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Townsend ML, Barr KR, Miller CE, Sanzone G. Self-harm and suicidal behaviors in children: perspectives of mental health clinicians. J Pediatr Psychol 2024:jsae044. [PMID: 38872281 DOI: 10.1093/jpepsy/jsae044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 05/21/2024] [Accepted: 05/25/2024] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVE Presentations for self-harm and suicidal behaviors are increasing in children and young people, although less is known about these presentations in children aged 12 years and under. This study aims to understand how mental health clinicians in public health services conceptualize, identify and respond to self-harm and suicidal behaviors in children. METHODS 26 mental health clinicians provided their perspectives through interviews or focus groups. Participant responses were analyzed using reflexive thematic analysis. RESULTS Mental health clinicians described how self-harm and suicidal behaviors may present differently in children compared with adolescents, particularly with the methods used. Using developmentally appropriate language and including parents or carers when screening for self-harm and suicidal behaviors was recommended by clinicians. The inclusion of parents or carers throughout the treatment process was important for clinicians, including helping parents understand their child's behavior and manage their own distress. Clinicians also highlighted the benefit of collaborating with schools to support children, yet noted primary school staff require training in responding to child self-harm and suicidal behavior. The limited services available for children 12 years and under including emergency care services, was identified as a problem. CONCLUSIONS Findings highlight the importance of timely assessment and interventions which include mental health and medical clinicians, parents, carers, and school staff to support children with self-harm and suicidal behaviors.
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Affiliation(s)
- Michelle L Townsend
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Karlen R Barr
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Caitlin E Miller
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Gillian Sanzone
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
- Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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Idnay B, Cordoba E, Ramirez SO, Xiao E, Wood OR, Batey DS, Garofalo R, Schnall R. Social Marketing Perspective on Participant Recruitment in Informatics-Based Intervention Studies. AIDS Behav 2024:10.1007/s10461-024-04355-6. [PMID: 38703337 DOI: 10.1007/s10461-024-04355-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
Effective recruitment strategies are pivotal for informatics-based intervention trials success, particularly for people living with HIV (PLWH), where engagement can be challenging. Although informatics interventions are recognized for improving health outcomes, the effectiveness of their recruitment strategies remains unclear. We investigated the application of a social marketing framework in navigating the nuances of recruitment for informatics-based intervention trials for PLWH by examining participant experiences and perceptions. We used qualitative descriptive methodology to conduct semi-structured interviews with 90 research participants from four informatics-based intervention trials. Directed inductive and deductive content analyses were guided by Howcutt et al.'s social marketing framework on applying the decision-making process to research recruitment. The majority were male (86.7%), living in the Northeast United States (56%), and identified as Black (32%) or White (32%). Most participants (60%) completed the interview remotely. Sixteen subthemes emerged from five themes: motivation, perception, attitude formation, integration, and learning. Findings from our interview data suggest that concepts from Howcutt et al.'s framework informed participants' decisions to participate in an informatics-based intervention trial. We found that the participants' perceptions of trust in the research process were integral to the participants across the four trials. However, the recruitment approach and communication medium preferences varied between older and younger age groups. Social marketing framework can provide insight into improving the research recruitment process. Future work should delve into the complex interplay between the type of informatics-based interventions, trust in the research process, and communication preferences, and how these factors collectively influence participants' willingness to engage.
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Affiliation(s)
- Betina Idnay
- School of Nursing, Columbia University, New York, NY, USA.
- Department of Biomedical Informatics, Columbia University, New York, NY, USA.
| | - Evette Cordoba
- School of Nursing, Columbia University, New York, NY, USA
| | | | - Eugenia Xiao
- School of Nursing, Columbia University, New York, NY, USA
| | - Olivia R Wood
- School of Nursing, Columbia University, New York, NY, USA
| | - D Scott Batey
- School of Social Work, Tulane University, New Orleans, LA, USA
| | - Robert Garofalo
- Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine Northwestern University, Chicago, IL, USA
| | - Rebecca Schnall
- School of Nursing, Columbia University, New York, NY, USA
- Mailman School of Public Health, Columbia University, New York, NY, USA
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Djiofack Kentsop HB, Zarowsky C, Von Oettingen JE. Type 1 diabetes care delivery in Yaoundé, Cameroon: Social and political representations. Afr J Prim Health Care Fam Med 2024; 16:e1-e16. [PMID: 38572859 PMCID: PMC11019050 DOI: 10.4102/phcfm.v16i1.4229] [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: 07/09/2023] [Revised: 02/04/2024] [Accepted: 02/04/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Increasing chronic diseases challenges the health systems of low- and middle-income countries, including Cameroon. Type 1 diabetes (T1D), among the most common chronic diseases in children, poses particular care delivery challenges. AIM We examined social representations of patients' roles and implementation of T1D care among political decision-makers, healthcare providers and patients within families. SETTING The study was conducted in Yaoundé, Cameroon. METHODS Eighty-two individuals were included in the study. The authors conducted semi-structured interviews with policy makers (n = 5), healthcare professionals (n = 7) and patients 'parents (n = 20). Questionnaires were administered to paediatric patients with T1D (n = 50). The authors also observed care delivery at a referral hospital and at a T1D-focused non-governmental organisation over 15 days. Data were analysed using thematic content analysis and descriptive statistics. RESULTS Cameroonian health policy portrays patients with T1D as passive recipients of care. While many practitioners recognised the complex social and economic determinants of adherence to T1D care, in practice interactions focused on specific biomedical issues and offered brief guidance. Cultural barriers and policy implementation challenges prevent patients and their families from being fully active participants in care. Parents and children prefer an ongoing relationship with a single clinician and interactions with other patients and families. CONCLUSION Patients and families mobilise experience and lay knowledge to complement biomedical knowledge, but top-down policy and clinical practice limit their active engagement in T1D care.Contribution: Children with T1D and their families, policy makers, healthcare professionals, and civil society have new opportunities to contribute to person-centred care, as advocated by the Sustainable Development Goals.
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Affiliation(s)
- Hervé B Djiofack Kentsop
- Department of Social and Preventive Medicine, Faculty of Public Health, University of Montreal, Montreal, Canada; Public Health Research Center, Faculty of Public Health, University of Montreal, Montreal, Canada; and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal.
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Zhou C, Okafor C, Greisz J, Ryu HS, Hagood J, DeLisser HM. Psychological and emotional experiences of participants in a medical school, early assurance admissions program targeting students from groups underrepresented in medicine. J Natl Med Assoc 2024; 116:24-32. [PMID: 38142142 DOI: 10.1016/j.jnma.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/28/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND There are growing number of pathway programs, with an early assurance of admission, that target undergraduate students from groups underrepresented in medicine (URiM) to enable their competitiveness for and matriculation to medical school, including the Penn Access Summer Scholars (PASS) program. The psychological and emotional experiences of students in these programs, however, have not been previously described. METHODS Students from the summer 2021 cohort of the PASS program were interviewed using a structured set of questions that explored four specific areas: (i) the application process; (ii) the benefits and value of being in the PASS program; (iii) the emotional and psychological challenges and stresses of being in the PASS program; (iv) feelings and emotions about not taking the MCAT or having to interview at multiple schools. The transcribed, de-identified interviews were then subjected to a qualitative analysis. RESULTS Students in PASS reported that the program was valuable to them in that it reduced the stress of the pre-medical process; relieved worry and anxiety surrounding the MCAT; enabled development of supportive relationships and provided meaningful exposures to the medical profession and biomedical research. Despite this, students reported feelings of imposterism, guilt, and fear of disappointing, along with varying degrees of regret over not taking the MCAT and not interviewing at more than one medical school. CONCLUSIONS URiM and other marginalized students participating in early assurance admissions programs likely enter medical school with a range of positive and negative emotions as a result of their participation in these programs. These data can be used to inform the development of programing and other initiatives that further support the transition and success of these students in medical school.
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Affiliation(s)
- Cecilia Zhou
- Inclusion, Diversity, Inclusion And Learn Experience Program In Undergraduate Medical Education, Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Chielozor Okafor
- Inclusion, Diversity, Inclusion And Learn Experience Program In Undergraduate Medical Education, Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Justin Greisz
- Inclusion, Diversity, Inclusion And Learn Experience Program In Undergraduate Medical Education, Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Han-Seul Ryu
- Inclusion, Diversity, Inclusion And Learn Experience Program In Undergraduate Medical Education, Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Jamal Hagood
- Inclusion, Diversity, Inclusion And Learn Experience Program In Undergraduate Medical Education, Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Horace M DeLisser
- Inclusion, Diversity, Inclusion And Learn Experience Program In Undergraduate Medical Education, Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
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Delemere E, Gitonga I, Maguire R. "A Really Really Almost Impossible Journey" Perceived Needs and Challenges of Families Impacted by Pediatric Cancer: A Qualitative Analysis. Compr Child Adolesc Nurs 2023; 46:277-294. [PMID: 37409984 DOI: 10.1080/24694193.2023.2229429] [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: 09/01/2022] [Accepted: 06/16/2023] [Indexed: 07/07/2023]
Abstract
Caring for a child with cancer can place a number of burdens on families, however it is unclear the extent to which health-care professionals (HCPs) and other personnel supporting families are aware of these burdens. This study sought to explore the needs and challenges encountered by families impacted by pediatric cancer in Ireland from the perspectives of both parents and the personnel who support them. Twenty-one participants, comprising seven parents (one male, six females), and 14 supportive personnel (nine hospital-based volunteers and five HCPs) took part in in-depth semi-structured interviews via Microsoft Teams (December 2020 to April 2021) to obtain a perspective of the needs, challenges, and currently available support for families. A reflexive thematic approach to analysis was employed. The need to navigate a new normal, a sense of riding the wave and reliance on others were perceived to be the primary challenges encountered by families. Participants reported a need for community service provision, connectivity across the health-care system and more accessible psychological support. High levels of overlap across themes were found for parents and supportive personnel, particularly HCPs. Results highlight the significant challenges encountered by families impacted by pediatric cancer. Themes voiced by parents were frequently echoed by HCPs, suggesting this group is attuned to broader family needs. As such, they may be capable of providing insight where parent perspectives are unavailable. While further analysis including children's voices is needed, findings highlight key areas toward which support for families should be directed.
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Affiliation(s)
- Emma Delemere
- Department of Psychology, Maynooth University Co., Kildare, Ireland
| | - Isaiah Gitonga
- Department of Psychology, Maynooth University Co., Kildare, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University Co., Kildare, Ireland
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Thompson D, Miranda J, Callender C, Dave JM, Appiah G, Musaad SMA. See Me, Hear Me, Know Me: Perspectives on Diet and Physical Activity Influences among Teens Living in Rural Texas Communities. Nutrients 2023; 15:4695. [PMID: 37960349 PMCID: PMC10650212 DOI: 10.3390/nu15214695] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
Teens in rural communities are at greater risk of obesity than teens in urban areas. Diet and physical activity influence obesity risk. Understanding their perspectives is an important step in intervention design. This qualitative investigation explored teen perspectives on how living in a rural community influenced their diet and physical activity choices. Forty parent-teen pairs were recruited. Data collection included surveys and telephone interviews. This paper reports teen perspectives identified in the first interview. Thematic analysis was used to code and analyze the data. Findings revealed that the primary factor driving teens' diet and physical activity behaviors was the teens themselves. They clearly understood their role in the choices they made, although they acknowledged not always making the healthiest choice. This belief was driven by their motivation to engage in healthy behaviors, which was influenced by the perceived benefits derived from making healthy choices and from the synergistic relationship between diet and physical activity. Diet and physical activity, in turn, were influenced by the environment, particularly the home, social, and community environments. Family and friends were particularly influential, as well as resource availability. These findings can serve as a foundation for designing interventions tailored to this population.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; (J.M.); (C.C.); (J.M.D.); (G.A.); (S.M.A.M.)
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Alcaire F, Machín L, Curutchet MR, Giménez A, Ares G. Parent Experiences With Warning Labels After Policy Implementation in Uruguay. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:823-832. [PMID: 37804264 DOI: 10.1016/j.jneb.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To explore the perception and experiences of parents of children and adolescents during the first year of the mandatory implementation of nutritional warning labels in Uruguay. DESIGN Qualitative research based on semistructured interviews. SETTING Montevideo, Uruguay. PARTICIPANTS Twenty-eight parents of children and adolescents. PHENOMENON OF INTEREST Perception of and experiences with warning labels, a front-of-pack nutrition labeling scheme that has become increasingly popular in Latin America. ANALYSIS Content analysis of the transcripts based on a deductive-inductive approach. RESULTS Interview transcripts evidenced high awareness, acceptance, and understanding of warning labels among parents of children and adolescents. Most participants reported considering warnings for decision making and changing their purchase decisions because of their implementation, particularly when choosing foods for their children. They reported their children were aware of and understood warnings but did not tend to take them into account when choosing foods. CONCLUSIONS AND IMPLICATIONS Results from the present work contribute to the growing body of literature showing the effectiveness of warning labels. Lack of interest or perceived benefits and structural barriers emerged as key motives for not using the warnings when making purchasing decisions, suggesting the need to develop additional strategies to increase policy effectiveness.
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Affiliation(s)
- Florencia Alcaire
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay
| | - Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | | | - Ana Giménez
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay
| | - Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay; Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay.
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Suda S, Burkbauer L, White B, Browning J, DeLisser HM. Medical Students' Reflections on Their Experiences in a Trauma Chaplain Shadowing Program. Am J Hosp Palliat Care 2023; 40:1124-1131. [PMID: 36592479 DOI: 10.1177/10499091221149192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The importance of spirituality in patient care is well recognized and efforts to develop educational opportunities to improve medical students' competency in spirituality and health are ongoing. In this regard, shadowing of healthcare chaplains has emerged as an experiential approach for providing exposure to and instruction in issues of spirituality in the patient experience and in patient care. Recently published data suggest that a 6-8 hour experience of shadowing a trauma chaplain is effective at introducing first-year medical students to healthcare chaplaincy, difficult spiritual conversations with patients and families, and interprofessional collaboration. As a follow-up to these data, this study provides a qualitative analysis of student reflections written immediately after their shadowing experience with the goal of further characterizing the educational impact of trauma chaplain shadowing. Qualitative analysis of 90 anonymous, student reflections indicated that trauma chaplain shadowing was an experience that provided insights about nature of chaplaincy, enabled opportunities to closely observe the relational skills of chaplains, allowed students to bear witness to suffering, fostered growth toward a professional identity, and facilitated recognition of shortcomings in medical education and clinical medicine. These data therefore provide further evidence of the value of chaplain shadowing in not only enhancing students' understanding of various dimensions of spirituality and medicine but also in promoting their development of a strong physician identity.
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Affiliation(s)
- Seiji Suda
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Burkbauer
- Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Betty White
- Department of Pastoral Care and Education, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - James Browning
- Department of Pastoral Care and Education, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Horace M DeLisser
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Atkins R, Deatrick JA, Bocage C, Huc R, Aromolaran D, Beisser E, Hinckson A, Joseph M, Kim D, Lagman DMC, Gadsden V, Lipman TH. School readiness and social determinants of health: A collaboration with community teachers and parents. J Pediatr Nurs 2023; 72:73-83. [PMID: 37099820 DOI: 10.1016/j.pedn.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE To explore perceptions of community dwelling caregivers of preschool-aged children regarding the influence of social determinants of health (SDOH) on children's school readiness. Parents' perspectives regarding solutions to enhance school readiness in preschool-aged children are also explored. METHODS This study employed a qualitative, descriptive design and a community based participatory research (CBPR) approach. An academic institution collaborated with parents, teachers, and administrators at a community-based preschool learning center. Ten young-adult to middle-aged mothers and caregivers attended two separate focus groups and completed open-ended questionnaires. Inductive and deductive thematic analysis of text were employed. FINDINGS Three themes emerged 1) Families described the vast lack of appropriate community resources and inability to access those resources that are available to prepare their children for school 2). Family members need help processing information about social resources 3) Community, individual and systemic level solutions to enhance school readiness. CONCLUSIONS Academic-Community partnerships provide an opportunity to (1) identify solutions to remove systemic barriers that impede children's readiness for school, and (2) design interventions to support families through that process. Interventions to enhance school readiness should be family-focused and can be informed by understanding the influence of SDOH during the planning stages. SDOH create barriers and prevent parents from prioritizing their children's school, health-care, and developmental needs. PRACTICE IMPLICATIONS Interventions to enhance school readiness should be family-based and can be informed by understanding the influence of SDOH during the planning stages. Social advocacy is also needed to enhance the ability of parents to enhance their children's school readiness.
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Affiliation(s)
- Rahshida Atkins
- The College of New Jersey, 2000 Pennington Road, Ewing, NJ 08102, United States of America.
| | - Janet A Deatrick
- University of Pennsylvania School of Nurisng, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Claire Bocage
- University of Pennsylvania School of Nurisng, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Regi Huc
- TYL II Preschool Learning Central Preschool, 5727 Walnut St. Philadelphia, PA 19139, United States of America.
| | - Damilola Aromolaran
- The College of New Jersey, 2000 Pennington Road, Ewing, NJ 08102, United States of America.
| | - Emily Beisser
- University of Pennsylvania School of Nurisng, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Afia Hinckson
- The College of New Jersey, 2000 Pennington Road, Ewing, NJ 08102, United States of America.
| | - Melanie Joseph
- University of Pennsylvania School of Nurisng, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Dinah Kim
- University of Pennsylvania School of Nurisng, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Danica Mae Catedral Lagman
- University of Pennsylvania School of Nurisng, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Vivian Gadsden
- University of Pennsylvania, Graduate School of Education, United States of America
| | - Terri H Lipman
- University of Pennsylvania School of Nurisng, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
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Kuiper SZ, Dirksen CD, Mitalas L, Clermonts SHEM, Van Dam KAM, De Witte E, Melenhorst J, Van Kuijk SMJ, Breukink SO, Kimman ML. Responsiveness of the Patient-Reported Outcome Measure-Haemorrhoidal Impact and Satisfaction Score in patients with haemorrhoidal disease. Colorectal Dis 2023; 25:1832-1838. [PMID: 37475163 DOI: 10.1111/codi.16668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 07/22/2023]
Abstract
AIM In this study we aimed to assess the responsiveness of the symptom score of the recently developed Patient-Reported Outcome Measure-Haemorrhoidal Impact and Satisfaction Score (PROM-HISS). Furthermore, the minimally relevant difference (MRD) was determined. METHOD The responsiveness of PROM-HISS was tested using a criterion-based (i.e. anchor) and construct-based (i.e. hypotheses testing) approach. Patients with haemorrhoidal disease (HD) completed the PROM-HISS before and 1 week after treatment in hospital. A global self-assessment of change question (SCQ) was administered 1-week after treatment and functioned as the criterion. The following analyses were performed: (1) correlation between the PROM-HISS symptom score and the criterion (SCQ) and (2) hypotheses testing. The MRD was determined as change in symptoms of the subgroup reporting 'somewhat fewer complaints' on the SCQ. RESULTS Between February and August 2022, 94 patients with grade II-IV HD from three hospitals were included. The correlation between the SCQ and a change on the PROM-HISS symptom score was 0.595 indicating that an improvement on the SCQ corresponds to an improvement on the PROM-HISS symptom score. As hypothesized, the mean change in PROM-HISS scores was significantly different between subgroups of patients based on their SCQ responses. Patients reporting a small change in HD symptoms on the SCQ corresponded to a mean change of 0.3 on the PROM-HISS symptom score. CONCLUSION The PROM-HISS symptom score is a responsive instrument as it identifies change in HD symptoms because of treatment. The estimated MRD of 0.3 can be used to inform clinical research and practice.
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Affiliation(s)
- Sara Z Kuiper
- Department of Surgery, Maastricht University, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, the Netherlands
| | - Carmen D Dirksen
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health, Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Litza Mitalas
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | | | | | - Evelien De Witte
- Department of Surgery, Zuyderland Medical Centre, Sittard, the Netherlands
| | - Jarno Melenhorst
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Surgery, Maastricht University, School for Oncology and Reproduction (GROW), Maastricht, the Netherlands
| | - Sander M J Van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health, Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Stephanie O Breukink
- Department of Surgery, Maastricht University, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, the Netherlands
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Surgery, Maastricht University, School for Oncology and Reproduction (GROW), Maastricht, the Netherlands
| | - Merel L Kimman
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health, Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, the Netherlands
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Hoffman SJ, Fredkove WM. Using a Constructivist-Oriented Modified Grounded Theory Approach in the Study of Intrafamily Trauma Communication Process in War-Affected Families: A Methodologic Example. ANS Adv Nurs Sci 2023:00012272-990000000-00077. [PMID: 37498059 PMCID: PMC10818002 DOI: 10.1097/ans.0000000000000506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Grounded theory methodology is frequently applied in health research, yet studies contending with contextual constraints may require a more pragmatic approach, including potential methodologic divergence and modifications of method choice and application. Dissemination of a detailed documentation and justification of methodologic choices, and specific method modifications and/or innovations, are uncommon in extant literature; however, a more expansive approach to such reporting has the potential to enhance research practices, increase transparency, and contribute to the ongoing discourse around research approaches and rigor. Here, we articulate our methodologic decision-making and methods, including modifications, as applied to the qualitative strand of an explanatory mixed-methods study. The primary aim of this article is to contribute to the discourse and collective learning around methodology and method choices and modifications by presenting one approach to applying a constructivist-oriented, modified version of grounded theory analytic methods through a worked qualitative study example.
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Baudino MN, Inverso H, Wang C, Tully C, Levy W, Clary L, Gallagher KA, Monaghan M, Streisand R, Hilliard ME. Satisfaction With Participation in the First STEPS Behavioral Intervention: Experiences of Parents of Young Children With Newly Diagnosed Type 1 Diabetes. J Pediatr Psychol 2023; 48:605-613. [PMID: 37344161 PMCID: PMC10544724 DOI: 10.1093/jpepsy/jsad039] [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: 02/03/2023] [Revised: 05/08/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVE Parents of young children with new-onset type 1 diabetes (T1D) often experience significant distress and struggle with T1D management during a challenging developmental stage. The First STEPS (Study of Type 1 in Early childhood and Parenting Support) trial evaluated a stepped-care behavioral intervention comprising increasingly intensive intervention steps (peer parent coach, cognitive-behavioral counseling, consultations with diabetes educator and psychologist) based on need. The intervention improved parental depressive symptoms compared to usual care. Subsequently, we examined parent satisfaction with the intervention to guide potential implementation and refinement for future trials. METHODS Participants were 157 parents of young children newly diagnosed with T1D. At 9 months post randomization, n = 153 completed satisfaction questionnaires and n = 17 completed qualitative interviews. Satisfaction ratings about trial procedures and each intervention step were summarized. We used thematic analysis with the interview transcripts to generate themes related to participants' experiences in the trial overall and intervention specifically. We explored differences in themes between participants who did versus did not respond to the intervention and among those who experienced different intervention steps. RESULTS Most participants in both arms rated study participation and methods positively (>95%), and those completing interviews described high satisfaction with study procedures overall, retention incentives, and contact with study staff. Intervention participants' satisfaction ratings were high across steps. Two qualitative themes reflected satisfaction with the intervention enhancing self-efficacy and social support. CONCLUSIONS High satisfaction suggests implementing a stepped-care behavioral intervention as part of routine clinical care following T1D diagnosis would be well received.
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Affiliation(s)
- Marissa N Baudino
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Hailey Inverso
- Clinical and Translational Research, Children’s National Hospital, USA
| | - Christine Wang
- Clinical and Translational Research, Children’s National Hospital, USA
| | - Carrie Tully
- Clinical and Translational Research, Children’s National Hospital, USA
- Department of Psychiatry, George Washington University School of Medicine, USA
| | - Wendy Levy
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Lauren Clary
- Clinical and Translational Research, Children’s National Hospital, USA
- Department of Psychiatry, George Washington University School of Medicine, USA
| | - Katherine A Gallagher
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Maureen Monaghan
- Clinical and Translational Research, Children’s National Hospital, USA
- Department of Psychiatry, George Washington University School of Medicine, USA
| | - Randi Streisand
- Clinical and Translational Research, Children’s National Hospital, USA
- Department of Psychiatry, George Washington University School of Medicine, USA
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
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13
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Chardon ML, Klages KL, Joffe NE, Pai ALH. Pediatric Hematopoietic Stem Cell Transplant Medication Adherence Facilitators and Strategies: A Qualitative Study. J Pediatr Psychol 2023; 48:415-424. [PMID: 36173365 PMCID: PMC10199727 DOI: 10.1093/jpepsy/jsac078] [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: 02/25/2022] [Revised: 08/10/2022] [Accepted: 09/18/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Taking medications as prescribed after hematopoietic stem cell transplant (HCT) is key for ensuring children's survival; however, suboptimal medication adherence is common. Development of evidence-based interventions to improve medication adherence post-HCT is contingent upon understanding what adherence facilitators (i.e., unique traits, characteristics, or resources inherent to the individual, medical treatment, or healthcare team) and strategies (i.e., tools caregivers or medical providers intentionally use) promote medication adherence in this population. Therefore, this study examined caregiver-perceived medication facilitators post-HCT. METHODS Semi-structured qualitative interviews and demographic questionnaires were completed by 29 caregivers of children (≤12 years) who had received an HCT within the past 2 years. RESULTS Thematic analysis guided by grounded theory revealed 14 saturated themes that were grouped into 4 categories: family facilitators, medication facilitators, caregiver strategies, and multidisciplinary treatment team strategies. CONCLUSIONS Overall, findings suggest that caregivers of children who received an HCT are highly resourceful and independently develop many strategies to assist them with medication management after their child's HCT. These facilitators and strategies varied between caregivers and over time. Despite prevalent facilitators and strategies, caregiver burden associated with medication adherence remains high. Caregivers may benefit from the multidisciplinary treatment team providing individualized and multicomponent (educational and behavioral) medication adherence supports to ease this burden particularly shortly after hospital discharge.
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Affiliation(s)
- Marie L Chardon
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, USA
| | - Kimberly L Klages
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, USA
| | - Naomi E Joffe
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, USA
- Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, USA
| | - Ahna L H Pai
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, USA
- Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, USA
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14
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Rich A, Viney R, Silkens M, Griffin A, Medisauskaite A. UK medical students' mental health during the COVID-19 pandemic: a qualitative interview study. BMJ Open 2023; 13:e070528. [PMID: 37076141 PMCID: PMC10124246 DOI: 10.1136/bmjopen-2022-070528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVES To understand the impact of COVID-19 on medical students with mental health problems. DESIGN Qualitative study employing in-depth semistructured interviews with medical students which were analysed using reflexive thematic analysis. SETTING AND PARTICIPANTS A purposive sample of 20 students originating from 8 geographically spread UK medical schools were selected, representing various mental health issues and demographic characteristics. RESULTS Three themes were identified: (1) medical schools' response to the pandemic-schools increased awareness-raising of mental health support and increased flexibility in regards to academic requirements; (2) disruption to the medical degree-COVID-19 brought change and uncertainty to medical education and missed learning opportunities reduced students' confidence and (3) psychological consequences of the pandemic-COVID-19 had a negative impact on mental health, most notably raising stress and anxiety but also triggering new or existing conditions. CONCLUSIONS While there were many negative aspects of the pandemic for medical students experiencing mental ill health, there were also positives. Students felt that the increased focus on mental health support during the pandemic had reduced stigma towards mental health. Given stigma has been identified as a key barrier for help-seeking in medical students, future research should investigate the longer-term impacts of the pandemic and whether medical students are more likely to seek help for mental health difficulties postpandemic.
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Affiliation(s)
- Antonia Rich
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Rowena Viney
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Milou Silkens
- Centre for Healthcare Innovation Research, Department of Health Services Research and Management, City University, London, UK
| | - Ann Griffin
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Asta Medisauskaite
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
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15
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Thomas C, Ramirez AP, Alderfer MA, Patton SR, Carakushansky M, Enlow PT. Telehealth and Type 1 Diabetes Care During COVID-19: Perceptions From Youth of Color, Caregivers, and Health Care Providers. Diabetes Spectr 2023; 36:245-252. [PMID: 37583556 PMCID: PMC10425226 DOI: 10.2337/ds22-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Objective At the outset of the coronavirus disease 2019 (COVID-19) pandemic, health care systems rapidly implemented telehealth services to maintain continuity of type 1 diabetes care. Youth of color are more likely to have suboptimal glycemic control and may benefit most from efforts to ensure continuity of care. However, research examining the perspectives of families of youth of color regarding telehealth for pediatric type 1 diabetes care is limited. We gathered perspectives from youth of color, their caregivers, and health care providers (HCPs) on telehealth for type 1 diabetes care during COVID-19. Methods Fifty participants (22 caregivers, 19 youth, and nine HCPs) completed semi-structured interviews conducted in English (n = 44) or Spanish (n = 6). Transcripts containing mentions of telehealth (n = 33) were included for qualitative analysis to extract themes pertaining to perceptions of type 1 diabetes care and telehealth use during COVID-19. Results Themes related to perceptions, feasibility, and quality of telehealth diabetes care were obtained. Most families had positive perceptions of telehealth. Families and HCPs described logistical and technical challenges and noted the potential for disparities in telehealth access and use. Furthermore, caregivers and HCPs felt that the lack of in-person interaction and limited access to clinical data affected the quality of care. Conclusion Families of youth of color with type 1 diabetes mostly had positive perceptions of telehealth but also identified issues with feasibility and quality of care. Our findings highlight a need for interventions promoting equal access to telehealth and quality care for all youth with type 1 diabetes to minimize disruptions in care.
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Affiliation(s)
- Courtney Thomas
- Center for Healthcare Delivery Science, Nemours Children’s Hospital, Delaware, Wilmington, DE
| | - Alejandra Perez Ramirez
- Center for Healthcare Delivery Science, Nemours Children’s Hospital, Delaware, Wilmington, DE
| | - Melissa A. Alderfer
- Center for Healthcare Delivery Science, Nemours Children’s Hospital, Delaware, Wilmington, DE
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Susana R. Patton
- Center for Healthcare Delivery Science, Nemours Children’s Health, Jacksonville, FL
| | - Mauri Carakushansky
- Division of Endocrinology, Nemours Children’s Hospital, Florida, Orlando, FL
- Department of Pediatrics, University of Central Florida College of Medicine, Orlando, FL
| | - Paul T. Enlow
- Center for Healthcare Delivery Science, Nemours Children’s Hospital, Delaware, Wilmington, DE
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
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16
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Ares G, Antúnez L, Curutchet MR, Galicia L, Natero V, Giménez A, Otterbring T. Qualitative exploration of the reasons for not using nutritional warnings after policy implementation in Uruguay. Health Promot Int 2023; 38:6974787. [PMID: 36617288 DOI: 10.1093/heapro/daac174] [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: 01/09/2023] Open
Abstract
Nutritional warnings have gained popularity, particularly in the region of the Americas, to facilitate the identification of products with excessive content of nutrients associated with non-communicable diseases and encourage healthier food choices. Although warnings have been shown to be effective, an in-depth understanding of the reasons why some consumers do not use them is still lacking. The aim of the present work was to explore self-reported use of nutritional warnings and to identify the reasons for not considering nutritional warnings for making food purchase decisions after policy implementation in Uruguay. A non-probabilistic sample of 858 Uruguayan participants was recruited using an advertisement on Facebook and Instagram. Through an online survey, self-reported use of nutritional warnings was asked using a closed-open ended questions. Participants who reported not considering warnings to make their purchase decisions were asked to explain the reasons why using an open-ended question. Responses were analysed using deductive coding, based on the Behavioural Drivers Model. Thirty seven percent of the participants stated that the warnings had not influenced their purchase decisions. Motives for not being influenced by the warnings were related to lack of interest, attitudes, lack of perceived self-efficacy, cognitive biases and limited rationality when making purchase decisions. In addition, structural barriers, such as availability, cost and trust in the food industry also emerged from participants' responses. Strategies to encourage the use of warnings should include communication campaigns and policies to address structural barriers related to the perceived availability and affordability of healthy foods.
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Affiliation(s)
- Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. C.P. 91000, Pando, Canelones, Uruguay
| | - Lucía Antúnez
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. C.P. 91000, Pando, Canelones, Uruguay
| | | | - Luis Galicia
- Ministerio de Salud Pública, 18 de Julio 1892, CP 11200, Montevideo, Uruguay
| | - Virginia Natero
- Ministerio de Salud Pública, 18 de Julio 1892, CP 11200, Montevideo, Uruguay
| | - Ana Giménez
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. C.P. 91000, Pando, Canelones, Uruguay
| | - Tobias Otterbring
- Department of Management, School of Business and Law, University of Agder, Kristiansand, Norway
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17
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Paidipati CP, Foxwell AM, Mooney-Doyle K, Tiller D, Pinto-Martin J, Ulrich CM. Caregiver Perspectives on the Benefits, Burdens, and Moral Distress of Participation in Cancer Clinical Trials. JOURNAL OF FAMILY NURSING 2023; 29:89-98. [PMID: 35611586 DOI: 10.1177/10748407221098187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Caregivers often face critical decisions, burdens, and perceived benefits related to a loved one participating in cancer clinical trial (CCTs). The purpose of this analysis was to better understand caregivers' perceptions on the benefits and burdens of participation in cancer clinical trials. Using a qualitative descriptive design, interviews with 20 caregivers of patient-participants from a larger parent study were conducted. Three major themes emerged. The benefits of research participation focused on enhancing the potential for saving a loved one's life, improving quality of life, and holding altruistic intentions. The burden of research participation emphasized a loved one's suffering as well as physical, emotional, logistical, and financial burden to caregivers. Caregiver moral distress highlighted distressing ethical encounters, such as making decisions on research participation and navigating suboptimal care. Understanding caregiver perceptions is an important step in designing future CCTs that minimize burdens and maximize patient and caregiver health and family-centered care.
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Affiliation(s)
| | - Anessa M Foxwell
- University of Pennsylvania, Philadelphia, USA
- University of Pennsylvania, School of Nursing, Philadelphia, USA
| | | | - Deborah Tiller
- The Wistar Institute, Philadelphia, PA, USA
- University of Pennsylvania, School of Nursing, Philadelphia, USA
| | - Jennifer Pinto-Martin
- University of Pennsylvania, Philadelphia, USA
- University of Pennsylvania, School of Nursing, Philadelphia, USA
| | - Connie M Ulrich
- University of Pennsylvania, Philadelphia, USA
- University of Pennsylvania, School of Nursing, Philadelphia, USA
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18
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Lin TF, Shune S. The Mind-Body-Breath Link During Oral Intake in Chronic Obstructive Pulmonary Disease: A Grounded Theory Analysis. Dysphagia 2023; 38:367-378. [PMID: 35713729 DOI: 10.1007/s00455-022-10473-x] [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: 09/11/2021] [Accepted: 05/31/2022] [Indexed: 01/27/2023]
Abstract
Both chronic obstructive pulmonary disease (COPD) and dysphagia can be complicated by the shared physiological-psychoemotional manifestations of the conditions, such as anxiety and respiratory dysfunction. Despite their shared comorbidities, clinical research and management often focus on the isolated physiological impairments of each condition separately. Crucially, the oral intake experience of individuals with COPD-central for improved quality of life-remains underexplored. Thus, the purpose of this study was to understand the oral intake experience among individuals with COPD, including perceived barriers, behaviors, and emotions. Fourteen individuals with COPD (mean age 68.9; 7 females; 2 with diagnosed dysphagia) participated. Using grounded theory methodology, semi-structured interviews were conducted and analyzed. Four themes surfaced: (a) participants experience physiological manifestations of COPD (dyspnea, coughing) during eating/drinking; (b) emotions related to eating/drinking, such as concern, fear, anxiety, panic, and frustration stem from the physiological manifestations; (c) these emotions worsen the physiological manifestations; and (d) as a result of the physiological manifestations, they adapt eating/drinking behaviors (e.g., choose easier to eat foods, reduce intake size). The theory 'the mind-body-breath feedback and feedforward loops as a contributor to the oral intake experience in individuals with COPD' is subsequently proposed. Of clinical importance, many participants did not recognize their swallowing status as an issue. Ultimately, to promote patient-centered care, we need to view the oral intake experience for individuals with COPD through a more comprehensive lens that incorporates the interrelationships between the physiological and psychoemotional manifestations of COPD and better educate patients on COPD's impact on eating and drinking.
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Affiliation(s)
- Ting-Fen Lin
- Department of Communicative Sciences and Deaf Studies, California State University, Fresno, 93740, USA.
| | - Samantha Shune
- Communication Disorders and Sciences Program, University of Oregon, Eugene, 97403, USA
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19
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Chardon ML, Klages KL, Joffe NE, Pai ALH. Recommendations for Providing Medication Adherence Support After Pediatric Hematopoietic Stem Cell Transplant: Caregivers' Lived Experience. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:5-16. [PMID: 36221958 PMCID: PMC9982233 DOI: 10.1177/27527530221121723] [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] [Indexed: 12/05/2022]
Abstract
Background. Medication adherence is challenging after pediatric hematopoietic stem cell transplant (HCT), particularly after hospital discharge. Post-HCT medication adherence is important to manage morbidity and mortality risk. Designing interventions that are effective and acceptable to caregivers is key to improving post-HCT medication adherence. This study aimed to characterize caregiver preferences about medication adherence support from their child's medical team. Methods. Twenty-nine caregivers of children who received an HCT completed semi-structured qualitative interviews about their experience with, and recommendations for improving, medication adherence support provided by the medical team. Twenty-two caregivers also completed a card sort task to clarify the content of received support and caregiver recommendations for future HCT families. Results. Thematic analysis revealed eight themes grouped into two categories: Communication Is Key and Practical Medication Adherence Support. Caregivers emphasized the importance of communication in helping them manage their child's outpatient medications and provided suggestions to further strengthen communication. The types of practical medication adherence support used varied across caregivers highlighting the importance of tailoring adherence support to each family's needs. Caregivers also identified all the domains as potentially helpful for other families. Discussion. Findings suggest that caregivers prefer that efforts to improve outpatient medication adherence post-HCT prioritize the medical team initiating frequent, clear, and open communication about medications, and provide educational materials on adherence (e.g., handouts). Results also indicate that practical medication adherence supports should be offered based on family preferences but that families may particularly appreciate tips about addressing medication challenges based on other caregivers' lived experience.
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Affiliation(s)
- Marie L. Chardon
- Division of Behavioral Medicine & Clinical Psychology,
Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, OH, USA
| | - Kimberly L. Klages
- Division of Behavioral Medicine & Clinical Psychology,
Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, OH, USA
| | - Naomi E. Joffe
- Division of Behavioral Medicine & Clinical Psychology,
Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Patient and Family Wellness Center, Cancer and Blood Diseases
Institute, CCHMC, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of
Medicine, Cincinnati, OH, USA
| | - Ahna L. H. Pai
- Division of Behavioral Medicine & Clinical Psychology,
Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Patient and Family Wellness Center, Cancer and Blood Diseases
Institute, CCHMC, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of
Medicine, Cincinnati, OH, USA
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20
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Ulrich CM, Deatrick JA, Wool J, Huang L, Berlinger N, Grady C. Ethical Challenges Experienced by Clinical Ethicists during COVID-19. AJOB Empir Bioeth 2023; 14:1-14. [PMID: 35994631 DOI: 10.1080/23294515.2022.2110965] [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: 01/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic continues to disrupt every society as SARs-CoV-2 variants surge among the populations. Health care providers are exhausted, becoming ill themselves, and in some instances have died. Indeed, hospitals are struggling to find staff to care for critically ill patients most in need. Previous work has reported on the unending work-related conditions that hospital staff are laboring under and their subsequent mental and physical health strains. Health care providers need support, but it is not clear where that support is to come from. While much research has reported on the COVID-19-related fears of nurses and physicians, fewer studies have focused on supportive features of the hospital work environment and how it may provide relief to front-line health care providers. PURPOSE This purpose of this study was to explore an often-overlooked resource within hospital systems across the United States-clinical ethicists-and examine their many roles during COVID-19 and the types of ethical issues they addressed with nurses, physicians, administrators, and others. METHODS This was a primary analysis of semi-structured, qualitative interviews with 23 clinical ethicists across the United States. The interviews were conducted from November 2020-April 2021 and were audiotaped, transcribed verbatim, and de-identified; both inductive and deductive analyses were used to identify qualitative themes. RESULTS Five major themes were identified: ethical issues that were increasingly more complex, moral distress that was "endemic," shifting ethical paradigms from the focus on the individual to the population, fostering a supportive environment, and organizational ethics: variation in the value, roles, and policy input of clinical ethicists. CONCLUSIONS Our findings report on the integral and expanded role of clinical ethicists at an unprecedented time in our nation, and how they stepped forward to support front-line clinicians in hospitals across the country.
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Affiliation(s)
- Connie M Ulrich
- Biobehavioral Health Sciences Department, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Janet A Deatrick
- Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Jesse Wool
- Biobehavioral Health Sciences Department, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,LaSalle University, Philadelphia, Pennsylvania, USA
| | - Liming Huang
- Office of Nursing Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | | | - Christine Grady
- Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland, US
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21
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McDonald KP, Fisher R, Connolly J. Building a specialized model of care for youth involved in sex trafficking in child welfare: A systematic review and interviews with experts-by-experience. CHILD ABUSE & NEGLECT 2023; 135:105987. [PMID: 36527983 DOI: 10.1016/j.chiabu.2022.105987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Sex trafficking of youth involved in the child welfare system is a critical global issue; however, there are limited counter-trafficking programs designed to specifically meet the needs of this population. OBJECTIVE The present study aimed to identify components essential to building a model of care for youth involved in sex trafficking in child welfare. The specific goals of this investigation were to: 1) systematically review the literature for programs implemented with child-welfare involved youth at risk of or involved in sex trafficking, and 2) examine convergent and divergent evidence through interviews with experts-by-experience (i.e., survivors and child welfare personnel). PARTICIPANTS AND SETTING 13 child welfare workers and 6 survivors of sex trafficking. METHODS Systematic review identified articles that included programs and interventions for youth involved in sex trafficking in child welfare. Interviews with experts-by-experience were analysed through reflexive thematic analysis. Content analysis was used to examine convergent and divergent evidence between the two noted methods of inquiry (systematic review and interviews with experts). RESULTS Findings from the systematic review support a model of care comprised of two overarching components: 1) wraparound supports, and 2) trained caregivers and supported foster homes. Thematic analyses also revealed that experts thought that an appropriate model of care would require child welfare agencies to take a preventative stance, such as conducting early coordinated risk assessments on all youth in care. Convergent with the literature, experts noted the need for enhanced wraparound supports and specific training for caregivers and service providers. CONCLUSIONS Components essential to building a model of care for youth at risk of or involved in sex trafficking in child welfare were extracted and discussed based on the evidence gathered.
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22
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Brodar KE, Leite RO, Jaramillo M, Marchetti D, Davis E, Sanchez J, Saab PG, Delamater AM, La Greca AM. Psychosocial screening in a pediatric diabetes clinic: Adolescents' and mothers' perspectives. Pediatr Diabetes 2022; 23:1101-1112. [PMID: 35752873 DOI: 10.1111/pedi.13385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/17/2022] [Accepted: 06/23/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Adolescents with type 1 diabetes (T1D) frequently experience psychosocial concerns, and mental health screening is becoming increasingly common in routine diabetes care. However, little is known about what adolescents or their caregivers think about the role of mental health screening and intervention within the context of comprehensive diabetes care, or how their diabetes care providers should be involved in navigating mental health concerns. This study used qualitative methods to obtain the perspectives of adolescents with T1D and their caregivers regarding these issues. METHODS Participants were 13 adolescents with T1D (ages 12-19 years; M = 15.1 years; 53.8% female; 61.5% Hispanic/Latinx White) and 13 mothers, recruited from an outpatient pediatric endocrinology clinic in South Florida, who participated in semi-structured interviews via video teleconference. Thematic content analysis was used to evaluate participants' responses. RESULTS Adolescents and their mothers reported positive experiences with the clinic's psychosocial screening procedures and appreciated meeting with the psychology team during visits. They wanted the clinic to offer more opportunities for peer support. Mothers highlighted barriers to seeking mental health care outside of the clinic and the importance of mental health professionals understanding diabetes. Mothers also wanted the clinic to offer more on-site therapeutic services. DISCUSSION Study participants valued psychosocial screening and supported addressing mental health as a routine part of diabetes comprehensive care.
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Affiliation(s)
- Kaitlyn E Brodar
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Rafael O Leite
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Manuela Jaramillo
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Daniella Marchetti
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Eileen Davis
- Mailman Center for Child Development, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Janine Sanchez
- Mailman Center for Child Development, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Patrice G Saab
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Alan M Delamater
- Mailman Center for Child Development, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Annette M La Greca
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
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23
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Aslam F, Mahboob U, Zahra Q, Zohra S, Malik R, Khan RA. The Drudgery of a Doctor's Disciple: Exploring the effects of Negative Role Modelling on medical students' professional development. MEDICAL TEACHER 2022; 45:1-7. [PMID: 36272400 DOI: 10.1080/0142159x.2022.2133690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Role modelling is considered an essential component of teaching in various educational settings and impact students' professional development. Most studies found in the literature have explored the influence of positive role models and limited data is available about the negative role modelling. This study explores the effects of negative role modelling of teachers on the professional development of future doctors. METHODS A qualitative exploratory study was done in three medical colleges of Lahore, Pakistan. Fifteen, telephonic, semi-structured interviews were done with fifth-year MBBS students. A thematic analysis was done through manual coding of transcribed interviews. RESULTS A total of 374 codes were generated in the first cycle of coding, that was merged to 42 in the second cycle. These codes led to 4 subthemes that finally emerged as two themes. The first theme was "Students & patients: In the same boat" highlighting the damaging effects of negative role modelling. The second theme was "Taking the bad with the good" focusing on the ambivalent response of students towards the unprofessional behaviours of their role models. CONCLUSION Negative role modelling exponentially affects the attitude and behaviour of medical students especially in informal settings and have detrimental effects on patient care. Students lose some degree of humanism while unconsciously observing the unethical behaviours, to become a part of hospital culture whereas some students show determination to channelize their resentment to reforms.
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Affiliation(s)
- Fatima Aslam
- Department of Psychiatry & Behavioural Sciences, Avicenna Medical College & Hospital, Lahore, Pakistan
| | - Usman Mahboob
- Institute of Health Professions Education (IHPE&R), Khyber Medical University, Peshawar, Pakistan
| | - Qundeel Zahra
- Department of Ophthalmology, Azra Naheed Medical College & Hospital, Lahore, Pakistan
| | | | - Rabia Malik
- Department of Medical Education, Muhammad Islam Medical & Dental College, Gujranwala, Pakistan
| | - Rehan Ahmed Khan
- Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan
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Taraban L, Wasserman R, Cao VT, Eshtehardi SS, Anderson BJ, Thompson D, Marrero DG, Hilliard ME. Diabetes-Related Worries and Coping Among Youth and Young Adults With Type 1 Diabetes. J Pediatr Psychol 2022; 47:1145-1155. [PMID: 35773974 PMCID: PMC9582784 DOI: 10.1093/jpepsy/jsac055] [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: 12/16/2021] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Although mood and anxiety symptoms are common in youth with type 1 diabetes (T1D), little research has described their worries across developmental stages or the strategies they use to cope with these worries. This secondary data analysis aimed to describe and characterize common T1D-related worries and coping strategies from middle childhood through young adulthood. METHODS Twenty-three youth (9 children, 7 adolescents, and 7 young adults) completed semistructured qualitative interviews about health-related quality of life. We coded interview transcripts using thematic analysis to generate common themes of diabetes-related worries and coping strategies. RESULTS Participants' worries fell into four major themes: Managing Blood Glucose, Self-Efficacy for Diabetes Management, Interpersonal Relationships, and Lifestyle Impact, and eight youth denied having diabetes-related worries. Coping strategies fell into the three major themes: Attempts to Change Source of Worry, Attempts to Change Reactions to Worry, and Attempts to Orient Away from the Worry. CONCLUSIONS Youths' worries about various aspects of living with and feeling able to self-manage diabetes are important to consider across pediatric development as they can impact youths' participation in daily activities and future plans. By adolescence, youth report longer-term worries about the health and lifestyle implications of diabetes. Youths' reported coping strategies are generally consistent with existing coping frameworks, though our data suggest some possible refinements. Social support emerged as an important coping strategy for all age groups. Thus, interventions supporting youth in building and strengthening their social networks may be particularly beneficial in helping youth cope with their diabetes-related worries across development.
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Affiliation(s)
- Lindsay Taraban
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Rachel Wasserman
- Nemours Children’s Health and University of Central Florida College of Medicine, USA
| | - Viena T Cao
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Sahar S Eshtehardi
- Department of Psychological Health and Learning Sciences, University of Houston, USA
| | - Barbara J Anderson
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, USA
| | | | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
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Jaeger SR, Vidal L, Chheang SL, Ares G. Consumer conceptualisations of food-related wellbeing: An exploration of wellbeing-related terms in four industrialised countries. Appetite 2022; 179:106286. [PMID: 36038074 DOI: 10.1016/j.appet.2022.106286] [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: 06/21/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022]
Abstract
Perceived (or subjective) wellbeing is regarded as key to understanding consumer food choices and the development of strategies to promote desirable eating habits. Yet, in-depth understanding of the specific factors that contribute to people's perceived wellbeing across cultures is lacking. These factors motivated the present research that used word associations to conduct an exploratory analysis of consumer conceptualisations of food-related wellbeing (WB). Adults (n = 4945) living in the United Kingdom, Australia, Singapore or Germany, speaking respectively, English or German, took part in the study. Health, pleasure, food quality, positive emotions and social aspects of food consumption were the main associations with food-related wellbeing. Absence hereof was associated with unhealthiness, disgust, negative emotions and poor mental health. The differences in these main associations emphasised the importance of exploring wellbeing, as well as lack hereof. Not doing so leads to an incomplete understanding of this multidimensional construct. The research was conducted with four terms related to wellbeing (each in their positive and negative versions): 'sense of wellbeing' and 'lack of wellbeing', 'feeling good' and 'feeling bad/unhappy', 'satisfied with life' and 'dissatisfied with life' and 'fulfilled in life' and 'unfulfilled in life'. Because these different terms gave rise to different wellbeing associations, researchers in this area must choose their empirical approach with care. The terms 'sense of wellbeing' and 'feeling good' tended to more frequently give rise to health-related associations. Conversely, 'satisfied with life' and 'fulfilled in life' tended to more frequently give rise to positive spiritual and emotional associations of food-related wellbeing. The main conceptualisations of food-related wellbeing were cross-culturally similar, but extension of the present research to other Asian countries was recommended based on several differences between Singaporean participants and those from other countries. In ethnically diverse countries like Singapore, further within-country investigations of different cultures also have merit.
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Affiliation(s)
- Sara R Jaeger
- The New Zealand Institute for Plant and Food Research Limited, 120 Mt Albert Road, Private Bag, 92169, Victoria Street West, Auckland, New Zealand.
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de La República, By Pass de Rutas 8 y 101 S/n, CP 91000, Pando, Canelones, Uruguay
| | - Sok L Chheang
- The New Zealand Institute for Plant and Food Research Limited, 120 Mt Albert Road, Private Bag, 92169, Victoria Street West, Auckland, New Zealand
| | - Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de La República, By Pass de Rutas 8 y 101 S/n, CP 91000, Pando, Canelones, Uruguay
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Dimensions of Proximity: An Actionable Framework to Better Understand Integrated Practices in Cancer Networks. Int J Integr Care 2022; 22:9. [PMID: 36060829 PMCID: PMC9389948 DOI: 10.5334/ijic.6434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 08/03/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: This study empirically explores how dimensions of proximity that support integrated care emerge from deliberate actions within a cancer network in Quebec (Canada). Methods: We conduct a supplementary analysis of qualitative data from a primary multi-case study focused on collaborative governance and cancer care integration. Data from semi-structured interviews, documents and observation are analysed to find out how relationships take shape through actions that create different dimensions of proximity, and how these contribute to integrated practices. Results: Deliberate actions at different levels within the network create dimensions of proximity. The creation of committees and communities of practice at national and local level establish geographic proximity. Relational proximity among actors emerges to different degrees in these venues. Cognitive proximity is generated by consistent promotion of the national cancer plan and person-centred care. The priority of cancer care at policy level and prescription of common standards enhance organizational proximity. Synergy between dimensions of proximity appears essential to the emergence of integrated practices. Insufficient efforts to create technological and institutional proximity contribute to inconsistent clinical and professional integration. Conclusion: The concept of proximity appears a promising complement to existing models of integration, especially in complex contexts such as cancer networks. Highlights The multiple dimensions of proximity appear a promising complement to existing models of integration, especially in complex contexts such as cancer networks.
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Fiskum C, Johns UT, Andersen TG, Jacobsen K. Parents’ Experiences of Change in Developmental and Transactional Processes After Time-Limited Intersubjective Child Psychotherapy – A Qualitative Study. Front Psychol 2022; 13:898389. [PMID: 35910974 PMCID: PMC9326770 DOI: 10.3389/fpsyg.2022.898389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
Psychopathology in children cannot be understood without considering developmental processes and transactional relationships, particularly the relationship with caregivers. Time-limited intersubjective child psychotherapy (TIC) is a developmental and transactional approach aimed at helping children and caregivers get back on healthier developmental trajectories. Core developmental processes, such as self-other-regulation and affect integration, are considered particularly important for healthy function and transactions with caregivers and contexts. Therefore, TIC seeks to strengthen core developmental processes in the child and the caregivers’ ability to scaffold the child’s development. This is achieved through parallel child therapy and parent sessions. The current study is a qualitative study of parents’ experiences of change after TIC. The study explores parents’ perception of change in their child, themselves, and their transactions, and what they experienced as helpful in therapy.Materials and MethodsNine semi-structured qualitative interviews were conducted with parents (n = 13) of nine children aged 9–12 years with internalizing difficulties after completing TIC. The data were analyzed with thematic analysis.ResultsThe parents described positive changes in the children’s ability to understand, regulate and express themselves. The parents also described positive changes in their parenting, and for all nine children the parents reported positive changes in the transactions between themselves and the child. Most parents saw the parallel child and parental sessions as particularly important, while several parents mentioned play and the therapeutic focus.DiscussionParents’ description of changes after TIC indicate that the parents perceived their children as strengthened in core developmental processes important for intersubjective exchanges such as self-regulation and affect integration. In addition, parents saw their children and their own contributions more clearly, and their transactions were described as more supportive and positive.ConclusionThe results from this study give support to TIC as a developmentally supportive approach to therapy, with potential effects on children’s core developmental processes, their parents’ ability to both see and scaffold the child’s development and positive effects on the transactions between children and parents. The positive effects likely result from the integration of the different parts of TIC and the synergies taking place between them, rather than any one component by itself.
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Affiliation(s)
- Charlotte Fiskum
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- *Correspondence: Charlotte Fiskum,
| | - Unni Tanum Johns
- Child and Adolescent Mental Health Services, Akershus University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Karl Jacobsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Kaya Y, Kılıç ST, Öz F. Holistic nursing clinical practice experiences of nursing students in medical-surgical clinics: A qualitative study. Perspect Psychiatr Care 2022; 58:1121-1129. [PMID: 34223650 DOI: 10.1111/ppc.12910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study was conducted to examine the experiences of nursing students in holistic nursing clinical practice. DESIGN Twenty senior nursing students participated in this study. Data were collected through focus group interviews with a qualitative approach followed by thematic data analysis. FINDINGS Four themes were obtained holistic care, barriers to holistic care, the contributions of holistic nursing internship, and students' expectations. PRACTICE IMPLICATIONS The participants stated that they believe that physical care is sufficient enough in the care they provide to patients and their families in clinical practice and that they only provide physical care. However, they stated that they became aware of the importance of holistic care with this practice and gained better insights into their professional requirements.
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Affiliation(s)
- Yunus Kaya
- Child Development Department, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey
| | - Sevcan T Kılıç
- Gerontology Deparment, Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey
| | - Fatma Öz
- Nursing Deparment, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
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Matthie NS, Clayton-Jones DL, Jenerette CM. "Into the Lion's Den": COVID-19 Experiences of Black Adults with Sickle Cell Disease. QUALITATIVE HEALTH RESEARCH 2022; 32:1328-1341. [PMID: 35621329 DOI: 10.1177/10497323221094143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Adults living with sickle cell disease are at risk for experiencing severe illness from coronavirus disease 2019 (COVID-19) due to the complexity of their disease. Additionally, self-management and navigating the healthcare system may be challenging during the COVID-19 pandemic. Therefore, we conducted telephone interviews with 25 participants to explore the experiences of Black adults living with sickle cell disease during the early months of the pandemic in the United States. Three overarching themes characterize their experiences: management of sickle cell disease was further complicated by the pandemic, fear of the virus contributed to physical and social isolation, and employment and financial challenges affected well-being. The pandemic contributed to changes in health care maintenance and had a disproportionate impact on this population. Addressing social and structural determinants of health and disruptions in health care accessibility is critical to advancing health and health care equity for individuals living with sickle cell disease.
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Affiliation(s)
- Nadine S Matthie
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
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El-Banna G, Higuera K, Mendoza FS. The Intergenerational Health Effects of the Deferred Action for Childhood Arrivals Program on Families With Mixed Immigration Status. Acad Pediatr 2022; 22:729-735. [PMID: 34320415 PMCID: PMC8786974 DOI: 10.1016/j.acap.2021.07.016] [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: 11/18/2020] [Revised: 06/09/2021] [Accepted: 07/20/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Children of undocumented mothers with Deferred Action for Childhood Arrivals (DACA) have better mental health outcomes than children of DACA-ineligible mothers. This study explored the intergenerational health effects of DACA on undocumented parents and their children in families with mixed immigration status. METHODS Forty-eight semistructured interviews were selected from a study on life transitions of 50 undocumented immigrants. Prevalent themes related to the intergenerational health effects of DACA on undocumented immigrants were identified through thematic analysis of the transcripts, and quotes were selected to illustrate themes in the participants' own words. RESULTS Thirty-three of the 48 respondents were DACA recipients. Twenty-six respondents were parents with a total of 61 children, 73.8% of whom were US-born. Four themes were identified: 1) DACA recipients reported decreased familial stress because of protection from deportation and increased access to health care, 2) both DACA and DACA-ineligible parents prioritized regular pediatrician visits for their children, but DACA-ineligible parents suffered from poor health because of decreased access to health care, 3) adults with DACA mirror the health behaviors of their DACA-ineligible parents, and 4) the poor health access of DACA-ineligible family members appeared to stress DACA recipients and US-born children in these families. CONCLUSIONS DACA decreases children's fear of parental deportation and loss. However, the suffering of DACA-ineligible parents and family members may stress their children and influence their health-seeking behavior in adulthood. Health care access for all members of immigrant families needs to be examined, since their well-being impacts the well-being of their children.
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Ares G, Antúnez L, de León C, Alcaire F, Vidal L, Natero V, Otterbring T. 'Even if you don't pay attention to it, you know it's there': A qualitative exploration of adolescents' experiences with digital food marketing. Appetite 2022; 176:106128. [PMID: 35718311 DOI: 10.1016/j.appet.2022.106128] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/02/2022]
Abstract
Adolescents are particularly vulnerable to digital food marketing. However, research on adolescents' recall, awareness, and opinions of this type of marketing is still scarce. Accordingly, the present study aimed to conduct an in-depth examination of adolescents' experiences with digital food marketing. A convenience sample of 209 adolescents was recruited at two private educational institutions and a public health facility in Montevideo, the capital city of Uruguay. Semi-structured group interviews were conducted, recorded in audio and transcribed. The transcripts were analyzed using content analysis based on a deductive-inductive approach. Results showed that participants were highly exposed to digital food marketing, as they all remembered having seen advertisements, with those of fast-food restaurants and food-ordering apps being the most frequently mentioned. According to the adolescents' accounts, images, colors, music, oversized portions, product novelty, price promotions and celebrities were the most memorable aspects of food advertisements. Participants recognized the effect of advertisements on product awareness and wanting, and, to a lesser extent, on actual purchase and consumption behavior. Factors that were thought to mediate the impact of digital marketing on food choice were also identified. In the final part of the interviews, participants proposed strategies to reduce the effect of digital marketing on their food choices, which included both regulatory approaches to reduce exposure to digital marketing of unhealthy foods and behavior change communication. Together, the current findings provide insights for the development of multifaceted strategies to reduce the effects of digital food marketing on the eating habits of adolescents.
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Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000. Pando, Canelones, Uruguay.
| | - Lucía Antúnez
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000. Pando, Canelones, Uruguay
| | | | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000. Pando, Canelones, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000. Pando, Canelones, Uruguay
| | - Virginia Natero
- Departamento de Alimentos, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Tobias Otterbring
- School of Business and Law, Department of Management, University of Agder, Universitetsveien 17, 4630 Kristiansand, Norway; Institute of Retail Economics, Regeringsgatan 60, 103 29, Stockholm, Sweden
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Evans C, Fidler A, Baker D, Wagner M, Fedele D. Sleep and asthma management in youth with poorly-controlled asthma and their caregivers: a qualitative approach. J Asthma 2022; 59:1131-1138. [PMID: 33827372 PMCID: PMC10072859 DOI: 10.1080/02770903.2021.1914650] [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: 02/05/2023]
Abstract
OBJECTIVE Youth with poorly-controlled asthma are at increased risk for sleep disturbances caused by nocturnal symptoms like coughing. Asthma-related sleep disturbances can have downstream consequences for youth with asthma and their families. This study aims to describe (1) sleep disturbances in adolescents with poorly-controlled asthma and their caregivers and (2) the relationship between sleep and asthma management. METHODS Adolescents with poorly-controlled asthma and their caregivers completed the Family Asthma Management System Scale (FAMSS), a semi-structured interview that assesses youth asthma management within the family context. Interviews were audio-recorded and transcribed. Two authors coded each transcript for sleep-related data in NVivo using descriptive content analysis. RESULTS Thirty-three adolescents ages 12-15 years old (M = 13.2, SD = 1.2) with poorly-controlled asthma and their caregivers participated in this study. Four main themes emerged: sleep difficulties, sleep environment, sleep and self-management, and fatigue and self-management. 42% of youth and caregivers reported worse nocturnal asthma symptoms (e.g. coughing) that caused frequent nighttime awakening. Approximately 27% of caregivers expressed distress over their child's nocturnal asthma and described their management strategies (e.g. co-sleeping, nighttime symptom monitoring). Adolescents described sleepiness as a barrier to asthma self-management tasks (e.g. medication adherence, response to exacerbation). CONCLUSION Interview responses demonstrated the considerable interrelationship of sleep and asthma management in adolescents with poorly-controlled asthma. Asthma providers should consider discussing sleep difficulties with their adolescent patients and their families. Addressing these difficulties may help adolescents improve their asthma self-management and help caregivers better cope with their child's disease.
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Affiliation(s)
- Corinne Evans
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Andrea Fidler
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Dawn Baker
- UF Health Pediatric Pulmonary, University of Florida, Gainesville, FL, USA
| | - Mary Wagner
- UF Health Pediatric Pulmonary, University of Florida, Gainesville, FL, USA
| | - David Fedele
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Thompson D, Deatrick JA, Knafl KA, Swallow VM, Wu YP. A Pragmatic Guide to Qualitative Analysis for Pediatric Researchers. J Pediatr Psychol 2022; 47:1019-1030. [PMID: 35552750 DOI: 10.1093/jpepsy/jsac040] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe four approaches to qualitative analysis in order to provide a pragmatic, application-oriented guide to their use in research focused on children and their families. METHODS Four commonly used approaches to qualitative analysis-framework analysis, rapid qualitative analysis, content analysis, and reflexive thematic analysis-are described and compared, including their analytic strategies, tips for use, terminology, and application to a hypothetical example. RESULTS A pragmatic guide to each method is provided as well as examples of how each analytic approach could be utilized to analyze the same dataset. CONCLUSIONS A variety of approaches to qualitative analysis are available to both novice and experienced qualitative researchers. The approach selected from the options presented in this article will depend on numerous factors, such as the clinical problem being explored, research context, aims, objectives, research questions, and resources available such as time and funds, and the qualitative expertise of the team.
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Affiliation(s)
- Debbe Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Janet A Deatrick
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Kathleen A Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Veronica M Swallow
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
| | - Yelena P Wu
- Department of Dermatology and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Fidler AL, Voorhees S, Zhou ES, Stacciarini JM, Fedele DA. A systematic review and proposed conceptual model of sleep disturbances during pediatric hospitalizations. Sleep 2022; 45:zsac038. [PMID: 35554575 DOI: 10.1093/sleep/zsac038] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/19/2022] [Indexed: 09/21/2023] Open
Abstract
STUDY OBJECTIVES The current review aims to examine factors that influence pediatric inpatient sleep and determine the effectiveness of sleep promotion interventions among hospitalized children. METHODS A systematic literature search was conducted across PubMed, PsycINFO, CINAHL, Cochrane Central, Web of Science, Embase, and Scopus databases. Studies included children with a mean age between 1 and 18 years old that either described factors affecting the sleep of children who are hospitalized on a non-intensive care unit or reported on sleep-related intervention outcomes. We conducted separate narrative reviews for each of the two aims and then synthesized findings from quantitative and qualitative studies across both aims. RESULTS Forty-five articles were included for review. Despite most sleep disturbances being attributed to environmental disruptions (e.g. noise, staff interruptions), most interventions targeted the child level using relaxation techniques. Although the majority of interventions were small pilot studies, preliminary findings appear to positively impact sleep duration. The Pediatric Inpatient Sleep Model was proposed to illustrate connections between sleep disturbances, factors influencing sleep, and existing intervention components. CONCLUSIONS Replication studies are needed, including larger-scale sleep promotion interventions among hospitalized children. Given the identification of environmental factors as the main cause of night wakings, environmental modifications are crucial. Additional research examining contributors to intraindividual variability in disrupted sleep patterns during hospitalizations as well as the consequences of these disturbances is warranted.
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Affiliation(s)
- Andrea L Fidler
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Sara Voorhees
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Eric S Zhou
- Dana-Farber Cancer Institute, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | | | - David A Fedele
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Carreon SA, Cao VT, Anderson BJ, Thompson DI, Marrero DG, Hilliard ME. 'I don't sleep through the night': Qualitative study of sleep in type 1 diabetes. Diabet Med 2022; 39:e14763. [PMID: 34875120 DOI: 10.1111/dme.14763] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 12/03/2021] [Indexed: 11/28/2022]
Abstract
AIMS Individuals with type 1 diabetes (T1D) experience greater sleep disturbances than people without diabetes. However, the nature, causes and effects of sleep disruption in individuals with T1D and their family are not well understood. The purpose of this study was to explore and characterise the perspectives of parents, partners and individuals with diabetes about T1D-related sleep issues. METHODS Participants included 44 youth and adults with T1D (ages 9-69), 24 parents of youth with T1D, and 14 partners of adults with T1D, recruited from diabetes clinics at two academic medical centres in the Southwestern and Midwestern United States. Semi-structured qualitative interviews were transcribed verbatim, coded and analysed using hybrid thematic analysis. RESULTS We identified two central themes: Emotional Distress and Sleep Disruption. Each theme had multiple subthemes, and the two central themes were related to one another via a shared subtheme, Worry Impacting Sleep. CONCLUSIONS Complex T1D-related emotional and behavioural factors both contributed to and resulted from sleep difficulties. Diabetes care providers should routinely assess for sleep concerns in people with T1D and their parents and partners. It may be important to consider both diabetes-related causes of sleep disruptions and potential impacts on self management and emotional functioning.
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Affiliation(s)
- Samantha A Carreon
- Baylor College of Medicine & Texas Children's Hospital, Houston, Texas, USA
| | - Viena T Cao
- Baylor College of Medicine & Texas Children's Hospital, Houston, Texas, USA
| | - Barbara J Anderson
- Baylor College of Medicine & Texas Children's Hospital, Houston, Texas, USA
| | - Deborah I Thompson
- Baylor College of Medicine & Texas Children's Hospital, Houston, Texas, USA
- USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA
| | | | - Marisa E Hilliard
- Baylor College of Medicine & Texas Children's Hospital, Houston, Texas, USA
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Mukund B, Jena SPK. Qualitative analysis of school children's experience of receiving “Coping Cat program”: A cognitive behavioral therapy program for high anxiety. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Bhavna Mukund
- Department of Psychology, Faculty of Arts University of Delhi, North Campus Delhi Delhi India
| | - S. P. K. Jena
- Department of Applied Psychology University of Delhi, South Campus Delhi India
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Paidipati CP, Deatrick JA, Eiraldi RB, Ulrich CM, Lane JM, Brawner BM. Caregivers' perspectives on the contextual influences within family management for ethnically diverse children with ADHD. J SPEC PEDIATR NURS 2022; 27:e12365. [PMID: 34962094 DOI: 10.1111/jspn.12365] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/15/2021] [Accepted: 12/08/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder affecting over 9% of children in the United States. Family caregivers are often responsible for the management of their child's ADHD. Contextual influences, such as healthcare providers, systems, and resources, are factors contributing to the ease or difficulty of family management. The purpose of this article is to qualitatively describe the major contextual influences that impact family management for ethnically diverse children with ADHD. DESIGN AND METHODS This analysis is part of a mixed methods study using a concurrent nested design (QUAL + quant) to understand the phenomenon of family management from a contextual and socioecological perspective. In this analysis, cross-sectional data from caregivers of children with ADHD (N = 50) within a large northeastern city in the United States were collected, analyzed, and interpreted in the qualitative descriptive tradition. Semistructured interviews were conducted with participants to understand the contextual influences within family management. Conventional content analysis resulted in the emergence of barrier and facilitator domains and subdomains. RESULTS Caregivers were predominantly female (98%) and between 24 and 61 years with a mean age of 37.54 (SD = 1.18). Caregivers identified their children as Black or African American (56%), White (26%), Multi-Racial (16%), Hispanic or Latinx (8%), and Asian (2%). Contextual influences within family management emerged as barrier or facilitator domains. Barrier domains included: (1) family, (2) healthcare systems, (3) educational systems, (4) stigma, and (5) financial, insurance, and policy issues. Facilitator domains included: (1) family and community, (2) healthcare providers, and (3) educational providers. Subdomains within each domain are expanded in the article. PRACTICE IMPLICATIONS Specialists in pediatric nursing should consider contextual influences within family management for ethnically diverse children with ADHD. As healthcare providers, it is important to recognize system-level barriers or facilitators for caregivers and their children and find creative ways to overcome obstacles and leverage strengths within families, communities, and care systems. Another important area for pediatric specialists to consider is understanding how stigma impacts children with ADHD. Policy-level engagement and advocacy should maximize the political will of nurses, families, and educators to create change within communities.
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Affiliation(s)
- Cynthia P Paidipati
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, Illinois, USA
| | - Janet A Deatrick
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ricardo B Eiraldi
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Connie M Ulrich
- School of Nursing, Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jamil M Lane
- Warner Graduate School of Education and Human Development, University of Rochester, Rochester, New York, USA
| | - Bridgette M Brawner
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Short E, Sharma J, Thompson DI, Taren D, Gonzalez R, Hingle M. Food Assistance Use Among Food Bank Clients Affected by Type 2 Diabetes. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:288-298. [PMID: 35034840 PMCID: PMC9007878 DOI: 10.1016/j.jneb.2021.11.001] [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: 05/05/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To understand the perspectives of food bank clients affected by type 2 diabetes (T2DM). DESIGN Semi-structured in-depth interviews conducted with food bank clients. SETTING Arizona regional food bank. PARTICIPANTS Twenty English- and Spanish-speaking food bank clients with T2DM or living with a person with T2DM, aged 45-83 years, majority female, Hispanic, and food insecure. PHENOMENON OF INTEREST Food bank use and preferences, and how these related to T2DM management. ANALYSIS A hybrid thematic analysis combining inductive and deductive reasoning. RESULTS Three organizing themes emerged from the analysis. First, food assistance was influenced by food preferences and the ability to pair with existing household foods. Second, desired support included fresh fruits and vegetables, meat, oats, oil, and herbs; recipes; cooking demonstrations; and social support. Third, factors influencing T2DM management were lack of financial resources, low motivation, insufficient nutrition knowledge, low medication adherence, and multiple comorbidities. Participants also expressed resilience and interest in improving T2DM management. CONCLUSIONS AND IMPLICATIONS Among a predominantly Hispanic food bank sample, produce and protein-rich foods, nutrition and culinary education, and social support were components of a supportive food bank experience and should be considered when designing food-based interventions for T2DM management for food insecure persons.
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Affiliation(s)
- Eliza Short
- School of Nutritional Sciences and Wellness, College of Agriculture and Life Sciences, The University of Arizona, Tucson, AZ; University of Arizona Collaboratory for Metabolic Disease Prevention and Treatment, Abrams Public Health Center, The University of Arizona, Tucson, AZ.
| | - Jayati Sharma
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Debbe I Thompson
- Department of Pediatrics, US Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Douglas Taren
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
| | | | - Melanie Hingle
- School of Nutritional Sciences and Wellness, College of Agriculture and Life Sciences, The University of Arizona, Tucson, AZ; University of Arizona Collaboratory for Metabolic Disease Prevention and Treatment, Abrams Public Health Center, The University of Arizona, Tucson, AZ
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Tremblay D, Turcotte A, Touati N, Poder TG, Kilpatrick K, Bilodeau K, Roy M, Richard PO, Lessard S, Giordano É. Development and use of research vignettes to collect qualitative data from healthcare professionals: a scoping review. BMJ Open 2022; 12:e057095. [PMID: 35105654 PMCID: PMC8804653 DOI: 10.1136/bmjopen-2021-057095] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To clarify the definition of vignette-based methodology in qualitative research and to identify key elements underpinning its development and utilisation in qualitative empirical studies involving healthcare professionals. DESIGN Scoping review according to the Joanna Briggs Institute framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. DATA SOURCES Electronic databases: Academic Search Complete, CINAHL Plus, MEDLINE, PsycINFO and SocINDEX (January 2000-December 2020). ELIGIBILITY CRITERIA Empirical studies in English or French with a qualitative design including an explicit methodological description of the development and/or use of vignettes to collect qualitative data from healthcare professionals. Titles and abstracts were screened, and full text was reviewed by pairs of researchers according to inclusion/exclusion criteria. DATA EXTRACTION AND SYNTHESIS Data extraction included study characteristics, definition, development and utilisation of a vignette, as well as strengths, limitations and recommendations from authors of the included articles. Systematic qualitative thematic analysis was performed, followed by data matrices to display the findings according to the scoping review questions. RESULTS Ten articles were included. An explicit definition of vignettes was provided in only half the studies. Variations of the development process (steps, expert consultation and pretesting), data collection and analysis demonstrate opportunities for improvement in rigour and transparency of the whole research process. Most studies failed to address quality criteria of the wider qualitative design and to discuss study limitations. CONCLUSIONS Vignette-based studies in qualitative research appear promising to deepen our understanding of sensitive and challenging situations lived by healthcare professionals. However, vignettes require conceptual clarification and robust methodological guidance so that researchers can systematically plan their study. Focusing on quality criteria of qualitative design can produce stronger evidence around measures that may help healthcare professionals reflect on and learn to cope with adversity.
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Affiliation(s)
- Dominique Tremblay
- School of Nursing, Université de Sherbrooke, Longueuil, Quebec, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
| | - Annie Turcotte
- School of Nursing, Université de Sherbrooke, Longueuil, Quebec, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
| | - Nassera Touati
- École Nationale d'Administration Publique, Montreal, Quebec, Canada
| | - Thomas G Poder
- School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Kelley Kilpatrick
- Ingram School of Nursing, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Susan E. French Chair in Nursing Research and Innovative Practice, Montreal, Quebec, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Mathieu Roy
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Patrick O Richard
- Department of Surgery, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sylvie Lessard
- Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
| | - Émilie Giordano
- Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
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Ferro C, Ares G, Aschemann-Witzel J, Curutchet MR, Giménez A. "I don't throw away food, unless I see that it's not fit for consumption": An in-depth exploration of household food waste in Uruguay. Food Res Int 2022; 151:110861. [PMID: 34980397 DOI: 10.1016/j.foodres.2021.110861] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/01/2021] [Accepted: 12/01/2021] [Indexed: 01/09/2023]
Abstract
Significant reductions in household food waste have been regarded as a key step towards achieving global sustainable development. Household food waste is a complex phenomenon determined by consumer behavior along the steps of the "food journey" that goes from purchasing to final disposal. Although avoiding food waste is socially desirable and raises positive attitudes, consumers do not frequently engage in avoidance behaviors. The objectives of the present work were: i) to explore the views of Uruguayan citizens on household food waste, and ii) to identify drivers of food waste among Uruguayan households. A total of 20 in-depth interviews based on a semi-structured guide were conducted by telephone. Participants were asked to recall and describe the last time they discarded food, as well as to describe the most common food waste situations in their household, the most commonly used strategies to avoid food waste and how they could reduce it. The transcripts were analyzed using content analysis based on a deductive-inductive approach. Interviews revealed that most of the participants perceived food waste in their homes as null or low, whereas food waste in the country was regarded as high. When participants described food waste incidents, they perceived it as 'unavoidable', suggesting that they tended to find a rational explanation outside of their will to justify their behavior. Participants' discourses enabled the identification of drivers related to behavioral factors, personal factors, product factors, and contextual factors. Results stress that most promising entry points for communication campaigns and intervention programs to reduce household food waste should focus on behavioral factors, planning throughout all the household stages of the food journey and the provision of knowledge and skills on food storage, handling, and preparation.
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Affiliation(s)
- Camila Ferro
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200 Montevideo, Uruguay
| | - Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000 Pando, Canelones, Uruguay
| | - Jessica Aschemann-Witzel
- MAPP Centre - Research on Value Creation in the Food Sector, Aarhus University, Fuglesangsalle 4, 8210 Aarhus V, Denmark
| | - María Rosa Curutchet
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 1100 Montevideo, Uruguay
| | - Ana Giménez
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000 Pando, Canelones, Uruguay.
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Welling MS, Abawi O, van den Eynde E, van Rossum EFC, Halberstadt J, Brandsma AE, Kleinendorst L, van den Akker ELT, van der Voorn B. Impact of the COVID-19 Pandemic and Related Lockdown Measures on Lifestyle Behaviors and Well-Being in Children and Adolescents with Severe Obesity. Obes Facts 2022; 15:186-196. [PMID: 34743080 PMCID: PMC8805051 DOI: 10.1159/000520718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION COVID-19 lockdown measures have large impact on lifestyle behaviors and well-being of children. The aim of this mixed-methods study was to investigate the impact of COVID-19 lockdown measures on eating styles and behaviors, physical activity (PA), screen time, and health-related quality of life (HRQoL) in children (0-18 years) with severe obesity. METHODS During the first COVID-19 wave (April 2020), validated questionnaires were completed and semi-structured telephone interviews were conducted with parents of children with severe obesity (adult body mass index [BMI]-equivalent ≥35 kg/m2) and/or with the children themselves. Changes in pre-pandemic versus lockdown scores of the Dutch Eating Behavior Questionnaire Children, Pediatric Quality of Life Inventory, and Dutch PA Questionnaire were assessed. Qualitative analyses were performed according to the Grounded Theory. RESULTS Ninety families were approached of which 83 families were included. Characteristics of the included children were: mean age 11.2 ± 4.6 years, 52% female, mean BMI SD-score +3.8 ± 1.0. Emotional, restrained, and external eating styles, HRQoL, and (noneducational) screen time did not change on group level (all p > 0.05). However, weekly PA decreased (mean difference -1.9 h/week, p = 0.02) mostly in adolescents. In the majority of children, mean weekly PA decreased to ≤2 h/week. Children with high emotional or external eating scores during lockdown or pre-existent psychosocial problems had the lowest HRQoL (p < 0.01). Qualitative analyses revealed an increased demand for food in a significant proportion of children (n = 21), mostly in children <10 years (19/21). This was often attributed to loss of daily structure and perceived stress. Families who reported no changes (n = 15) or improved eating behaviors (n = 11) attributed this to already existing strict eating schemes that they kept adhering to during lockdown. CONCLUSION This study shows differing responses to COVID-19 lockdown measures in children with severe obesity. On group level, PA significantly decreased and in substantial minorities eating styles and HRQoL deteriorated. Children with pre-existent psychosocial problems or pre-pandemic high external or emotional eating scores were most at risk. These children and their families should be targeted by health care professionals to minimize negative physical and mental health consequences.
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Affiliation(s)
- Mila S Welling
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ozair Abawi
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands,
| | - Emma van den Eynde
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jutka Halberstadt
- Department of Health Sciences, Amsterdam Public Health Research Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annelies E Brandsma
- Division of Endocrinology, Department of Pediatrics, Obesity Center CGG, Maasstad Ziekenhuis, Rotterdam, The Netherlands
| | - Lotte Kleinendorst
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Erica L T van den Akker
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bibian van der Voorn
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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McCurry I, Jennett P, Oh J, White B, DeLisser HM. Chaplain Care in the Intensive Care Unit at the End of Life: A Qualitative Analysis. Palliat Med Rep 2021; 2:280-286. [PMID: 34927154 PMCID: PMC8675270 DOI: 10.1089/pmr.2021.0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 12/27/2022] Open
Abstract
Background: The provision of spiritual care is a key component of high-quality patient-centered care, particularly in the intensive care unit (ICU). However, the integration of spiritual care into the care of patients in the ICU is variable, especially at the end of life, which may be due in part to poor or incomplete provider knowledge of the work of chaplains. Objective: To characterize the care and services provided by chaplains to patients in an ICU at the end of life and/or their families. Design: A retrospective chart review was performed to identify all patients admitted over a three-month period to an ICU who had visits with a chaplain and an ICU course that ended in death, discharge to a palliative care facility or discharge to hospice. Subjects/setting: Twenty-five chaplains at a U.S. medical center. Measurements: Qualitative analysis was performed using directed content analysis on the notes written by the chaplains. Results: Qualitative analyses of the chaplain notes revealed four broad themes regarding the activities of chaplains in the ICU with respect to patients and families. These were that chaplains provide comfort to patients and family facing the end of life, provide prayers with a variety of purposes, assist in supporting family members through complex medical decision making, and provide connections to appropriate resources. Conclusions: Chaplains contribute to the care of patients in the ICU through a wide range of activities that demonstrate the unique intermediary and collaborative role chaplains can play within the health care team at the end of life in the ICU.
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Affiliation(s)
- Ian McCurry
- Academic Programs Office and the Pulmonary, Allergy and Critical Care Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Pastoral Care and Education, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Pauline Jennett
- Department of Pastoral Care and Education, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Jimin Oh
- Graduate School of Education, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Betty White
- Department of Pastoral Care and Education, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Horace M DeLisser
- Academic Programs Office and the Pulmonary, Allergy and Critical Care Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Henderson MD, McCurry IJ, Deatrick JA, Lipman TH. Experiences of Adult Men Who Are Homeless Accessing Care: A Qualitative Study. J Transcult Nurs 2021; 33:199-207. [PMID: 34784822 DOI: 10.1177/10436596211057895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Homeless individuals experience increased rates of chronic physical and mental health conditions. They also experience difficulty accessing care and poor health outcomes compounded by social and economic factors, such as housing insecurity, unemployment, and limited social support. The purpose of this study was to describe the perceptions of homeless individuals related to their health and experiences accessing care. METHOD Qualitative descriptive methods and content analysis were used to gather, analyze, and interpret the data and identify themes. RESULTS Three themes were identified: men who are homeless experience bias throughout their health care and interpersonal relationships, the best care is person-centered and considers patients' priorities, and care coordination resources are inadequate. DISCUSSION The housing needs of homeless individuals are best contextualized by their health and social needs. In addition, their priorities must be taken into consideration to develop culturally congruent services that are appropriate and effective care for this population.
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Srivastava K, Yadav R, Pelly L, Hamilton E, Kapoor G, Mishra AM, Anis P, Crockett M. Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff. BMC Public Health 2021; 21:2027. [PMID: 34742283 PMCID: PMC8572490 DOI: 10.1186/s12889-021-12047-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 10/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Uttar Pradesh (UP), India continues to have a high burden of mortality among young children despite recent improvement. Therefore, it is vital to understand the risk factors associated with under-five (U5) deaths and episodes of severe illness in order to deliver programs targeted at decreasing mortality among U5 children in UP. However, in rural UP, almost every child has one or more commonly described risk factors, such as low socioeconomic status or undernutrition. Determining how risk factors for childhood illness and death are understood by community members, community health workers and facility staff in rural UP is important so that programs can identify the most vulnerable children. METHODS This qualitative study was completed in three districts of UP that were part of a larger child health program. Twelve semi-structured interviews and 21 focus group discussions with 182 participants were conducted with community members (mothers and heads of households with U5 children), community health workers (CHWs; Accredited Social Health Activists and Auxiliary Nurse Midwives) and facility staff (medical officers and staff nurses). All interactions were recorded, transcribed and translated into English, coded and clustered by theme for analysis. The data presented are thematic areas that emerged around perceived risk factors for childhood illness and death. RESULTS There were key differences among the three groups regarding the explanatory perspectives for identified risk factors. Some perspectives were completely divergent, such as why the location of the housing was a risk factor, whereas others were convergent, including the impact of seasonality and certain occupational factors. The classic explanatory risk factors for childhood illness and death identified in household surveys were often perceived as key risk factors by facility staff but not community members. However, overlapping views were frequently expressed by two of the groups with the CHWs bridging the perspectives of the community members and facility staff. CONCLUSION The bridging views of the CHWs can be leveraged to identify and focus their activities on the most vulnerable children in the communities they serve, link them to facilities when they become ill and drive innovations in program delivery throughout the community-facility continuum.
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Affiliation(s)
- Kanchan Srivastava
- India Health Action Trust, 404 - 4th Floor, 20-A Ratan Square, Vidhan Sabha Marg, Lucknow, Uttar Pradesh, 226001, India
| | - Ranjana Yadav
- India Health Action Trust, 404 - 4th Floor, 20-A Ratan Square, Vidhan Sabha Marg, Lucknow, Uttar Pradesh, 226001, India
| | - Lorine Pelly
- University of Manitoba, Institute for Global Public Health, R070 Med Rehab Building, 771 McDermot Avenue, Winnipeg, Manitoba, R3E 0T6, Canada.
| | - Elisabeth Hamilton
- University of Manitoba, Institute for Global Public Health, R070 Med Rehab Building, 771 McDermot Avenue, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Gaurav Kapoor
- India Health Action Trust, 404 - 4th Floor, 20-A Ratan Square, Vidhan Sabha Marg, Lucknow, Uttar Pradesh, 226001, India
| | - Aman Mohan Mishra
- India Health Action Trust, 404 - 4th Floor, 20-A Ratan Square, Vidhan Sabha Marg, Lucknow, Uttar Pradesh, 226001, India
| | - Parwez Anis
- India Health Action Trust, 404 - 4th Floor, 20-A Ratan Square, Vidhan Sabha Marg, Lucknow, Uttar Pradesh, 226001, India
| | - Maryanne Crockett
- University of Manitoba, Institute for Global Public Health, R070 Med Rehab Building, 771 McDermot Avenue, Winnipeg, Manitoba, R3E 0T6, Canada.,Departments of Pediatrics and Child Health, Medical Microbiology and Infectious Diseases and Community Health Sciences, University of Manitoba, Winnipeg, Canada
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Tremblay ES, Ruiz J, Dykeman B, Maldonado M, Garvey K. Hispanic Caregivers' experience of pediatric type 1 diabetes: A qualitative study. Pediatr Diabetes 2021; 22:1040-1050. [PMID: 34232537 PMCID: PMC8530860 DOI: 10.1111/pedi.13247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/30/2021] [Accepted: 07/05/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE It is widely recognized that Type 1 Diabetes (T1D) outcomes are worse among Hispanic children; however, little is published about the perspectives of these patients and their caregivers. Our intent was to characterize the lived experience of Hispanic caregivers of children with T1D, focusing on the role of language and culture and their perspectives on current medical care and alternative care models. We studied Hispanic caregivers of patients (age 2-17 years) with T1D of greater than 6 months' duration. RESEARCH DESIGN AND METHODS We completed semi-structured interviews and focus-groups of a purposive sample of 20 members of our population of interest. We developed a codebook and completed multidisciplinary consensus coding, then conducted iterative thematic analysis using qualitative software and discussion to generate themes. RESULTS We gathered data from 20 Hispanic caregivers of T1D patients (11.37 ± 3.00 years old, 4.80 ± 2.84 years since diagnosis). 85% of caregivers were female, 80% preferred Spanish, and 15% were college-educated. Our analysis yielded 4 themes across the participants: (1) Culturally-based nutrition challenges, (2) Social isolation and lack of support for T1D care, (3) Hesitancy to fully embrace diabetes technology, and (4) Deferential views of care experience and providers. Overarching all of these themes was support for Hispanic group-based models of care tailored to address these concerns. CONCLUSIONS The unique concerns among Hispanic caregivers of children with T1D suggest the importance of culturally tailored interventions to improve care. With successful implementation, such interventions could diminish widening disparities in healthcare outcomes.
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Affiliation(s)
- Elise Schlissel Tremblay
- Division of Endocrinology, Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Jessica Ruiz
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Blair Dykeman
- Boston Children’s Hospital, Institutional Centers for Clinical and Translational Research
| | - Michele Maldonado
- Boston Children’s Hospital, Children’s Hospital Primary Care Center, Social Work
| | - Katharine Garvey
- Division of Endocrinology, Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
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Waters AR, Warner EL, Vaca Lopez PL, Kirchhoff AC, Ou JY. Perceptions and knowledge of air pollution and its health effects among caregivers of childhood cancer survivors: a qualitative study. BMC Cancer 2021; 21:1070. [PMID: 34592955 PMCID: PMC8482574 DOI: 10.1186/s12885-021-08739-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 08/30/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Emerging research suggests that survivors of childhood and adolescent cancers are at risk for morbidity and mortality associated with air pollutants. However, caregiver perceptions of the effects of air pollution are unknown. Thus, to address this gap we described caregivers' perceptions of air pollution's impact on general population health and specifically on childhood cancer survivors, and caregivers' air pollution information-seeking and exposure reduction behaviors. METHODS Participants were Utah residents, ≥18 years, and caregiver of a childhood cancer survivor who had completed treatment. Semi-structured interviews were conducted with caregivers to describe their perspectives on air quality, how air pollution impacts health (general population and survivor health), and their information seeking and exposure reduction behaviors. Interviews were recorded, transcribed, and analyzed through two rounds of structured coding. RESULTS Caregivers (N = 13) were non-Hispanic white and primarily females (92.3%) between 30 and 49 years old (46.2%). Most families lived within the Wasatch Front (69.2%), the main metropolitan of Utah. Two categories emerged pertaining to caregiver's perceptions of air pollution: 1) Limited awareness about the health effects of air pollution, and 2) Unsuccessful information seeking and minimal exposure reduction behaviors. All caregivers held negative perceptions of air pollution in Utah, but most were unaware of how pollution affects health. While some families limited air pollution exposure by avoiding outdoor activity or physically leaving the region, few practiced survivor-specific exposure reduction. Nearly half of caregivers worried about potential effects of air pollution on survivor health and wanted more information. CONCLUSIONS Despite negative perceptions of air pollution, caregivers were divided on whether air pollution could impact survivor health. Few caregivers engaged in exposure reduction for their cancer survivor. As air pollution levels increase in the U.S., continued research on this topic is essential to managing cancer survivor respiratory and cardiovascular health.
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Affiliation(s)
- Austin R Waters
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
| | - Echo L Warner
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Perla L Vaca Lopez
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Judy Y Ou
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
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Swenson R, Alldred P, Nicholls L. Doing gender and being gendered through occupation: Transgender and non-binary experiences. Br J Occup Ther 2021. [DOI: 10.1177/03080226211034422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Transgender people can face discrimination which can be reflected in and encoded by their occupational experiences. There is emerging research regarding those who are transgender but experiences of non-binary people remain under-explored. Purpose This study considered the occupational experiences of transgender and non-binary people and how gender expression related to engagement in occupations and space. Method Five transgender and non-binary people participated in repeat interviews, including a ‘walking interview’. Analysis was informed by new materialism. Findings Occupational engagement can re-enforce binary understandings of gender or facilitate creative expressions of gender identity. Within normative environments, occupational participation can offer assimilation, particularly for non-binary people. Some occupations provided emancipation from binary gender norms through expression such as clothing and creative activities which provided recognition and belonging. Symbolic and personal meanings of occupations shifted when participants were able to express themselves in a way that felt authentic. Conclusion ‘Occupational assimilation’ can bring safety from scrutiny for those who are transgender and non-binary but curtails authentic expression. Occupational therapists have a role in supporting transgender and non-binary people in accessing occupations which facilitate their authentic gender expression and need to improve critical awareness of the culturally encoded binary nature of many occupations and environments.
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Affiliation(s)
- Rebecca Swenson
- School of Health and Social Care, London South Bank University, London, UK
| | | | - Lindsey Nicholls
- School of Health and Social Care, Essex University, Colchester, UK
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Tremblay D, Touati N, Usher S, Bilodeau K, Pomey MP, Lévesque L. Patient participation in cancer network governance: a six-year case study. BMC Health Serv Res 2021; 21:929. [PMID: 34493271 PMCID: PMC8423332 DOI: 10.1186/s12913-021-06834-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 07/30/2021] [Indexed: 11/18/2022] Open
Abstract
Background Patient participation in decision-making has become a hallmark of responsive healthcare systems. Cancer networks in many countries have committed to involving people living with and beyond cancer (PLC) at multiple levels. However, PLC participation in network governance remains highly variable for reasons that are poorly understood. This study aims to share lessons learned regarding mechanisms that enable PLC participation in cancer network governance. Methods This multiple case study, using a qualitative approach in a natural setting, was conducted over six years in three local cancer networks within the larger national cancer network in Quebec (Canada), where PLC participation is prescribed by the Cancer Directorate. Data were collected from multiple sources, including individual and focus group interviews (n = 89) with policymakers, managers, clinicians and PLC involved in national and local cancer governance committees. These data were triangulated and iteratively analysed according to a framework based on functions of collaborative governance in the network context. Results We identify three main mechanisms that enable PLC participation in cancer network governance: (1) consistent emphasis on patient-centred care as a network objective; (2) flexibility, time and support to translate mandated PLC representation into meaningful participation; and (3) recognition of the distinct knowledge of PLC in decision-making. The shared vision of person-centred care facilitates PLC participation. The quality of participation improves through changes in how committee meetings are conducted, and through the establishment of a national committee where PLC can pool their experience, develop skills and establish a common voice on priority issues. PLC knowledge is especially valued around particular challenges such as designing integrated care trajectories and overcoming barriers to accessing care. These three mechanisms interact to enable PLC participation in governance and are activated to varying extents in each local network. Conclusions This study reveals that mandating PLC representation on governance structures is a powerful context element enabling participation, but that it also delineates which governance functions are open to influence from PLC participation. While the activation of mechanisms is context dependent, the insights from this study in Quebec are transferable to cancer networks in other jurisdictions seeking to embed PLC participation in decision-making. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06834-1.
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Affiliation(s)
- Dominique Tremblay
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles LeMoyne - Bureau 200, Québec, J4K 0A, Longueuil, Canada.
| | - Nassera Touati
- École Nationale d'Administration Publique, 4750 ave Henri-Julien, 5e étage, Québec, H2T 3E5, Montréal, Canada
| | - Susan Usher
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles LeMoyne - Bureau 200, Québec, J4K 0A, Longueuil, Canada.,École Nationale d'Administration Publique, 4750 ave Henri-Julien, 5e étage, Québec, H2T 3E5, Montréal, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Pavillon Marguerite-d'Youville, local 7101, 2375 chemin de la Côte-Ste-Catherine, Québec, H3T 1A8, Montréal, Canada
| | - Marie-Pascale Pomey
- School of Public Health, Université de Montréal, 7101 ave du Parc, 3e étage, bureau 3014-8, Québec, H3N 1X9, Montréal, Canada
| | - Lise Lévesque
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles LeMoyne - Bureau 200, Québec, J4K 0A, Longueuil, Canada
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"I'm With my People!": Perceived Benefits of Participation in a Group Social Skills Intervention for Children and Adolescent Survivors of Brain Tumors. Cancer Nurs 2021; 44:197-204. [PMID: 32000176 DOI: 10.1097/ncc.0000000000000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children and adolescent survivors of brain tumors may experience impairments in social competence. OBJECTIVE This qualitative randomized controlled substudy aimed to investigate the outcomes of a social skills intervention group by interviewing these children and adolescents and their caregivers following group participation. INTERVENTIONS/METHODS Children and adolescents were randomized to the Social Skills Intervention Program or the attention control group. Using purposive sampling, 12 patients (average age, 11.42 years) and 12 caregivers were interviewed following group participation. The Social Skills Intervention Program consists of eight 2-hour manualized sessions delivered weekly; each session was structured around a social skill (eg, making friends, bullying) through arts and crafts and cognitive-behavioral strategies. The sessions in the control group were structured around daily themes (eg, summer activities) doing arts and crafts. Interviews were analyzed using content analysis. RESULTS Themes unique to the intervention program included improved self-control and self-acceptance, reduced feelings of sadness, and improved problem solving. Themes common to both groups included group bonding over similar experiences, increased social confidence with peers and family, and reduced acting out. CONCLUSIONS This study uncovered additional unique intervention effects not captured by quantitative measures: improved self-control and problem solving and benefits of the group experience in general. IMPLICATIONS FOR PRACTICE Findings support the need for group socialization opportunities for children with brain tumors. Nurses can promote socializing opportunities for children and adolescent survivors of brain tumors during and after medical treatment ends to prevent social competence deterioration.
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Law EF, Zhou C, Seung F, Perry F, Palermo TM. Longitudinal study of early adaptation to the coronavirus disease pandemic among youth with chronic pain and their parents: effects of direct exposures and economic stress. Pain 2021; 162:2132-2144. [PMID: 34050112 PMCID: PMC8205975 DOI: 10.1097/j.pain.0000000000002290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/29/2021] [Indexed: 12/12/2022]
Abstract
ABSTRACT The novel coronavirus disease (COVID-19) has caused prolonged disruptions in daily life for many communities. Little is known about the impact of the COVID-19 pandemic on the health and well-being of youth with chronic pain and their families. We conducted a longitudinal, mixed-methods study to characterize early adaptation to the COVID-19 pandemic among 250 families of youth (ages 12-21 years) diagnosed with chronic headache (64%) or other chronic pain conditions (36%) and to determine whether direct exposures to COVID-19 and secondary economic stress modified symptom trajectories. Youth and parents reported on pain interference, anxiety, depression, and insomnia symptoms at 4 waves of data collection from April 2020 to July 2020. We also collected qualitative data on the impact of the pandemic on the youth's pain problem. Nearly half of our sample (49.6%) experienced direct exposures to COVID-19. Secondary economic stress was also common, affecting 44.4% of families. Symptom trajectories for pain, insomnia, depression, and anxiety remained stable or improved for most participants, indicating adaptive adjustment. However, overall symptom burden was high with persistent and clinically elevated depression, anxiety, and insomnia symptoms common among youth and parents. Direct exposures to COVID-19 did not modify symptom trajectories. However, youth pain interference and parent insomnia worsened in families who experienced secondary economic stress. Qualitative data revealed perceived benefits and harms from school closures on the youth's pain problem. Our findings of high symptom burden suggest that pediatric pain clinicians should offer distance assessment and treatment (eg, through telemedicine) to avoid pandemic-related disruptions in pain care.
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Affiliation(s)
- Emily F. Law
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine
| | - Chuan Zhou
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
- Department of Pediatrics, University of Washington School of Medicine
| | - Fiona Seung
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
| | - Frankie Perry
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
| | - Tonya M. Palermo
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine
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