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Chapot L, Hibbard R, Ariyanto KB, Maulana KY, Yusuf H, Febriyani W, Cameron A, Paul M, Vergne T, Faverjon C. Needs and capabilities for improving poultry production and health management in Indonesia. PLoS One 2024; 19:e0308379. [PMID: 39172873 PMCID: PMC11340977 DOI: 10.1371/journal.pone.0308379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 07/23/2024] [Indexed: 08/24/2024] Open
Abstract
In Indonesia, the development of the poultry industry is facing numerous challenges. Major constraints include high disease burdens, large fluctuations in farm input and output prices, and inadequate biosecurity. Timely and reliable information about animal production and health can help stakeholders at all levels of the value chain make appropriate management decisions to optimize their profitability and productivity while reducing risks to public health. This study aimed to describe the challenges in the Indonesian poultry industry, assess stakeholders' needs and capabilities in terms of generating and using poultry information for making production and health management decisions, and identify levers for improvement. Interviews were conducted with a diversity of key informants and value chain actors in five Indonesian provinces. Thematic analysis was applied with an interpretivist approach to gain an in-depth understanding of the lived experiences of various stakeholders and their opinions as to what might constitute appropriate solutions. Our findings indicate that market and political instability, ineffective management of poultry data, and limited inter-sectoral collaboration are limiting the development of the sector. Increased intersectoral cooperation is needed to implement standards for data collection and sharing across the industry, provide education and practical training on the use of information technologies for farm management, and accelerate research and innovation. Our study can contribute to the development of data-driven tools to support evidence-based decision-making at all levels of the poultry system.
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Affiliation(s)
- Lorraine Chapot
- Ausvet Europe, Lyon, France
- IHAP, INRAE, ENVT, Université de Toulouse, Toulouse, France
| | - Rebecca Hibbard
- Ausvet Europe, Lyon, France
- IHAP, INRAE, ENVT, Université de Toulouse, Toulouse, France
| | | | | | - Havan Yusuf
- Ausvet Representative Office Indonesia, Jakarta, Indonesia
| | | | | | - Mathilde Paul
- IHAP, INRAE, ENVT, Université de Toulouse, Toulouse, France
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2
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Kitchingman TA, Caputi P, Woodward A, Wilson I, Wilson C. The impact of their role on telephone crisis support workers' psychological wellbeing and functioning: Qualitative findings from a mixed methods investigation. DEATH STUDIES 2024:1-14. [PMID: 38975977 DOI: 10.1080/07481187.2024.2376038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Little is known about how telephone crisis support workers are impacted by frequent empathic engagement with callers in crisis, including those who are suicidal. This is the only known qualitative study to specifically examine the impact of their role on telephone crisis support workers' psychological wellbeing and functioning. Eighteen telephone crisis support workers participated in semi-structured interviews, providing detailed accounts of the impact of the role on their wellbeing and functioning. Interpretive Phenomenological Analysis of interview data resulted in four key themes. Results suggest that telephone crisis support workers' motivations, background, personal help-seeking and coping practices are likely to impact their experiences of psychological wellbeing and functioning in relation to empathic engagement with callers in crisis. Telephone crisis services should seek to integrate an understanding of workers' experiences into the provision of training, supervision and support strategies to optimize workers' wellbeing and functioning.
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Affiliation(s)
- Taneile A Kitchingman
- School of Psychology, University of Wollongong, Wollongong, Australia
- School of Psychology, Charles Sturt University, Wagga Wagga, Australia
| | - Peter Caputi
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Alan Woodward
- Centre for Mental Health, University of Melbourne, Melbourne, Australia
| | - Ian Wilson
- School of Medicine, University of Wollongong, Wollongong, Australia
| | - Coralie Wilson
- School of Medicine, University of Wollongong, Wollongong, Australia
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3
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Zakai-Mashiach M. "I Was Like a Bird Without Wings": Autistic Women's Retrospective Experiences in General Schools. J Autism Dev Disord 2023; 53:4258-4270. [PMID: 35972623 DOI: 10.1007/s10803-022-05717-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2022] [Indexed: 11/25/2022]
Abstract
Autistic individuals' experience of the inclusion process is poorly understood, especially that of female pupils. This study retrospectively explored the views of autistic women who were included in general schools throughout childhood and adolescence, from elementary to high school, to understand their unique experiences and learn more about their needs in general schools. Semi-structured interviews were conducted, data were thematically analyzed, and key issues emerged pertaining to each educational level. The women described a complex journey within the general education system. Their responses highlight the need for greater attention to autistic females' patterns of behavior in research and practice. Implications and recommendations for educators and schools are provided, and directions for future research are outlined.
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Affiliation(s)
- Mati Zakai-Mashiach
- The MOFET Institute, 13 Shoshana Persitz St, 61484, Tel Aviv, Israel.
- Department of Special Education, Beit-Berl Academic College, 4490500, Kfar-Saba, Israel.
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4
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Smith CM, Daley LA, Lea C, Daniel K, Tweedy DS, Thielman NM, Staplefoote-Boynton BL, Aimone E, Gagliardi JP. Experiences of Black Adults Evaluated in a Locked Psychiatric Emergency Unit: A Qualitative Study. Psychiatr Serv 2023; 74:1063-1071. [PMID: 37042104 PMCID: PMC10732806 DOI: 10.1176/appi.ps.20220533] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
OBJECTIVE Evidence shows that Black individuals have higher rates of coercive emergency psychiatric interventions than other racialized groups, yet no studies have elevated the voices of Black patients undergoing emergency psychiatric evaluation. This qualitative study sought to explore the experiences of Black individuals who had been evaluated in a locked psychiatric emergency unit (PEU). METHODS Electronic health records were used to identify and recruit adult patients (ages ≥18 years) who self-identified as Black and who had undergone evaluation in a locked PEU at a large academic medical center. In total, 11 semistructured, one-on-one interviews were conducted by telephone, exploring experiences during psychiatric evaluation. Transcripts were analyzed with thematic analysis. RESULTS Participants shared experiences of criminalization, stigma, and vulnerability before and during their evaluation. Although participants described insight into their desire and need for treatment and identified helpful aspects of the care they received, they noted a mismatch between their expectations of treatment and the treatment received. CONCLUSIONS This study reveals six major patient-identified themes that supplement a growing body of quantitative evidence demonstrating that racialized minority groups endure disproportionate rates of coercive interventions during emergency psychiatric evaluation. Interdisciplinary systemic changes are urgently needed to address structural barriers to equitable psychiatric care.
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Affiliation(s)
- Colin M Smith
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
| | - Lori-Ann Daley
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
| | - Chris Lea
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
| | - Keith Daniel
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
| | - Damon S Tweedy
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
| | - Nathan M Thielman
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
| | - B Lynette Staplefoote-Boynton
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
| | - Elizabeth Aimone
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
| | - Jane P Gagliardi
- Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina (Smith); Department of Psychiatry and Behavioral Sciences (Daley, Tweedy, Staplefoote-Boynton, Gagliardi) and Department of Medicine (Thielman, Staplefoote-Boynton, Gagliardi), School of Medicine, Duke University, Durham, North Carolina; School of Medicine (Lea), Duke University, Durham, North Carolina; Duke Divinity School, Duke University, Durham, North Carolina (Daniel); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill (Aimone)
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5
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Thompson L. Using mixed-methods in evidence-based nursing: a scoping review guided by a socio-ecological perspective. J Res Nurs 2022; 27:639-652. [PMID: 36405803 PMCID: PMC9669941 DOI: 10.1177/17449871221113740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
Background Increased pressure for evidence-based practice in nursing necessitates that researchers use effective approaches. Mixed-methods research (MMR) has potential to improve the knowledge and implementation of evidence-based nursing (EBN) by generating outcome-based and contextually-focused evidence. Aims To identify methodological trends in how MMR is used in EBN research. Methods Searches were completed in PubMed, CINAHL, and Google Scholar using the terms "nursing", "mixed-methods", and "evidence-based". Seventy-two articles using MMR to address EBN and published 2000-2021 were reviewed across content themes and methodological domains of the Socio-Ecological Framework for MMR. Results Mixed-methods research has been used to study how EBN strategies are perceived, developed and assessed, and implemented or evaluated. A few studies provided an MMR definition reflecting the methods perspective, and the dominant MMR rationale was gaining a comprehensive understanding of the issue. The leading design was concurrent, and half of studies intersected MMR with evaluation, action/participatory, and/or case-study approaches. Research quality was primarily assessed using criteria specific to quantitative and qualitative approaches. Conclusions Mixed-methods research has great potential to enhance EBN research by generating more clinically useful findings and helping nurses understand how to identify and implement the best available research evidence in practice.
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Affiliation(s)
- Lieu Thompson
- PhD Candidate, Health Services Administration, The University of Alabama at
Birmingham, Birmingham, AL, USA
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6
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Lim CYS, Laidsaar-Powell RC, Young JM, Solomon M, Steffens D, Blinman P, O'Loughlin S, Zhang Y, Butow P. Fear of Cancer Progression and Death Anxiety in Survivors of Advanced Colorectal Cancer: A Qualitative Study Exploring Coping Strategies and Quality of Life. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221121493. [PMID: 36127158 DOI: 10.1177/00302228221121493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to examine coping strategies used by advanced colorectal cancer (CRC-A) survivors to manage death anxiety and fear of cancer progression, and links between these strategies and quality of life (QoL), distress, and death acceptance. Qualitative semi-structured interviews of 38 CRC-A survivors (22 female) were analysed via framework analysis. QoL and distress were assessed through the FACT-C and Distress Thermometer. Eleven themes were identified and mapped to active avoidance (keeping busy and distracted), passive avoidance (hoping for a cure), active confrontation (managing negative emotions; reaching out to others; focusing on the present; staying resilient), meaning-making (redefining one's identity; contributing to society; gaining perspective; remaining spiritual), and acceptance (accepting one's situation). Active confrontation (specifically utilising informal support networks) and meaning-making appeared beneficial coping strategies; more research is needed to develop and evaluate interventions which increase CRC-A survivors' use of these strategies to manage and cope with their death anxiety.
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Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah C Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW
| | - Michael Solomon
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Prunella Blinman
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - Scott O'Loughlin
- Ramsay Mental Health, Macarthur Hospital, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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7
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Intersubjectivity and the meaning of Nordic Walking practice in the view of people with Parkinson’s disease. SCIENTIA MEDICA 2022. [DOI: 10.15448/1980-6108.2022.1.39969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aims: whilst Nordic Walking (NW) practice is spreading worldwide, few studies have addressed the issue of intersubjectivity and the perception of PD individuals practicing NW and its possible impact on their daily life across different countries and cultures. This pilot study sought to explore the possible relationship between the habit of practicing NW and the perception of functionality and quality of life in the participants’ cultural context. Methods: the focus group (FG) technique was used, with 10 individuals participating in a NW program. Results: content analysis revealed five main discourse categories: a) “NW benefits for people with PD”; b) “incorporation of the NW poles in daily life”; c) “Belonging to a NW group as a treatment aid”; d) “how PD people feel about their condition”; and, finally, e) “the present and the future: expectations and issues”. Conclusion: in general, NW was found to generates positive content regarding coping with PD, beyond the biomechanical and quantitative functional effects previously studied. We suggest NW might be an important adjuvant resource for improving perceived functionality among people with PD.
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Mozersky J, Friedrich AB, DuBois JM. A Content Analysis of 100 Qualitative Health Research Articles to Examine Researcher-Participant Relationships and Implications for Data Sharing. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2022; 21:10.1177/16094069221105074. [PMID: 38404360 PMCID: PMC10888521 DOI: 10.1177/16094069221105074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
We conducted a qualitative content analysis of health science literature (N = 100) involving qualitative interviews or focus groups. Given recent data sharing mandates, our goal was to characterize the nature of relationships between the researchers and participants to inform ethical deliberations regarding qualitative data sharing and secondary analyses. Specifically, some researchers worry that data sharing might harm relationships, while others claim that data cannot be analyzed absent meaningful relationships with participants. We found little evidence of relationship building with participants. The majority of studies involve single encounters (95%), lasting less than 60 min (59%), with less than half of authors involved in primary data collection. Our findings suggest that relationships with participants might not pose a barrier to sharing some qualitative data collected in the health sciences and speak to the feasibility in principle of secondary analyses of these data.
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Affiliation(s)
- Jessica Mozersky
- Bioethics Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Annie B. Friedrich
- Bioethics Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - James M. DuBois
- Bioethics Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
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9
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Mozersky J, McIntosh T, Walsh HA, Parsons MV, Goodman M, DuBois JM. Barriers and facilitators to qualitative data sharing in the United States: A survey of qualitative researchers. PLoS One 2021; 16:e0261719. [PMID: 34972126 PMCID: PMC8719660 DOI: 10.1371/journal.pone.0261719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/08/2021] [Indexed: 11/19/2022] Open
Abstract
Qualitative health data are rarely shared in the United States (U.S.). This is unfortunate because gathering qualitative data is labor and time-intensive, and data sharing enables secondary research, training, and transparency. A new U.S. federal policy mandates data sharing by 2023, and is agnostic to data type. We surveyed U.S. qualitative researchers (N = 425) on the barriers and facilitators of sharing qualitative health or sensitive research data. Most researchers (96%) have never shared qualitative data in a repository. Primary concerns were lack of participant permission to share data, data sensitivity, and breaching trust. Researcher willingness to share would increase if participants agreed and if sharing increased the societal impact of their research. Key resources to increase willingness to share were funding, guidance, and de-identification assistance. Public health and biomedical researchers were most willing to share. Qualitative researchers need to prepare for this new reality as sharing qualitative data requires unique considerations.
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Affiliation(s)
- Jessica Mozersky
- Bioethics Research Center, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Tristan McIntosh
- Bioethics Research Center, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Heidi A. Walsh
- Bioethics Research Center, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Meredith V. Parsons
- Bioethics Research Center, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Melody Goodman
- School of Global Public Health, New York University, New York, NY, United States of America
| | - James M. DuBois
- Bioethics Research Center, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, United States of America
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10
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Gragoll I, Schumann L, Neubauer M, Westphal C, Lang H. Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics. BMC Oral Health 2021; 21:563. [PMID: 34743719 PMCID: PMC8574006 DOI: 10.1186/s12903-021-01933-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/19/2021] [Indexed: 01/08/2023] Open
Abstract
Background The treatment of acute pain is part of everyday dental practice. Often, these symptoms result from years of patients' inadequate or missing dental routines and lead to a reduction in the quality of life or health of the patients and to high costs for the health care system. Despite the enormous advantages of modern dentistry, many patients avoid going to the dentist. Therefore, the study aimed to determine the reasons and behaviours that cause patients to avoid visits to the dentist. Methods We conducted semi-structured interviews with patients who had an above-average DMFT index and had been going to the dentist only irregularly for years. The sample participants were recruited from the northern German region of Mecklenburg-Western Pomerania. 20 individual interviews were recorded, transcribed verbatim and coded. We used a qualitative framework approach to code the transcripts in order to establish a consensus among the researchers. Ultimately, through discussions and reviews of the attributes and meaning of the topics, a typology could be established. Results A typology of patients who avoid the dentist was developed. Four independent characteristic patterns of dentist avoidance could be developed: avoiding the dentist due to "distance" (type A; includes subtype A1 "avoiding the dentist due to negligence" and subtype A2 "dental avoidance due to neutralization"), "disappointment" (type B), "shame" (type C), and "fear" (type D). Using the typology as a generalised tool to determine the minimum and maximum contrasts, it was possible to capture the diversity and multidimensionality of the reasons and behaviours for avoidance. All patients had negative dental experiences, which had led to different avoidance patterns and strategies. Conclusions The identified avoidance characteristics represent a spectrum of patients from Northern Germany who avoid going to the dentist. This is the first comprehensive study in Germany representing avoidance behaviour of dentist patients in the form of a typology. The results suggest that dentistry also needs qualitative research to better understand patient characteristics and provide direct access to patients who avoid regular dental visits. Thus, the results make a potentially fundamental contribution to the improvement of dental care and enrich its understanding.
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Affiliation(s)
- Isabell Gragoll
- Department of Operative Dentistry and Periodontology, Rostock University Medical Center, Strempelstraße 13, 18057, Rostock, Germany
| | - Lukas Schumann
- Department of Operative Dentistry and Periodontology, Rostock University Medical Center, Strempelstraße 13, 18057, Rostock, Germany.
| | - Monique Neubauer
- Institute for General Pedagogy and Social Pedagogy, University of Rostock, August-Bebel-Straße 28, 18055, Rostock, Germany
| | - Christina Westphal
- Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057, Rostock, Germany.,Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Schillingallee 68, 18055, Rostock, Germany
| | - Hermann Lang
- Department of Operative Dentistry and Periodontology, Rostock University Medical Center, Strempelstraße 13, 18057, Rostock, Germany
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Hayashi P, Abib G, Hoppen N, Wolff LDG. Processual Validity in Qualitative Research in Healthcare. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2021; 58:469580211060750. [PMID: 34845941 PMCID: PMC8640329 DOI: 10.1177/00469580211060750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Knowledge development has been continuously challenging. Qualitative research seems to be promising; however, there are difficulties and complexities involved, one of which is validity. Qualitative research is based on different paradigms, ontologies, theories, and methods, and validity assessment may vary. We argue that processual validity can positively influence qualitative health care research. Processual validity is a methodological construction that involves all research steps, including those before and after data collection and analysis. We selected a processual validity model and two cases to illustrate its use and demonstrate processual validity’s importance and applicability. One case explores the gap between medical education and patients’ needs in primary health care. Other studies focus on health care improvements in hospitals. Our results highlight the benefits of processual validity to ensure the transparency and reliability of the research process and provide evidence of the findings to positively influence thinking and the execution of qualitative research in health care.
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Affiliation(s)
| | | | - Norberto Hoppen
- Vale do Rio dos Sinos University, São Leopoldo, Rio Grande do Sul, Brazil
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12
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Bannister-Tyrrell M, Meiqari L. Qualitative research in epidemiology: theoretical and methodological perspectives. Ann Epidemiol 2020; 49:27-35. [PMID: 32711056 DOI: 10.1016/j.annepidem.2020.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/30/2020] [Accepted: 07/15/2020] [Indexed: 11/26/2022]
Abstract
Increasingly, modern epidemiology has adopted complex causal frameworks incorporating individual- and population-level determinants of health. Despite the growing use of qualitative methodologies in public health research generally, discussion of causal reasoning in epidemiology rarely considers evidence derived from qualitative research. This article argues for a coherent role of qualitative research within epidemiology through analysis of the principles of causal reasoning that underlie current debates about causal inference in epidemiology. It introduces two approaches to causal inference by Russo and Williamson (2009) and Reiss (2012) that emphasize the relevance of both the nature of causation and how knowledge is gained about causation in assessing evidence for a causal relation. Both theories have scope for incorporating multiple types of evidence to assess causal claims. We argue that these theories align with the empirical focus of epidemiology and allow for different types of evidence to evaluate causal claims, including evidence originating from qualitative research; such evidence can contribute to a mechanistic understanding of causal relations and to understanding the effects of context on health-related outcomes. Finally, we discuss this approach in light of previous literature on the role of qualitative research in epidemiology and implications for future epidemiologic research.
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Affiliation(s)
| | - Lana Meiqari
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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13
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Irarrázaval L. A Phenomenological Paradigm for Empirical Research in Psychiatry and Psychology: Open Questions. Front Psychol 2020; 11:1399. [PMID: 32670164 PMCID: PMC7330133 DOI: 10.3389/fpsyg.2020.01399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/25/2020] [Indexed: 11/13/2022] Open
Abstract
This article seeks to clarify the way in which phenomenology is conceptualized and applied in empirical research in psychiatry and psychology, emphasizing the suitability of qualitative research. It will address the “What,” “Why,” and “How” of phenomenological interviews, providing not only preliminary answers but also a critical analysis and pointing to future directions for research. The questions it asks are: First, what makes an interview phenomenological? What are phenomenological interviews used for in empirical research in psychiatry and psychology? Second, why do we carry out phenomenological interviews with patients? Is merely contrasting phenomenological hypotheses or concepts enough to do justice to the patients’ involvement? Third, how should we conduct phenomenological interviews with patients? How can we properly perform analysis in empirical phenomenological research in psychiatry and psychology? In its conclusion, the article attempts to go a step beyond these methodological questions, highlighting the “bigger picture”: namely, the phenomenological scientific paradigm and its core philosophical claim of reality as mind-dependent.
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Affiliation(s)
- Leonor Irarrázaval
- Section Phenomenological Psychopathology and Psychotherapy, Psychiatric Department, University Clinic Heidelberg, Heidelberg, Germany.,Centro de Atención Psicológica, Facultad de Ciencias Sociales y Humanidades Sede Talca, Universidad Autónoma de Chile, Talca, Chile
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Joyner RL, Strickland SL, Becker EA, Ginier E, Keene S, Rye K, Haas CF. Adequacy of the Provider Workforce for Persons With Cardiopulmonary Disease. Chest 2020; 157:1221-1229. [DOI: 10.1016/j.chest.2019.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/16/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022] Open
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Mahoney B, Walklet E, Bradley E, Thrush S, Skillman J, Whisker L, Barnes N, Holcombe C, Potter S. Experiences of implant loss after immediate implant-based breast reconstruction: qualitative study. BJS Open 2020; 4:380-390. [PMID: 32181587 PMCID: PMC7260419 DOI: 10.1002/bjs5.50275] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 02/06/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Immediate implant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure in the UK, but almost one in ten women experience implant loss and reconstructive failure after this technique. Little is known about how implant loss impacts on patients' quality of life. The first phase of the Loss of implant Breast Reconstruction (LiBRA) study aimed to use qualitative methods to explore women's experiences of implant loss and develop recommendations to improve care. METHODS Semistructured interviews were conducted with a purposive sample of women who experienced implant loss after immediate IBBR, performed for malignancy or risk reduction across six centres. Interviews explored decision-making regarding IBBR, and experiences of implant loss and support received. Thematic analysis was used to explore the qualitative interview data. Sampling, data collection and analysis were undertaken concurrently and iteratively until data saturation was achieved. RESULTS Twenty-four women were interviewed; 19 had surgery for malignancy and five for risk reduction. The median time between implant loss and interview was 42 (range 22-74) months. Ten women had undergone secondary reconstruction, two were awaiting surgery, and 12 had declined further reconstruction. Three key themes were identified: the need for accurate information about the risks and benefits of IBBR; the need for more information about 'early-warning' signs of postoperative problems, to empower women to seek help; and better support following implant loss. CONCLUSION Implant loss is a devastating event for many women. Better preoperative information and support, along with holistic patient-centred care when complications occur, may significantly improve the experience and outcome of care.
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Affiliation(s)
- B. Mahoney
- School of Psychology, College of Business, Psychology and SportUniversity of WorcesterWorcesterUK
| | - E. Walklet
- School of Psychology, College of Business, Psychology and SportUniversity of WorcesterWorcesterUK
| | - E. Bradley
- College of Health, Life and Environmental SciencesUniversity of WorcesterWorcesterUK
| | - S. Thrush
- Breast UnitWorcester Royal HospitalWorcesterUK
| | - J. Skillman
- Department of Plastic SurgeryUniversity Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge RoadCoventryUK
| | - L. Whisker
- Nottingham Breast InstituteCity HospitalNottinghamUK
| | - N. Barnes
- Nightingale Breast UnitManchester University NHS Foundation TrustManchesterUK
| | - C. Holcombe
- Linda McCartney CentreRoyal Liverpool and Broadgreen University HospitalLiverpoolUK
| | - S. Potter
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical SchoolBristolUK
- Bristol Breast Care Centre, North Bristol NHS TrustSouthmead HospitalBristolUK
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Athanasakis E. Registered Nurses' Experiences of Medication Errors-An Original Research Protocol: Methodology, Methods, and Ethics. Can J Nurs Res 2020; 53:171-183. [PMID: 32000508 DOI: 10.1177/0844562120902668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The investigation of medication errors in nursing includes both methodological and ethical considerations because it is a sensitive field of research. PURPOSE To present an original research protocol for the investigation of nurses' experiences of medication errors with interpretative phenomenological analysis and the relevant methodological and ethical considerations. METHODS A discursive paper which presents an original research protocol about nurses' experiences of medication errors with interpretative phenomenological analysis followed by a literature review and personal reflections about the relevant methodological and ethical considerations. The review included papers published in English from 1990 to February 2019 on PubMed, BNI (British Nursing Index), CINAHL (Cumulative Index to Allied Health Literature), ScienceDirect, and Wiley Online Library. RESULTS The following methodological considerations were identified: recruitment of participants, data collection, and data analysis, and the ethical considerations included researcher's morality, ethics committees, sensitivity, phrasing of sentences and words, recruitment of participants, location of interviews, type of interviews, emotionality management, medication error incidents' management, researcher, or nurse? CONCLUSION By facing as many as possible methodological and ethical considerations and establishing solutions for them, the study's validity, reliability, and rigor are enhanced, and the study is ethically robust. Finally, their understanding enables researchers to uncover nurses' experiences and interpret the meanings they generate in depth.
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Affiliation(s)
- Efstratios Athanasakis
- Respiratory Assessment Unit, Nottingham University Hospitals NHS Foundation Trust, Nottingham, UK
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Abstract
Qualitative methodologies are commonly used in the social sciences. This paper discusses how this type of research can enhance evidence-based practice in health care settings. Examples taken from qualitative studies are included in order to demonstrate how such research can be applied to medical settings. Additionally, this paper describes some of the unique characteristics inherent in qualitative research.
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Ramos KJ, Smith PJ, McKone EF, Pilewski JM, Lucy A, Hempstead SE, Tallarico E, Faro A, Rosenbluth DB, Gray AL, Dunitz JM. Lung transplant referral for individuals with cystic fibrosis: Cystic Fibrosis Foundation consensus guidelines. J Cyst Fibros 2019; 18:321-333. [PMID: 30926322 PMCID: PMC6545264 DOI: 10.1016/j.jcf.2019.03.002] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/08/2019] [Accepted: 03/09/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Provide recommendations to the cystic fibrosis (CF) community to facilitate timely referral for lung transplantation for individuals with CF. METHODS The CF Foundation organized a multidisciplinary committee to develop CF Lung Transplant Referral Consensus Guidelines. Three workgroups were formed: timing for transplant referral; modifiable barriers to transplant; and transition to transplant care. A focus group of lung transplant recipients with CF and spouses of CF recipients informed guideline development. RESULTS The committee formulated 21 recommendation statements based on literature review, committee member practices, focus group insights, and in response to public comment. Critical approaches to optimizing access to lung transplant include early discussion of this treatment option, assessment for modifiable barriers to transplant, and open communication between the CF and lung transplant centers. CONCLUSIONS These guidelines will help CF providers counsel their patients and may reduce the number of individuals with CF who die without consideration for lung transplant.
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Affiliation(s)
- Kathleen J Ramos
- Division of Pulmonary, Critical Care, and Sleep Medicine, Dept of Medicine, University of Washington, Seattle, WA, USA.
| | - Patrick J Smith
- Department of Psychiatry and Behavioral Sciences, Behavioral Medicine Division, Department of Medicine, Pulmonary Division, Duke University Medical Center, Durham, NC, USA.
| | - Edward F McKone
- National Referral Centre for Adult Cystic Fibrosis, St. Vincent's University Hospital, Dublin, Ireland.
| | - Joseph M Pilewski
- Division of Pulmonary, Allergy & Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Amy Lucy
- Cystic Fibrosis Foundation, Bethesda, MD, USA
| | | | | | - Albert Faro
- Cystic Fibrosis Foundation, Bethesda, MD, USA.
| | - Daniel B Rosenbluth
- Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - Alice L Gray
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA.
| | - Jordan M Dunitz
- Division of Pulmonary, Allergy, Critical Care Medicine and Sleep, Dept of Medicine, University of Minnesota, Minneapolis, MN, USA.
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Larkin PJ, De Casterlé BD, Schotsmans P. Transition towards End of Life in Palliative Care: An Exploration of its Meaning for Advanced Cancer Patients in Europe. J Palliat Care 2019. [DOI: 10.1177/082585970702300202] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Transition as a concept in healthcare has been explored, but there is limited empirical work which considers transition in the context of palliative care, specifically from the patient perspective. This article reports findings from a qualitative study designed to explore transition experiences of 100 advanced cancer patients in six European countries. Data were analyzed using the ATLAS.ti program. Findings suggest that transition is a confusing time of mixed messages, poor communication, and uncertainty, but the physical environment of the hospice offers a place of ontological security from which to address this. Transition concepts fail to capture the palliative care experience fully. Transience, as an alternative concept, is reported, although further research is needed to explore this. In clinical practice, the value given to hospice by patients suggests that clinicians must carefully balance the benefit of mainstream integration with sensitive assimilation of hospice philosophy.
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Abstract
PURPOSE To explore the views of adolescents with chronic idiopathic neck pain toward an intervention consisting of pain neuroscience education and exercise administered in the school setting. METHODS Four focus group interviews were conducted with 21 adolescents with chronic idiopathic neck pain who participated in a 4-week intervention consisting of pain neuroscience education and exercise. The interviews were transcribed verbatim and analyzed using content analysis. RESULTS Two main themes emerged: the perceived relevance of acquired knowledge and the perceived adequacy of the intervention. CONCLUSION An intervention consisting of pain neuroscience education and exercise administered in the school setting is well accepted and considered relevant and appropriate by adolescents with chronic idiopathic neck pain.
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DunnGalvin A, Polloni L, Le Bovidge J, Muraro A, Greenhawt M, Taylor S, Baumert J, Burks W, Trace A, DunnGalvin G, Forristal L, McGrath L, White J, Vasquez M, Allen K, Sheikh A, Hourihane J, Tang ML. Preliminary Development of the Food Allergy Coping and Emotions Questionnaires for Children, Adolescents, and Young People: Qualitative Analysis of Data on IgE-Mediated Food Allergy from Five Countries. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018. [DOI: 10.1016/j.jaip.2017.11.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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How do youth with experience of violence victimization and/or risk drinking perceive routine inquiry about violence and alcohol consumption in Swedish youth clinics? A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 13:51-57. [DOI: 10.1016/j.srhc.2017.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 06/13/2017] [Accepted: 06/16/2017] [Indexed: 01/29/2023]
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Obiwuru O, Joseph S, Liu L, Palomeque A, Tarlow L, Langer-Gould AM, Amezcua L. Perceptions of Multiple Sclerosis in Hispanic Americans: Need for Targeted Messaging. Int J MS Care 2017; 19:131-139. [PMID: 28603461 DOI: 10.7224/1537-2073.2015-081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Illness perceptions have been reported to be important determinants of multiple sclerosis (MS)-related well-being. Hispanic culture is defined by strong cultural beliefs in which illness is often perceived to arise from strong emotions. Understanding the perceptions of MS in Hispanic Americans may provide a better understanding of cultural barriers that may exist. The purpose of this study was to describe Hispanic American perceptions of MS. METHODS We gathered information from semistructured interviews, focus groups, and participant responses from the University of Southern California Hispanic MS Registry. This information was then stratified into a matrix of environmental, biological, and sociocultural determinants. Differences were examined by place of birth, treatment preference, and ambulatory difficulty. Logistic regression was used to investigate the relationship between sociocultural perceptions, place of birth, and ambulation. RESULTS Most participants were female (n = 64, 61%), US born (n = 64, 61%), and receiving treatment for MS. Participants cited environmental and sociocultural perceptions, with significant differences noted by place of birth. Sociocultural factors such as strong emotions were almost four times more commonly perceived in immigrants compared with US-born participants (adjusted odds ratio, 3.66; 95% confidence interval, 1.12-11.90; P = .03). Male, low-education, and low-income participants were also more likely to perceive MS to be a result of strong emotions, but these differences were not statistically significant. CONCLUSIONS Hispanic American perceptions of MS differ by place of birth, with reports of cultural idioms more common among immigrants, which could affect disease management. These findings may be useful in designing educational interventions to improve MS-related well-being in Hispanic populations.
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Lovell A, Bailey J. Nurses' perceptions of personal attributes required when working with people with a learning disability and an offending background: a qualitative study. J Psychiatr Ment Health Nurs 2017; 24:4-14. [PMID: 27439391 DOI: 10.1111/jpm.12326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 11/28/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Learning disability nursing in the area of people with a learning disability and an offending background has developed considerably over recent years, particularly since the publication of the Bradley (). There has been limited work into the competencies nurses require to work in this area, and even less about the personal attributes of learning disability nurses. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Learning disability nursing's specific contribution to the care of this population lies in their knowledge of the interaction between the learning disability, an individual's, sometimes abusive, personal history and an understanding of the subsequent offending behaviour. The knowledge base of nurses working with people with learning disabilities and an offending background needs to reflect the changing service user group. This is particularly in relation to substance misuse, borderline personality disorder, and mental health and the way such factors inter-relate with the learning disability. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further research is required into the relationship among decision making, risk taking or reluctance to do this, and the personal attributes required by nurses to work in secure learning disability care. Learning disability secure services are likely to continue to undergo change as circumstances alter and the offending population demonstrate greater complexity; nursing competencies and personal attributes need similarly to adapt to such changes. Mental health nursing has a great deal to contribute to effective working with this population, specifically with regard to developing strong relationships when concerns around borderline personality disorder or substance misuse are particularly in evidence. ABSTRACT Aim To identify and discuss the personal attributes required by learning disability nurses to work effectively with people with an offending background in secure and community settings. Background This study was part of a larger research investigation into the nursing competencies required to work with people with an offending background. There are few existing studies examining the personal attributes necessary for working with this group. Design A qualitative study addressing the perceptions of nurses around the personal attributes required to work with people with learning disabilities and an offending background. Methods A semi-structured interview schedule was devised and constructed, and 39 individual interviews were subsequently undertaken with learning disability nurses working in high, medium, low secure and community settings. Data were collected over 1 year in 2010/11 and analysed using a structured thematic analysis supported by the software package MAXqda. Findings The thematic analysis produced three categories of personal attributes, named as looking deeper, achieving balance and connecting, each of which contained a further three sub-categories. Conclusion Nursing of those with a learning disability and an offending background continues to develop. The interplay among personal history, additional background factors, nurses' personal attributes and learning disability is critical for effective relationship building.
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Affiliation(s)
- A Lovell
- Department of Mental Health & Learning Disabilities, Faculty of Health & Social Care, University of Chester, Chester, UK
| | - J Bailey
- Faculty of Health & Social Care, University of Chester, Chester, UK
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Catrinoiu D, Craciun LR, Cristea SA. Analyses Of Research For Understanding The Problems Of Patients With Diabetes. ARS MEDICA TOMITANA 2017. [DOI: 10.1515/arsm-2017-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
In spite of advances in the management of diabetes mellitus, late complications still represent a problem. Research suggests that improved metabolic control, including the change of lifestyle, which requires the patient’s own willingness and ability to adapt, could limit those complications. This article is intended to provide the background to a long-term research programme designed to gain a deeper understanding of diabetic patients′ perspectives in their attempt to adapt. It uses the experiences of further groups of diabetic patients, in an attempt to show the usefulness of a cumulative approach towards the building up of a theoretical framework.
Aims of study
This study aims to:
1. give a background to a long-term qualitative theory generating study concerning patients' experiences of managing diabetes.
2. argue that diabetic patients (and nursing as a discipline) might benefit from qualitative research with a focus on the patients’ perspective.
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Affiliation(s)
- Doina Catrinoiu
- University “Ovidius” of Constanta, Faculty of Medicine, Romania
| | - L. R. Craciun
- 3rd Department, Medical Sciences, Faculty of Medicine University “Ovidius” of Constanta 145 Tomis Bvd., Constanta, 900591, Romania
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O'Byrne PM, FitzGerald JM, Zhong N, Bateman E, Barnes PJ, Keen C, Almqvist G, Pemberton K, Jorup C, Ivanov S, Reddel HK. The SYGMA programme of phase 3 trials to evaluate the efficacy and safety of budesonide/formoterol given 'as needed' in mild asthma: study protocols for two randomised controlled trials. Trials 2017; 18:12. [PMID: 28069068 PMCID: PMC5223341 DOI: 10.1186/s13063-016-1731-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 11/28/2016] [Indexed: 11/22/2022] Open
Abstract
Background In many patients with mild asthma, the low frequency of symptoms and the episodic nature of exacerbations make adherence to regular maintenance treatment difficult. This often leads to over-reliance on short-acting β2-agonist (SABA) reliever medication and under-treatment of the underlying inflammation, with poor control of asthma symptoms and increased risk of exacerbations. The use of budesonide/formoterol ‘as needed’ in response to symptoms may represent an alternative treatment option for patients with mild asthma. Methods/design The SYmbicort Given as needed in Mild Asthma (SYGMA) programme consists of two 52-week, double-blind, randomised, multicentre, parallel-group, phase 3 trials of patients aged 12 years and older with a clinical diagnosis of asthma for at least 6 months, who would qualify for treatment with regular inhaled corticosteroids (ICS). SYGMA1 aims to recruit 3750 patients who will be randomised to placebo twice daily (bid) plus as-needed budesonide/formoterol 160/4.5 μg, placebo bid plus as-needed terbutaline 0.4 mg, or budesonide 200 μg bid plus as-needed terbutaline 0.4 mg. The primary objective is to demonstrate the superiority of as-needed budesonide/formoterol over as-needed terbutaline for asthma control, as measured by well-controlled asthma weeks; a secondary objective is to establish the noninferiority of as-needed budesonide/formoterol versus maintenance budesonide plus as-needed terbutaline using the same outcome measure. SYGMA2 aims to recruit 4114 patients who will be randomised to placebo bid plus as-needed budesonide/formoterol 160/4.5 μg, or budesonide 200 μg bid plus as-needed terbutaline 0.4 mg. The primary objective is to demonstrate the noninferiority of as-needed budesonide/formoterol over budesonide bid plus as-needed terbutaline as measured by the annualised severe exacerbation rate. In both studies, use of all blinded study inhalers will be recorded electronically using Turbuhaler® Usage Monitors. Discussion Given the known risks of mild asthma, and known poor adherence with regular inhaled corticosteroids, the results of the SYGMA programme will help to determine the efficacy and safety of as-needed budesonide/formoterol therapy in mild asthma. Patient recruitment is complete, and completion of the phase 3 studies is planned in 2017. Trial registration ClinicalTrials.gov identifiers: NCT02149199 SYGMA1 and NCT02224157 SYGMA2. Registered on 16 May 2014 and 19 August 2014, respectively. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1731-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul M O'Byrne
- Michael G DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada. .,Firestone Institute of Respiratory Health, St Joseph's Healthcare and Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - J Mark FitzGerald
- Institute for Heart and Lung Health, University of British Columbia, Vancouver, BC, Canada
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Diseases, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Eric Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Peter J Barnes
- Airway Disease Section, National Heart and Lung Institute, Imperial College, London, UK
| | | | | | | | | | | | - Helen K Reddel
- Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
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Cridland EK, Phillipson L, Brennan-Horley C, Swaffer K. Reflections and Recommendations for Conducting In-Depth Interviews With People With Dementia. QUALITATIVE HEALTH RESEARCH 2016; 26:1774-1786. [PMID: 27055496 DOI: 10.1177/1049732316637065] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Despite the importance and advantages of including people with dementia in research, there are various challenges for researchers and participants to their involvement. This article draws on the literature and experiences of a diverse group of authors, including a person with dementia, to provide recommendations about conducting research with people with dementia. Particular attention is given to in-depth interviews as a qualitative technique. More specifically, topics discussed include interview guide preparation, recruitment, obtaining consent/assent, conducting effective interviews, analysis and interpretation of data, effective communication of research findings, and reflections and recommendations for maintaining researcher and participant health. Given the current obstacles to participation in research of people with dementia, this is a timely article providing useful insights to promote improved outcomes using in-depth interviews.
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Affiliation(s)
| | - Lyn Phillipson
- 1 University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Kate Swaffer
- 1 University of Wollongong, Wollongong, New South Wales, Australia
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King R, Robinson V, Ryan CG, Martin DJ. An exploration of the extent and nature of reconceptualisation of pain following pain neurophysiology education: A qualitative study of experiences of people with chronic musculoskeletal pain. PATIENT EDUCATION AND COUNSELING 2016; 99:1389-1393. [PMID: 27021238 DOI: 10.1016/j.pec.2016.03.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/03/2016] [Accepted: 03/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Pain neurophysiology education (PNE), a method of pain education, purports to work by helping patients reconceptualise their pain, shifting from a tissue injury model towards a biopsychosocial understanding related to neural sensitivity. Better understanding of pain reconceptualisation following PNE is needed to improve the delivery of this educational approach to enhance its effectiveness. This study aimed to investigate the extent and nature of reconceptualisation following PNE. METHODS In a qualitative design, based on Interpretive Phenomenological Analysis, thematic analysis was carried out on individual interviews with 7 adults before and three weeks after receiving PNE at a pain clinic. RESULTS Three themes emerged describing variable degrees of reconceptualisation; prior beliefs as facilitators and barriers to reconceptualisation; and the influence of reconceptualisation on clinical benefits of PNE. CONCLUSION The results lend support to claims that reconceptualisation is an important mechanism in PNE and justify further investigation of this phenomenon. PRACTICAL IMPLICATIONS When delivering PNE to patients with chronic pain helping patients to reconceptualise their pain may be key to enhancing the clinical benefits of the intervention. Understanding prior beliefs may be an important step in facilitating reconceptualisation.
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Affiliation(s)
- Rick King
- Health and Social Care Institute, Teesside University, Middlesbrough, UK; Pain Clinic, James Cook University Hospital, South Tees NHS Hospitals Trust, Middlesbrough, UK.
| | - Victoria Robinson
- Pain Clinic, James Cook University Hospital, South Tees NHS Hospitals Trust, Middlesbrough, UK.
| | - Cormac G Ryan
- Health and Social Care Institute, Teesside University, Middlesbrough, UK.
| | - Denis J Martin
- Health and Social Care Institute, Teesside University, Middlesbrough, UK.
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Baert V, Gorus E, Mets T, Bautmans I. Motivators and barriers for physical activity in older adults with osteoporosis. J Geriatr Phys Ther 2016; 38:105-14. [PMID: 25594524 DOI: 10.1519/jpt.0000000000000035] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Although physical activity (PA) is an important tool to counter osteoporosis, too few older patients with osteoporosis (OPWO) engage in PA. Little is known about specific motivators for and barriers to PA in OPWO, hindering the development of targeted PA promotion campaigns for these persons. Therefore, the main objective of this study was to identify motivators for and barriers to PA specifically in OPWO. METHODS This qualitative study identified specific motivators for and barriers to PA in OPWO through 2 different methods: focus groups with professionals and in-depth interviews with OPWO. RESULTS The OPWO tended to give a broad interpretation of what they considered as PA (practicing sports, physical work, and performing household activities), whereas the professionals seemed to mainly focus on (therapeutic) exercise as PA. Fifteen different motivators and 18 barriers have been identified. Among others, health improvement, social contact, habit, feeling good, and receiving medical advice from a medical doctor were motivators. Pain, fear of falling, bad weather, lack of interest, and caring for an ill partner were barriers to PA. For some older respondents, osteoporosis acted as a trigger for PA, and for others it was a barrier. CONCLUSIONS This study emphasizes the importance for health care professionals to give personalized PA advice regarding the nature and frequency of PA that is safe and beneficial for osteoporosis. It stands to reason that the information about PA needs to be clear and consistent. Furthermore, it is quintessential to mention that it can take some time to adapt to physical exercise and to experience the beneficial effects, because pain sensations during the first PA sessions can be perceived as barriers to OPWO. Misconceptions or barriers to PA should be countered by assessing motivators for and barriers to PA by the health care professional together with the older client so that barriers can be eliminated and motivators can be strengthened. Physical activity education should involve not only the OPWO but also their relatives, friends, and important peers. Different social aspects of PA and the encouragements from peers are stimulating for older adults to initiate and to continue PA. The results of our study can constitute a starting point for further research to identify the motivators for and barriers to PA with the highest impact on PA behavior in OPWO, thus enabling evidence-based PA promotion campaigns for this patient group.
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Affiliation(s)
- Veerle Baert
- 1Frailty in Ageing research (FRIA) & Gerontology (GERO) Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium. 2Geriatrics Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
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A qualitative exploration of people's experiences of pain neurophysiological education for chronic pain: The importance of relevance for the individual. ACTA ACUST UNITED AC 2016; 22:56-61. [DOI: 10.1016/j.math.2015.10.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 10/01/2015] [Accepted: 10/04/2015] [Indexed: 11/20/2022]
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Heyhoe J, Lawton R, Armitage G, Conner M, Ashurst NH. Understanding diagnostic error: looking beyond diagnostic accuracy. ACTA ACUST UNITED AC 2015. [PMID: 29540042 DOI: 10.1515/dx-2015-0015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Whether a diagnosis is correct or incorrect is often used to determine diagnostic performance despite there being no valid measure of diagnostic accuracy. In this paper we draw on our experience of conducting research on diagnostic error and discuss some of the challenges that a focus on accuracy brings to this field of research. In particular, we discuss whether diagnostic accuracy can be captured and what diagnostic accuracy does and does not tell us about diagnostic judgement. We draw on these points to argue that a focus on diagnostic accuracy may limit progress in this field and suggest that research which tries to understand more about the factors that influence decision making during the diagnostic process may be more useful in helping to improve diagnostic performance.
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Affiliation(s)
- Jane Heyhoe
- 1Bradford Institute for Health Research, Bradford, UK
| | - Rebecca Lawton
- 1Bradford Institute for Health Research, Bradford, UK2School of Psychology, University of Leeds, Leeds, UK
| | - Gerry Armitage
- 3Faculty of Health, University of Bradford, Bradford, UK
| | - Mark Conner
- 4School of Psychology, University of Leeds, Leeds, UK
| | - Neil H Ashurst
- 5Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Abey S, Lea S, Callaghan L, Shaw S, Cotton D. Identifying factors which enhance capacity to engage in clinical education among podiatry practitioners: an action research project. J Foot Ankle Res 2015; 8:66. [PMID: 26617676 PMCID: PMC4661951 DOI: 10.1186/s13047-015-0123-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 11/14/2015] [Indexed: 11/24/2022] Open
Abstract
Background Health profession students develop practical skills whilst integrating theory with practice in a real world environment as an important component of their training. Research in the area of practice placements has identified challenges and barriers to the delivery of effective placement learning. However, there has been little research in podiatry and the question of which factors impact upon clinical educators’ capacity to engage with the role remains an under-researched area. This paper presents the second phase of an action research project designed to determine the factors that impact upon clinical educators’ capacity to engage with the mentorship role. Methods An online survey was developed and podiatry clinical educators recruited through National Health Service (NHS) Trusts. The survey included socio-demographic items, and questions relating to the factors identified as possible variables influencing clinical educator capacity; the latter was assessed using the ‘Clinical Educator Capacity to Engage’ scale (CECE). Descriptive statistics were used to explore demographic data whilst the relationship between the CECE and socio-demographic factors were examined using inferential statistics in relation to academic profile, career profile and organisation of the placement. Results The survey response rate was 42 % (n = 66). Multiple linear regression identified four independent variables which explain a significant proportion of the variability of the dependent variable, ‘capacity to engage with clinical education’, with an adjusted R2 of 0.428. The four variables were: protected mentorship time, clinical educator relationship with university, sign-off responsibility, and volunteer status. Conclusion The identification of factors that impact upon clinical educators’ capacity to engage in mentoring of students has relevance for strategic planning and policy-making with the emphasis upon capacity-building at an individual level, so that the key attitudes and characteristics that are linked with good clinical supervision are preserved.
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Affiliation(s)
- Sally Abey
- Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
| | - Susan Lea
- Deputy Vice-Chancellor (Academic), University of Greenwich, London, UK
| | - Lynne Callaghan
- Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Cornwall, UK
| | - Steve Shaw
- School of Computing and Mathematics, Plymouth University, Plymouth, UK
| | - Debbie Cotton
- Pedagogic Research Institute and Observatory, Plymouth University, Plymouth, UK
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Moharra M, Almazán C, Decool M, Nilsson AL, Allegretti N, Seven M. Implementation of a cross-border health service: physician and pharmacists' opinions from the epSOS project. Fam Pract 2015; 32:564-7. [PMID: 26148726 DOI: 10.1093/fampra/cmv052] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To explore the opinions of health professionals with experience of the European Patient Smart Open Services (epSOS) system regarding the epSOS services perceived utility, potential impact and main barriers and facilitators to its use. METHODS Qualitative study design involving focus groups with health care professionals with experience of epSOS system. A semi-structured topic guide was developed to guide the discussion. RESULTS epSOS services were seen as interesting intuitive services and easy to operate. The greatest impact was in terms of positive impact on communication, clinical safety and patient management. Data reliability, difficulties in accessing the service and aspects related to information technology architecture were considered the most relevant barriers. CONCLUSION This study has provided insights into the strengths and limitations of two new eHealth services for use across countries within the European Union, and has provided indications of how those services could be improved.
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Affiliation(s)
- Montse Moharra
- Agency for Healthcare Quality and Assessment of Catalonia, Barcelona, Spain,
| | - Cari Almazán
- Agency for Healthcare Quality and Assessment of Catalonia, Barcelona, Spain
| | - Marie Decool
- Agency for Healthcare Quality and Assessment of Catalonia, Barcelona, Spain
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Leidel S, Wilson S, McConigley R, Boldy D, Girdler S. Health-care providers' experiences with opt-out HIV testing: a systematic review. AIDS Care 2015; 27:1455-67. [PMID: 26272473 DOI: 10.1080/09540121.2015.1058895] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
HIV is now a manageable chronic disease with a good prognosis, but early detection and referral for treatment are vital. In opt-out HIV testing, patients are informed that they will be tested unless they decline. This qualitative systematic review explored the experiences, attitudes, barriers, and facilitators of opt-out HIV testing from a health-care provider (HCP) perspective. Four articles were included in the synthesis and reported on findings from approximately 70 participants, representing diverse geographical regions and a range of human development status and HIV prevalence. Two synthesized findings emerged: HCP attitudes and systems. The first synthesized finding encompassed HCP decision-making attitudes about who and when to test for HIV. It also included the assumptions the HCPs made about patient consequences. The second synthesized finding related to systems. System-related barriers to opt-out HIV testing included lack of time, resources, and adequate training. System-related facilitators included integration into standard practice, support of the medical setting, and electronic reminders. A common attitude among HCPs was the outdated notion that HIV is a terrible disease that equates to certain death. Some HCPs stated that offering the HIV test implied that the patient had engaged in immoral behaviour, which could lead to stigma or disengagement with health services. This paternalism diminished patient autonomy, because patients who were excluded from opt-out HIV testing could have benefited from it. One study highlighted the positive aspects of opt-out HIV testing, in which participants underscored the professional satisfaction that arose from making an HIV diagnosis, particularly when marginalized patients could be connected to treatment and social services. Recommendations for opt-out HIV testing should be disseminated to HCPs in a broad range of settings. Implementation of system-related factors such as electronic reminders and care coordination procedures should be considered, and a social-justice commitment among HCPs should be encouraged.
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Affiliation(s)
- Stacy Leidel
- a School of Nursing and Midwifery , Curtin University , Perth , Australia
| | - Sally Wilson
- a School of Nursing and Midwifery , Curtin University , Perth , Australia
| | - Ruth McConigley
- a School of Nursing and Midwifery , Curtin University , Perth , Australia
| | - Duncan Boldy
- a School of Nursing and Midwifery , Curtin University , Perth , Australia
| | - Sonya Girdler
- b School of Occupational Therapy and Social Work , Curtin University , Perth , Australia
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How JA, Abitbol J, Lau S, Gotlieb WH, Abenhaim HA. The Impact of Qualitative Research on Gynaecologic Oncology Guidelines. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2015; 37:138-144. [DOI: 10.1016/s1701-2163(15)30335-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tan AC, Emmerton LM, Hattingh HL, La Caze A. Funding issues and options for pharmacists providing sessional services to rural hospitals in Australia. AUST HEALTH REV 2015; 39:351-358. [PMID: 25556894 DOI: 10.1071/ah14081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 11/03/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Many of Australia' s rural hospitals operate without an on-site pharmacist. In some, community pharmacists have sessional contracts to provide medication management services to inpatients. This paper discusses the funding arrangements of identified sessional employment models to raise awareness of options for other rural hospitals. METHODS Semistructured one-on-one interviews were conducted with rural pharmacists with experience in a sessional employment role (n =8) or who were seeking sessional arrangements (n = 4). Participants were identified via publicity and referrals. Interviews were conducted via telephone or Skype for ~40-55 min each, recorded and analysed descriptively. RESULTS A shortage of state funding and reliance on federal funding was reported. Pharmacists accredited to provide medication reviews claimed remuneration via these federal schemes; however, restrictive criteria limited their scope of services. Funds pooling to subsidise remuneration for the pharmacists was evident and arrangements with local community pharmacies provided business frameworks to support sessional services. CONCLUSION Participants were unaware of each other's models of practice, highlighting the need to share information and these findings. Several similarities existed, namely, pooling funds and use of federal medication review remuneration. Findings highlighted the need for a stable remuneration pathway and business model to enable wider implementation of sessional pharmacist models.
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Affiliation(s)
- Amy Cw Tan
- Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
| | - Lynne M Emmerton
- Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
| | - H Laetitia Hattingh
- School of Pharmacy, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Adam La Caze
- School of Pharmacy, The University of Queensland, St Lucia, Brisbane, Qld 4072, Australia
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Irarrázaval L. The lived body in schizophrenia: transition from basic self-disorders to full-blown psychosis. Front Psychiatry 2015; 6:9. [PMID: 25691874 PMCID: PMC4315119 DOI: 10.3389/fpsyt.2015.00009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 01/19/2015] [Indexed: 11/13/2022] Open
Abstract
This paper provides the results of a phenomenological study of patients with schizophrenia during their first psychiatric hospitalization. The study aims at clarify aspects related to the diagnosis of schizophrenia and to reach a greater understanding of the illness, with a view to contribute to prevention and psychotherapeutic intervention models. First, the paper offers a description of the patients' "disembodiment" manifested in acute phases of schizophrenia. Second, it presents a description of the subjective anomalies that may be considered as disorders of "ipseity" or of pre-reflexive self-awareness. Third, the description is extended to encompass secondary disturbances to processes of establishing consensual intersubjectivity that lead to difficulties in shared communication practices and a progressive withdrawal from the intersubjective world. The conclusion states that a structural element, a key part of the personal processes involved in schizophrenia, is the diminishment of self-presence in experience, which manifests on both individual and social levels.
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Affiliation(s)
- Leonor Irarrázaval
- Centro de Estudios de Fenomenología y Psiquiatría, Facultad de Medicina, Universidad Diego Portales , Santiago , Chile ; Section Phenomenological Psychopathology and Psychotherapy, Psychiatric Department, University Clinic Heidelberg , Heidelberg , Germany
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Tan ACW, Emmerton LM, Hattingh HL, La Caze A. Cross-sector, sessional employment of pharmacists in rural hospitals in Australia and New Zealand: a qualitative study exploring pharmacists' perceptions and experiences. BMC Health Serv Res 2014; 14:567. [PMID: 25391333 PMCID: PMC4236748 DOI: 10.1186/s12913-014-0567-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 10/27/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many rural hospitals in Australia and New Zealand do not have an on-site pharmacist. Sessional employment of a local pharmacist offers a potential solution to address the clinical service needs of non-pharmacist rural hospitals. This study explored sessional service models involving pharmacists and factors (enablers and challenges) impacting on these models, with a view to informing future sessional employment. METHODS A series of semi-structured one-on-one interviews was conducted with rural pharmacists with experience, or intention to practise, in a sessional employment role in Australia and New Zealand. Participants were identified via relevant newsletters, discussion forums and referrals from contacts. Interviews were conducted during August 2012-January 2013 via telephone or Skype™, for approximately 40-55 minutes each, and recorded. RESULTS Seventeen pharmacists were interviewed: eight with ongoing sessional roles, five with sessional experience, and four working towards sessional employment. Most participants provided sessional hospital services on a weekly basis, mainly focusing on inpatient medication review and consultation. Recognition of the value of pharmacists' involvement and engagement with other healthcare providers facilitated establishment and continuity of sessional services. Funds pooled from various sources supplemented some pharmacists' remuneration in the absence of designated government funding. Enhanced employment opportunities, district support and flexibility in services facilitated the continuous operation of the sessional service. CONCLUSIONS There is potential to address clinical pharmacy service needs in rural hospitals by cross-sector employment of pharmacists. The reported sessional model arrangements, factors impacting on sessional employment of pharmacists and learnings shared by the participants should assist development of similar models in other rural communities.
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van Wesel F, Boeije HR, Alisic E. Towards a method for synthesizing diverse evidence using hypotheses as common language. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s11135-014-0105-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Creating an eLearning resource to improve knowledge and understanding of pregnancy in the context of HIV infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:10504-17. [PMID: 25317982 PMCID: PMC4210992 DOI: 10.3390/ijerph111010504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/30/2014] [Accepted: 09/30/2014] [Indexed: 12/24/2022]
Abstract
Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma. This paper presents how we sought to translate the evidence from a qualitative study of the perspectives of HIV affected pregnant women and expectant fathers on the care they received, from the pre conception to post natal period, into educational material for maternity care practice. Narrative scripts were written based on the original research interviews, with care taken to reflect the key themes from the research. We explore the way in which the qualitative findings bring to life patient and partner experiences and what it means for nurses, midwives and doctors to be prepared to care for couples affected by HIV. In so doing, we challenge the inequity between the dominance of biomedical knowledge over understanding the patient experience in the preparation of health professionals to care for HIV affected women and men who are having a baby or seeking to have a baby.
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Irarrázaval L, Sharim D. Intersubjectivity in schizophrenia: life story analysis of three cases. Front Psychol 2014; 5:100. [PMID: 24575073 PMCID: PMC3921581 DOI: 10.3389/fpsyg.2014.00100] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 01/24/2014] [Indexed: 11/18/2022] Open
Abstract
The processes involved in schizophrenia are approached from a viewpoint of understanding, revealing those social elements susceptible to integration for psychotherapeutic purposes, as a complement to the predominant medical-psychiatric focus. Firstly, the paper describes the patients’ disturbances of self-experience and body alienations manifested in acute phases of schizophrenia. Secondly, the paper examines the patients’ personal biographical milestones and consequently the acute episode is contextualized within the intersubjective scenario in which it manifested itself in each case. Thirdly, the patients’ life stories are analyzed from a clinical psychological perspective, meaningfully connecting symptoms and life-world. Finally, it will be argued that the intersubjective dimension of the patients’ life stories shed light not only on the interpersonal processes involved in schizophrenia but also upon the psychotherapeutic treatment best suited to each individual case.
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Affiliation(s)
- Leonor Irarrázaval
- Centro de Estudios de Fenomenología y Psiquiatría, Facultad de Medicina, Universidad Diego Portales Santiago, Chile
| | - Dariela Sharim
- Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile Santiago, Chile
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Abadir AM, Lang A, Klein T, Abenhaim HA. Influence of qualitative research on women's health screening guidelines. Am J Obstet Gynecol 2014; 210:44.e1-6. [PMID: 24055587 DOI: 10.1016/j.ajog.2013.09.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 09/03/2013] [Accepted: 09/13/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Considerable time and resources are allocated to carry out qualitative research. The purpose of our study was to evaluate the availability of qualitative research on women's health screening and assess its influence on screening practice guidelines in the United States, Canada, and the United Kingdom. STUDY DESIGN Medline, CINHAL, and WEB of Science databases were used to identify the availability of qualitative research conducted in the past 15 years on 3 different women's health screening topics: cervical cancer screening, breast cancer screening, and prenatal first-trimester screening. Key national practice guidelines on women's health screening were selected using the National Guideline Clearinghouse web site. Bibliometric analysis was used to determine the frequency of qualitative references cited in the guidelines. RESULTS A total of 272 qualitative research papers on women's health screening was identified: 109 on cervical cancer screening, 104 on breast cancer screening, and 59 on prenatal first-trimester screening. The qualitative studies focused on health care provider perspectives as well as ethical, ethnographic, psychological, and social issues surrounding screening. Fifteen national clinical practice guidelines on women's health screening were identified. A total of 943 references was cited, only 2 of which comprised of qualitative research cited by only 1 clinical practice guideline. CONCLUSION Although there is considerable qualitative research that has been carried out on women's health screening, its incorporation into clinical practice guidelines is minimal. Further exploration of the disconnect between the two is important for enhancing knowledge translation of qualitative research within clinical practice.
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Affiliation(s)
- Anna Maria Abadir
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Ariella Lang
- Victorian Order of Nurses of Canada, Ottawa, ON, Canada
| | | | - Haim Arie Abenhaim
- Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, QC, Canada.
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Being a Girl in a Boys’ World: Investigating the Experiences of Girls with Autism Spectrum Disorders During Adolescence. J Autism Dev Disord 2013; 44:1261-74. [DOI: 10.1007/s10803-013-1985-6] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Reid FC. Lived experiences of adult community nurses delivering palliative care to children and young people in rural areas. Int J Palliat Nurs 2013; 19:541-7. [DOI: 10.12968/ijpn.2013.19.11.541] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Fiona Cathryn Reid
- Paediatric Oncology/Haematology Nurse Specialist for NHS Highland, Scotland
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Cohen L, Greer N, Berliner E, Sprigle S. mobilityRERC State of the Science Conference: considerations for developing an evidence base for wheeled mobility and seating service delivery. Disabil Rehabil Assist Technol 2013; 8:462-71. [DOI: 10.3109/17483107.2013.823577] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Townsend A, Backman CL, Adam P, Li LC. A qualitative interview study: patient accounts of medication use in early rheumatoid arthritis from symptom onset to early postdiagnosis. BMJ Open 2013; 3:bmjopen-2012-002164. [PMID: 23408077 PMCID: PMC3586058 DOI: 10.1136/bmjopen-2012-002164] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To examine accounts of medication use in participants with early rheumatoid arthritis (RA) from symptom onset to early postdiagnosis. DESIGN Qualitative study with in-depth, personal interviews. PARTICIPANTS 37 women and one man, aged 30-70s, with a diagnosis of RA <12 months. MAIN OUTCOME MEASURE Participants' experiences and feelings of medication use in early RA. SETTING British Columbia, Canada. RESULTS Medications were central to how people managed symptoms and disease. Two main themes were identified, showing that optimum medication use was hampered, and how this related to delayed diagnosis and effective care. The first theme, 'paradox of prediagnosis reliance on over the counter (OTC) medications', describes how people's self-management with OTC medications was 'effective'. Participants relied extensively on OTC medications for pain relief and to maintain 'normal life'. However, as this contributed to delayed medical consultation, diagnosis and effective treatment, OTC medication was also potentially detrimental to disease outcome. The second theme, 'ambivalence around prescription medications post diagnosis', describes how adherence was hindered by patient beliefs, priorities and ambivalence towards medications. CONCLUSIONS This study highlights how people use medications in early RA and contributes to a better understanding of medication use that may transfer to other conditions. Given the drive towards active self-management in healthcare and patients' ambivalence about using strong medications, an in-depth understanding of how these combined factors impact patient experiences will help healthcare providers to support effective medication practices. The reported extensive reliance on OTC medications may speak to a care gap needing further investigation in the context of health behaviours and outcomes of patient self-management.
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Affiliation(s)
- Anne Townsend
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- The Arthritis Research Centre of Canada, Richmond, Nr Vancouver, British Columbia, Canada
| | - Catherine L Backman
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- The Arthritis Research Centre of Canada, Richmond, Nr Vancouver, British Columbia, Canada
| | - Paul Adam
- Department of Rheumatology Liaison & Outreach Services, Mary Pack Arthritis Program, Vancouver, British Columbia, Canada
| | - Linda C Li
- The Arthritis Research Centre of Canada, Richmond, Nr Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Sandelowski M, Leeman J. Writing usable qualitative health research findings. QUALITATIVE HEALTH RESEARCH 2012; 22:1404-13. [PMID: 22745362 DOI: 10.1177/1049732312450368] [Citation(s) in RCA: 206] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Scholars in diverse health-related disciplines and specialty fields of practice routinely promote qualitative research as an essential component of intervention and implementation programs of research and of a comprehensive evidence base for practice. Remarkably little attention, however, has been paid to the most important element of qualitative studies--the findings in reports of those studies--and specifically to enhancing the accessibility and utilization value of these findings for diverse audiences of users. The findings in reports of qualitative health research are too often difficult to understand and even to find owing to the way they are presented. A basic strategy for enhancing the presentation of these findings is to translate them into thematic statements, which can then in turn be translated into the language of intervention and implementation. Writers of qualitative health research reports might consider these strategies better to showcase the significance and actionability of findings to a wider audience.
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Affiliation(s)
- Margarete Sandelowski
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
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Nicholson S, Sniehotta FF, van Wijck F, Greig CA, Johnston M, McMurdo MET, Dennis M, Mead GE. A Systematic Review of Perceived Barriers and Motivators to Physical Activity after Stroke. Int J Stroke 2012; 8:357-64. [DOI: 10.1111/j.1747-4949.2012.00880.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background and purpose Physical fitness is impaired after stroke, may contribute to disability, yet is amenable to improvement through regular physical activity. To facilitate uptake and maintenance of physical activity, it is essential to understand stroke survivors' perceived barriers and motivators. Therefore, we undertook a systematic review of perceived barriers and motivators to physical activity after stroke. Methods Electronic searches of EMBASE, Medline, CINAHL, and PsychInfo were performed. We included peer-reviewed journal articles, in English, between 1 January 1966 and 30 August 2010 reporting stroke survivors' perceived barriers and motivators to physical activity. Results Searches identified 73 807 citations of which 57 full articles were retrieved. Six articles were included, providing data on 174 stroke survivors (range 10 to 83 per article). Two reported barriers and motivators, two reported only motivators, and two reported only barriers. Five were qualitative articles and one was quantitative. The most commonly reported barriers were lack of motivation, environmental factors (e.g. transport), health concerns, and stroke impairments. The most commonly reported motivators were social support and the need to be able to perform daily tasks. Conclusion This review has furthered our understanding of the perceived barriers and motivators to physical activity after a stroke. This review will enable the development of tailored interventions to target barriers, while building upon perceived motivators to increase and maintain stroke survivors' physical activity.
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Affiliation(s)
| | - Falko F. Sniehotta
- The Centre for Translational Research in Public Health, Institute of Health & Society, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Frederike van Wijck
- Neurological Rehabilitation Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Marie Johnston
- School of Psychology, College of Life Sciences and Medicine, Institute of Applied Health Sciences, School of Medicine, University of Aberdeen School of Psychology, Aberdeen, UK
| | - Marion E. T. McMurdo
- Ageing and Health Centre for Cardiovascular & Lung Biology, Division of Medical Sciences College of Medicine, Dentistry & Nursing Ninewells Hospital & Medical School, Dundee, UK
| | - Martin Dennis
- Division of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
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Brown KF, Long SJ, Athanasiou T, Vincent CA, Kroll JS, Sevdalis N. Reviewing methodologically disparate data: a practical guide for the patient safety research field. J Eval Clin Pract 2012; 18:172-81. [PMID: 20704633 DOI: 10.1111/j.1365-2753.2010.01519.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This article addresses key questions frequently asked by researchers conducting systematic reviews in patient safety. This discipline is relatively young, and asks complex questions about complex aspects of health care delivery and experience, therefore its studies are typically methodologically heterogeneous, non-randomized and complex; but content rich and highly relevant to practice. Systematic reviews are increasingly necessary to drive forward practice and research in this area, but the data do not always lend themselves to 'standard' review methodologies. This accessible 'how-to' article demonstrates that data diversity need not preclude high-quality systematic reviews. It draws together information from published guidelines and experience within our multidisciplinary patient safety research group to provide entry-level advice for the clinician-researcher new to systematic reviewing, to non-biomedical research data or to both. It offers entry-level advice, illustrated with detailed practical examples, on defining a research question, creating a comprehensive search strategy, selecting articles for inclusion, assessing study quality, extracting data, synthesizing data and evaluating the impact of your review. The article concludes with a comment on the vital role of robust systematic reviews in the continuing advancement of the patient safety field.
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Affiliation(s)
- Katrina F Brown
- Imperial Centre for Patient Safety and Service Quality and Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
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Machin AI, Machin T, Pearson P. Maintaining equilibrium in professional role identity: a grounded theory study of health visitors’ perceptions of their changing professional practice context. J Adv Nurs 2011; 68:1526-37. [DOI: 10.1111/j.1365-2648.2011.05910.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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