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Michalaki F, Triantafillopoulou KM, Pagkozidis I, Tirodimos I, Dardavesis T, Tsimtsiou Z. The impact of COVID-19 pandemic on Primary Health Care through 'health providers' eyes': Α qualitative study of focus groups and individual interviews in Greece. Eur J Gen Pract 2024; 30:2382218. [PMID: 39052024 PMCID: PMC11275516 DOI: 10.1080/13814788.2024.2382218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 06/03/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Primary Health Care (PHC) was the cornerstone of the pandemic response. OBJECTIVES We aimed to explore the positive and negative impact of the pandemic, during its final wave, through 'PHC providers' eyes', as well as their recommendations towards restructuring and enhancing PHC services. METHODS A two-phase qualitative study was conducted, pursuing data triangulation from Focus Groups (FGs) and individual, semi-structured interviews for the purposes of data completeness and confirmation (summer 2022 and spring 2023, respectively). A purposive sample of settings was employed, including in total five PHC units according to location with different population distribution; one in Athens (FGs) and four in Northern Greece (interviews). Inductive content analysis was used. RESULTS In total, 24 PHC professionals participated in FGs, whereas 17 were individually interviewed. Our findings reflect a general understanding of the pandemic's positive imprint, namely acceleration of digitalisation, establishment of health protection measures, recognition of PHC's role, raise in public awareness of primary prevention, team-cooperation, increase in providers' self-efficacy, appointment of health professionals and re-organisation of accessibility. The negative impact is summarised in fatigue/burnout in PHC providers, patient safety concerns and changes in patients' behaviour. To increase resilience, participants suggest restructuring PHC, recruiting PHC personnel and enhancing digital infrastructure, maintenance of sanitary protection measures, investment in quality, and empowering patients through health literacy. CONCLUSION Based on the lessons learnt, building further on the pandemic-accelerated digitalisation, emphasising on quality improvement and patient safety, ensuring providers' well-being, and empowering citizens through health literacy could be key in promoting PHC resilience.
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Affiliation(s)
- Foteini Michalaki
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Korina Marina Triantafillopoulou
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ilias Pagkozidis
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ilias Tirodimos
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Dardavesis
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zoi Tsimtsiou
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Wehbe LH, Duncan S, Banas K, Papies EK. To stand out or to conform: Stereotypes and meta-stereotypes as barriers in the transition to sustainable diets. Appetite 2024; 200:107506. [PMID: 38782094 DOI: 10.1016/j.appet.2024.107506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
What factors hinder the reduction of meat and/or dairy intake? In this study, we explored the perceived barriers that meat and/or dairy reducers experienced when shifting their diets. We particularly focused on how meat and/or dairy reducers were affected by their beliefs about how omnivores stereotype vegans (i.e., meta-stereotypes), as meta-stereotypes have not been previously explored in this context. Through open-ended questions in an online survey, we explored the experiences and perceived barriers among female meat and/or dairy reducers (n = 272), as well as their perceptions of vegans (i.e., stereotypes and meta-stereotypes), and how these perceptions affected their lived experiences. We analysed the data using reflexive thematic analysis and generated six themes. We highlighted perceptions of cost (Theme 1) and perceptions of health concerns (Theme 2) as the most dominant barriers to the reduction of meat and/or dairy intake. Regarding (meta) stereotypes, participants' perceptions of vegans were shaped by personal experiences and encounters with vegans (Theme 3), and how participants related to vegans was sometimes reflected in the language they used to describe vegans (Theme 4). Participants felt that they, or reducers more generally, were occasionally judged as vegans (Theme 5), which might influence participants' choices and conformity to eating norms (Theme 6). Meta-stereotypes may play a role in polarised dietary group perceptions, and we discuss how they are shaped by social identity processes as well as by aspects of Western food systems.
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Affiliation(s)
- Lara H Wehbe
- School of Psychology and Neuroscience, University of Glasgow, United Kingdom.
| | - Sophie Duncan
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Well-being, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, United Kingdom.
| | - Kasia Banas
- Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, United Kingdom.
| | - Esther K Papies
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Well-being, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, United Kingdom.
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Merenda T, Cannella S, Denis J, Patris S. Assistive products in pharmacy practice to optimize medications use for visually impaired patients: Focus groups to explore community pharmacists' opinions and expectations. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 15:100467. [PMID: 38983637 PMCID: PMC11231704 DOI: 10.1016/j.rcsop.2024.100467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/30/2024] [Accepted: 06/14/2024] [Indexed: 07/11/2024] Open
Abstract
Background Visual impairment can significantly affect a person's ability to take medications safely. Therefore, pharmacists need to ensure safe and effective access to medication information, particularly through the use of assistive products, which are devices that compensate for partial or total vision loss. Although assistive products are used by visually impaired patients for activities of daily living, their use in medication management needs to be more widespread. Objective The study aimed to investigate community pharmacists' opinions and excpectations on the use of assistive products in pharmacy practice to optimize and secure medications use for visually impaired patients. The goal is to transfer these assistive products to pharmacy practice. Methods Focus groups were conducted with 6 French-speaking community pharmacists via videoconference in Belgium, following the principle of participatory action-research. The participants were recruited voluntarily, and moderator's guides were developed to lead the discussion. The focus groups were recorded, transcribed verbatim, and analyzed in a double-blind fashion using thematic analysis. The data were organized by NVivo software. Results Four themes were identified: easy-to-use assistive products according to pharmacists, usefulness of assistive products in pharmacy practice, barriers to the use of assistive products, and potential solutions. According to community pharmacists, certain assistive products were deemed easy-to-use and transferable to pharmacy practice. Conclusions This qualitative study demonstrates the transferability of assistive products to pharmacy practice for visually impaired patients in medications use. The study taken into account the patient's profile and the multidisciplinary approach, which community pharmacists consider essential.
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Affiliation(s)
- Théodora Merenda
- Unit of Clinical Pharmacy, Faculty of Medicine and Pharmacy, University of Mons (UMONS), Avenue du Champ de Mars 25, Mons, Belgium
| | - Sofia Cannella
- Unit of Clinical Pharmacy, Faculty of Medicine and Pharmacy, University of Mons (UMONS), Avenue du Champ de Mars 25, Mons, Belgium
| | - Jennifer Denis
- Unit of Clinical Psychology, Faculty of Psychology and Education, University of Mons (UMONS), Place du Parc 14, Mons, Belgium
| | - Stéphanie Patris
- Unit of Clinical Pharmacy, Faculty of Medicine and Pharmacy, University of Mons (UMONS), Avenue du Champ de Mars 25, Mons, Belgium
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Bojórquez I, Infante C, Villanueva-Borbolla MA, Orjuela-Grimm M. Solidarity through food: Coping with food insecurity among adolescent migrants in transit through Mexico and Central America. Appetite 2024; 200:107549. [PMID: 38862079 PMCID: PMC11227384 DOI: 10.1016/j.appet.2024.107549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/31/2024] [Accepted: 06/07/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND The food choices of migrants are frequently limited by lack of access to sufficient and adequate food. Food insecurity (FI) during adolescence has potential negative health consequences, however the experiences of FI of adolescent in-transit migrants have seldom been reported. OBJECTIVE To explore the experiences of FI of adolescent in-transit migrants and their ways of coping with it. METHODS Qualitative study, with 19 semi-structured interviews with adolescents (ages 13-19 years), in shelters for migrants in Mexico in 2022-2023. We followed a reflexive thematic analysis strategy. RESULTS Most participants had experienced FI during the journey, and responded by limiting intake, choosing food according to price, seeking temporary work or asking for food or money in the streets. We defined "solidarity through food" as a central theme that summarized participants' experiences of sharing food with other migrants, as givers or recipients. Solidarity through food was a response to FI, benefitting the more disadvantaged (e.g. young children, those who had been robbed). Despite their young age, interviewees took part in this, giving their food to others and restricting their intake to prioritize younger siblings. DISCUSSION/CONCLUSIONS Solidarity through food was a form of generalized reciprocity, enacted not only among family members or friends, but extended to other migrants sharing the route. In further studies, it will be important to explore the role and nuances of food sharing as a practice of social exchange of responsibility and care, on adolescent migrants' health, and in their psychological and relational development into adulthood.
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Affiliation(s)
- Ietza Bojórquez
- Departamento de Estudios de Población, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico
| | - Cesar Infante
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública de México, Cuernavaca, Morelos, Mexico.
| | | | - Manuela Orjuela-Grimm
- Department of Epidemiology, Mailman School of Public Health, and Department of Pediatrics, Columbia University, USA
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Diedericks A, Bruwer Z, Laing N, Eastman E, De Vries J, Newton CR, Abubakar A, Robinson EB, Donald KA. Parental perspectives regarding the return of genomic research results in neurodevelopmental disorders in South Africa: anticipated impact and preferences. J Community Genet 2024:10.1007/s12687-024-00723-w. [PMID: 39090365 DOI: 10.1007/s12687-024-00723-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024] Open
Abstract
Few policies and little research exist regarding the disclosure of genomic results to research participants in Africa. As understanding participant preferences would be pivotal to the success of the feedback process, this study set out to address this issue by engaging with enrolled participants from an ongoing genomics research project on neurodevelopmental disorders with the aim to assess the anticipated impact of receiving pertinent results and explore the preferences for feedback in a South African context. Twelve semi-structured interviews were conducted with 17 parents of children participating in the research study. Transcribed interview data and observational notes were analysed using thematic analysis and framework matrices. Participants linked their own meaning to the impact of receiving a pertinent result and perceived the information as useful for reasons other than only clinical utility. These included closure, improved management of their child's condition and information regarding recurrence risks. In terms of preferences for feedback, an in-person result delivery session, conducted by a member of the study team or medical professional familiar with their child was preferred. In addition, participants felt a sense of ownership over their blood or their contribution to the research study, finding meaning even in non-pertinent results. These findings provide insight into the type of discussions that may be valuable in enabling the development of best practices and guidelines for the return of individual genetic research results, in a culturally appropriate manner, within South African communities.
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Affiliation(s)
- Angelique Diedericks
- Human Genetics, Department of Medicine, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Zandré Bruwer
- Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa.
| | - Nakita Laing
- Human Genetics, Department of Medicine, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Emma Eastman
- Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
| | - Jantina De Vries
- The Ethics Lab, Neuroscience Institute and Department of Medicine, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Charles R Newton
- Neuroscience Unit, Center for Geographic Medicine Research Coast, KEMRI-Wellcome Trust, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, London, UK
- Institute of Human Development, Aga Khan University, Nairobi, Kenya
| | - Amina Abubakar
- Neuroscience Unit, Center for Geographic Medicine Research Coast, KEMRI-Wellcome Trust, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, London, UK
- Institute of Human Development, Aga Khan University, Nairobi, Kenya
| | - Elise B Robinson
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Kirsten A Donald
- Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa
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Dağ YS, Zengin M, Yayan EH, Dağ S. Understanding the impact of natural disasters on children within fist hours and days after an event: A phenomenological study through the experience of nurses. Int Nurs Rev 2024. [PMID: 39092828 DOI: 10.1111/inr.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/12/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Children are a particularly vulnerable group in natural disasters such as earthquakes, and although they represent a difficult group to research in such situations, there appears to be a lack of literature investigating children's experiences in the immediate post-earthquake period. Experienced nurses can shed light on children's experiences. AIM This study was conducted to examine the experiences of nurses caring for children affected by the earthquake in Kahramanmaraş, Turkey. METHODS This phenomenological study was conducted with nurses who provided care to children during the Kahramanmaraş earthquake between May and August 2023. The study sample consisted of 14 nurses selected using a purposive sampling technique. Data were collected through in-depth interviews by using the "Introductory Information Form" and "Semi-structured Interview Form" developed by the researchers. The interviews were subsequently analyzed using Colaizzi's method. RESULTS The results revealed five themes under two main themes. Under the main theme of nurse, there are subthemes of chaos, helplessness-incompetence, while under the main theme of child, there are subthemes of unresponsiveness, intertwined needs, empathy, and care. The study also highlights the chaotic environment in the immediate aftermath of the earthquake, characterized by a high number of pediatric casualties and psychological trauma, and the nurses' feelings of helplessness as a result of being separated from their families. CONCLUSION This study found that nurses caring for children in the earthquake had difficulties in managing children's hospital processes and they demonstrated an empathic approach by trying to communicate with the children in their care. The nurses stated that children should be supported psychologically as well as having their basic needs such as water, food, and shelter met. IMPLICATIONS FOR NURSING AND HEALTH POLICY Health policymakers should be aware that in the early stages of major disasters such as earthquakes, children are not only physically injured but also have basic needs such as water, shelter, and food, and are emotionally affected. It is recommended that disaster management plans be developed to address all children's needs and nurses be provided with psychological support and training to improve their knowledge and skills.
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Affiliation(s)
- Yeliz Suna Dağ
- Firat University, Faculty of Health Sciences, London, Canada
| | - Mürşide Zengin
- Adiyaman University, Faculty of Health Sciences, London, Canada
| | | | - Serhat Dağ
- Inonu University, Vocational School of Health Services, Malatya, Turkey
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Kyei-Arthur F, Aballo J, Mahama AB, Adu-Afarwuah S. Infant and young child feeding practices among mothers in the pilot Micronutrient Powder Initiative in four geographically and ethnically diverse districts in Ghana. PLoS One 2024; 19:e0307961. [PMID: 39088512 PMCID: PMC11293642 DOI: 10.1371/journal.pone.0307961] [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: 09/20/2023] [Accepted: 07/15/2024] [Indexed: 08/03/2024] Open
Abstract
In Ghana, breastfeeding and complementary feeding counselling have been used as a nutritional intervention to promote optimal Infant and Young Child Feeding (IYCF) and nutrition. This study examined IYCF practices in four geographically and ethnically diverse districts (Ho West, Tain, Talensi and Tolon). A qualitative study involving key informant interviews (KIIs) and focus group discussions (FGDs) was conducted between November and December 2019 among women who participated in a pilot micronutrient powder intervention for children 6-23 months of age. The KIIs and FGDs were audio-taped, transcribed verbatim, and analyzed thematically using NVivo 10. Three themes emerging from the KIIs and FGDs were: level of adherence to IYCF recommendations among mothers and caregivers; IYCF recommendations perceived as the hardest to follow; and perceived motivators, facilitators, and barriers to IYCF practices. Mothers in the four districts generally followed the eight IYCF recommendations. Mothers in the Tolon district demonstrated adherence to IYCF practices, often citing the need for early initiation of breastfeeding, timely introduction of complementary feeding, and feeding children aged 9-23 months 3 times daily in addition to breastfeeding. In contrast, mothers in other districts faced challenges that hindered adherence. Giving children 4 or more food groups and timely introduction of complementary feeding were perceived as the hardest practices to follow. The main facilitators of IYCF practices include midwives and frontline nurses teaching mothers how to breastfeed, and midwives ensuring mothers initiate breastfeeding immediately after delivery. The main barriers to IYCF practices identified were insufficient breastmilk; mothers-in-law giving water to children before six months; resumption of work; and lack of financial means. Mothers in the Ho West district reported more barriers to IYCF practices, followed by mothers in the Tain, Talensi, and Tolon districts. Health practitioners, stakeholders, and policymakers should design targeted interventions that address the contextual barriers to improve IYCF practices in the various districts.
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Affiliation(s)
- Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | | | | | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
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Briggs ES, Thomas RM, Frost MC, Fletcher OV, Crothers K, Chalal CK, Shahrir SF, McClure JB, Catz SL, Williams EC. "I Thought Cancer was a Tobacco Issue": Perspectives of Veterans with and without HIV on Cancer and Other Health Risks Associated with Alcohol and Tobacco/Nicotine Use. AIDS Behav 2024; 28:2607-2618. [PMID: 38869757 DOI: 10.1007/s10461-024-04363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 06/14/2024]
Abstract
U.S. Veterans and people living with HIV (PWH) experience higher rates of unhealthy alcohol and tobacco/nicotine use than non-Veterans and people without HIV (PWoH). Both groups are susceptible to adverse health outcomes associated with alcohol and tobacco/nicotine use. We explored awareness of alcohol- and tobacco/nicotine-related cancer and immune health risks among Veterans Health Administration (VA) patients with and without HIV. Among a sample of 41 (46% PWH; 73% male; 39% Black) purposively-selected VA patients receiving care 2020-2021 we conducted semi-structured interviews via telephone; interviews were recorded, transcribed and analyzed using a Rapid Assessment Process. Purposive selection was based on HIV status, alcohol and/or tobacco/nicotine use, and demographics. Among participants, 66% reported current smoking, and most screened positive for unhealthy alcohol use. Participants had high awareness of cancer and other health risks related to smoking but low awareness of synergistic risks and cancer risks associated with alcohol use despite awareness of a range of other alcohol-related risks. Awareness of alcohol and/or tobacco/nicotine's impacts on the immune system was variable. Findings did not distinctly differ between PWH and PWoH. Low awareness of alcohol-related cancer risk, risks of co-occurring use, and varying awareness of the impacts of alcohol and tobacco/nicotine on the immune system suggest a need for improved messaging regarding substance use-related cancer and immune risk. This may be especially important among PWH, for whom the prevalence and adverse effects of alcohol and tobacco use, and immune dysfunction are higher.
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Affiliation(s)
- Elsa S Briggs
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA.
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
| | - Rachel M Thomas
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
| | - Madeline C Frost
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Olivia V Fletcher
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
| | - Kristina Crothers
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Clementine K Chalal
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
| | - Shahida F Shahrir
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Center for Health Workforce Studies, Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Jennifer B McClure
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Sheryl L Catz
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA
| | - Emily C Williams
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
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Jamieson F, Rasmussen-Barr E. How do information and physiotherapy affect health-related quality of life among patients with spinal stenosis undergoing decompression surgery: A qualitative study. Musculoskelet Sci Pract 2024; 72:103124. [PMID: 38901062 DOI: 10.1016/j.msksp.2024.103124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND There is a lack of qualitative research on how patients with lumbar spinal stenosis (LSS) undergoing surgery perceive their health-related quality of life (HRQOL). Research that increases our understanding in this area could facilitate a biopsychosocial approach to care. AIM We aimed to investigate the experiences of patients with LSS undergoing decompression surgery regarding their pre- and post-surgery perceptions of HRQOL and the pre-and post-operative information and physiotherapy. METHOD We used a qualitative design with semi-structured interviews to perform content analysis using an inductive approach. Twelve patients (7 female, 5 male) were included post-surgery and interviewed by phone. The interviews were recorded and transcribed verbatim. RESULTS Four distinct categories with nine associated subcategories were identified: Patients' feelings of safety and empowerment are enhanced by healthcare professionals; Divided perceptions of information and physiotherapy in a group context; Health-related quality of life is associated with patients' perceived physical capacity; Patients' optimism and concerns influence health-related quality of life. CONCLUSION Both physical and psychological factors pre- and post-surgery appear to influence patients' HRQOL. Inherent optimism and feelings of empowerment in the care process appear to be important factors, regardless of physical health status. A strong patient-provider relationship is important to promote self-efficacy, which may positively affect perceived HRQOL and is in line with the generally recommended biopsychosocial approach in the treatment of people with low back pain. As qualitative studies in this area are scarce, there is a need for further studies to validate our findings.
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Affiliation(s)
- Fiona Jamieson
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Alfred Nobels Allé 23, 141 83, Huddinge, Stockholm, Sweden
| | - Eva Rasmussen-Barr
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Alfred Nobels Allé 23, 141 83, Huddinge, Stockholm, Sweden.
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Shi N, Zhang N, Wong FKY, Zhu W, Lai X, Jin Y, Gu C, Nie L, Dong X, Wong AKC. Perceptions of utilizing a symptom self-management app for breast cancer patients receiving outpatient chemotherapy. Eur J Oncol Nurs 2024; 71:102624. [PMID: 38878691 DOI: 10.1016/j.ejon.2024.102624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/20/2024] [Accepted: 05/26/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE Breast cancer (BC) patients who are undergoing outpatient chemotherapy encounter difficulties in symptom self-management at home. We have developed a mobile app with the support of self-regulation activities and nurse-led social service to empower self-management of BC patients during outpatient chemotherapy. The study aimed to explore the perceptions of breast cancer patients and nurses in utilizing an app with the functions of proactive nursing support and empowerment. METHODS This is a qualitative study including group interviews with nurses and patients with breast cancer receiving outpatient chemotherapy. A total of eleven patients and five nurses were enrolled from August 2022 to October 2022. Thematic analysis was adopted to analyze the interview transcripts. Main themes and related sub-themes were drawn from the transcripts. RESULTS Barriers (the lack of a contractual spirit) and facilitators (social support and native high-adherence) to app usage were identified. Following the six-week program, patients underwent various transformations such as improved health awareness and a tendency to pay more attention to psychological symptoms. This program also led to various changes in the nurses, including a transformation from taking the reactive emergency calls to a proactive approach of incorporating a self-regulation process and social support. CONCLUSIONS The findings from the group interviews stressed the importance of integrating technology and nursing social support in facilitating patient symptom self-management.
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Affiliation(s)
- Nuo Shi
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China; School of Nursing, Dalian Medical University, Dalian, China
| | - Nan Zhang
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Weiyi Zhu
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaobin Lai
- School of Nursing, Fudan University, Shanghai, China
| | - Yufei Jin
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengjia Gu
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijing Nie
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojing Dong
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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McConville K, White C. Students' experiences of a GP escape room. EDUCATION FOR PRIMARY CARE 2024:1-9. [PMID: 39077887 DOI: 10.1080/14739879.2024.2364885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/01/2024] [Accepted: 04/29/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Educational escape games have become more common, yet their effectiveness needs to be evaluated to establish whether or not they are a constructive pedagogical tool. AIM This study explored students' experiences of a general practice (GP) based escape game to uncover whether it deserves a place in a medical school's curriculum. DESIGN AND SETTING A mixed methods case study within one Scottish Medical School. METHOD Data were collected during March 2020 via 32 video recordings of an Escape Room Game, combined with participant, post-game questionnaire analysis. Video footage was reviewed in an ethnographic manner and thematic analysis conducted. RESULTS Fourteen team events constituting 718 minutes were analysed. From the footage, five themes with fourteen subthemes emerged. The five main themes were: teamwork, leadership, clinical thinking, numeracy, and gamification. From the student questionnaires (n = 131), it was reported that the GP escape room was predominantly an extremely positive educational experience. CONCLUSION Educational escape games appear invaluable in medical education. They can promote the growth of non-technical skills such as teamwork, leadership, and clinical thinking; all essential to working in a multidisciplinary team and enabling patient safety. Our participants struggled with numeracy in this high-pressured environment, this must be addressed to reduce potential mistakes made in the workplace. Results are supportive of educational escape games being worthy of a space within a medical school's curriculum. A GP-orientated escape room allows for early GP exposure from a different perspective, as well as equipping students with the skills to be successful in this field.
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Affiliation(s)
- Kevin McConville
- Undergraduate General Practice, School of Medicine, University of Dundee, Dundee, UK
| | - Clara White
- School of Medicine, University of Dundee, Dundee, UK
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12
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Austin EJ, Chen J, Soyer E, Idrisov B, Briggs ES, Ferro L, Saxon AJ, Fortney JC, Curran GM, Moghimi Y, Blanchard BE, Williams EC, Ratzliff AD, Ruiz MS, Koch U. Optimizing Patient Engagement in Treatment for Opioid Use Disorder: Primary Care Team Perspectives on Influencing Factors. J Gen Intern Med 2024:10.1007/s11606-024-08963-9. [PMID: 39073482 DOI: 10.1007/s11606-024-08963-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Opioid use disorder (OUD) care engagement rates in primary care (PC) settings are often low. Little is known about PC team experiences when delivering OUD treatment and potential factors that influence their capacity to engage patients in treatment. Exploring PC team experiences may inform needed supports that can optimize OUD care delivery and improve outcomes for patients with OUD. OBJECTIVE We explored multidisciplinary PC team perspectives on barriers and facilitators to engaging patients in OUD treatment. DESIGN Qualitative study using in-depth interviews. PARTICIPANTS Primary care clinical teams. APPROACH We conducted semi-structured interviews (n = 35) with PC team members involved in OUD care delivery, recruited using a combination of criterion and maximal variation sampling. Data collection and analysis were informed by existing theoretical literature about patient engagement, specifically that patient engagement is influenced by factors across individual (patient, provider), interpersonal (patient-provider), and health system domains. Interviews were professionally transcribed and doubled-coded using a coding schema based on the interview guide while allowing for emergent codes. Coding was iteratively reviewed using a constant comparison approach to identify themes and verified with participants and the full study team. KEY RESULTS Analysis identified five themes that impact PC team ability to engage patients effectively, including limited patient contact (e.g., phone, text) in between visits, varying levels of provider confidence to navigate OUD treatment discussions, structural factors (e.g., schedules, productivity goals) that limited provider time, the role of team-based approaches in lessening discouragement and feelings of burnout, and lack of shared organizational vision for reducing harms from OUD. CONCLUSIONS While the capacity of PC teams to engage patients in OUD care is influenced across multiple levels, some of the most promising opportunities may involve addressing system-level factors that limit PC team time and collaboration and promoting organizational alignment on goals for OUD treatment.
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Affiliation(s)
- Elizabeth J Austin
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA.
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, D.C., USA.
| | - Jessica Chen
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA
| | - Elena Soyer
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA
| | - Bulat Idrisov
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA
| | - Elsa S Briggs
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA
| | - Lori Ferro
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Andrew J Saxon
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound, Seattle, WA, USA
| | - John C Fortney
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound, Seattle, WA, USA
- Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington, Seattle, WA, USA
| | - Geoffrey M Curran
- Departments of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Central Arkansas Veterans Health Care System, Little Rock, USA
| | - Yavar Moghimi
- Department of Psychiatry and Behavioral Sciences, School of Medicine and Health Sciences, The George Washington University, Washington, D.C., USA
| | - Brittany E Blanchard
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington, Seattle, WA, USA
| | - Emily C Williams
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, USA
- Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound, Seattle, WA, USA
| | - Anna D Ratzliff
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Advancing Integrated Mental Health Solutions (AIMS) Center, University of Washington, Seattle, WA, USA
| | - Monica S Ruiz
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, D.C., USA
| | - Ulrich Koch
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, D.C., USA
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13
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Álvarez-Villarreal M, Velarde-García JF, San Martín-Gómez A, Gómez-Sánchez SM, Gil-Crujera A, Palacios-Ceña D. Experience of Diagnosis and Initiation of Renal Replacement Therapy in Women with Chronic Kidney Disease. Clin Nurs Res 2024:10547738241264591. [PMID: 39049532 DOI: 10.1177/10547738241264591] [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: 07/27/2024]
Abstract
Chronic kidney disease (CKD) has considerable effects on the quality of life of female patients. Receiving the diagnosis and beginning renal replacement therapy (RRT) has a great personal impact on patients. The purpose of this study was to describe the experience of female patients with CKD at an ambulatory dialysis unit regarding diagnosis, life changes, and initiation of RRT. A qualitative exploratory study was conducted based on a social contructivism framework. Participants were recruited using purposeful sampling. In total, 18 women who received treatment for CKD with RRT were included. The women were attending the Ambulatory Dialysis Unit at a hospital belonging to the public health system of Madrid (Spain). Unstructured and semi-structured in-depth interviews, researchers' field notes, and women's personal letters were used. A systematic text condensation analysis was performed. The criteria used to control trustworthiness were credibility, transferability, dependability, and confirmability. Two themes emerged from the data: (a) A turning point in their lives, and (b) The emotional journey of beginning RRT. The diagnosis of CKD and the beginning of treatment implies changing routines and adapting to a new life with CKD. The first dialysis and puncture of the arteriovenous fistula is a major experience. Support from other CKD patients with more experience is perceived as a necessity and a tool to share their experiences and resolve doubts among peers. The diagnosis and initiation of RRT leads to numerous changes in the lives of women with CKD, which may influence the acceptance of treatment.
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Affiliation(s)
| | - Juan Francisco Velarde-García
- Department of Nursind, Red Cross Nursing School, Universidad Autónoma de Madrid, Spain
- Research Nursing Group of Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Madrid, Spain
| | - Ana San Martín-Gómez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Antonio Gil-Crujera
- Department of Basic Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain
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14
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Shawli L, Alsobhi M, Faisal Chevidikunnan M, Rosewilliam S, Basuodan R, Khan F. Physical therapists' perceptions and attitudes towards artificial intelligence in healthcare and rehabilitation: A qualitative study. Musculoskelet Sci Pract 2024; 73:103152. [PMID: 39067366 DOI: 10.1016/j.msksp.2024.103152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Artificial intelligence (AI) is being introduced to rehabilitation practices, and it can optimize the patient's outcome through their ability to design personalized care strategies and interventions. OBJECTIVES To understand the attitudes and perceptions of physical therapy professionals on the use of AI in rehabilitation in regard to treatment planning, diagnosis, outcome prediction, and advantages and disadvantages. DESIGN AND METHODS This paper followed an exploratory, qualitative research design. Semi-structured, one-to-one interviews were conducted with participants of different experience levels and specialties in physical therapy. Results were evaluated using thematic analysis. RESULTS Four themes were identified: (i) perceptions of AI and its applications in healthcare services, (ii) impact on the workforce (iii) considerations around implementing AI within rehabilitation and (iv) AI, and the fast-approaching future. Participants shared views on the potential impact of AI on rehabilitation practices, such as aiding the decision-making process, saving time and effort of both the therapist and patients. Participants have stressed on potential pitfalls that still need to be considered, such as patient data privacy, potential loss of patient-healthcare practitioner relationship, ethical concerns regarding overreliance on these applications and how that might hinder effective patient care. CONCLUSION The findings add to the literature about physical therapists' understanding regarding the use of AI in patient care. Several concerns were raised to the adoption of AI, including concerns about patient privacy, and ethical concerns. Based on the study findings, researchers emphasize the importance of establishing guidelines when incorporating AI in rehabilitation to improve the therapist's knowledge and skills.
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Affiliation(s)
- Lama Shawli
- Department of Occupational Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mashael Alsobhi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Mohamed Faisal Chevidikunnan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sheeba Rosewilliam
- School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Reem Basuodan
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fayaz Khan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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15
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Lee S, Nolan A, Guerin J, Koons B, Matura LA, Jurgens CY, Dickson VV, Riegel B. The symptom perception processes of monitoring, awareness, and evaluation in patients with heart failure: a qualitative descriptive study. Eur J Cardiovasc Nurs 2024; 23:521-531. [PMID: 38168812 DOI: 10.1093/eurjcn/zvad116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 01/05/2024]
Abstract
AIMS Patients with heart failure (HF) experience various signs and symptoms and have difficulties in perceiving them. Integrating insights from patients who have engaged in the process of symptom perception is crucial for enhancing our understanding of the theoretical concept of symptom perception. This study aimed to describe how patients with HF perceive symptoms through the processes of monitoring, awareness, and evaluation and what influences the process. METHODS AND RESULTS Using a qualitative descriptive design, we conducted in-person semi-structured interviews with a purposeful sample of 40 adults experiencing an unplanned hospitalization for a HF symptom exacerbation. We elicited how patients monitor, become aware of, and evaluate symptoms prior to hospitalization. Data were analysed using directed qualitative content analysis. One overarching theme and three major themes emerged. Patients demonstrated Body listening, which involved active and individualized symptom monitoring tactics to observe bodily changes outside one's usual range. Trajectory of bodily change involved the patterns or characteristics of bodily changes that became apparent to patients. Three subthemes-sudden and alarming change, gradual change, and fluctuating change emerged. Patients evaluated symptoms through an Exclusionary process, sequentially attributing symptoms to a cause through a cognitive process of excluding possible causes until the most plausible cause remained. Facilitators and barriers to symptom monitoring, awareness, and evaluation were identified. CONCLUSION This study elaborates the comprehensive symptom perception process used by adults with HF. Tailored nursing interventions should be developed based on the factors identified in each phase of the process to improve symptom perception in HF.
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Affiliation(s)
- Solim Lee
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, 269 E College Avenue, State College, PA 16801, USA
| | - Amy Nolan
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104, USA
| | - Julie Guerin
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104, USA
| | - Brittany Koons
- M. Lousie Fitzpatrick College of Nursing, Villanova University, 800 E. Lancaster Avenue, Villanova, PA 19085, USA
| | - Lea Ann Matura
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104, USA
| | - Corrine Y Jurgens
- Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
| | | | - Barbara Riegel
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104, USA
- Center for Home Care Policy & Research at VNS Health, 220 East 42nd Street, New York, NY 10017, USA
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16
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Bonell Monsonís O, Verhagen E, Spörri J, Gouttebarge V, Bolling C. 'Every turn can be the last one I do' - Perceptions of injury risk in high-performance snow sports and its implication for injury prevention. Inj Prev 2024; 30:341-349. [PMID: 38195657 DOI: 10.1136/ip-2023-045084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES High-performance snow sports (HPSS) athletes compete in a performance-driven context with a high risk of injury. While there is a lack of evidence on effective prevention measures in snow sports, this study explored the perspectives and perceptions of HPSS stakeholders on sports injury prevention. METHODS We conducted an exploratory qualitative study based on the grounded theory principles through 11 semistructured interviews with athletes, coaches and healthcare providers from different national teams about sports injury prevention. The interviews were inductively analysed through constant comparative data analysis. RESULTS Participants defined risk management as a central concept in which they approached injury prevention by assessing, managing and sometimes accepting risks. Many factors, such as athlete-related and external factors, are considered in this process, ultimately influencing their decision-making. Participants acknowledged the value of experience when managing and dealing with risks, a key aspect of their learning process and career development. Within this context, open and trustworthy communication and shared responsibilities among all stakeholders influenced and shaped injury prevention strategies and behaviours. Understanding and balancing out speed and risks was considered pivotal in their daily practice. Therefore, injury prevention awareness, ownership, communication, teamwork and shared responsibilities may contribute to the success of sports injury prevention in HPSS. CONCLUSION These findings substantiate the significance of such contextual factors in sports injury prevention. Considering the high-risk nature of HPSS, injury prevention suggests a shift towards risk management strategies, with a strong emphasis on contextual factors and their interactions. Young athletes might benefit from educational interventions centred on developing skills to assess and manage risks.
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Affiliation(s)
- Oriol Bonell Monsonís
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centres - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health & Sports, Amsterdam, Netherlands
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centres - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health & Sports, Amsterdam, Netherlands
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Vincent Gouttebarge
- Amsterdam Movement Sciences, Musculoskeletal Health & Sports, Amsterdam, Netherlands
- Amsterdam UMC location University of Amsterdam, Orthopaedic Surgery and Sports Medicine, Amsterdam, Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Caroline Bolling
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centres - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam UMC location University of Amsterdam, Orthopaedic Surgery and Sports Medicine, Amsterdam, Netherlands
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17
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Hu CJ, Chang LH, Lo YT, Wang JJ. Exploring Healthcare Providers' Difficulties and Strategies when Caring for Community-Dwelling People With Dementia Who are at Risk of Getting Lost. J Appl Gerontol 2024:7334648241261142. [PMID: 39023860 DOI: 10.1177/07334648241261142] [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: 07/20/2024] Open
Abstract
Caring for patients with dementia at risk of getting lost is challenging for community healthcare providers. Through semi-structured interviews with 25 participants, we examined the challenges faced by these providers and the strategies they employed. We identified the following themes of challenging parts: (a) the disturbance caused by behavioral and psychological symptoms in dementia; (b) difficulty in helping older family caregivers to keep the patient from going out; (c) difficulty in changing the attitudes of the family members; families' unawareness of the risk of getting lost. We also identified the following strategies to mitigate these themes: (a) detecting the risk of getting lost through early assessment; (b) encouraging the family to use resources or devices to prevent the patient from getting lost; (c) educating the family to manage behavior and psychological symptoms of dementia; (d) strengthening the patient's crisis awareness.
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Affiliation(s)
- Chia Jung Hu
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Ling Hui Chang
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan (R.O.C.)
| | - Yu Tai Lo
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, Tainan, Taiwan (R.O.C.)
- College of Medicine, National Cheng Kung University, Tainan, Taiwan (R.O.C.)
| | - Jing Jy Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan (R.O.C.)
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Mansilla-Domínguez JM, Recio-Vivas AM, Lorenzo-Allegue L, Cachón-Pérez JM, Esteban-Gonzalo L, Palacios-Ceña D. The role of duty, gender and intergenerational care in grandmothers' parenting of grandchildren: a phenomenological qualitative study. BMC Nurs 2024; 23:477. [PMID: 39010065 PMCID: PMC11247794 DOI: 10.1186/s12912-024-02151-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 07/05/2024] [Indexed: 07/17/2024] Open
Abstract
OBJECTIVES The aim of this study was to describe grandmothers' experiences of taking care of their grandchildren in terms of their care-giving tasks, motivations and emotions. METHODS A qualitative phenomenological study was conducted. Purposive sampling was used, based on the relevance of the research question. Seventeen participants were included, women ≥ 65 years old, grandmothers who care for their grandchildren at least 10 h per week and who attended the Nursing units of the Primary Care Health Centers (Madrid Public Health Service). Seventeen in-depth interviews were conducted. The interviews were audio-recorded, transcribed verbatim and thematic analysis was carried out from the perspective of hermeneutic phenomenology. For the analysis, the Excel program was used to organize and share the coding process. Also, we followed COREQ guidelines. RESULTS Four main themes were identified: (a) Care out of obligation, where participants feel an obligation to help their children by caring for grandchildren, regardless of their number, and prefer to do so voluntarily; (b) Care out of responsibility, where grandmothers see their role as a responsibility that includes saving costs by caring for grandchildren and facilitating their children's work life balance; (c) Care as a social duty, reflecting a moral commitment inherited from their mothers to help future generations; and (d) Construction of care from a gender perspective, where grandmothers, as women, primarily assume the care and upbringing of grandchildren. DISCUSSION Our results contribute to increase knowledge about childcare provided by grandmothers to their grandchildren. Grandmothers become fundamental pillars of families by helping their children balance family and work. Behind this care there is a strong sense of obligation, duty and generational responsibility. Grandmothers' help presents differences in the distribution of tasks and care by sex. Identifying factors that motivate grandmothers to care for their grandchildren helps nurses to perform higher quality comprehensive care.
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Affiliation(s)
| | - Ana María Recio-Vivas
- Department of Nursing, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | - Laura Lorenzo-Allegue
- Department of Nursing, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain.
| | - José Miguel Cachón-Pérez
- Department of Nursing, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | - Laura Esteban-Gonzalo
- Department of Nursing, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
- Departament of Nursing, Universidad Complutense de Madrid, Madrid, Spain
| | - Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (Hum&QRinHS), Alcorcón, Spain
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19
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Preitschopf A, Holstege M, Ligthart A, Buurman B, Pol M. The design elements of outpatient geriatric rehabilitation from patient, healthcare professional, and organizational perspective; a qualitative study. Disabil Rehabil 2024:1-9. [PMID: 38988290 DOI: 10.1080/09638288.2024.2377818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 07/04/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE To gain a rich understanding of the experiences and opinions of patients, healthcare professionals, and policymakers regarding the design of OGR with structure, process, environment, and outcome components. METHODS Qualitative research based on the constructive grounded theory approach is performed. Semi-structured interviews were conducted with patients who received OGR (n = 13), two focus groups with healthcare professionals (n = 13), and one focus group with policymakers (n = 4). The Post-acute Care Rehabilitation quality framework was used as a theoretical background in all research steps. RESULTS The data analysis of all perspectives resulted in seven themes: the outcome of OGR focuses on the patient's independence and regaining control over their functioning at home. Essential process elements are a patient-oriented network, a well-coordinated dedicated team at home, and blended eHealth applications. Additionally, closer cooperation in integrated care and refinement regarding financial, time-management, and technological challenges is needed with implementation into a permanent structure. All steps should be influenced by the stimulating aspect of the physical and social rehabilitation environment. CONCLUSION The three perspectives generally complement each other to regain patients' quality of life and autonomy. This study demonstrates an overview of the building blocks that can be used in developing and designing an OGR trajectory.
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Affiliation(s)
- Astrid Preitschopf
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, Netherlands
- Omring and Zorgcirkel, Department of Research GRZPLUS, GRZPLUS, Hoorn, Netherlands
| | - Marije Holstege
- Omring and Zorgcirkel, Department of Research GRZPLUS, GRZPLUS, Hoorn, Netherlands
- Department of Research Omring, Omring, Hoorn, Netherlands
| | - Andrea Ligthart
- Omring and Zorgcirkel, Department of Research GRZPLUS, GRZPLUS, Hoorn, Netherlands
| | - Bianca Buurman
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, Netherlands
- Research Group Geriatric Rehabilitation, Faculty of Health, Sports and Social Work, Centre of Expertise Prevention in Health and Social Care, Inholland University of Applied Sciences, Amsterdam, Netherlands
| | - Margriet Pol
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, Netherlands
- Research Group Occupational Therapy: Technology and Participation, Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
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20
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Sole G, van Deventer A, Harris L, Wassinger C, Olds M. The "glass shoulder": Patients' lived experiences of a traumatic shoulder dislocation - A qualitative study. Musculoskelet Sci Pract 2024; 73:103143. [PMID: 39047593 DOI: 10.1016/j.msksp.2024.103143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/19/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Anterior shoulder dislocations have a high recurrence rate, often necessitating stabilizing surgery, with residual long-term fear of reinjury. OBJECTIVES To explore patients' experiences of anterior shoulder dislocations in relation to their lives, well-being, fear of reinjury, and future perspectives. DESIGN Qualitative study. METHODS We interviewed fourteen individuals (median age 27.5 yrs, range 21-40; two women) with traumatic anterior glenohumeral dislocation within 5 years, with or without past stabilizing surgery. We analysed data using Interpretive Description. RESULTS We constructed three main themes. (1) Downward wellness spiral: The injury shattered their lives, influencing their self-identity and -confidence. Sleep disturbances added to stress levels, loss, depression and grief. The re-injury risk could lead to social isolation. (2) Out of arm's reach: Recurrences led to frustration as the prior surgery and rehabilitation appeared to have been unsuccessful, having to start again. Support from healthcare providers and whānau/family was crucial to regain trust in the body. (3) Obligatory compromise: Over time, some individuals accepted the re-injury risk, learnt to heed warning signals, or compromised by avoiding specific social and recreational activities, changing their sports or to other roles in their preferred sport, and adapting work-related and daily tasks. CONCLUSION Participants described in-depth socio-emotional responses following shoulder dislocations. Most participants described an ongoing interplay between fear and confidence in their shoulder. Healthcare provider support and professional relationship, on-going shoulder-related strengthening, and risk mitigation strategies were important to facilitate and maintain confidence and self-efficacy, and to re-consider and adjust the participant's goals when needed.
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Affiliation(s)
- Gisela Sole
- Center for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, Aotearoa New Zealand.
| | - Anlo van Deventer
- Center for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, Aotearoa New Zealand; Elite Health and Performance, Brisbane, Australia
| | - Leon Harris
- Center for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, Aotearoa New Zealand; Foundation Clinic, Tauranga, New Zealand. https://twitter.com/AnlovanDeventer
| | - Craig Wassinger
- Tufts University, Boston, USA. https://twitter.com/Craig_Wassinger
| | - Margie Olds
- Auckland Shoulder Clinic, Auckland, Aotearoa New Zealand. https://twitter.com/Margie_Olds
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21
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Sonesson S, Lindblom H, Hägglund M. To play or not to play, that is the question: an interview study with amateur football coaches on perceptions of pain during sports participation. BMJ Open Sport Exerc Med 2024; 10:e001941. [PMID: 39006390 PMCID: PMC11243123 DOI: 10.1136/bmjsem-2024-001941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2024] [Indexed: 07/16/2024] Open
Abstract
Amateur football coaches play a key role in preventing, assessing and treating pain among their players, as they are often the first point of contact and may be the main source of advice and guidance. The objective of this study was to explore amateur football coaches' perceptions of pain during sports participation and their approach to pain management. We conducted a qualitative interview study with 20 amateur football coaches from a strategically selected sample of male and female, and junior and senior teams. A semistructured interview guide and conventional qualitative content analysis were used. One overall theme emerged: To play or not to play-coaches navigating difficult terrain with limited resources. The theme included four main categories: How can pain be understood?; Can pain be avoided?; How to manage players with pain?; What resources do we need? Different ways of understanding pain emerged, and coaches described that players have different pain thresholds. Pain was seen as a part of the game that cannot be completely avoided. In general, there was a restrictive attitude regarding pain medication, though actual consumption was not known. Coaches emphasised shared responsibility with players to achieve adequate training loads, a positive communication climate surrounding pain, and a need for education and competence. In conclusion, coaches expressed various interpretations of pain during sports participation and pain management, where they need to take on great responsibility despite limited medical competence. Coaches believed that adequate pain management is important, and their keys to reducing the risk of pain included structured and customised training, a well-balanced training load and recovery, and a positive communication climate in the team. Coaches often decide whether players experiencing pain can participate in team training and match play, emphasising the need for education support and access to medical competence.
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Affiliation(s)
- Sofi Sonesson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Hanna Lindblom
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
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22
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Foxwell AM, Ulrich CM, Walter JK, Weaver MS. Everyday Ethics or Deference to Expertise: Experiences of Pediatric Palliative Care Teams with Ethics Consultancy. J Palliat Med 2024. [PMID: 38973557 DOI: 10.1089/jpm.2023.0568] [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: 07/09/2024] Open
Abstract
Background: Little is known about the extent to which pediatric palliative care (PPC) clinicians are engaged in ethics consults or how they perceive interactions with ethics consultants. Objective: Describe the extent to which PPC team members serve in pediatric health care ethics (PHCE) consultancy roles and to describe their experiences interacting with pediatric ethic consultant services. Design: Online survey distributed to members of the American Academy of Pediatrics and American Academy of Hospice and Palliative Care pediatric and ethics section and special interest groups in the United States. Results: Eighty-six responses were obtained (response rate 45%) from PPC teams in 70 different children's hospitals located in 34 states. Almost all (97%) reported a functional ethics consult service such that PPC is not expected to meet the ethics need of the institution. A person involved on the PPC team also performed ethics consults in half (49%) of the settings, predominantly the PPC physician. Most respondents who perceive PPC teams engage in ethics-relevant work as part of their everyday PPC work. Formal ethics training was lacking among PPC members involved in ethics consults with few ethics degrees (15%), certifications (6%), or fellowships (2%). Discord (67%), conflict (49%), limitations to treatment (48%), and distress (41%) were cited as the most frequent reasons for which PPC teams consult ethics. PPC respondents identified role clarity, coordinated engagement, timely presence, and open communication as strong PHCE consultant practices. Conclusions: PPC team members performing ethics consults may benefit from additional ethics education and training. Further research is warranted to delineate scope of ethics consultancy relevant to PPC and role clarity.
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Affiliation(s)
- Anessa M Foxwell
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Connie M Ulrich
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer K Walter
- Department of Medical Ethics and Pediatric Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Meaghann S Weaver
- Pediatric Palliative Care, University of Nebraska Medical Center, Omaha, Nebraska, USA
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23
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Velarde-García JF, Güeita-Rodríguez J, Jiménez-Antona C, García-Bravo C, Aledo-Serrano Á, Gómez-Sánchez SM, Palacios-Ceña D. The impact of developmental and epileptic encephalopathies on families: a qualitative study. Eur J Pediatr 2024:10.1007/s00431-024-05677-2. [PMID: 38965081 DOI: 10.1007/s00431-024-05677-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/06/2024]
Abstract
Developmental and epileptic encephalopathies (DEEs) cause disability and dependence affecting both children and the family. The aim of the study was to describe the perspective of parents of children with DEEs regarding the impact of the disease on the family. We carried out a qualitative study based on the interpretivist paradigm. Twenty-one participants were selected using purposive sampling. Parents of children with DEEs of SCN1A, KCNQ2, CDKL5, PCDH19, and GNAO1 variants were included. In-depth interviews and researcher notes were used for data collection. A thematic analysis was performed on the data. Three themes were identified in the results: (a) Assuming conflicts and changes within the couple, causing them to distance themselves, reducing their time and intimacy and leading them to reconsider having more children; (b) impact of the disorder on siblings and grandparents, where siblings perceived DEE as a burden in their lives, felt neglected, and needed to grow and mature alone; conversely, the grandparents suffered for their grandchildren and the parents, in addition to perceiving that their health worsened, and (c) reconciling the care of the child with family life and work; this led the parents to share tasks, abandon or reduce working hours and ask for help.Conclusions: Caring for a child with DEE can result in neglect of social, psychological, emotional, recreational, educational, or occupational needs and obligations that ultimately impact all family members. What is Known: • Children with DEE may develop seizures and experience developmental and cognitive problems. • Caring for a child with DEE has a social and psychological impact on the entire family. Caring for a child with DEE has a social and psychological impact on the entire family. What is New: • Within the couple, there are tensions due to a lack of time, which could be alleviated by alternating childcare duties. • It is necessary to implement programs that address the physical and mental needs of the couple, as well as cater to the needs of siblings and alleviate the suffering of grandparents.
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Affiliation(s)
- Juan Francisco Velarde-García
- Red Cross Nursing School, Universidad Autónoma de Madrid, Madrid, Spain
- Research Nursing Group of Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Alcorcón, Madrid, Spain
| | - Javier Güeita-Rodríguez
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Alcorcón, Madrid, Spain.
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - Carmen Jiménez-Antona
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Alcorcón, Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Cristina García-Bravo
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Alcorcón, Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Ángel Aledo-Serrano
- Epilepsy and Neurogenetics Program, Vithas Hospital Group, Vithas Madrid La Milagrosa University Hospital, Madrid, Spain
| | - Stella Maris Gómez-Sánchez
- Research Group, GAMDES of Universidad Rey Juan Carlos, Madrid, Spain
- Department of Basic Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Alcorcón, Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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24
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Ackeret N, Röthlin P, Horvath S. Factors contributing to elite athletes' mental health in the junior-to-senior transition: A mixed methods study. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 73:102645. [PMID: 38608852 DOI: 10.1016/j.psychsport.2024.102645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/01/2023] [Accepted: 04/06/2024] [Indexed: 04/14/2024]
Abstract
The goals of this study were to examine factors that may affect the mental health of elite athletes during their junior-to-senior transition and to explore the types and frequency of facilitators and challenges athletes encounter during this transition. Using a cross-sectional, embedded QUAN(qual) mixed methods study design, we surveyed two samples for the study goals. All participants completed demographic data (e.g., gender, age, sports). Sample one (N = 394, Mage = 18.46 years, SD = 2.2) consisted of current transitioning athletes which completed questionnaires on stress, anxiety, depression, well-being, self-compassion, and social support. Mediation and moderation analyses revealed that stress leads to resource depletion, and that self-compassion can be an important resource for young athletes to draw upon to maintain their mental health. Regarding social support results were less conclusive. Sample two (N = 371, Mage = 27.70 years, SD = 8.3) consisted of athletes that have passed the transition. They responded to open questions about helpful strategies and challenges faced during their junior-to-senior transition, which were analyzed using thematic content analysis. Results showed that during the junior-to-senior transition, external resources were more frequently mentioned than internal resources when it came to facilitators. Furthermore, external challenges were perceived as hindering more frequently than internal challenges. These findings can guide practitioners by providing potential starting points for improving the mental health of transitioning elite athletes, as well as information on helpful strategies and barriers during the transition.
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Affiliation(s)
- Nadja Ackeret
- Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland; Department of Psychology, University of Bern, Bern, Switzerland.
| | - Philipp Röthlin
- Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland; Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Stephan Horvath
- Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland
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25
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Chan KKY, Yeung NCY, Mo PKH, Yang X. Common stressors, coping processes, and professional help-seeking of medical professionals in Hong Kong: A qualitative study. J Health Psychol 2024; 29:891-904. [PMID: 38160404 DOI: 10.1177/13591053231218658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Despite the high prevalence of perceived stress and mental health problems among medical professionals (MPs), their professional help-seeking is extremely low. This qualitative study explored MPs' stressors, stress-coping, barriers and facilitators of professional help-seeking. 10 MPs (30% male, Mage = 34.8 years) were recruited by purposive-sampling for views from different roles/settings. Thematic analyses revealed five central stressors: emerging novel diseases, challenges from technology-advancement, patient-communication difficulties, lack of workplace mental health care culture, excessive workload/manpower shortage. Participants predominantly used peer support/supervision and de-stress activities for stress-coping. Five factors affecting professional help-seeking were time constraint versus flexibility, mental health stigma versus de-stigmatization, concern over confidentiality/anonymity versus sense of privacy, worry about damage on professional role versus least work disruption, doubts of service providers versus perceived efficacy. All participants indicated a preference for online mental health service delivery. Results reflected unmet needs and service gaps from MPs' perspectives for the development of future interventions.
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Affiliation(s)
| | | | | | - Xue Yang
- The Chinese University of Hong Kong, Hong Kong
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26
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MacCormick H, Johnson LT, Burchell D, Munro A, Lorello GR, George RB, Bould MD. Lived experiences of transgender and nonbinary people in the perioperative context: a qualitative study. CMAJ 2024; 196:E806-E815. [PMID: 38955410 PMCID: PMC11230684 DOI: 10.1503/cmaj.240061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Transgender and nonbinary (TNB) people experience obstacles that create barriers to accessing health care, including stigmatization and health inequities. Our intention was to describe the lived experiences of TNB patients and identify potential gaps in the education of health care professionals. METHODS We conducted a qualitative descriptive study influenced by phenomenology by interviewing with TNB adults who underwent surgery in Canada within the previous 5 years. We recruited participants using purposeful and snowball sampling via online social networking sites. Audio recordings were transcribed. Two authors coded the transcripts and derived the themes. RESULTS We interviewed 21 participants, with a median interview duration of 49 minutes. Participants described positive and negative health care encounters that led to stress, confusion, and feelings of vulnerability. Major themes included having to justify their need for health care in the face of structural discrimination; fear and previous traumatic experiences; community as a source of support and information; and the impact of interactions with health care professionals. INTERPRETATION Participants detailed barriers to accessing care, struggled to participate in shared decision-making, and desired trauma-informed care principles; they described strength in community and positive interactions with health care professionals, although barriers to accessing gender-affirming care often overshadowed other aspects of the perioperative experience. Additional research, increased education for health care professionals, and policy changes are necessary to improve access to competent care for TNB people.
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Affiliation(s)
- Hilary MacCormick
- Department of Women's & Obstetric Anesthesia (MacCormick, Munro), IWK Health; Department of Anesthesia, Pain Management and Perioperative Medicine (MacCormick, Munro) and Centre for Learning and Teaching (Johnson), Dalhousie University; Centre for Research in Family Health (Burchell), IWK Health, Halifax, NS; Department of Anesthesiology and Pain Medicine (Lorello), University of Toronto; Department of Anesthesia and Pain Management (Lorello), University Health Network - Toronto Western Hospital; Department of Anesthesiology and Pain Medicine (George), University of Toronto, Toronto, Ont.; Department of Anesthesiology and Pain Medicine (Bould), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont.
| | - Les T Johnson
- Department of Women's & Obstetric Anesthesia (MacCormick, Munro), IWK Health; Department of Anesthesia, Pain Management and Perioperative Medicine (MacCormick, Munro) and Centre for Learning and Teaching (Johnson), Dalhousie University; Centre for Research in Family Health (Burchell), IWK Health, Halifax, NS; Department of Anesthesiology and Pain Medicine (Lorello), University of Toronto; Department of Anesthesia and Pain Management (Lorello), University Health Network - Toronto Western Hospital; Department of Anesthesiology and Pain Medicine (George), University of Toronto, Toronto, Ont.; Department of Anesthesiology and Pain Medicine (Bould), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont
| | - Drew Burchell
- Department of Women's & Obstetric Anesthesia (MacCormick, Munro), IWK Health; Department of Anesthesia, Pain Management and Perioperative Medicine (MacCormick, Munro) and Centre for Learning and Teaching (Johnson), Dalhousie University; Centre for Research in Family Health (Burchell), IWK Health, Halifax, NS; Department of Anesthesiology and Pain Medicine (Lorello), University of Toronto; Department of Anesthesia and Pain Management (Lorello), University Health Network - Toronto Western Hospital; Department of Anesthesiology and Pain Medicine (George), University of Toronto, Toronto, Ont.; Department of Anesthesiology and Pain Medicine (Bould), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont
| | - Allana Munro
- Department of Women's & Obstetric Anesthesia (MacCormick, Munro), IWK Health; Department of Anesthesia, Pain Management and Perioperative Medicine (MacCormick, Munro) and Centre for Learning and Teaching (Johnson), Dalhousie University; Centre for Research in Family Health (Burchell), IWK Health, Halifax, NS; Department of Anesthesiology and Pain Medicine (Lorello), University of Toronto; Department of Anesthesia and Pain Management (Lorello), University Health Network - Toronto Western Hospital; Department of Anesthesiology and Pain Medicine (George), University of Toronto, Toronto, Ont.; Department of Anesthesiology and Pain Medicine (Bould), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont
| | - Gianni R Lorello
- Department of Women's & Obstetric Anesthesia (MacCormick, Munro), IWK Health; Department of Anesthesia, Pain Management and Perioperative Medicine (MacCormick, Munro) and Centre for Learning and Teaching (Johnson), Dalhousie University; Centre for Research in Family Health (Burchell), IWK Health, Halifax, NS; Department of Anesthesiology and Pain Medicine (Lorello), University of Toronto; Department of Anesthesia and Pain Management (Lorello), University Health Network - Toronto Western Hospital; Department of Anesthesiology and Pain Medicine (George), University of Toronto, Toronto, Ont.; Department of Anesthesiology and Pain Medicine (Bould), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont
| | - Ronald B George
- Department of Women's & Obstetric Anesthesia (MacCormick, Munro), IWK Health; Department of Anesthesia, Pain Management and Perioperative Medicine (MacCormick, Munro) and Centre for Learning and Teaching (Johnson), Dalhousie University; Centre for Research in Family Health (Burchell), IWK Health, Halifax, NS; Department of Anesthesiology and Pain Medicine (Lorello), University of Toronto; Department of Anesthesia and Pain Management (Lorello), University Health Network - Toronto Western Hospital; Department of Anesthesiology and Pain Medicine (George), University of Toronto, Toronto, Ont.; Department of Anesthesiology and Pain Medicine (Bould), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont
| | - M Dylan Bould
- Department of Women's & Obstetric Anesthesia (MacCormick, Munro), IWK Health; Department of Anesthesia, Pain Management and Perioperative Medicine (MacCormick, Munro) and Centre for Learning and Teaching (Johnson), Dalhousie University; Centre for Research in Family Health (Burchell), IWK Health, Halifax, NS; Department of Anesthesiology and Pain Medicine (Lorello), University of Toronto; Department of Anesthesia and Pain Management (Lorello), University Health Network - Toronto Western Hospital; Department of Anesthesiology and Pain Medicine (George), University of Toronto, Toronto, Ont.; Department of Anesthesiology and Pain Medicine (Bould), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont
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Ntho TA, Ngoatle C, Mothiba TM, Hlahla LS, Phukubye TA, Bopape MA. Being a Postgraduate Nursing Student in Limpopo Province, South Africa: An Exploratory Study. NURSING REPORTS 2024; 14:1621-1632. [PMID: 39051357 PMCID: PMC11270213 DOI: 10.3390/nursrep14030121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 07/27/2024] Open
Abstract
Research proficiencies for nurses include the ability to search for and evaluate evidence, disseminate findings, and apply findings to practice within the context of caring. Aim: This study explored the experiences of distant postgraduate nursing students in Limpopo Province, South Africa. Methods: The population consists of all students registered for postgraduation studies in a nursing programme at two South African universities in Limpopo Province. Purposive sampling was used to select 23 registered postgraduate nursing students. Data were collected through unstructured one-on-one interviews, including an audio recorder and field notes. The narrative data from interviews were analysed qualitatively through Tesch's open coding descriptive qualitative data analysis method. Results: Three main themes emerged: the reasons behind engaging in postgraduate studies, factors impacting postgraduate studies' success, and a description of challenges associated with conducting research. Conclusions: The students generally have varied experiences about whether or not completing a research project is a valuable learning experience. The relationship between a postgraduate student and their research supervisor is crucial to ensuring that the students advance consistently and complete their theses on time. The study will, therefore, assist HEIs offering postgraduate programmes in nursing in realising the challenges faced by students and coming up with strategies to combat the challenges.
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Affiliation(s)
- Tshepo Albert Ntho
- Department of Nursing Science, University of Limpopo, Sovenga 0727, South Africa
| | - Charity Ngoatle
- Department of Nursing Science, University of Limpopo, Sovenga 0727, South Africa
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28
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Giöstad A, Carlsson IK, Dahlin LB, Nyman E. Experience of living with chronic pain in conjunction with surgery for ulnar nerve entrapment at the elbow-A qualitative study. PLoS One 2024; 19:e0306327. [PMID: 38941288 PMCID: PMC11213347 DOI: 10.1371/journal.pone.0306327] [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: 10/30/2023] [Accepted: 06/15/2024] [Indexed: 06/30/2024] Open
Abstract
PURPOSE Pain in conjunction with surgery for ulnar nerve entrapment at the elbow is seldom highlighted in the literature. This study aimed to explore patients' experiences of living with chronic pain (≥3 months duration) in conjunction with surgery for ulnar nerve entrapment at the elbow, the consequences and the coping strategies applied. MATERIAL AND METHODS In-depth interviews were conducted with 10 participants aged 18-60 years. The narratives were analyzed using an inductive approach and content-analysis. RESULTS The analysis revealed seven main categories: "Physical symptoms/impairments" and "Mood and emotions"comprise symptoms caused by ulnar nerve entrapment at the elbow and chronic pain; "Consequences in daily life" includes challenges and obstacles in every-day life, impact on leisure activities and social life; "Struggling with self-image" embraces experiences closely related to identity; "Coping strategies" covers adaptive resources; "Experience of relief "describes perceived improvements; "Key message for future care" comprises important aspects for healthcare providers to consider. CONCLUSIONS The results clarify the need for healthcare personnel to adopt a biopsychosocial approach when treating patients with ulnar nerve entrapment at the elbow. Emotional symptoms and sleep disturbances should be identified and treated properly since they contribute to the heavy burden experienced by the individual.
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Affiliation(s)
- Alice Giöstad
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Ingela K. Carlsson
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine – Hand Surgery, Lund University, Malmö, Sweden
| | - Lars B. Dahlin
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine – Hand Surgery, Lund University, Malmö, Sweden
| | - Erika Nyman
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden
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29
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Muhayimana A, Kearns I. Healthcare providers' perspectives on sustaining respectful maternity care appreciated by mothers in five hospitals of Rwanda. BMC Nurs 2024; 23:442. [PMID: 38943122 PMCID: PMC11212382 DOI: 10.1186/s12912-024-02017-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 05/15/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Childbirth reserves respect, as emphasized by the World Health Organization in 2018, and the focus towards the need for positive, dignified delivery experiences has become an integral aspect of Respectful Maternity Care (RMC). It is a known fact that RMC is pivotal for favourable birth outcomes and contributes to the satisfaction of maternity care. The absence of RMC negatively affects women's and newborns' rights. The study aimed to explore healthcare providers' perspectives on sustaining RMC actions that mothers previously reported. METHODOLOGY This study was conducted in five hospitals in the Eastern province of Rwanda, involving 5 Focus Group Discussions (FGDs) with midwives and nurses. For interviews, we purposively selected 5-unit managers and five physicians. Additionally, 40 midwives and nurses were recruited for the FGDs. The research utilized the Dream phase of Appreciative Inquiry (AI) for interviews and Focus Groups. Data collection aimed to gain insights into Healthcare Providers' perceptions of how RMC is provided and how to establish and sustain RMC in Rwandan health facilities. Nvivo 12 was employed for organizing codes and creating a codebook, and thematic analysis was applied. RESULTS Four themes with sub-themes emerged. Namely, 1) Women-centered care, with Compassionate care, Privacy and confidentiality maintenance, Information provision and Liberty in decision making, Effective communication, Family involvement, Cleanliness, and Equality care. 2) Professionalism compliance with Motivated staff, Teamwork, Continuous development, Quality work provision, and Community trust. 3) RMC encounters 4) RMC sustenance. CONCLUSION AND RECOMMENDATIONS The continuous pursuit of high RMC standards in Rwanda involves improving childbirth experiences through utilizing existing resources, ongoing improvement, and sustaining achievements. Key recommended actions in this study for sustaining RMC encompass promoting women-centred care, enhancing healthcare provider attitudes, ensuring professionalism, building community trust, maintaining conducive health facility environments, and involving leadership.
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Affiliation(s)
- Alice Muhayimana
- Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda
| | - Irene Kearns
- Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
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30
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Duarte ST, Moniz A, Caeiro C, Heleno B, Aguiar P, Cruz EB. Exploring barriers and facilitators to the adoption of regular exercise practice in patients at risk of a recurrence of low back pain (MyBack project): a qualitative study. Disabil Rehabil 2024:1-10. [PMID: 38934086 DOI: 10.1080/09638288.2024.2369665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE This study aimed to explore potential barriers and facilitators to the adoption of regular exercise practice in patients at risk of a recurrence of low back pain (LBP). MATERIALS AND METHODS Eleven patients, who recovered from a previous episode of LBP, participated in two focus groups. The semi-structured interview schedule was informed by the Behaviour Change Wheel and the Theoretical Domains Framework. Focus groups were held through videoconference, audio and video recorded and transcribed verbatim. A deductive content analysis was performed by two researchers independently. RESULTS Eighteen barriers and 19 facilitators were identified. The most common barriers included "lack of knowledge on how to manage a recurrence of LBP," "lack of behavioural regulation strategies and having other priorities" and "lack of self-efficacy/confidence to practice exercise autonomously and deal with a new episode of LBP." "Knowledge on exercise and recurrences," "regular exercise habits," "having specific behavioural regulation strategies," "exercise practice with others," "willingness to practice exercise and considering it a priority," and "presence of positive emotions related with exercise practice" were the most common facilitators. CONCLUSIONS These findings will inform the development of a behaviour change-informed exercise intervention to promote regular exercise practice among patients at risk of a recurrence of LBP.
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Affiliation(s)
- Susana T Duarte
- Comprehensive Health Research Center (CHRC), National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Physiotherapy Department, School of Health, Polytechnic Institute of Setúbal, Setúbal, Portugal
| | - Alexandre Moniz
- Physiotherapy Department, School of Health, Polytechnic Institute of Setúbal, Setúbal, Portugal
- Comprehensive Health Research Center (CHRC), NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Universidade NOVA de Lisboa, Lisbon, Portugal
- EpiDoc Unit, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Universidade Nova de Lisboa, Lisbon, Portugal
| | - Carmen Caeiro
- Physiotherapy Department, School of Health, Polytechnic Institute of Setúbal, Setúbal, Portugal
| | - Bruno Heleno
- Comprehensive Health Research Center (CHRC), NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Pedro Aguiar
- Comprehensive Health Research Center (CHRC), National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Eduardo B Cruz
- Physiotherapy Department, School of Health, Polytechnic Institute of Setúbal, Setúbal, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
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Tshivhase L, Moyo I, Mogotlane SM, Moloko SM. Barriers to accessing and utilising under-five primary health care services in Vhembe District. Afr J Prim Health Care Fam Med 2024; 16:e1-e7. [PMID: 38949440 PMCID: PMC11220142 DOI: 10.4102/phcfm.v16i1.4429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/17/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Sub-Saharan Africa continues to be the region with the highest under-five mortality rate globally, with 74 deaths per 1000 live births. Even though under-five child primary health care (PHC) services are free in South Africa, accessing such services remains challenging. Children under 5 years reportedly die from common illnesses such as pneumonia, diarrhoea and malaria, which are treatable in PHC facilities. AIM The study explored the barriers to accessing and utilising under-five PHC services in the Vhembe District. SETTING The study was conducted in two PHC centres in Vhembe District among guardians accessing care for under-five child health services. METHODS An interpretative phenomenology design was followed using a semi-structured individual interview guide. Sixteen participants were purposively sampled for the study. Colaizzi's steps of data analysis were followed, and trustworthiness as well as ethical principles were ensured throughout the study. RESULTS Four themes emerged as health system barriers, health personnel-related behaviours, health facility infrastructure barriers and guardians-related barriers. Subthemes emerged as distance from the facility, lack of resources, long waiting times; poor time management, lack of commitment and work devotion, insufficient waiting space; challenges with water and sanitation, guardians' healthcare beliefs and the urgency of the illness. CONCLUSION It is imperative that an enabling professional and friendly environment is created to facilitate better access to PHC services for children under 5 years.Contribution: The study's findings brought insight into considering the context of the guardians in improving quality care for under 5 years.
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Affiliation(s)
- Livhuwani Tshivhase
- Department of Nursing, School of Health Care, Sefako Makgatho Health Sciences University, Pretoria.
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Engels B, Kloek CJJ, Sol ME, Bolster EAM, Kotte EMW, Wittink H, Engelbert RHH, Gorter JW, Bloemen MAT. Exploring needs and requirements for a prototype device measuring physical activity in pediatric physical therapy: A qualitative study. PLoS One 2024; 19:e0305968. [PMID: 38917177 PMCID: PMC11198827 DOI: 10.1371/journal.pone.0305968] [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: 01/23/2024] [Accepted: 06/08/2024] [Indexed: 06/27/2024] Open
Abstract
AIMS To analyze needs and requirements of Pediatric Physical Therapists (PPTs), parents, children and adolescents with and without developmental disabilities in the future use of an activity monitor prototype (AM-p) in everyday clinical practice. METHODS Qualitative exploratory study with a thematic analysis approach, based on Braun and Clarke's six steps. Codes derived from the analysis and central themes were collated, based on Fleuren et al.'s groupings of determinants. RESULTS We interviewed 25 PPTs, 12 parents, and 12 children and adolescents. Within four groupings of determinants, we found nine themes: 1) development of information materials; 2) application: output visualization and ease of use; 3) design; 4) relevance and acceptance; 5) shared decision-making; 6) compatibility in daily living; 7) finances, 8) time, and 9) legislation and regulations. CONCLUSIONS End-users have similar basic needs, with individual fine-tuning to be addressed during further development of the AM-p. A child-friendly design, information material, and an easy-to-use application to read and interpret results, need to be developed. Efficient training for PPTs is important for the use of the AM-p and analysis of results. Communication between PPTs and children as well as parents enhances shared decision-making. We recommend involving diverse end-users to enable maximum customization of the AM-p.
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Affiliation(s)
- Barbara Engels
- Research Centre Healthy and Sustainable Living, Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine, Utrecht University, Utrecht, the Netherlands
| | - Corelien J. J. Kloek
- Research Centre Healthy and Sustainable Living, Research Group Innovation of Human Movement Care, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Marleen E. Sol
- Research Centre Healthy and Sustainable Living, Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Eline A. M. Bolster
- Research Centre Healthy and Sustainable Living, Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | | | - Harriët Wittink
- Research Centre Healthy and Sustainable Living, Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Raoul H. H. Engelbert
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Willem Gorter
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- CanChild, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Manon A. T. Bloemen
- Research Centre Healthy and Sustainable Living, Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, The Netherlands
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Searant I, Brown BT, Jenkins HJ. Chiropractors' perceptions on the use of spinal radiographs in clinical practice: a qualitative study. Chiropr Man Therap 2024; 32:23. [PMID: 38909258 PMCID: PMC11193277 DOI: 10.1186/s12998-024-00547-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/18/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Radiography is commonly used in the assessment of spinal disorders, despite a lack of high-quality evidence demonstrating improved clinical outcomes or additional benefit to the patient. There is disagreement amongst chiropractors regarding the appropriate use of radiography for clinical management. This study aims to qualitatively explore chiropractors' perceptions on the use of spinal radiographs in clinical practice with respect to how they determine when to order radiographs; and how they use radiographs to inform clinical management. METHODS Online qualitative semi-structured interviews were conducted with 17 Australian chiropractors who currently manage patients with spinal disorders. Convienence, snowball, and purposive sampling strategies were used to ensure an appropriate breadth and depth of participant characterisitcs and beliefs. Interview data were recorded, transcribed and analysed using framework analysis. RESULTS Three themes were developed to describe how chiropractors determined when to order radiographs. These themes included specific findings from the clinical encounter that may inform clinical management, their perceptions of radiation risk, and the influence of clinical experience/intuition. Three themes and four subthemes were developed for how chiropractors use radiographs to inform their management. These themes explored the use of radiography for the application of chiropractic technique, as well as the role of radiographs in predicting patient prognosis, and as an educational tool to provide reassurance. CONCLUSION Australian chiropractors' decision-making around spinal radiography is diverse and can be influenced by a number of clinical and external factors. Previously unexplored uses of spinal radiography in clinical practice were highlighted. Some chiropractors reported potential benefits of radiography that are currently not supported by research evidence. Future research should address how radiographic findings are reported to patients with spinal disorders and how this could be optimised to improve patient outcomes.
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Affiliation(s)
- Isaac Searant
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
| | - Benjamin T Brown
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Hazel J Jenkins
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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Tabib M, Humphrey T, Forbes-McKay K. The influence of antenatal relaxation classes on perinatal psychological wellbeing and childbirth experiences: a qualitative study. J Reprod Infant Psychol 2024:1-19. [PMID: 38895982 DOI: 10.1080/02646838.2024.2369937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND There is growing evidence that antenatal education incorporating relaxation practices can positively influence perinatal psychological wellbeing. However, a paucity of qualitative research is evident. Gaining insight into how and why such education may influence childbearing women, can inform the design of effective educational interventions. This study aimed to explore the perspectives of women and their partners on how and why a single Antenatal Relaxation Class (ARC) might influence perinatal psychological wellbeing and childbirth experiences. METHOD In this descriptive qualitative study, 17 women and 9 partners participated in semi-structured in-depth interviews and the data were analysed using thematic analysis. The study was carried out in a Scottish NHS Health Board where ARC was provided to expectant parents. FINDINGS Two themes were generated, namely: 'the turning point', and 'recognition of an inner resource'. Participants perceived ARC as 'the turning point' when they became more confident, equipped, and less fearful and anxious towards childbirth. 'Understanding of the psychophysiological processes of childbirth', 'positive stories', and 'practice of relaxation techniques' were reported as the main reasons for these positive changes. Participants explained ARC had enabled them to access a deep sense of calmness as 'an inner resource' and motivated the use of relaxation techniques as a self-care behaviour throughout pregnancy and childbirth. CONCLUSION A single antenatal relaxation class has the potential to enhance perinatal psychological wellbeing and childbirth experiences. This study provides valuable insights for maternity services seeking to develop effective health-promoting antenatal education.
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Affiliation(s)
- Mo Tabib
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, UK
| | - Tracy Humphrey
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
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Bijker L, Scholten-Peeters GGM, Donker MH, Coppieters MW, Cuijpers P, Busink V, Poolman EY, de Wit LM. 'Leaving my comfort zone'. A qualitative study of physiotherapists' experiences blending an eHealth psychosocial intervention with face-to-face physiotherapy. Musculoskelet Sci Pract 2024; 73:103121. [PMID: 38936263 DOI: 10.1016/j.msksp.2024.103121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/21/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Many physiotherapists do not feel adequately equipped to address psychosocial risk factors in people with complex pain states. Hence, a biopsychosocial blended intervention (Back2Action) was developed to assist physiotherapists to manage people with persistent spinal pain and coexisting psychosocial risk factors associated with the development or maintenance of persistent pain. OBJECTIVE This study aimed to gain insight into the experiences of physiotherapists with this blended psychosocial intervention. DESIGN and methods: This was an interpretative qualitative study with a reflexive thematic analysis of semi-structured interviews with physiotherapists (N = 15) who delivered Back2Action. The interview started with the grand-tour question: "What was your experience in using Back2Action?" Physiotherapist were encouraged to provide examples, and follow-up questions were posed to ensure a deeper understanding could be reached. RESULTS Four themes were constructed: Physiotherapists became increasingly aware of (1) their own implicit expectations, biases and skills, and underlying treatment paradigms, and (2) the implicit expectations from their patients towards them. This led to (3) creating a deeper and stronger therapeutic alliance with the patient, but also (4) an understanding that implementation of a true biopsychosocial intervention - even if offered in a blended form - requires more practice, confidence and resources. CONCLUSIONS Back2Action is considered a valuable treatment to deliver a biopsychosocial intervention in primary care. Considering the high level of knowledge, skills and competency of the participating physiotherapists, the perceived barriers may be more difficult to overcome for more junior physiotherapists.
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Affiliation(s)
- L Bijker
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands; Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
| | - G G M Scholten-Peeters
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands.
| | - M H Donker
- Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands.
| | - M W Coppieters
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands; School of Health Sciences and Social Work, and Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia.
| | - P Cuijpers
- Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
| | - V Busink
- Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - E Y Poolman
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, the Netherlands; Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
| | - L M de Wit
- Amsterdam Public Health Research Institute, Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands.
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An SJ, Seo YS. Exploring Loneliness among Korean Adults: A Concept Mapping Approach. Behav Sci (Basel) 2024; 14:492. [PMID: 38920824 PMCID: PMC11201173 DOI: 10.3390/bs14060492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024] Open
Abstract
In South Korea, the proportion of adults experiencing severe loneliness has been increasing rapidly. Accordingly, this study examines the elements of loneliness experienced by Korean adults and investigates their structural relevance using concept mapping. Korean adults (47) were recruited for individual in-depth interviews based on their scores on the UCLA Loneliness Scale. The interviews yielded 80 unique statements, which were then evaluated using multidimensional scaling and a hierarchical cluster analysis. A cluster map of loneliness was derived, with three clusters: (1) emotional distress due to the actual or anticipated absence of connection in relationships, (2) emotional distance from oneself or from others in a relationship, and (3) powerlessness and emptiness due to being directionless. Two dimensions distinguished these clusters: the lack of a sense of connection or self-assurance, and an inward or outward focus. These findings reveal that loneliness encompasses more than unmet relational needs; it also involves self-attentional focus, indicating a need to reconceptualize the notion of loneliness. The study's implications extend to counseling theory and practices by highlighting the importance of addressing both relational connections and self-perceptions in interventions for loneliness. By expanding the understanding of loneliness through empirical data, this research provides a more comprehensive framework for addressing loneliness.
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Affiliation(s)
- Soo-Jung An
- Department of Psychotherapy, Myongji University, Seoul 03674, Republic of Korea;
| | - Young-Seok Seo
- Faculty of Education, Yonsei University, Seoul 03722, Republic of Korea
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Diedericks A, Bruwer Z, Laing N, Eastman E, De Vries JDV, Donald KA, Robinson EB, Newton CR, Abubakar A. Parental Perspectives Regarding the Return of Genomic Research Results in Neurodevelopmental Disorders in South Africa: Anticipated Impact and Preferences. RESEARCH SQUARE 2024:rs.3.rs-4448155. [PMID: 38946993 PMCID: PMC11213179 DOI: 10.21203/rs.3.rs-4448155/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Few policies and little research exist regarding the disclosure of genomic results to research participants in Africa. As understanding participant preferences would be pivotal to the success of the feedback process, this study set out to address this issue by engaging with enrolled participants from an ongoing genomics research project on neurodevelopmental disorders with the aim to assess the anticipated impact of receiving pertinent results and explore the preferences for feedback in a South-African context. Twelve semi-structured interviews were conducted with 17 parents of children participating in the research study. Transcribed interview data and observational notes were analysed using thematic analysis and framework matrices. Participants linked their own meaning to the impact of receiving a pertinent result and perceived the information as useful for reasons other than only clinical utility. These included closure, improved management of their child's condition and information regarding recurrence risks. In terms of preferences for feedback, an in-person result delivery session, conducted by a member of the study team or medical professional familiar with their child was preferred. In addition, participants felt a sense of ownership over their blood or their contribution to the research study, finding meaning even in non-pertinent (secondary findings) or negative results. These findings provide insight into the type of discussions that may be valuable in enabling the development of best practices and guidelines for the return of individual genetic research results, in a culturally appropriate manner, within South-African communities.
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Affiliation(s)
- Angelique Diedericks
- Human Genetics, Department of Medicine, University of Cape Town, Groote Schuur Hospital
| | - Zandré Bruwer
- Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town
| | - Nakita Laing
- Human Genetics, Department of Medicine, University of Cape Town, Groote Schuur Hospital
| | - Emma Eastman
- Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town
| | | | - Kirsten A Donald
- Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town
| | - Elise B Robinson
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Charles R Newton
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya; Department of Psychiatry, UnivInstitute of Human Development, Aga Khan University, Nairobi, Kenya
| | - Amina Abubakar
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya; Department of Psychiatry, UnivInstitute of Human Development, Aga Khan University, Nairobi, Kenya
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Gerritse K, Martens C, Bremmer MA, Kreukels BPC, de Boer F, Molewijk BC. "I Should've Been Able to Decide for Myself, but I Didn't Want to Be Left Alone." A Qualitative Interview Study of Clients' Ethical Challenges and Norms Regarding Decision-Making in Gender-Affirming Medical Care. JOURNAL OF HOMOSEXUALITY 2024; 71:1757-1781. [PMID: 37097132 DOI: 10.1080/00918369.2023.2201972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This qualitative study aimed to map and provide insight into the ethical challenges and norms of adult transgender and gender diverse (TGD) clients in gender-affirming medical care (GAMC). By doing so, we seek to make an empirical and constructive contribution to the dialogue on and moral inquiry into what good decision-making in GAMC should entail. We conducted 10 semi-structured interviews with adult Dutch TGD people who received GAMC. In our thematic analysis, we (1) included both ethical challenges and norms, (2) differentiated between explicit and implicit ethical challenges and norms, and (3) ascertained the specific context in which the latter emerged. We identified the following themes: (1) clients should be in the lead, (2) harm should be prevented, and (3) the decision-making process should be attuned to the individual client. These themes arose in the context of (1) a precarious client-clinician relationship and (2) distinct characteristics of GAMC. Our findings highlight divergent and dynamic decisional challenges and normative views-both within individual clients and among them. We conclude that there is no single ideal model of good decision-making in GAMC and argue that elucidating and jointly deliberating on decisional norms and challenges should be an inherent part of co-constructing good decision-making.
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Affiliation(s)
- Karl Gerritse
- Department of Ethics, Law, and Humanities, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Liaison Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Casper Martens
- Department of Ethics, Law, and Humanities, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marijke A Bremmer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Liaison Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Baudewijntje P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fijgje de Boer
- Department of Ethics, Law, and Humanities, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bert C Molewijk
- Department of Ethics, Law, and Humanities, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Merenda T, Denis J, Patris S. Pharmaceutical care for visually impaired patients: a qualitative study of community pharmacists' needs and professional experience. Int J Clin Pharm 2024; 46:665-674. [PMID: 38407693 DOI: 10.1007/s11096-023-01684-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/30/2023] [Indexed: 02/27/2024]
Abstract
BACKGROUND Visual impairment is a disability that can have a significant impact on the ability to take medication safely. As a result, pharmacists must adjust their practice to provide targeted and adapted support for this type of patient. AIM The aims of the present study were (1) to illustrate the usual clinical practice of community pharmacists to support the optimisation of medication use in visually impaired patients, and (2) to identify solutions to improve pharmaceutical care for visually impaired patients. METHOD Semi-structured interviews with 18 French-speaking community pharmacists were conducted via videoconference in Belgium. Participants were recruited on a voluntary basis and through a snowball method. An interview guide was developed based on literature review. Interviews were carried out until theoretical saturation of the data, recorded, transcribed verbatim and analysed using thematic analysis. Data were organised by NVivo Software. RESULTS Four themes were identified: community pharmacists' training, identification of visually impaired patients by the pharmacist, communication with visually impaired patients and their proxies, and provision of appropriate pharmaceutical care. Participants stated that they had not received any training regarding visual impairment. They described that they did not always know how to recognise visually impaired patients and that communication was often difficult. CONCLUSION This qualitative study has highlighted a lack of knowledge and skills among community pharmacists regarding visual impairment. One possible solution could be to develop recommendations and tools to improve the care of these patients.
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Affiliation(s)
- Théodora Merenda
- Unit of Clinical Pharmacy, Faculty of Medicine and Pharmacy, University of Mons, Avenue du Champ de Mars 25, Building 6, 7000, Mons, Belgium.
| | - Jennifer Denis
- Unit of Clinical Psychology, Faculty of Psychology and Education, University of Mons, Place du Parc 14, 7000, Mons, Belgium
| | - Stéphanie Patris
- Unit of Clinical Pharmacy, Faculty of Medicine and Pharmacy, University of Mons, Avenue du Champ de Mars 25, Building 6, 7000, Mons, Belgium
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Bozzolan M, Bighi E, Occhi A, Mottaran S, Simoni G, Valpiani G, Bombardi S, Da Roit M. Professional practice, competence, and education related to COVID-19: A mixed-methods light study of physiotherapists' experiences. Physiother Theory Pract 2024; 40:1215-1231. [PMID: 36369771 DOI: 10.1080/09593985.2022.2142083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/16/2022] [Accepted: 10/16/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) became a significant challenge for the work and personal experience of physiotherapists (PTs). OBJECTIVE To investigate how the work activities of PTs in a region in Italy have changed, describe the reasons for change, perceived competence, and effectiveness of professional education, and explore their personal experience. METHODS We adopted a monocentric convergent mixed-methods light-questionnaire variant study. The questionnaire contains both closed-ended and open-ended questions. Quantitative and qualitative data were combined to interpret the results. RESULTS Among 78 respondents (response rate 24.4%), 87.2% worked during the pandemic, 52.9% treated patients with COVID-19, and 45.6% changed their working activities. Professional competence was perceived as low in intensive and sub-intensive care settings. The major critical aspect of professional education was respiratory rehabilitation. Life-learning education was judged as effective, even if mainly focused on safety. Nine themes emerged from the analysis of the PTs' experiences: 1) Physiotherapy during COVID-19; 2) Fear and negative feelings; 3) Positive aspects; 4) Organization and management; 5) Prevention measures; 6) Patients; 7) Change; 8) Information; and 9) Professional education. CONCLUSIONS PTs who have direct experience with patients with COVID-19 showed great resilience. They overcame the first phase of disorientation and fear, despite a specific lack of competence in the respiratory field.
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Affiliation(s)
- Michela Bozzolan
- Interdepartmental Educational Service, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Elisa Bighi
- Fondazione "San Salvatore" Via Piave, Ficarolo (RO), Italy
| | - Antonella Occhi
- Rehabilitation Medicine Unit - S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Silvia Mottaran
- Acquired Brain Injuries Unit - S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | | | - Giorgia Valpiani
- Research Innovation Quality and Accreditation Unit, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Sandra Bombardi
- Research Innovation Quality and Accreditation Unit, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Marco Da Roit
- Belluno Community Hospital, Azienda AULSS1 Dolomiti via Feltre, Belluno, Italy
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Doornbos MM, Zandee GL, Bjelland C. Men's mental health - Conceptualization, effects, and coping. Arch Psychiatr Nurs 2024; 50:100-107. [PMID: 38789221 DOI: 10.1016/j.apnu.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 10/30/2023] [Accepted: 03/10/2024] [Indexed: 05/26/2024]
Abstract
Men are predisposed to suffer with unaddressed depression and anxiety. This study sought to empower men, in three urban, racially/ethnically diverse, underserved, and impoverished neighborhoods, for mental health self-care by capturing their perceptions of depression and anxiety. Using community-based participatory research, in the context of long-term partnerships between a department of nursing and these neighborhoods, the researchers recruited 50 men aged 23-83 years. Data were collected via six homogeneous, zoom-based focus groups composed of Black, Hispanic, and White men, respectively. The men identified themes pertaining to the conceptualization and devastating effects of depression and anxiety as well as coping strategies employed to mitigate the symptoms.
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Ratnapradipa KL, Napit K, King KM, Ramos AK, Luma LBL, Dinkel D, Robinson T, Rohde J, Schabloske L, Tchouankam T, Watanabe-Galloway S. African American and Hispanic Cancer Survivors' and Caregivers' Experiences in Nebraska. J Immigr Minor Health 2024; 26:554-568. [PMID: 38180583 DOI: 10.1007/s10903-023-01570-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/06/2024]
Abstract
Racial and ethnic minority populations experience poorer cancer outcomes compared to non-Hispanic White populations, but qualitative studies have typically focused on single subpopulations. We explored experiences, perceptions, and attitudes toward cancer care services across the care continuum from screening through treatment among African American and Hispanic residents of Nebraska to identify unique needs for education, community outreach, and quality improvement. We conducted four focus groups (N = 19), April-August 2021 with people who were aged 30 or older and who self-identified as African American or Hispanic and as cancer survivors or caregivers. Sessions followed a structured facilitation guide, were audio recorded and transcribed, and were analyzed with a directed content analysis approach. Historical, cultural, and socioeconomic factors often led to delayed cancer care, such as general disuse of healthcare until symptoms were severe due to mistrust and cost of missing work. Obstacles to care included financial barriers, transportation, lack of support groups, and language-appropriate services (for Hispanic groups). Knowledge of cancer and cancer prevention varied widely; we identified a need for better community education about cancer within the urban Hispanic community. Participants had positive experiences and a sense of hope from the cancer care team. African American and Hispanic participants shared many similar perspectives about cancer care. Our results are being used in collaboration with national and regional cancer support organizations to expand their reach in communities of color, but structural and cultural barriers still need to be addressed.
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Affiliation(s)
- Kendra L Ratnapradipa
- Department of Epidemiology, University of Nebraska Medical Center College of Public Health, 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA.
| | - Krishtee Napit
- Department of Epidemiology, University of Nebraska Medical Center College of Public Health, 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA
| | - Keyonna M King
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Athena K Ramos
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Lady Beverly L Luma
- Office of Community Outreach and Engagement, Fred and Pamela Buffett Cancer Center, Omaha, NE, USA
| | - Danae Dinkel
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | | | - Jolene Rohde
- Nebraska Comprehensive Cancer Control Program, Nebraska Department of Health and Human Services, Lincoln, NE, USA
| | | | - Tatiana Tchouankam
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, University of Nebraska Medical Center College of Public Health, 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA
- Office of Community Outreach and Engagement, Fred and Pamela Buffett Cancer Center, Omaha, NE, USA
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Björklund S, Lilja Hagell P, Hagell P, Persson M, Holmberg M. Ambulance staff's ways of understanding health care encounters in stigmatized neighborhoods - A phenomenographic study. Int Emerg Nurs 2024; 74:101451. [PMID: 38663203 DOI: 10.1016/j.ienj.2024.101451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/27/2024] [Accepted: 04/06/2024] [Indexed: 05/28/2024]
Affiliation(s)
- Sara Björklund
- The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden; Department of Ambulance Service, Region Blekinge, Länsmansvägen 1, 374 41 Karlshamn, Sweden; Center of Interprofessional Collaboration within Emergency Care, Linnaeus University, Box 451, SE-351 06 Växjö, Sweden.
| | - Petra Lilja Hagell
- The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden
| | - Peter Hagell
- The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden
| | - Martin Persson
- The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden
| | - Mats Holmberg
- Center of Interprofessional Collaboration within Emergency Care, Linnaeus University, Box 451, SE-351 06 Växjö, Sweden; Faculty of Health and Life Sciences, Linnaeus University, Box 451, SE-351 06 Växjö, Sweden; Department of Ambulance Service, Region Sörmland, Österleden 20, SE-641 49 Katrineholm, Sweden; Center for Clinical Research Sörmland, Uppsala University, Mälarsjukhuset, SE-631 88 Eskilstuna, Sweden
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Engeda EH, Aldersey HM, Davison CM, Gelaye KA, Fayed N. Severe malaria-related disability in Ethiopian children from the perspectives of caregivers: an interpretive description study. Disabil Rehabil 2024; 46:2327-2337. [PMID: 37303154 DOI: 10.1080/09638288.2023.2221457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/28/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE This study explored severe malaria-related disability in children from the perspectives of their caregivers. MATERIALS AND METHODS The interpretive description qualitative approach was employed. The participants were selected using the purposive sampling technique considering the child's history of severe malaria, age (0-10 years), and location (urban/rural). Data were collected through face-to-face interviews with sixteen caregivers. Reflexive thematic data analysis was utilized. Through prolonged engagement, reflective journaling, an audit trail, and co-authors' review, trustworthiness was enhanced. RESULTS The study generated five themes from the interviews: mitigators of disability, contributors of disability, impact on body function, impact on activities and participation, and uncertainties about future well-being. The findings revealed previously unstudied social components of disability and environmental factors. Furthermore, the research uncovered health-related quality of life aspects that are out of the scope of the current comprehensive disability framework. CONCLUSIONS The study contributes to a deeper understanding of severe malaria-related disability in children from the biopsychosocial perspective. The findings could help policymakers, researchers, and clinicians who want to design rehabilitation interventions for the affected children or examine the components of disability on a large scale using quantitative methods.IMPLICATIONS FOR REHABILITATIONVarious contextual factors interacted with severe malaria and influenced functioning either as facilitators or barriers, implying disability related to malaria can be prevented or created.The long-term impacts of severe malaria are not limited to functioning and disability but also affect the health-related quality of life of children who survive severe malaria.Rehabilitation professionals should consider applying comprehensive functioning and disability frameworks such as the ICF when designing (or applying) screening tools, planning interventions, and evaluating the outcomes of intervention for children with severe malaria-related disability.Rehabilitation interventions for children with severe malaria-related disability should consider patient- or caregiver-reported outcomes (components of disability).
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Affiliation(s)
- Eshetu Haileselassie Engeda
- Department of Pediatric and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Queen's University School of Rehabilitation Therapy, Kingston, Canada
| | | | - Colleen M Davison
- Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nora Fayed
- Queen's University School of Rehabilitation Therapy, Kingston, Canada
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Zidan T, Iskafi H, Ali A, Barham H, Al-Sayed Ahmad M, Masalma R, Hossoon A, Barham A, Shawahna R. Experiences of Multiple Myeloma Patients With Treatment in the Palestinian Practice: A Multicenter Qualitative Study in a Resource-Limited Healthcare System. Cureus 2024; 16:e63365. [PMID: 39070431 PMCID: PMC11283748 DOI: 10.7759/cureus.63365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
Background Multiple myeloma is a crippling cancer that puts a significant strain on patients and their families alike. The long and exhausting treatment journey with the disease is challenging not only for patients but also for healthcare systems. This exploratory study was conducted to look into these patients' experiences with their treatment and explore their recommendations and views to improve the Palestinian healthcare system, which can be viewed as an evolving healthcare system within a resource-limited and developing country. Methods The consolidated criteria for reporting qualitative research (COREQ) checklist was used for conducting this multicenter exploratory qualitative study. A total number of eight patients with multiple myeloma who received treatment in the Palestinian healthcare system participated in semi-structured in-depth interviews. The semi-structured in-depth interviews followed a set interview schedule. Thematic analysis of the data was done using the qualitative interpretive description approach. Results A total of 5.48 h (329 min) of total interview time was analyzed. Among the patients, 6 (75%) were males, 5 (63.5%) lived in urban areas, 5 (62.5%) reported satisfaction with their household income, 6 (75%) underwent bone marrow transplantation, and all of them (100%) had governmental insurance. The qualitative data that emerged after analysis were classified into three major themes and multiple sub-themes. The three major themes were: (1) treatment side effects, (2) factors affecting treatment experience, and (3) recommendations to improve healthcare service. Conclusion The results of this qualitative study offer insight into how people with multiple myeloma view the healthcare system in Palestine and shed light on the variable and challenging experiences with their treatment, side effects, and communication with healthcare providers within the context of a resource-limited and developing country. Future research should involve hemato-oncology doctors and benefit from their expertise in the field.
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Affiliation(s)
- Thabet Zidan
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
| | - Hala Iskafi
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
| | - Ahmad Ali
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
| | - Husam Barham
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
| | - Mahdi Al-Sayed Ahmad
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
| | - Raed Masalma
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
| | - Ahmed Hossoon
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
| | - Ali Barham
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
| | - Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE
- Clinical Research, An-Najah National University Hospital, Nablus, PSE
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Faal Siahkal S, Javadifar N, Najafian M, Iravani M, Zakerkish M, Heshmati R. Psychosocial needs of inpatient women with gestational diabetes mellitus: a qualitative study. J Reprod Infant Psychol 2024; 42:464-480. [PMID: 35946413 DOI: 10.1080/02646838.2022.2110221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common medical complications associated with pregnancy. Its treatment requires multidisciplinary cooperation, and identifying the psychosocial needs of patients is important in the management of their condition. OBJECTIVE This study investigates the psychosocial needs of inpatient mothers with GDM from the joint perspectives of future mothers and healthcare providers. METHODS This qualitative study used a content analysis approach. Semi-structured individual interviews focusing on the psychosocial needs of women with GDM were conducted with twelve women suffering from GDM and eight medical staff. Sampling continued until data saturation. RESULTS According to the findings of this study, the psychosocial needs of these mothers were classified into the following categories: Support for worries related to the consequences of the disease, Interpersonal support, Infrastructural support, educational support. CONCLUSION The psychosocial needs of inpatient mothers with GDM were identified in this study. Attention to these needs can help enhance the mother's satisfaction and treatment adherence, and reduce worries and anxiety during hospitalisation. ABBREVIATIONS GDM: Gestational Diabetes Mellitus; hPGH: human placental growth hormone; COREQ: Consolidated criteria for reporting qualitative research; WHO: World Health Organization; HCP: healthcare provider.
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Affiliation(s)
- Shahla Faal Siahkal
- Midwifery Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Javadifar
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahin Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mina Iravani
- Reproductive Health Promotion Research Center, Midwifery and Reproductive Health Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehrnoosh Zakerkish
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Rasoul Heshmati
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
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Opsomer S, De Clercq L, De Lepeleire J, Joossens S, Luyten P, Pype P, Lauwerier E. Do all roads lead to Rome? An ideal-type study on trajectories of resilience in advanced cancer caregiving. PLoS One 2024; 19:e0303966. [PMID: 38820251 PMCID: PMC11142429 DOI: 10.1371/journal.pone.0303966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/03/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE Studies on resilience in advanced cancer caregiving typically focus on the interplay between resilience-promoting resources and coping strategies that may be associated with resilience. However, no studies have investigated the emergence of trajectories of resilience and distress in individuals confronted with a cancer diagnosis of a loved one. METHODS Ideal-type analysis, a method for constructing typologies from qualitative data, was used to identify trajectories involving resilience or the lack thereof based on fifty-four interviews conducted with seventeen partners of patients recently diagnosed with advanced cancer over a period of three years. FINDINGS Six trajectories could be distinguished, three of which involved resilience (rapidly adapting resilience, gradually adapting resilience, and slowly adapting resilience), while the other three trajectories (continuing distress, delayed distress, and frozen disconnection) reflected a less optimal adjustment. These different trajectories seemed to be rooted in the individual characteristics of partners, the behavior of a support network, and interactions between the two. CONCLUSION The differentiation between these trajectories in partners of patients diagnosed with cancer not only furthers research on resilience in the face of adversity, but also promises to assist healthcare professionals in optimizing support for this often-neglected group of partners of patients diagnosed with cancer.
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Affiliation(s)
- Sophie Opsomer
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Luca De Clercq
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Jan De Lepeleire
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Sofie Joossens
- Program of Health, University Colleges Leuven ‐ Limburg, Leuven, Belgium
| | - Patrick Luyten
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- End-of-Life Care Research Group, Ghent University campus, Ghent, Belgium
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Department of Health Psychology, Faculty of Psychology, Open University, Heerlen, Netherlands
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Thys T, Bogaert L, Dankaerts W, Depreitere B, Van Wambeke P, Brumangne S, Bultheel M, Vanden Abeele V, Moke L, Spriet A, Schelfaut S, Janssens L, Swinnen TW. Qualitative study exploring the views of patients and healthcare providers on current rehabilitation practices after lumbar fusion surgery. BMJ Open 2024; 14:e077786. [PMID: 38816040 PMCID: PMC11141188 DOI: 10.1136/bmjopen-2023-077786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 05/12/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVES To explore the views of patients and healthcare providers on current rehabilitation after lumbar fusion surgery (LFS) to fuel the development of a novel rehabilitation care pathway. DESIGN A cross-sectional, qualitative study with an interpretive descriptive design. SETTING Academic and non-academic hospital setting in Belgium. PARTICIPANTS 31 caregivers from (non)-academic settings and 5 patients with LFS were purposefully sampled and in-depth interviewed. RESULTS Out of the data of all interviews, participants reported opinions on 23 thematic clusters that were expressed in a time-contingent manner from the preoperative, perioperative to postoperative phase. Afterwards, themes were mapped to the Consolidated Framework for Implementation Research, with a larger role for concepts related to the innovation, inner and individual domain. As an overarching theme, the importance of an 'individualised, patient-centred rehabilitation built on a strong therapeutic alliance with an accessible interprofessional team' was stressed for patients undergoing LFS. Specifically, participants stated that a biopsychosocial approach to rehabilitation should start in the preoperative phase and immediately be continued postoperatively. No consensus was observed for movement restrictions postoperatively. Uniform communication between the involved caregivers was considered essential for optimal therapeutic alliance and clinical outcome. The precise role and competence of each member of the interprofessional team needs, therefore, to be clearly defined, respected and discussed. An accessible case manager to guide the patient trajectory and tackle problems could further support this. Interestingly, only patients, psychologists and physiotherapists addressed return to work as an important outcome after LFS. CONCLUSIONS This qualitative study identified key experiences and points to consider in the current and future rehabilitation pathway for LFS. Future research should incorporate these findings to build a novel rehabilitation pathway for LFS and evaluate its feasibility and cost-effectiveness. TRIAL REGISTRATION NUMBER This study was registered at clinicaltrials.gov (NCT03427294).
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Affiliation(s)
- Tinne Thys
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Liedewij Bogaert
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Wim Dankaerts
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Bart Depreitere
- Division of Neurosurgery, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Peter Van Wambeke
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Simon Brumangne
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Michael Bultheel
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Vero Vanden Abeele
- Department of Computer Science, E-media Research Lab, KU Leuven, Leuven, Belgium
| | - Lieven Moke
- Division of Orthopaedic Surgery, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Ann Spriet
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Sebastiaan Schelfaut
- Division of Orthopaedic Surgery, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Lotte Janssens
- Faculty of Rehabilitation Sciences, University Hasselt, Hasselt, Belgium
| | - Thijs Willem Swinnen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Division of Rheumatology, KU Leuven University Hospitals Leuven, Leuven, Belgium
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McCauley R, Ryan K, McQuillan R, Selman LE, Foley G. Supportive relationships between patients and family caregivers in specialist palliative care: a qualitative study of barriers and facilitators. BMJ Support Palliat Care 2024; 14:233-242. [PMID: 38050065 DOI: 10.1136/spcare-2023-004371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/18/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVES Patients with advanced illness and their family caregivers can be mutually supportive. However, what facilitates and/or restricts supportive relationships between patients and family caregivers in palliative care remains unclear. We aimed to identify key barriers to and facilitators of supportive relationships between people with advanced illness and family caregivers in specialist palliative care. METHODS A qualitative study using grounded theory methodology was conducted. Semistructured interviews were undertaken with 15 patients with advanced illness and 21 family caregivers purposively and theoretically sampled from a large regional specialist palliative care service. Verbatim transcripts were analysed in line with grounded theory coding procedures. RESULTS Mutual support was underpinned by mutual concern and understanding. Facilitators of supportive relationships included patients and family caregivers already having a close relationship, caregivers assuming caregiving duties by choice, caregivers feeling competent in a caregiving role, patients valuing caregiver efforts, availability of respite for the caregiver and direct support from healthcare professionals to help both patients and caregivers adjust to advanced illness. Barriers to supportive relationships included absence of support from the wider family, prior mutual conflict between the patient and caregiver, caregivers feeling constrained in their caregiving role and patient and caregiver distress induced by mutual loss. CONCLUSIONS Multiple factors at both a micro (eg, relationship based) and mesolevel (eg, assistance from services) impact patient and family caregiver ability to support one another in specialist palliative care. Supportive relationships between patients and family caregivers are mediated by feelings pertaining to both control and loss.
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Affiliation(s)
- Rachel McCauley
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Karen Ryan
- St Francis Hospice Dublin, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Regina McQuillan
- St Francis Hospice Dublin, Dublin, Ireland
- Department of Palliative Care, Beaumont Hospital, Dublin, Ireland
| | - Lucy E Selman
- Palliative and End of Life Care Research Group, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Geraldine Foley
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Oreg A, Ben Shlomo S. Performances of Hope and Despair: A Case Study of Organ Donation Between a Palestinian and Israeli Jew Amidst War. QUALITATIVE HEALTH RESEARCH 2024:10497323241238919. [PMID: 38758602 DOI: 10.1177/10497323241238919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
We explore the phenomenon of organ donation between rivals in time of war when a significant gift such as organ donation is given not just to a "stranger" but to a stranger who may be considered an enemy. This is a case study of a unique organ donation event that occurred in Israel during Operation Guardian of the Walls in May 2021. It involved a Palestinian boy killed by a Jewish policeman and a Jewish man killed by Palestinian youths. Both victims, lacking organ donor cards, had their organs donated by their families with the awareness that recipients could come from the "opposing" group. We ask: (1) How do families from rival groups construct meaning in their decision to donate organs? (2) How do they construct meaning in their experience of loss? The findings reveal that bereaved families imbue their actions with political and religious significance, framing the organ donations as a "universal gift" guided by religious commandments to save lives. While these acts initially transcend cultural and national boundaries, a lack of recognition and gratitude afterward can lead to disillusionment, reinforcing "us" versus "them" boundaries. This study underscores the intricate dynamics in organ donations during political conflict and the pivotal role of religious authorities in shaping perceptions and meaning. Moreover, it highlights the potential for organ donations to foster reconciliation and coexistence amidst conflict, provided mutual recognition in cases where compassion and understanding of loss are prioritized.
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Affiliation(s)
- Ayelet Oreg
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Shirley Ben Shlomo
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
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