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O'Connor CMC, Poulos RG, Heldon M, Preti C, Beattie E, Poulos CJ. Implementation of an Arts at Home program for people living with dementia: Learnings from key stakeholders. Health Promot J Austr 2024. [PMID: 38952243 DOI: 10.1002/hpja.897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/20/2024] [Accepted: 06/14/2024] [Indexed: 07/03/2024] Open
Abstract
ISSUE ADDRESSED This study explores experiences of people with dementia and family carers who participated in an Arts on Prescription at Home (AoP@Home) program, artists who delivered the AoP@Home program and the managers who coordinated the AoP@Home programs. METHODS Semi structured interviews were conducted with the three stakeholder groups to explore experiences around implementation of AoP@Home. Interview questions were specific to each stakeholder group, and designed to capture the varied experiences around coordinating, delivering and participating in AoP@Home programs when delivered as a standard service offering. Qualitative content analysis was applied to evaluate the transcripts. RESULTS A total of 13 stakeholders participated in interviews: four people living with dementia and four family carers, three artists and two AoP program managers. Three overarching themes emerged across the stakeholder groups: 'what worked well', 'challenges' and 'moving forward'. CONCLUSIONS AoP@Home has potential as an important offering for community-dwelling people with dementia who may no longer be able to access group-based community programs. As AoP@Home is expanded, ongoing implementation monitoring and quality improvement will be essential to ensure maximal applicability of the program across the community aged care sector. SO WHAT?: The implementation of a new AoP@home service has been examined, and finds consumer satisfaction (person with dementia and their carer), and support from staff (artists and program managers). The novel nature of the service, however, requires considerable work to educate service referrers about the service and its benefits.
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Affiliation(s)
- Claire M C O'Connor
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- HammondCare, Centre for Positive Ageing, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Ageing Futures Institute, Sydney, New South Wales, Australia
| | - Roslyn G Poulos
- University of New South Wales, School of Population Health, Sydney, New South Wales, Australia
| | - Michelle Heldon
- HammondCare, Centre for Positive Ageing, Sydney, New South Wales, Australia
| | - Costanza Preti
- HammondCare, Centre for Positive Ageing, Sydney, New South Wales, Australia
| | - Elizabeth Beattie
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Christopher J Poulos
- HammondCare, Centre for Positive Ageing, Sydney, New South Wales, Australia
- University of New South Wales, School of Population Health, Sydney, New South Wales, Australia
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Irizarry-Pérez CD, Bell LM, Rodriguez MN, Viramontes V. Spanish-Speaking Mothers' Experiences of School-Based Speech Therapy. Lang Speech Hear Serv Sch 2024; 55:629-647. [PMID: 38394224 DOI: 10.1044/2024_lshss-23-00043] [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: 02/25/2024] Open
Abstract
PURPOSE Spanish-speaking families are a growing population that speech-language pathologists must be prepared to work with. To provide culturally responsive intervention, speech-language pathologists (SLPs) must understand the perspectives of Spanish-speaking caregivers when providing intervention. These values and experiences may differ from those of monolingual, mainstream culture. Understanding the impact of the COVID-19 pandemic on these experiences is also important. In this qualitative study, we explore the experiences of Spanish-speaking mothers whose children have received school-based speech-language intervention and the impact of the COVID-19 pandemic. METHOD We interviewed five Spanish-speaking mothers who were identified as having bilingual children who had or were currently receiving speech therapy, all through the public school system. The mothers participated in a semistructured interview to share their experiences with their children receiving intervention. We analyzed the transcripts through interpretative phenomenological analysis to identify salient themes among participants. All research team members reviewed and agreed upon themes to ensure credibility. RESULTS The findings revealed six group experiential themes: (a) lack of services and frustration with and barriers to accessing services, (b) greater improvements in English compared with Spanish, (c) bilingual speech therapy has positive effects on children and Spanish-speaking mothers, (d) family involvement in speech therapy is highly important, (e) family stress related to speech difficulties, and (f) pandemic negatively impacted children's socialization and learning. DISCUSSION The results are discussed in the context of equity. Through understanding the experiences of Spanish-speaking mothers, SLPs can work to ensure service levels comparable with those of monolingual children and support bilingual acquisition.
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Affiliation(s)
| | - Lindsey M Bell
- College of Education & Human Sciences, The University of New Mexico, Albuquerque
| | - Monique N Rodriguez
- College of Education & Human Sciences, The University of New Mexico, Albuquerque
| | - Vanessa Viramontes
- Department of Speech and Hearing Sciences, The University of New Mexico, Albuquerque
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Ponnapakkam A, Krick J, Brink H, Koslow E, Cervero R, Martin PC. Conceptualizing and Developing Competence in Newborn Medicine Among Military Pediatricians. Mil Med 2024:usae318. [PMID: 38894667 DOI: 10.1093/milmed/usae318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/25/2024] [Accepted: 06/11/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Competence in neonatal care is especially important for military pediatricians because military pediatricians can be asked to serve in remote duty locations with limited resources. We sought to understand how this competence is defined, developed, and assessed by military pediatric training programs. MATERIALS AND METHODS After Institutional Review Board approval was obtained, we interviewed educators and recent graduates from every pediatric military training program to construct a shared definition of competence. We then used Kern's Six Steps for curriculum development to understand how competence is taught and assessed. RESULTS Participants felt that competence for military pediatricians in the neonatal setting meant that learners should be able to provide a full spectrum of newborn care in any military setting. Participants confirmed that this competence was particularly important for military pediatricians because of the possibility of remote duty locations. Participants felt that specific knowledge, skills, and attitudes supported competence. Knowledge domains include distinguishing normal newborns from abnormal newborns, managing normal newborn care, managing common newborn abnormalities, and creating a safe escalation plan for complicated or uncommon newborn abnormalities. Specific skills that support competence are newborn resuscitation, delivery of effective ventilation, and neonatal circumcision. Specific attitudes that support competence are, understanding the personal limits of knowledge and understanding the resources for escalation of care. Educators use a variety of modalities to teach toward competence, including the structured curricula, bedside teaching, and simulation. According to participants, the assessment of learners occurs primarily through narrative assessment and feedback but would ideally occur through direct observation. CONCLUSIONS Competence in the neonatal setting is particularly important for military pediatricians. Essential skills undergo differential assessment and current assessment methods differ from ideal assessment methods. Future work should focus on how these facets can support a unified curriculum in newborn medicine.
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Affiliation(s)
- Adharsh Ponnapakkam
- Department of Pediatrics, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Jeanne Krick
- Department of Pediatrics, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Hannah Brink
- Department of Pediatrics, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Elizabeth Koslow
- Department of Pediatrics, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Ronald Cervero
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Paolo C Martin
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Rizzolo K, Rockey N, Cervantes L. Centering marginalized voices in advocacy for equitable policy change in kidney disease. Curr Opin Nephrol Hypertens 2024:00041552-990000000-00168. [PMID: 38873772 DOI: 10.1097/mnh.0000000000001005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
PURPOSE OF REVIEW Inequities in kidney disease are a result of differences in healthcare access and inequitable structural policies that lead to downstream social challenges. An individual with kidney disease sits at the intersection of a variety of governmental and institutional policies that directly affect their access to kidney healthcare and different care delivery models. However, their voice in policy change is often neglected by stakeholders with more structural power. Marginalized individuals with kidney disease are disproportionately affected by kidney disease and inequitable policies can further these health disparities. The review aims to describe how marginalized individuals can be centered in research and lead in advocacy efforts to promote equitable policy change. RECENT FINDINGS The marginalized patient voice is critical in advocacy to promote equitable policy change. We discuss examples illustrating research and advocacy methods which center and partner with marginalized communities to catalyze effective policy interventions. SUMMARY Centralizing the patient voice when engaging in advocacy can identify and contextualize the effects of inequitable public policy and improve advocacy efforts.
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Affiliation(s)
- Katherine Rizzolo
- Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Section of Nephrology, Boston, Massachusetts
| | - Nathan Rockey
- Department of General Internal Medicine, University of Colorado, Anschutz Campus, Aurora, Colorado, USA
| | - Lilia Cervantes
- Department of General Internal Medicine, University of Colorado, Anschutz Campus, Aurora, Colorado, USA
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Joyce E, Pratt D, Lea J. " Where Is My Place?" A Qualitative Study of Gay Men's Experiences of Social Support, Relationships and Community in Relation to Psychological Wellbeing and Distress. JOURNAL OF HOMOSEXUALITY 2024:1-27. [PMID: 38787790 DOI: 10.1080/00918369.2024.2354408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
This study aimed to understand young gay men's experiences of social support, relationships, community networks, talking about psychological distress, and their impact on distress and wellbeing. Eight verbatim transcriptions from semi-structured interviews with gay men aged 18-35 years were analyzed using Interpretative Phenomenological Analysis. Three super-ordinate themes were developed; 1) Growing up gay in a straight world: Developmental traumas, regarding men's experiences of homophobic abuse and exclusion and the internalized impact on their identities and identity concealment. 2) Belonging and not belonging within LGBTQ+ communities, encompassing men's varied experiences of LGBTQ+ communities and the corresponding impacts upon their wellbeing. 3) Relational responses to rejection, describing how men made sense of and managed their relationships within the context of the developmental traumas they had experienced growing up as gay men. These findings illuminate the psychological impact of experiencing multiple developmental traumas related to one's identity as a gay man, and how this influences lifelong relational behavior; and how experiences of social support, relationships and LGBTQ+ communities influence men's mental health. They provide a strong rationale for psychological interventions to acknowledge and address gay men's unique and adverse social experiences within their relationships, communities and societies.
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Affiliation(s)
- Emmeline Joyce
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Suicide Risk and Safety Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - James Lea
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Karhulahti VM. Reasons for qualitative psychologists to share human data. BRITISH JOURNAL OF SOCIAL PSYCHOLOGY 2023; 62:1621-1634. [PMID: 36068662 DOI: 10.1111/bjso.12573] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/17/2022] [Indexed: 11/29/2022]
Abstract
Qualitative data sharing practices in psychology have not developed as rapidly as those in parallel quantitative domains. This is often explained by numerous epistemological, ethical and pragmatic issues concerning qualitative data types. In this article, I provide an alternative to the frequently expressed, often reasonable, concerns regarding the sharing of qualitative human data by highlighting three advantages of qualitative data sharing. I argue that sharing qualitative human data is not by default 'less ethical', 'riskier' and 'impractical' compared with quantitative data sharing, but in some cases more ethical, less risky and easier to manage for sharing because (1) informed consent can be discussed, negotiated and validated; (2) the shared data can be curated by special means; and (3) the privacy risks are mainly local instead of global. I hope this alternative perspective further encourages qualitative psychologists to share their data when it is epistemologically, ethically and pragmatically possible.
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Affiliation(s)
- Veli-Matti Karhulahti
- Department of Music, Art and Culture Studies, Faculty of Humanities and Social Sciences, University of Jyväskylä, Jyväskylä, Finland
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D'Hooghe S, Inaç Y, Deforche B, Van Dyck D, de Ridder K, Vandevijvere S, Van de Weghe N, Dury S. The role of the perceived environment for recreational walking among adults in socioeconomically disadvantaged situations: A study using walk-along interviews. SSM Popul Health 2023; 23:101456. [PMID: 37501782 PMCID: PMC10368917 DOI: 10.1016/j.ssmph.2023.101456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
Background Persons in socioeconomically disadvantaged situations (PSEDS) are generally less likely to engage in recreational walking (RW) compared to higher socioeconomic groups and are often more dependent on their local environment. Studies on RW have primarily focused on the role of the built environment for the general adult population and the older population in urban areas. The aim of this study is to qualitatively identify the perceived environmental factors affecting RW among PSEDS in peri-urban areas. Methods In two peri-urban municipalities in Belgium, walk-along interviews were conducted until data saturation with a purposeful convenience sampling of 38 PSEDS (25-65y/o) to identify local environmental factors affecting RW. A subsample of 22 participants joined a focus group (n = 4) to categorize the identified factors into environmental types (physical, sociocultural, political, and economic) of the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The interviews were transcribed and analyzed thematically using Maxqda 2022.0. Results The information environment (dissemination, retrieving and understanding of information) was added to the ANGELO framework, highlighting the importance of digital literacy. Availability and accessibility of well-maintained walking surfaces, toilets, street lighting and seating options (physical environment), social support, dog-ownership, stigmatization, social isolation, and a sense of belonging (sociocultural environment) and indirect costs (economic environment) were identified as important environmental factors in RW among PSEDS. The identified political and economic factors are intertwined with the other environments. Conclusions Perceived environmental factors affect RW among PSEDS and peri-urban settings offer specific challenges. Local governments should incorporate citizen perception into decision-making processes to create supportive environments that have the potential to promote RW among PSEDS in a peri-urban setting.
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Affiliation(s)
- Suzannah D'Hooghe
- Sciensano, Department of Epidemiology and Public Health, Belgium
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Yasemin Inaç
- Sciensano, Department of Epidemiology and Public Health, Belgium
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium
- Ghent University, Faculty of Sciences, Department of Geography, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Benedicte Deforche
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium
- Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Belgium
| | - Delfien Van Dyck
- Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Belgium
| | - Karin de Ridder
- Sciensano, Department of Epidemiology and Public Health, Belgium
| | | | - Nico Van de Weghe
- Ghent University, Faculty of Sciences, Department of Geography, Belgium
| | - Sarah Dury
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Wakeling J, Cleland J, Stirling SA, Johnston P. 'A Unique opportunity to test things out': a qualitative study of broad-based training in Scotland. BMJ Open 2023; 13:e067733. [PMID: 37202146 DOI: 10.1136/bmjopen-2022-067733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES A recent review recommended UK postgraduate medical education should produce doctors capable of providing general care in broad specialties across a range of different settings. Responding to this, broad-based training (BBT) was introduced in Scotland in 2018 to provide postgraduate trainees with a grounding in four specialties. Introduced as an option for trainees after initial postgraduate 'Foundation' training, it comprises 6 months in general medicine, general practice, paediatrics and psychiatry.This study addresses two key BBT outcomes. It examines how successful BBT is in developing trainees who perceive they are able to work beyond traditional specialty boundaries to care for patients with complex, multifactorial healthcare needs. Second, it explores how well BBT prepares trainees for their next stage in training. DESIGN A longitudinal qualitative study using semistructured interviews to collect data from BBT trainees, trainers and 'programme architects'. Fifty-one interviews were conducted, 31 with trainees (with up to three interviews per trainee across BBT and immediately afterwards (post-BBT)) and 20 with trainers. Data were subject to thematic analysis. RESULTS Two overarching themes were identified: (1) trainees able to work beyond specialty boundaries and (2) preparation for the next stage in training. BBT trainees were able to see the links and overlap between different specialties and understand the interface between primary and secondary care. They did not perceive that BBT (as compared with single-specialty early-stage training) disadvantaged them, other than in terms of specialty examination preparation. BBT was seen as a way to keep career options open in a system where it is difficult to switch training pathway. CONCLUSIONS BBT has the capacity to create doctors who will carry on using their generalist skills to care for patients more holistically, even if they end up working in focused practice areas. BBT helps to keep options open for longer, which is beneficial in a highly structured training environment.
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Affiliation(s)
| | - Jennifer Cleland
- Medical Education Research & Scholarship Unit, Lee Kong Chian School of Medicine, Singapore
| | | | - Peter Johnston
- Medicine, NHS Education for Scotland, Edinburgh, UK
- Centre for Healthcare Education Research & Innovation, University of Aberdeen, Aberdeen, UK
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Versluis MAC, Jöbsis NC, Jaarsma ADC, Tuinsma R, Duvivier R. International Health Electives: defining learning outcomes for a unique experience. BMC MEDICAL EDUCATION 2023; 23:157. [PMID: 36922810 PMCID: PMC10015142 DOI: 10.1186/s12909-023-04124-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND An International Health Elective (IHE) can be a unique learning experience for students. However, it has proven difficult to clearly define learning outcomes that capture the complexity of an IHE and are aligned with future professional performance. This study aimed to further define learning outcomes for IHEs in low- to middle-income countries (LMIC) from a student perspective. METHODS We conducted a deductive analysis of pre-departure and post-elective reflective reports of fifth-year medical students who participated in an IHE as part of their program. This provided possible learning objectives that were further explored in semi-structured individual interviews with medical students who had recently returned from an IHE. RESULTS We analyzed 33 reports of students participating in an IHE from 2017-2019 and held 19 interviews. Thematic analysis revealed 9 themes: developing intercultural competence, developing appreciation for differences in health care delivery systems, understanding international health, understanding the global burden of disease, developing a career perspective, developing clinical skills in resource low settings, becoming cost conscious, developing social responsibility and self-actualization. CONCLUSIONS We identified 9 learning outcomes that are directly and indirectly related to clinical practice. They add to the on-going discourse on the benefits of IHEs. These outcomes can be further developed by investigating the perspectives of home and host supervisors and educationalists, while taking the local context into account. Follow-up studies can evaluate to what extend these outcomes are achieve during an IHE.
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Affiliation(s)
- M A C Versluis
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, PO Box 30001, 9700RB, Groningen, the Netherlands.
- Rijksuniversiteit Groningen, Faculteit der Medische Wetenschappen, Groningen, the Netherlands.
- Center for Educational Development and Research in Health Sciences (CEDAR), Lifelong learning, Education and Assessment Research Network (LEARN), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - N C Jöbsis
- Faculty of Medical Sciences, University Medical Center Groningen, Groningen, the Netherlands
| | - A D C Jaarsma
- Center for Educational Development and Research in Health Sciences (CEDAR), Lifelong learning, Education and Assessment Research Network (LEARN), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - R Tuinsma
- International Office, Wenckebach Institute for Education and Training, University Medical Center Groningen, Groningen, the Netherlands
| | - R Duvivier
- Center for Educational Development and Research in Health Sciences (CEDAR), Lifelong learning, Education and Assessment Research Network (LEARN), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Parnassia Psychiatric Institute, The Hague, the Netherlands
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Fortin J, Rivest-Beauregard M, Defer C, Leblanc M, Thamar Louis LA, Roy CA, Lapierre I, Brunet A, Montreuil M, Marin MF. The Impact of Canadian Medical Delays and Preventive Measures on Breast Cancer Experience: A Silent Battle Masked by the COVID-19 Pandemic. Can J Nurs Res 2023; 55:55-67. [PMID: 35484788 PMCID: PMC9086203 DOI: 10.1177/08445621221097520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic led to the prioritization of breast cancer services towards patients who are currently in treatment or diagnosed with advanced stages of breast cancer, and the self-assessment of both tumor growth and treatment side effects. Alongside the stress associated with cancer itself, delays and complications due to COVID-19 may impact patients' mental health. PURPOSE To describe the experiences of Canadians living with breast cancer who received a diagnosis and/or treatment during the pandemic, and to identify their recommendations for improving patients well-being during future pandemics. METHODS Semi-structured interviews were conducted with eighteen women living with breast cancer who also completed the Distress Thermometer questionnaire. The transcripts were analyzed using a descriptive thematic content methodology. RESULTS Women who started their breast cancer screening or treatment before the pandemic reported fewer delays and less psychological distress than those who started during the pandemic. Participants reported feeling dehumanized while receiving their medical care, being unable to be accompanied during medical visits, and fearing treatment interruption during the pandemic. Patient recommendations for improving care and psychological support included the presence of family caregivers at consultations to receive the diagnosis and for the first treatment session. CONCLUSION Study findings provide new insights on how healthcare restrictions during the pandemic impacted on patient experiences and their well-being during screening and treatment for breast cancer. The need for cancer nursing practices and care delivery strategies that promote the delivery of compassionate, patient-centred care and the provision of psychological support during future pandemics are identified.
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Affiliation(s)
- Justine Fortin
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada,Centre de recherche de l’Institut en santé mentale de Montréal, CIUSSS-de-l’Est-de-l’Île-de-Montréal, Montreal, Quebec, Canada,Justine Fortin, 7331, rue Hochelaga Montréal, Québec, H1N 3V2, Canada.
| | | | - Clarisse Defer
- Department of Oncology, Hôpital Maisonneuve-Rosemont (CIUSSS-de-l’Est-de-l’Île-de-Montréal), Montreal, Quebec, Canada
| | | | | | - Carol-Anne Roy
- Department of Psychology, Université du Québec en Outaouais, Montreal, Quebec, Canada
| | | | - Alain Brunet
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Marjorie Montreuil
- Centre de recherche de l’Institut en santé mentale de Montréal, CIUSSS-de-l’Est-de-l’Île-de-Montréal, Montreal, Quebec, Canada,Department of Nursing, McGill University, Montreal, Quebec, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada,Centre de recherche de l’Institut en santé mentale de Montréal, CIUSSS-de-l’Est-de-l’Île-de-Montréal, Montreal, Quebec, Canada
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Amerzadeh M, Takian A, Pouraram H, Akbari Sari A, Ostovar A. Economic barriers and gaps to reach the desirable consumption of salt, sugar, and fat in Iran: a qualitative study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:8. [PMID: 36717955 PMCID: PMC9885062 DOI: 10.1186/s41043-023-00348-8] [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: 10/13/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Non-communicable diseases (NCDs), also known as chronic diseases, specifically cardiovascular diseases (CVD), cancers, respiratory diseases, and diabetes are the main reason for more than two-thirds of global deaths, in which the unhealthy diet is one of the primary risk factors. The golden solution to reducing obesity and CVD linked to an unhealthy diet is to reduce calories, salt, sugar, and fat intake. Besides, activities highlighting lifestyles that contain healthy diets usually focus on reducing salt, sugar, and saturated fat consumption. As a result, the researchers aimed to study the gaps and economic barriers to recommended consumption of salt, sugar, and fat in Iran, based on WHO recommendations. METHODS This is a qualitative study. We conducted semi-structured and in-depth interviews with 30 stakeholders, including academics, experts, and key informants in different sectors from December 2018 until August 2019 in Tehran, Iran. We used a purposeful and snowball sampling method to select participants. All interviews were transcribed verbatim and thematically analyzed using MAXQDA 11. RESULTS Economic problems and inflation in Iran caused people to eat more unhealthy foods, while a healthy diet consumption was reduced due to higher prices. Unfair political sanctions imposed on the country caused economic pressure and adversely affected family nutrition. Worse still, despite legal bans, advertising unhealthy foods via media, mainly to generate revenue, encouraged more consumption of unhealthy food. The lack of targeted subsidies and failure in tax legislation and implementation related to the unhealthy products deteriorated the conditions. CONCLUSION Some economic barriers have hampered plans to reduce salt, fat, and sugar consumption in Iran. Fundamental reforms in the tax and subsidy system are required to improve people's eating habits. In particular, citizens' income that has been continuously shrinking due to economic conditions, imposed sanctions, and the inevitably high inflation needs to be addressed urgently. Unless the government of Iran deals with the economic barriers to healthy nutrition, the pathway for implementing the national action plan for prevention and control of NCDs toward a 30% mortality reduction due to NCDs by 2030 looks unlikely to reach.
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Affiliation(s)
- Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amirhossein Takian
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Poursina Ave, Tehran, Iran.
- Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- Heath Equity Research Center (HERC) - TUMS, Tehran, Iran.
- National Center for Health Insurance Research, The Iranian Health Insurance Organization, Tehran, Iran.
| | - Hamed Pouraram
- Ommunity Nutrition Department, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Poursina Ave, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Amerzadeh M, Takian A, Pouraram H, Sari AA, Ostovar A. Policy analysis of nutrition stewardship for prevention and control of Non-communicable diseases in Iran. BMC Health Serv Res 2023; 23:79. [PMID: 36694184 PMCID: PMC9873537 DOI: 10.1186/s12913-023-09087-2] [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: 08/05/2022] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Non- communicable diseases (NCDs) are the main cause of death, which lead to over 73% of death and 62% of DALYs globally. As an unhealthy diet is the leading behavioral risk factor of NCDs, in line with the national action plan for the prevention and control of NCD, this study explored the nutrition-related stewardship problems to reduce the burden of NCDs in Iran. METHODS This is a qualitative study. We interviewed 30 purposefully identified key informants, i.e., stakeholders, policymakers, and academics, from December 2018 to August 2019. All interviews were recorded and transcribed verbatim. We analyzed data using qualitative content analysis facilitated by MAXQDA 11 software. RESULTS Ample policies and laws were identified, most of which were not or partially implemented. Despite some plausible efforts, NCDs do not seem to be a top priority for high-level managers and decision-makers. Besides, the role of non-state actors, i.e., the private sector, is marginal in NCD's planning and management. Whereas the government, e.g., the Food and Drug Organization (FDO), is the biggest player. Worse still, many harmful products are advertised and easily distributed across the country. CONCLUSION Iran's government has created a noticeable roadmap to battle NCDs despite imposing many sanctions and related socioeconomic problems. Nevertheless, more interventions are needed to strengthen the stewardship of NCDs by various stakeholders. We recommend the government to monitor the implementation of policies and advertisement of harmful products to prioritize prevention and control of NCDs. In addition, we advocate employing the capacity of non-state actors to reduce the consumption of unhealthy food and the burden of NCDs across the country, ultimately.
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Affiliation(s)
- Mohammad Amerzadeh
- grid.412606.70000 0004 0405 433XSocial Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin university of Medical Sciences, Qazvin, Iran
| | - Amirhossein Takian
- grid.411705.60000 0001 0166 0922Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran ,grid.411705.60000 0001 0166 0922Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran ,Heath Equity Research Center (HERC) – TUMS, Tehran, Iran ,National Center for Health Insurance Research, The Iranian Health Insurance Organization, Tehran, Iran
| | - Hamed Pouraram
- grid.411705.60000 0001 0166 0922Community Nutrition Department, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ali Akbari Sari
- grid.411705.60000 0001 0166 0922Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Afshin Ostovar
- grid.411705.60000 0001 0166 0922Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Larsen SM, Brandt Å, Hounsgaard L, Kristensen HK. Occupational therapists’ perspectives on an evidence-based, client-centered assistive technology intervention. Br J Occup Ther 2023. [DOI: 10.1177/03080226221148409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction: Reviews within the field of assistive technology have shown that a client-centered approach is important for user satisfaction, and that assistive technology service delivery should be evidence-based, systematic, and structured. However, client-centered instruments and systematic, structured models are not used consistently. As part of a larger research project, an evidence-based, client-centered assistive technology service delivery process was developed and piloted. The purpose of this study was to investigate occupational therapists’ perspectives on this evidence-based, client-centered assistive technology intervention. Method: Ten occupational therapists, from two Danish municipalities, participated in focus groups. Data were analyzed based on a hermeneutic approach. Results: Three themes emerged from the analysis: a more refined collaboration with clients; advantages of using theoretical frameworks, structured models and instruments and challenges in using the intervention. Conclusion: By using the evidence-based, client-centered intervention, the occupational therapists found that the collaboration with the clients was refined—more emphasis was placed on shared responsibility. They found that the intervention was time-efficient in the long run; however, there seems to be a particular challenge in designing services that are inclusive of clients with cognitive limitations.
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Affiliation(s)
- Stina Meyer Larsen
- Centre for Innovative Medical Technology (CIMT), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Åse Brandt
- User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lise Hounsgaard
- Odense Patient data Explorative Network (OPEN), Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense Denmark
- Centre for Psychiatric Nursing and Health Research, Department of Regional Health Research, University of Southern Denmark
- Institute of Nursing & Health Science, University of Greenland, Nuuk, Greenland
| | - Hanne Kaae Kristensen
- Centre for Innovative Medical Technology (CIMT), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Health Sciences Research Centre, UCL University College, Odense, Denmark
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Karnieli-Miller O, Divon-Ophir O, Sagi D, Pessach-Gelblum L, Ziv A, Rozental L. More Than Just an Entertainment Show: Identification of Medical Clowns' Communication Skills and Therapeutic Goals. QUALITATIVE HEALTH RESEARCH 2023; 33:25-38. [PMID: 36384326 PMCID: PMC9827496 DOI: 10.1177/10497323221139781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Medical clowns (MCs) are trained professionals who aim to change the hospital environment through humor. Previous studies focused on their positive impact and began identifying their various skills in specific situations. When placed in pediatrics, MCs face various challenges, including approaching frustrated adolescents who are unwilling to cooperate with their care, dealing with their anxious parents, and communicating in a team in the presence of other health professionals. Research that systematically describes MCs' skills and therapeutic goals in meeting these challenges is limited. This article describes a qualitative, immersion/crystallization study, triangulating between 26 video-recorded simulations and 12 in-depth-semi-structured interviews with MCs. Through an iterative consensus-building process we identified 40 different skills, not limited to humor and entertainment. Four main therapeutic goals emerged: building a relationship, dealing with emotions, enhancing a sense of control, caring, and encouragement, and motivating treatment adherence. Mapping MCs' skills and goals enhances the understanding of MCs' role and actions to illustrate their unique caring practices. This clarification may help other healthcare professionals to recognize their practices and the benefits in involving them in care. Furthermore, other health professionals may apply some of the identified skills when faced with these challenges themselves.
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Affiliation(s)
| | | | | | | | - Amitai Ziv
- Tel Aviv
University, Tel Aviv, Israel
- Sheba Medical
Center, Israel
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15
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Sarpy C, Shukralla H, Greville H, Thompson SC. Exploring the Implementation of Workplace-Focused Primary Prevention Efforts to Reduce Family Violence in a Regional City: The Need for Clarity, Capacity, and Communication. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16703. [PMID: 36554584 PMCID: PMC9779125 DOI: 10.3390/ijerph192416703] [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: 11/18/2022] [Revised: 12/02/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
In response to the high burden of family and domestic violence (FDV), The Australian National Plan to End Violence Against Women and Children has established that primary prevention measures are necessary to reduce FDV's harmful impacts on health. The Community, Respect, and Equality (CRE) project is a primary prevention initiative aimed towards changing harmful social norms and practices that enable FDV in Geraldton, Western Australia. Organizations affiliated with the CRE are required to promote gender equality and a respectful work environment. However, there is a gap in the literature regarding the impact and effectiveness of such interventions, especially in rural/regional areas. As such, this study served to evaluate the project's effectiveness in a CRE-certified workspace, a local non-profit social services provider. Investigators conducted interviews to learn how the organization had implemented the CRE, and whether the CRE had had an impact on social norms and practices within the work environment. Findings indicated that the project had largely failed to permeate workplace culture due to a lack of effective promotion, low perceived benefits, and low resources. Future interventions must take persuasive measures, even for organizations perceived to be receptive to change.
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Affiliation(s)
- Caroline Sarpy
- School of Health, Georgetown University, Washington, DC 20057, USA
- School of Allied Health, University of Western Australia, Perth, WA 6009, Australia
| | - Heidi Shukralla
- School of Allied Health, University of Western Australia, Perth, WA 6009, Australia
| | - Heath Greville
- School of Allied Health, University of Western Australia, Perth, WA 6009, Australia
| | - Sandra C. Thompson
- School of Allied Health, University of Western Australia, Perth, WA 6009, Australia
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Ojifinni OO, Ibisomi L. Perception of men's need for preconception care-A qualitative exploration among health care providers and community members. Front Public Health 2022; 10:958618. [PMID: 36523582 PMCID: PMC9745313 DOI: 10.3389/fpubh.2022.958618] [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: 05/31/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Several studies have shown that suboptimal health in men can result in poor reproductive health outcomes. The factors associated include lifestyle exposures and poor health-seeking behavior. The poor reproductive health outcomes can be mitigated through preconception care (PCC). PCC services for men are however rare. This qualitative study explored views about men's need for PCC in Nigeria. Methods This exploratory qualitative study was done in Ibadan North Local Government Area, Oyo State, Nigeria. Focus group discussions were held with 12 religious leaders, 22 men and 23 women of reproductive age at the community level. There were key informant interviews with two community leaders and 26 health workers including specialist physicians and nurses at the primary, secondary, and tertiary health care levels. Transcribed data were analyzed thematically using inductive coding on MAXQDA. Results The reasons participants proffered for men's health requiring attention included men's genetic contribution to pregnancy, treatment of low sperm count, and preventing transmission of infection to their partners. Participants stated however that men are often reluctant about accessing health services until complications arise. Opinions differed on men's need for PCC: while some believed that men need PCC, others expressed contrary views stating that men do not require PCC as the service is more appropriate for women. Conclusion Successful deployment and uptake of PCC services require the availability of the services and improved awareness about the need to optimize men's health along with that of their partners.
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Affiliation(s)
- Oludoyinmola O. Ojifinni
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Latifat Ibisomi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Monitoring and Evaluation Department, Nigerian Institute of Medical Research, Lagos, Nigeria
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Nagington M, King S. Support, care and peer support for gay and bi men engaging in chemsex. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6396-e6403. [PMID: 36256495 PMCID: PMC10092040 DOI: 10.1111/hsc.14081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/29/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
The objective of this research was to explore how gay men use drugs in their sex lives, colloquially called "chemsex". This paper reports on a sub-theme within the research about support, care and peer support. Longitudinal interviews were conducted with 20 gay and bi men between April 2017 and July 2019. Participants were recruited via geolocated dating apps (n = 17) and snowball sampling (n = 3). The main findings of this research are that medicalised forms of support for gay and bi men engaging in chemsex are often tardy in their responses to need, and whilst helpful for cessation of drug use, fail to address the holistic needs of the participants. A wide variety of peer support was practiced amongst the sample which often echoed previous forms of peer support practiced in the LGBT+ community. It was offered by both people who engaged in chemsex and those who did not and was highly beneficial to people who experienced problems with chemsex. However, peer support was also limited by factors such as shame and the instability of those offering support. In conclusion, we suggest that medicalised forms of chemsex support could benefit from more rigorous and rapid forms of assessment for problematic chemsex, and also provide infrastructure and training to peer support initiatives. We also suggest that medical services could learn from patients and their peers about what support needs remain unaddressed by professional services, and engage in collaborative approaches to practice development.
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von Rieben MA, Boyd L, Sheen J. Care in the time of COVID: An interpretative phenomenological analysis of the impact of COVID-19 control measures on post-partum mothers’ experiences of pregnancy, birth and the health system. Front Psychol 2022; 13:986472. [PMID: 36211889 PMCID: PMC9537098 DOI: 10.3389/fpsyg.2022.986472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFindings suggest pandemic control measures have modified maternal health practices, compromising the quality of care provided to new and expectant mothers and interfering with their birthing experiences. For this reason, this study explored the lived experiences of post-partum Victorian mothers during the pandemic as well as the potential influence of control measures over their perceptions regarding the health system.MethodsThis study used a qualitative approach. Recruitment was conducted between May and June 2021, using both the Australian Breastfeeding Association’s social media pages and snowball recruitment. Interviews were semi-structured using open-ended questions relating to key themes. Seven Victorian post-partum mothers were identified and their transcripts analysed using Interpretative Phenomenological Analysis.ResultsMothers described how unexpected changes to maternal care exacerbated feelings of uncertainty regarding pregnancy and birth. Mothers also differentiated between impacts by the health system and the role healthcare professionals played in moderating these effects. Whilst visitor restrictions provided some benefit, restrictions to familial and social support left many of the mothers feeling alone during their pregnancy and interfered with their immediate post-partum experience.ConclusionThis study illustrates the importance of evidence-based practice in maternal care and provides insights for both health professionals and policy analysts in developing new or modifying existing guidelines that better balance the needs of expectant and post-partum mothers with pandemic control measures.
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Affiliation(s)
- Mikhayl A. von Rieben
- School of Psychology, Deakin University, Burwood, VIC, Australia
- *Correspondence: Mikhayl A. von Rieben,
| | - Leanne Boyd
- Monash University, Eastern Health, Melbourne, VIC, Australia
| | - Jade Sheen
- School of Psychology, Deakin University, Burwood, VIC, Australia
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Dunkley‐Smith AJ, Reupert AE, Sheen JA. 'It's like they're learning what it is for the very first time': Clinician's accounts of self-compassion in clients whose parents experience mental illness. Psychol Psychother 2022; 95:738-753. [PMID: 35475532 PMCID: PMC9545345 DOI: 10.1111/papt.12396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/28/2022] [Accepted: 04/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Individuals who have a parent with mental illness are more likely to experience mental illness than their contemporaries. As such, it is valuable to examine potential psychological resources, which might assist these individuals to experience good mental health throughout their lifespan. We aimed to learn how clinicians perceive self-compassion, and how it can be incorporated into therapy with clients who have parents with mental illness. DESIGN A qualitative interview design was employed to explore clinicians' perspectives and experiences. METHODS Eight mental health clinicians experienced in working with clients who have parents with mental illness were interviewed. Interpretative phenomenological analysis was used to establish themes representing the clinicians' perspectives and experiences of incorporating self-compassion into their work. RESULTS This study found that clinicians were generally positive about incorporating self-compassion into interventions with clients who are children of parents with mental illness. The participants noted barriers to self-compassion for these clients, namely a poor sense of self and divided loyalty between self and family. Participants recommended taking time and care, building rapport and involving others when cultivating self-compassion with those who have parents with mental illness. CONCLUSIONS This group of clinicians viewed self-compassion as relevant to clients whose parents have mental illness and believe it can be introduced therapeutically in various ways. Suggestions are made for tailoring self-compassion training to the needs and experiences of this group.
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20
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Band-Winterstein T, Goldblatt H, Lev S, Harel D. Forms of sexual assault against older women in the context of acquaintance relationships: An intersectional perspective. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2330-e2339. [PMID: 34850479 DOI: 10.1111/hsc.13672] [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: 03/21/2021] [Revised: 11/14/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
This study addresses forms of sexual assault against women in late life (SAWLL) from an intersectional perspective, focusing on acquaintance relationships. Qualitative research was conducted, using in-depth interviews with 18 welfare and healthcare professionals who treated sexual assault survivors. Five forms (themes) emerged, relevant to the identification of SAWLL: (1) Coercive sexual assault in the context of changes brought on by old age, (2) contempt and sexual humiliation based on ageist and sexist social constructions, (3) violation of the older women's dignity in the multigenerational context, (4) life-long incestuous relationships and sexual assault against older women and (5) erotic touching and exhibitionism in caregiving relationships. The revealed forms emphasise the vulnerability of older women who are sexually assaulted in domestic relationships by perpetrators whom they know. These forms can contribute to filling the existing gap in knowledge on SAWLL and promote the visibility of sexually assaulted older women in the justice system. In addition, they can aid law enforcement, health and welfare professionals and policymakers to advance the general understanding of SAWLL as well as improve the response to this phenomenon.
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Affiliation(s)
- Tova Band-Winterstein
- Department of Gerontology, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Hadass Goldblatt
- Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Sagit Lev
- School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
| | - Dovrat Harel
- The Drama Therapy Graduate Program, Tel Hai Academic College, Kiryat Shmona, Israel
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21
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Surendran S, Foo CD, Matchar DB, Ansah JP, Car J, Koh GCH. Developing integration among stakeholders in the primary care networks of Singapore: a qualitative study. BMC Health Serv Res 2022; 22:782. [PMID: 35706015 PMCID: PMC9198200 DOI: 10.1186/s12913-022-08165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/09/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Integrating healthcare services across and between the different health system levels can be achieved in a few ways; however, examining the social side of integration is essential and challenging. This paper explores the concept of integration perceived by general practitioners (GPs) and primary care network (PCN) representatives from the regional health systems (RHS) in a GP-RHS PCN and their perceived partnership success. METHODS In this study, we explored three GP-RHS PCNs in Singapore. We used a qualitative research design and, overall, performed 17 semi-structured in-depth interviews with GPs (n = 11) and PCN representatives (n = 6) from the RHS. All interviews were audiotaped and transcribed verbatim. We conducted thematic analysis to inductively identify themes from the data. Singer's conceptual model of integration types was used as guiding principles to derive relevant and salient themes for integration. RESULTS GPs and the RHS perceived the concept of integration through a series of interrelated strategies. Within the normative dimension, a sense of urgency motivated GPs to integrate improvements into their general practice. Participants perceived teamwork and relational climate as appropriate enablers for achieving interpersonal integration in a primary care partnership. While developing a trusted relationship was a perceived success of this partnership across the network, developing camaraderie and gaining knowledge in chronic disease management through the components of functional integration was a perceived success at an individual general practice level. The data also revealed some operational challenges within the structural dimension and some inabilities of the PCN to achieve complete process integration. CONCLUSIONS Our study points to multi-faceted integration, comprising various forms that need to be manifested at all levels of care to achieve coordinated, seamless, and comprehensive care for patients suffering from chronic conditions. The present iteration of the PCN has been shown to offer integration at a level that warrants praise but still requires structural and process integration improvement.
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Affiliation(s)
- Shilpa Surendran
- grid.4280.e0000 0001 2180 6431Health Systems and Behavioral Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, Singapore, Singapore
| | - Chuan De Foo
- grid.4280.e0000 0001 2180 6431Health Systems and Behavioral Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, Singapore, Singapore
| | - David Bruce Matchar
- grid.428397.30000 0004 0385 0924Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - John Pastor Ansah
- grid.428397.30000 0004 0385 0924Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Josip Car
- grid.59025.3b0000 0001 2224 0361Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Gerald Choon Huat Koh
- grid.4280.e0000 0001 2180 6431Health Systems and Behavioral Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, Singapore, Singapore
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Gosling H, Pratt D, Lea J. Understanding self-harm urges and behavior amongst non-binary young adults: A grounded theory study. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2073310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hannah Gosling
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - James Lea
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Horton A, Nugus P, Fortin MC, Landsberg D, Cantarovich M, Sandal S. Health system barriers and facilitators to living donor kidney transplantation: a qualitative case study in British Columbia. CMAJ Open 2022; 10:E348-E356. [PMID: 35440483 PMCID: PMC9022938 DOI: 10.9778/cmajo.20210049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In patients with kidney failure, living donor kidney transplantation (LDKT) is the best treatment option; yet, LDKT rates have stagnated in Canada and vary widely across provinces. We aimed to identify barriers and facilitators to LDKT in a high-performing health system. METHODS This study was conducted using a qualitative exploratory case study of British Columbia. Data collection, conducted between October 2020 and January 2021, entailed document review and semistructured interviews with key stakeholders, including provincial leadership, care teams and patients. We recruited participants via purposive sampling and snowballing technique. We generated themes using thematic analysis. RESULTS After analysis of interviews conducted with 22 participants (5 representatives from provincial organizations, 7 health care providers at transplant centres, 8 health care providers from regional units and 2 patients) and document review, we identified the following 5 themes as facilitators to LDKT: a centralized infrastructure, a mandate for timely intervention, an equitable funding model, a commitment to collaboration and cultivating distributed expertise. The relationship between 2 provincial organizations (BC Transplant and BC Renal Agency) was identified as key to enabling the mandate and processes for LDKT. Five barriers were identified that arose from silos between provincial organizations and manifested as inconsistencies in coordinating LDKT along the spectrum of care. These were divided accountability structures, disconnected care processes, missed training opportunities, inequitable access by region and financial burden for donors and recipients. INTERPRETATION We found strong links between provincial infrastructure and the processes that facilitate or impede timely intervention and referral of patients for LDKT. Our findings have implications for policy-makers and provide opportunities for cross-jurisdictional comparative analyses.
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Affiliation(s)
- Anna Horton
- Research Institute of the McGill University Health Centre (Horton, Cantarovich, Sandal); Department of Family Medicine and Institute of Health Sciences Education (Nugus), McGill University; Division of Nephrology (Fortin), Department of Medicine, Centre hospitalier de l'Université de Montréal; Centre de recherche du Centre hospitalier de l'Université de Montréal (Fortin), Montréal, Que.; Department of Medicine (Landsberg), University of British Columbia, Vancouver, BC; Division of Nephrology (Cantarovich, Sandal), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - Peter Nugus
- Research Institute of the McGill University Health Centre (Horton, Cantarovich, Sandal); Department of Family Medicine and Institute of Health Sciences Education (Nugus), McGill University; Division of Nephrology (Fortin), Department of Medicine, Centre hospitalier de l'Université de Montréal; Centre de recherche du Centre hospitalier de l'Université de Montréal (Fortin), Montréal, Que.; Department of Medicine (Landsberg), University of British Columbia, Vancouver, BC; Division of Nephrology (Cantarovich, Sandal), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - Marie-Chantal Fortin
- Research Institute of the McGill University Health Centre (Horton, Cantarovich, Sandal); Department of Family Medicine and Institute of Health Sciences Education (Nugus), McGill University; Division of Nephrology (Fortin), Department of Medicine, Centre hospitalier de l'Université de Montréal; Centre de recherche du Centre hospitalier de l'Université de Montréal (Fortin), Montréal, Que.; Department of Medicine (Landsberg), University of British Columbia, Vancouver, BC; Division of Nephrology (Cantarovich, Sandal), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - David Landsberg
- Research Institute of the McGill University Health Centre (Horton, Cantarovich, Sandal); Department of Family Medicine and Institute of Health Sciences Education (Nugus), McGill University; Division of Nephrology (Fortin), Department of Medicine, Centre hospitalier de l'Université de Montréal; Centre de recherche du Centre hospitalier de l'Université de Montréal (Fortin), Montréal, Que.; Department of Medicine (Landsberg), University of British Columbia, Vancouver, BC; Division of Nephrology (Cantarovich, Sandal), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - Marcelo Cantarovich
- Research Institute of the McGill University Health Centre (Horton, Cantarovich, Sandal); Department of Family Medicine and Institute of Health Sciences Education (Nugus), McGill University; Division of Nephrology (Fortin), Department of Medicine, Centre hospitalier de l'Université de Montréal; Centre de recherche du Centre hospitalier de l'Université de Montréal (Fortin), Montréal, Que.; Department of Medicine (Landsberg), University of British Columbia, Vancouver, BC; Division of Nephrology (Cantarovich, Sandal), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - Shaifali Sandal
- Research Institute of the McGill University Health Centre (Horton, Cantarovich, Sandal); Department of Family Medicine and Institute of Health Sciences Education (Nugus), McGill University; Division of Nephrology (Fortin), Department of Medicine, Centre hospitalier de l'Université de Montréal; Centre de recherche du Centre hospitalier de l'Université de Montréal (Fortin), Montréal, Que.; Department of Medicine (Landsberg), University of British Columbia, Vancouver, BC; Division of Nephrology (Cantarovich, Sandal), Department of Medicine, McGill University Health Centre, Montréal, Que.
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Amerzadeh M, Takian A, Pouraram H, Sari AA, Ostovar A. Policy analysis of socio-cultural determinants of salt, sugar and fat consumption in Iran. BMC Nutr 2022; 8:26. [PMID: 35337385 PMCID: PMC8948451 DOI: 10.1186/s40795-022-00518-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 03/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Noncommunicable diseases (NCDs) are the first reason for death worldwide, in which poor diet is the leading risk factor. It is estimated that 20% of all death is related to food. The Unhealthy diet includes many foods with excessive salt, sugar and fat. This paper reports a national study on the socio-cultural determinants affecting salt, sugar and fat consumption in Iran. Methods This is a qualitative study. We conducted semi-structured interviews with 30 various purposefully identified key stakeholders to collect data from December 2018 until August 2019 in Iran. Results We identified socio-cultural determents of salt, fat and sugar consumption as follows: Inadequate structure of traditional medicine and people’s desire for traditional foods, low health literacy, the global trend of nutritional transition and its impact on Iranian society, The progressive decline of people’s trust in NGOs, and Inappropriate media management. Worse still, the global trend of nutritional transition and people’s tendency towards fast foods, unhealthy diet and junk foods, partially due to establishing children’s taste mainly with salty, high-fat and sweet foods, has jeopardized their desire to eat healthily during adulthood. Conclusion Reducing salt, fat and sugar consumption is problematic in Iran, mainly due to multi-dimensional socio-cultural determinants. In line with sustainable development goal (SDG) 3.4 to reduce 30% of premature death due to NCDs and related risk factors by 2030 in Iran, various stakeholders from multiple sectors need to initiate coherent series of interventions to alter people’s approach to select food so that they may reduce the consumption of foods with excessive salt, fat and sugar. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00518-7.
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Affiliation(s)
- Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin university of Medical Sciences, Qazvin, Iran
| | - Amirhossein Takian
- Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran. .,Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran. .,Heath Equity Research Center (HERC) - TUMS, Tehran, Iran.
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Afshin Ostovar
- Center for NCD Prevention and Management, Ministry of Health and Medical Education, Tehran, Iran.,Osteoporosis Research Center, Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Hoedl M, Thonhofer N, Schoberer D. COVID
‐19 pandemic: Burdens on and consequences for nursing home staff. J Adv Nurs 2022; 78:2495-2506. [PMID: 35285060 PMCID: PMC9111450 DOI: 10.1111/jan.15193] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/20/2021] [Accepted: 01/15/2022] [Indexed: 01/13/2023]
Abstract
The objective of this study was to assess burdens placed on and consequences of the COVID‐19 pandemic on nursing home staff.
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Affiliation(s)
- Manuela Hoedl
- Institute of Nursing Science Medical University of Graz Graz Austria
| | - Nina Thonhofer
- Institute of Nursing Science Medical University of Graz Graz Austria
| | - Daniela Schoberer
- Institute of Nursing Science Medical University of Graz Graz Austria
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Surendran S, Foo CD, Tam CH, Ho EQY, Matchar DB, Car J, Koh GCH. The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041817. [PMID: 33668610 PMCID: PMC7917999 DOI: 10.3390/ijerph18041817] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022]
Abstract
In recent years, there is growing interest internationally to implement patient-centered medical homes (PCMHs), and Singapore is no exception. However, studies understanding the influence of contextual policy factors on the implementation of PCMHs are limited. We conducted 10 semi-structured in-depth interviews with general practitioners working in seven out of the nine PCMHs. Audio recordings were transcribed and analyzed by two study team members in NVivo 12 Software using grounded theory techniques. Power dynamics between the stakeholders and lack of shared decision-making among them in selecting the locale of the PCMH and formulating the practice fee and pharmacy structure were the key factors which negatively affected the implementation of PCMHs on a larger scale. Over time, lack of funding to hire dedicated staff to transfer patients and misalignment of various stakeholders’ interest to other right-siting programs also resulted in low number of patients with chronic conditions and revenue. Countries seeking to implement a successful PCMH may benefit from building trust and relationship between stakeholders, engaging in shared decision-making, ongoing cost-efficiency efforts, and formulating a clear delineation of responsibilities between stakeholders. For a healthcare delivery model to succeed in the primary care landscape, policies should be developed keeping mind the realities of primary care practice.
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Affiliation(s)
- Shilpa Surendran
- Health Systems and Behavioral Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (C.D.F.); (C.H.T.); (E.Q.Y.H.); (G.C.H.K.)
- Correspondence:
| | - Chuan De Foo
- Health Systems and Behavioral Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (C.D.F.); (C.H.T.); (E.Q.Y.H.); (G.C.H.K.)
| | - Chen Hee Tam
- Health Systems and Behavioral Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (C.D.F.); (C.H.T.); (E.Q.Y.H.); (G.C.H.K.)
| | - Elaine Qiao Ying Ho
- Health Systems and Behavioral Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (C.D.F.); (C.H.T.); (E.Q.Y.H.); (G.C.H.K.)
| | - David Bruce Matchar
- Health Services and Systems Research, Duke—NUS Medical School, 8 College Road, Singapore 169857, Singapore;
- Department of Medicine (General Internal Medicine), Duke University School of Medicine, 400 Morris Street 3rd Floor, Durham, NC 27701, USA
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore;
| | - Gerald Choon Huat Koh
- Health Systems and Behavioral Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (C.D.F.); (C.H.T.); (E.Q.Y.H.); (G.C.H.K.)
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Walsh SD, Yakhnich L. “Maybe One Day I Will also be Almito”: Ethiopian Israelis, Naming, and the Politics of Immigrant Identity. INTERNATIONAL MIGRATION REVIEW 2020. [DOI: 10.1177/0197918320961996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The issue of name change, and in particular name reclaiming (i.e., taking back a heritage name), among immigrants has been rarely studied academically, despite its centrality to immigrant identity and immigration experiences. Immigrants, in many countries, are often encouraged or pressured to change their names, but in recent years, some have chosen to reclaim their heritage or original names. This article analyzes the practice of name reclaiming among young Israelis of Ethiopian heritage, a community that has experienced racial discrimination. Data were gathered through a qualitative phenomenological study of 19 young adults who immigrated to Israel from Ethiopia as minors. The analysis yielded two simultaneous dialogues: an internal dialogue in which individuals described their personal experience of name reclaiming and an external dialogue in which name reclaiming reflected a political and social process through which a discriminated minority could express increased feelings of power and agency. The results enrich the study of migration by showing the ways in which personal and social-political processes experienced by a discriminated minority intertwine, as vividly illustrated by the specific case of name reclaiming.
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Affiliation(s)
- Sophie D Walsh
- Department of Criminology, Bar Ilan University, Ramat Gan, Israel
| | - Liat Yakhnich
- Department of Youth Development, Beit Berl College, Israel
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Quigley D, Loftus L, McGuire A, O'Grady K. An optimal environment for placement learning: listening to the voices of speech and language therapy students. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:506-519. [PMID: 32189425 DOI: 10.1111/1460-6984.12533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/31/2020] [Accepted: 02/29/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Placements are a core component of learning within speech and language therapy (SLT) undergraduate and postgraduate university programmes. They facilitate the development of students' professional and clinical competencies and socialization into the profession. It is indicated that an optimal environment for placement learning often pivots on the mentoring, supervision and feedback the student receives. AIMS To explore the perspectives of student SLTs in the Republic of Ireland in relation to factors that would best support their learning and competency development on placement. METHODS & PROCEDURES Qualitative data were collected from an anonymous online student survey that consisted of eight open-ended questions. Thematic analysis was applied to the data. Excerpts from the data were selected to illustrate the themes constructed. OUTCOMES & RESULTS A total of 117 students responded. Four salient themes were generated that capture the students' perspectives of an optimal environment for placement learning and competency development. CONCLUSIONS & IMPLICATIONS This study supports quality assurance within the practice education of student SLTs and highlights aspects of an optimal learning environment that practice educators can strive to develop. In parallel, this study points to the need for improved supports from university personnel and placement site managers, and an increased need for student preparedness and self-reflection. Implications for continuing professional development specific to the role of a practice educator is described, in addition to the recommendation of an expanded perspective of supervision within SLT. What this paper adds What is already known on the subject Placements are an integral component of SLT undergraduate and postgraduate university programmes that enable students to translate theory to practice. Placement involves a transition from structured and predictable learning of the classroom to more dynamic learning environment within the placement site. Assessment of placement is carried out by practice educators using competency assessment tools. An optimal environment for placement learning often pivots on the mentoring, supervision and feedback that the student receives from their practice educator. What this paper adds to existing knowledge This study explores student SLTs' voices in relation to what they consider an optimal environment for placement learning should be and what they believe may best support them in their journey to develop their clinical competencies. It supports quality assurance of the practice education of our future colleagues. What are the potential or actual clinical implications of this work? The findings of this enquiry emphasize the distinction between competence as a SLT and competence as a practice educator and have subsequent implications for the content of continuing professional development for practice educators. In particular, an expanded perspective of the models and frameworks of supervision to promote and implement within the practice education of SLT students is presented.
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Affiliation(s)
- Duana Quigley
- Department of Clinical Speech & Language Studies, Trinity College, Dublin, Ireland
| | - Laura Loftus
- Discipline of Speech & Language Therapy, School of Health Sciences, National University of Ireland, Galway, Ireland
| | - Aoife McGuire
- Speech & Language Therapy, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Kerrie O'Grady
- Department of Speech and Hearing Sciences, School of Clinical Therapies, University College Cork, Cork, Ireland
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Barrett PM, Mullen L, McCarthy T. Enduring psychological impact of childhood cancer on survivors and their families in Ireland: A national qualitative study. Eur J Cancer Care (Engl) 2020; 29:e13257. [PMID: 32537764 PMCID: PMC7988562 DOI: 10.1111/ecc.13257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 01/30/2020] [Accepted: 04/16/2020] [Indexed: 12/12/2022]
Abstract
Objective To establish the major expressed psychological needs of adult survivors of childhood cancer living in Ireland. Methods Seven focus groups were conducted with adult survivors of childhood cancer and their parents in 2018. Survivors were invited to participate if they were diagnosed with cancer before age 18. Results Thirty‐three participants (15 survivors, 18 parents; 27 female, 6 male) were included. They had experienced a range of haematological and solid tumours. Five themes were generated: (a) Enduring psychological impact on survivors; many survivors experience delayed trauma and mental health crises in adulthood. (b) Enduring psychological impact on family members; parents and siblings have unmet psychological needs relating to the family's experience of cancer. (c) Enduring impact on family dynamics; survivors and parents expressed fear and guilt relating to cancer which impacted on family interactions. (d) Challenges accessing support; psychological support services are inadequate to meet expressed needs. (e) Desired model of care; no single service model appeals to all survivors, and flexibility is required in the delivery of psychological support. Conclusion Adult survivors of childhood cancer and their family members experience enduring psychological effects relating to their diagnosis and treatment. Psychological support services are inadequate to meet the expressed needs of this growing population.
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Affiliation(s)
- Peter M Barrett
- HSE National Cancer Control Programme, Dublin 1, Ireland.,School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland.,Wellcome Trust/HRB Irish Clinical Academic Training (ICAT) Programme, University College Cork, Cork, Ireland
| | - Louise Mullen
- HSE National Cancer Control Programme, Dublin 1, Ireland
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Nwolise CH, Carey N, Shawe J. Exploratory study of clinician and patient views regarding the use of a preconception care app for women with diabetes. Health Informatics J 2020; 26:2673-2688. [PMID: 32460661 DOI: 10.1177/1460458220921707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Women with diabetes are at increased risk of adverse maternal and foetal outcomes. Preconception care can minimise risk of complications and improve outcomes, but current provision is inadequate. Electronic health technology, particularly apps, could improve preconception care provision but research is lacking in this area. The aim of this article is to explore the views and experiences of clinicians and women with diabetes regarding the use of a mobile app for preconception care. An exploratory study was conducted. Data were collected using focus group and interviews with 19 participants, comprising 10 clinicians and 9 women with type 1 or 2 diabetes. Data were analysed thematically. Women with diabetes and clinicians highlighted the inadequacy and challenges of current preconception care service provision and expressed a high level of enthusiasm and interest, towards a preconception care app that could support preconception care delivery for women with diabetes and overcome barriers to preconception care service provision and uptake. The acceptability of mobile health technology to both women and clinicians creates an important opportunity to overcome existing barriers to service provision, delivery and uptake, and improve both maternal and foetal outcomes for women with diabetes.
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Goldblatt H, Freund A, Drach-Zahavy A, Enosh G, Peterfreund I, Edlis N. Providing Health Care in the Shadow of Violence: Does Emotion Regulation Vary Among Hospital Workers From Different Professions? JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:1908-1933. [PMID: 29294693 DOI: 10.1177/0886260517700620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Research into violence against health care staff by patients and their families within the health care services shows a rising frequency of incidents. The potentially damaging effects on health care staff are extensive, including diverse negative psychological and physical symptoms. The aim of this qualitative study was to examine how hospital workers from different professions reacted to patients' and visitors' violence against them or their colleagues, and how they regulated their emotional reactions during those incidents. The research question was as follows: How do different types of hospital workers regulate the range of their emotional reactions during and after violent events? Participants were 34 hospital workers, representing several professional sectors. Data were collected through in-depth semistructured interviews, which were later transcribed and thematically content analyzed. Five themes were revealed, demonstrating several tactics that hospital workers used to regulate their emotions during incidents of violent outbursts by patients or visitors: (1) Inability to Manage Emotion Regulation, (2) Emotion Regulation by Distancing and Disengagement Tactics, (3) Emotion Regulation Using Rationalization and Splitting Tactics, (4) Emotion Regulation via the Use of Organizational Resources, and (5) Controlling Emotions by Suppression. Hospital workers who experienced dissonance between their professional expectations and their emotional reactions to patients' violence reported using various emotion regulation tactics, consequently managing to fulfill their duty competently. Workers who did not experience such dissonance felt in full control of their emotions and did not manifest responses of emotion regulation. Others, however, experienced intense emotional flooding and failed to regulate their emotions. We recommend developing health care staff's awareness of possible emotional implications of violent incidents, for themselves as people and for their intact functioning at work. In addition, we recommend further development of health care staff training programs for coping with violent patients and enhancement of formal and informal organizational support.
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Broberg L, De Wolff MG, Anker L, Damm P, Tabor A, Hegaard HK, Midtgaard J. Experiences of participation in supervised group exercise among pregnant women with depression or low psychological well-being: A qualitative descriptive study. Midwifery 2020; 85:102664. [PMID: 32126317 DOI: 10.1016/j.midw.2020.102664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 01/07/2020] [Accepted: 02/10/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore experiences with supervised group exercise during pregnancy in women with depression or low psychological well-being. DESIGN A qualitative descriptive study based on semi-structured, individual, in-depth interviews analyzed by means of thematic analysis. SETTING The Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Denmark. PARTICIPANTS Through a purposeful, criterion-based sampling strategy, women with a current diagnosis of depression with prescribed antidepressant and/or a score ≤50 on the five-item World Health Organization Well-being Index were included. The women were recruited from a randomized controlled trial on the effects of supervised group exercise (the EWE study) and participated in the exercise program during the period 26 January 2017-8 March 2018. A total of 282 pregnant women participated in the RCT, of which 143 women were allocated to the intervention group. Of these, 27 women were eligible and were invited; 19 accepted the invitation and were included in the current qualitative descriptive study. Diversity of age, parity, level of education and employment status was seen in the sample. The average time from completing the exercise program to conducting the interview was 6.5 months, ranging from 1 week to 13 months. INTERVENTION The participants were offered an in-hospital supervised group exercise program twice weekly for 12 weeks from 17-22 weeks gestation in addition to standard antenatal care. MEASUREMENTS AND FINDINGS Qualitative thematic analysis of the interviews resulted in the identification of the overarching theme: Vulnerable yet strong. This theme was comprised from three main themes (1) From judging the body to feeling it, (2) A "we" is created, and (3) Taking responsibility and succeeding, together with nine sub-themes. KEY CONCLUSIONS The supervised group exercise intervention provided experiences of peer support and increased body awareness, which contributed to an experience of improved psychological equilibrium and preparedness for the coming birth and motherhood. The findings suggest that participation in group-based supervised exercise during pregnancy in women with depression or low psychological well-being contributes to psychological resilience, which may persist as a positive influence postpartum and beyond. IMPLICATIONS FOR PRACTICE In-hospital supervised group-based exercise can be a safe means to health promotion in a secure environment that supports pregnant women's physical and mental well-being while also preparing them for birth and the transition to motherhood.
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Affiliation(s)
- Lotte Broberg
- The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark.
| | - Mie Gaarskjær De Wolff
- The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark.
| | - Lise Anker
- The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Peter Damm
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Ann Tabor
- Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Hanne Kristine Hegaard
- The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - Julie Midtgaard
- The University Hospital's Centre for Health Research at Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Public Health, University of Copenhagen, Denmark.
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Falk LL, Augustin H, Torén K, Magnusson M. Doctoral students' perceived working environment, obstacles and opportunities at a Swedish medical faculty: a qualitative study. BMC MEDICAL EDUCATION 2019; 19:250. [PMID: 31286962 PMCID: PMC6615109 DOI: 10.1186/s12909-019-1684-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/25/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Investment in research is high on the agenda of many countries in recognition of the fact that research is important for the development of society. Doctoral students have a vital role and represent a substantial part of this investment. It is therefore imperative to reduce the risk of students dropping out from doctoral studies. The aim of this qualitative study was to gain deeper insight into the working conditions of, and obstacles and opportunities for, doctoral students at an institute of medicine in Sweden. METHODS Semi-structured interviews were conducted in 2013 with 17 doctoral students-of varying genders, professions and fields of research-from the Institute of Medicine, Sahlgrenska Academy, at the University of Gothenburg, Sweden. The recorded interviews were transcribed and analysed using systematic text condensation. RESULTS Four categories emerged from the data. They were: Safety, Frustrating Structures, Others - not me, and the future. They included positive as well as negative perceptions. Among the positive perceptions were recognition of the importance of the supervisor, as well as secure conditions, and personal development. Frustrating structures in the academic culture, stress and differences in career building constituted the negative points. CONCLUSIONS Our findings suggest that there is a need for structures within the university that support doctoral students who feel they are not receiving the assistance they need, who believe they have unreasonable working conditions, or who may need to change supervisors in order to complete their graduate research studies. Our study also highlights the fact that supervisors have a major influence on the work environment of doctoral students, and that the general and academic perception of the research area likewise has an effect on the successful completion of the research project and dissertation. Providing leadership training for supervisors could be an important measure that may help improve conditions for the doctoral students they supervise.
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Affiliation(s)
- Lena Ljungkrona Falk
- Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Primary Healthcare, Närhälsan, Västra Götaland, Sweden
| | - Hanna Augustin
- Department of internal medicine and clinical nutrition, Institute of medicine, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
| | - Kjell Torén
- Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Samo AH, Qazi SW, Buriro WM. Labelling them is negating them. MANAGEMENT RESEARCH REVIEW 2019. [DOI: 10.1108/mrr-04-2018-0170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Asif Hussain Samo
- Department of Business Administration, Sindh Maddressatul Islam University, Karachi, Pakistan
| | - Sarah Wali Qazi
- Department of Business Administration, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
| | - Wafa Mansoor Buriro
- Department of Business Administration, Sindh Maddressatul Islam University, Karachi, Pakistan
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Sandal S, Charlebois K, Fiore JF, Wright DK, Fortin MC, Feldman LS, Alam A, Weber C. Health Professional-Identified Barriers to Living Donor Kidney Transplantation: A Qualitative Study. Can J Kidney Health Dis 2019; 6:2054358119828389. [PMID: 30792874 PMCID: PMC6376531 DOI: 10.1177/2054358119828389] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/18/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Living donor kidney transplantation (LDKT) has several advantages over deceased donor kidney transplantation. Yet rates of living donation are declining in Canada and there exists significant interprovincial variability. Efforts to improve living donation tend to focus on the patient and barriers identified at their level, such as not knowing how to ask for a kidney or lack of education. These efforts favor those who have the means and the support to find living donors. Thus, a Canadian Institutes of Health Research (CIHR)-organized workshop recommended that education efforts to understand and remove barriers should focus on health professionals (HPs). Despite this, little attention has been paid to what they identify as barriers to discussing LDKT with their patients. OBJECTIVE Our aim was to explore HP-identified barriers to discuss living donation with patients in 3 provinces of Canada with low (Quebec), moderate (Ontario), and high (British Columbia) rates of LDKT. DESIGN This study consists of an interpretive descriptive approach as it enables to move beyond description and inform clinical practice. SETTING Purposive criterion and quota sampling were used to recruit HPs from Quebec, Ontario, and British Columbia who are involved in the care of patients with kidney disease and/or with transplant coordination. PATIENTS Not applicable. MEASUREMENTS Semistructured interviews were conducted. The interview guide was developed based on a preliminary analytical framework and a review of the literature. METHODS Thematic analysis was used to analyze the data stemming from the interviews. The coding process comprised of a deductive and inductive approach, and the use of a qualitative analysis software (NVivo 11). Following this, themes were identified and developed. Interviews were conducted until thematic saturation was obtained. In total, we conducted 16 telephone interviews as thematic saturation was attained. RESULTS Six predominant themes emerged: (1) lack of communication between transplant and dialysis teams, (2) absence of referral guidelines, (3) role perception and lack of multidisciplinary involvement, (4) HP's lack of information and training, (5) negative attitudes of some HP toward LDKT, (6) patient-level barriers as defined by the HP. HPs did mention patients' attitudes and some characteristics as the main barriers to discussions about living donation; this was noted in all provinces. HPs from Ontario and British Columbia indicated multiple strategies being implemented to address some of these barriers. Those from Ontario mentioned strategies that center on the core principles of provincial-level standardization, while those from British Columbia center on engaging the entire multidisciplinary team and improved role perception. We noted a dearth of such efforts in Quebec; however, efforts around education and promotion, while tentative, have emerged. LIMITATIONS Social desirability and selection bias. Our analysis might not be applicable to other provinces. CONCLUSIONS HPs involved with the referral and coordination of transplantation play a major role in access to LDKT. We have identified challenges they face when discussing living donation with their patients that warrant further assessment and research to inform policy change.
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Affiliation(s)
- Shaifali Sandal
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | | | - Julio F. Fiore
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - David Kenneth Wright
- St. Mary’s Research Center, Montreal, QC, Canada
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Marie-Chantal Fortin
- Division of Nephrology, Department of Medicine, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Liane S. Feldman
- Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Ahsan Alam
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Catherine Weber
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
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Valaitis R, Meagher-Stewart D, Martin-Misener R, Wong ST, MacDonald M, O'Mara L. Organizational factors influencing successful primary care and public health collaboration. BMC Health Serv Res 2018; 18:420. [PMID: 29880042 PMCID: PMC5992823 DOI: 10.1186/s12913-018-3194-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 05/09/2018] [Indexed: 11/14/2022] Open
Abstract
Background Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. Methods We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Results Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. Conclusion While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations. Electronic supplementary material The online version of this article (10.1186/s12913-018-3194-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ruta Valaitis
- School of Nursing, McMaster University, HSc Room 3N25, 1280 Maim Street West, Hamilton, ON, L8S4K1, Canada.
| | - Donna Meagher-Stewart
- Dalhousie University, Room G26, Forrest Bldg., PO Box 15000, 5869 University Avenue, Halifax, NS, B3H 4R2, Canada
| | - Ruth Martin-Misener
- Dalhousie University, Room G26, Forrest Bldg., PO Box 15000, 5869 University Avenue, Halifax, NS, B3H 4R2, Canada
| | - Sabrina T Wong
- UBC School of Nursing and Centre for Health Services and Policy Research, T201 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Marjorie MacDonald
- University of Victoria, HSD B220, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Linda O'Mara
- School of Nursing, McMaster University, HSc Room 3N25, 1280 Maim Street West, Hamilton, ON, L8S4K1, Canada
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Shillito JA, Lea J, Tierney S, Cleator J, Tai S, Wilding JPH. Why I eat at night: A qualitative exploration of the development, maintenance and consequences of Night Eating Syndrome. Appetite 2018; 125:270-277. [PMID: 29454015 DOI: 10.1016/j.appet.2018.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/20/2017] [Accepted: 02/06/2018] [Indexed: 11/29/2022]
Abstract
Night Eating Syndrome (NES), as a diagnosis, presents as a combination of disordered eating, sleep and mood. Patients identified as having both NES and obesity demonstrate poorer outcomes in terms of weight loss compared to those with NES only. However, research focusing on psychological factors associated with NES remains relatively underdeveloped. This study aimed to explore the relationship between NES and the experience of emotion from the perspective of patients accessing a weight management service. Ten adults who met diagnostic criteria for moderate or full NES took part in a semi-structured interview. Data were analysed using a constructivist approach to grounded theory. A core concept to emerge from the analysis was termed 'emotional hunger'; reflecting an urge or need to satiate a set of underlying unmet emotional needs. It was underpinned by the following interrelated themes: (1) Cultivating a dependency on food; (2) Relying on food to regulate emotions; (3) Understanding the significance of night-time; (4) Acknowledging the consequences of night eating. This study provides an in-depth understanding of the relationship between NES and the experience of emotion from the perspective of patients attending a weight management service. Results have potential to inform future service development, particularly around the adoption of a more holistic approach to night eating behaviours.
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Affiliation(s)
- James A Shillito
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK.
| | - James Lea
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - Stephanie Tierney
- Royal College of Nursing Research Institute, University of Warwick, Coventry, CV4 7AL, UK
| | - Jacqueline Cleator
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK
| | - Sara Tai
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - John P H Wilding
- Department of Obesity and Endocrinology, University of Liverpool, Merseyside, L7 8TX, UK
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Wu JP, Damschroder LJ, Fetters MD, Zikmund-Fisher BJ, Crabtree BF, Hudson SV, Ruffin MT, Fucinari J, Kang M, Taichman LS, Creswell JW. A Web-Based Decision Tool to Improve Contraceptive Counseling for Women With Chronic Medical Conditions: Protocol For a Mixed Methods Implementation Study. JMIR Res Protoc 2018; 7:e107. [PMID: 29669707 PMCID: PMC5932336 DOI: 10.2196/resprot.9249] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/18/2017] [Accepted: 02/05/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Women with chronic medical conditions, such as diabetes and hypertension, have a higher risk of pregnancy-related complications compared with women without medical conditions and should be offered contraception if desired. Although evidence based guidelines for contraceptive selection in the presence of medical conditions are available via the United States Medical Eligibility Criteria (US MEC), these guidelines are underutilized. Research also supports the use of decision tools to promote shared decision making between patients and providers during contraceptive counseling. OBJECTIVE The overall goal of the MiHealth, MiChoice project is to design and implement a theory-driven, Web-based tool that incorporates the US MEC (provider-level intervention) within the vehicle of a contraceptive decision tool for women with chronic medical conditions (patient-level intervention) in community-based primary care settings (practice-level intervention). This will be a 3-phase study that includes a predesign phase, a design phase, and a testing phase in a randomized controlled trial. This study protocol describes phase 1 and aim 1, which is to determine patient-, provider-, and practice-level factors that are relevant to the design and implementation of the contraceptive decision tool. METHODS This is a mixed methods implementation study. To customize the delivery of the US MEC in the decision tool, we selected high-priority constructs from the Consolidated Framework for Implementation Research and the Theoretical Domains Framework to drive data collection and analysis at the practice and provider level, respectively. A conceptual model that incorporates constructs from the transtheoretical model and the health beliefs model undergirds patient-level data collection and analysis and will inform customization of the decision tool for this population. We will recruit 6 community-based primary care practices and conduct quantitative surveys and semistructured qualitative interviews with women who have chronic medical conditions, their primary care providers (PCPs), and clinic staff, as well as field observations of practice activities. Quantitative survey data will be summarized with simple descriptive statistics and relationships between participant characteristics and contraceptive recommendations (for PCPs), and current contraceptive use (for patients) will be examined using Fisher exact test. We will conduct thematic analysis of qualitative data from interviews and field observations. The integration of data will occur by comparing, contrasting, and synthesizing qualitative and quantitative findings to inform the future development and implementation of the intervention. RESULTS We are currently enrolling practices and anticipate study completion in 15 months. CONCLUSIONS This protocol describes the first phase of a multiphase mixed methods study to develop and implement a Web-based decision tool that is customized to meet the needs of women with chronic medical conditions in primary care settings. Study findings will promote contraceptive counseling via shared decision making and reflect evidence-based guidelines for contraceptive selection. TRIAL REGISTRATION ClinicalTrials.gov NCT03153644; https://clinicaltrials.gov/ct2/show/NCT03153644 (Archived by WebCite at http://www.webcitation.org/6yUkA5lK8).
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Affiliation(s)
- Justine P Wu
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | | | - Michael D Fetters
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Brian J Zikmund-Fisher
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, United States.,Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Benjamin F Crabtree
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Shawna V Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Mack T Ruffin
- Department of Family and Community Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Juliana Fucinari
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Minji Kang
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - L Susan Taichman
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - John W Creswell
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
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Allan N, Wilkes-Gillan S, Bundy A, Cordier R, Volkert A. Parents' perceptions of the long-term appropriateness of a psychosocial intervention for children with attention deficit hyperactivity disorder. Aust Occup Ther J 2018; 65:259-267. [PMID: 29574905 DOI: 10.1111/1440-1630.12460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIM Designing psychosocial interventions that parents perceive as appropriate is essential to enhancing their engagement with the intervention and their long-term use of the intervention strategies. The aim of this study was to explore the long-term appropriateness of a play-based psychosocial intervention for children with Attention Deficit Hyperactivity Disorder (ADHD) from the perspectives of parents. METHODS Semi-structured phone interviews were conducted with 14 parents of children with ADHD who participated in a randomised controlled trial of the play-based intervention 1 year earlier. RESULTS Thematic analysis led to the development of three core-themes: (i) Everybody needs a parenting handbook, (ii) No one thing you are dealing with, and (iii) A different approach: Reframing. DISCUSSION The core-themes related back to a definition of intervention appropriateness that acknowledges the intervention as important/relevant, beneficial, socially and ecologically valid and promotes sustainable change, indicating parents perceived the intervention as appropriate. The core-themes also resembled aspects of the process of family adaptation. Findings highlight the importance of designing interventions that are appropriate from parents' perspectives to enhance their long-term engagement and use of the intervention strategies as well as outcomes for their child in the long term.
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Affiliation(s)
- Nicola Allan
- Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Wilkes-Gillan
- Discipline of Occupational Therapy, School of Allied and Public Health, Australian Catholic University, Sydney, NSW, Australia
| | - Anita Bundy
- Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Reinie Cordier
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Anita Volkert
- Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
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40
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Appleton L, Poole H, Wall C. Being in safe hands: Patients’ perceptions of how cancer services may support psychological well-being. J Adv Nurs 2018; 74:1531-1543. [DOI: 10.1111/jan.13553] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Lynda Appleton
- The Clatterbridge Cancer Centre NHS Foundation Trust; Bebington UK
| | - Helen Poole
- Faculty of Science; Liverpool John Moores University; Tom Reilly Building; Liverpool UK
| | - Christine Wall
- Faculty of Education, Health and Community; Liverpool John Moores University; Henry Cotton Building; Liverpool UK
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Ong SE, Tyagi S, Lim JM, Chia KS, Legido-Quigley H. Health systems reforms in Singapore: A qualitative study of key stakeholders. Health Policy 2018; 122:431-443. [PMID: 29478876 DOI: 10.1016/j.healthpol.2018.02.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 01/11/2018] [Accepted: 02/10/2018] [Indexed: 02/06/2023]
Abstract
In response to a growing chronic disease burden and ageing population, Singapore implemented Regional Health Systems (RHS) in 2008. In January 2017, the MOH announced that the six RHS clusters would be reorganised into three in 2018. This qualitative study sought to identify the health system challenges, opportunities, and ways forward for the implementation of the RHS. We conducted semi-structured interviews with 35 key informants from RHS clusters, government, academia, and private and voluntary sectors. Integration, innovation, and people-centeredness were identified as the key principles of the RHS. The RHS was described as an opportunity to holistically care for a person across the care continuum, address social determinants of health, develop new models of care, and work with social and community partners. Challenges to RHS implementation included difficulties aligning the goals, values, and priorities of multiple actors, the need for better integration across clusters, differing care capabilities and capacities across partners, healthcare financing structures that may not reflect RHS goals, scalability and evaluation of pilot programmes, and disease-centricity, provider-centricity, and medicalisation in health and healthcare. Suggested ways forward included building relationships between actors to facilitate integration; exploring innovative new models of care; clear long-term/scale-up plans for successful pilots; healthcare financing reforms to meet changing patient and population needs; and developing evaluation systems reflective of RHS principles and priorities.
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Affiliation(s)
- Suan Ee Ong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Shilpa Tyagi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jane Mingjie Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; London School of Hygiene and Tropical Medicine, United Kingdom.
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Dibley L, Norton C, Whitehead E. The experience of stigma in inflammatory bowel disease: An interpretive (hermeneutic) phenomenological study. J Adv Nurs 2017; 74:838-851. [PMID: 29105144 DOI: 10.1111/jan.13492] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 01/13/2023]
Abstract
AIM To explore experiences of stigma in people with inflammatory bowel disease. BACKGROUND Diarrhoea, urgency and incontinence are common symptoms in inflammatory bowel disease. Social rules stipulate full control of bodily functions in adulthood: poor control may lead to stigmatization, affecting patients' adjustment to disease. Disease-related stigma is associated with poorer clinical outcomes, but qualitative evidence is minimal. DESIGN An interpretive (hermeneutic) phenomenological study of the lived experience of stigma in inflammatory bowel disease. METHODS Forty community-dwelling adults with a self-reported diagnosis of inflammatory bowel disease were recruited purposively. Participants reported feeling stigmatized or not and experiencing faecal incontinence or not. Unstructured interviews took place in participants' homes in the United Kingdom (September 2012 - May 2013). Data were analysed using Diekelmann's interpretive method. FINDINGS Three constitutive patterns-Being in and out of control, Relationships and social Support and Mastery and mediation-reveal the experience of disease-related stigma, occurring regardless of continence status and because of name and type of disease. Stigma recedes when mastery over disease is achieved through development of resilience-influenced by humour, perspective, mental well-being and upbringing (childhood socialization about bodily functions). People travel in and out of stigma, dependent on social relationships with others including clinicians and tend to feel less stigmatized over time. CONCLUSION Emotional control, social support and mastery over disease are key to stigma reduction. By identifying less resilient patients, clinicians can offer appropriate support, accelerating the patient's path towards disease acceptance and stigma reduction.
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Affiliation(s)
- Lesley Dibley
- Reader in Nursing Research and Education, University of Greenwich and Bart's Health NHS Trust, London, UK
| | - Christine Norton
- Professor of Clinical Nursing Research, King's College London, London, UK
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Cultural barriers in access to healthcare services for people with disability in Iran: A qualitative study. Med J Islam Repub Iran 2017; 31:51. [PMID: 29445680 PMCID: PMC5804431 DOI: 10.14196/mjiri.31.51] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Indexed: 12/02/2022] Open
Abstract
Background: People with disability experience various problems to access to healthcare services. This study aimed to identify cultural
barriers in access to healthcare services for people with disability in Iran.
Methods: We conducted a qualitative study using content analysis to identify the cultural barriers. We used semi-structured interviews
to collect data. Participants were selected through purposeful sampling with maximum variation. 50 individual interviews were
conducted with three groups of people with disability, healthcare services providers and policy makers, September to May 2015, at
different locations in Tehran, Iran.
Results: We identified a number of different cultural barriers in access to health services for people with disability in Iran. These
related to health service providers, namely reluctance to provide health services and disrespect; related to People with disability, namely
denial of disability, disproportionate expectation, shame and insufficient sociocultural supports; and related to policy makers, namely
lack of concern, little attention to the culture of disability and discrimination. We categorized misconception as a barrier that was
observed at all levels of the society.
Conclusion: Disability is a reality that some human being may experience and live with it. The negative attitude towards people with
disability has a close relationship with the cultural norms of a society. The culture of disability in different dimensions should be a
priority for all policy makers. Removing cultural barriers in access to healthcare for people with a disability needs collective efforts
and collaborations among all stakeholders.
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Origlia Ikhilor P, Hasenberg G, Kurth E, Stocker Kalberer B, Cignacco E, Pehlke-Milde J. Barrier-free communication in maternity care of allophone migrants: BRIDGE study protocol. J Adv Nurs 2017; 74:472-481. [PMID: 28833465 DOI: 10.1111/jan.13441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 12/01/2022]
Abstract
AIM To describe communication and access barriers encountered by allophone women of different migration backgrounds in the Swiss maternity care services, from the perspective of users, healthcare professionals and intercultural interpreters. BACKGROUND In addition to the challenges of maternal adjustment, pregnant migrant women must also deal with an unfamiliar health service system. Some must overcome language barriers and the stress of uncertain residence status. Limited access to maternity care increases perinatal morbidity and mortality. Almost 10% of foreigners speak none of Switzerland's official languages. Factors that facilitate or hinder communication between migrant women and perinatal healthcare professionals are under-studied and must be understood if we are to overcome those barriers in clinical practice. DESIGN Qualitative exploratory study with quantitative sub-study. METHODS Participants will be drawn from German to speaking regions of Switzerland. We will conduct focus group discussions and semi-structured interviews with users in their own language (Albanian and Tigrinya) and with healthcare professionals and intercultural interpreters (March-June 2016), then perform Thematic Analysis on the data. In the sub-study, midwives will report their experience of using a telephone interpreting service during postnatal home visits in a questionnaire (October 2013-March 2016). Data will be analysed with descriptive statistics. DISCUSSION Our study will reveal patterns in communications between allophone migrant women and healthcare providers and communication barriers. By incorporating multiple perspectives, we will describe the challenges all parties face. Our results will inform those who draft recommendations to improve provision of maternity care to allophone women and their families. TRIAL REGISTRATION ClinicalTrials.gov ID: BernUAS NCT02695316.
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Affiliation(s)
| | | | - Elisabeth Kurth
- Swiss Tropical and Public Health Institute, University of Basel, Switzerland.,Familystart beider Basel, Basel, Switzerland.,Institute of Midwifery, Zurich University of Applied Sciences, Winterthur, Switzerland
| | | | - Eva Cignacco
- Department of Midwifery Research, Bern University of Applied Sciences, Bern, Switzerland
| | - Jessica Pehlke-Milde
- Research & Development, Institute of Midwifery, Zurich University of Applied Sciences, Winterthur, Switzerland
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Varpio L, Ajjawi R, Monrouxe LV, O'Brien BC, Rees CE. Shedding the cobra effect: problematising thematic emergence, triangulation, saturation and member checking. MEDICAL EDUCATION 2017; 51:40-50. [PMID: 27981658 DOI: 10.1111/medu.13124] [Citation(s) in RCA: 386] [Impact Index Per Article: 55.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 03/24/2016] [Accepted: 05/16/2016] [Indexed: 05/10/2023]
Abstract
CONTEXT Qualitative research is widely accepted as a legitimate approach to inquiry in health professions education (HPE). To secure this status, qualitative researchers have developed a variety of strategies (e.g. reliance on post-positivist qualitative methodologies, use of different rhetorical techniques, etc.) to facilitate the acceptance of their research methodologies and methods by the HPE community. Although these strategies have supported the acceptance of qualitative research in HPE, they have also brought about some unintended consequences. One of these consequences is that some HPE scholars have begun to use terms in qualitative publications without critically reflecting on: (i) their ontological and epistemological roots; (ii) their definitions, or (iii) their implications. OBJECTIVES In this paper, we share our critical reflections on four qualitative terms popularly used in the HPE literature: thematic emergence; triangulation; saturation, and member checking. METHODS We discuss the methodological origins of these terms and the applications supported by these origins. We reflect critically on how these four terms became expected of qualitative research in HPE, and we reconsider their meanings and use by drawing on the broader qualitative methodology literature. CONCLUSIONS Through this examination, we hope to encourage qualitative scholars in HPE to avoid using qualitative terms uncritically and non-reflexively.
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Affiliation(s)
- Lara Varpio
- Department of Medicine, Faculty of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Rola Ajjawi
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Victoria, Australia
| | - Lynn V Monrouxe
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Bridget C O'Brien
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Charlotte E Rees
- HealthPEER (Health Professions Education and Education Research), Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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The Adoption of Cloud Computing in the Field of Genomics Research: The Influence of Ethical and Legal Issues. PLoS One 2016; 11:e0164347. [PMID: 27755563 PMCID: PMC5068798 DOI: 10.1371/journal.pone.0164347] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 09/23/2016] [Indexed: 11/30/2022] Open
Abstract
This study aims to understand the influence of the ethical and legal issues on cloud computing adoption in the field of genomics research. To do so, we adapted Diffusion of Innovation (DoI) theory to enable understanding of how key stakeholders manage the various ethical and legal issues they encounter when adopting cloud computing. Twenty semi-structured interviews were conducted with genomics researchers, patient advocates and cloud service providers. Thematic analysis generated five major themes: 1) Getting comfortable with cloud computing; 2) Weighing the advantages and the risks of cloud computing; 3) Reconciling cloud computing with data privacy; 4) Maintaining trust and 5) Anticipating the cloud by creating the conditions for cloud adoption. Our analysis highlights the tendency among genomics researchers to gradually adopt cloud technology. Efforts made by cloud service providers to promote cloud computing adoption are confronted by researchers’ perpetual cost and security concerns, along with a lack of familiarity with the technology. Further underlying those fears are researchers’ legal responsibility with respect to the data that is stored on the cloud. Alternative consent mechanisms aimed at increasing patients’ control over the use of their data also provide a means to circumvent various institutional and jurisdictional hurdles that restrict access by creating siloed databases. However, the risk of creating new, cloud-based silos may run counter to the goal in genomics research to increase data sharing on a global scale.
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Kersten P, Dudley M, Nayar S, Elder H, Robertson H, Tauroa R, McPherson KM. Cross-cultural acceptability and utility of the strengths and difficulties questionnaire: views of families. BMC Psychiatry 2016; 16:347. [PMID: 27733140 PMCID: PMC5062850 DOI: 10.1186/s12888-016-1063-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 10/04/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Screening children for behavioural difficulties requires the use of a tool that is culturally valid. We explored the cross-cultural acceptability and utility of the Strengths and Difficulties Questionnaire for pre-school children (aged 3-5) as perceived by families in New Zealand. METHODS A qualitative interpretive descriptive study (focus groups and interviews) in which 65 participants from five key ethnic groups (New Zealand European, Māori, Pacific, Asian and other immigrant parents) took part. Thematic analysis using an inductive approach, in which the themes identified are strongly linked to the data, was employed. RESULTS Many parents reported they were unclear about the purpose of the tool, affecting its perceived value. Participants reported not understanding the context in which they should consider the questions and had difficulty understanding some questions and response options. Māori parents generally did not support the questionnaire based approach, preferring face to face interaction. Parents from Māori, Pacific Island, Asian, and new immigrant groups reported the tool lacked explicit consideration of children in their cultural context. Parents discussed the importance of timing and multiple perspectives when interpreting scores from the tool. CONCLUSIONS In summary, this study posed a number of challenges to the use of the Strengths and Difficulties Questionnaire in New Zealand. Further work is required to develop a tool that is culturally appropriate with good content validity.
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Affiliation(s)
- Paula Kersten
- School of Health Sciences, University of Brighton, Brighton, UK. .,Faculty of Health & Environmental Sciences, AUT University, Auckland, New Zealand.
| | - Margaret Dudley
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Shoba Nayar
- Centre for Person Centred Research, AUT University, Private Bag 92006, Auckland, 1142 New Zealand
| | - Hinemoa Elder
- Te Whare Mātai Aronui, Te Whare Wānanga o Awanuiārangi, Auckland, New Zealand
| | - Heather Robertson
- Centre for Person Centred Research, AUT University, Private Bag 92006, Auckland, 1142 New Zealand
| | - Robyn Tauroa
- Centre for Person Centred Research, AUT University, Private Bag 92006, Auckland, 1142 New Zealand
| | - Kathryn M. McPherson
- Centre for Person Centred Research, AUT University, Private Bag 92006, Auckland, 1142 New Zealand ,Chief Executive Health Research Council of New Zealand, 110 Stanley St, Auckland, New Zealand
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Currie ER, Roche C, Christian BJ, Bakitas M, Meneses K. Recruiting bereaved parents for research after infant death in the neonatal intensive care unit. Appl Nurs Res 2016; 32:281-285. [PMID: 27969043 DOI: 10.1016/j.apnr.2016.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/22/2016] [Accepted: 08/26/2016] [Indexed: 11/30/2022]
Abstract
Understanding parental experiences following infant death in the neonatal intensive care unit (NICU) is a high research priority and a necessary first step to improving health services. However, recruiting bereaved parents to discuss their experiences on such an extremely sensitive topic can be challenging and research procedures must be planned carefully in order to get an adequate sample. There is little published in the literature detailing specific strategies for recruiting bereaved parents for grief research, especially strategies for contacting parents and identifying factors that might affect participation. The purpose of this paper is to describe the process of recruiting bereaved parents into a qualitative research study exploring parental NICU experiences and grief responses following infant death. We describe a successful recruitment plan that led to the enrollment of difficult to recruit participants such as fathers, and individuals representing minorities and those from lower socioeconomic (SES) groups. Bereaved parents of infants after an NICU hospitalization should continue to be recruited for research studies for their unique perspectives and valuable insights about the devastating experience of infant death. Participants in this study reported more benefits than harm and the results addressed a critical gap in the literature.
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Affiliation(s)
- Erin R Currie
- University of Alabama at Birmingham School of Nursing, Birmingham, AL 35294, USA.
| | - Cathy Roche
- University of Alabama at Birmingham School of Nursing, Birmingham, AL 35294, USA.
| | - Becky J Christian
- University of Louisville School of Nursing, Louisville, KY 40292, USA.
| | - Marie Bakitas
- University of Alabama at Birmingham School of Nursing, Birmingham, AL 35294, USA; University of Alabama at Birmingham, Center for Palliative and Supportive Care, Birmingham, AL 35233, USA.
| | - Karen Meneses
- University of Alabama at Birmingham School of Nursing, Birmingham, AL 35294, USA.
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Thomas DR. Feedback from research participants: are member checks useful in qualitative research? QUALITATIVE RESEARCH IN PSYCHOLOGY 2016. [DOI: 10.1080/14780887.2016.1219435] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
AbstractThis study explored aged care support workers’ perceptions of how their health was influenced by their job, highlighting similarities and differences of those working in community-based and institution-based care. Support workers working in two institution-based and three community-based aged care organisations were invited to participate. Semi-structured interviews were undertaken with ten participants. Open-ended questions probed participants’ perceptions of their health as it related to their work. Data were analysed with the General Inductive Approach. Four central themes were identified, many of which related to mental, as opposed to physical health. ‘Love of the job’ described various sources of satisfaction for participants. These factors commonly overrode the negative aspects. ‘Stress’ encompassed the negative influences on all aspects of health. ‘Support’ described the positive influences on health, which supported participants in their job. ‘Physicality’ described the physical nature of the job and the positive and negative impact this had on participants’ health. Support workers perform numerous tasks, which often impact upon their health. Aspects of the job that may impact the health of the worker are improved communication and support from management, as well as recognition for support workers’ contribution to society. These could be targeted to enhance support worker health. Additional training and reduced time pressure may also represent aspects for improvement, to optimise support workers’ physical health.
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