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Nagdee N, de Andrade VM, Banoo M. The dizzying cycle: a qualitative study showing the effects of vestibular disorders and stress on work experience. Int J Audiol 2024; 63:431-438. [PMID: 37079320 DOI: 10.1080/14992027.2023.2199444] [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: 04/13/2022] [Accepted: 03/28/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE Quantitative studies have explored the work abilities of persons with specific vestibular-related symptoms, but there seems to be a dearth of research that has explored the work experience of persons-with- vestibular- disorders, so this qualitative study explored this phenomenon. DESIGN Audio-recorded semi-structured interviews were conducted online. Thematic analysis was used to analyse the transcripts. Together, two researchers coded the transcripts and deductively identified the main themes on the main components of the expanded International Classification of Functioning, Disability, and Health scheme, and thereafter generated the sub-themes inductively. STUDY SAMPLE Fourteen people with various vestibular disorders and occupations in South Africa participated in the study. RESULTS Participants reported having difficulty performing work-related tasks requiring attention to detail and ambulation, and work environmental conditions triggered their vestibular-related symptoms. Some participants received time off from work and support from their supervisors and colleagues, while others did not. Seeking mental services allowed them to overcome their negative feelings, medication suppressed their vestibular-related symptoms, and vestibular rehabilitation allowed them to focus on their work. CONCLUSION Vestibular-related symptoms may hinder persons- with- vestibular- disorders from completing and participating in work-related activities, which may result in them experiencing negative feelings. The nature of some of the work-related tasks that they need to complete and experiencing negative feelings may trigger their vestibular-related symptoms. Together, the work-related activity limitations, participation restrictions, and environmental and personal factors may cause persons- with- vestibular- disorders to experience disability in their workplaces. To prevent this potential disability, persons with vestibular disorders should be supported by and receive workplace accommodations. Furthermore, they should be enrolled into work rehabilitation programmes that include, vestibular rehabilitation, medication regimens, and mental health services.
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Affiliation(s)
- Nabeelah Nagdee
- Department of Speech-Pathology and Audiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Victor Manuel de Andrade
- Department of Speech-Pathology and Audiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Mahdiyyah Banoo
- Department of Speech-Pathology and Audiology, University of the Witwatersrand, Johannesburg, South Africa
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Gwata D, Ventriglio A, Hughes P, Deahl M. Structural inequalities, knife crime: A qualitative study. Int J Soc Psychiatry 2024; 70:667-678. [PMID: 38557268 DOI: 10.1177/00207640231221092] [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: 04/04/2024]
Abstract
The importance and impact of youth violence is increasingly being recognised and is a cause of international concern. In the UK, youth violence, specifically knife crime, is on the increase and has resulted in the deaths of many young people. In order to explore the impact of knife crimes on mental health and wellbeing of individuals, a number of focus groups were conducted with 24 professionals from multiple agencies. Qualitative analysis showed various emerging themes, which included ineffective mental health systems, structural violence and inequalities, policing, safety and community engagement, vulnerability and resilience in minority communities. Equity in mental health services, further development and roll-out of public mental health approaches and training accompanied by sufficient resources is needed.
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Affiliation(s)
| | | | | | - Martin Deahl
- Institute of Psychiatry, Kings College, London, UK
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Hodgetts Morton V, Man R, Perry R, Hughes T, Tohill S, MacArthur C, Magill L, Morris RK. Childbirth Acquired Perineal Trauma study (CHAPTER): a UK prospective cohort study protocol. BMJ Open 2024; 14:e086724. [PMID: 38803248 PMCID: PMC11129024 DOI: 10.1136/bmjopen-2024-086724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Childbirth-related perineal trauma (CRPT) is the most common complication of childbirth affecting 80% of women overall after vaginal birth. There remains a lack of comprehensive evidence relating to the prevalence of subsequent health problems. Current evidence is related to short-term outcomes, for example, pain, but there is less known about longer-term outcomes such as infection, wound dehiscence, pelvic floor function and psychological outcomes. This is a protocol for a cohort study assessing outcomes of women after CRPT. METHODS AND ANALYSIS A multicentre, prospective UK cohort study aiming to include 1000 women. All women who have sustained CRPT will be eligible for inclusion and will be followed-up for 12 months after childbirth. The primary outcome will be perineal infection at 6 weeks post-birth. Secondary outcomes will include antibiotic use for perineal infection, wound breakdown, use of analgesia, the requirement for admission or surgical intervention, urinary and faecal incontinence, anxiety and depressive symptoms, sexual function and impact on daily activities. Outcomes will be measured at 6 weeks, 6 months and 12 months post partum, with some outcomes being measured at all time points and others at selected most appropriate time points only. Outcome data will be obtained from a review of clinical notes and from patient questionnaires. Simple descriptive statistics will be used to summarise characteristics and outcomes, with categorical variables expressed as percentages and continuous variables as mean averages, alongside the corresponding standard deviatons. ETHICS AND DISSEMINATION Ethical approval has been granted by the Research Ethics Council with reference 23/WA/0169. Data collected from the Childbirth Acquired Perineal Trauma (CHAPTER) cohort study will highlight the prevalence and type of complications after CRPT and which women are more at risk. After the conclusion of this study, findings will be used to work with governmental organisations and Royal Colleges to target resources and ultimately improve care.
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Affiliation(s)
- Victoria Hodgetts Morton
- Birmingham Women's Hospital, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rebecca Man
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rita Perry
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Terry Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Susan Tohill
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Christine MacArthur
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Laura Magill
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - R Katie Morris
- Birmingham Women's Hospital, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Keefner T, Minton M, Antonen K. Embracing Emotional Pain: A Case Study of Adolescent Suicidality and Spirituality. J Am Psychiatr Nurses Assoc 2024; 30:397-408. [PMID: 36016492 DOI: 10.1177/10783903221118932] [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: 11/16/2022]
Abstract
BACKGROUND Suicidality continues to be the second leading cause of adolescent death. Nurses are in a prime position to address the emotional pain associated with adolescent suicidality but report skepticism and discomfort. Moreover, spirituality is identified as a protective factor against suicidality, yet a gap exists related to exploring spirituality within the context of the emotional pain associated with adolescent suicidality. Building awareness of adolescents' spirituality and emotional pain associated with suicidality is essential to address nurse skepticism and discomfort. AIMS The purpose of this study was to explore young adults' experiences of suicide attempt(s) during adolescence in the context of spirituality using a case study application of participant narratives to Minton and Antonen's B.L.E.S.S. acronym. METHOD A multiple-case study design was used to provide an alternative perspective for understanding adolescent suicidality from a spiritual context. Reed's theory of self-transcendence and the B.L.E.S.S. acronym guided the analysis and interpretation. Convenience online sampling resulted in six adult participants who provided email narratives of their adolescent experiences. Email data collection was guided by Fritz and Vandermause. Analysis of participant narratives followed the protocol of Baxter and Jack. RESULTS Participant's narratives revealed self-transcendence that paralleled the five truths about emotional pain and spirituality inherent in the B.L.E.S.S. acronym. CONCLUSION This case study provides nurses a guide for counteracting the barriers of skepticism and stigma to promote help-seeking behavior associated with adolescent suicidality. Further research is needed for the application of the B.L.E.S.S. acronym with other population samples.
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Affiliation(s)
- Tamara Keefner
- Tamara Keefner, PhD, RN, CNE, University of South Dakota, Vermillion, SD, USA
| | - Mary Minton
- Mary Minton, PhD, RN, CHPN, South Dakota State University, Brookings, SD, USA
| | - Kathy Antonen
- Kathy Antonen, PhD, South Dakota School of Mines and Technology, Rapid City, SD, USA
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Kabeya V, Puthussery S, Furmanski A. Barriers and facilitators to genetic testing for breast and ovarian cancer amongst Black African women in Luton (UK). J Genet Couns 2024; 33:425-444. [PMID: 37403830 DOI: 10.1002/jgc4.1742] [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: 11/24/2021] [Revised: 04/22/2023] [Accepted: 05/28/2023] [Indexed: 07/06/2023]
Abstract
Evidence suggests that although Black African women have the lowest incidence of breast and ovarian cancer, they have the highest mortality rate and low rates of uptake for cancer screening services for these conditions in the United Kingdom (UK). This study aimed to explore the perceived barriers and facilitators to genetic testing for breast and ovarian cancer amongst Black African women in Luton (UK). We conducted a qualitative study that included one face-to-face and five telephone focus group discussions. Consistent with the health belief model, a focus group discussion guide was developed. A total of 24 participants, aged 23-57 who self-identified as Black African women and who were English speakers residing in Luton, took part in the focus group discussions. Purposive and snowballing sampling were used to recruit the participants for this study. The focus group discussions were recorded, transcribed per verbatim, coded and analyzed using an inductive thematic analysis approach, and the findings were classified. Nine themes emerged from the narratives obtained including six barriers and three facilitators. Barriers to genetic testing included (1) Cost and affordability, (2) Lack of knowledge, awareness, and family health history knowledge, (3) Language barrier, immigration, and distrust in western healthcare services, (4) Fear, (5) Cultural, religious, and intergenerational views and perceptions, and (6) Eligibility for genetic testing for the BRCA1/2 pathogenic variants and a lack of referral to specialist genetic clinics. Facilitators to genetic testing included (7) Availability of tests cost-free under the National Health Service (NHS) (8) Family members' health and (9) Awareness and education on genetic testing. The barriers and facilitators identified could enable policy makers and healthcare services alike to gain a better understanding of the factors influencing Black African women's decision-making process toward genetic testing. Ultimately, this work can inform interventions aiming to increase the uptake of genetic testing among this group.
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Affiliation(s)
- Valencia Kabeya
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Luton, UK
| | - Shuby Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Luton, UK
| | - Anna Furmanski
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Diaz MA, Angus FC, Bickenbach JE. Perceived barriers and facilitators to good end of life care: Focusing on people with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13186. [PMID: 38097500 DOI: 10.1111/jar.13186] [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: 04/17/2023] [Revised: 10/25/2023] [Accepted: 12/01/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND People with intellectual disabilities are often left out of research on important topics. This exploratory study investigated their views on barriers and facilitators to accessing care at end of life, both at home and in a hospice setting. METHOD This qualitative study used reflexive thematic analysis. Two focus groups were held via Zoom with a total of four participants. RESULTS Three themes were produced: Unsettling Transitions, Maintaining Familiarity, and Respecting People's Wishes. Keeping things as unchanged as possible at end of life was highlighted as an ideal. Respecting people's wishes and education were highlighted as facilitators to good end of life care. CONCLUSIONS The themes identified in this study highlight the fears and wishes of this population with regards to receiving quality end of life care. Training for staff and families, as well as advanced care planning, could focus on enhancing facilitators and decreasing barriers for this population.
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Affiliation(s)
| | | | - Jerome E Bickenbach
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Nyatanga B, Wormington R, Wilkinson L. Exploring the experiences of adults adjustment when living with a primary brain tumour. Int J Palliat Nurs 2024; 30:66-78. [PMID: 38407152 DOI: 10.12968/ijpn.2024.30.2.66] [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: 02/27/2024]
Abstract
BACKGROUND Brain tumours are the ninth most common cancer in the UK, and account for 3% of all new cancer cases. AIM To understand the impact of living with a primary brain tumour and identify adjustments that patients make in order to cope with their condition. This also encomapsses the impact of interventions like support groups in terms of care and therapeutic value. METHODS After ethical approval, a qualitative approach was employed, which set out to interview 11 adult patients living with primary brain tumours. The interviews were conducted face-to-face and were semi-structured interviews. Interview data were coded and thematic analysis used. FINDINGS Four themes were developed, namely: adjustment; loss of independence; support; and health and symptoms. CONCLUSION Living with a brain tumour leads to an inevitable adjustment to maintain day-to-day life. The findings suggest there are a number of adjustments that patients make to maintain some independence. Many people valued the support they received from support groups, while others felt that the support they received was inadequate. The mandatory loss of a driving licence for people in the UK was the most concerning. Its removal led to a loss of confidence and made them immediately dependent on others for travel. While support was provided, there was an apparent omission in the provision of psychological support. Oncology and palliative care nurses are in key positions to explore psychological concerns and offer tailored support.
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Affiliation(s)
- Brian Nyatanga
- Lead researcher, Senior Lecturer, Palliative and End of Life Care, University of Worcester
| | | | - Lucy Wilkinson
- Co-researcher, Support Professional, Brain Tumour Support
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Tawankanjanachot N, Truesdale M, Orachon P, Kidd L. Social skills interventions for Thai adolescents with Autism Spectrum Disorder (ASD): a qualitative study of the perceptions and experiences of Thai adolescents, their caregivers and healthcare professionals. Int J Ment Health Syst 2024; 18:1. [PMID: 38167087 PMCID: PMC10763348 DOI: 10.1186/s13033-023-00617-3] [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: 10/28/2022] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Social skills interventions (SSIs) are effective for enhancing social skills and decreasing mental health problems in adolescents with autism spectrum disorder (ASD). However, these interventions have been designed and their effectiveness has been established in Western countries. Lack of culturally acceptable SSIs for Asian nations is a possible barrier to implementing effective and tailored interventions that address the unique requirements of ASD individuals across countries and cultures. This study aims to explore the needs and preferences of adolescents with ASD, their caregivers, and healthcare professionals (HPs) in Thailand regarding the components, delivery formats, and cultural adaptation required for an outpatient-based social skills intervention. METHODS Qualitative data was collected via three focus groups of HPs (n = 20) and 24 paired interviews with adolescents with ASD and their caregivers from a child psychiatric hospital in Thailand. Purposive sampling was employed, and thematic analysis was used to analyse the data. RESULTS Nine themes emerged from the data generated by HPs, and seven from adolescents with ASD and their caregivers. SSIs for Thai adolescents with ASD and their caregivers should emphasise specific social skills training and assess the abilities of adolescents as required. Incorporating various learning strategies is important. Parental involvement is essential and provides knowledge of an adolescent's symptoms and coaching skills, which are best used to support their adolescents. Cultural considerations include the need for social knowledge of Thai culture, promoting assertiveness and praising parents' abilities, implementing a programme in time to not interrupt academic achievement, and renaming a programme from social skills intervention to social communication intervention. Barriers to implementing a programme included HPs' need for specialised training and education and decreased workload. Also, the caregivers' and adolescents' stigma reduced attendance in a programme. Increased extra compensation and relocation days off are provided as policy support for staff who deliver the intervention. CONCLUSION The results suggest that SSIs for Thai adolescents with ASD should be tailored to meet the needs for specific knowledge, skills, and parental collaboration as coaches for their adolescents. Additionally, it should incorporate Thai culture. It is necessary to consider staff knowledge, workload, and stigma in order to reduce barriers to implementation in practice.
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Affiliation(s)
- Nadlada Tawankanjanachot
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, 57-61 Oakfield Avenue, Glasgow, G12 9LL, UK.
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Maria Truesdale
- School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 0XH, UK
| | - Pornpun Orachon
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health, Ministry of Public Health, Samut Prakan, 10270, Thailand
| | - Lisa Kidd
- School of Health & Life Sciences, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, G4 OBA, UK
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Gwon SH, Thongpriwan V, Mobarki A, Eyadat A, Noonan D. Experiences and Perceptions of E-Cigarette Cessation for Young Adults in Rural Communities. Nurs Res 2024; 73:46-53. [PMID: 37768961 DOI: 10.1097/nnr.0000000000000692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are the most commonly used tobacco products among young adults in the United States. Young adults in rural areas have a higher prevalence of ENDS use compared to their urban counterparts, yet there is limited evidence regarding the in-depth understanding of experiences and perspectives directly from young adults. OBJECTIVES The aim of this study was to explore individual experiences and perspectives about use and cessation of ENDS from young adults in rural areas. METHODS This was a qualitative study using interpretive description for analysis. Young adults (18-24 years) who used ENDS every day but not other tobacco products (cigarettes, smokeless, etc.) in the past month and had an address in a rural county of Wisconsin were eligible; there were nine participants interviewed using Zoom. Interview questions focused on initial use, maintenance of use, experiences of quitting, and social and rural environmental contexts regarding ENDS. RESULTS Three themes emerged with eight categories: (a) addiction to ENDS and health, (b) cessation and resources, and (c) rural environment and culture in ENDS addiction. DISCUSSION Findings have implications for ENDS cessation interventions targeting young adults in rural areas.
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McCaffrey J, Terao M, McCaffrey C, Igoe A, Loughran O, McDonagh K, McDonogh S, Shackleton E, Whooley E, Jelovac A, McLoughlin DM, Hunter A. Protocol Development for a Qualitative Methodological Study Within a Trial (Qual-SWAT): The KARMA-Dep-2 Trial. HRB Open Res 2023; 6:29. [PMID: 37361338 PMCID: PMC10285324 DOI: 10.12688/hrbopenres.13721.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 06/28/2023] Open
Abstract
Background Despite methodological improvements in clinical trial design and conduct more generally, methodological limitations persist in trials concerning mental health care. A qualitative Study Within A Trial (Qual-SWAT), embedded in the KARMA-Dep-2 host trial, will be undertaken to explore and gain an understanding of two methodological questions in randomised trials specific to mental health care: (1) what are the key barriers and enablers of participation in randomised trials in mental health; and (2) how can randomised trials become part of routine mental health care. These issues will be examined from patient-participant and clinician- / researcher-participant perspectives, in alignment with PRioRiTy research themes. Methods A descriptive qualitative study design will be used. Data will be collected via one-to-one semi-structured interviews, conducted via Microsoft Teams. The interview data will be analysed using Braun and Clarke's Thematic Analysis approach. One-to-one interviews will be conducted with three participant groups ( N = 30): 1) host trial patient-participants ( n = 10); 2) potentially eligible host trial patient-participants who refused enrolment in the host trial ( n = 10); and 3) clinician- / researcher-participants who are associated with work on the host trial ( n = 10). Ethics and dissemination Ethical approval has been granted by St. Patrick's Mental Health Services Research Ethics Committee, Ireland (Ref: Protocol 09/20). When the study is completed, a report will be prepared and submitted to the Health Research Board (HRB). Findings will be shared with the host trial team and study participants, and submitted for publication. Host trial registration ClinicalTrials.gov ( NCT04939649); EudraCT ( 2019-003109-92). Official title: Ketamine as an Adjunctive Therapy for Major Depression - A Randomised Controlled Trial: [KARMA-Dep (2)].
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Affiliation(s)
- John McCaffrey
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Masashi Terao
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Cathal McCaffrey
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Anna Igoe
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Orlaith Loughran
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Kelly McDonagh
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Sarah McDonogh
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Ellie Shackleton
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Emma Whooley
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Ana Jelovac
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
| | - Declan M. McLoughlin
- Department of Psychiatry, Trinity College Dublin, St. Patrick’s University Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Andrew Hunter
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Qualitative Research in Trials Centre (QUESTS), University of Galway, Galway, Ireland
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Saleh EA, Klapprott F, Heinz A, Kluge U. Challenges in substance use treatment as perceived by professionals and Arabic-speaking refugees in Germany. Subst Abuse Treat Prev Policy 2023; 18:69. [PMID: 37978534 PMCID: PMC10656940 DOI: 10.1186/s13011-023-00576-5] [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: 05/01/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Substance use (SU) and substance use disorders (SUDs) have been recently documented among forcibly displaced populations as a coping mechanism to migration and postmigration stressors. Although the literature exploring substance use among refugees has grown recently, little is known about SU among Arabic-speaking refugees and, more specifically, on the challenges and experiences in regards to SU treatment. This study investigates this topic from the perspectives of Arabic-speaking refugees and professionals in Germany. METHODS Design and participants To expand our knowledge on this topic, a qualitative approach was employed by conducting in-depth and semi-structured interviews among 26 participants (13 refugees and 13 professionals) in Germany during 2020-2021. Purposive sampling was used to recruit Arabic-speaking refugees in two rehabilitation centers in Berlin. Data and analysis Interviews were conducted with 26 participants of which 13 were refugees and 13 professionals. Refugees were interviewed individually in the rehabilitation centers, they ranged from 21 to 52 years of age, and their average time in Germany was 6.3 years. An open-ended survey was conducted among the professionals via the SoSci-survey platform, and they ranged from 22 to 66 years of age, with an average of 5 to 9 years of work experience. Data were analyzed using thematic analysis. RESULTS Three themes resulted from the thematic analysis: (1) The treatment is facilitated by institutional and emotional support; (2) The affected refugees struggle with complex contextual barriers to access SUD treatment; and (3) Individual and community preventive strategies are needed. CONCLUSIONS This study provides insight into the support and challenges of accessing effective SU treatment and prevention among Arabic-speaking refugees in Germany. Collaborative efforts by the community, professionals, and policymakers are needed to facilitate access to effective treatment and implement culturally and linguistically sensitive approaches for the treatment and prevention of SU among refugees.
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Affiliation(s)
- Ebtesam A Saleh
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany.
- Department of Pharmacology, Faculty of Pharmacy, University of Aden, Aden, Yemen.
| | - Felix Klapprott
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute for Integration and Migration Research (BIM), Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ulrike Kluge
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute for Integration and Migration Research (BIM), Humboldt-Universität zu Berlin, Berlin, Germany
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Bailey C, Guo P, MacArtney J, Finucane A, Meade R, Swan S, Wagstaff E. "Palliative care is so much more than that": a qualitative study exploring experiences of hospice staff and bereaved carers during the COVID-19 pandemic. Front Public Health 2023; 11:1139313. [PMID: 38026434 PMCID: PMC10662348 DOI: 10.3389/fpubh.2023.1139313] [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: 05/18/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background The way in which end-of-life care was provided changed significantly during the first 2 years of the COVID-19 pandemic. The national lockdown restrictions reduced formal care support services and increased the burden on many carers taking on the caring role for the first time. We aimed to explore decision-making about the place of care during the COVID-19 pandemic and the impact on experience from the perspectives of carers and hospice staff caring for people at the end-of-life. Methods A qualitative study using virtual interviews was conducted between October 2020 and April 2021. Data were analyzed thematically using framework analysis, an analytical framework that enables qualitative research to be organized into defined themes derived from the research question. Findings were presented to stakeholders in policy roundtables between March 2022 and March 2023 and discussed collaboratively with staff, stakeholders, and the public to inform policy and practice change. Findings A total of 37 participants (15 bereaved carers and 22 staff) were recruited via hospice services in England and Scotland. Four key themes were identified: (1) changing preferences relating to decision-making about the place of care and the impact at the time of death and into bereavement; (2) missed opportunities related to not being there, not having others around, and being robbed of memory-making; (3) the lone carer during a period of high intensity and reduced home support; (4) process vs. person-centered care resulting from changing rules and restrictions and prioritization of regulations over essential palliative care. Conclusion The study provides valuable global implications for all involved in end-of-life care. Despite great efforts to provide dignified, quality care, palliative care during the pandemic changed, focusing on essential 'physical care'. The psychological suffering experienced by staff and carers may need longer-term support mechanisms put in place, which will benefit from a public health approach. Policymakers should consider improving carer identification and resources for wider end-of-life care education to support the needs of carers, health and social care staff, and citizens.
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Affiliation(s)
- Cara Bailey
- School of Nursing and Midwifery, University of Birmingham, Birmingham, United Kingdom
| | - Ping Guo
- School of Nursing and Midwifery, University of Birmingham, Birmingham, United Kingdom
| | - John MacArtney
- Unit of Primary Care, University of Warwick, Coventry, United Kingdom
| | - Anne Finucane
- Clinical Psychology, University of Edinburgh, Edinburgh, United Kingdom
- Marie Curie Hospice, Edinburgh, United Kingdom
| | - Richard Meade
- Clinical Psychology, Carers UK, Edinburgh, United Kingdom
| | - Susan Swan
- Maggie's Glasgow, Glasgow, United Kingdom
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Jones S, Tyson S, Yorke J. Development and validation of the MAnchester Needs Tool for Injured Children (MANTIC). Clin Rehabil 2023; 37:1201-1212. [PMID: 36872874 PMCID: PMC10387723 DOI: 10.1177/02692155231158475] [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: 08/12/2022] [Accepted: 01/27/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE To develop a measure of the needs injured children and their families' needs throughout recovery; The MAnchester Needs Tool for Injured Children (MANTIC). DESIGN Tool development, psychometric testing. SETTING Five children's major trauma centres in England. PARTICIPANTS Children aged 2 to 16 years with any type of moderate/severe injury(ies) treated in a major trauma centre within 12 months of injury, plus their parents. METHODS Stage 1a (Item generation): Interviews with injured children and their parents to generate draft items. Stage 1b (Co-production): Feedback about item clarity, relevance and appropriate response options was provided by parents and the patient and public involvement group. Stage 2 (Psychometric development): Completion of the prototype MANTIC by injured children and their parents with restructuring (as necessary) to establish construct validity. Concurrent validity was assessed by correlation with quality of life (EQ-5D-Y). MANTICs were repeated 2 weeks later to assess test-retest reliability. RESULTS Stages 1a,b: Interviews (13 injured children, 19 parents) generated 64 items with semantic differential four-point response scale (strongly disagree, disagree, agree, strongly agree). Stage 2: One hundred and forty-four participants completed MANTIC questionnaires (mean age 9.8 years, SD 3.8; 68.1% male). Item responses were strong requiring only minor changes to establish construct validity. Concurrent validity with quality of life was moderate (r = 0.55, P < 0.01) as was test-retest reliability (ICC = 0.46 and 0.59, P < 0.001). Uni-dimensionality was strong (Cronbach's α > 0.7). CONCLUSION The MANTIC is a feasible, acceptable, valid self-report measure of the needs of injured children and their families, freely available for clinical or research purposes.
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Affiliation(s)
- Samantha Jones
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Department of Paediatric Trauma & Orthopaedics, Manchester Foundation Trust, Royal Manchester Children’s Hospital, Manchester, UK
- Manchester Academic Health Science Centre (MAHSC) Manchester, Manchester, UK
| | - Sarah Tyson
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre (MAHSC) Manchester, Manchester, UK
| | - Janelle Yorke
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre (MAHSC) Manchester, Manchester, UK
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Öcalan S, Üzar-Özçetin YS. "Cancer Never Goes Out of Your Mind Even for a Single Second". Cancer-Related Ruminations From the Perspectives of Cancer Survivors. Semin Oncol Nurs 2023; 39:151427. [PMID: 37069011 DOI: 10.1016/j.soncn.2023.151427] [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: 12/08/2022] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE This study aimed to explore a deeper understanding of how cancer survivors experience and manage ruminative thoughts. DATA SOURCES A descriptive qualitative design. The study was conducted with cancer survivors (n = 21). A semistructured interview guide was used for data collection, and content analysis method was implemented to gain a better understanding from the collected data. The study procedure and reporting adhere to the guideline for reporting qualitative research COnsolidated criteria for REporting Qualitative research (COREQ) checklist. CONCLUSION Three main themes were developed: "Struggling within cognitions", "Coping", and "Required needs". The results highlight that cancer survivors have intrusive ruminative thoughts about cancer and need support to cope with these thoughts. It was also found that over time, they experienced changes in their perspectives, gained meaning, and were able to use deliberate ruminations. IMPLICATIONS FOR NURSING PRACTICE Nurses have an effective role in providing care and determining the needs of individuals. Nurses can easily recognize intrusive ruminations, help cancer survivors raise awareness about the effects of ruminative thoughts on them, and support them in coping with intrusive ruminations using effective interventions.
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Affiliation(s)
- Sinem Öcalan
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey 06100.
| | - Yeter Sinem Üzar-Özçetin
- University College Dublin, School of Nursing, Midwifery, and Health Systems, UCD Health Sciences Centre, Dublin, Ireland
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15
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Jack SM, Orr E, Campbell KA, Whitmore C, Cammer A. A framework for selecting data generation strategies in qualitative health research studies. J Hum Nutr Diet 2023; 36:1480-1495. [PMID: 36617529 DOI: 10.1111/jhn.13134] [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: 06/30/2022] [Accepted: 01/03/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Qualitative health research has the potential to answer important applied health research questions to inform nutrition and dietetics practice, education and policy. Qualitative health research is a distinct subdiscipline of qualitative inquiry that purposefully draws upon the context of healthcare and emphasises health and wellness. METHODS Qualitative health research is defined by two parameters: (1) the focus of the study and (2) the methods used. When considering the methods to be used, decisions are required about the type of data to be generated (e.g., transcripts, images and notes) and the process involved in data generation (e.g., interviews, elicitation strategies and observations) to answer the research question(s). Drawing upon examples from nutrition and dietetics literature, this paper provides a framework to support decision-making for nutrition and dietetics researchers and clinician researchers designing conducting qualitative health research. RESULTS The guiding questions of the framework include: What types of data will be generated? Who is involved in data generation? Where will data generation occur? When will data generation occur? How will data be recorded and managed? and How will participants' and researchers' emotional safety be promoted? CONCLUSION Questions about the types of data, those involved, where and when, as well as how safety can be maintained in data generation, not only support a more robust design and description of data generation methods but also keep the person at the centre of the research.
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Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Orr
- Department of Nursing, Brock University, St. Catharines, Ontario, Canada
| | | | - Carly Whitmore
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Allison Cammer
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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16
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Reynish TD, Hoang H, Bridgman H, Easpaig BNG. Kink-Oriented People and Exogenous Oppressions: Understanding Mental Health and Related Service Use in a Rural Context. JOURNAL OF HOMOSEXUALITY 2023; 70:1479-1502. [PMID: 35113001 DOI: 10.1080/00918369.2022.2036531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Rural, kink-oriented people experience much exogenous oppression and yet related research is scarce. This study examined the risk and protective factors of kink-oriented rural Tasmanian Australians with preexisting mental health conditions and help-seeking barriers and facilitators. Participants completed either an online survey (n = 42), an interview (n = 10), or both. Thematic analysis and descriptive statistics were used to analyze the qualitative and quantitative data, respectively. Participants aged 18 to 61 were gender and sexually diverse and better educated but had more lifetime suicide attempts than the general public. Despite the increasing normalization of kink, 90.5% of participants have never seen a kink-aware mental health professional (MHP) and nearly 83.0% did not disclose to an MHP for fear of stigma or discrimination. Self-awareness, resilience, social support and kink improved participants' mental health. Tailored support from trained MHP is vital to improve the mental health of kink-oriented people in rural areas.
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Affiliation(s)
- Tamara D Reynish
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Bróna Nic Giolla Easpaig
- Centre for Healthcare Resilience & Implement Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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17
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James A, Boughton E, Pattni N, Thomas N, Bench S. Overcoming the challenges of recruiting and interviewing patients following critical illness. Nurse Res 2023; 31:11-18. [PMID: 36924132 DOI: 10.7748/nr.2023.e1854] [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: 12/07/2022] [Indexed: 03/18/2023]
Abstract
BACKGROUND The strict restrictions implemented in England during the COVID-19 pandemic meant it was no longer possible to recruit or interview participants in person. However, virtual recruitment and interviews are not without their challenges, particularly when exploring sensitive topics. AIM To discuss how to overcome some of the challenges involved in recruiting and interviewing participants who have been critically ill with COVID-19. DISCUSSION An exploratory, descriptive study was conducted involving interviews with 20 people who had been critically ill with COVID-19 and had been discharged from two community-based healthcare settings in London, England. Participants were interviewed at home after being discharged from hospital after at least one month. The sensitivity of the research topic meant strategies for recruiting and interviewing needed to be adapted, including involving patient experience facilitators, using virtual interviews, managing the distress of participants and self-care for the researchers. CONCLUSION The adaptations used in this study can be used in research involving people who have been critically ill. IMPLICATIONS FOR PRACTICE Researchers can explore innovative ways to recruit participants using hospital or community staff who are not usually involved in research. Virtual interviews require additional skills, such as building rapport with participants, so may require additional training. A distress protocol for participants should always be considered when discussing sensitive topics. Self-care and debrief strategies for interviewers are also critical.
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Affiliation(s)
- Alison James
- School of Health and Social Care, London South Bank University, London, England
| | - Emily Boughton
- Central London Community Healthcare NHS Trust, London, England
| | - Neeta Pattni
- Central London Community Healthcare NHS Trust, London, England
| | - Nicola Thomas
- School of Health and Social Care, London South Bank University, London, England
| | - Suzanne Bench
- School of Health and Social Care, London South Bank University, London, England
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18
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Jones L, Danks E, Costello B, Jolly K, Cross-Sudworth F, Latthe P, Fassam-Wright M, Clarke J, Byrne A, Taylor J. Views of female genital mutilation survivors, men and health-care professionals on timing of deinfibulation surgery and NHS service provision: qualitative FGM Sister Study. Health Technol Assess 2023; 27:1-113. [PMID: 36946235 PMCID: PMC10041342 DOI: 10.3310/jhwe4771] [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: 03/17/2023] Open
Abstract
Background Female genital mutilation is an important UK health-care challenge. There are no health benefits of female genital mutilation, and it is associated with lifelong physical, psychological and sexual impacts. The annual cost to the NHS to care for survivors is £100M. Deinfibulation may improve the health and well-being of some women, but there is no consensus on the optimal timing of surgery for type 3 survivors. UK care provision is reportedly suboptimal. Objectives We aimed to explore the views of survivors, men and health-care professionals on the timing of deinfibulation surgery and NHS service provision. Methods This was a qualitative study informed by the Sound of Silence framework. This framework is useful for researching sensitive issues and the health-care needs of marginalised populations. A total of 101 interviews with 44 survivors, 13 men and 44 health-care professionals were conducted, supplemented by two workshops with affected communities (participants, n = 10) and one workshop with stakeholders (participants, n = 30). Data were analysed using a hybrid framework method. Results There was no clear consensus between groups on the optimal timing of deinfibulation. However, within groups, survivors expressed a preference for deinfibulation pre pregnancy; health-care professionals preferred antenatal deinfibulation, with the caveat that it should be the survivor's choice. There was no consensus among men. There was agreement that deinfibulation should take place in a hospital setting and be undertaken by a suitable health-care professional. Decision-making around deinfibulation was complex. Deficiencies in professionals' awareness, knowledge and understanding resulted in impacts on the provision of appropriate care. Although there were examples of good practice and positive care interactions, in general, service provision was opaque and remains suboptimal, with deficiencies most notable in mental health. Deinfibulation reportedly helps to mitigate some of the impacts of female genital mutilation. Interactions between survivors and health-care professionals were disproportionately framed around the law. The way in which services are planned and provided often silences the perspectives and preferences of survivors and their families. Limitations Only a minority of the interviews were conducted in a language other than English, and the recruitment of survivors was predominantly through maternity settings, which meant that some voices may not have been heard. The sample of men was relatively small, limiting interpretation. Conclusions In general, service provision remains suboptimal and can silence the perspectives and preferences of survivors. Deinfibulation services need to be widely advertised and information should highlight that the procedure will be carried out in hospital by suitable health-care professionals and that a range of time points will be offered to facilitate choice. Future services should be developed with survivors to ensure that they are clinically and culturally appropriate. Guidelines should be updated to better reflect the needs of survivors and to ensure consistency in service provision. Future work Research is needed to (1) map female genital mutilation service provision; (2) develop and test effective education to address deficits in awareness and knowledge for affected communities and health-care professionals; and (3) develop, monitor and evaluate clinically and culturally competent female genital mutilation services. Trial registration Current Controlled Trials ISRCTN14710507. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment Programme and will be published in full in Health Technology Assessment; Vol. 27, No. 3. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Laura Jones
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Emma Danks
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Benjamin Costello
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Kate Jolly
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Fiona Cross-Sudworth
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Pallavi Latthe
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Joanne Clarke
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Alison Byrne
- University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Birmingham, UK
| | - Julie Taylor
- School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Reynish T, Hoang H, Bridgman H, Nic Giolla Easpaig B. Psychological Distress, Resilience, and Help-Seeking Experiences of LGBTIQA+ People in Rural Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2842. [PMID: 36833541 PMCID: PMC9956917 DOI: 10.3390/ijerph20042842] [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: 12/02/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
The aims of this paper were to explore mental health, the aspects associated with psychological distress and resilience, and the help-seeking experiences of LGBTIQA+ people. This research used a mixed-method approach using a survey and semi-structured interviews. The study was conducted in rural and remote Tasmania, Australia. Sixty-six participants completed the survey, and 30 participated in interviews. Participants reported a range of mental health concerns and varied experiences of accessing care and support in rural Australia. Depression and anxiety were the most common among participants. Almost half of all participants had attempted suicide in their lifetime, and just over a fifth had self-harmed. Two-thirds of the sample had high/very high psychological distress. For respondents, lacking social support was associated with increased psychological distress and low level of resilience. Public acceptance and social support enhanced interviewees' resilience. Interviewees experienced a lack of nearby mental health professionals, were unimpeded by operating hours, and trusted mental health professionals, which impacted help seeking and mental health. The findings indicate that acceptance, access and proximity to care, and mental health professionals' cultural competence would benefit rural Tasmanian LGBTIQA+ peoples' mental health. There is a need to improve public education, improve mental health professionals' curricula, and provide inclusive and tailored mental health care.
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Affiliation(s)
- Tamara Reynish
- Centre for Rural Health, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston, TAS 7250, Australia
| | - Ha Hoang
- Centre for Rural Health, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston, TAS 7250, Australia
| | - Heather Bridgman
- Centre for Rural Health, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston, TAS 7250, Australia
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20
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Manor-Binyamini I, Schreiber-Divon M. Exposing the Secret: Listening to Bedouin Men Who Have Experienced Sexual Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3468-3488. [PMID: 35658742 DOI: 10.1177/08862605221107054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There are few indigenous men's voices regarding sexual violence against them, particularly concerning Bedouin men's views. How do Bedouin men who have experienced SV describe, perceive, and interpret their experiences in their cultural context? Seventeen Bedouin men, residents of either recognized or unrecognized Bedouin settlements in the Negev, Israel. Phenomenological semi-structured interviews were recorded, transcribed verbatim, and then translated into English. Themes were generated using thematic analysis. Three main themes were found: descriptions of the incidents, reactions to the experiences, and the need for keeping incidents of SV secret due to the stigma involved as a result of patriarchal, political (i.e., tribal hierarchy), and private (i.e., family loyalty) norms, and the matrix of multiple and often conflicting roles and identities that Bedouin men must assume despite their experiences. The incidence of SV against men in the Bedouin community is alarming and must be acknowledged by the research community and public health practitioners as a serious health issue that requires more holistic research to better understand the men's experiences. More efforts are needed on the local, regional, and global levels to provide post-violence care for survivors and to prevent SV. In particular, there is a need to reduce the stigma associated with SV so that young men will be willing to speak up about their trauma without shame and receive help.
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21
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Gwon SH, Thongpriwan V, Kett P, Cho Y. Public health nurses' perceptions and experiences of emergency preparedness, responsiveness, and burnout during the COVID-19 pandemic. Public Health Nurs 2023; 40:124-134. [PMID: 36271604 PMCID: PMC9874467 DOI: 10.1111/phn.13141] [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: 05/05/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE(S) To describe PHNs' perceptions and experiences of the COVID-19 pandemic, including training, response activities, and work-related challenges. DESIGN This was a qualitative study using interpretive description for analysis. SAMPLE PHN participants who worked in public health departments in Wisconsin were recruited using purposive sampling. A total of 15 PHNs participated in the study, including both general and supervisor-level PHNs. MEASUREMENTS Data were collected via semi-structured interviews from March to May 2021. Interview questions focused on PHNs' perceptions, experiences, response activities, and burnout in relation to the current pandemic as well as perceptions and experiences of emergency preparedness and response in general. RESULTS Five themes emerged in the study. These were: (1) experiences and observations of the COVID-19 pandemic, (2) organizational changes and their impacts, (3) public health emergency preparedness and response, (4) public health emergency response activities, and (5) role strain and burnout. CONCLUSIONS Findings presented here have important implications for PHN training and support in emergency preparedness and response. A wide array of strategies focused on developing and supporting the PHN workforce in response to the public health crisis this area need to be implemented at the organizational, community, and policy levels.
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Affiliation(s)
- Seok Hyun Gwon
- College of NursingUniversity of Wisconsin–MilwaukeeMilwaukeeWisconsin
| | | | - Paula Kett
- Center for Health Workforce Studies, Department of Family MedicineUniversity of WashingtonSeattleWashington
| | - Young Cho
- Joseph J. Zilber School of Public HealthUniversity of Wisconsin–MilwaukeeMilwaukeeWisconsin
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22
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Sen Mukherjee A, Barr M. ‘A blessing and a burden’: Exploring post traumatic growth in doctors with acquired invisible disability—An interpretative phenomenological analysis. Br J Health Psychol 2022; 28:586-603. [PMID: 36526305 DOI: 10.1111/bjhp.12642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 11/03/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Qualitative studies of the relationship between acquired invisible disability (AcqID) and posttraumatic growth (PTG) are scant, especially in the context of healthcare professionals. This study aimed to explore in-depth accounts of the lived experience of PTG in doctors with AcqID arising from physical illness with cognitive dysfunction. DESIGN Five doctors who had been diagnosed in the last decade with a physical illness with cognitive dysfunction resulting in an AcqID, and who self-reported at least one feature of PTG participated in this qualitative research study. METHODS Semi-structured interviews were used to collect data, which were analysed using interpretative phenomenological analysis. RESULTS This study recognized that AcqID supported a process of PTG for participants. Three superordinate themes were apparent across the sample: identity (The human left behind), self (Acceptance of the disabled self), and rebirth (The phoenix rises from the ashes). Human connection, service as a value, and the role of the body were found to be key facilitators of PTG in these participants. This study offers new perspectives on cognitive-embodied appreciation in facilitating PTG in doctors with AcqID. CONCLUSIONS While the participants perceived AcqID with cognitive dysfunction to be a trauma, they also experienced PTG, Corporeal PTG and a new considered domain, Cognitive-Embodied PTG. The unrealised potential of PTG can be harnessed if doctors with disability are viewed as assets to the medical profession, and diversity is promoted through the provision of appropriate support. Thus, there is potential to cultivate a flourishing, inclusive, and compassionate culture within medicine.
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Affiliation(s)
| | - Margaret Barr
- School of Psychology University of East London London UK
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Nwankwo H, Coast J, Hewison A, Kinghorn P, Madathil S, Bailey C. A think-aloud study of the feasibility of patients with end-stage organ failure completing the ICECAP-SCM. Palliat Med 2022; 36:1559-1569. [PMID: 36114631 PMCID: PMC9749016 DOI: 10.1177/02692163221122979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The ICECAP-Supportive Care Measure (SCM) is a self-complete measure developed to inform economic decision making at the end-of-life. Previous research has demonstrated its feasibility in hospice and nursing home settings. This is the first study of its use with patients on the organ failure trajectory. AIM To determine the feasibility of using the ICECAP-SCM with patients experiencing end-stage organ failure in a hospital setting. DESIGN Participants were asked to 'think aloud' when completing the ICECAP-SCM, ICECAP-A and EQ-5D-5L measures. The interviews were transcribed verbatim and examined for errors in comprehension, retrieval, judgement, and response by five raters. Qualitative data were collected to explore reasons for errors in completing the measures and participants' views about the measures. SETTING/PARTICIPANTS Sixty patients (with end-stage renal failure n = 18; end-stage heart failure n = 21; end-stage chronic obstructive pulmonary disease n = 21) participated. Senior clinicians applied prognostic criteria to determine eligibility. RESULTS Participants reported that the measures were acceptable, clear, and easy to complete. Error rates in completing the measures were low (ICECAP-A = 3%,and ICECAP-SCM = 5.7% and EQ-5D-5L = 6.3%). There was some variation in responses between patients with different end-stage conditions, particularly those with symptom fluctuation. Some patients had not considered their end-of-life (i.e. advance care planning) and reported finding questions about this difficult to answer. CONCLUSION It is feasible to use the ICECAP-SCM with patients with end-stage organ failure receiving care in hospital settings. This study provides evidence for researchers and policy makers involved in measuring end-of-life care globally. The ICECAP-SCM can be recommended for research with patients in end-stage organ failure to appropriately capture the broader benefits of end-of-life care.
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Affiliation(s)
- Henry Nwankwo
- Centre for Health Economics at Warwick, Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Joanna Coast
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alistair Hewison
- School of Nursing, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Philip Kinghorn
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Shyam Madathil
- Respiratory Medicine Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Cara Bailey
- School of Nursing, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Reynish TD, Hoang H, Bridgman H, Nic Giolla Easpaig B. Mental health and related service use by sex workers in rural and remote Australia: 'there's a lot of stigma in society'. CULTURE, HEALTH & SEXUALITY 2022; 24:1603-1618. [PMID: 34704889 DOI: 10.1080/13691058.2021.1985616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
Sex workers experience risk and protective factors that affect their psychological well-being, yet little is known about sex workers' mental health and their experiences with related services in rural and remote Tasmania, Australia. Semi-structured interviews were conducted with six current or former sex workers with pre-existing mental health problems, and thematic analysis was used to identify their experiences with mental health and related care. Generally, sex work does not contribute to participants' mental health concerns; rather, social exclusion and systemic issues cause psychological harm. Ineffective mental health professionals and the lack of tailored or culturally competent support serve as barriers to care. Significantly, widespread stigma was both a risk factor to participants' mental health and a barrier to help seeking and resulted in isolation and identity concealment. Resilience, self-awareness and social inclusion reduce the psychological impact of exogenous oppression and encourage help seeking. The decriminalisation of sex work could improve sex worker mental health and reduce stigma by normalising sex work.
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Affiliation(s)
- Tamara D Reynish
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
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Kwan C, Tam HC. "What If I Die and No One Notices?" A Qualitative Study Exploring How Living Alone and in Poverty Impacts the Health and Well-Being of Older People in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15856. [PMID: 36497930 PMCID: PMC9739217 DOI: 10.3390/ijerph192315856] [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: 10/31/2022] [Revised: 11/24/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Despite the growing number of older people who live alone and in poverty, the intersection of these two social risk factors and the impacts on older adults' health and well-being have not been widely examined. This qualitative study explores the challenges and strengths of 47 older people who live alone and in poverty in Hong Kong. Thematic analysis was used to identify eight themes related to challenges: (i) social isolation and loneliness, (ii) self-esteem and self-efficacy, (iii) declining mobility, health and activity levels, (iv) high medical expenses, (v) age discrimination and long wait times for medical health services, (vi) age discrimination, retirement, and wanting part-time employment, (vii) not enough gender-specific social participation activities, and (viii) housing insecurity. Four themes related to strengths were identified: (i) An "I have enough" mindset, (ii) strong formal social support, (iii) contributing to the community and others, and (v) "Most of us like to be alone." Successfully addressing poverty in old age and tackling the challenges associated with living alone will require focusing on and activating not only external and systemic resources but also the intrinsic capacities and strengths of older adults themselves. Five discussion points are raised addressing the implications for future gerontological research and practice.
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Blair C, Shields J, Mullan R, Johnston W, Davenport A, Fouque D, Kalantar-Zadeh K, Maxwell P, McKeaveney C, Noble H, Porter S, Seres D, Slee A, Swaine I, Witham M, Reid J. Exploring the lived experience of renal cachexia for individuals with end-stage renal disease and the interrelated experience of their carers: Study protocol. PLoS One 2022; 17:e0277241. [PMID: 36327348 PMCID: PMC9632830 DOI: 10.1371/journal.pone.0277241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Renal cachexia is an important consideration in the person-centred care that is needed in end-stage renal disease (ESRD). However, given that clinical guidelines relating to renal cachexia are largely absent, this is an unmet care need. To inform guidelines and future renal service planning, there is an urgency to understand individuals’ experiences of renal cachexia and the interrelated experiences of the carers in their lives. We report here the protocol for an interpretative phenomenological study which will explore this lived experience. A purposive sampling strategy will recruit individuals living with ESRD who have cachexia and their carers. A maximum of 30 participants (15 per group) dependent on saturation will be recruited across two nephrology directorates, within two healthcare trusts in the United Kingdom. Individuals with renal cachexia undergoing haemodialysis will be recruited via clinical gatekeepers and their carers will subsequently be invited to participate in the study. Participants will be offered the opportunity to have a face-to-face, virtual or telephone interview. Interviews will be audio-recorded, transcribed verbatim and analysed using interpretative phenomenological analysis. NVivo, will be used for data management. Ethical approval for this study was granted by the Office for Research Ethics Committees Northern Ireland (REC Reference: 22/NI/0107). Scientific evidence tends to focus on measurable psychological, social and quality of life outcomes but there is limited research providing in-depth meaning and understanding of the views of individuals with renal disease who are experiencing renal cachexia. This information is urgently needed to better prepare healthcare providers and in turn support individuals with ESRD and their carers. This study will help healthcare providers understand what challenges individuals with ESRD, and their carers face in relation to cachexia and aims to inform future clinical practice guidelines and develop supportive interventions which recognise and respond to the needs of this population.
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Affiliation(s)
- Carolyn Blair
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Joanne Shields
- Regional Nephrology Unit, Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - Robert Mullan
- Renal Unit, Antrim Area Hospital, Northern Health & Social Care Trust, Antrim, United Kingdom
| | - William Johnston
- Northern Ireland Kidney Patients Association, Belfast, United Kingdom
| | - Andrew Davenport
- UCL Department of Renal Medicine Royal Free Hospital University College London, London, United Kingdom
| | - Denis Fouque
- Division of Nephrology, Dialysis and Nutrition, Hôpital Lyon Sud and University of Lyon, Pierre-Bénite, France
| | - Kamyar Kalantar-Zadeh
- Irvine Division of Nephrology, Hypertension and Kidney Transplantation, University of California, Irvine, CA, United States of America
| | - Peter Maxwell
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Clare McKeaveney
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Helen Noble
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, United Kingdom
| | - David Seres
- Institute of Human Nutrition and Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Adrian Slee
- Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Ian Swaine
- School of Human Sciences, University of Greenwich, Greenwich, United Kingdom
| | - Miles Witham
- Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Joanne Reid
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
- * E-mail:
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Mooney-Doyle K, Pyke-Grimm KA, Lanzel AF, Montgomery KE, Hassan J, Thompson A, Rouselle R, Matheny Antommaria AH. Balancing Protection and Progress in Pediatric Palliative Care Research: Stakeholder Perspectives. Pediatrics 2022; 150:e2022057502. [PMID: 36069137 DOI: 10.1542/peds.2022-057502] [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] [Accepted: 07/20/2022] [Indexed: 11/24/2022] Open
Abstract
Pediatric palliative care, including end-of-life care, remains a relatively new area of interdisciplinary clinical practice and research. Improving the multifaceted and complex care of children and their families involves research that (1) documents the experiences of children with serious illness, their families, and clinicians; (2) evaluates relationships between contextual factors and health outcomes; and (3) establishes a stronger foundation for child- and family-focused interventions to improve care. Partnership among stakeholders in family-focused research begins from design through conduct of the study. This partnership is the foundation of a dynamic research process that illuminates critical perspectives. We present a hypothetical pediatric palliative study; a qualitative descriptive study of the perspectives of adolescents and young adults with life-limiting illnesses and their parents after a discussion about an end-of-life decision. Pediatric palliative care researchers, institutional review board leaders, and the parent of a child who died comment on how to balance the obligations to improve clinical care and to protect participants in research. Their recommendations include recruiting a wide range of participants, differentiating emotional responses from harm, approaching potential participants as individuals, and seeking feedback from family advisory boards and designated reviewers with content expertise.
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Affiliation(s)
| | | | | | | | | | - Anisha Thompson
- Emory University Institutional Review Board, Atlanta, Georgia
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28
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Crook A, Jacobs C, Newton‐John T, McEwen A. Genetic counseling and diagnostic genetic testing for familial amyotrophic lateral sclerosis and/or frontotemporal dementia: A qualitative study of client experiences. J Genet Couns 2022; 31:1206-1218. [PMID: 35635300 PMCID: PMC9796327 DOI: 10.1002/jgc4.1591] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/01/2022] [Accepted: 05/07/2022] [Indexed: 01/01/2023]
Abstract
Genetic counseling and diagnostic genetic testing is part of the multidisciplinary care of people with amyotrophic lateral sclerosis (ALS, commonly called motor neurone disease, MND) and frontotemporal dementia (FTD). We explored client experiences of genetic counseling and diagnostic testing to inform the care of future families. Semi-structured interviews with individuals with ALS/MND/FTD or their relatives were conducted. The study was designed to include a wide variety of participants with varying disease status and abilities. Genetic counseling and diagnostic testing experiences were explored using interpretive description methodology. Bioecological theory was used as the framework for the reflexive thematic analysis. Eighteen individuals with ALS/MND/FTD or their relatives from 13 Australian families participated. Three themes were identified: sharing knowledge, (un)supportive care, and 'circumstance is everything'. Consistent with bioecological theory, one's genetic counseling experience was informed by individual circumstances, time, and proximal factors. These informed the level of information and support required in the genetic counseling process. Although some client circumstances cannot be changed, efforts could be made to enhance genetic counseling experiences by improving interactions between the client and their care team. Some clients may benefit from further discussions regarding the familial implications of genetic testing, and greater support with family communication. Clients' needs were derived from the data and will contribute to genetic counseling consensus guidelines.
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Affiliation(s)
- Ashley Crook
- Graduate School of HealthUniversity of Technology SydneyChippendaleNew South WalesAustralia,Faculty of Medicine, Health and Human Sciences, Centre for MND ResearchMacquarie UniversitySydneyNew South WalesAustralia
| | - Chris Jacobs
- Graduate School of HealthUniversity of Technology SydneyChippendaleNew South WalesAustralia
| | - Toby Newton‐John
- Graduate School of HealthUniversity of Technology SydneyChippendaleNew South WalesAustralia
| | - Alison McEwen
- Graduate School of HealthUniversity of Technology SydneyChippendaleNew South WalesAustralia
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Ibrahim H, Goessmann K, Neuner F. Sharing for relief: associations of trauma-focused interviews and well-being among war-affected displaced populations in the Middle East. ETHICS & BEHAVIOR 2022. [DOI: 10.1080/10508422.2022.2122466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Hawkar Ibrahim
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University
| | - Katharina Goessmann
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University
| | - Frank Neuner
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University
- Vivo International, Konstanz, Germany
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30
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Experiences of infertile women pursuing treatment in Kenya: a qualitative study. BMC Womens Health 2022; 22:364. [PMID: 36056344 PMCID: PMC9440532 DOI: 10.1186/s12905-022-01950-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background The infertility treatment process is associated with various psychological, physical, social, moral, and financial challenges, especially for women. The women are likely to report low marital satisfaction and emotional distress due to fertility treatment demands. This study explored how infertile women described their treatment experience and how they coped with treatment demands as they underwent treatment at three gynecology outpatient clinics in Kenya. Methods A qualitative phenomenological research design was used to analyze and describe women’s fertility treatment experiences. The data were collected through semi-structured in-depth interviews with 33 infertile women selected purposively. Trustworthiness of the findings was ensured using Guba and Lincoln’s criteria. The recorded interviews were transcribed verbatim and then analyzed using reflective thematic analysis, developed by Braun and Clarkes. Results Three themes and 13 sub-themes related to women’s fertility treatment experiences and coping strategies were identified. The theme challenges encountered during fertility treatment have three sub-themes: emotional distressing, physical pain, and financial constraining. Theme impacts of fertility treatment on relationships have three sub-themes: relationship with their husband, relationship with their family, and relationship with their friends. Finally, coping with fertility treatment has six sub-themes: religious practices and personal faith, giving in to feelings, shifting focus, taking a break, staying with their relative’s children, and receiving support from others. Conclusion The experiences of women undergoing treatment are multi-dimensional. Therefore, incorporating psychosocial interventions or counseling into the fertility treatment routine with National Health Insurance Fund cards may reduce the treatment burden, improving women’s psychological well-being and relationships with their husbands, family, and friends.
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Quirke F, Ariff S, Battin M, Bernard C, Bloomfield FH, Daly M, Devane D, Haas DM, Healy P, Hurley T, Kibet V, Kirkham JJ, Koskei S, Meher S, Molloy E, Niaz M, Ní Bhraonáin E, Okaronon CO, Tabassum F, Walker K, Biesty L. Core outcomes in neonatal encephalopathy: a qualitative study with parents. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001550. [PMID: 36053648 PMCID: PMC9328095 DOI: 10.1136/bmjpo-2022-001550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/07/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify the outcomes considered important to parents or caregivers of infants diagnosed with neonatal encephalopathy, hypoxic ischaemic encephalopathy or birth asphyxia in high-income and low- to middle-income countries (LMiCs), as part of the outcome-identification process in developing a core outcome set (COS) for the treatment of neonatal encephalopathy. DESIGN A qualitative study involving 25 semistructured interviews with parents or other family members (caregivers) of infants who were diagnosed with, and treated for, neonatal encephalopathy, hypoxic ischaemic encephalopathy or birth asphyxia. SETTING Interviews were conducted in high-income countries (HiCs) (n=11) by Zoom video conferencing software and in LMiCs (n=14) by phone or face to face. FINDINGS Parents identified 54 outcomes overall, which mapped to 16 outcome domains. The domains identified were neurological outcomes, respiratory outcomes, gastrointestinal outcomes, cardiovascular outcomes, motor development, cognitive development, development (psychosocial), development (special senses), cognitive development, development (speech and social), other organ outcomes, survival/living outcomes, long-term disability, hospitalisation, parent-reported outcomes and adverse events. CONCLUSIONS This study provides insight into the outcomes that parents of infants diagnosed with neonatal encephalopathy have identified as the most important, to be considered in the process of developing a COS for the treatment of neonatal encephalopathy. We also provide description of the processes employed to ensure the inclusion of participants from LMiCs as well as HiCs.
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Affiliation(s)
- Fiona Quirke
- Health Research Board - Neonatal Encephalopathy PhD Training Network (NEPTuNE), Trinity College Dublin, Dublin, Ireland .,Health Research Board-Trials Methodology Research Network (HRB-TMRN), Galway, Ireland.,School of Nursing & Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Shabina Ariff
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Caitlin Bernard
- Department of Obstetrics and Gynecology, Indiana University, Bloomington, Indiana, USA
| | | | - Mandy Daly
- Advocacy and Policymaking Irish Neonatal Health Alliance, Wicklow, Ireland
| | - Declan Devane
- Health Research Board - Neonatal Encephalopathy PhD Training Network (NEPTuNE), Trinity College Dublin, Dublin, Ireland.,Health Research Board-Trials Methodology Research Network (HRB-TMRN), Galway, Ireland.,School of Nursing & Midwifery, National University of Ireland Galway, Galway, Ireland.,Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland.,Cochrane Ireland, National Univeristy of Ireland Galway, Galway, Ireland
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University, Bloomington, Indiana, USA
| | - Patricia Healy
- School of Nursing & Midwifery, National University of Ireland Galway, Galway, Ireland.,Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland
| | - Tim Hurley
- Health Research Board - Neonatal Encephalopathy PhD Training Network (NEPTuNE), Trinity College Dublin, Dublin, Ireland.,Department of Paediatric and Child Health, Tallaght University Hospital (TUH), Dublin, Ireland
| | | | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | | | - Eleanor Molloy
- Health Research Board - Neonatal Encephalopathy PhD Training Network (NEPTuNE), Trinity College Dublin, Dublin, Ireland.,Paediatrics, Trinity College Dublin, Dublin, Ireland.,Paediatrics, Tallaght Hospital, Dublin, Ireland
| | - Maira Niaz
- Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | | | | | | | - Karen Walker
- Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Linda Biesty
- School of Nursing & Midwifery, National University of Ireland Galway, Galway, Ireland.,Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland.,Qualitative Research in Trials Centre (QUESTS), National University of Ireland Galway, Galway, Ireland
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Chynoweth SK, Buscher D, Martin S, Zwi AB. Characteristics and Impacts of Sexual Violence Against Men and Boys in Conflict and Displacement: A Multicountry Exploratory Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP7470-NP7501. [PMID: 33118459 DOI: 10.1177/0886260520967132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Evidence of sexual violence against men and boys in many conflict-affected settings is increasingly recognized. Yet relatively little is currently known about the varied forms, sites, and impacts of this violence. Further, scant research on sexual violence against men and boys in displacement contexts has been undertaken to date. To begin to address these knowledge gaps, we undertook a multicountry, qualitative, exploratory study to gain insights into these issues. Study settings and populations were Rohingya refugees in Bangladesh; refugees and migrants who had traveled through Libya residing in Italy; and refugees from eastern Democratic Republic of the Congo (DRC), Somalia, and South Sudan residing in Nairobi and Mombasa, Kenya. Methods included 55 semi-structured focus group discussions with 310 refugees and semi-structured key informant interviews with 148 aid workers and human rights experts. Data were thematically analyzed using NVivo 12. Findings suggest that sexual violence against men and boys may not be rare in Myanmar (northern Rakhine state), Libya, eastern DRC, and South Sudan. Frequently reported forms of violence in these settings were genital violence, forced witnessing of sexual violence, and rape. Sites where violence was often reported included border crossings, along the roadside, and during imprisonment. In host countries, forms of sexual violence included sexual abuse of boys, sexual exploitation particularly of adolescents and persons with diverse sexual orientation and gender identity, and rape. Impacts on survivors involved short- and long-term physical, mental, economic, and familial dimensions. These findings aim to inform sexual violence-related prevention, mitigation, and response efforts in humanitarian settings. More research is warranted, including on sexual violence against men and boys in Somalia, sexual violence by family and community members in conflict and displacement settings, sexual exploitation of adolescent boys, and sexual violence including sexual exploitation of persons with diverse sexual orientation and gender identity.
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Affiliation(s)
- Sarah K Chynoweth
- Women's Refugee Commission, New York, NY, USA
- The University of New South Wales, Sydney, NSW, Australia
| | | | - Sarah Martin
- Gender Associations International Consulting, Berlin, Germany
| | - Anthony B Zwi
- The University of New South Wales, Sydney, NSW, Australia
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Abdekhodaie Z. The lived experience of bereaved Iranian families with COVID-19 grief. DEATH STUDIES 2022; 47:381-391. [PMID: 35475416 DOI: 10.1080/07481187.2022.2068698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The present study investigated the lived experience of bereaved family members from grief due to COVID-19 using descriptive phenomenological method via in-depth interviews. The participants (N = 30) were spouses, children, parents, and siblings of the deceased. The obtained data from interviewing were analyzed using Colaizzi's method. Eight main themes were obtained. Findings suggest that society is confronted with the prolonged grief on a large scale and has put people in an existential experience situation. Different experiences, which have led to creation of new meaning in loss and life, has been able to help some post-traumatic growth in the bereaved.
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Kearns S, Houghton C, O'Shea D, Neff K. Study protocol: navigating access to gender care in Ireland-a mixed-method study on the experiences of transgender and non-binary youth. BMJ Open 2022; 12:e052030. [PMID: 35292489 PMCID: PMC8928252 DOI: 10.1136/bmjopen-2021-052030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION There has been a global increase in demand for gender-specific healthcare services and a recognition that healthcare access is complex and convoluted, even in countries with well-developed healthcare services. Despite evidence in Ireland supporting the improvement in physical and mental health following access to gender care, little is known about the local healthcare navigation challenges. Internationally, research focuses primarily on the experience of service users and omits the perspective of other potential key stakeholders. Youth experiences are a particularly seldom-heard group. METHODS AND ANALYSIS This study will use a sequential exploratory mixed-methods design with a participatory social justice approach. The qualitative phase will explore factors that help and hinder access to gender care for young people in Ireland. This will be explored from multiple stakeholders' perspectives, namely, young people, caregivers and specialist healthcare providers. Framework analysis will be used to identify priorities for action and the qualitative findings used to build a survey tool for the quantitative phase. The quantitative phase will then measure the burden of the identified factors on healthcare navigation across different age categories and gender identities (transmasculine vs transfeminine vs non-binary). ETHICS AND DISSEMINATION This study has been approved by St Vincent's Hospital Research Ethics Committee (RS21-019), University College Dublin Ethics Committee (LS-21-14Kearns-OShea) and the Transgender Equality Network Ireland's Internal Ethics Committee (TIECSK). We aim to disseminate the findings through international conferences, peer-review journals and by utilisation of expert panel members and strategic partners.
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Affiliation(s)
- Seán Kearns
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Donal O'Shea
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Karl Neff
- School of Medicine, University College Dublin, Dublin, Ireland
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Suarez C, Adair P, Doherty N, McCormack D. Exploring Adjustment and Parent-Infant Relations in Mothers of Premature Infants: Thematic Analysis Using a Multisensory Approach. J Pediatr Psychol 2022; 47:827-839. [PMID: 35286395 PMCID: PMC9297088 DOI: 10.1093/jpepsy/jsac007] [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: 08/21/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of the study was to explore mothers’ experiences of having an infant born prematurely (28–32 weeks gestation). In particular, the study aimed to explore the developing parent–infant relationship 12–30 months since birth and the developing parental identity during hospitalization and discharge. Methods Twelve mothers, aged between 22 and 43, participated in the semi-structured interviews. The mean age of infants was 19 months. Interviews comprised open-ended questions and visual stimuli consisting of photographs brought by participants, word selection, and card sorting techniques. Data were analyzed using Braun and Clarke’s thematic analysis (Braun & Clarke, 2013). Results Three themes arose from a clustering of 10 subthemes: (a) Emotional Impact, (b) Searching for Parent Identity, and (c) Moving Beyond Adversity. Participants expressed experiencing heightened emotional distress during the time of their infants’ birth and hospitalization and initially not feeling like parents. Their parental identity strengthened as they became more involved in the care of their infant and began to accept the situation. Participants described parenting their premature infants differently compared with parents of full-term infants, and described adjusting to this difference over time. Conclusions The findings highlight the emotional experience and adjustment of mothers of premature infants, from hospital and postdischarge. The need for psycho-educational interventions postdischarge and parent-partnered models during hospitalization is discussed. In addition, the study demonstrates the use of integrating visual stimuli in qualitative data collection procedures, to elicit further meaning and interaction from participants with the interview process.
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Affiliation(s)
- Catalina Suarez
- Department of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Pauline Adair
- Department of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Nicola Doherty
- Western Health and Social Care Trust, Londonderry, Northern Ireland
| | - David McCormack
- Department of Psychology, Queen's University Belfast, Belfast, Northern Ireland
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O'Hora KP, Osorno RA, Sadeghi-Bahmani D, Lopez M, Morehouse A, Kim JP, Manber R, Goldstein-Piekarski AN. Viability of an Early Sleep Intervention to Mitigate Poor Sleep and Improve Well-being in the COVID-19 Pandemic: Protocol for a Feasibility Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34409. [PMID: 34995204 PMCID: PMC8923148 DOI: 10.2196/34409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/07/2021] [Accepted: 12/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to drastic increases in the prevalence and severity of insomnia symptoms. These increases in insomnia complaints have been paralleled by significant decreases in well-being, including increased symptoms of depression, anxiety, and suicidality and decreased quality of life. However, the efficacy and impact of early treatment of insomnia symptoms on future sleep and well-being remain unknown. OBJECTIVE Here, we present the framework and protocol for a novel feasibility, pilot study that aims to investigate whether a brief telehealth insomnia intervention targeting new insomnia that developed during the pandemic prevents deterioration of well-being, including symptoms of insomnia, depression, anxiety, suicidality, and quality of life. METHODS The protocol details a 2-arm randomized controlled feasibility trial to investigate the efficacy of a brief, telehealth-delivered, early treatment of insomnia and evaluate its potential to prevent deterioration of well-being. Participants with clinically significant insomnia symptoms that began during the pandemic were randomized to either a treatment group or a 28-week waitlist control group. Treatment consists of 4 telehealth sessions of cognitive behavioral therapy for insomnia (CBT-I) delivered over 5 weeks. All participants will complete assessments of insomnia symptom severity, well-being, and daily habits checklist at baseline (week 0) and at weeks 1-6, 12, 28, and 56. RESULTS The trial began enrollment on June 3, 2020 and closed enrollment on June 17, 2021. As of October 2021, 49 participants had been randomized to either immediate treatment or a 28-week waitlist; 23 participants were still active in the protocol. CONCLUSIONS To our knowledge, this protocol would represent the first study to test an early sleep intervention for improving insomnia that emerged during the COVID-19 pandemic. The findings of this feasibility study could provide information about the utility of CBT-I for symptoms that emerge in the context of other stressors before they develop a chronic course and deepen understanding of the relationship between sleep and well-being. TRIAL REGISTRATION ClinicalTrials.gov NCT04409743; https://clinicaltrials.gov/ct2/show/NCT04409743. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/34409.
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Affiliation(s)
| | - Raquel A Osorno
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Dena Sadeghi-Bahmani
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States.,Department of Psychology, Stanford University, Stanford, CA, United States
| | - Mateo Lopez
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Allison Morehouse
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Jane P Kim
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Rachel Manber
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Andrea N Goldstein-Piekarski
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States.,Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
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37
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Cook E, Markham S, Parker J, John A, Barnicot K, McManus S. Risk, responsibility, and choice in research ethics. Lancet Psychiatry 2022; 9:5-6. [PMID: 34921795 PMCID: PMC8673868 DOI: 10.1016/s2215-0366(21)00434-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Elizabeth Cook
- Violence and Society Centre, City, University of London, London EC1V 0HB, UK
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Jennie Parker
- School of Health Sciences, City, University of London, London EC1V 0HB, UK
| | - Ann John
- Population Data Science, Swansea University, Swansea, UK
| | - Kirsten Barnicot
- School of Health Sciences, City, University of London, London EC1V 0HB, UK
| | - Sally McManus
- Violence and Society Centre, City, University of London, London EC1V 0HB, UK; National Centre for Social Research, London, UK.
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Pinto A, Rodriguez A, Smith J. Researching sensitive topics in healthcare. Evid Based Nurs 2021; 25:41-43. [PMID: 34844987 DOI: 10.1136/ebnurs-2021-103501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Alexandra Pinto
- Health Care, University of Leeds, School of Healthcare, Leeds, UK
| | - Alison Rodriguez
- Children's Nursing, University of Leeds, School of Healthcare, Leeds, UK
| | - Joanna Smith
- Health Care, University of Leeds, School of Healthcare, Leeds, UK.,Children's Nursing, University of Leeds, School of Healthcare, Leeds, UK
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Lasrado R, Bielsten T, Hann M, Schumm J, Reilly ST, Davies L, Swarbrick C, Dowlen R, Keady J, Hellström I. Developing a Management Guide (the DemPower App) for Couples Where One Partner Has Dementia: Nonrandomized Feasibility Study. JMIR Aging 2021; 4:e16824. [PMID: 34783666 PMCID: PMC8663680 DOI: 10.2196/16824] [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: 10/28/2019] [Revised: 03/31/2021] [Accepted: 06/02/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Promoting the health and well-being of couples where one partner has dementia is an overlooked area of care practice. Most postdiagnostic services currently lack a couple-centered approach and have a limited focus on the couple relationship. To help address this situation, we developed a tablet-based self-management guide (DemPower) focused on helping couples enhance their well-being and relationship quality. OBJECTIVE The aim of this study is to investigate the feasibility and acceptability of the DemPower app. METHODS A nonrandomized feasibility design was used to evaluate the DemPower intervention over 3 months among couples where a partner had a diagnosis of dementia. The study recruited 25 couples in the United Kingdom and 19 couples in Sweden. Outcome measures were obtained at baseline and postintervention. The study process and interventions were evaluated at various stages. RESULTS The study was completed by 48% (21/44) of couples where one partner had dementia, of whom 86% (18/21) of couples accessed all parts of the DemPower app. Each couple spent an average of 8 hours (SD 3.35 hours) using the app during the study period. In total, 90% (19/21) of couples reported that all sections of DemPower were useful in addressing various aspects of daily life and helped to focus on how they interacted in their relationship. Of the 4 core subjects on which the DemPower app was structured, home and neighborhood received the highest number of visits. Couples used activity sections more often than the core subject pages. The perception of DemPower's utility varied with each couple's lived experience of dementia, geographic location, relationship dynamics, and opportunities for social interaction. A 5.2-point increase in the dementia quality of life score for people with dementia and a marginal increase in the Mutuality scale (+1.23 points) for caregiver spouses were found. Design and navigational challenges were reported in the DemPower app. CONCLUSIONS The findings suggest that the DemPower app is a useful resource for couples where one partner has dementia and that the implementation of the app requires the support of memory clinics to reach couples at early diagnosis. TRIAL REGISTRATION ISRCTN Registry ISRCTN10122979; http://www.isrctn.com/ISRCTN10122979.
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Affiliation(s)
- Reena Lasrado
- Social Care & Society, The University of Manchester, Manchester, United Kingdom
| | - Therese Bielsten
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mark Hann
- Division of Population Health, The University of Manchester, Manchester, United Kingdom
| | | | | | - Linda Davies
- Division of Population Health, The University of Manchester, Manchester, United Kingdom
| | - Caroline Swarbrick
- Faculty of Health and Medicine, University of Lancaster, Lancaster, United Kingdom
| | - Robyn Dowlen
- Centre for Cultural Value, School of Performance and Cultural Industries, University of Leeds, Leeds, United Kingdom
| | - John Keady
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, United Kingdom
| | - Ingrid Hellström
- Department of Health Care Sciences & Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
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Being a Parent: Findings from a Grounded Theory of Memory-Making in Neonatal End-of-Life Care. J Pediatr Nurs 2021; 61:51-58. [PMID: 33752063 DOI: 10.1016/j.pedn.2021.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 03/07/2021] [Accepted: 03/11/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Neonatal palliative care guidelines increasingly recommend that parents be encouraged to provide care for their dying baby and to spend time with the before and after death. However, little is currently known about how parents perceive such memory-making interventions. This study explored the significance of memory-making for bereaved parents and the impact of memory-making on parents' experience of neonatal end-of-life care. DESIGN AND METHODS We conducted extended interviews with 18 parents who had experienced neonatal loss. Corbin and Strauss' grounded theory method was used throughout sampling, data collection and data analysis. A constant comparative approach was utilised throughout each stage of the data collection/data analysis process, resulting in the development of a grounded theory titled "Affirmed Parenthood". RESULTS The core category of "Affirmed parenthood" was underpinned by three primary categories: 'Creating Evidence', 'Needing Guidance' and 'Being a parent'. Opportunities to parent the baby by having contact with them, engaging with them, and providing care were central to parent's experiences of memory-making in the context of neonatal bereavement. CONCLUSIONS 'Being a Parent' provided important affirmation of the baby's identity and importance, and affirmed the role of the parents. 'Being a Parent' was a critical element of memory-making and had a significant impact on parents' experience of loss. PRACTICE IMPLICATIONS Parents should be supported to have unrestricted contact with their baby, to engage with them, and to provide care throughout the baby's brief life and after their baby's death.
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Grannell A, le Roux CW, McGillicuddy D. "You Are Always at War With Yourself" The Perceptions and Beliefs of People With Obesity Regarding Obesity as a Disease. QUALITATIVE HEALTH RESEARCH 2021; 31:2470-2485. [PMID: 34581642 DOI: 10.1177/10497323211040767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Obesity as a disease remains poorly understood by key stakeholders. Here, in people living with severe obesity, perceptions and beliefs relating to obesity as a disease and obesity causality were examined. Semi-structured interviews were conducted in a tertiary care obesity clinic. 23 people with obesity (10 males, 13 females) volunteered. An overall agreement that obesity is a disease was present. Perceptions related to why obesity is and is not a disease were diverse: Lack of control and addiction, biological determinism, and personal responsibility. For weight loss maintenance, the perceptions and beliefs were heterogeneous with biological factors not considered a determinant of success. Instead, exercise, support, and willpower were described as associated with success. Barriers related to remaining in a weight-reduced state included the following: Emotional eating, sustainability of diet, occupational impact, and defeatism due to misaligned expectation and outcome. In conclusion, people living with obesity tend to agree obesity is a disease yet an incomplete understanding of the disease is present.
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Bayuo J, Anago EK, Agyei FB, Salifu Y, Kyei Baffour P, Atta Poku C. "Resuscitate and Push": End-of-Life Care Experiences of Healthcare Staff in the Emergency Department - A Hermeneutic Phenomenological Study. J Palliat Care 2021; 37:494-502. [PMID: 34713731 DOI: 10.1177/08258597211050740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Care in the emergency department focuses significantly on delivering lifesaving/ life-sustaining clinical actions, often with limited attention to health-related suffering even at the end-of-life. How healthcare staff experience and navigate through the end-of-life phase remains minimally explored. Thus, this study aimed to uncover the lived experiences of emergency department staff at the end-of-life. METHODS van Manen's hermeneutic phenomenological approach was used. Nineteen healthcare staff were purposively recruited and interviewed. Interviews were audio-taped, transcribed verbatim, and thematic categories formulated. The existential lifeworld themes (corporeality, relationality, spatiality, and temporality) were used as heuristic guides for reflecting and organizing the lived experiences of participants. RESULTS The overarching category, 'resuscitate and push', was captured as corporeality (resisting death and dying); relationality (connectedness to the body of the patient; and lacking support for family and self); spatiality (navigating through a liminal space and lack of privacy for patients); and temporality (having limited to no time for end-of-life care and grieving). The end-of-life space was unpleasant. Although participants experienced helplessness and feelings of failure, support systems to help them to navigate through these emotions were lacking. Grief was experienced covertly and concealed by the entry of a new patient. CONCLUSION End-of-life in the emergency department is poorly defined. In addition to shifting from the traditional emergency care model to support the streamlining of palliative care in the department, staff will require support with navigating through the liminal space, managing their grief, and developing a better working relationship with patients/ families.
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Affiliation(s)
- Jonathan Bayuo
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Mohd Mydin FH, Othman S, Choo WY, Mohd Hairi NN, Mohd Hairi F, Ali Z, Abdul Aziz S. Primary care nurses' challenges, opportunities, and facilitators of elder abuse intervention in Malaysia. Public Health Nurs 2021; 39:3-14. [PMID: 34386986 DOI: 10.1111/phn.12961] [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: 03/24/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore the views of nurses on challenges, perceived roles and improvement strategies concerning elder abuse intervention in Malaysia. DESIGN AND SAMPLE Eleven focus group discussions were conducted using a semi-structured interview based on the socio-ecological framework. The data were analyzed using a multistep process of thematic analysis. RESULTS Three themes emerged from the data analysis: (1) The predicament: being unwilling or not able to intervene (2) Bridging the older people and health system gap (3) Getting to grips with the barriers. There are multifactorial contributors identified at the individual, interpersonal, organizational, community and policy levels in each theme. These factors interact across the levels to influence nurses' capability to intervene in elder abuse. CONCLUSION A framework is needed to articulate Malaysian nurses' role in elder abuse intervention in terms of personal and professional development through culturally sensitive education and the establishment of clinical guidelines in the primary care setting. Strengthening organizational support and the institution of national policy and permissive reporting laws of elder abuse will empower the primary care nurses to address elder abuse in primary care settings and communities.
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Affiliation(s)
- Fadzilah Hanum Mohd Mydin
- Department of Primary Care Medicine, University Malaya Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, University Malaya Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- Department of Social Preventive Medicine, Centre for Evidence-Based Practice, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Mohd Hairi
- Department of Social Preventive Medicine, Centre for Evidence-Based Practice, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Department of Social Preventive Medicine, Centre for Evidence-Based Practice, University of Malaya, Kuala Lumpur, Malaysia
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Jefferson K, Stanhope KK, Jones-Harrell C, Vester A, Tyano E, Hall CDX. A scoping review of recommendations in the English language on conducting research with trauma-exposed populations since publication of the Belmont report; thematic review of existing recommendations on research with trauma-exposed populations. PLoS One 2021; 16:e0254003. [PMID: 34324528 PMCID: PMC8321367 DOI: 10.1371/journal.pone.0254003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 06/17/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To identify recommendations for conducting public health research with trauma-exposed populations. METHODS Researchers searched Embase, PubMed, Scopus, Web of Science, Open Grey, and Google Scholar for recommendations. Trauma that causes psychological impact was our exposure of interest and we excluded clinical articles on treating physical trauma. We reviewed titles and abstracts of 8,070 articles and full text of 300 articles. We analyzed recommendations with thematic analysis, generated questions from the existing pool of recommendations, and then summarized select gaps. RESULTS We abstracted recommendations from 145 articles in five categories: community benefit, participant benefit, safety, researcher well-being, and recommendations for conduct of trauma research. CONCLUSIONS Gold standards to guide the conduct of trauma-informed public health research do not yet exist. The literature suggests participation in trauma research is not inherently harmful, and current recommendations concern using research to benefit communities and participants, protecting participants and researchers from harm, and improving professional practice. As public health researchers increasingly analyze trauma as a determinant of health, gold standards for the conduct of trauma-informed public health research would be appropriate and timely.
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Affiliation(s)
- Kevin Jefferson
- Independent Researcher, Atlanta, Georgia, United States of America
| | - Kaitlyn K. Stanhope
- Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Carla Jones-Harrell
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Aimée Vester
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Emma Tyano
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States of America
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Well-being, Northwestern University, Evanston, Illinois, United States of America
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois, United States of America
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Ecological Systems Affecting Urban Childbearing Puerto Rican Women in the City of Philadelphia. Matern Child Health J 2021; 25:929-937. [PMID: 33759042 DOI: 10.1007/s10995-021-03121-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of this study was to explore socio-ecological influences affecting the daily lives of urban, pregnant Puerto Rican women and factors negatively influencing their health seeking behaviors related to prenatal care. METHODS Qualitative, descriptive methods were used including individual interviews and focus groups to obtain maximum understanding of the women's lives. The interviews and focus groups were conducted using a semi-structured interview guide based on various components of the study's conceptual framework. Content analytic strategies included rigorous and systematic processes to increase trustworthiness: training, supervision, audits, electronic technologies, and ongoing input of the research team. RESULTS Factors on all levels of the study's conceptual framework compound the effects of stressors and restrictions on the lives of urban, childbearing Puerto Rican woman. The intersectionality of issues for Puerto Rican women can either mitigate or heighten the pressure on their daily lives. CONCLUSIONS This initial research sets the groundwork for further studies, such as narrative analysis, to better understand how to build appropriate and relevant interventions. Uncovering the women's stories gives them the opportunity to be a critical part of cross-sector partnerships towards the development of sustainable interventions.
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Tabib M, Humphrey T, Forbes-McKay K, Lau A. Expectant parents' perspectives on the influence of a single antenatal relaxation class: A qualitative study. Complement Ther Clin Pract 2021; 43:101341. [PMID: 33662893 DOI: 10.1016/j.ctcp.2021.101341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
AIM This study explores the perspectives of expectant parents on the influence of a single antenatal class incorporating education on childbirth physiology and relaxation techniques. METHOD The data for this qualitative descriptive study were collected via in-depth interviews with six women and three birth partners. FINDINGS An enhanced understanding of childbirth physiology formed a 'different way of thinking' about childbirth, 'inspired and motivated' the exertion of the learnt relaxation techniques which led to a 'deepsense of calmness' associated with increased confidence and reduced fear. However, reaching such sense of calmness during childbirth required a 'space for relaxation' which was influenced by birth attendants. An overarching theme of 'a positive outlook' towards childbirth was identified. CONCLUSION Including education on childbirth physiology and a range of relaxation techniques may reduce fear, empower prospective parents and positively influence their experiences of pregnancy and childbirth.
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Affiliation(s)
- Mo Tabib
- School of Nursing and Midwifery, Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen, AB10 7AQ, UK, Scotland, United Kingdom.
| | - Tracy Humphrey
- School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Qld, 4072, Australia.
| | - Katrina Forbes-McKay
- School of Applied Social Studies, Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen, AB10 7QG, UK, Scotland, United Kingdom.
| | - Annie Lau
- School of Nursing and Midwifery, Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen, AB10 7AQ, UK, Scotland, United Kingdom.
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Bayuo J, Bristowe K, Harding R, Agbeko AE, Baffour PK, Agyei FB, Wong FKY, Allotey G, Agbenorku P, Hoyte-Williams PE. "Managing uncertainty": Experiences of family members of burn patients from injury occurrence to the end-of-life period. Burns 2021; 47:1647-1655. [PMID: 33832797 DOI: 10.1016/j.burns.2021.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/14/2021] [Accepted: 02/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although mortality rates associated with burns have decreased, there is still a significant number of persons who may not survive severe forms of the injury and thus, undergo comfort/end of life care. The experiences of family members of persons whose injuries are deemed unsurvivable remain minimally explored and there is a general lack of practice guidelines and recommendations to support them at the end-of-life period. AIM To explore the experiences of family members whose relatives died in the burn unit to inform the development of practice recommendations. METHODS Qualitative description was employed for this study. Convenience sampling was used to recruit 23 family members of injured persons who died in the burn unit. Face to face semi-structured interviews were conducted and followed up with telephone interviews. The interviews were audio-recorded, transcribed verbatim and thematic analysis performed inductively. RESULTS Three themes emerged: reactions following injury occurrence, navigating through the experience, and managing uncertainties about survival. The sudden nature of the injury led to feelings of self-blame, guilt, helplessness, and grief and these escalated at the end of life. As the family members journeyed through their uncertainties regarding the outcomes of care, they had a feeling of being a part of the patient's suffering. Family members received little professional support in coming to terms with their loss in the post-bereavement period. CONCLUSIONS Family members experience distress following the occurrence of burns and at the endof-life period. Practice recommendations should focus on communication, bereavement, and post-bereavement support.
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Affiliation(s)
- Jonathan Bayuo
- Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College, Ghana; School of Nursing, The Hong Kong Polytechnic University, Hong Kong, PR China.
| | - Katherine Bristowe
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Kings College, London, United Kingdom
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Kings College, London, United Kingdom
| | | | - Prince Kyei Baffour
- Burns Intensive Care Unit, Plastics and Reconstructive Surgical Unit, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Frank Bediako Agyei
- Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College, Ghana
| | | | - Gabriel Allotey
- Burns Intensive Care Unit, Plastics and Reconstructive Surgical Unit, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Pius Agbenorku
- Plastics, Burns and Reconstructive Surgical Division, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana; School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Paa Ekow Hoyte-Williams
- Plastics, Burns and Reconstructive Surgical Division, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
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Stevens K, Thambinathan V, Hollenberg E, Inglis F, Johnson A, Levinson A, Salman S, Cardinale L, Lo B, Shi J, Wiljer D, Korczak DJ, Cleverley K. Core components and strategies for suicide and risk management protocols in mental health research: a scoping review. BMC Psychiatry 2021; 21:13. [PMID: 33413192 PMCID: PMC7792084 DOI: 10.1186/s12888-020-03005-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/07/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Suicide and risk management protocols in mental health research aim to ensure patient safety, provide vital information on how to assess suicidal ideation, manage risk, and respond to unexpected and expected situations. However, there is a lack of literature that identifies specific components and strategies to include in suicide and risk management protocols (SRMPs) for mental health research. The goal of this scoping review was to review academic and grey literature to determine core components and associated strategies, which can be used to inform SRMPs in mental health research. METHODS AND ANALYSIS The methodological framework outlined by Arksey and O'Malley was used for this scoping review. The search strategy, conducted by a medical librarian, was multidisciplinary and included seven databases. Two reviewers independently assessed eligibility criteria in each document and used a standardized charting form to extract relevant data. The extracted data were then examined using qualitative content analysis. Specifically, summative content analysis was used to identify the core components and strategies used in SRMPs. The data synthesis process was iterative. RESULTS This review included 36 documents, specifically 22 peer-reviewed articles and 14 documents from the grey literature. Five core components of SRMPs emerged from the reviewed literature including: training; educational resources for research staff; educational resources for research participants; risk assessment and management strategies; and clinical and research oversight. Potentials strategies for risk mitigation within each of the core components are outlined. CONCLUSIONS The five core components and associated strategies for inclusion in SRMPs will assist mental health researchers in conducting research safely and rigorously. Findings can inform the development of SRMPs and how to tailor them across various research contexts.
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Affiliation(s)
- Katye Stevens
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Vivetha Thambinathan
- The Western Centre for Public Health and Family Medicine, Western University, London, Ontario, Canada
| | - Elisa Hollenberg
- Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Fiona Inglis
- Library Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Humber Libraries, Humber College, Toronto, Ontario, Canada
| | - Andrew Johnson
- Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Andrea Levinson
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Soha Salman
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leah Cardinale
- Lawrence S. Bloomberg Faculty of Nursing and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Brian Lo
- Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Information Management Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jenny Shi
- Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - David Wiljer
- Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Centre for Excellence in Economic Analysis Research, St. Michael's Hospital, Toronto, Ontario, Canada
- Education, Technology and Innovation, UHN Digital, University Health Network, Toronto, Ontario, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kristin Cleverley
- The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Lawrence S. Bloomberg Faculty of Nursing and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Grannell A, le Roux CW, McGillicuddy D. "I am terrified of something happening to me" The lived experience of people with obesity during the COVID-19 pandemic. Clin Obes 2020; 10:e12406. [PMID: 32885595 DOI: 10.1111/cob.12406] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/22/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022]
Abstract
Obesity is emerging as a risk factor for COVID-19 disease severity. The impact of the pandemic and knowledge of obesity as a risk factor on the lived experience of people with obesity is not fully understood. The aim of this study was to investigate the impact of the COVID-19 pandemic on people living with severe obesity (BMI ≥35 kg/m2 ), currently engaged in multi-modal treatment. The primary objectives were to examine the impact of the pandemic on their lived experience from a treatment and psychosocial standpoint and additionally explore their awareness of obesity as a risk factor for COVID-19 disease severity. An in-depth qualitative study was adopted employing semi-structured interviews with open-ended questions. Interpretive thematic analysis was adopted to analyse the data and identify key themes taking a grounded approach. Themes that emerged from the perspective of impact on lived experience were (a) challenge sustaining treatment and (b) psychosocial impact. There was an even split regarding awareness and lack of awareness of obesity as risk factor which itself contributes towards a negative psychosocial impact in most patients. The COVID-19 pandemic is posing a diverse challenge to people with obesity. This has implications for their on-going treatment. From an ethical standpoint, there is a need to fully elucidate the link between obesity and COVID-19, disseminate this information using people friendly language and imagery in a manner that does not exacerbate a harmful psychosocial response or lead to stigmatization.
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Affiliation(s)
- Andrew Grannell
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
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The Influence of Peer Relationships on Latina Adolescents' Experiences with Depressive Symptoms. J Pediatr Nurs 2020; 55:250-257. [PMID: 32950334 PMCID: PMC7722008 DOI: 10.1016/j.pedn.2020.07.004] [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: 01/29/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Previous research has demonstrated that peers may play an integral role in the development of depressive symptoms among Latina adolescents; however, little is known about the function of peers in the ongoing management of depressive symptoms for Latina adolescents. The purpose of this study was to describe how peers influence Latina adolescents' experiences with the onset and ongoing management of depressive symptoms. DESIGN AND METHODS Qualitative descriptive methods were used in conducting semi-structured interviews with twenty-five young Latinas (ages 13-20) who had a history of depressive symptoms during adolescence. Participants were asked to describe their experiences with depressive symptoms and how they interacted with others in relation to their depressive symptoms. Thematic analysis methods were used to identify common themes in how peers influenced Latina adolescents' experiences with depressive symptoms. RESULTS Latina adolescents experienced tensions with peers in the development, disclosure, and self-management of depressive symptoms. Peers were: 1) allies and bullies; 2) confidants and betrayers; and 3) up-lifters and downers. CONCLUSIONS Peer relationships can be a source of risk and resiliency for Latina adolescents throughout the process of experiencing depressive symptoms. PRACTICE IMPLICATIONS Interventions preventing or treating depression among Latina adolescents should capitalize on the strengths of peer relationships, while recognizing that peers may also contribute to risk.
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