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Spooner M, Reinhardt C, Boland F, McConkey S, Pawlikowska T. Risky business: medical students' feedback-seeking behaviours: a mixed methods study. MEDICAL EDUCATION ONLINE 2024; 29:2330259. [PMID: 38529848 DOI: 10.1080/10872981.2024.2330259] [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: 08/14/2023] [Accepted: 03/08/2024] [Indexed: 03/27/2024]
Abstract
There are differing views on how learners' feedback-seeking behaviours (FSB) develop during training. With globalisation has come medical student migration and programme internationalisation. Western-derived educational practices may prove challenging for diverse learner populations. Exploring undergraduate activity using a model of FSB may give insight into how FSB evolves and the influence of situational factors, such as nationality and site of study. Our findings seek to inform medical school processes that support feedback literacy. Using a mixed methods approach, we collected questionnaire and interview data from final-year medical students in Ireland, Bahrain, and Malaysia. A validated questionnaire investigated relationships with FSB and goal orientation, leadership style preference, and perceived costs and benefits. Interviews with the same student population explored their FSB experiences in clinical practice, qualitatively, enriching this data. The data were integrated using the 'following the thread' technique. Three hundred and twenty-five of a total of 514 completed questionnaires and 57 interviews were analysed. Learning goal orientation (LGO), instrumental leadership and supportive leadership related positively to perceived feedback benefits (0.23, 0.2, and 0.31, respectively, p < 0.05). Perceived feedback benefits are related positively to feedback monitoring and inquiry (0.13 and 0.38, respectively, p < 0.05). The personal cost of feedback is unsupported in quantitative data, but was a strong theme in interviews, as was feedback avoidance, peer feedback, and unsupportive learning environment. No differences were observed across sub-groups based on gender, study site, or student nationality. Integrated analysis describes FSB: avoiding 'unsafe' feedback (first, do no harm) and overcoming barriers (beat the system) and goal-centred curation (shop around) to optimise benefits. Diverse medical students across three continents undertake FSB with careful navigation, as a valued but risky business, that is highly contextualised. Promoting a constructive FSB is complex. Overcoming outdated theory and practices on the wards remains a challenge to psychologically safe, learner-centred feedback.
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Affiliation(s)
- Muirne Spooner
- Health Professions Education Centre, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Ciarán Reinhardt
- Department of Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Samuel McConkey
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Teresa Pawlikowska
- Health Professions Education Centre, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
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George S, Regan J, Awan A, O’Connor M, Foster A, Raymond K, Gorfinkel I, McNeil SA. Attitudes, barriers, and facilitators to adherent completion of the recombinant zoster vaccine regimen in Canada: Qualitative interviews with healthcare providers and patients. Hum Vaccin Immunother 2024; 20:2317595. [PMID: 38502342 PMCID: PMC10956622 DOI: 10.1080/21645515.2024.2317595] [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: 10/09/2023] [Accepted: 02/08/2024] [Indexed: 03/21/2024] Open
Abstract
This qualitative, cross-sectional study aimed to understand the barriers and facilitators related to the adherence and completion of the recombinant zoster vaccine (RZV) two-dose series in Canada, as perceived by healthcare providers (HCPs) and patients. Data collection occurred via 60-minute concept elicitation interviews with 12 HCPs (4 physicians, 2 nurse practitioners, 6 pharmacists) who had prescribed and/or administered RZV in Canada, and 21 patients aged ≥50 years who had received ≥1 dose of RZV. Patients were categorized as adherent (received both doses within the recommended 2-to-6-month timeframe; n = 11) or non-adherent (received only one dose or second dose outside the recommended timeframe; n = 10). Interview transcripts were coded and analyzed using a two-part thematic analysis approach. HCP-identified barriers to RZV adherence included high out-of-pocket cost, inconsistent/lack of health plan coverage, inconvenient processes for accessing RZV, and patient forgetfulness. HCP-identified facilitators included desire for shingles protection, HCP encouragement, and reminders. Barriers to RZV adherence identified by patients included lack of HCP knowledge/experience with RZV, receiving unreliable/confusing information, having unpleasant/severe side effects following the first dose, high out-of-pocket cost, lack of insurance coverage, and forgetfulness. Patient-identified facilitators included self-motivation, financial support, convenient processes for obtaining RZV, and reminders. In conclusion, many factors can influence RZV series completion and adherence among adults in Canada, including cost, insurance coverage, HCP knowledge and encouragement, and reminders. Awareness of these factors may inform HCPs in helping patients overcome barriers and identify opportunities for future consideration, facilitating protection against herpes zoster.
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Affiliation(s)
| | | | | | | | | | | | | | - Shelly A. McNeil
- Canadian Center for Vaccinology, IWK Health and Nova Scotia Health, Dalhousie University, Halifax, NS, Canada
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van Wijk EV, van Blankenstein FM, Janse RJ, Dubois EA, Langers AMJ. Understanding students' feedback use in medical progress testing: A qualitative interview study. MEDICAL EDUCATION 2024; 58:980-988. [PMID: 38462812 DOI: 10.1111/medu.15378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Active engagement with feedback is crucial for feedback to be effective and improve students' learning and achievement. Medical students are provided feedback on their development in the progress test (PT), which has been implemented in various medical curricula, although its format, integration and feedback differ across institutions. Existing research on engagement with feedback in the context of PT is not sufficient to make a definitive judgement on what works and which barriers exist. Therefore, we conducted an interview study to explore students' feedback use in medical progress testing. METHODS All Dutch medical students participate in a national, curriculum-independent PT four times a year. This mandatory test, composed of multiple-choice questions, provides students with written feedback on their scores. Furthermore, an answer key is available to review their answers. Semi-structured interviews were conducted with 21 preclinical and clinical medical students who participated in the PT. Template analysis was performed on the qualitative data using a priori themes based on previous research on feedback use. RESULTS Template analysis revealed that students faced challenges in crucial internal psychological processes that impact feedback use, including 'awareness', 'cognizance', 'agency' and 'volition'. Factors such as stakes, available time, feedback timing and feedback presentation contributed to these difficulties, ultimately hindering feedback use. Notably, feedback engagement was higher during clinical rotations, and students were interested in the feedback when seeking insights into their performance level and career perspectives. CONCLUSION Our study enhanced the understanding of students' feedback utilisation in medical progress testing by identifying key processes and factors that impact feedback use. By recognising and addressing barriers in feedback use, we can improve both student and teacher feedback literacy, thereby transforming the PT into a more valuable learning tool.
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Affiliation(s)
- Elise V van Wijk
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
| | - Floris M van Blankenstein
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
| | - Roemer J Janse
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eline A Dubois
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
| | - Alexandra M J Langers
- Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
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Brooks J, Ruane H, McDiarmid S, Vyas A, Issa B, Harvie M. Do people with type 2 diabetes find continuous and intermittent low-energy diets for weight loss and diabetes remission acceptable? J Hum Nutr Diet 2024; 37:995-1006. [PMID: 38798236 DOI: 10.1111/jhn.13313] [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: 10/23/2023] [Accepted: 04/13/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND The Manchester Intermittent versus Daily Diet App Study (MIDDAS) tested the feasibility and potential efficacy of two remotely delivered low-energy diet (LED) programmes (800 kcal/day) to support weight loss and remission of type 2 diabetes: continuous [CLED] (8 weeks of daily LED) and intermittent [ILED] (2 days of LED/week for 28 weeks). Understanding participant experiences can help us to understand the acceptability of LED programmes to people with type 2 diabetes, informing future programme development and implementation. METHODS Twenty participants (10 CLED; 10 ILED) took part in interviews conducted at the end of the active weight loss phase (CLED week 12, ILED week 28). Interviews were transcribed and analysed thematically using the template analysis approach, with an a priori focus on acceptability. Four themes are presented: prospective acceptability, intervention coherence and perceived effectiveness, opportunity costs and self-efficacy. RESULTS Both remotely supported CLED and ILED interventions appeared acceptable to participants. CLED participants found the rapid initial weight loss phase comparatively easy and highly motivating but expressed more concerns around weight maintenance. ILED participants found the more gradual weight loss initially frustrating but expressed greater confidence in their longer-term adherence. The importance of continued individualised support from healthcare professionals was emphasised, and evidence of weight loss and improvement in other medical markers through monitoring via the mobile phone app was useful. CONCLUSION Different approaches to remotely delivered LEDs appear acceptable; therefore asking patients which approach may be more acceptable to them may be a useful way to offer individualised and tailored support.
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Affiliation(s)
- Joanna Brooks
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen Ruane
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Sarah McDiarmid
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Avni Vyas
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Basil Issa
- Department of Endocrinology and Diabetes, Manchester University NHS Foundation Trust, Manchester, UK
| | - Michelle Harvie
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
- Manchester Cancer Research, Centre and NIHR Manchester Biomedical Research Centre, Manchester, UK
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Oatley R, Atkinson T. A qualitative study of the benefits and challenges of different models of extra care housing for residents living with dementia. DEMENTIA 2024; 23:981-1000. [PMID: 38702049 PMCID: PMC11290033 DOI: 10.1177/14713012241249794] [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] [Indexed: 05/06/2024]
Abstract
Extra care housing (ECH) is a type of housing with care and support designed to enable older people to age in place. Approximately one fifth of residents living in ECH are living with dementia and yet, there remains gaps as to how best to support people to live well with dementia in the context. ECH stock across the United Kingdom (UK) includes a diverse range of options that can be grouped into integrated, specialist and separated accommodation. Integrated models involve residents with dementia living alongside residents without dementia. Specialist ECH offer accommodation exclusively for people living with dementia. Separated models offer a separate area for residents with dementia within a larger, integrated site. How these different models work for residents living with dementia is little known and has remained a significant gap in knowledge that impairs both professionals and people living with dementia when choosing housing and care. This paper reports on findings from a large study of residents living with dementia in ECH. The focus is on the potential benefits and challenges of different models of provision. Data were generated from interviews with 100 participants (residents, family members, staff, and adult social care professionals) at eight case study sites across England. Findings demonstrated that there are potential benefits and challenges within each model, but the limited diversity of stock limits choice. Multiple variables beyond the model of provision affect the lived experience, meaning that there is no universal model of optimal support. Rather, the approach and resources of each site is more important than the model of provision. Suggestions for future research directions are considered.
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Affiliation(s)
| | - Teresa Atkinson
- Association for Dementia Studies, University of Worcester, UK
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Fallon L, Lau AY, Ciccia D, Duckworth TJ, Pereira C, Kopp E, Perica V, Sherman KA. Perceived challenges in treatment decision-making for endometriosis: healthcare professional perspectives. Health Psychol Behav Med 2024; 12:2383469. [PMID: 39100426 PMCID: PMC11295683 DOI: 10.1080/21642850.2024.2383469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/13/2024] [Indexed: 08/06/2024] Open
Abstract
Background Endometriosis, a systemic chronic inflammatory condition which has no cure, has a high symptom burden that can negatively impact every facet of life. Given the absence of a gold-standard treatment, the best symptom management regimen in endometriosis is heavily reliant on a patient's values and preferences, making shared decision-making (SDM) vital. However, a comprehensive patient decision aid (PtDA) intervention that could facilitate patient decision-making and promote SDM is lacking in endometriosis, and there is little research on the decisional support needs of individuals with this condition. This qualitative study aimed to explore healthcare professional (HP) perspectives of their clients' decisional support needs when choosing treatments to manage endometriosis symptoms, with a view to evaluating the need for a PtDA. Methods Australian HPs identified as specialising in endometriosis care (N = 13) were invited to participate in a short interview over the Internet by phone. Questions focussed on perceived facilitators and challenges of decision-making when choosing treatments for endometriosis. Transcribed qualitative data were thematically analysed and verified by multiple coders, using the template approach. Results Four themes were identified: (1) Identifying and setting priorities; (2) HPs' lack of time and perceived lack of knowledge; (3) Patient-centred care and SDM, including patient capacity; and (4) Decision-making blinded by hope. This is the first known study to explore HPs' perspectives on patient decision-making challenges in endometriosis. Discussion Findings draw attention to the difficulties people with endometriosis experience when assessing and choosing treatments, highlighting the need for a comprehensive PtDA intervention to support this decision-making.
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Affiliation(s)
- Lynda Fallon
- School of Psychological Sciences, Macquarie University, Sydney, Australia
- Lifespan Health and Wellbeing Research Centre, Sydney, Australia
| | - Annie Y.S. Lau
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Donna Ciccia
- National Institute of Complementary Medicine (NICM), Health Research Institute, Western Sydney University, Sydney, Australia
- Endometriosis Australia, Sydney, Australia
| | - Tanya Jane Duckworth
- Endometriosis Australia, Sydney, Australia
- School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Chantelle Pereira
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emily Kopp
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Valentina Perica
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Kerry A. Sherman
- School of Psychological Sciences, Macquarie University, Sydney, Australia
- Lifespan Health and Wellbeing Research Centre, Sydney, Australia
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7
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Doidge C, Ånestad LM, Burrell A, Frössling J, Palczynski L, Pardon B, Veldhuis A, Bokma J, Carmo LP, Hopp P, Guelbenzu-Gonzalo M, Meunier NV, Ordell A, Santman-Berends I, van Schaik G, Kaler J. A Living Lab approach to understanding dairy farmers' technology and data needs to improve herd health: Focus groups from 6 European countries. J Dairy Sci 2024; 107:5754-5778. [PMID: 38490555 DOI: 10.3168/jds.2024-24155] [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: 09/04/2023] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
For successful development and adoption of technology on dairy farms, farmers need to be included in the innovation process. However, the design of agricultural technologies usually takes a top-down approach with little involvement of end-users at the early stages. Living Labs offer a methodology that involve end-users throughout the development process and emphasize the importance of understanding users' needs. Currently, exploration of dairy farmers' technology needs has been limited to specific types of technology (e.g., smartphone apps) and adult cattle. The aim of this study was to use a Living Lab approach to identify dairy farmers' data and technology needs to improve herd health and inform innovation development. We conducted 18 focus groups with a total of 80 dairy farmers from Belgium, Ireland, the Netherlands, Norway, Sweden, and the United Kingdom. Data were analyzed using Template Analysis, and 6 themes were generated representing the fundamental needs of autonomy, comfort, competence, community and relatedness, purpose, and security. Farmers favored technologies that provided them with convenience, facilitated their knowledge and understanding of problems on farm, and allowed them to be self-reliant. Issues with data sharing and accessibility and usability of software were barriers to technology use. Furthermore, farmers were facing problems around recruitment and management of labor and needed ways to reduce stress. Controlling aspects of the barn environment, such as air quality, hygiene, and stocking density, were particular concerns in relation to youngstock management. Overall, the findings suggest that developers of farm technologies may want to include farmers in the design process to ensure a positive user experience and improve accessibility. The needs identified in this study can be used as a framework when designing farm technologies to strengthen need satisfaction and reduce any potential harm toward needs.
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Affiliation(s)
- C Doidge
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington LE12 5RD, United Kingdom.
| | - L M Ånestad
- Norwegian Veterinary Institute, 1431 Ås, Norway
| | - A Burrell
- Animal Health Ireland, Carrick-on-Shannon, Co. Leitrim N41 WN27, Ireland
| | - J Frössling
- Department of Epidemiology, Surveillance and Risk Assessment, Swedish Veterinary Agency (SVA), 751 89 Uppsala, Sweden; Department of Applied Animal Science and Welfare, Swedish University of Agricultural Sciences (SLU), 532 23 Skara, Sweden
| | - L Palczynski
- Innovation for Agriculture, Stoneleigh Park, Warwickshire CV8 2LZ, United Kingdom
| | - B Pardon
- Department of Internal Medicine, Reproduction, and Population Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
| | - A Veldhuis
- Royal GD, 7400 AA Deventer, the Netherlands
| | - J Bokma
- Department of Internal Medicine, Reproduction, and Population Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
| | - L P Carmo
- Norwegian Veterinary Institute, 1431 Ås, Norway
| | - P Hopp
- Norwegian Veterinary Institute, 1431 Ås, Norway
| | | | - N V Meunier
- Animal Health Ireland, Carrick-on-Shannon, Co. Leitrim N41 WN27, Ireland
| | - A Ordell
- Department of Epidemiology, Surveillance and Risk Assessment, Swedish Veterinary Agency (SVA), 751 89 Uppsala, Sweden
| | | | - G van Schaik
- Royal GD, 7400 AA Deventer, the Netherlands; Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, the Netherlands
| | - J Kaler
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington LE12 5RD, United Kingdom
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Rathi N, Kansal S, Worsley A. Indian fathers' perceptions of young childcare and feeding - A qualitative study. Appetite 2024; 199:107404. [PMID: 38723669 DOI: 10.1016/j.appet.2024.107404] [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: 08/14/2023] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024]
Abstract
The role of parents in fostering children's healthy habits is a robust area of research. However, most of the existing literature predominantly focuses on mothers' parenting practices. Given the emergence of nuclear, dual earning families and the recent surge in maternal employment in urban India, fathers' engagement in child rearing and feeding warrants attention. The purpose of this research was to document the views of Indian fathers about paternal parenting practices, with an emphasis on children's diet among other health behaviors. Thirty-three fathers of children aged 6-59 months from Kolkata, India took part in semi-structured interviews conducted either face-to-face or over Zoom/telephone in Hindi, Bengali, and English. The interviews were audio recorded, transcribed verbatim, and translated to English. The transcribed data were subjected to thematic analysis informed by the Template Analysis technique. Themes were detected using the NVivo software program. Overall, these Indian fathers played an important role in early childhood care and feeding as reflected in the following seven themes: (i) Involvement of fathers in various childcare activities; (ii) Implementation of responsive and non-responsive feeding practices; (iii) Concerns regarding fussy and slow eating; (iv) Concerns regarding excessive screen time; (v) Paternal vs maternal parenting; (vi) Barriers to routine engagement of fathers in childcare; (vii) Desire for more nutrition and health knowledge. This enhanced understanding of paternal parenting behavior supports the inclusion of fathers in future family-focused lifestyle interventions aimed at improving children's health outcomes, including their dietary habits.
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Affiliation(s)
- Neha Rathi
- Department of Home Science, Mahila Maha Vidyalaya, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.
| | - Sangeeta Kansal
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
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9
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Miller LJ, Halliday V, Snowden JA, Aithal GP, Lee J, Greenfield DM. Health professional attitudes and perceptions of prehabilitation and nutrition before haematopoietic cell transplantation. J Hum Nutr Diet 2024; 37:1007-1021. [PMID: 38696512 DOI: 10.1111/jhn.13315] [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: 12/20/2023] [Accepted: 04/20/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Nutritional prehabilitation may improve haematopoietic cell transplantation (HCT) outcomes, although little evidence exists. The present study aimed to understand healthcare professional (HCP) perceptions of prehabilitation and nutritional care pre-HCT in UK centres. METHODS An anonymous online survey (developed and refined via content experts and piloting) was administered via email to multidisciplinary HCPs in 39 UK adult centres, between July 2021 and June 2022. Data are presented as proportions of responses. Routine provision denotes that care was provided >70% of time. RESULTS Seventy-seven percent (n = 66) of HCPs, representing 61.5% (n = 24) of UK adult HCT centres, responded. All HCPs supported prehabilitation, proposing feasible implementation between induction chemotherapy (60.4%; n = 40) and first HCT clinic (83.3%; n = 55). Only 12.5% (n = 3) of centres had a dedicated prehabilitation service. Nutrition (87.9%; n = 58), emotional wellbeing (92.4%; n = 61) and exercise (81.8%; n = 54) were considered very important constituents. HCPs within half of the HCT centres (n = 12 centres) reported routine use of nutrition screening pre-HCT with a validated tool; 66.7% of HCPs (n = 36) reported using the malnutrition universal screening tool (MUST). Sixty-two percent (n = 41) of HCPs reported those at risk, received nutritional assessments, predominantly by dietitians (91.6%; n = 22) using the dietetic care process (58.3%; n = 14). Body mass index (BMI) was the most frequently reported body composition measure used by HCPs (70.2%, n = 33). Of 59 respondents, non-dietitians most routinely provided dietary advice pre-HCT (82.4%; n = 28 vs. 68%; n = 17, p = 0.2); including high-energy/protein/fat and neutropenic diet advice. Prophylactic enteral feeding pre-HCT was rare, indicated by low BMI and significant unintentional weight loss. Just under half (n = 25 of 59, 42.4%) HCPs reported exercise advice was given routinely pre-HCT. CONCLUSIONS Nutrition and prehabilitation pre-HCT are considered important and deliverable by HCPs, but current provision in UK centres is limited and inconsistent.
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Affiliation(s)
- Laura J Miller
- Department of Dietetics and Nutrition, Nottingham University Hospitals NHS Trust, Nottingham, UK
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Vanessa Halliday
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - John A Snowden
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- British Society of Blood and Marrow Transplantation & Cellular Therapy (BSBMTCT), London, UK
| | - Guruprasad P Aithal
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Julia Lee
- British Society of Blood and Marrow Transplantation & Cellular Therapy (BSBMTCT), London, UK
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O'Driscoll C, Azmoodeh K, Rana R, Hardy G. The identity of clinical associates in psychology: a cross sectional, national survey. BMC MEDICAL EDUCATION 2024; 24:825. [PMID: 39085904 PMCID: PMC11293191 DOI: 10.1186/s12909-024-05802-7] [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: 08/21/2023] [Accepted: 07/21/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND The Clinical Associate in Psychology (CAP) is a new psychological profession within the National Health Service (NHS) in the United Kingdom. This paper considers the processes developing the CAPs' professional identity, specifically how their roles are embedded within services. METHODS This study utilised an online survey of CAPs and all academic, clinical and managerial staff involved with CAPs. An inductive thematic analysis was undertaken. RESULTS A total of 164 participants responded to the survey. Five themes were identified: Widening Access to Psychology, Workforce Development, Navigating the Unfamiliar, Trained [Master's level] Professionals and An Emerging Ethos. In addition, key skills and unique contributions from CAPs were identified. CONCLUSIONS A clear professional identity is emerging, with CAPs depicted as offering versatile interventions in diverse health care settings, fostering a positive and encouraging integration of psychological expertise into the healthcare service. The study highlights areas for development to facilitate the growth and advancement of the role within the psychological workforce.
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Affiliation(s)
- Ciarán O'Driscoll
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, UK.
| | - Kiana Azmoodeh
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, UK
| | | | - Gillian Hardy
- Centre for Psychological Services Research, Department of Psychology, University of Sheffield, Sheffield, UK
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Belhomme N, Lescoat A, Launey Y, Robin F, Pottier P. "With Great Responsibility Comes Great Uncertainty". J Gen Intern Med 2024:10.1007/s11606-024-08954-w. [PMID: 39085579 DOI: 10.1007/s11606-024-08954-w] [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: 02/12/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Uncertainty is inherent in medicine, and trainees are particularly exposed to the adverse effects of uncertainty. Previous work suggested that junior residents seek to leverage the support of supervisors to regulate the uncertainty encountered in clinical placements. However, a broader conceptual framework addressing uncertainty experience, from the sources of uncertainty to residents' responses, is still needed. OBJECTIVE To capture the spectrum of uncertainty experiences in medical residents, providing an integrative framework that considers the influence of specialties and training stages on their experience with clinical uncertainty. DESIGN We used Hillen's uncertainty tolerance framework to conduct a thematic template analysis of individual and focus group interviews, identifying themes and subthemes reflecting residents' experience of clinical uncertainty. PARTICIPANTS Medical residents from diverse medical specialty training programs, across five French medical schools. APPROACH Qualitative study driven by an interpretivist research paradigm. RESULTS Twenty residents from all years of medical residency and diverse medical specialties were interviewed during three focus groups and five individual interviews. They described managing treatments, making ethical decisions, and communicating uncertainty, as their major sources of uncertainty. We identified residents' delayed response to uncertainty as a key theme, fostering the development of experiential learnings. Prior clinical experience was a key determinant of uncertainty tolerance in medical residents. Entrusting residents with responsibilities in patient management promoted their perception of self-efficacy, although situations of loneliness resulted in stress and anxiety. CONCLUSION Residents face significant uncertainty in managing treatments, ethical decisions, and communication due to limited clinical experience and growing responsibilities. Scaffolding their responsibilities and clearly defining their roles can improve their comfort with uncertainty. To that extent, effective supervision and debriefing are crucial for managing emotional impacts and fostering reflection to learn from their uncertain experiences.
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Affiliation(s)
- Nicolas Belhomme
- Service de Médecine Interne et Immunologie Clinique, CHU Rennes, Université Rennes, Rennes, France.
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France.
- LISEC (Laboratoire Interuniversitaire des Sciences de l'Education et de la Communication) - UR_2310, Université de Strasbourg, Strasbourg, France.
| | - Alain Lescoat
- Service de Médecine Interne et Immunologie Clinique, CHU Rennes, Université Rennes, Rennes, France
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | - Yoann Launey
- Réanimation chirurgicale, Département d'Anesthésie-Réanimation-Médecine Périopératoire, CHU Rennes, Université Rennes, Rennes, France
| | - François Robin
- Service de Rhumatologie, CHU Rennes, Université Rennes, INSERM, U 1241, Institut NuMeCan (Nutrition Metabolisms and Cancer), Rennes, France
| | - Pierre Pottier
- Service de Médecine Interne et Immunologie Clinique, CHU Nantes, 1 Place Alexis-Ricordeau, 44000, Nantes, France
- Faculté de Médecine-Pôle Santé, Nantes Université, Nantes, France
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12
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Bijker R, Merkouris SS, Dowling NA, Rodda SN. ChatGPT for Automated Qualitative Research: Content Analysis. J Med Internet Res 2024; 26:e59050. [PMID: 39052327 DOI: 10.2196/59050] [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: 03/31/2024] [Revised: 05/08/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Data analysis approaches such as qualitative content analysis are notoriously time and labor intensive because of the time to detect, assess, and code a large amount of data. Tools such as ChatGPT may have tremendous potential in automating at least some of the analysis. OBJECTIVE The aim of this study was to explore the utility of ChatGPT in conducting qualitative content analysis through the analysis of forum posts from people sharing their experiences on reducing their sugar consumption. METHODS Inductive and deductive content analysis were performed on 537 forum posts to detect mechanisms of behavior change. Thorough prompt engineering provided appropriate instructions for ChatGPT to execute data analysis tasks. Data identification involved extracting change mechanisms from a subset of forum posts. The precision of the extracted data was assessed through comparison with human coding. On the basis of the identified change mechanisms, coding schemes were developed with ChatGPT using data-driven (inductive) and theory-driven (deductive) content analysis approaches. The deductive approach was informed by the Theoretical Domains Framework using both an unconstrained coding scheme and a structured coding matrix. In total, 10 coding schemes were created from a subset of data and then applied to the full data set in 10 new conversations, resulting in 100 conversations each for inductive and unconstrained deductive analysis. A total of 10 further conversations coded the full data set into the structured coding matrix. Intercoder agreement was evaluated across and within coding schemes. ChatGPT output was also evaluated by the researchers to assess whether it reflected prompt instructions. RESULTS The precision of detecting change mechanisms in the data subset ranged from 66% to 88%. Overall κ scores for intercoder agreement ranged from 0.72 to 0.82 across inductive coding schemes and from 0.58 to 0.73 across unconstrained coding schemes and structured coding matrix. Coding into the best-performing coding scheme resulted in category-specific κ scores ranging from 0.67 to 0.95 for the inductive approach and from 0.13 to 0.87 for the deductive approaches. ChatGPT largely followed prompt instructions in producing a description of each coding scheme, although the wording for the inductively developed coding schemes was lengthier than specified. CONCLUSIONS ChatGPT appears fairly reliable in assisting with qualitative analysis. ChatGPT performed better in developing an inductive coding scheme that emerged from the data than adapting an existing framework into an unconstrained coding scheme or coding directly into a structured matrix. The potential for ChatGPT to act as a second coder also appears promising, with almost perfect agreement in at least 1 coding scheme. The findings suggest that ChatGPT could prove useful as a tool to assist in each phase of qualitative content analysis, but multiple iterations are required to determine the reliability of each stage of analysis.
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Affiliation(s)
- Rimke Bijker
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | | | | | - Simone N Rodda
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
- School of Psychology, Deakin University, Burwood, Australia
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13
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Pembroke L, Sherman KA, Dhillon HM, Francis H, Gillatt D, Gurney H. Online Group Cognitive Rehabilitation Program for Prostate Cancer Survivors: Development Using Codesign and the Theoretical Domains Framework. Semin Oncol Nurs 2024:151695. [PMID: 39054190 DOI: 10.1016/j.soncn.2024.151695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES This study aimed to describe the adaptation of a group cognitive rehabilitation program for prostate cancer survivors (PCS) via telehealth delivery using a codesign approach with PCS experiencing cancer-related cognitive impairment. The Theoretical Domains Framework (TDF) also informed the intervention development. METHODS Intervention development consisted of three steps: 1) Adapting an existing cancer-related cognitive rehabilitation program for PCS; 2) Conducting a codesign focus group workshop to gather feedback that was analyzed using a template approach; and 3) Incorporation of consumer feedback to refine the program for future piloting in PCS. Components of the finalized intervention were mapped onto the TDF domains. RESULTS Six PCS were involved in the codesign focus group workshop, providing feedback on program structure, the topics and its order, and rehabilitation activities. A manualized four-week online group cognitive rehabilitation program titled "Promoting Cognitive Wellbeing in Prostate Cancer Survivors (ProCog)" was developed. Four sessions of 2-hours' duration were designed exploring: cognitive/brain functions; the impact of cancer treatments and ageing; the relationship between thoughts, feelings and behaviors; values-based goal-setting; and skills/strategies to manage fatigue and improve attention, memory, aspects of executive functioning, and emotional functioning. CONCLUSIONS Consumer input and guidance from the TDF ensures a robust development process for the online ProCog intervention, designed for and with PCS experiencing cognitive difficulties. As an important initial step before piloting, this adaptation and development process ensures that ProCog addresses consumer needs and preferences and targets factors increasing behavior change. IMPLICATIONS FOR NURSING PRACTICE This research raises awareness of possible cancer-related cognitive impairments in prostate cancer survivors and strategies for rehabilitation. ProCog is an accessible online intervention that nurses can use to refer patients needing cognitive rehabilitation.
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Affiliation(s)
- Lorna Pembroke
- Lifespan Health and Wellbeing Research Centre, Macquarie University, New South Wales, Australia; School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University & Macquarie University Hospital, New South Wales, Australia.
| | - Kerry A Sherman
- Lifespan Health and Wellbeing Research Centre, Macquarie University, New South Wales, Australia; School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University & Macquarie University Hospital, New South Wales, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia; Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - Heather Francis
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University & Macquarie University Hospital, New South Wales, Australia
| | - David Gillatt
- Macquarie University Urology Clinic, Faculty of Medicine and Health Sciences, Macquarie, University & Macquarie University Hospital, New South Wales, Australia
| | - Howard Gurney
- Macquarie University Clinical Trials Unit (CTU), Faculty of Medicine and Health Sciences, Macquarie University & Macquarie University Hospital, New South Wales, Australia
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14
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Brown CEB, Richardson K, Halil-Pizzirani B, Hughes S, Atkins L, Perowne R, Pitt J, Yücel M, Segrave RA. Developing the PEAK mood, mind, and marks program to support university students' mental and cognitive health through physical exercise: a qualitative study using the Behaviour Change Wheel. BMC Public Health 2024; 24:1959. [PMID: 39039474 PMCID: PMC11265317 DOI: 10.1186/s12889-024-19385-x] [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: 01/31/2024] [Accepted: 07/05/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Concerns about mental and cognitive health are common among university students. Engaging in regular physical exercise has been shown to enhance both mental health and cognitive performance, yet most students are not participating in the level of exercise required to obtain these benefits. The Behaviour Change Wheel (BCW) provides a framework for developing behavioural interventions that are informed by theory, evidence, and stakeholder perspectives. The current study aimed to apply the BCW to develop the PEAK Mood, Mind, and Marks program (i.e., PEAK), a behaviour change intervention designed to increase university students' exercise engagement for the benefit of their mental and cognitive health. METHODS PEAK was developed across three stages of the BCW: (1) understand the target behaviour, (2) identify intervention options, and (3) identify intervention content and delivery mode. Development was informed by triangulated data from a systematic literature review, co-design consultations with key stakeholders, and knowledge of relevant experts. Consultations with stakeholders involved focus groups with 25 university students and individual interviews with 10 university leaders and staff to identify barriers and facilitators to students' exercise engagement and the adoption and implementation of PEAK by universities. Template analysis was used to code transcripts to the capability, opportunity, and motivation (COM-B) model of behaviour. The BCW was applied to identify the most appropriate intervention types and behaviour change techniques (BCTs). RESULTS Thirty-one barriers and facilitators were identified and mapped to seven intervention types (Education; Modelling; Persuasion; Environmental Restructuring; Incentivisation; Training; and Enablement) and 26 BCTs, which were delivered across digital channels and in-person. The final intervention consisted of multiple components targeting students' capability (e.g., increasing knowledge about the mental and cognitive health benefits of exercise), opportunity (e.g., providing a flexible range of accessible exercise options and social support), and motivation (e.g., increasing the perceived importance of exercise) to exercise. CONCLUSIONS University students and staff describe a need and appetite for more empowering, scalable solutions to support students' mental and cognitive health. Exercise-based approaches that are informed by behaviour change frameworks, evidence, and stakeholder perspectives, such as PEAK, have the potential to address this need. Current findings will inform a pilot of PEAK to evaluate its efficacy and implementation.
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Affiliation(s)
- Catherine E B Brown
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.
| | - Karyn Richardson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | | | - Sam Hughes
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Lou Atkins
- Centre for Behaviour Change, University College London, London, UK
| | - Rachel Perowne
- Centre for Behaviour Change, University College London, London, UK
| | - Joseph Pitt
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Murat Yücel
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, QLD, Australia
| | - Rebecca A Segrave
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
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Sauerzopf L, Luft A, Maeusli V, Klamroth-Marganska V, Sy M, Spiess MR. Technology Use for Home-Based Stroke Rehabilitation in Switzerland From the Perspectives of Persons Living With Stroke, Informal Caregivers, and Therapists: Qualitative Interview and Focus Group Study. JMIR Rehabil Assist Technol 2024; 11:e59781. [PMID: 39024576 PMCID: PMC11294768 DOI: 10.2196/59781] [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: 04/28/2024] [Revised: 05/31/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Stroke is a leading cause for long-term disability, requiring both inpatient and outpatient rehabilitation and self-training in the home environment. Technology-based tools are gradually gaining acceptance as additional and suitable options for extending the rehabilitation process. While the experiences of persons living with stroke, therapists, and informal caregivers with respect to technology use have already been investigated in other countries, this topic is underexplored in the Swiss context. OBJECTIVE We aimed to explore the experiences and needs of persons living with stroke, informal caregivers, and therapists in using technology-based tools in a home environment for stroke rehabilitation in Switzerland. METHODS This study followed a qualitative descriptive methodology, including semistructured interviews and focus group discussions. We applied a deductive template analysis alongside the accessibility, adaptability, accountability, and engagement framework to analyze the qualitative data sets for technology-assisted solutions for poststroke rehabilitation. RESULTS We collected the experiences and needs of persons living with stroke (7/23, 30%), informal caregivers (4/23, 17%), and therapists (occupational and physical therapists; 12/23, 52%). The 4 categories we used to organize the analysis and results were accessibility to quality rehabilitation, adaptability to patient differences, accountability or compliance with rehabilitation, and engagement with rehabilitation. Persons living with stroke stated that they use various tools within their rehabilitation process depending on their specific needs. They felt that there is a plethora of tools available but sometimes felt overwhelmed with the selection process. Informal caregivers indicated that they generally felt underserved and insufficiently informed throughout the rehabilitation process. They reported that they use technology-based tools to support their relatives affected by stroke in becoming more independent. Therapists appreciate the numerous possible applications of technology-based tools in rehabilitation. At the same time, however, they express dissatisfaction with the lack of clarity in Switzerland regarding cost coverage, recommendations, and training opportunities. CONCLUSIONS Persons living with stroke, informal caregivers, and therapists in Switzerland reported varied and unique experiences and needs with the use of technology-based tools in outpatient stroke rehabilitation. Written recommendations, the assumption of financial costs, and the provision of information and education could foster increased confidence in the use of technology-based tools for patients and therapists.
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Affiliation(s)
- Lena Sauerzopf
- Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Andreas Luft
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University of Zurich, Zurich, Switzerland
| | - Valeria Maeusli
- Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | | | - Michael Sy
- Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Martina Rebekka Spiess
- Institute of Occupational Therapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
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Rose DM, Sieck CJ, Kaur A, Wheeler KK, Sullivan L, Yang J. Factors Influencing Participation and Engagement in a Teen Safe Driving Intervention: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:928. [PMID: 39063504 PMCID: PMC11276654 DOI: 10.3390/ijerph21070928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
(1) Background: Few teen driving safety programs focus on increasing parental engagement with high-risk teen drivers, specifically those with a traffic violation. This study explored parents'/guardians' ('parents') experiences with a teen driving safety program, ProjectDRIVE, including facilitators and barriers to program engagement. (2) Methods: We conducted virtual, semi-structured interviews with parents who completed ProjectDRIVE, which included in-vehicle driving feedback technology and individualized virtual training with parents on effective parent-teen communication. (3) Results: Twenty interviews (with 17 females and three males) were transcribed verbatim and independently coded by three coders using systematic, open, and focused coding. Three major themes were identified: factors influencing a parent's initial decision to participate, factors influencing continued engagement, and perceived benefits of participation. The decision to participate was influenced by these subthemes: parental motivation to help their teen, perceived program usefulness, program endorsement, program incentives, parents' busy schedules, and lack of access to a car/internet. Subthemes impacting continued engagement included enhanced communication skills, teen willingness to engage, strong parental engagement, and teens' other priorities. Perceived benefits included greater self-efficacy in communication, improved communication patterns and frequency, and enhanced parent-teen relationships. (4) Conclusions: These findings may set the foundation for developing and implementing future court-ordered parent-based teen safe driving programs for teens with traffic citations.
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Affiliation(s)
- Dominique M. Rose
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (D.M.R.); (A.K.); (K.K.W.)
| | - Cynthia J. Sieck
- Center for Health Equity, Dayton Children’s Hospital, Dayton, OH 45404, USA;
- Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA
| | - Archana Kaur
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (D.M.R.); (A.K.); (K.K.W.)
| | - Krista K. Wheeler
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (D.M.R.); (A.K.); (K.K.W.)
| | - Lindsay Sullivan
- Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Jingzhen Yang
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA; (D.M.R.); (A.K.); (K.K.W.)
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
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17
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Debets MPM, Jansen I, Diepeveen M, Bogerd R, Molewijk BAC, Widdershoven GAM, Lombarts KMJMH. Compassionate care through the eyes of patients and physicians: An interview study. PLoS One 2024; 19:e0305007. [PMID: 38985731 PMCID: PMC11236150 DOI: 10.1371/journal.pone.0305007] [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: 06/27/2023] [Accepted: 05/21/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Although compassion is a crucial element of physicians' professional performance and high-quality care, research shows it often remains an unmet need of patients. Understanding patients' and physicians' perspectives on compassionate care may provide insights that can be used to foster physicians' ability to respond to patients' compassion needs. Therefore, this study aims to understand how both patients and physicians experience the concept and practice of compassionate care. METHODS We conducted semi-structured interviews with eight patients and ten resident physicians at a University Medical Center in the Netherlands. Using thematic analysis, we separately coded patient and resident transcripts to identify themes capturing their experiences of compassionate care. This study was part of a larger project to develop an educational intervention to improve compassion in residents. RESULTS For both patients and residents, we identified four themes encompassing compassionate care: being there, empathizing, actions to relieve patients' suffering, and connection. For residents, a fifth theme was professional fulfillment (resulting from compassionate care). Although patients and residents both emphasized the importance of compassionate care, patients did not always perceive the physician-patient encounter as compassionate. According to residents, high workloads and time pressures hindered their ability to provide compassionate care. DISCUSSION AND CONCLUSION Patients and residents have similar and varying understandings of compassionate care at the same time. Understanding these differences can aid compassion in medical practice. Based on the findings, three topics are suggested to improve compassion in residents: (1) train residents how to ask for patients' compassion needs, (2) address residents' limiting beliefs about the concept and practice of compassion, and (3) acknowledge the art and science of medicine cannot be separated.
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Affiliation(s)
- Maarten P. M. Debets
- Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Quality of Care, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Iris Jansen
- Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Quality of Care, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Mariëlle Diepeveen
- Quality of Care, Amsterdam Public Health, Amsterdam, the Netherlands
- Ethics, Law and Humanities, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Rosa Bogerd
- Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Quality of Care, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Bert A. C. Molewijk
- Quality of Care, Amsterdam Public Health, Amsterdam, the Netherlands
- Ethics, Law and Humanities, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Guy A. M. Widdershoven
- Quality of Care, Amsterdam Public Health, Amsterdam, the Netherlands
- Ethics, Law and Humanities, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Kiki M. J. M. H. Lombarts
- Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Quality of Care, Amsterdam Public Health, Amsterdam, the Netherlands
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Heier L, Weiß J, Heuser C, Nakata H, Brock-Midding E, Horbach-Bremen R, Brümmendorf TH, Brüne M, Dohmen M, Drueke B, Geiser F, Holsteg S, Icks A, Karger A, Panse J, Petermann-Meyer A, Viehmann A, Ernstmann N. Communication patterns in families affected by parental cancer from the healthy parents' perspective-process evaluation of the complex intervention Family-SCOUT. Support Care Cancer 2024; 32:500. [PMID: 38985388 PMCID: PMC11236872 DOI: 10.1007/s00520-024-08705-x] [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: 03/20/2024] [Accepted: 07/01/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE Within families affected by parental cancer, open communication impacts the well-being of parents and their children; however, limited research exists on communication patterns in these families. This sub-study addresses this through the Family-SCOUT study, a multicenter, prospective, interventional, and non-randomized investigation with intervention (IG) and control group (CG). The purpose of this sub-study was to identify and compare the differences in communication patterns between the IG and CG as part of the process evaluation. The research question was addressed in both groups: What communication patterns do healthy parents perceive within their families? METHODS Using a qualitative approach, the study involved interviewing healthy parents as surrogates for their families. The interviews were audio-recorded, transcribed, and coded using a template analysis. The resulting data were analyzed at the group level. RESULTS Twenty-three interviews were conducted in the IG and 27 interviews in the CG. The analysis of themes centered on communication patterns as seen in the family structure. Both groups exhibited instances of open communication about fears and wishes as well as the use of child-friendly language when discussing cancer. Notable differences were observed: challenges in open communication with children were sorely reported in CG interviews, and "the illness is discussed when necessary" was sorely described in IG interviews. CONCLUSION This study underscores the need to address and encourage open communication within families with parental cancer.
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Affiliation(s)
- L Heier
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany.
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany.
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, The Netherlands.
- Department of Clinical Pharmacy, Cardiovascular Research Institute Maastricht, CARIM, Maastricht University, Maastricht, The Netherlands.
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Health Services Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - J Weiß
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
| | - C Heuser
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Health Services Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - H Nakata
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
| | - E Brock-Midding
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
| | - R Horbach-Bremen
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - T H Brümmendorf
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - M Brüne
- Center for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - M Dohmen
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - B Drueke
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Institute for Medical Psychology and Medical Sociology, Faculty of Medicine and University Hospital, RWTH Aachen University, Aachen, Germany
| | - F Geiser
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University Bonn, Bonn, Germany
| | - S Holsteg
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - A Icks
- Center for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Munich-Neuherberg, Germany
| | - A Karger
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - J Panse
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - A Petermann-Meyer
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - A Viehmann
- Center for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - N Ernstmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, University Hospital Bonn, University Bonn, Bonn, Germany
- Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO-ABCD), Aachen, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair of Health Services Research, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Neelakantan L, Fry D, Florian L, Silion D, Filip M, Thabeng M, Te K, Sunglao JA, Lu M, Ward CL, Baban A, Jocson RM, Peña Alampay L, Meinck F. "We don't know how to talk": Adolescent meaning making and experiences of participating in research on violence in Romania, South Africa, and the Philippines. CHILD ABUSE & NEGLECT 2024:106931. [PMID: 38972820 DOI: 10.1016/j.chiabu.2024.106931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 06/02/2024] [Accepted: 06/28/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Current evidence on adolescent participation in violence research has primarily measured distress, harm or upset using quantitative methods. There are relatively few studies which have employed qualitative methods to understand adolescent emotional experiences, and to articulate the experiences of participation from their own perspective. OBJECTIVE This study aimed to assess adolescents' experiences of participating in research on violence in different contexts, namely Romania, South Africa, and the Philippines. METHODS A purposive sample of adolescents (N = 53, 51 % female) were recruited from rural, urban, and peri-urban areas in Romania, the Eastern Cape Province of South Africa, and Metro Manila, Philippines. Semi-structured one-on-one in-depth interviews and drawings sought adolescent perspectives on their experiences of participation, including the emotions they felt, and their perceptions of research on violence. RESULTS Drawing on analysis of interviews and drawings, adolescents reported a layered emotional experience, ranging from sadness, anger, apprehension, and upset, to joy, relief, and laughter. Their emotional experiences were driven by participation as a relational encounter, both with the researchers involved, as well as with other children and young people they encountered. Adolescents emphasized participation as enabling disclosure of difficult experiences, and the creation of awareness of violence. CONCLUSIONS Adolescent perspectives of participation in research on violence are nuanced and encompass their lived experience as well as the fundamentally relational nature of participation. Adolescents experienced increased awareness of topics in violence and perceived research participation as enabling disclosure and possible help-seeking. Measures of participation impact developed along with adolescents, which reflect this complexity, are needed.
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Affiliation(s)
- Lakshmi Neelakantan
- Population Mental Health Unit, Centre for Mental Health and Community Wellbeing, School of Population and Global Health, University of Melbourne, Australia.
| | - Deborah Fry
- Childlight - Global Child Safety Institute, Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Lani Florian
- Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Doriana Silion
- Department of Psychology, Babes-Bolyai University, Romania
| | - Madalina Filip
- Department of Psychology, Babes-Bolyai University, Romania
| | | | - Kathlyn Te
- Department of Psychology, Ateneo de Manila University, Philippines
| | | | - Mengyao Lu
- Childlight - Global Child Safety Institute, Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Catherine L Ward
- Department of Psychology & Safety and Violence Initiative, University of Cape Town, South Africa.
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Romania
| | - Rosanne M Jocson
- National Institute of Education, Nanyang Technological University, Singapore.
| | | | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, UK; OPTENTIA, Faculty of Health Sciences, North-West University, Vanderbijlpark, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
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20
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Pope L, Rose KL. "It's All Just F*cking Impossible:" The influence of Taylor Swift on fans' body image, disordered eating, and rejection of diet culture. Soc Sci Med 2024; 355:117100. [PMID: 39094218 DOI: 10.1016/j.socscimed.2024.117100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/01/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024]
Abstract
Taylor Swift is arguably one of the most popular and influential celebrities. Of particular interest is her power as a role model for millions of fans across the world. Swift has spoken openly about different cultural issues, including her struggles with disordered eating and diet culture. Thus, the purpose of this paper was to explore whether Swift's disclosures of her own eating and body image struggles influenced her fans. Over 200 TikTok and Reddit posts related to Swift and eating disorders or body image, as well as their associated comments, were qualitatively coded to examine relevant themes. Key themes included: 1) Swift as a role model for disordered eating recovery; 2) use of or identification with specific Swift songs to illustrate struggles with eating or body image; 3) continued objectification of Swift's body; and 4) conflicted reaction to a scene in Swift's video for 'Anti-Hero' that depicted the word 'fat' on a scale. Overall, Swift's disclosures of her own eating/body image struggles positively influenced her fans' relationships with their eating behaviors and body image. This analysis illustrates the positive influence celebrities can have while also highlighting the limitations of personal disclosures to impact understanding of systemic issues like anti-fat bias.
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Affiliation(s)
- Lizzy Pope
- University of Vermont, Dept. of Nutrition and Food Sciences, 254 Carrigan Wing, 109 Carrigan Drive, Burlington, VT, 05405, USA.
| | - Kelsey L Rose
- University of Vermont, Dept. of Nutrition and Food Sciences, 254 Carrigan Wing, 109 Carrigan Drive, Burlington, VT, 05405, USA.
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21
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Bouwmans M, Lub X, Orlowski M, Nguyen TV. Developing the digital transformation skills framework: A systematic literature review approach. PLoS One 2024; 19:e0304127. [PMID: 38968253 PMCID: PMC11226094 DOI: 10.1371/journal.pone.0304127] [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: 01/24/2024] [Accepted: 05/06/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Digital transformation (DT) involves integrating digital technologies into organizations to improve productivity, efficiency, and quality. Investing in the workforce's skillsets is essential for successful DT. However, it remains unclear which skillsets are essential. OBJECTIVES This study aims to identify and define the essential skillsets needed for exploiting the full potential of DT, and to consolidate the identified skills into a comprehensive framework of DT skills. METHOD A systematic literature review was conducted using the PRISMA approach for selecting studies. This led to the selection of 36 articles that were examined using thematic analysis for identifying and consolidating skills into a framework. RESULTS The Digital Transformation Skills Framework (DTSF) was developed, which contains six overarching skillsets and 44 underlying skills. The framework covers key skillsets in the areas of digital work, entrepreneurship, evidence-based work, collaboration, communication, and adaptation. CONCLUSION AND DISCUSSION The DTSF offers a comprehensive understanding of essential skills for today's evolving organizations, addressing a critical gap in existing literature. It is valuable for organizations and HR professionals, serving as a foundation for re- and upskilling initiatives. Ongoing research should expand the framework to include domain-specific DT skills and emerging digital technologies.
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Affiliation(s)
- Machiel Bouwmans
- Research Group Organizations in Digital Transition, HU Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Institute for People & Business, HU Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Xander Lub
- Research Group Organizations in Digital Transition, HU Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Research Group Strategy, Organization & Leadership, Nyenrode Business University, Breukelen, The Netherlands
| | - Marissa Orlowski
- MV Hospitality Solutions, LLC, Aurora, Colorado, United States of America
- Department of Marketing, Entrepreneurship, Hospitality and Tourism, Bryan School of Business, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
| | - Thuy-Vy Nguyen
- Institute for People & Business, HU Utrecht University of Applied Sciences, Utrecht, The Netherlands
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22
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Fryer K, Hutt I, Aminu H, Linton E, White J, Reynolds J, Mitchell C. Contextualising and challenging under-representation in research in light of Cultural Trauma: a qualitative focus group and interview study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:69. [PMID: 38956744 PMCID: PMC11218400 DOI: 10.1186/s40900-024-00600-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Although underserved populations- including those from ethnic minority communities and those living in poverty-have worse health and poorer healthcare experiences, most primary care research does not fairly reflect these groups. Patient and public involvement (PPI) is usually embedded within research studies in the United Kingdom (UK), but often fails to represent underserved populations. This study worked with patient and public contributors and local community leaders, situated in a socio-economically deprived and ethnically diverse urban area, to explore under-representation in primary healthcare research. METHODS We undertook a focus group with a purposive sample of 6 members of a Patient and Public Involvement Group (PPIG), and interviews with 4 community leaders (representing Black, South Asian, Roma and socio-economically deprived communities). An iterative analysis process based on template analysis was used. Focus group 1 was rapidly analysed, and a template created. Findings were presented in focus group 2, and the template further developed. The Cultural Trauma concept was than applied to the template to give a wider theoretical lens. In-depth analysis of focus groups and interviews was then performed based on the template. RESULTS Wider societal and historical influences have degraded trust in academic and healthcare institutions within underserved populations. Along with more practical considerations, trust underpins personal motivations to engage with research. Researchers need to invest time and resources in prolonged, mutually beneficial engagement with communities of importance to their research, including sharing power and influence over research priorities. Researcher reflexivity regarding differential power and cultural competencies are crucial. Utilising participatory methodologies including co-production demonstrates a commitment to inclusive study design. CONCLUSIONS Re-framing evidence-based medicine to be more useful and relevant to underserved populations with the highest burden of ill health is urgently needed. Lack of representation in primary healthcare research reflects wider societal inequalities, to which Cultural Trauma provides a useful lens. However, there are actions that researchers can take to widen representation. This will ultimately help achieve the goal of increased health equity by enhancing scientific rigour and research generalizability.
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Affiliation(s)
- Kate Fryer
- Population Health, Research Associate, University of Sheffield, Sheffield, UK.
| | - Isobel Hutt
- Medical Student, University of Sheffield, Sheffield, UK
| | - Habiba Aminu
- Population Health, Research Associate, University of Sheffield, Sheffield, UK
| | - Emma Linton
- Population Health, Academic Clinical Fellow, University of Sheffield, Sheffield, UK
| | | | - Josie Reynolds
- Population Health, Academic Clinical Fellow, University of Sheffield, Sheffield, UK
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23
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Skov SS, Berg ME, Andersen JR, Schou-Juul F, Jensen AMB, Folker AP, Lauridsen S. 'We had conversations we wouldn't have had otherwise'-Exploring home-dwelling people with dementia and family members' experiences of deliberating on ethical issues in a literature-based intervention. J Clin Nurs 2024; 33:2719-2731. [PMID: 38528439 DOI: 10.1111/jocn.17138] [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: 10/26/2023] [Revised: 02/07/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Abstract
AIM To explore home-dwelling people with dementia and family members' perceptions of the feasibility and acceptability of an intervention using dementia-related literature excerpts to facilitate conversations on ethical issues related to living with dementia. BACKGROUND Ethical issues in dementia care emerge throughout the illness. In the early stages, they may involve decisions about disclosing the illness to the family, shifting roles and responsibilities, and considerations of transitioning to a nursing home. Addressing ethical issues and providing adequate support to home-dwelling people with dementia and their families are often lacking. DESIGN An exploratory-descriptive qualitative study. METHODS We conducted eight interviews with 14 home-dwelling persons with dementia and their family caregivers. Six were dyadic interviews, and two were individual interviews with family caregivers. We analysed the interview data using template analysis. We adhered to the COREQ checklist in reporting this study. RESULTS Using excerpts from dementia-related literature was a feasible and acceptable way of initiating discussions on ethical issues among home-dwelling persons with dementia and family caregivers. However, engaging the families of newly diagnosed individuals was challenging due to emotional distress. The intervention provided peer support, including identifying with others and sharing experiences. Moreover, participating couples found intimacy and relational attunement through shared reflections. CONCLUSION Based on the findings, it appears that the participants in this study felt that using excerpts from dementia-related literature to deliberate on ethical issues was feasible and acceptable. Deliberating on ethical issues with peers and family caregivers offers valuable social support and opportunities for strengthening relationships. IMPLICATIONS FOR PATIENT CARE This study makes an important contribution by providing valuable insights into how ethical issues related to living with dementia can be addressed using related literature and suggests how the intervention can be integrated into existing care initiatives for home-dwelling people with dementia and their families. REPORTING METHOD We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION A healthcare professional working as a so-called dementia coordinator (a title used in the Danish context) was involved in the conduct of this study by being responsible for the recruitment of home-dwelling people with dementia and their family members. Moreover, she had joint responsibility for facilitating the intervention along with the first author.
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Affiliation(s)
- Sofie Smedegaard Skov
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Marie Eva Berg
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Frederik Schou-Juul
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anja M B Jensen
- Section for Health Services Research, Center for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sigurd Lauridsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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24
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Meinert E, Milne-Ives M, Lim E, Higham A, Boege S, de Pennington N, Bajre M, Mole G, Normando E, Xue K. Accuracy and safety of an autonomous artificial intelligence clinical assistant conducting telemedicine follow-up assessment for cataract surgery. EClinicalMedicine 2024; 73:102692. [PMID: 39050586 PMCID: PMC11266473 DOI: 10.1016/j.eclinm.2024.102692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
Background Artificial intelligence deployed to triage patients post-cataract surgery could help to identify and prioritise individuals who need clinical input and to expand clinical capacity. This study investigated the accuracy and safety of an autonomous telemedicine call (Dora, version R1) in detecting cataract surgery patients who need further management and compared its performance against ophthalmic specialists. Methods 225 participants were recruited from two UK public teaching hospitals after routine cataract surgery between 17 September 2021 and 31 January 2022. Eligible patients received a call from Dora R1 to conduct a follow-up assessment approximately 3 weeks post cataract surgery, which was supervised in real-time by an ophthalmologist. The primary analysis compared decisions made independently by Dora R1 and the supervising ophthalmologist about the clinical significance of five symptoms and whether the patient required further review. Secondary analyses used mixed methods to examine Dora R1's usability and acceptability and to assess cost impact compared to standard care. This study is registered with ClinicalTrials.gov (NCT05213390) and ISRCTN (16038063). Findings 202 patients were included in the analysis, with data collection completed on 23 March 2022. Dora R1 demonstrated an overall outcome sensitivity of 94% and specificity of 86% and showed moderate to strong agreement (kappa: 0.758-0.970) with clinicians in all parameters. Safety was validated by assessing subsequent outcomes: 11 of the 117 patients (9%) recommended for discharge by Dora R1 had unexpected management changes, but all were also recommended for discharge by the supervising clinician. Four patients were recommended for discharge by Dora R1 but not the clinician; none required further review on callback. Acceptability, from interviews with 20 participants, was generally good in routine circumstances but patients were concerned about the lack of a 'human element' in cases with complications. Feasibility was demonstrated by the high proportion of calls completed autonomously (195/202, 96.5%). Staff cost benefits for Dora R1 compared to standard care were £35.18 per patient. Interpretation The composite of mixed methods analysis provides preliminary evidence for the safety, acceptability, feasibility, and cost benefits for clinical adoption of an artificial intelligence conversational agent, Dora R1, to conduct follow-up assessment post-cataract surgery. Further evaluation in real-world implementation should be conducted to provide additional evidence around safety and effectiveness in a larger sample from a more diverse set of Trusts. Funding This manuscript is independent research funded by the National Institute for Health Research and NHSX (Artificial Intelligence in Health and Care Award, AI_AWARD01852).
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Affiliation(s)
- Edward Meinert
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Health Technology, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Madison Milne-Ives
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Health Technology, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Ernest Lim
- Ufonia Limited, 104 Gloucester Green, Oxford, UK
- Imperial College Healthcare NHS Trust, Western Eye Hospital, London, UK
- Department of Computer Science, University of York, York, UK
| | - Aisling Higham
- Ufonia Limited, 104 Gloucester Green, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Selina Boege
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Health Technology, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | | | - Mamta Bajre
- Oxford Academic Health Science Network, Oxford Science Park, Robert Robinson Ave, Oxford, UK
| | - Guy Mole
- Ufonia Limited, 104 Gloucester Green, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Eduardo Normando
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Kanmin Xue
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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25
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Peters SE, López Gómez MA, Hendersen G, Martínez Maldonado M, Dennerlein J. Feasibility of a Capacity Building Organizational Intervention for Worker Safety and Well-being in the Transportation Industry: Pivoting to Address the COVID-19 Pandemic and Social and Political Unrest in Chile. J Occup Environ Med 2024; 66:e272-e284. [PMID: 38595081 DOI: 10.1097/jom.0000000000003112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study developed, implemented, and evaluated the feasibility of executing an organizational capacity building intervention to improve bus driver safety and well-being in a Chilean transportation company. Method: Through an implementation science lens and using a pre-experimental mixed methods study design, we assessed the feasibility of implementing a participatory organizational intervention designed to build organizational capacity. Result: We identified contextual factors that influenced the intervention mechanisms and intervention implementation and describe how the company adapted the approach for unexpected external factors during the COVID-19 pandemic and social and political unrest experienced in Chile. Conclusions: The intervention enabled the organization to create an agile organizational infrastructure that provided the organization's leadership with new ways to be nimbler and more responsive to workers' safety and well-being needs and was robust in responding to strong external forces that were undermining worker safety and well-being.
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Affiliation(s)
- Susan E Peters
- From the Center for Work, Health, and Well-being, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (S.E.P., J.D.); Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (S.E.P.); Sociology Department, Memorial University of Newfoundland, St. John's, NL, Canada (M.-A.L.G.); Center for Demographic Studies (CED), CED-CERCA, Barcelona, Spain (M.-A.L.G.); College of Osteopathic Medicine, University of New England, Biddeford, Maine (G.H.); Subgerencia de Innovación e Investigación, Mutual de Seguridad CChC, Santiago, Chile (M.M.M.); and Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts (J.D.)
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26
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Bradford BF, Cronin RS, Popoola T, Bright N, Silverio SA. Care, connection, and social distancing: The challenges of baby loss during the COVID-19 pandemic in Aotearoa New Zealand. Women Birth 2024; 37:101622. [PMID: 38744163 DOI: 10.1016/j.wombi.2024.101622] [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: 03/13/2024] [Revised: 04/21/2024] [Accepted: 04/23/2024] [Indexed: 05/16/2024]
Abstract
PROBLEM The COVID-19 pandemic hindered access to routine healthcare globally, prompting concerns about possible increases in pregnancy loss and perinatal death. BACKGROUND PUDDLES is an international collaboration exploring the impact of the COVID-19 pandemic on parents who experience pregnancy loss and perinatal death in seven countries, including Aotearoa New Zealand. AIM To explore parents' experiences of access to healthcare services and support following baby loss during the COVID-19 pandemic in Aotearoa New Zealand. METHODS We conducted in-depth, semi-structured interviews with 26 bereaved parents, including 20 birthing mothers, and six non-birthing parents (one mother and five fathers). Types of loss included 15 stillbirths, four late miscarriages, and one neonatal death. Participant ethnicities were broadly representative of Aotearoa New Zealand's multi-ethnic society. Data were analysed using Template Analysis. FINDINGS Analysis revealed five themes relating to pandemic impact on bereaved parent's experiences. These were: 'Distanced and Impersonal care'; 'Navigating Hospital Rules'; Exclusion of Non-birthing Parents; 'Hindered Access to Social Support'; and 'Continuity of Relational Care'. DISCUSSION The COVID-19 pandemic exacerbated isolation of bereaved parents through perceived impersonal care by healthcare professionals and restrictions on movement hindered access to social and cultural support. Compassionate bending of the rules by healthcare professionals and community postnatal visits by continuity of care midwives following the bereavement appeared to be mitigating factors. CONCLUSION Social isolation is an added challenge for parents experiencing baby loss during a pandemic, which may be mitigated by flexible and compassionate care from healthcare professionals, especially continuity of care midwives.
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Affiliation(s)
- Billie F Bradford
- School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, New Zealand; Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.
| | - Robin S Cronin
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand; Health New Zealand, Te Whatu Ora Counties Manukau, Auckland, New Zealand
| | - Tosin Popoola
- School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, New Zealand; School of Nursing and Midwifery, University of Newcastle, Australia
| | | | - Sergio A Silverio
- Department of Women & Children's Health, King's College London, London, United Kingdom
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Jeffery T, Postavaru GI, Matei R, Meizel K. 'I Have Had to Stop Singing Because I Can't Take the Pain': Experiences of Voice, Ability, and Loss in Singers With Hypermobility Spectrum Disorders. J Voice 2024; 38:966.e19-966.e29. [PMID: 34973894 DOI: 10.1016/j.jvoice.2021.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study explored the voice experience, singing ability, and wellbeing of singers diagnosed with Hypermobility Spectrum Disorder (HSD) or hypermobile Ehlers-Danlos Syndrome (h-EDS). STUDY DESIGN This was a mixed-method study. A purposive sampling strategy was used. Data were collected via an online survey, using written closed and open-ended questions. METHODS 276 adults completed the survey. This study focuses on a subset of professionally-trained singers (n=71). Responses elicited information about participants' voice health and function, symptoms of hypermobility, singing experiences and training. Data were analysed using template analysis. RESULTS Many participants reported wide vocal ranges and enjoyment of singing but 74.6% of participants across all age groups (18-60 years) experienced voice difficulties. Three common themes were identified: (1) 'My unreliable voice': The ups and downs; (2) Wider effects of HSD/h-EDS on singers, and (3) Need for acknowledgment and support. CONCLUSIONS Voice difficulties and hypermobility-related health conditions affected the participants' abilities to sing and perform; this impacted their professional and personal opportunities, communication, relationships, and wellbeing. Our results indicate that symptoms of voice disorder worsen over time. We suggest practical strategies that singers and training providers could implement to support hypermobile singers. More research is needed to fully understand voice difficulties in singers with HSD/H-EDS and to inform tuition and support.
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Affiliation(s)
- Tracy Jeffery
- Department of Education and Lifelong Learning, Bishop Grosseteste University, Lincoln, UK.
| | | | - Raluca Matei
- Department of Organizational Psychology, Birkbeck, University of London, London, UK
| | - Katherine Meizel
- College of Musical Arts, Bowling Green State University, Ohio, USA
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Hendrieckx C, Russell-Green S, Skinner T, Ng AH, Lee C, Barlow S, Davey A, Rogers C, Holmes-Truscott E, Speight J. Diabetes Research Matters: A Three-Round Priority-Setting Survey Consultation with Adults Living with Diabetes and Family Members in Australia. THE PATIENT 2024; 17:441-455. [PMID: 38582797 PMCID: PMC11189946 DOI: 10.1007/s40271-024-00688-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE We aimed to identify the health and quality-of-life research priorities of Australians with diabetes or family members. METHODS Through an iterative, three-step, online survey process we (1) qualitatively generated research topics (long list) in response to one question "What research is needed to support people with diabetes to live a better life?"; (2) determined the most important research questions (short list); and (3) ranked research questions in order of importance (priorities). We aimed to recruit N = 800 participants, with approximate equal representation of diabetes type and family members. RESULTS Participants (N = 661) were adults (aged 18+ years) in Australia with a self-reporting diagnosis of diabetes (type 1, n = 302; type 2, n = 204; prior/current gestational, n = 58; less common types, n = 22, or a family member, n = 75). Retention rates for Surveys 2 and 3 were 47% (n = 295) and 50% (n = 316), respectively. From 1549 open-text responses, 25 topics and 125 research questions were identified thematically. Research priorities differed by cohort, resulting in specific lists developed and ranked by each cohort. The top-ranked research question for the type 1 diabetes cohort was "How can diabetes technology be improved …?" and for the type 2 diabetes cohort: "How can insulin resistance be reversed …?". One question was common to the final lists of all cohorts: "What are the causes or triggers of diabetes?" Within cohorts, the top priorities were perceived as being of similar importance. CONCLUSIONS The research priorities differ substantially by diabetes type and for family members. These findings should inform funding bodies and researchers, to align future research and its communication with community needs.
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Affiliation(s)
- Christel Hendrieckx
- School of Psychology, Deakin University, 1-11 Gheringhap Street, Geelong, VIC, 3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Sienna Russell-Green
- School of Psychology, Deakin University, 1-11 Gheringhap Street, Geelong, VIC, 3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Timothy Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, VIC, Australia
| | - Ashley H Ng
- Monash Partners Academic Health Science Centre, Melbourne, VIC, Australia
| | - Chris Lee
- National Aboriginal Community Controlled Health Organisation, Canberra, ACT, Australia
| | - Siobhan Barlow
- Diabetes Research Matters Steering Group, Melbourne, Australia
| | - Alan Davey
- Diabetes Research Matters Steering Group, Melbourne, Australia
| | - Caitlin Rogers
- Diabetes Research Matters Steering Group, Melbourne, Australia
| | - Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, 1-11 Gheringhap Street, Geelong, VIC, 3220, Australia.
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
| | - Jane Speight
- School of Psychology, Deakin University, 1-11 Gheringhap Street, Geelong, VIC, 3220, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
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O'Brien J, McIver S, Evans S, Trethewey E, O'Shea M. Yoga as an adjunct treatment for eating disorders: a qualitative enquiry of client perspectives. BMC Complement Med Ther 2024; 24:245. [PMID: 38915010 PMCID: PMC11194889 DOI: 10.1186/s12906-024-04514-1] [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: 08/14/2023] [Accepted: 05/22/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND This qualitative enquiry explores the experiences and perspectives of individuals with an eating disorder (ED) regarding their perceptions of yoga as an adjunct intervention to psychotherapy. It also explores the feasibility, acceptability, and safety of yoga from their perspectives. METHODS This study used a practice-based evidence framework and employed semi-structured interviews with 16 females with an ED. Participants were asked about their perspectives on the use of yoga as an adjunct intervention in ED recovery, perceived risks and what factors supported or hindered engagement. Thematic template analysis was used. RESULTS Three topic areas were elaborated. The first included participants' perceptions of how yoga enhanced their ED recovery. The second included how and when participants came to find yoga in their ED recovery. The final topic explored factors that supported participants with ED to engage in yoga. These resulted in the development of guiding principles to consider when designing a yoga intervention for EDs. CONCLUSIONS This study adds further to the emerging evidence that yoga can bring complementary benefits to ED recovery and provides a biopsychosocial-spiritual framework for understanding these. Findings provide an understanding of how yoga programs can be adapted to improve safety and engagement for people with an ED. Yoga programs for people with EDs should be co-designed to ensure that the physical, social, and cultural environment is accessible and acceptable.
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Affiliation(s)
- Jennifer O'Brien
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia.
| | - Shane McIver
- School of Health and Social Development, Deakin University, Melbourne, Australia
| | - Subhadra Evans
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Eleanor Trethewey
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Melissa O'Shea
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
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Chen J, Ye X, Wang D, Xu H. Exploring Preoperative Experiences and Informational Needs Among Chinese School-Age Children Undergoing Elective Surgery: A Qualitative Study. J Pediatr Health Care 2024:S0891-5245(24)00135-4. [PMID: 38904594 DOI: 10.1016/j.pedhc.2024.05.005] [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: 11/22/2023] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024]
Abstract
AIM To understand preoperative experiences and information needs of Chinese school-aged children undergoing elective surgery to design standardized preoperative education programs to alleviate preoperative anxiety. METHODS Semi-structured interviews combined with drawing, writing, and telling techniques were conducted in 12 children. The paintings were interpreted alongside children's verbal expressions. All data were analyzed using thematic analysis. RESULTS Three themes emerged: Origins of Surgical Knowledge: Proximity-based knowledge, media exposure, past personal medical experiences, ward-mate interactions, healthcare staff education; Pre-Surgery Experiences: Anticipation of pain, post-op sensations and impact on life, fantasizing about the operation, being aware of risks, demonstrating psychological resilience, being curious about anesthesia experience, enjoying a break; Preoperative Informational Needs: 55 identified. CONCLUSIONS Lack of standardized preoperative education creates a gap between children's knowledge and actual surgical experiences. Developing preoperative education tailored to individualized informational needs and developmental level helps fill their gaps, alleviate preoperative anxiety and improve health outcomes.
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Affiliation(s)
- Junqing Chen
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Binjiang, Hangzhou, China
| | - Xian Ye
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Binjiang, Hangzhou, China
| | - Dan Wang
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Binjiang, Hangzhou, China
| | - Hongzhen Xu
- Nursing Department, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Binjiang, Hangzhou, China.
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Muñoz Bohorquez J, Channell Doig A, Goldring S, Campos E, Burton K, Delacey JL, McCoy LH, Sorenson C, Crist G, Terhune C, Kim J. Access Barriers, Trusted Channels, and Misconceptions About the COVID-19 Vaccine Among Rural Immigrant Farmworkers. HISPANIC HEALTH CARE INTERNATIONAL 2024:15404153241262050. [PMID: 38881300 DOI: 10.1177/15404153241262050] [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: 06/18/2024]
Abstract
Background: Although COVID-19 has disproportionately impacted immigrant agricultural workers, vaccination efforts have been challenging. Barriers to immunization include language, visa status, and access to medical care. Additionally, vaccine hesitancy, mistrust, and misinformation contributed to low uptake. Methods: A community needs assessment was conducted with immigrant agricultural workers (n = 9) and community stakeholders (n = 15) in rural areas of Maryland and Delaware. In-depth interviews were recorded, transcribed verbatim, and analyzed using template analysis. Results: The participants named trusted and untrusted sources, sources of misinformation, and barriers to accessing information and physical locations to receive the vaccine as reasons for not getting the vaccine. Trusted sources included known community leaders and television programs. Some barriers mentioned were fear of deportation, lack of paid time off, language barriers, and difficulty navigating the U.S. healthcare system. Discussion: There is a need for culturally-tailored programs that address misinformation and barriers and use community-based programming.
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Affiliation(s)
- Juliana Muñoz Bohorquez
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
| | - Amara Channell Doig
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
| | - Sarah Goldring
- Cooperative Extension, University of Delaware, Newark, Delaware, USA
| | - Esmeralda Campos
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland, USA
| | - Kiarra Burton
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
| | - Jennifer Lynne Delacey
- Department of Health Policy and Management, University of Maryland, College Park, Maryland, USA
| | - Lisa H McCoy
- University of Maryland Extension, University of Maryland, College Park, Maryland, USA
| | - Catherine Sorenson
- University of Maryland Extension, University of Maryland, College Park, Maryland, USA
| | - Gina Crist
- Cooperative Extension, University of Delaware, Newark, Delaware, USA
| | - Crystal Terhune
- University of Maryland Extension, University of Maryland, College Park, Maryland, USA
| | - Jinhee Kim
- University of Maryland Extension, University of Maryland, College Park, Maryland, USA
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Rogers JM, Colvin K, Epstein DH, Grundmann O, McCurdy CR, Smith KE. Growing pains with kratom: experiences discussed in subreddits contrast with satisfaction expressed in surveys. Front Pharmacol 2024; 15:1412397. [PMID: 38948457 PMCID: PMC11211595 DOI: 10.3389/fphar.2024.1412397] [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] [Received: 04/04/2024] [Accepted: 05/28/2024] [Indexed: 07/02/2024] Open
Abstract
Background "Kratom" refers to an array of bioactive products derived from Mitragyna speciosa, a tree indigenous to Southeast Asia. Most kratom consumers report analgesic and stimulatory effects, and common reasons for use are to address mental and physical health needs, manage pain, and to reduce use of other substances. Natural-history studies and survey studies suggest that many kratom consumers perceive benefits from those uses, but such studies are unlikely to capture the full range of kratom-use experiences. Methods We collected text data from Reddit posts from 2020-2022 to qualitatively examine conceptualizations, motivations, effects, and consequences associated with kratom use among people posting to social media. Reddit posts mentioning kratom were studied using template thematic analysis, which included collecting descriptions of kratom product types and use practices. Network analyses of coded themes was performed to examine independent relationships among themes, and between themes and product types. Results Codes were applied to 329 of the 370 posts that comprised the final sample; 134 posts contained kratom product descriptions. As Reddit accounts were functionally anonymous, demographic estimates were untenable. Themes included kratom physical dependence (tolerance, withdrawal, or use to avoid withdrawal), perceived addiction (net detrimental effects on functioning), and quitting. Extract products were positively associated with reports of perceived addiction, dependence, and experiences of quitting kratom. Many used kratom for energy and self-treatment of pain, fatigue, and problems associated with opioid and alcohol; they perceived these uses as effective. Consumers expressed frustrations about product inconsistencies and lack of product information. Conclusion As in previous studies, kratom was deemed helpful for some and a hindrance to others, but we also found evidence of notable negative experiences with kratom products that have not been well documented in surveys. Daily kratom use may produce mild-moderate physical dependence, with greater severity being possibly more common with concentrated extracts; however, there are currently no human laboratory studies of concentrated kratom extracts. Such studies, and detailed kratom product information, are needed to help inform consumer decision-making.
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Affiliation(s)
- Jeffrey M. Rogers
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Kayla Colvin
- Real-world Assessment, Prediction, and Treatment Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, United States
| | - David H. Epstein
- Real-world Assessment, Prediction, and Treatment Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, United States
| | - Oliver Grundmann
- College of Pharmacy, Department of Medicinal Chemistry, University of Florida, Gainesville, FL, United States
| | - Christopher R. McCurdy
- College of Pharmacy, Department of Medicinal Chemistry, University of Florida, Gainesville, FL, United States
| | - Kirsten E. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, United States
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Myers AL, Hill J, Fortuna KL. Barriers and Facilitators to Accessing and Utilizing Medicaid Smartphone Services: Perspectives of Peer Support Specialists and Patients with a Diagnosis of a Serious Mental Illness. Community Ment Health J 2024:10.1007/s10597-024-01290-7. [PMID: 38856868 DOI: 10.1007/s10597-024-01290-7] [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: 09/20/2023] [Accepted: 04/28/2024] [Indexed: 06/11/2024]
Abstract
Access to smartphone and data plan services may impact levels of connection and opportunities for health management for patients with a diagnosis of a serious mental illness. Such smartphone-based services provide opportunities that extend the reach of physical and mental health care programs. The purpose of this study was to explore barriers and facilitators faced by individuals with mental health challenges when accessing Medicaid SafeLink smartphones and data plans. Interview guides were developed using the Consolidated Framework for Implementation Research. Individual semi-structured interviews were conducted to collect qualitative data on 18 participants' experiences with SafeLink services. Two main themes were identified- barriers and facilitators. Sub-themes included monthly data limits, followed by account management (barriers), opportunities for safety, and connection (facilitators). Massachusetts SafeLink policies provide individuals with an opportunity for smartphone ownership. However, results imply that expanding the current policy's usage limits may provide additional opportunities for connection and access to health services.
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Affiliation(s)
- Amanda L Myers
- Heller School for Social Policy and Management at Brandeis University, 415 South St, Waltham, MA, 02453, USA.
| | - Julia Hill
- Geisel School of Medicine , Dartmouth, Lebanon, NH, 03766, USA
| | - Karen L Fortuna
- Geisel School of Medicine , Dartmouth, Lebanon, NH, 03766, USA
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Mulgrew KE, Hinz A, Bray M, Jona CMH, Merollini KMD. A qualitative analysis of the usefulness, risks, and challenges of incorporating functionality and body compassion into the prevention and treatment of eating disorders. Body Image 2024; 51:101754. [PMID: 38861766 DOI: 10.1016/j.bodyim.2024.101754] [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: 02/21/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/13/2024]
Abstract
Functionality appreciation and body compassion are empirically supported concepts that can help one to view their body in different and compassionate ways. However, they have yet to be applied to eating disorder (ED) samples and therefore it is important to explore the perceived benefit, risk, and nuance in this population. Semi-structured interviews (N = 25) were conducted with treatment providers, those with a lived experience of an ED, or history of body image distress. Usefulness, applicability, potential risks, benefits, and desired delivery format were probed. Thematic analysis was used. Participants reported that compassion and functionality approaches were useful, complement existing treatment approaches, and important for early intervention. Although considered safe, caveats were noted for ED samples, including introducing content at the right time (e.g., when medically stable), and when having the cognitive flexibility to think about one's body in different ways. For example, functionality appreciation could trigger thoughts about what one's body cannot do while compassion may allow for normalising negative thoughts. Both concepts were viewed as useful and safe to support positive body image at a community level and can be used with ED samples with additional support. This insight from potential users helps with co-design of appropriate content.
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Affiliation(s)
- Kate E Mulgrew
- School of Health, University of the Sunshine Coast, Australia.
| | - Angela Hinz
- School of Health, University of the Sunshine Coast, Australia
| | | | - Celine M H Jona
- School of Health, University of the Sunshine Coast, Australia
| | - Katharina M D Merollini
- School of Health, University of the Sunshine Coast, Australia; Sunshine Coast Health Institute, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
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35
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Young-Silva Y, Berenguera A, Juvinyà-Canal D, Martí-Lluch R, Arroyo-Uriarte P, Tamayo-Morales O, Marcilla-Toribio I, Elizondo-Alzola U, Méndez-López F, Chela-Àlvarez X, Motrico E. Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system. Front Public Health 2024; 12:1387528. [PMID: 38898892 PMCID: PMC11186474 DOI: 10.3389/fpubh.2024.1387528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/07/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect. Objectives To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system. Methods and analysis This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed. Discussion This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role. Trial registration ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.
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Affiliation(s)
- Yudy Young-Silva
- Unitat de Suport a la Recerca Girona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Goli Gurina (IDIAPJGol), Barcelona, Spain
- Escola de doctorat, Universitat de Girona, Girona, España
| | - Anna Berenguera
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Goli Gurina (IDIAPJGol), Barcelona, Spain
- Department d’Infermeria, Universitat de Girona, Girona, Spain
- Departament de Salut Pública. Universitat Autònoma de Barcelona, Bellaterra, España
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
| | - Dolors Juvinyà-Canal
- Department d’Infermeria, Universitat de Girona, Girona, Spain
- Grup de Recerca Salut i Atenció sanitària Universitat de Girona, Girona, Spain
- Càtedra de Promoció de la Salut Universitat de Girona, Girona, Spain
| | - Ruth Martí-Lluch
- Departament de Salut Pública. Universitat Autònoma de Barcelona, Bellaterra, España
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
- Parc Hospitalari Martí Julià, Institut d'Investigació Biomèdica de Girona (IDIBGI), Salt, Spain
| | - Paula Arroyo-Uriarte
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Olaya Tamayo-Morales
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Irene Marcilla-Toribio
- Centro de Estudios Sociosanitarios, Universidad de Castilla-La Mancha, Edificio Melchor Cano, Campus de Cuenca s/n, Cuenca, Spain
- Grupo de Investigación Health, Gender, and Social Determinants, Universidad de Castilla-La Mancha, Edificio Melchor Cano, Campus de Cuenca s/n, Cuenca, Spain
| | - Usue Elizondo-Alzola
- Grupo de Investigación en Ciencias de la Diseminación e Implementación en Servicios Sanitarios, Instituto Investigación de Biocruces, Barakaldo, Spain
- Osakidetza Basque Health Service, Debagoiena-Integrated Health Care Organization, Pharmacy Service (Primary Care), Arrasate, Gipuzkoa, Spain
| | - Fátima Méndez-López
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Aragonese Primary Care Research Group (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Xènia Chela-Àlvarez
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion-Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Emma Motrico
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Department of Developmental and Educational Psychology, Institute of Biomedicine of Seville (IBIS), University of Seville, Seville, Spain
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Smart A, Williams R, Weiner K, Cheng L, Sobande F. Ethico-racial positioning in campaigns for COVID-19 research and vaccination featuring public figures. SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:984-1003. [PMID: 38234078 DOI: 10.1111/1467-9566.13748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/07/2023] [Indexed: 01/19/2024]
Abstract
This article analyses a set of videos which featured public figures encouraging racially minoritised people in the UK to take the COVID-19 vaccine or get involved in related research. As racially targeted health communication has both potentially beneficial and problematic consequences, it is important to examine this uniquely high-profile case. Using a purposive sample of 10 videos, our thematic content analysis aimed to reveal how racially minoritised people were represented and the types of concerns about the vaccine that were expressed. We found representations of racialised difference that centred on 'community' and invoked shared social experiences. The expressed concerns centred on whether ethnic difference was accounted for in the vaccine's design and development, plus the overarching issue of trust. Our analysis adopts and develops the concept of 'racialisation'; we explore how 'mutuality' underpinned normative calls to action ('ethico-racial imperatives') and how the videos 'responsibilised' racially minoritised people. We discuss two points of tension in this case: the limitations for addressing the causes of mistrust and the risks of reductivism that accompanied the ambiguous notion of community. Our analysis develops scholarship on racialisation in health contexts and provides public health practitioners with insights into the socio-political considerations of racially targeted communications.
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Affiliation(s)
- Andrew Smart
- School of Sciences, Bath Spa University, Bath, UK
| | - Ros Williams
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Kate Weiner
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Lijiaozi Cheng
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Francesca Sobande
- School of Journalism, Media and Culture, Cardiff University, Cardiff, UK
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Cucciare MA, Benton C, Hildebrand D, Marchant K, Ghaus S, Han X, Williams JS, Thompson RG, Timko C. Adapting an Alcohol Care Linkage Intervention to US Military Veterans Presenting to Primary Care with Hazardous Drinking and PTSD and/or Depression Symptoms: A Qualitative Study. J Clin Psychol Med Settings 2024; 31:417-431. [PMID: 38100057 DOI: 10.1007/s10880-023-09986-w] [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: 10/29/2023] [Indexed: 02/04/2024]
Abstract
There is a critical need to improve linkage to alcohol care for veterans in primary care with hazardous drinking and PTSD and/or depression symptoms (A-MH). We adapted an alcohol care linkage intervention, "Connect to Care" (C2C), for this population. We conducted separate focus groups with veterans with A-MH, providers, and policy leaders. Feedback centered on how psychologists and other providers can optimally inform veterans about their care options and alcohol use, and how to ensure C2C is accessible. Participants reported that veterans with A-MH may not view alcohol use as their primary concern but rather as a symptom of a potential co-occurring mental health condition. Veterans have difficulty identifying and accessing existing alcohol care options within the Veterans Health Administration. C2C was modified to facilitate alcohol care linkage for this population specific to their locality, provide concrete support and education, and offer care options to preserve privacy.
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Affiliation(s)
- Michael A Cucciare
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA.
- Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR, 72205, USA.
- Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 West Markham Street (#755), Little Rock, AR, 72205, USA.
| | - Cristy Benton
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Deanna Hildebrand
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Kathy Marchant
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Sharfun Ghaus
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA
| | - Xiaotong Han
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
- Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR, 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 West Markham Street (#755), Little Rock, AR, 72205, USA
| | - James S Williams
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
| | - Ronald G Thompson
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 West Markham Street (#755), Little Rock, AR, 72205, USA
| | - Christine Timko
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA
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Kamanga TW, Chitete MMN, Kamanga BCG, Damazio C, Yafeti Y, Sibande M. Towards Sustainable Solid Waste Management Systems: Empirical Evidence From Northern Malawi. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241255800. [PMID: 38828045 PMCID: PMC11143808 DOI: 10.1177/11786302241255800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/02/2024] [Indexed: 06/05/2024]
Abstract
Solid waste management system in Mzuzu City is a growing concern due to its inefficiency and the resulting effect of accumulation of solid waste. In light of this environmental challenge, a study was conducted to assess the system's effectiveness. Through a mixed methods approach and random sampling, 400 respondents from 5 different areas of the city of Mzuzu were selected to provide comprehensive and unbiased responses. It was found that both the public and private sectors lack a complete commitment to sustainable waste management, citing reasons such as limited knowledge on recycling benefits, inadequate infrastructure and budgetary constraints. As a solution, the study proposes a government-led campaign to change attitudes towards waste production and promote recycling. Additionally, a Public-Private Partnership (PPP) should be utilised to develop policies and strategies that encourage private sector involvement in eco-friendly waste management. To further enhance recycling practices, support is needed in transitioning to circular economy waste management practices through regular education and training.
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Affiliation(s)
| | - Moses MN Chitete
- Department of Agribusiness and Entrepreneurship, University of Livingstonia, Mzuzu, Malawi
| | | | - Chitsanzo Damazio
- School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi
| | - Yamikani Yafeti
- Department of Public Health, Lake Malawi Anglican University, Lilongwe, Malawi
| | - Mary Sibande
- Department of Public Health, University of Livingstonia, Mzuzu, Malawi
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Krewulak KD, Knight G, Irwin A, Morrissey J, Stelfox HT, Bagshaw SM, Zuege D, Roze des Ordons A, Fiest K, Parhar KKS. Acceptability of the Venting Wisely pathway for use in critically ill adults with hypoxaemic respiratory failure and acute respiratory distress syndrome (ARDS): a qualitative study protocol. BMJ Open 2024; 14:e075086. [PMID: 38806421 PMCID: PMC11138268 DOI: 10.1136/bmjopen-2023-075086] [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: 04/26/2023] [Accepted: 05/03/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION Hypoxaemic respiratory failure (HRF) affects nearly 15% of critically ill adults admitted to an intensive care unit (ICU). An evidence-based, stakeholder-informed multidisciplinary care pathway (Venting Wisely) was created to standardise the diagnosis and management of patients with HRF and acute respiratory distress syndrome. Successful adherence to the pathway requires a coordinated team-based approach by the clinician team. The overall aim of this study is to describe the acceptability of the Venting Wisely pathway among critical care clinicians. Specifically, this will allow us to (1) better understand the user's experience with the intervention and (2) determine if the intervention was delivered as intended. METHODS AND ANALYSIS This qualitative study will conduct focus groups with nurse practitioners, physicians, registered nurses and registered respiratory therapists from 17 Alberta ICUs. We will use template analysis to describe the acceptability of a multicomponent care pathway according to seven constructs of acceptability: (1) affective attitude;,(2) burden, (3) ethicality, (4) intervention coherence, (5) opportunity costs, (6) perceived effectiveness and (7) self-efficacy. This study will contribute to a better understanding of the acceptability of the Venting Wisely pathway. Identification of areas of poor acceptability will be used to refine the pathway and implementation strategies as ways to improve adherence to the pathway and promote its sustainability. ETHICS AND DISSEMINATION The study was approved by the University of Calgary Conjoint Health Research Ethics Board. The results will be submitted for publication in a peer-reviewed journal and presented at a scientific conference. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT04744298.
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Affiliation(s)
- Karla D Krewulak
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Gwen Knight
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Andrea Irwin
- Critical Care Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - Jeanna Morrissey
- Critical Care Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - Henry Thomas Stelfox
- University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Sean M Bagshaw
- University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Danny Zuege
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | | | - Kirsten Fiest
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Ken Kuljit Singh Parhar
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
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Abbott P, Shanks R, Stanley I, D’Ambruoso L. A protocol for a critical realist systematic synthesis of interventions to promote pupils' wellbeing by improving the school climate in low- and middle-income countries. PLoS One 2024; 19:e0286489. [PMID: 38748720 PMCID: PMC11095672 DOI: 10.1371/journal.pone.0286489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION The review described in this protocol will be the first critical realist review of the literature reporting on the impact of interventions to promote pupils' wellbeing by improving the school climate in Low- and Middle-Income Countries. The review is being carried out to inform the programme theory for a critical realist evaluation of a whole school mindfulness intervention in Ethiopia and Rwanda to improve pupils' mental wellbeing. Our initial programme theory hypothesises that pupils' (and teachers') responses to the mindfulness intervention as well as changing the behaviour and attitudes of individual pupils and teachers, will change the 'school climate' in ways that have a positive impact on mental wellbeing. This literature review will facilitate the identification of mechanisms for change working at the level of the whole school climate, something which is only infrequently discussed in evaluations of mindfulness interventions. METHODS AND ANALYSIS A critical realist review methodology will be used to provide a causal interdisciplinary understanding of how school climate can promote the wellbeing of pupils. This will be done through a systematic literature review and extrapolating context, agency, intervention, mechanisms, and outcome configurations and synthesising these to provide a conceptual understanding of the impact of interventions to improve school climate. DISCUSSION The review findings will inform a critical realist evaluation of a mindfulness intervention in schools that we will be carrying out. The findings from the review will enable us to focus more precisely and transparently on what policymakers and other stakeholders need to know about how school climate changes due to introducing mindfulness to the curriculum and how this impacts pupils' wellbeing [and for which pupils]. We will publish the findings from the review in academic and professional publications, policy briefs, workshops, conferences, and social media. PROSPERO registration number: CRD42023417735.
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Affiliation(s)
- Pamela Abbott
- Centre for Global Development, University of Aberdeen, Aberdeen, United Kingdom
- School of Education, University of Aberdeen, Aberdeen, United Kingdom
| | - Rachel Shanks
- Centre for Global Development, University of Aberdeen, Aberdeen, United Kingdom
- School of Education, University of Aberdeen, Aberdeen, United Kingdom
| | - Isabel Stanley
- Centre for Global Development, University of Aberdeen, Aberdeen, United Kingdom
- School of Education, University of Aberdeen, Aberdeen, United Kingdom
| | - Lucia D’Ambruoso
- Centre for Global Development, University of Aberdeen, Aberdeen, United Kingdom
- Aberdeen Centre for Data Science, University of Aberdeen, Aberdeen, United Kingdom
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Katz C, Evans S, Mikocka-Walus A. 'Listen to women as if they were your most cherished person': Australian women's perspectives on living with the pain of endometriosis: A mixed-methods study. J Health Psychol 2024:13591053241250101. [PMID: 38738914 DOI: 10.1177/13591053241250101] [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: 05/14/2024] Open
Abstract
This mixed-methods study used an online cross-sectional survey to explore perspectives of 533 adult Australian women living with endometriosis pain, and their relationship with biopsychosocial factors. Four themes were constructed: The primary theme, 'Stigma and change' reflected women's experience of dismissal, and the wish to reverse the narrative of pain as normal. Some women emphasised self-education and self-advocacy to affect change, reflecting the theme 'self-empowerment'. Participants described the 'debilitating impact' of endometriosis and the enduring difficulty of 'inadequate healthcare', reflecting themes three and four. Analysis indicated type of social support may impact perceived outcomes for endometriosis. Hierarchical regression analyses indicated too few significant relationships between biopsychosocial factors and themes to indicate meaningful patterns without risk of common method variance. Future research should explore the influence of social support and interventions which develop participant autonomy and practitioner competence and knowledge, using disease-specific measures over time.
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McNeice Z, Tomlin D, Timmer BHB, Short CE, Galvin K. Adults' recollections of discussions with their audiologist: a qualitative study of what was and was not successfully communicated about listening difficulties. Int J Audiol 2024:1-12. [PMID: 38739207 DOI: 10.1080/14992027.2024.2351033] [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: 10/20/2023] [Accepted: 04/26/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES Some adults experience challenges in successfully communicating their listening difficulties to their audiologist, and report feeling that they are not always listened to or understood. This project examined adults' recollections of discussions with their audiologist to explore (1) how adults report describing their listening difficulties and (2) information that adults report they do not communicate, or do not communicate successfully, to their audiologist. DESIGN Individual semi-structured interviews were conducted. Interview transcripts were analysed using a template analysis approach. STUDY SAMPLE Fifteen adults who self-report listening difficulties, and who had previously consulted an audiologist. RESULTS Four themes were identified from adults' recollections of how they describe their listening difficulties: (1) situation or context of listening difficulties, (2) behavioural responses, (3) impacts of listening difficulties and (4) contributing factors. Adults report not always successfully communicating (1) emotional concerns and impacts, (2) descriptions of sound quality and (3) descriptions of changed listening experiences. CONCLUSION Results provide insights about the times when adults feel that communication with their audiologist is successful, or unsuccessful. The results are useful for informing interventions to help adults and audiologists communicate more effectively together. To further inform interventions, factors affecting adults' communication should be explored.
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Affiliation(s)
- Zoe McNeice
- Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Dani Tomlin
- Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Barbra H B Timmer
- Centre for Hearing Research (CHEAR), School of Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Sonova AG, Staefa, Switzerland
| | - Camille E Short
- Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Karyn Galvin
- Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
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Yang L, Ye J, Zhu H, Tang Y, Li X. Development and evaluation of a family-child reading picture book on reducing autism spectrum disorder caregivers' psychological stress: a mixed method study. Front Psychiatry 2024; 15:1390430. [PMID: 38863613 PMCID: PMC11165404 DOI: 10.3389/fpsyt.2024.1390430] [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: 02/26/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction The rapid increasing prevalence of ASD has become a significant global health issue. Caregivers of children with ASD are experiencing higher level of psychological stress and mental disorders. However, interventions to improve the psychological health of caregivers of children with ASD have largely been neglected. Methods Based on the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model, we initially did in-depth interviews with 8 caregivers, and conducted field observation in two rehabilitation centers to analyze the daily lives, the empowered components, the emotional moments of the children with autism and their caregivers. Then we designed the outline of the picture book, and developed it by a multi-disciplinary team by 4 rounds. After that, this picture book was sent out to 54 caregivers of children with ASD for family-child reading in one month. A quantitative questionnaire was administered before and after their reading to evaluate the efficacy of reducing their stress and affiliate stigma, and improving self-efficacy, resilience, empowerment capacity; and exit interviews were conducted after their initial reading to assess the acceptability, content appropriateness, perceived benefits and generalizability of this picture book. Quantitative data were analyzed by descriptive analysis and paired t-tests using IBM SPSS 26.0. Qualitative data were analyzed using template analysis. Results In total, 54 caregivers read the picture book with their child, with the total of 149 (an average of 2.76 per family) times reading in one month. Among them, 39 caregivers returned the following-up questionnaires. Although most of the outcome measures did not showed significant changes except the stress level decreased statistically significant (13.38 ± 3.864 to 11.79 ± 3.238, P=0.001), caregivers reported that the picture book echoed their daily lives and gave them a sense of warmth, inspiration, and hope, as well as some insight on family relationships and attitudes towards the disorder. They also expressed a willingness to disseminate the book to other families with children suffering ASD and the public. Conclusion This specially designed picture book has been proven to be an acceptable, content-appropriate, and effective family-centered psychological intervention, which could be easily scaled up.
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Affiliation(s)
- Lei Yang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jinlin Ye
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hongrui Zhu
- School of International Nursing, Hainan Medical University, Haikou, Hainan, China
| | - Yao Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Chen SC, Yeung WF, Cheng HL, Li MH, Ho YS. Views of Hong Kong Chinese medicine practitioners on the application of the "Chinese Medicine Anti-epidemic Plans" prepared by the Chinese medicine expert group of central authorities: a focus group study. BMC Complement Med Ther 2024; 24:184. [PMID: 38704524 PMCID: PMC11069236 DOI: 10.1186/s12906-024-04469-3] [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: 12/20/2023] [Accepted: 04/05/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Drawing on the extensive utilization of traditional Chinese medicine (TCM) to combat COVID-19 in Mainland China, experts designed a series of TCM anti-epidemic strategies. This study aims to understand Hong Kong CM practitioners' application of and opinions on the "Chinese Medicine Anti-epidemic Plans." METHODS Online focus group interviews were conducted, and purposive sampling was employed to invite 22 CM practitioners to voluntarily participate in three interview sessions. The interviews were audio recorded, then transcribed verbatim. The transcripts were analyzed using template analysis. RESULTS Three themes were derived: (1) facilitators of the "Chinese Medicine Anti-epidemic Plans," (2) barriers of the "Chinese Medicine Anti-epidemic Plans," and (3) expectations on improving the "Chinese Medicine Anti-epidemic Plans." The participants could obtain relevant information from various sources, which highlights the value of the plans for TCM medicinal cuisine and non-pharmacologic therapies and guiding junior CM practitioners, supplementing Western medicine interventions, and managing Chinese herb reserves in clinics. However, the barriers included the lack of a specialized platform for timely information release, defective plan content, limited reference value to experienced CM practitioners, and lack of applicability to Hong Kong. The expectations of the CM practitioners for improving the plans were identified based on the barriers. CONCLUSIONS To enhance the implementation of the anti-epidemic plans, CM practitioners in Hong Kong expect to utilize a specific CM platform and refine the plans to ensure that they are realistic, focused, comprehensive, and tailored to the local context.
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Affiliation(s)
- Shu Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China
| | - Hui Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China
| | - Man Ho Li
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China
| | - Yuen Shan Ho
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China.
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Najmabadi L, Agénor M, Tendulkar S. "Pouring From an Empty Cup": Manifestations, Drivers, and Protective Factors of Occupational Stress Among Healthcare Providers of Trauma-Informed Care. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2041-2075. [PMID: 38059411 DOI: 10.1177/08862605231215028] [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: 12/08/2023]
Abstract
In the United States alone, 10 million people are affected by family and domestic violence (DV). DV survivors experience many forms of victimization, including physical, psychological, and sexual abuse resulting in trauma. The DV workforce, including healthcare providers, social workers, advocates, and other providers, utilize trauma-informed care in a variety of settings to help DV survivors heal and recover from their traumatic experiences. Given the intensity of DV work and occupational stressors associated with navigating complex survivor cases and systems of care, health and mental health professionals can experience burnout, compassion fatigue, and secondary traumatic stress. The purpose of this qualitative study was to explore how professionals in the DV workforce, including healthcare and mental health professionals, experience and mitigate occupational stress. Twenty in-depth interviews were conducted with DV professionals, who worked in medical settings like urban hospitals as well as DV shelters and rape crisis centers in Boston, MA. A semistructured interview guide was developed, and pilot tested and addressed the following topics including experiences of occupational stress, and mitigators of occupational stress. The interviews were audio recorded, transcribed, and analyzed using a thematic analysis approach. Codes were organized into themes and subthemes, which were reviewed and refined during research team discussions. Risk factors of occupational stress included caseload quantity and intensity, workplace isolation, and length of time in the field. Protective factors spanned individual, interpersonal, and organizational level factors. Participants described various strategies for mitigating occupational stress, including training, supervision, and self-care. Findings from this study have the potential to inform policies and practices among healthcare organizations that support professionals in the DV workforce who work with DV survivors.
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Affiliation(s)
| | - Madina Agénor
- Brown University School of Public Health, Providence, RI, USA
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O'Donoghue M, Kennedy N, Forbes J, Murphy CA. Feasible Peer-Mediated Intervention for Autistic Children Using Minimal Speech: A Qualitative Intervention Development Process. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1337-1355. [PMID: 38346137 DOI: 10.1044/2024_ajslp-23-00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
PURPOSE Qualitative engagement with stakeholders in the development of interventions can provide insight into strategies to maximize feasibility in real-life settings. We engaged stakeholders (autistic adults, early childhood educators, early childhood sector leaders and policy influencers, parents of autistic children, and speech-language pathologists) to inform the development of an educator-led peer-mediated intervention (PMI) for autistic preschoolers who use minimal speech that is feasible to implement in inclusive early childhood education and care (ECEC) settings. METHOD A qualitative iterative intervention design process was utilized. Stakeholders (N = 15) attended an online workshop and completed a document review exploring the acceptability and feasibility of the proposed embedded PMI. A two-step analysis procedure using the Theoretical Domains Framework and template analysis was conducted to identify the barriers, enablers, and supports to the implementation of embedded PMI in early childhood settings. RESULTS While embedded PMI was unanimously acceptable to stakeholders, several participants expressed concerns regarding feasibility. Barriers to the successful integration and implementation of PMI in inclusive preschool contexts included access to skills, knowledge, and resources. Participants identified strategies to overcome modifiable barriers and to enhance the existing enablers. These strategies are reflected in the following themes: build on the familiar, build capacity in augmentative and alternative communication, adopt a whole center approach, adapt to meet the needs of the ECEC setting, and engage in proactive implementation. CONCLUSION To address barriers to the implementation of embedded PMI, action is needed at various levels: macro (national/policy), meso (organization/setting), and micro (individual). SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25155770.
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Affiliation(s)
- Michelle O'Donoghue
- Health Research Institute, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Ireland
| | - Norelee Kennedy
- Health Research Institute, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Ireland
| | - John Forbes
- Health Research Institute, Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Ireland
| | - Carol-Anne Murphy
- Health Research Institute, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Ireland
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Morris SM, Gunter KE, Jia JL, Baig AA. Factors Influencing Shared Decision-Making Between Healthcare Providers and Lesbian, Gay, Bisexual, Transgender, and Queer People of Color About Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241248434. [PMID: 38666658 DOI: 10.1177/08862605241248434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Within the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, people of color (POC) disproportionately experience intimate partner violence (IPV). While shared decision-making (SDM)-a model of patient-provider communication-about IPV could benefit LGBTQ POC, its unique challenges merit consideration. This study identifies key factors affecting SDM between LGBTQ POC and healthcare providers surrounding IPV. LGBTQ POC participants (n = 217) in Chicago and San Francisco completed surveys about demographic information, healthcare utilization, and IPV history. Individual interviews and focus groups were then conducted with a Chicago-based subset of participants (n = 46) who identified as LGBTQ IPV survivors of color. Descriptive analyses were conducted of survey responses while focus group and interview transcripts were analyzed and thematically coded. Although 71% of survey participants experienced IPV, only 35% were asked about IPV in healthcare interactions within the previous year. Focus group and interview participants endorsed encounter-, patient-, and provider-centered factors affecting SDM around IPV. When IPV was discussed, patient-provider trust was essential while concordance of identities could either encourage or discourage IPV disclosure. Patients were hesitant to disclose IPV if they had never discussed their LGBTQ identity with their provider or thought providers would ignore their preferences for addressing IPV. Deterrents to SDM included providers denying the prevalence of IPV among LGBTQ individuals or lacking resources to support LGBTQ IPV survivors of color. This study highlights the identity-driven barriers that LGBTQ POC face in discussing IPV with providers. Utilizing SDM to discuss IPV with LGBTQ POC can better address the diverse health needs of this community. However, its success requires that providers acknowledge the diversity of experiences among this population, promote LGBTQ-inclusive practices, and identify resources welcome to LGBTQ POC.
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Tan NQP, Lowenstein LM, Douglas EE, Silva J, Bershad JM, An J, Shete SS, Steinberg MB, Ferrante JM, Clark EC, Natale-Pereira A, Sahu NN, Hastings SE, Hoffman RM, Volk RJ, Kinney AY. The TELEhealth Shared decision-making Coaching and Navigation in Primary carE (TELESCOPE) intervention: a study protocol for delivering shared decision-making for lung cancer screening by patient navigators. RESEARCH SQUARE 2024:rs.3.rs-4254047. [PMID: 38746205 PMCID: PMC11092847 DOI: 10.21203/rs.3.rs-4254047/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: 05/16/2024]
Abstract
Background Lung cancer screening (LCS) can reduce lung cancer mortality but has potential harms for patients. A shared decision-making (SDM) conversation about LCS is required by the Centers for Medicare & Medicaid Services (CMS) for LCS reimbursement. To overcome barriers to SDM in primary care, this protocol describes a telehealth decision coaching intervention for LCS in primary care clinics delivered by patient navigators. The objective of the study is to evaluate the effectiveness of the intervention and its implementation potential, compared with an enhanced usual care (EUC) arm. Methods Patients (n = 420) of primary care clinicians (n = 120) are being recruited to a cluster randomized controlled trial. Clinicians are randomly assigned to 1) TELESCOPE intervention: prior to an upcoming non-acute clinic visit, patients participate in a telehealth decision coaching session about LCS delivered by trained patient navigators and nurse navigators place a low-dose CT scan (LDCT) order for each TELESCOPE patient wanting LCS, or 2) EUC: patients receive enhanced usual care from a clinician. Usual care is enhanced by providing clinicians in both arms with access to a Continuing Medical Education (CME) webinar about LCS and an LCS discussion guide. Patients complete surveys at baseline and 1-week after the scheduled clinic visit to assess quality of the SDM process. Re-navigation is attempted with TELESCOPE patients who have not completed the LDCT within 3 months. One month before being due for an annual screening, TELESCOPE patients whose initial LCS showed low-risk findings are randomly assigned to receive a telehealth decision coaching booster session with a navigator or no booster. Electronic health records are abstracted at 6, 12 and 18 months after the initial decision coaching session (TELESCOPE) or clinic visit (EUC) to assess initial and annual LCS uptake, imaging results, follow-up testing for abnormal findings, cancer diagnoses, treatment, and tobacco treatment referrals. This study will evaluate factors that facilitate or interfere with program implementation using mixed methods. Discussion We will assess whether a decision coaching and patient navigation intervention can feasibly support high-quality SDM for LCS and guideline-concordant LCS uptake for patients in busy primary care practices serving diverse patient populations. Trial Registration This study was registered at ClinicalTrials.gov (NCT05491213) on August 4, 2022.
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Lim S, Lang S, Savaglio M, Skouteris H, Moran LJ. Intervention Strategies to Address Barriers and Facilitators to a Healthy Lifestyle Using the Behaviour Change Wheel: A Qualitative Analysis of the Perspectives of Postpartum Women. Nutrients 2024; 16:1046. [PMID: 38613079 PMCID: PMC11013589 DOI: 10.3390/nu16071046] [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: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Postpartum women experience unique barriers to maintaining healthy lifestyles after birth. Theory-based behaviour change techniques and intervention strategies can be integrated into postpartum lifestyle interventions to enable women to overcome barriers to change. This study aims to explore barriers and facilitators to engaging in healthy postpartum lifestyle behaviours and develop intervention strategies for integration in a postpartum lifestyle intervention using the Behaviour Change Wheel (BCW). Semi-structured interviews were conducted with women up to two years postpartum (n = 21). Interviews were thematically analysed, themes were mapped to the Capability, Opportunity, and Motivation Model of Behaviour Change and intervention strategies were developed using the BCW. Findings suggest that women face barriers and facilitators within capability (sleep deprivation, mental exhaustion, ability to plan), opportunity (support of friends, partners and extended families) and motivation (challenges with prioritising self, exercise to cope with stress). Intervention strategies included supporting behaviour regulation and sleep to enhance capability, engaging partners, strengthening peer support to create opportunities and highlighting the mental health benefits of healthy lifestyles to inspire motivation. Integrating targeted evidence-based behaviour change strategies into postpartum lifestyle interventions may support women in overcoming commonly reported barriers to a healthy lifestyle.
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Affiliation(s)
- Siew Lim
- Health Systems and Equity, Eastern Health Clinical School, Monash University, 5 Arnold Street, Boxhill, VIC 3128, Australia
- Monash Centre of Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (S.L.); (M.S.); (H.S.); (L.J.M.)
| | - Sarah Lang
- Monash Centre of Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (S.L.); (M.S.); (H.S.); (L.J.M.)
| | - Melissa Savaglio
- Monash Centre of Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (S.L.); (M.S.); (H.S.); (L.J.M.)
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Helen Skouteris
- Monash Centre of Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (S.L.); (M.S.); (H.S.); (L.J.M.)
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Lisa J. Moran
- Monash Centre of Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (S.L.); (M.S.); (H.S.); (L.J.M.)
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Down MJA, Picknoll D, Hoyne G, Piggott B, Bulsara C. e-Delphi in the outdoors: Stakeholder contributions to the development of a wellbeing-focused outdoor adventure education intervention program. Health Promot J Austr 2024; 35:470-480. [PMID: 37434344 DOI: 10.1002/hpja.777] [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: 01/12/2023] [Revised: 06/02/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023] Open
Abstract
ISSUE ADDRESSED Outdoor adventure education (OAE) (programs involving outdoor activities such as rock climbing or white-water canoeing) that participants perceive as risky, conducted in a social support setting, can be utilised by practitioners to elicit changes in educational and psychosocial outcomes to support participant adolescent wellbeing. METHODS This study garnered the opinions of an expert OAE panel on the content of future programs aiming to impact adolescent wellbeing. The panel consisted of local (Western Australia, n = 7), national (Australia, n = 4), and international (Canada, Germany, New Zealand, United Kingdom, United States, n = 7) experts. A two-round, mixed-methods Delphi approach was employed. Extensive formative work led to the development of a series of open-ended questions requiring qualitative responses for round one. Panellists were also asked to respond to 17 statements using Likert scales in the second round. RESULTS After analysis, a consensus was reached for all statements, with five statements having high consensus and being considered important by panellists. CONCLUSIONS The statement 'Equity for all participants requires flexible delivery and facilitation' had the highest level of agreement amongst panellists. Connections, authentic experiences, and equitable experiences developed as key themes. SO WHAT?: Future OAE interventions focused on wellbeing impact could use the findings of this research as a basis for program design.
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Affiliation(s)
- Michael J A Down
- School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
| | - Duncan Picknoll
- School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
| | - Gerard Hoyne
- School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
| | - Ben Piggott
- School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
| | - Caroline Bulsara
- School of Nursing and Midwifery, The University of Notre Dame Australia, Fremantle, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia
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