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do Rosário FS, Soares M, Mesquita F, Raposo JF. Naming hypoglycemia: a narrative tool for young people with type 1 diabetes and their families. Diabetol Int 2024; 15:550-561. [PMID: 39101166 PMCID: PMC11291804 DOI: 10.1007/s13340-024-00731-8] [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: 10/02/2023] [Accepted: 05/05/2024] [Indexed: 08/06/2024]
Abstract
Objective Hypoglycemia constitutes a communication barrier between youth with type 1 diabetes, their family members and health professionals. A narrative tool may contribute to a more effective communication. Methods Semi-structured interviews with six open-ended questions using narrative techniques collect and analyze (thematic and comparative analysis) different ways of "naming" the lived experience of hypoglycemia. Results 103 participants, 40 with type 1 Diabetes aged 10-18 years (17 female), 63 relatives (40 female). Group 1 (G1), 10-14 years old (n = 21), Group 2 (G2), 15-18 years old (n = 19), Group 3 (G3) relatives, 30-59 years old. G3 was divided, G3.1: female (n = 42) and G3.2: male (n = 21).G1 and G2 presents greater attention to symptoms. G1 refers a greater need for help, G2 emphasizes autonomy. G2 and G3 describes better the medical protocol. G1 and G2 refer more topics such as "discomfort", "frustration", "obligation", "difficulty in verbalizing", G3 refers to "gilt", "fear" and "responsibility". G3.1 refer more "symptoms", "responsibility", "fault", "incapacity". Conclusions A narrative tool enhances the singularity of a common experience, proving itself useful to adolescents, relatives, and healthcare professionals. Practice implications In addition to gathering information that is usually acquired empirically, a narrative tool exposes knowledge gaps and may allow implementing intervention strategies.
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Affiliation(s)
- Francisco Sobral do Rosário
- Diabetology Department, APDP-Diabetes Portugal, Rua Rodrigo da Fonseca, 1, 1250-189 Lisbon, Portugal
- Narrative & Medicine Research Group at CEAUL-ULICES (Lisbon University Center for English Studies), Lisbon, Portugal
| | - Marta Soares
- Narrative & Medicine Research Group at CEAUL-ULICES (Lisbon University Center for English Studies), Lisbon, Portugal
- Instituto Superior de Ciências Sociais E Políticas, Lisbon University, Lisbon, Portugal
| | - Filipe Mesquita
- Narrative & Medicine Research Group at CEAUL-ULICES (Lisbon University Center for English Studies), Lisbon, Portugal
| | - João Filipe Raposo
- Diabetology Department, APDP-Diabetes Portugal, Rua Rodrigo da Fonseca, 1, 1250-189 Lisbon, Portugal
- Nova Medical School, New University of Lisbon, Lisbon, Portugal
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Cadenhead VH. Storytelling: An Educational Intervention for Oral Learners. J Christ Nurs 2023; 40:253-259. [PMID: 35533288 DOI: 10.1097/cnj.0000000000000981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT This state of the science review synthesizes the current literature and theoretical background of storytelling as a health communication tool for oral learners. Storytelling is globally applicable in a variety of settings and formats. Cultural considerations are important. Both theoretical and biblical examples explain how storytelling can influence knowledge, behaviors, attitudes, and outcomes. Although further research is needed, evidence indicates storytelling is an effective tool that nurses can use to fulfill their essential duty of health teaching.
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Affiliation(s)
- Virginia H Cadenhead
- Virginia H. Cadenhead, PhD, MSN, RN, CNM , is an assistant professor of nursing at California Baptist University, Riverside, CA. She has more than 23 years of transcultural nursing experience as a missionary in North Africa and Central America
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Gucciardi E, Reynolds E, Karam G, Beanlands H, Sidani S, Espin S. Group-based storytelling in disease self-management among people with diabetes. Chronic Illn 2021; 17:306-320. [PMID: 31266352 PMCID: PMC8414823 DOI: 10.1177/1742395319859395] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/13/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We explored the underlying mechanisms by which storytelling can promote disease self-management among people with type 2 diabetes. METHODS Two, eight-session storytelling interventions were delivered to a total of eight adults with type 2 diabetes at a community health center in Toronto, Ontario. Each week, participants shared stories about diabetes self-management topics of their choice. Using a qualitative descriptive approach, transcripts from each session and focus groups conducted during and following the intervention were coded and analyzed using NVivo software. Through content analysis, we identified categories that describe processes and benefits of the intervention that may contribute to and support diabetes self-management. RESULTS Our analysis suggests that storytelling facilitates knowledge exchange, collaborative learning, reflection, and making meaning of one's disease. These processes, in turn, could potentially build a sense of community that facilitates peer support, empowerment, and active engagement in disease self-management. CONCLUSION Venues that offer patients opportunities to speak of their illness management experiences are currently limited in our healthcare systems. In conjunction with traditional diabetes self-management education, storytelling can support several core aspects of diabetes self-management. Our findings could guide the design and/or evaluation of future story-based interventions.
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Affiliation(s)
- Enza Gucciardi
- School of Nutrition, Ryerson University, Toronto, Ontario,
Canada
| | - Erica Reynolds
- School of Nutrition, Ryerson University, Toronto, Ontario,
Canada
| | - Grace Karam
- School of Nutrition, Ryerson University, Toronto, Ontario,
Canada
| | - Heather Beanlands
- Daphne Cockwell School of Nursing, Ryerson University, Toronto,
Ontario, Canada
| | - Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, Toronto,
Ontario, Canada
| | - Sherry Espin
- Daphne Cockwell School of Nursing, Ryerson University, Toronto,
Ontario, Canada
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Eating Experiences of People with Disabilities: A Qualitative Study in Spain. Healthcare (Basel) 2020; 8:healthcare8040512. [PMID: 33255395 PMCID: PMC7712265 DOI: 10.3390/healthcare8040512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/03/2020] [Accepted: 11/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Disability causes changes in the eating process, which is central to the definition of each individual’s social and psychological spaces. Methods: This is a qualitative study based on grounded theory. Interviews were carried out in clinical hospital settings and headquarters of several disability organisations. The study included 27 individuals, aged between 18–75 years. All participants had a disability that caused a functional deficiency in the occupational aspects of the eating process. Results: The respondents’ narratives were analysed through observations made in different contexts, allowing us to describe and understand the significance attributed by the participants to their reality and experiences. Three key themes emerged from the analysis: (1) waning bodies (assumption of a diminished corporality); (2) redefinition of food-related social spaces; and (3) perceived burdensomeness, shame, and loneliness. Conclusions: Assisted feeding tends to prioritise the nutritional component of food ingestion. However, cultural, social, and contextual factors have a critical impact on an individual’s well-being and quality of life. This study stresses the importance of re-addressing intervention models affecting differently-abled people and incorporating approaches that take into account the contextual aspects of occupational therapy.
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Sobral do Rosário F, Almeida DV, Oliveira J, Lima ML, Raposo JF. A Randomized Trial of the Close Reading and Creative Writing Program: An Alternative Educational Method for Adult Group Care Intervention in Type 2 Diabetes Management. Can J Diabetes 2020; 44:253-260. [DOI: 10.1016/j.jcjd.2019.07.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/15/2019] [Accepted: 07/19/2019] [Indexed: 10/26/2022]
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Gucciardi E, Jean-Pierre N, Karam G, Sidani S. Designing and delivering facilitated storytelling interventions for chronic disease self-management: a scoping review. BMC Health Serv Res 2016; 16:249. [PMID: 27401836 PMCID: PMC4940988 DOI: 10.1186/s12913-016-1474-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 06/17/2016] [Indexed: 01/20/2023] Open
Abstract
Background Little is known about how to develop and deliver storytelling as an intervention to support those managing chronic illnesses. This scoping review aims to describe the core elements of storytelling interventions in order to help facilitate its implementation. Methods A scoping review was conducted in seven databases for articles published up to May 2014 to identify interventions that describe in detail how storytelling was used to support people in disease self-management interventions. Results Ten articles met all inclusion criteria. Core elements consistently observed across the storytelling interventions were: reflection and interactive meaning-making of experiences; principles of informality and spontaneity; non-directional and non-hierarchical facilitation; development of group norms and conduct to create a community among participants; and both an individual and collective role for participants. Differences were also observed across interventions, such as: the conceptual frameworks that directed the design of the intervention; the type and training of facilitators; intervention duration; and how session topics were selected and stories delivered. Furthermore, evaluation of the intervention and outcome assessment varied greatly across studies. Conclusion The use of storytelling can be a novel intervention to enhance chronic disease self-management. The core elements identified in the review inform the development of the intervention to be more patient-centred by guiding participants to take ownership of and lead the intervention, which differs significantly from traditional support groups. Storytelling has the potential to provide patients with a more active role in their health care by identifying their specific needs as well as gaps in knowledge and skills, while allowing them to form strong bonds with peers who share similar disease-related experiences. However, measures of impact differed across interventions given the variation in chronic conditions. Our findings can guide future development and implementations of storytelling interventions.
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Affiliation(s)
- Enza Gucciardi
- Ryerson University, School of Nutrition, 350 Victoria Street, Kerr Hall South, room 349-I, Toronto, ON, M5B 2 K3, Canada.
| | - Nicole Jean-Pierre
- North York Family Health Team, 240 Duncan Mill Rd, Suite 707, Toronto, ON, M3B 3S6, Canada
| | - Grace Karam
- Humber River Family Health Team, 245 Dixon Road, Etobicoke, ON, M9P 2 M4, Canada
| | - Souraya Sidani
- Ryerson University, Daphne Cockwell School of Nursing, 350 Victoria Street, Toronto, ON, M5B 2 K3, Canada
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Menchik DA. Decisions about knowledge in medical practice: the effect of temporal features of a task. AJS; AMERICAN JOURNAL OF SOCIOLOGY 2014; 120:701-749. [PMID: 25848669 DOI: 10.1086/679105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A classic question of social science is how knowledge informs practice. Research on physicians' decisions about medical knowledge has focused on doctors' personal capabilities and features of the knowledge corpus, producing divergent findings. This study asks, instead, How is decision making about the use of knowledge influenced by features of work? From observations of one team's decisions in multiple clinical and administrative contexts, the author argues that making decisions is contingent upon temporal features of physicians' tasks. Physicians receive feedback at different speeds, and they must account for these speeds when judging what they can prioritize. This finding explains doctors' perceived uncertainty in other studies as a product of the long feedback loop in tasks, and their certainty or pragmatism as a product of shorter feedback loops. In these latter scenario's, physicians consider and deploy scientific knowledge after--and not before, as is usually assumed--determining a fruitful plan of action.
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Gau YM, Usher K, Stewart L, Buettner P. Burden experienced by community health volunteers in Taiwan: a qualitative study. Int J Nurs Pract 2013; 19:74-80. [PMID: 23432892 DOI: 10.1111/ijn.12024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In Taiwan, volunteers of each Community Health Promotion Development Centres help to diffuse healthy lifestyle education and complement the paid workforce, especially community nurses. An interpretive, descriptive qualitative design, using focus groups, was conducted to explore the burden experienced by community health volunteers in Taiwan. The data were analyzed inductively, and emergent themes were explored. The majority of participants were female between 50 and 59 years old with an average of 4.5 years experience as a volunteer. Thematic analysis resulted in four themes: preparation and scope of practice, lack of support for the role, work overload and expectations of the role. Volunteers in Taiwan do not always have the necessary skills to care for their clientele because of an inadequate programme of orientation, lack of continuing education and support for the role, role overload and expectations placed upon them by the clients and others.
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Affiliation(s)
- Yueh-Mei Gau
- School of Nursing, Midwifery and Nutrition, James Cook University, Townsville, Queensland, Australia.
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Hinton R, Earnest J. Stressors, coping, and social support among women in Papua New Guinea. QUALITATIVE HEALTH RESEARCH 2010; 20:224-38. [PMID: 20065306 DOI: 10.1177/1049732309357572] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
In this study we used an interpretive, ethnographic, qualitative approach to examine Papua New Guinean women's narratives and perceptions about their health and the ways in which these were linked to coping with personal adversity. Women used a variety of strategies to cope with psychosocial stressors and challenging life circumstances, including both reliance on their own agency and active efforts and the seeking of social and spiritual support. We observed that limited access to social and economic resources, combined with gender constraints, made women socially and culturally vulnerable to social strain that affected their physical and emotional health. A number of women used avoidance strategies that were related to lower levels of self-esteem and life satisfaction and displayed high levels of anxiety. We propose the need to understand the context in which coping takes place and to enhance resilience strategies used by women in developing countries such as Papua New Guinea to manage the multiple stressors associated with confronting life's challenges.
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Affiliation(s)
- Rachael Hinton
- Curtin University of Technology, Perth, Western Australia, Australia.
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Khunti K, Camosso-Stefinovic J, Carey M, Davies MJ, Stone MA. Educational interventions for migrant South Asians with Type 2 diabetes: a systematic review. Diabet Med 2008; 25:985-92. [PMID: 18959614 DOI: 10.1111/j.1464-5491.2008.02512.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To conduct a systematic review to determine the scope of published assessments of educational initiatives for South Asians with Type 2 diabetes living in Western countries and to consider the effectiveness of reported interventions. METHODS A range of electronic databases was searched using Medical Subject Headings (MeSH) and free text terms; papers published up to the end of 2007 were considered. Two researchers independently reviewed titles and abstracts and the full text of selected citations. Reference list review and consultation with experts in the field were used to check for completeness of the final sample of studies prior to data extraction. RESULTS Only nine studies, including five randomized controlled trials with a combined total of 1004 cases, met our inclusion criteria. The quality of reporting in some studies was limited, e.g. omission of detailed information about ethnicity. Selected studies included a range of group and one-to-one interventions with varied knowledge, psychological and biomedical outcome measures. The effectiveness of the interventions was also variable, and the low number and heterogeneity of the studies made identification of factors linked to effectiveness difficult and meta-analysis inappropriate. However, it appeared that improvements in knowledge levels may be easier to achieve than positive biomedical outcomes, and the need for tailored approaches was suggested. CONCLUSIONS Our findings confirm the difficulty of designing, assessing and achieving an impact through educational interventions for migrant South Asians with Type 2 diabetes and emphasize the need for good-quality studies in these high-risk populations.
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Affiliation(s)
- K Khunti
- Department of Health Scienes, University of Leicester, University Hospital of Leicester NHS Trust, Leicester, UK.
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