service providers. METHOD A qualitative descriptive study design was used. In-depth semi-structured interviews were conducted between March and August 2021 with adults with CP, people who supported them, and health professionals. Thematic analysis was used to evaluate the data. RESULTS Twenty-one adults with CP, seven support people (family carer[s], spouse or partner, or friend), and 15 service providers participated in the study. Adults had a mean age of 38 years 5 months (range 22-58 years) and were classified in Gross Motor Function Classification System levels I to V. Five themes were identified from the data: (1) access challenges in adult services; (2) knowledge and understanding of CP; (3) support people's role and care burden; (4) communication and interaction in adult services; and (5) health system challenges. CONCLUSION Adults with CP in Ireland face multiple challenges accessing the health services they need. Services were reported to be inadequate, with limited resources and understanding of CP. Participants highlighted a need for system-level interventions, including enhanced training for health professionals to effectively meet the needs of adults with CP.
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Affiliation(s)
- Manjula Manikandan
- School of Physiotherapy, RCSI, University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, UK
| | - Jennifer Fortune
- School of Physiotherapy, RCSI, University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Jennifer Ryan
- School of Physiotherapy, RCSI, University of Medicine and Health Sciences, Dublin, Ireland
- College of Health and Life Sciences, Brunel University, London, UK
| | - Aisling Walsh
- Department of Public Health and Epidemiology, School of Population Health, RCSI, University of Medicine and Health Sciences, Dublin, Ireland
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Cardle P, Kumar S, Leach M, McEvoy M, Veziari Y. "Diluting Its Value as a Word by Applying It to Everything": A Qualitative Study Exploring Perspectives and Practices of Mindfulness Practitioners. J Multidiscip Healthc 2024; 17:3439-3457. [PMID: 39050694 PMCID: PMC11268647 DOI: 10.2147/jmdh.s465423] [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: 04/12/2024] [Accepted: 06/10/2024] [Indexed: 07/27/2024] Open
Abstract
Objective The aim of this research was to explore the perspective, language, description, and practices of practitioners who identify as using mindfulness techniques for a range of health and clinical conditions. Methods This study was guided by a qualitative descriptive methodology. Mindfulness practitioners from a variety of backgrounds that included medical, allied health, complementary and alternative medicine, and traditional Buddhism from across Australia were invited to share their perspectives. Semi-structured interviews were conducted via Zoom, telephone, and face-to-face which were audio-recorded and transcribed verbatim. The transcripts were thematically analysed. Results Sixteen mindfulness practitioners from Australia self-nominated to participate in this study. Overall, the interviews revealed similarities, differences and even disagreements between participants from the different modalities regarding mindfulness. Participants from similar disciplines also reported differing perspectives and nuanced opinions. Differences appeared to stem from both participant background, training, and the overall aims of their practice. Conclusion This research highlights the complexities of what constitutes mindfulness. This study has highlighted, across a broad cohort, that for mindfulness practitioners, their beliefs, aims, and practices are varied and influenced by a range of factors including their ideological perspectives. While the diversity and broad application of mindfulness may be one of its strengths, it may also be its weakness as its value may be diluted due to plurality of understanding and multiplicity in use. This requires careful and considered actions from mindfulness stakeholders.
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Affiliation(s)
- Paul Cardle
- Allied Health and Human Performance Unit, The University of South Australia, Adelaide, SA, Australia
| | - Saravana Kumar
- Allied Health and Human Performance Unit, The University of South Australia, Adelaide, SA, Australia
| | - Matthew Leach
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Maureen McEvoy
- Allied Health and Human Performance Unit, The University of South Australia, Adelaide, SA, Australia
| | - Yasamin Veziari
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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Yu J, Chen J, Wang B, Wen H, Li H, Wu Y, Hu R. Symptom experience and self-management strategies of adults undergoing hematopoietic stem cell transplantation after hospital discharge: A longitudinal qualitative study. Eur J Oncol Nurs 2024; 72:102666. [PMID: 39163757 DOI: 10.1016/j.ejon.2024.102666] [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: 01/31/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 08/22/2024]
Abstract
PURPOSE To explore the symptom experience and self-management strategies of adults undergoing hematopoietic stem cell transplantation after hospital discharge. METHODS A longitudinal qualitative study was employed. A heterogeneous sample of 22 patients who underwent hematopoietic stem cell transplantation from August 2022 to April 2023 were included. Semi-structured interviews were conducted at three time points post-discharge and provided a dataset of 56 interviews. The content analysis method was used for manual analysis. This study followed the COREQ checklist. RESULTS The data from this study were categorized into four themes and 14 subthemes: (1) complexity and multidimensionality of symptom experience: diversity, dynamism, continuity, relatedness, and functional loading; (2) multiple variations in symptom self-management; (3) barriers to symptom self-management: limited access to information resources, insufficient awareness and skills in symptom self-management, lack of economic and social support, and difficulties in medical visits and reviews; and (4) facilitators of symptom self-management: perceived benefits, experience-driven, and peer experiences. CONCLUSION Patients undergoing hematopoietic stem cell transplantation experience multiple and complex symptom experiences after hospital discharge, and their symptom self-management remains challenging. The findings underscore the necessity for healthcare professionals to regularly and consistently evaluate the symptoms and self-management practices of patients undergoing hematopoietic stem cell transplantation and execute focused interventions to alleviate their symptom load and enhance their long-term well-being.
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Affiliation(s)
- Jiejie Yu
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jingyi Chen
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Binbin Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hongmei Wen
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hao Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China.
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Stott D, Sharma C, Deutsch JM, Milliron BJ. The Connections among Interacting with Nature, Nature Relatedness and Dietary Choices: A Pilot Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:899. [PMID: 39063476 PMCID: PMC11276622 DOI: 10.3390/ijerph21070899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/19/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
Interacting with nature and a connection to nature (Nature Relatedness [NR]) have been associated with better mental and physical health as well as higher levels of physical activity. However, limited research has explored how interacting with nature and NR may promote healthful dietary behaviors. The purpose of this pilot convergent mixed methods study was to explore the connections between interacting with nature, NR, and dietary choices. For descriptive purposes, we measured participants' (n = 25) interactions with nature, NR (total, experience, perspective, and self) scores, physical activity, and Healthy Eating Index-2020 scores. In-depth interviews (n = 13) explored the factors that influence interacting with nature and food choices. Quantitative and qualitative data were analyzed separately, and later integrated to yield a more complete understanding of the research inquiry than either form of data would have provided alone. The results from this pilot mixed methods study indicate that there are connections between the variables of interest and that NR may play a pivotal role in how interacting with nature may promote sustainable dietary behaviors. These findings could promote the potential for utilizing nature-based experiences to improve dietary intake.
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Affiliation(s)
- Dahlia Stott
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19104, USA; (D.S.); (C.S.); (J.M.D.)
| | - Chetan Sharma
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19104, USA; (D.S.); (C.S.); (J.M.D.)
- Department of Food and Animal Sciences, Tennessee State University, Nashville, TN 37209, USA
| | - Jonathan M Deutsch
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19104, USA; (D.S.); (C.S.); (J.M.D.)
| | - Brandy-Joe Milliron
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19104, USA; (D.S.); (C.S.); (J.M.D.)
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Miyoshi Y, Yoshioka SI, Yamamoto M. Transferability of Effective Consultation Skills for Decision-Making Support in the Voluntary Surrender of Older Adult Drivers' Licences in Super-Aged Japan. Int J Older People Nurs 2024; 19:e12630. [PMID: 38990513 DOI: 10.1111/opn.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 06/12/2024] [Accepted: 06/20/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION Previously, we identified eight effective consultation skills to support decision-making in the voluntary surrender of older adult drivers' licences in super-aged Japan. This study aimed to clarify the transferability of these skills. METHODS We collected text data by interviewing 11 safe-driving counsellors (four police officers, four clerical staff and three nurses) in the License Division of the National Police Agency from February to March 2022. Interviews were semi-structured and conducted by telephone or email. During the interview, participants were asked to recall their experiences as counsellors providing decision-making support to older drivers and to compare their experiences with the eight consultation skills. We analysed the content of the responses by quantitative text analysis with KH Coder 3 software. RESULTS As a characteristic of the words and phrases used by counsellors in their narratives about consultation skills, the most frequently extracted words from among 3147 words were think, parties and family, and promote had the highest mediation centrality. The eight subgraphs were 'Respecting the will of relevant parties from their standpoint is natural', 'Listening attentively and empathetically to relevant parties is effective', 'Presenting objective data to guide decisions is successful', 'Showing cognitive functioning test results is often effective', 'Counselors with medical expertise can elicit positive counseling outcomes', 'Intervention by medical or police counselors facilitates the decision to surrender voluntarily', 'Counseling skills need to be improved' and 'A diagram of the 8 skills is helpful for inexperienced counselors'. CONCLUSION The results suggest that the eight consultation skills have similarities and are transferable. This transferability might contribute to practical application or cohort follow-up study research. These skills can be incorporated into counsellor training, and counsellors can be expected to use these skills in the future. Regardless of the safe-driving counsellor's years of experience, the skills can help them provide uniform and accurate support in decision-making regarding the voluntary surrender of older adult drivers' licences. These skills are a promising approach to help older adults lead safe and secure lives as they age.
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Affiliation(s)
- Yoko Miyoshi
- Department of Adult and Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Shin-Ichi Yoshioka
- Department of Nursing Care Environment and Mental Health, School of Health Science, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Miwa Yamamoto
- Department of Gerontological Nursing, School of Nursing, Faculty of Medicine, Kagawa University, Kida, Kagawa, Japan
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Donnelly E, Lee J, Donnellan-Fernandez R. Understanding attrition of early career midwives in Australia. Women Birth 2024; 37:101636. [PMID: 38917646 DOI: 10.1016/j.wombi.2024.101636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024]
Abstract
PROBLEM There is a lack of understanding of the experiences of early career midwives which lead to workforce attrition. BACKGROUND In the Australian midwifery setting, workforce attrition in conjunction with the ageing profile of the workforce is of increasing concern. Midwives in the earliest stages of their career are most vulnerable to career attrition, however limited research specifically engages with this cohort. AIM To understand the professional and social circumstances that led early career midwives to leave clinical practice, how their midwifery background influenced career trajectories, and what would compel them to return to clinical practice. METHODS Semi-structured interviews were conducted with 11 early career midwives who had left the profession within 5 years of qualification. Transcripts underwent thematic analysis. FINDINGS Three themes described early career midwives' experiences: transition to professional practice, an untenable workplace culture, mental health impacts of early clinical midwifery practice. Two further themes emerged about experiences post-midwifery careers: influence of midwifery on subsequent career, and conditions for re-entry. DISCUSSION Challenges with transitioning to professional midwifery practice in conjunction with untenable workplace culture led to such deterioration in wellbeing that remaining within the profession became unfeasible for early career midwives. Desire to remain within health care was apparent, however re-entry to the profession was deemed by most to be out of the question. CONCLUSION Early workforce retention strategies should be the focus of future workforce planning and policy. Larger scale inquiry foregrounding early career midwives is necessary to inform strategies for midwifery workforce retention in Australia.
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Affiliation(s)
- Eleanor Donnelly
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia.
| | - Jessica Lee
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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Thompson C, Halcomb E, Masso M, Montgomery A. Ageing with chronic conditions and older persons' experience of social connections: a qualitative descriptive study. Aust J Prim Health 2024; 30:PY24019. [PMID: 38963890 DOI: 10.1071/py24019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
Background Chronic conditions may limit older peoples' social engagement and wellbeing. Reduced social connections can result in loneliness and social isolation. This study aimed to explore the experience of social connection in older people living with chronic conditions, and the factors influencing their social participation. Methods A purposive sample of 19 community-dwelling older Australians (mean age 75.5years) with one or more chronic conditions participated in a qualitative descriptive study. Semi-structured interviews explored participants' perceptions of their social connections and the potential impact of their chronic conditions. Views about the role of general practice in supporting older persons' wellbeing were discussed. Data were analysed inductively using thematic analysis. Results Five themes were identified: (1) the experience of loneliness, (2) managing diminishing social contacts, (3) living with chronic conditions, (4) barriers to social connection, and (5) facilitators of social connection. Participants felt that ageing with chronic conditions contributed to loss of function and independence, which limited social connections, and increased loneliness and social isolation. Barriers to social connections included issues with mobility, transport and forming new networks. Families were a primary support, with continued community engagement and general practice support crucial to staying well and socially connected. Conclusions Understanding older peoples' experiences, and the barriers and facilitators of social connections can guide clinicians' interventions. General practice is a promising intervention point because of its high use by those with chronic conditions to stay well. General practice nurses are well-placed to collaboratively address the barriers older people face in maintaining social connections.
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Affiliation(s)
- Cristina Thompson
- School of Nursing, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Malcolm Masso
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Amy Montgomery
- School of Nursing, University of Wollongong, Wollongong, NSW 2522, Australia
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Ribeiro DC, Wilkinson A, Gava V, Lamb SE, Abbott JH. Patients' perspectives on planned interventions tested in the Otago MASTER feasibility trial: an implementation-based process evaluation study. Braz J Phys Ther 2024; 28:101086. [PMID: 38936312 PMCID: PMC11260924 DOI: 10.1016/j.bjpt.2024.101086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 04/25/2024] [Accepted: 06/02/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Patients are key stakeholders of clinical research, and their perspectives are relevant for researchers when planning and conducting clinical trials. Numerous aspects of trial process can influence participants' experiences. Their experiences within a trial can impact retention rates. Poor treatment adherence may bias treatment effect estimates. One way to improve recruitment and adherence is to design trials that are aligned with patients' needs and preferences. This study reports a process evaluation of the Otago MASTER feasibility trial. OBJECTIVES Our aims were to investigate the patients' perceptions of the trial interventions through individual interviews. METHODS Twenty-five participants were recruited for the feasibility trial and were allocated to two groups: tailored or standardised exercise. Sixteen participants agreed to take part in individual semi-structured interviews. Interviews were transcribed verbatim, and all interviews were analysed thematically using an iterative approach. RESULTS Our key findings suggest participants: (1) took part in the study to access healthcare services and contribute to research; (2) valued interventions received; (3) reported certain barriers and facilitators to participate in the trial; and (4) highlighted areas for improvement when designing the full trial. CONCLUSION Participants volunteered to access healthcare and to contribute to research. Participants valued the personalised care, perceived that their engagement within the trial improved their self-management and self-efficacy behaviour, valued the time spent with clinicians, and the empathetic environment and education received. Facilitators and barriers will require careful consideration in the future as the barriers may impact reliability and validity of future trial results.
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Affiliation(s)
- Daniel Cury Ribeiro
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
| | - Amanda Wilkinson
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of Nursing, University of Otago, Christchurch, New Zealand
| | - Vander Gava
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Sarah E Lamb
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - J Haxby Abbott
- Department of Surgical Sciences, University of Otago Medical School, Dunedin, New Zealand
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Lyu XC, Chen C, Lee LH, Akkadechanunt T, Yang CI, Tao XB. Dealing With a Stressful Extra Duty: The Intrapersonal Conflict Experiences of Nurses Caring for Survivors of Suicide Attempts on Medical-Surgical Wards. Int J Ment Health Nurs 2024. [PMID: 38951125 DOI: 10.1111/inm.13386] [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: 01/21/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
Nurses are the frontline professionals caring for patients who have attempted suicide. When clinical nurses learn from medical records or nursing handover, or are proactively informed by patients or family members, that the patients they are caring for have suicidal tendencies, they often experience pressure and face challenges. However, little attention has been given to the experiences of the nurses caring for patients with suicidal intent on medical and surgical wards. We aimed to address this knowledge gap. The purpose of this study was to explore medical and surgical nurses' experiences, especially the internal conflicts they might experience while caring for patients who have a history of attempted suicide. A qualitative descriptive design and semi-structured interviews were used in this study. Twenty-three nurses were recruited and interviewed individually. Data were analysed by qualitative content analysis. The focus of this paper is to examine the emergent theme of intrapersonal conflict experienced by the participants. Nurses' experiences can be clustered into two themes: (1) Pity and annoyance and (2) Hard work does not necessarily pay off. Intrapersonal conflict was identified by participants as considerable fear and anxiety about the possibility of a patient's suicide, as well as a mixture of pity for and annoyance with the patients. Nurses feel sorry for such patients, but they are also annoyed by the extra work required to prevent suicide attempts in the ward. Additionally, having limited time and ability, they see that their hard work does not necessarily pay off and may sometimes lead to punishment. Our findings raise serious concerns about the adequacy of the knowledge of the nurses, their competence and their difficulties in caring for such patients. In addition, there is a need to provide them with appropriate on-the-job education and immediate emotional support relevant to caring for survivors of suicide attempts.
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Affiliation(s)
- Xiao-Chen Lyu
- Outpatient Operating Room, The First Affiliated Hospital of Wannan Medical College, Anhui, China
| | - Cheng Chen
- Department of Pain, The Affiliated Hospital of Chengdu University, Sichuan, China
| | - Li-Hung Lee
- Department of Nursing, Hungkuang University, Taichung, Taiwan
| | | | - Cheng-I Yang
- Department of Nursing, Hungkuang University, Taichung, Taiwan
| | - Xiu-Bin Tao
- Department of Nursing, The First Affiliated Hospital of Wannan Medical College, Anhui, China
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Hoberg MG, Demirci JR, Sereika SM, Levine MD, DeVito Dabbs A. Mixed-Methods Assessment of Maternal Anxiety During the First 8 Weeks After Birth. J Obstet Gynecol Neonatal Nurs 2024; 53:368-382. [PMID: 38325800 PMCID: PMC11246815 DOI: 10.1016/j.jogn.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE To describe and compare the experiences of postpartum anxiety among women with generalized anxiety and postpartum-specific anxiety. DESIGN Prospective, longitudinal, mixed methods. SETTING Academic tertiary center in the mid-Atlantic United States. Study activities were remote. PARTICIPANTS Women at 1 to 8 weeks after birth (N = 34). METHODS We used mobile surveys to measure daily anxiety ratings and responses to open-ended, theory-driven questions about anxiety. We used the cutoff scores on the State-Trait Anxiety Inventory and Postpartum Specific Anxiety Scale administered 8 weeks after birth to determine the presence of generalized and postpartum-specific anxiety. Participants' responses were analyzed with qualitative description and sorted by anxiety questionnaire scores at 8 weeks after birth. We compared qualitative findings between participants with generalized anxiety and postpartum-specific anxiety. RESULTS Participants with generalized anxiety had high levels of overwhelm and felt ill-equipped to handle daily stressors, whereas those with postpartum-specific anxiety felt adept at coping. Participants with generalized anxiety lacked emotional and physical support, and those with postpartum-specific anxiety reported more physical but variable emotional support. Sources of daily anxiety in participants with postpartum-specific anxiety were infant-centric (e.g., infant health, end of maternity leave, breastfeeding), whereas anxiety sources for participants with generalized anxiety were varied (e.g., self-health, partner concerns). Participants with generalized anxiety versus postpartum-specific anxiety were more likely to be multiparous and have comorbid depression symptoms. CONCLUSION Symptoms, levels of perceived support, and sources of anxiety differed between participants with generalized versus postpartum-specific anxiety. Our findings can inform postpartum anxiety screening strategies and support interventions.
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Bolgeo T, Di Matteo R, Gardalini M, Ruta F, Iacorossi L, Gambalunga F, Maconi A. Environmental diseases, recognition for care: A qualitative study of nurses' perceptions. Public Health Nurs 2024; 41:684-689. [PMID: 38752565 DOI: 10.1111/phn.13332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/03/2024] [Accepted: 04/24/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVES This study aims to investigate hospital nurses' perceptions of illness due to environmental exposures. DESIGN A qualitative exploratory study, designed in accordance with the specified reporting guidelines for qualitative research. SAMPLE Nurses working in Italian hospitals. METHODS Semi-structured interviews were used to collect data, then evaluated using the framework analysis methodology. Data collection was from January to June 2022 and analysed from July to September 2022. RESULTS Forty-two nurses were interviewed. Data analysis revealed three themes: 1) the concept of disease in relation to environmental exposure; 2) the dangers of chemical and physical substances; 3) environmental changes cause concern and a sense of helplessness for the future. CONCLUSIONS The results suggest the need for specific training on topics related to environmental disease types, environmental exposure, preventive measures, health promotion, and environmental impact to support professional development and support nurses in the management of this important aspect of health care.
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Affiliation(s)
- Tatiana Bolgeo
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliero - Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberta Di Matteo
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliero - Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Menada Gardalini
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliero - Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Federico Ruta
- Director of Nursing Professions, ASL, BT, Andria, Italy
| | - Laura Iacorossi
- Department of Life, Health and Health Professions Sciences, Link Campus University, Rome, Italy
| | - Francesca Gambalunga
- Professional Health Care Services Department, University Hospital "Policlinico Umberto I", Rome, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliero - Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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Cantón-Rodríguez Y, Ibáñez-Masero O, García-Navarro EB, Ortega-Galán ÁM, Ventura-Miranda MI, Ruiz-Fernández MD. Professional experiences of spanish advanced practice nurses: qualitative research. BMC Nurs 2024; 23:439. [PMID: 38926730 PMCID: PMC11201328 DOI: 10.1186/s12912-024-02105-6] [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: 10/21/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Advanced practice nursing has emerged as a result of the evolution of healthcare systems, the changing needs of the population and the academic development of nursing, as well as sociodemographic and epidemiological changes. The aim of this study is to describe the professional experiences of Spanish advanced practice nurses in specific positions within the healthcare system in order to better understand the development and characteristics of this specialised nursing role. METHODS A descriptive qualitative study was conducted. Fourteen advanced practice nurses from healthcare centres participated. Semi-structured interviews were carried out. Braun and Clarke's method for reflexive thematic analysis was followed. The Atlas. Ti version 22 program was used for technological support. The COREQ checklist was used to optimise the reporting of this qualitative study. RESULTS From the analysis of the data collected, three themes and six subthemes were extracted: 1) Advanced practice nursing on the rise: (a) The driving forces in the development of advanced practice nursing, (b) Barriers to the development of advanced practice nursing; 2) Advanced practice nurses as a response to the population's needs: (a) The development of a new professional nursing role, (b) The patient at the centre of care in advanced practice nursing; 3) Training as the foundation for advanced practice nursing: (a) Expert nurses in a specific context, (b) Differences in the level of training depending on the context. CONCLUSION Advanced practice nurses have faced countless barriers and difficulties that have impeded them from demonstrating their importance and effectiveness within the healthcare system. A stable regulatory framework for the functions of advanced practice nurses is required to promote care, training and research in the field of advanced practice nursing. Health institutions need to promote the role of advanced practice nurses, facilitate the employment of new professionals, and establish new areas of practice. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
| | | | | | | | | | - María Dolores Ruiz-Fernández
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Chile
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Winter N, Ugalde A, Coyne E, Dieperink KB, Jongebloed H, Livingston P. People affected by cancer and their carers from gender and sexually diverse communities: their experiences and the role of smartphone applications. BMC Public Health 2024; 24:1649. [PMID: 38902694 PMCID: PMC11191337 DOI: 10.1186/s12889-024-19144-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 06/14/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND People living with cancer, or carers who are from lesbian, gay, bisexual, transgender, queer, intersex or asexual (LGBTQIA+) communities experience unique information and support needs. Accessible technology-based resources providing tailored support are required to promote wellbeing, however this is a growing area of research requiring further investigation. The purpose of this study was to explore the experiences of healthcare services among people living with cancer, and their carers, who belong to sexual or gender diverse communities (LGBTQIA+), and identify how smartphone applications (apps) could support people from LGBTQIA + communities. METHODS This was a qualitative descriptive study where people living with cancer or carers from LGBTQIA + communities participated in phone interviews. Participants were recruited across Australia via social media advertisements, LGBTQIA + medical practices, and cancer advocacy groups. Participants were asked questions about their experiences, and were provided with screenshots of an existing app and asked to provide feedback on content and inclusiveness. Transcripts were coded and codes grouped together to form similar and concepts. Inductive and deductive analyses were used to create themes. RESULTS 13 patients (mean age 56 (SD:13)), and three carers (mean age 64 (SD:19)) completed phone interviews. The majority of participants identified their gender as female (patients n = 9, carers 3), and their sexuality as gay or lesbian (patients n = 10, carers n = 3). Four themes were created: (1) navigating disclosure in healthcare, described emotional challenges surrounding disclosure; (2) the power of positive experiences with clinicians, described positive interactions and gaps in care from clinicians; (3) impact of gender and sexuality on informal support, outlined support received from informal network and gaps in support, and; (4) opportunities to increase inclusivity in smartphone apps, generated ideas on how apps can be tailored to meet needs identified. CONCLUSION Disclosure of gender or sexuality, and interactions with clinicians had the potential to impact participants' experience of cancer care. Gaps in informal networks pointed at how to better support LGBTQIA + communities, and identified opportunities for inclusion in an app that will be tailored and trialled for this community. Future work should focus on addressing systems-level processes in acknowledging and supporting priority groups affected by cancer.
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Affiliation(s)
- Natalie Winter
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety in the Institute for Health Transformation, Deakin University, Geelong, 3220, Australia.
| | - Anna Ugalde
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety in the Institute for Health Transformation, Deakin University, Geelong, 3220, Australia
| | - Elisabeth Coyne
- School of Nursing, Griffith University, Brisbane, Australia
- School of Nursing, University of Southern Denmark, Odense, Denmark
| | - Karin B Dieperink
- Family Focused Healthcare Research Center FaCe, University of Southern Denmark, Odense, Denmark
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Hannah Jongebloed
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety in the Institute for Health Transformation, Deakin University, Geelong, 3220, Australia
| | - Patricia Livingston
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety in the Institute for Health Transformation, Deakin University, Geelong, 3220, Australia
- Faculty of Health, Deakin University, Geelong, 3220, Australia
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Lavelle-Cafferkey S, Comiskey C. Role of the addiction clinical nurse specialist in acute hospital settings. Nurs Stand 2024; 39:70-76. [PMID: 38680049 DOI: 10.7748/ns.2024.e12305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND The role of an addiction clinical nurse specialist (ACNS) is focused on individuals who misuse drugs and alcohol, and several benefits of the role have been identified in the literature. When people who misuse substances are admitted to acute general hospitals, there is an opportunity to engage with them and ensure they access support services to facilitate their recovery. AIM To determine general nurses' experience of caring for patients who misuse substances, and to gauge nurses' views on the implementation of an ACNS role in an acute general hospital. METHOD This study used a qualitative design involving online interviews with 11 hospital nurses. FINDINGS Many participants felt that an ACNS could provide them with education and support around substance misuse, while also advocating for patients who misuse substances, reducing stigma and enhancing patient care. CONCLUSION Participants indicated several benefits to implementing an ACNS role in their hospital, such as ensuring that patients who misuse substances experienced continuity of care which began at admission, was followed-up during inpatient stays and was maintained in the community.
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Affiliation(s)
- Sadie Lavelle-Cafferkey
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin, Republic of Ireland
| | - Catherine Comiskey
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin, Republic of Ireland
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Stitt A, Operacz R. A Qualitative Investigation of Parent Perceptions of Home Exercises for Congenital Muscular Torticollis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:689. [PMID: 38929268 PMCID: PMC11201539 DOI: 10.3390/children11060689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 05/28/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
The purpose of this qualitative study was to describe parent perceptions of the home exercise program (HEP) for infants with congenital muscular torticollis (CMT), and how these perceptions evolved over a physical therapy (PT) plan of care. Twelve participants were recruited from a pediatric PT clinic, and nine completed interviews at three time points. Qualitative description and an iterative approach for thematic analysis of 27 interviews yielded three themes that corresponded to the research questions. The participants' responses were categorized into three main themes: (1) parents' perceptions of three key exercises within the HEP, (2) internal and external sources of stress, and (3) sources of empowerment and disempowerment. Regarding the HEP, parents articulated common sentiments for three frequently prescribed exercises for the management of CMT: (1) tummy time was the fast favorite, (2) ipsilateral cervical rotation was perceived as stressful, and (3) contralateral cervical lateral flexion felt uncomfortable. Additionally, participants disclosed internal and external sources of stress (guilt, uncertainty, and the demands of returning to work) and sources of disempowerment (inconsistent messaging frompractitioners, feeling overwhelmed) and empowerment (being able to see the bigger picture and clear communication and education about the diagnosis) with respect to managing their infant's CMT. These themes provide insight into the evolution of parent perceptions over a PT plan of care for CMT. Participants' insights suggest a need for consistent messaging regarding the diagnosis and evidence-based management of CMT, addressing parent stress, and modifying how exercises are taught. This study contributes updated research on parents' experiences with physical therapy and the HEP for their infant's CMT.
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Affiliation(s)
- Audrey Stitt
- Physical Therapy Program, College of Public Health, Temple University, Philadelphia, PA 19122, USA
| | - Rebecca Operacz
- Physical Therapy Program, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Kato H, Iwasaki T, Ko A, Nishina Y, Tanigaki S, Norikoshi C, Sakai M, Ito M, Harasawa N, Tamura K, Nagae H. Experiences of dialogue in advance care planning educational programs. Nurs Ethics 2024; 31:493-507. [PMID: 37496291 DOI: 10.1177/09697330231166086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
BACKGROUND Advance care planning (ACP) is a process in which adults engage in an ongoing dialogue about future medical treatment and care. Though ACP is recommended to improve the quality of end-of-life care, the details of the dialogue experience in ACP are unknown. OBJECTIVE To explore participants' experiences of dialogue in an ACP educational program that encouraged them to discuss the value of a way of life. RESEARCH DESIGN This qualitative descriptive study used the focus group interview method. Data were analyzed using qualitative content analysis. PARTICIPANTS AND RESEARCH CONTEXT A dialogue-based ACP educational program was conducted in four regions in Japan for local citizens to discuss the value of their way of life. A total of 66 individuals (mean age = 55.5 ± 17.2 years; 50 women and 16 men) participated in focus group interviews. ETHICAL CONSIDERATIONS This study was approved by the Ethical Review Committee of Tokyo Women's Medical University (no. 4723) and Kyoto University (no. R2099). FINDINGS Five main themes were extracted: discussing one's thoughts with others in a considerate manner, reflecting on one's way of life through others, feeling a sense of connection with others through storytelling, realizing the difficulties of talking about "what if" topics, and turning one's eyes toward the future through the dialogue. These themes were interrelated and illustrated the complexity of the experience of discussing values. CONCLUSIONS The results suggest that dialogue in ACP is useful in clarifying values. They also indicated the need for dealing with the ethical challenges of discussing value and the importance of caring for the interlocutor to have a safe dialogue. In the ACP process, safety in dialogue may improve readiness in ACP, and health practitioners who support ACP need to address the ethical challenges entailing dialogue about values.
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Affiliation(s)
| | | | | | | | | | | | | | - Mari Ito
- Kawasaki Medical School General Medical Center, Japan
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Druye AA, Nelson K, Robinson B. Self-management for sickle cell disease among patients and parents: A qualitative study. Chronic Illn 2024; 20:233-245. [PMID: 37151019 DOI: 10.1177/17423953231172797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVE This study aimed to explore self-management practices among patients and parents of children with sickle cell disease (SCD). METHODS The qualitative descriptive design was employed. The study involved 19 participants comprising adult SCD patients ≥16 years, and nine parents of SCD children ≤ 15 years. Purposive sampling was conducted to select participants from a teaching hospital and SCD association. Data was collected using one-on-one interviews, transcribed verbatim, and analysed using qualitative content analysis. RESULTS Self-management was reported through four categories including preventive health, self-monitoring, self-diagnosis, and self-treatment. Hydration, nutrition, activity limitation, avoidance of cold temperatures, and supportive medications were the most common preventive health actions. Regarding self-monitoring and self-diagnosis, the parents emphasized objective indicators such as changes in urine and eye colour compared to the adults who utilize subjective indicators such as feeling unwell and easy fatigue. Pharmacological and non-pharmacological measures were reported by both groups for treating painful episodes, fever, leg ulcers, priapism, and unspecified symptoms. DISCUSSION The participants in this study practice several self-management actions with some differences in application between adults and children. Tailored self-management services may be helpful for adults and children when developing services for SCD patients.
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Affiliation(s)
- Andrews Adjei Druye
- School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Katherine Nelson
- Graduate School of Nursing and Midwifery, Victoria University of Wellington, Wellington, New Zealand
| | - Brian Robinson
- Graduate School of Nursing and Midwifery, Victoria University of Wellington, Wellington, New Zealand
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