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Zhang T, Dorian ER, Sewap S, Johnson R, Foulds H, Bath B, Lovo S. Community directed assessment of pain in a northern Saskatchewan Cree community. Int J Circumpolar Health 2024; 83:2300858. [PMID: 38184792 PMCID: PMC10773658 DOI: 10.1080/22423982.2023.2300858] [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: 11/08/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024] Open
Abstract
Indigenous Elder advisors in Pelican Narrows, a Cree community in Northern Saskatchewan, have indicated that Western pain scales may not be responsive tools for pain assessments within their community. This study employed a mixed methods research design that involved two phases. Phase one was the development of a pain scale in collaboration with an Elder and a Knowledge Keeper. Phase two was a pilot of the CDPS utilised during virtual physiotherapy sessions for chronic back pain. Twenty-seven participants completed the pre-physiotherapy treatment questionnaires, and 10 participants engaged in semi-structured interviews (9 community members; 1 healthcare provider). A weighted kappa analysis yielded k = 0.696, indicating a good agreement between the CDPS and Faces Pain Scale-Revised in terms of documenting participants' pain. Qualitative data from interviews with community members revealed three major themes: 1) Learnings Regarding Pain Scales, 2) Patient Centered Care; and 3) Strength-Based Solutions for Improving Pain Communication. Two themes were uncovered through conversations with the HCP: 1) Perspectives on CDPS and 2) Healthcare Provider Experiences Communicating about Pain. Moreover, a patient-centredcentred approach is important to ensure comprehensive pain assessments.
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Affiliation(s)
- Tayah Zhang
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Elder Rose Dorian
- Angelique Canada Health Center, Pelican Narrows, Saskatchewan, Canada
| | - Sally Sewap
- Angelique Canada Health Center, Pelican Narrows, Saskatchewan, Canada
| | - Rachel Johnson
- Angelique Canada Health Center, Pelican Narrows, Saskatchewan, Canada
| | - Heather Foulds
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Brenna Bath
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Stacey Lovo
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Goodwin J, McSherry E, Goulding R, O'Mahony J, O'Callaghan R, Chambers C. "People want better": a qualitative exploration of stakeholders' views on introducing well-being coordinators in the screen industry. Int J Qual Stud Health Well-being 2024; 19:2326681. [PMID: 38465627 DOI: 10.1080/17482631.2024.2326681] [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: 10/13/2023] [Accepted: 02/29/2024] [Indexed: 03/12/2024] Open
Abstract
PURPOSE There are several factors that negatively impact the well-being of those working in the screen industry. Consequently, the need to introduce Well-being Coordinators has been identified. This study explored the experiences of participants who undertook a Well-being Coordination course tailored for the screen sector. Additionally, it sought to delve into perspectives regarding well-being within the screen industry. METHODS Semi-structured interviews were conducted. The study was guided by an interpretive descriptive approach. Reflexive thematic analysis was used to analyse data. FINDINGS Five themes were identified: Opportunities and challenges working in the screen industry, co-existing with harassment, the need for change: importance of wellbeing, becoming a well-being co-ordinator: learning from the course, and the future of the well-being co-ordinator role: opportunities and challenges. The reality that cast and crew co-exist with several forms of harassment within the industry was noted. Despite this, there is hope for the future of the screen sector, particularly the positive impact the role of the Well-being Coordinator could have. CONCLUSIONS The experiences of professionals across the screen industry vary; however, a pervasive culture of bullying and harassment is commonplace. Through the introduction of Well-being Coordinators, there is the potential to enact positive change.
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Affiliation(s)
- John Goodwin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Eleanor McSherry
- Adult and Continuing Education, University College Cork, Cork, Ireland
| | - Ryan Goulding
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - James O'Mahony
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Rachael O'Callaghan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Ciara Chambers
- Department of Film & Screen Media, University College Cork, Cork, Ireland
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Flannigan K, Edwards DC, Murphy L, Pei J. Integrated service delivery for individuals with fetal alcohol spectrum disorder. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13277. [PMID: 39232856 DOI: 10.1111/jar.13277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 06/14/2024] [Accepted: 06/28/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Individuals with fetal alcohol spectrum disorder (FASD) experience complex needs that often necessitate support from multiple systems. There is growing evidence that people with FASD may benefit from integrated service delivery (ISD), but little is known about ISD elements and processes for this population. METHOD Using a multi-method approach involving a literature review, analysis of programme data, and staff interviews, we examined how ISD is enacted at a rural Canadian FASD centre, and identified facilitators, barriers, and potential impacts of ISD at the centre. RESULTS We describe key elements of integrated FASD programming and identify important contextual factors and themes related to ISD barriers, facilitators, and impacts: (1) connection, (2) freedom and autonomy, (3) client-centred care, (4) learning and growth, (5) and reframing expectations. CONCLUSIONS This study may help to inform a roadmap for enhancing FASD service delivery and guiding FASD research and policy in Canada and beyond.
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Affiliation(s)
- Katherine Flannigan
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, British Columbia, Canada
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Devon C Edwards
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Murphy
- Lakeland Centre for Fetal Alcohol Spectrum Disorder, Cold Lake, Alberta, Canada
| | - Jacqueline Pei
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, British Columbia, Canada
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
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Witry M, Guirguis L. Is it time to stop counting on saturation in pharmacy research? Ideas for a new way forward. Res Social Adm Pharm 2024; 20:1070-1074. [PMID: 39142906 DOI: 10.1016/j.sapharm.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/19/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024]
Abstract
The concept of saturation is commonly mentioned in pharmacy research, but there has been recent debate among the applied qualitative research community that challenges the appropriateness of this construct for many qualitative research efforts. This begins by describing the origins of saturation as a grounded theory construct and discusses how saturation is currently being used. Three challenges are discussed related to the use of saturation in pharmacy related to the epistemological, methodological, and practical use of saturation by pharmacy researchers and how they relate to the goals and reporting quality of pharmacy practice research The commentary describes how the concept of information power and established guidance on analysis quality can better justify sample size inform decisions about when to cease further data collection, hopefully increasing the transparency of reporting and supporting rigorous and coherent analyses.
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Affiliation(s)
- Matthew Witry
- Division of Health Services Research, University of Iowa College of Pharmacy, College of Pharmacy, 180 S. Grand Ave, 342 CPB, Iowa City, IA, 52242, USA.
| | - Lisa Guirguis
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Canada
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Klinepeter EA, Choate JD, Nelson Hall T, Gibbs KD. A "Whole Child Approach": Parent Experiences with Acute Care Hospitalizations for Children with Autism Spectrum Disorder and Behavioral Health Needs. J Autism Dev Disord 2024:10.1007/s10803-024-06573-2. [PMID: 39342543 DOI: 10.1007/s10803-024-06573-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2024] [Indexed: 10/01/2024]
Abstract
Children with Autism Spectrum Disorder (ASD) experience increased hospitalizations as compared to the general population, particularly in the context of mental health crises. Given the unique needs of children with ASD and behavioral health needs that can either lead to or emerge during hospitalization, an understanding of hospital experiences is critical. To date, research on caregiver experiences in acute care medical hospital settings is limited. Therefore, the purpose of this qualitative study was to investigate caregiver experiences with inpatient care for children with ASD and behavioral health needs, including factors and practices that impacted or were desirable for care. Two focus groups were conducted with a total of 12 parents of children with ASD admitted to a large pediatric hospital. Data were analyzed using interpretive description. Emerging themes pointed to the child, family, and staff factors and practices that intersect to influence hospitalization experiences. Child factors included the child's communication, sensory, behavioral, medical, and safety needs. Family factors included the family's relationship with the healthcare team, own needs, and advocacy experiences. Staff factors included staff communication practices, comfort, and knowledge when providing care. Overall, this research demonstrates the complexity of factors and practices that impact the behavioral health hospitalization experience for children with ASD and their caregivers. Experiences varied widely and were guided by the unique needs of each child. Findings point to care practices that can be adopted to best meet the needs of all stakeholders during hospitalization and offer implications for future educational initiatives.
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Affiliation(s)
- Elizabeth A Klinepeter
- Department of Pediatrics, Division of Psychology, Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin Street, Suite 1630, Houston, TX, 77030, USA.
| | - Jaime D Choate
- Nursing Professional Development Department, Texas Children's Hospital, Houston, TX, USA
| | - Tanya Nelson Hall
- Nursing Professional Development Department, Texas Children's Hospital, Houston, TX, USA
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Huang V, Marais O, Mortenson WB, Nadeau J, Arsenault S, Field TS, De Sousa I. "I just kept asking and asking and there was nothing": re-thinking community resources & supports for young adult stroke survivors. Disabil Rehabil 2024:1-10. [PMID: 39317344 DOI: 10.1080/09638288.2024.2404185] [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: 07/08/2024] [Revised: 09/08/2024] [Accepted: 09/10/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE Stroke is often regarded as a disease of the elderly. However, 10-15% of strokes occur in people aged 18 to 50, and rates continue to rise. Young stroke survivors face unique challenges due to their occupational, family and personal commitments, which current stroke rehabilitation services may not fully address. Our qualitative study aimed to identify gaps in patient care and resources for young stroke survivors. We used these findings to develop recommendations to inform clinical care, healthcare system design, and health policy. METHODS Using Interpretive Description, we conducted semi-structured interviews with 19 stroke survivors aged 18-55 living in British Columbia, Canada, to explore their experiences during stroke recovery and assess current gaps in support and resources. We applied broad-based coding and thematic analysis to the transcripts. RESULTS Key themes included: (1) the need for longitudinal medical follow-up and information provision, (2) the need for psychological/psychiatric care, (3) the need to adapt community supports and resources to young survivors, and (4) the need to centralize and integrate community stroke services and resources. CONCLUSION Young stroke survivors experience unique challenges and lack appropriate services and resources. Many of our findings may be representative of remediable gaps that persist nationally and internationally.
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Affiliation(s)
- Vivian Huang
- Division of Physical Medicine and Rehabilitation, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Olivia Marais
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Sacha Arsenault
- Stroke Services BC, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Thalia S Field
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Stroke Program, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Ismalia De Sousa
- Vancouver Stroke Program, Vancouver General Hospital, Vancouver, British Columbia, Canada
- School of Nursing-Vancouver, University of British Columbia, Vancouver, British Columbia, Canada
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Rahimi-Ardabili H, Magrabi F, Sanderson B, Schuler T, Coiera E. A qualitative analysis of health service problems and the strategies used to manage them in the COVID-19 pandemic: exploiting generic and context-specific approaches. BMC Health Serv Res 2024; 24:1067. [PMID: 39272078 PMCID: PMC11401272 DOI: 10.1186/s12913-024-11499-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted health systems around the globe. Lessons from health systems responses to these challenges may help design effective and sustainable health system responses for future challenges. This study aimed to 1/ identify the broad types of health system challenges faced during the pandemic and 2/ develop a typology of health system response to these challenges. METHODS Semi-structured one-on-one online interviews explored the experience of 19 health professionals during COVID-19 in a large state health system in Australia. Data were analysed using constant comparative analysis utilising a sociotechnical system lens. RESULTS Participants described four overarching challenges: 1/ System overload, 2/ Barriers to decision-making, 3/ Education or training gaps, and 4/ Limitations of existing services. The limited time often available to respond meant that specific and well-designed strategies were often not possible, and more generic strategies that relied on the workforce to modify solutions and repair unexpected gaps were common. For example, generic responses to system overload included working longer hours, whilst specific strategies utilised pre-existing technical resources (e.g. converting non-emergency wards into COVID-19 wards). CONCLUSION During the pandemic, it was often not possible to rely on mature strategies to frame responses, and more generic, emergent approaches were commonly required when urgent responses were needed. The degree to which specific strategies were ready-to-hand appeared to dictate how much a strategy relied on such generic approaches. The workforce played a pivotal role in enabling emergent responses that required dealing with uncertainties.
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Affiliation(s)
- Hania Rahimi-Ardabili
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Syndey, NSW, 2109, Australia
| | - Farah Magrabi
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Syndey, NSW, 2109, Australia
| | - Brenton Sanderson
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Syndey, NSW, 2109, Australia
- Department of Anaesthesia and Perioperative Medicine, Westmead Hospital, Sydney, NSW, Australia
| | - Thilo Schuler
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Syndey, NSW, 2109, Australia
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Enrico Coiera
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Syndey, NSW, 2109, Australia.
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Parsons K, Smith-Young J, Pike A. Understanding how community-dwelling persons with early dementia perceive health and community services: Informing the dementia strategy of Newfoundland and Labrador, Canada. DEMENTIA 2024:14713012241284693. [PMID: 39270131 DOI: 10.1177/14713012241284693] [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: 09/15/2024]
Abstract
BACKGROUND With an increased aging population, the number of individuals with dementia is expected to rise. The onset of dementia marks the start of negotiating access to a wide range of health and social services to find practical and emotional supports to deal with the management of changes and subsequent challenges that individual with dementia face. The toll of dementia goes beyond the health care system, affecting families and caregivers' quality of life. This places more pressure on family caregivers and health care institutions to provide services for affected individuals. It is important to understand the service needs of this population to enable them to live at home longer, contribute to society and maintain a positive quality of life. AIM To increase understanding of how persons living at home with early dementia and their caregivers/significant others currently perceive and interact with health and community-based services and service providers. METHODS A qualitative descriptive approach was used to explore the experiences of individuals with early dementia and care providers with health and community-based services using semi-structured interviews and content analysis. RESULTS Participants included 16 individuals 50 years and older with mild/early dementia living at home, 22 informal caregivers of individuals with mild/early dementia, and 5 key community informants (community health nurses and social workers). Four thematic categories of barriers and two thematic categories of facilitators for access to and uptake of supportive services were identified. Five strategies to inform the development of an action plan to enhance access to, and uptake of, supportive services were determined. CONCLUSIONS Early recognition of dementia through education and publicity enhanced public awareness, attention, and social inclusion with dementia-friendly neighborhoods and facilities need to be considered to achieve effective dementia-related services. Inclusion and recognition of the wishes of persons with dementia is key.
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Affiliation(s)
- Karen Parsons
- Faculty of Nursing, Memorial University, Newfoundland and Labrador, Canada
| | - Joanne Smith-Young
- Faculty of Nursing, Memorial University, Newfoundland and Labrador, Canada
| | - April Pike
- Faculty of Nursing, Memorial University, Newfoundland and Labrador, Canada
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Chen YM, Chang TH, Chang TF, Tzeng WC. Nursing department directors' perspectives on leadership training programme: A descriptive qualitative study. NURSE EDUCATION TODAY 2024; 143:106405. [PMID: 39288608 DOI: 10.1016/j.nedt.2024.106405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 08/30/2024] [Accepted: 09/09/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Leadership training is crucial for nurses to navigate changes, but research on nursing department directors' views of such programmes is limited. AIM To explore the perspectives and experiences of nursing department directors regarding a national leadership training programme for mid-level nurse managers. DESIGN Descriptive Qualitative Study. SETTINGS A national nurses association in Taiwan. PARTICIPANTS A purposive sample of 11 nursing department directors who recommended mid-level nurse managers for the programme. METHODS Eleven individual face-to-face interviews were conducted and analysed thematically between November 2022 and April 2023. RESULTS Three themes and eight subthemes emerged, including directors' strategies for identifying potential successors, providing coaching and guidance, and observing changes in trainees. Directors reported the programme broadened perspectives, fostered responsibility, and enhanced leadership skills in mid-level managers. CONCLUSIONS The engagement of nursing department directors and their adoption of a coaching style, such as fostering a growth mindset, were instrumental in the programme's success.
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Affiliation(s)
- Yao-Mei Chen
- Kaohsiung Medical University (KMU) and KMU Hospital, No. 100, Shiquan 1st Rd., Sanmin Dist., Kaohsiung City 807378, Taiwan.
| | - Tsyr-Huei Chang
- National Taiwan University Hospital, No.7, Chung-Shan South Rd., Taipei 100225, Taiwan.
| | - Tsui-Fen Chang
- Yunlin Christian Hospital, Taiwan, No. 375, Shichang S. Rd., Xiluo Township, Yunlin County 648106, Taiwan.
| | - Wen-Chii Tzeng
- National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City 114201, Taiwan.
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Boeken OJ, Heine J, Duda-Sikula M, Patricio V, Picard G, Buttard C, Benaiteau M, Mendes Á, Howard F, Easton A, Kurpas D, Honnorat J, Dalmau J, Finke C. Assessment of long-term psychosocial outcomes in N-methyl-D-aspartate receptor encephalitis - the SAPIENCE study protocol. BMC Neurol 2024; 24:322. [PMID: 39242986 PMCID: PMC11378596 DOI: 10.1186/s12883-024-03842-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 08/29/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND N-methyl-D-aspartate-receptor (NMDAR) encephalitis is a rare neurological autoimmune disease with severe neuropsychiatric symptoms during the acute phase. Despite good functional neurological recovery, most patients continue to experience cognitive, psychiatric, psychological, and social impairments years after the acute phase. However, the precise nature and evolving patterns over time of these long-term consequences remain unclear, and their implications for the well-being and quality of life of predominantly young patients have yet to be thoroughly examined. METHODS SAPIENCE is a European multi-center (n = 3) prospective observational cohort study studying the long-term cognitive, psychiatric, psychological, and social outcome in patients with NMDAR encephalitis. The study consists of three interconnected levels. Level 1 comprises a qualitative interview and focus groups with patients and their caregivers. Level 2 consists of a condensed form of the interview, standardized questionnaires, and a detailed neuropsychological examination of patients. Level 3 involves an online survey that will be open to patients world-wide and explores patient-reported outcomes (PROMs), and patient-reported experiences (PREMs) in association with clinical and cognitive outcomes. Levels 1 to 3 will progressively contribute developing of structured interviews, survey questions, and treatment guidelines by informing one another. DISCUSSION SAPIENCE is an in-depth study of the long-term effects of NMDAR encephalitis and bridges the gap between standardized assessments and individual patient experiences, intending to improve patient care and to increase awareness of the psychosocial long-term consequences of the disease. Through collaboration of experts in clinical neurology and social and health psychology across Europe, SAPIENCE aims to create online assessment tools and formulate guidelines for patient-centered post-acute care that will help enhance the quality of life for patients and caregivers.
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Affiliation(s)
- Ole Jonas Boeken
- Department of Neurology, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10177, Berlin, Berlin, Germany
| | - Josephine Heine
- Department of Neurology, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10177, Berlin, Berlin, Germany
| | - Marta Duda-Sikula
- Department of Family and Pediatric Nursing, Faculty of Health Sciences, WrocławDepartment of Family Medicine, Wroclaw Medical University, Bartla 5 St., wyb. Ludwika, Pasteura1, Wroclaw, 51-618, 50-367, Poland
| | - Víctor Patricio
- Fundacio de Clinic per a la Recerca Clinic Barcelona - Biomédica (FCRB) - Institut de Investigacions, Biomediques August Pi I Sunyer, c/Rosselló 149-153, Barcelona, Spain
| | - Géraldine Picard
- French reference center on paraneoplastic neurological diseases and autoimmune encephalitis, UMR MELIS Inserm, Université Claude Bernard Lyon1, Hôpital neurologique 59 Bd Pinel, Bron cedex, 69677, 1314 / CNRS 5284, France
| | - Chloé Buttard
- French reference center on paraneoplastic neurological diseases and autoimmune encephalitis, UMR MELIS Inserm, Université Claude Bernard Lyon1, Hôpital neurologique 59 Bd Pinel, Bron cedex, 69677, 1314 / CNRS 5284, France
| | - Marie Benaiteau
- French reference center on paraneoplastic neurological diseases and autoimmune encephalitis, UMR MELIS Inserm, Université Claude Bernard Lyon1, Hôpital neurologique 59 Bd Pinel, Bron cedex, 69677, 1314 / CNRS 5284, France
| | - Álvaro Mendes
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal, Rua Alfredo Allen, 8, 4200-180, Porto, Portugal
| | - Fuchsia Howard
- Faculty of Applied Sciences, The University of British Columbia, T201 - 211, Westbrook Mall, Vancouver, Canada
| | - Ava Easton
- Encephalitis International, YO17 7DT, Malton, UK
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - Donata Kurpas
- Department of Family and Pediatric Nursing, Faculty of Health Sciences, WrocławDepartment of Family Medicine, Wroclaw Medical University, Bartla 5 St., wyb. Ludwika, Pasteura1, Wroclaw, 51-618, 50-367, Poland
| | - Jérôme Honnorat
- French reference center on paraneoplastic neurological diseases and autoimmune encephalitis, UMR MELIS Inserm, Université Claude Bernard Lyon1, Hôpital neurologique 59 Bd Pinel, Bron cedex, 69677, 1314 / CNRS 5284, France
| | - Josep Dalmau
- Fundacio de Clinic per a la Recerca Clinic Barcelona - Biomédica (FCRB) - Institut de Investigacions, Biomediques August Pi I Sunyer, c/Rosselló 149-153, Barcelona, Spain
| | - Carsten Finke
- Department of Neurology, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10177, Berlin, Berlin, Germany.
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Wisener K, Driessen E, Tan A, Cuncic C, Eva K. From constructive to critical and everywhere in between: education leaders' decision-making related to harsh feedback from learners about their teachers. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10367-7. [PMID: 39222274 DOI: 10.1007/s10459-024-10367-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
Feedback from learners is important to support faculty development, but negative feedback can harm teachers' motivation, engagement, and retention. Leaders of educational programs, therefore, need to balance enabling students' voices to be heard with maintaining teachers' enthusiasm and commitment to teaching. Given the paucity of research to explain or guide this struggle, we explored why and how education leaders grapple with negative learner feedback received about their teachers. Using an Interpretive Description methodology, 11 education leaders participated in semi-structured interviews. Discussion was stimulated by showing participants learner narratives they had previously asked to be deleted because they perceived the narrative to be overly critical. Transcripts were iteratively analyzed as codes were developed, refined, and combined into themes. Education leaders interpreted the scope, framing, and focus of the feedback to decide whether it was overly critical. Such determinations were combined with contextual considerations such as the teacher's personal circumstances, the learning environment and how the teacher might react to think through what potential damage the feedback might do to the teacher. Throughout the process, leaders struggled with whether protecting teachers risked not protecting learners and remained unsure about the ethics of censoring student voices. Our study offers direction regarding how to optimize feedback to teachers while minimizing risks inherent in sharing negative feedback with them. Implications include that there is value in: (1) extending feedback interpretation support to teachers, education leaders and learners; (2) situating upward feedback in a coaching dialogue; and, (3) applying the same principles recommended for the provision of feedback to learners, to teachers.
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Affiliation(s)
- Katherine Wisener
- Faculty Development, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Faculty of Health, Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands.
| | - Erik Driessen
- Faculty of Health, Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | - Amy Tan
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Cary Cuncic
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kevin Eva
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Kennie-Kaulbach N, Cooley J, Williams C, Riley B, Anksorus H, O'Sullivan TA. How Preceptors Support Pharmacy Learner Professional Identity Formation. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100740. [PMID: 38908435 DOI: 10.1016/j.ajpe.2024.100740] [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: 02/23/2024] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE Pharmacy preceptors play a role in helping learners form professional identities during experiential education. However, it is not clear what specific roles and precepting strategies best foster professional identity formation (PIF). The objective of this study was to explore how preceptors support pharmacy learner PIF. METHODS This qualitative study used an interpretative descriptive approach. Preceptors from 5 experiential education programs were recruited using purposive sampling for individual semistructured interviews. Interviews were recorded, transcribed, coded, and analyzed by thematic analysis. Team members used a reflective and iterative approach for data analysis and generation of themes. RESULTS A total of 22 participants were interviewed from various pharmacy practice settings and precept a range of learners, including introductory pharmacy practice experiences, advanced pharmacy practice experiences, and residents. Four main themes were identified to support pharmacy leaner PIF: making learners part of the practice and team, preparing learners to assume the role of a pharmacist, helping learners navigate emotions during practice experiences, and supporting learners in finding the right fit within the profession. Specific precepting strategies associated with each theme were identified. CONCLUSION Preceptors play an important role in supporting learners in thinking and acting as professionals while also helping navigate emotional experiences that may impact PIF and having conversations to help define learner's future aspirations of the pharmacist they want to become. Strategies identified can inform curricular approaches and preceptor development that intentionally supports PIF.
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Affiliation(s)
| | - Janet Cooley
- University of Arizona, R. Ken Coit College of Pharmacy, Tucson, AZ, USA
| | - Charlene Williams
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Brittany Riley
- Marshall University, Marshall University School of Pharmacy, Huntington, WV, USA
| | - Heidi Anksorus
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA
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Deschênes MF, Charlin B, Akremi H, Lecours L, Moussa A, Jobin V, Fernandez N. Beliefs and experiences of educators when involved in the design of a Learning-by-concordance tool: A qualitative interpretative study. J Prof Nurs 2024; 54:180-188. [PMID: 39266088 DOI: 10.1016/j.profnurs.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 07/01/2024] [Accepted: 07/15/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Based on the involvement of qualified educators in its design, the Learning-by-Concordance tool aims to promote the learning of reasoning in contexts of uncertainty. However, data are still scarce on the experience of educators in terms of sharing and exposing their reasoning processes using this tool. PURPOSE This study sought to explore the beliefs and experiences of educators when involved in the design of a Learning-by-Concordance tool. METHOD This research used a descriptive qualitative design. Four dialogue groups were conducted with educators with different roles and responsibilities while designing a Learning-by-Concordance tool. A descriptive interpretative analysis of educators' verbatim quotes was done. FINDINGS A total of 14 participants took part in the study. The results show the discomfort of educators despite their recognized expertise. Three themes emerged: 1- the need to be reassured by the opinions of colleagues; 2-feeling like impostors; and 3- concerns for the quality of instructional supports. CONCLUSIONS The role taken by educators for teaching reasoning in contexts of uncertainty is to draw on practical experience where different types of knowledge intersect and are mobilized, to overcome feelings of insecurity, and to engage in close and authentic conversation with learners.
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Affiliation(s)
- Marie-France Deschênes
- Faculty of Nursing, University of Montréal, Montréal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Canada.
| | - Bernard Charlin
- Faculty of Medecine, University of Montréal, Montréal, Canada; Centre for Pedagogy Applied to the Health Sciences, Faculty of Medecine, University of Montréal, Montréal, Canada
| | - Haifa Akremi
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Canada; Centre for Pedagogy Applied to the Health Sciences, Faculty of Medecine, University of Montréal, Montréal, Canada; Department of Family Medicine and Emergency Medicine, University of Montréal, Montréal, Canada
| | | | - Ahmed Moussa
- Centre for Pedagogy Applied to the Health Sciences, Faculty of Medecine, University of Montréal, Montréal, Canada; CHU Sainte-Justine Research Centre, Montréal, Canada
| | - Vincent Jobin
- Faculty of Medecine, University of Montréal, Montréal, Canada; Centre for Pedagogy Applied to the Health Sciences, Faculty of Medecine, University of Montréal, Montréal, Canada
| | - Nicolas Fernandez
- Centre for Pedagogy Applied to the Health Sciences, Faculty of Medecine, University of Montréal, Montréal, Canada; Department of Family Medicine and Emergency Medicine, University of Montréal, Montréal, Canada
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14
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Maleki Z, Heidarabadi S, Mohammadi A, Azami-Aghdash S, Rosenbaum P, Cross A, Soper AK. Disseminating the F-Words for Child Development to Parents of Children With Developmental Disabilities in Iran: A Qualitative Pilot Feasibility Study. Child Care Health Dev 2024; 50:e13321. [PMID: 39169646 DOI: 10.1111/cch.13321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/09/2024] [Accepted: 07/26/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Attitudes toward childhood disability have historically focused on biomedical efforts on 'fixing'. The introduction of WHO's ICF framework for health and Canadian researchers' 'F-words' (functioning, fitness, fun, friends, family and future) have significantly changed the field. To explore whether the F-words ideas influenced parents' perspectives on their child's abilities and rehabilitation goals, this qualitative pilot study introduced the F-words to Iranian parents with a child with a developmental disability. METHODS This study was conducted in Tabriz, Iran, in 2023, using Iranian educational F-words materials built on ideas available on the CanChild F-words Knowledge Hub. Data were collected through semistructured interviews with five mothers of children <5 years old with a developmental disability before and after attending an 'F-words Awareness Session' and analysed using thematic analysis. RESULTS In the preinterviews, six themes (and 20 subthemes) were identified: (i) routines (5); (ii) challenges (4); (iii) parental concerns (3); (iv) child's needs and priorities (3); (v) the role of parents in satisfying needs and challenges (2); and (vi) expectations of rehabilitation (3). In the postinterview, the same six themes and four additional subthemes emerged. CONCLUSION Findings from the pilot study showed that the intervention had an impact on the attitudes and behaviours of participants. Specifically, teaching about the F-words reduced parents' emphasis on the concept of 'normality'. Families' positive response to the 'F-words Awareness Session' indicates their openness to incorporating this approach into their daily lives. These findings highlight the potential benefits of utilizing the F-words in rehabilitation in Iran. Studies like these can serve as a foundation for developing effective strategies for integrating the F-words into existing rehabilitation practices in Iran.
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Affiliation(s)
- Zahra Maleki
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seifollah Heidarabadi
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Mohammadi
- Department of Occupational Therapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peter Rosenbaum
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Cross
- Department of Pediatrics, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Alice Kelen Soper
- CanChild, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Mastwyk S, Taylor NF, Lowe A, Dalton C, Peiris CL. "You don't know what you don't know": Knowledge, attitudes, and current practice of physiotherapists in recognising and managing metabolic syndrome, a mixed methods study. Physiotherapy 2024; 124:75-84. [PMID: 38875840 DOI: 10.1016/j.physio.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 12/11/2023] [Accepted: 01/24/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES To determine the knowledge, attitudes, and current practice of primary care physiotherapists in recognising and managing clients with metabolic syndrome. DESIGN Mixed-methods research design comprising an online survey and focus groups. PARTICIPANTS Australian and English physiotherapists (n = 183) working in a primary care setting responded to the survey. Twelve physiotherapists participated in focus groups. RESULTS Metabolic syndrome was not on physiotherapists radar. They did not screen for metabolic syndrome nor provide management for it in primary care. Although most physiotherapists had some awareness of metabolic syndrome, they were not knowledgeable. Physiotherapists reported a need to focus on their clients' presenting condition, and there was uncertainty on whether metabolic syndrome management was within their scope of practice. Despite this, physiotherapists felt they had an important role to play in exercise and physical activity prescription for chronic disease management and were keen to further their knowledge and skills related to metabolic syndrome. Survey responses and focus group data were convergent. CONCLUSION Physiotherapists working in primary care settings are well-placed to identify metabolic risk factors in their clients and provide physical activity interventions to enhance management but currently lack knowledge to embed this in clinical practice. Training and resources are required to enable physiotherapists to identify and manage metabolic syndrome within their practice. CONTRIBUTION OF PAPER.
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Affiliation(s)
- Sally Mastwyk
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia; Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Nicholas F Taylor
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia; Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.
| | - Anna Lowe
- National Centre for Sports & Exercise Medicine, Sheffield Hallam University, Sheffield, UK.
| | - Caroline Dalton
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Casey L Peiris
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia; Allied Health, The Royal Melbourne Hospital, Parkville, Australia.
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Reischl S, Ziebart C, Johnston Z, Ma J, Pham D, Salloum JF, Sithganesan M, Wikkerink S, Munro K, MacDermid JC. Patient Experience of Stiffness With Knee Osteoarthritis: An Interpretative Description Study. Musculoskeletal Care 2024; 22:e1922. [PMID: 39073278 DOI: 10.1002/msc.1922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 07/09/2024] [Accepted: 07/14/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Knee OA (KOA) can lead to pain, loss of muscle strength, and changes in gait. Knee stiffness is a classic feature of KOA that can increase the risk of falls but has been understudied. OBJECTIVE To evaluate the impact of knee stiffness, the factors influencing the severity of stiffness, and the repercussions on participation for patients with KOA. METHODS This qualitative study used an interpretive description approach. Purposeful sampling was used for patients with KOA over 45 years of age, fluent in English, diagnosed with KOA and reported KOA stiffness within the last 6 months. Participants were recruited through social media and Ontario clinics. Semi-structured interviews were conducted over the phone or using zoom, recorded, and transcribed verbatim. Open, axial, and selective coding were used to identify clinically relevant themes. RESULTS Twelve participants (5F, 7M) with a mean age of 60 years were included. The five themes identified include elusive and variable perceptions of joint stiffness, inactivity or too much activity exacerbates stiffness, adapting to the ebb and flow of symptoms, risk experiences and safety fears leads to reduced participation, and KOA stiffness impairs quality of life. CONCLUSION This study highlights characteristics of knee stiffness, consequences on participation, and quality of life for people with KOA. Monitoring knee stiffness for KOA is recommended for more appropriate treatment intensity, which could improve adherence to a home programme and potentially reduce the risk of falls.
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Affiliation(s)
- S Reischl
- School of Physical Therapy, Western University, London, Canada
| | - C Ziebart
- School of Physical Therapy, Western University, London, Canada
| | - Z Johnston
- School of Physical Therapy, Western University, London, Canada
| | - J Ma
- School of Physical Therapy, Western University, London, Canada
| | - D Pham
- School of Physical Therapy, Western University, London, Canada
| | - J F Salloum
- School of Physical Therapy, Western University, London, Canada
| | - M Sithganesan
- School of Physical Therapy, Western University, London, Canada
| | - S Wikkerink
- School of Physical Therapy, Western University, London, Canada
| | - K Munro
- Hand and Upper Limb Centre, St. Joseph's Healthcare, London, Canada
| | - J C MacDermid
- School of Physical Therapy, Western University, London, Canada
- Hand and Upper Limb Centre, St. Joseph's Healthcare, London, Canada
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Toccalino D, Haag H(L, Nalder E, Chan V, Moore A, Colantonio A, Wickens CM. "A whole ball of all-togetherness": The interwoven experiences of intimate partner violence, brain injury, and mental health. PLoS One 2024; 19:e0306599. [PMID: 39178247 PMCID: PMC11343459 DOI: 10.1371/journal.pone.0306599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 06/20/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a global public health crisis, with physical violence leaving IPV survivors at high risk of brain injury (BI). Both BI and IPV have significant physical, psychological, cognitive, and social impacts, including a high risk of mental health concerns, yet there is limited exploration of IPV survivors' experiences with BI and mental health. This study aimed to explore the BI- and mental health-related needs and experiences of IPV survivors from the perspectives of survivors and service providers with the objective of developing knowledge translation materials to raise awareness and support survivors and service providers in addressing these concerns. METHODS This qualitative interpretive description study involved 19 semi-structured interviews and two focus group discussions (2-3 participants each) with 24 participants including IPV survivors experiencing BI and mental health concerns as well as IPV, mental health, and BI service providers between October 2020 and February 2021. Three screening questions were used to identify probable BI among survivors. Participants across groups were an average of 48.5±12.7 years old and were predominantly cisgender women (96%), of European origin (75%), with a university degree (71%). Interviews were recorded, transcribed, and thematically analyzed. FINDINGS Across interviews, participants spoke about IPV, BI, and mental health as being complex and interrelated experiences that have impacts across the survivor's life and extend well beyond the abusive relationship. Because of the underrecognized nature of BI in IPV, finding and accessing care requires persistence that survivors spoke of as being like "a full-time job." The benefit of making meaningful connections, particularly with other survivors, was highlighted. CONCLUSIONS Recognition of BI as a contributing factor shaping the lived experience of IPV survivors; acknowledgement that the impacts of IPV, BI, and mental health are far reaching and long lasting; and reducing barriers to finding and accessing appropriate care are critical to better supporting IPV survivors with BI and mental health concerns. Clinicians should consider BI and its lingering impacts among the IPV survivors with whom they work. Health and social policy that supports integration of care and the reduction of unnecessary barriers should be a priority.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Halina (Lin) Haag
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Emily Nalder
- Temerty Faculty of Medicine University of Toronto, Department of Occupational Science and Occupational Therapy, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Vincy Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Amy Moore
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Angela Colantonio
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Temerty Faculty of Medicine University of Toronto, Department of Occupational Science and Occupational Therapy, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Christine M. Wickens
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
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18
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Limoges J, Halkoaho A, Laaksonen M, Karwal M. Developing leadership competencies for genomics integration through globally networked learning and education. Front Med (Lausanne) 2024; 11:1404741. [PMID: 39188877 PMCID: PMC11345132 DOI: 10.3389/fmed.2024.1404741] [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: 03/21/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
Aim To describe the implementation and evaluation of an education strategy called the globally networked learning-genomics (GNL-G) used in Master's courses in Canada and Finland. The study focused on the feasibility and effectiveness of GNL-G in developing leadership competencies for integrating genomics into practice. Methods Interpretive description qualitative methodology was used to explore how GNL-G, global exchanges and assignments standardized with the Assessment of Strategies to Integrate Genomics in Nursing (ASIGN) tool influenced competency development. The Reporting Item Standards for Education and its Evaluation in Genomics (RISE2 Genomics) framework guided the design, implementation, evaluation, and reporting of GNL-G. Data included one-to-one interviews, written assignments, and reflections. Results Interviews and assignment data from three cohorts of students for a total of ten Canadian and 11 Finnish master's students participated in this study. The ASIGN Tool played a crucial role in facilitating students' analysis of their practice context and the development of leadership strategies. Participation in GNL-G enhanced students' confidence to lead efforts to integrate genomics, irrespective of their genomics expertise. Engagement with global peers emphasized the importance of incorporating equity, ethics, and social justice into leadership strategies for genomics integration. Conclusion The GNL-G strategy enhanced leadership competencies for genomics integration in graduate students from Canada and Finland. The ASIGN Tool and global peer collaboration highlight the importance of innovative educational methods in preparing leaders for the complexities of genomics in healthcare.
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Affiliation(s)
- Jacqueline Limoges
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - Arja Halkoaho
- School of Health Care and Social Services Education and R&D, Tampere University of Applied Sciences, Tampere, Finland
| | - Mari Laaksonen
- School of Health Care and Social Services Education and R&D, Tampere University of Applied Sciences, Tampere, Finland
| | - Muskaan Karwal
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
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Emezue CN, Dan-Irabor D, Anakwe A, Froilan AP, Dunlap A, Karnik NS, Julion WA. "I Have More Friends That Died Than Fingers and Toes": Service Utilization Needs and Preferences for Violence and Substance Use Prevention Among Young Black Boys and Men. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241262256. [PMID: 39126161 DOI: 10.1177/08862605241262256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
Young Black men (YBM) disproportionately face the most severe forms and consequences of youth violence (YV) and substance use disorders, but are less likely to access and be retained in services for these high-risk behaviors. Investigating service uptake disparities and the role of barrier-reducing intervention delivery models is essential; so is understanding the service needs and preferences of YBM. This study explores the experiences of violence-involved and substance-disordered YBM and service providers working with them from racially and economically diverse communities, focusing on their service needs and preferences. Additionally, we examine the potential benefits and drawbacks of digital health interventions in addressing crucial structural barriers to service access and promoting equity for Black boys in high-violence environments. Individual interviews were conducted with 16 YBM (selected from a larger pool of 300 participants from a pilot study) and 7 service providers (four females, three males). Data analysis utilized an Interpretive Description (ID) approach guided by the Phenomenological Variant of Ecological Systems Theory (PVEST). Four themes emerged: (1) Revolving Doors and Histories of Violence; (2) Benefits of Violence: "You Do Something to Me, I Do Something to You"; (3) Positive and Negative Perceptions of Violence and Substance Use Prevention Programs; and (4) Need for Equity-Focused and Barrier-Mitigating Digital Health Interventions. Our findings identified avoidance mechanisms utilized by YBM at both individual and community levels and highlighted perceptions of existing community-based programs and digital interventions as crucial tools for mitigating barriers to care. This study also confirms the prevalence of critical service gaps and program uptake issues, even in cities with abundant programs. Thus emphasizing the need for equity-focused interventions co-designed with and for YBM in high-violence and substance use contexts.
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Affiliation(s)
| | | | | | | | - Aaron Dunlap
- Rush University Medical Center, Chicago, IL, USA
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Bove DG, Simonsen SS, Herling SF, Timm H. Emergency nurses' experiences of caring for brought-in-dead persons and their relatives-a qualitative study. J Adv Nurs 2024. [PMID: 39104304 DOI: 10.1111/jan.16371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/10/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024]
Abstract
AIM To explore how emergency nurses experienced caring for brought-in-dead persons and their relatives, and what hindered or facilitated this care in an emergency setting. DESIGN A qualitative study using Interpretive Description. METHODS Data were collected as individual interviews with 13 nurses at seven Danish emergency departments from February to June 2023. FINDINGS Our analysis revealed the overarching theme 'Navigating the complexities of providing holistic care in a constrained environment', covering five sub-themes: (1) An important yet not recognized nursing task; (2) Pending care needs of the living and the dead; (3) No physical or mental room for the brought-in-dead persons; (4) Utilizing personal experiences in the absence of formal education and training and (5) Navigating professionalism and empathy. CONCLUSION Emergency departments posed unique challenges in providing care to brought-in-dead persons and their relatives. IMPLICATIONS FOR THE PROFESSION The unrecognized nature of caring for brought-in-dead persons and their relatives suggests a universal undervaluation of this care in emergency departments. IMPACT Care for brought-in-dead persons and their relatives is neither recognized nor evidence-based. This study initiates a discussion of the circumstances for delivering care for persons brought-in-dead and has an impact on nurses and nursing leaders employed in emergency departments. REPORTING METHOD The Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC CONTRIBUTION None.
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Affiliation(s)
- D G Bove
- Centre for Nursing, University College Absalon, Roskilde, Denmark
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - S S Simonsen
- Centre for Nursing, University College Absalon, Roskilde, Denmark
| | - S F Herling
- The Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Copenhhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - H Timm
- The University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen, Denmark
- National Institute of Public Health, University of Southern, Odense, Denmark
- Faculty of Health Sciences, University of the Faroe Islands, Torshavn, Faroe Islands
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21
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Haslbeck J, Casanova F, Cascais D, Staudacher S. [Chat-based cancer counseling in Switzerland: A reflexive thematic analysis of chat protocols focused on cancer survivors' needs]. Pflege 2024; 37:187-195. [PMID: 38450628 DOI: 10.1024/1012-5302/a000986] [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: 03/08/2024]
Abstract
Chat-based cancer counseling in Switzerland: A reflexive thematic analysis of chat protocols focused on cancer survivors' needs Abstract: Background: The number of people diagnosed with cancer and continue to live as cancer survivors is growing. Together with their relatives, they have information and counseling needs during the illness trajectory. With Cancerline, the Swiss Cancer League offers a chat-based counseling service for cancer survivors. Research question/objective: For the first time, the qualitative study investigated which needs cancer survivors express in Cancerline to gain insights for the further development and quality assurance of chat-based cancer counseling. Methods: Based on the principles of Interpretive Description, 669 chat counseling transcripts were analyzed using Braun et al. (2018) reflexive thematic analysis in an iterative process in six analysis steps. Results: Cancer survivorship needs in Cancerline are multifaceted, and we have identified nine themes: need anonymous chat to communicate, get informed, weigh ethical dilemmas and make decisions, seek meaning and hope, find ways to manage burdensome emotions, resolve social conflict and not burden others, feel understood and give space to own needs, clarify role as significant other acting correctly and seeking security. Conclusions: Chat-based counseling may contribute to supporting cancer survivors with information needs about cancer in a flexible way that is close to everyday life. Professionals can sensitize survivors to chat-based counseling, which makes low-threshold counseling accessible.
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Affiliation(s)
| | | | - Diana Cascais
- Gynäkologisches Tumorzentrum, Universitätsspital Basel, Schweiz
| | - Sandra Staudacher
- Institut für Pflegewissenschaft, Universität Basel, Schweiz
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Niederlande
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22
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Karmann J, Handlovsky I, Moullec G, Frohlich KL, Hébert R, Ferlatte O. Understanding the Experiences of COVID-19 Public Health Measures and Well-Being: A Qualitative Study Among Older Adults in Quebec, Canada. QUALITATIVE HEALTH RESEARCH 2024; 34:989-999. [PMID: 38442373 PMCID: PMC11375906 DOI: 10.1177/10497323241232928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
This interpretative descriptive study explores how public health measures implemented during the first wave of the COVID-19 pandemic in Quebec, Canada, affected the well-being of older adults. Twenty-six participants aged 60-81 took photographs to depict how COVID-19 public health measures affected their well-being and were invited to discuss their photographs in virtual focus groups. Data were analyzed using thematic analysis. The impacts of health measures on the well-being of participants were framed according to three overarching themes. First, participants endured an intensification of ageism, feeling diminished and excluded from their social spheres. Second, they faced a burden of loneliness due to the loss of connections with their communities, particularly for those who were single and without children. Third, participants highlighted navigating a degradation of social cohesion. This manifested through tensions and distrust in both the public and private spheres, as well as acts of resistance in response to rules deemed unjust. While public health measures were essential to prevent onward transmission of COVID-19 and mortality, they negatively impacted older adults' self-image, loneliness, and trust in society. This study argues for a rethinking of public health norms specific to older adults to address potential sources of inequality. In particular, a greater emphasis is needed on social connectedness and addressing the unique needs of older adults during pandemics.
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Affiliation(s)
- Julie Karmann
- École de Santé Publique de l'Université de Montréal, Montréal, QC, Canada
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | | | - Gregory Moullec
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
- Centre de Recherche du CIUSSS du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montréal, QC, Canada
| | - Katherine L Frohlich
- École de Santé Publique de l'Université de Montréal, Montréal, QC, Canada
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Réjean Hébert
- École de Santé Publique de l'Université de Montréal, Montréal, QC, Canada
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Olivier Ferlatte
- École de Santé Publique de l'Université de Montréal, Montréal, QC, Canada
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
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Richard E, Kim SBC. Career decisions and aspirations of early-career nurses: Insights from a qualitative interpretative description study. J Adv Nurs 2024; 80:3333-3344. [PMID: 38131513 DOI: 10.1111/jan.16034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 11/13/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
AIM To explore the career decisions and aspirations of early-career registered nurses in New Brunswick, Canada. DESIGN A qualitative study using an interpretive description approach was conducted. METHODS Semi-structured one-on-one interviews were conducted with a purposive sample of nurses (n = 22) currently working in New Brunswick, Canada, with up to 5 years of experience from February to April 2022. RESULTS Participants described diverse career paths and aspirations. Personal factors affecting these included the desire for meaningful work, career satisfaction, work-life balance, spending time with family, working in a preferred location, and finances. Professionally, working conditions were the dominant factor influencing early-career nurses' career decisions and aspirations. Participants described how short staffing, safety, support, and scheduling influenced their day-to-day work, mental and physical health, job and career satisfaction, and intent to leave. CONCLUSION The findings highlighted the abundant and diverse career opportunities available to nurses early in their careers. Early-career nurses are interested in finding nursing positions with a high degree of person-job fit and value opportunities for ongoing professional education and growth. IMPACT This study in New Brunswick, Canada, explores early-career nurses' career decisions and aspirations during nursing shortages and the pandemic, emphasizing the importance of person-job fit. Recommendations include improving working conditions and career pathways to enhance the sustainability of the nursing profession. REPORTING METHOD Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Emily Richard
- Faculty of Nursing, University of New Brunswick, Moncton, New Brunswick, Canada
| | - Su Bin Chloe Kim
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
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Akoo C, Price S, McMillan K, Ingraham K, Ayoub A, Rolle Sands S, Shankland M, Bourgeault I. Nurses Navigating Mental Health During Uncharted Times: Self, Others, Systems (S.O.S)! Can J Nurs Res 2024:8445621241266291. [PMID: 39054953 DOI: 10.1177/08445621241266291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
STUDY BACKGROUND The nursing profession is facing a multiplicity of stressors that have both predated and been exacerbated by the Covid-19 pandemic. The emotional and physical demands entailed in nursing predispose nurses to suboptimal mental health and burnout. PURPOSE This paper draws upon the narrative interviews of 53 Canadian nurses as part of a larger pan-Canadian, cross disciplinary study that examined the gendered experiences of mental health, leaves of absence, and return to work of 7 professions. METHODS Thorne's interpretive descriptive guided Iterative and thematic analysis which identified three predominant themes within the nursing dataset, this paper focuses on the substantive theme of 'Navigating it Alone,'. RESULTS Nurses expressed a profound sense of isolation at 3 particular levels: at home, at work, and in systems - while simultaneously balancing uniquely gendered familial responsibilities and workplace demands. CONCLUSIONS These results illuminate instrumental pathways for stakeholders to attenuate the personal and professional pressures that continue to be disproportionately carried by nurses as they navigate these particularly challenging times.
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Affiliation(s)
- Chaman Akoo
- School of Nursing, University of Ottawa, Ottawa, Canada
| | - Sheri Price
- School of Nursing, Dalhousie University, Nova Scotia, Canada
| | | | | | - Abby Ayoub
- School of Nursing, University of Ottawa, Ottawa, Canada
| | | | - Mylène Shankland
- Institute of Feminist and Gender Studies, University of Ottawa, Ottawa, Canada
| | - Ivy Bourgeault
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, Canada
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Hedqvist AT, Holmberg M, Bjurling-Sjöberg P, Ekstedt M. Bracing for the next wave: A critical incident study of frontline decision-making, adaptation and learning in ambulance care during COVID-19. J Adv Nurs 2024. [PMID: 39016315 DOI: 10.1111/jan.16340] [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: 10/27/2023] [Revised: 06/30/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
AIM To explore frontline decision-making, adaptation, and learning in ambulance care during the evolving COVID-19 pandemic. DESIGN Descriptive and interpretative qualitative study. METHODS Twenty-eight registered nurses from the Swedish ambulance services described 56 critical incidents during the COVID-19 pandemic through free-text questionnaires. The material was analysed using the Critical Incident Technique and Interpretive Description through the lens of potential for resilient performance. RESULTS The findings were synthesized into four themes: 'Navigating uncharted waters under never-ending pressure', 'Balancing on the brink of an abyss', 'Sacrificing the few to save the many' and 'Bracing for the next wave'. Frontline decision-making during a pandemic contribute to ethical dilemmas while necessitating difficult prioritizations to adapt and respond to limited resources. Learning was manifested through effective information sharing and the identification of successful adaptations as compared to maladaptations. CONCLUSIONS During pandemics or under other extreme conditions, decisions must be made promptly, even amidst emerging chaos, potentially necessitating the use of untested methods and ad-hoc solutions due to initial lack of knowledge and guidelines. Within ambulance care, dynamic leadership becomes imperative, combining autonomous frontline decision-making with support from management. Strengthening ethical competence and fostering ethical discourse may enhance confidence in decision-making, particularly under ethically challenging circumstances. IMPACT Performance under extreme conditions can elevate the risk of suboptimal decision-making and adverse outcomes, with older adults being especially vulnerable. Thus, requiring targeted decision support and interventions. Enhancing patient safety in ambulance care during such conditions demands active participation and governance from management, along with decision support and guidelines. Vertical communication and collaboration between management and frontline professionals are essential to ensure that critical information, guidelines, and resources are effectively disseminated and implemented. Further research is needed into management and leadership in ambulance care, alongside the ethical challenges in frontline decision-making under extreme conditions. REPORTING METHOD Findings are reported per consolidated criteria for reporting qualitative research (COREQ). PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Ann-Therese Hedqvist
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
- Ambulance Service, Region Kalmar, Västervik, Sweden
| | - Mats Holmberg
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
- Department of Ambulance Service, Region Sörmland, Sweden
- Centre for Clinical Research, Uppsala University, Uppsala, Sweden
| | - Petronella Bjurling-Sjöberg
- Centre for Clinical Research, Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Department of Patient Safety, Region Sörmland, Sweden
| | - Mirjam Ekstedt
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
- Department of Learning, Informatics, Management and Ethics, LIME, Karolinska Institutet, Stockholm, Sweden
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Tan AF, Patel P. Reporting Mistreatment in Medical School. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:706. [PMID: 38574202 DOI: 10.1097/acm.0000000000005727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
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Kilgour G, Stott NS, Steele M, Adair B, Hogan A, Imms C. More than just having fun! Understanding the experience of involvement in physical activity of adolescents living with cerebral palsy. Disabil Rehabil 2024; 46:3396-3407. [PMID: 37675880 DOI: 10.1080/09638288.2023.2251395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023]
Abstract
Purpose: To explore the experiences of involvement of adolescents living with cerebral palsy, and their parents, while participating in physical activity. Understanding involvement in physical activity may be used to guide future participation.Methods: Eight adolescents (mean age 13 years 11 months, SD 1 year 6 months) with cerebral palsy participated in a New Zealand-based high-level mobility programme (HLMP) focused on running skills, twice per week for 12 weeks. The adolescents and 12 parents were interviewed before, after the 12 weeks and 9-months following the HLMP. Guided by interpretative description, 38 interviews were coded, analysed, and interpreted.Results: Four themes were: "Turning up is not enough" ("There's no point being there if you're not involved"); "In it all the way", "Changes on a dime", and "What works for me." Perceptions of involvement varied between adolescents and parents. Being "very involved" related to high levels of focus, concentration, effort; but not always enjoyment.Conclusions: Focusing on enjoyment as the key experience of involvement understates the complexity and dynamic nature of involvement. "Being involved" is not always easy and may not mean the absence of discomfort or effort. Optimising the individuals' involvement continuum during physical activity may be essential to promote lifelong participation.IMPLICATIONS FOR REHABILITATIONAdolescents living with cerebral palsy and their parents have differing perspective of involvement and utilise different strategies to encourage being and staying active.Teaching adolescents living with cerebral palsy about their involvement continuum and optimal level of involvement for each activity, context and environment could promote sustained participation.To ensure adolescents are "being involved" in physical activity, opportunities for engagement, motivation and persistence are important; enjoyment is a possible, but not essential attribute of involvement.Encouraging involvement in physical activity can be a source of family conflict from a young age therefore clinicians have a role as an essential supporter, motivator and educator.
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Affiliation(s)
- Gaela Kilgour
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Ngaire Susan Stott
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Michael Steele
- Department of Biostatistics, Australian Catholic University, Brisbane, Australia
| | | | | | - Christine Imms
- Department of Paediatrics, The University of Melbourne, Murdoch Children's Research Institute, Melbourne, Australia
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Mharapara TL, Ravenswood K, Clemons JH, Kirton G, Greenslade-Yeats J. Enhancing midwives' occupational well-being: Lessons from New Zealand's COVID-19 experience. Health Care Manage Rev 2024; 49:210-219. [PMID: 38757905 DOI: 10.1097/hmr.0000000000000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND The World Health Organization posits that adequate maternity health is possible if midwives are supported, respected, protected, motivated, and equipped to work safely and optimally within interdisciplinary health care teams. Based on qualitative survey data, we argue that the COVID-19 pandemic amplified job demands and resources, professional invisibility, and gender norms to negatively impact midwives' well-being. PURPOSES We aim to develop a refined understanding of the antecedents of well-being in midwifery to equip policymakers, administrators, and professional associations with the knowledge to enhance midwives' well-being postpandemic. METHODOLOGY/APPROACH Drawing on the Job Demands-Resources model, we thematically analyzed qualitative survey data ( N = 215) from New Zealand midwives to reveal how job demands, resources, and structural factors impacted midwives' well-being. RESULTS We identified fear of contracting and spreading COVID-19, financial and legal imperatives (job demands), work-related hypervigilance, sense of professional duty, practical and social support, and appreciation and recognition (job resources) as key antecedents of midwives' well-being. These job demands and resources were influenced by professional invisibility and gender norms. CONCLUSION Policy and practice solutions must address job demands, resources, and structural factors to meaningfully enhance midwives' well-being postpandemic. PRACTICE IMPLICATIONS We recommend that policymakers, administrators, and professional associations monitor for signs of overcommitment and perfectionistic strivings and then take appropriate remedial action. We also suggest that midwives receive equitable pay, sick leave, and other related benefits.
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Glasdam S, Xu H, Gulestø RJA. A call for theory-inspired analysis in qualitative research: Ways to construct different truths in and about healthcare. Nurs Inq 2024; 31:e12642. [PMID: 38638008 DOI: 10.1111/nin.12642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/18/2024] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
Over the last 50 years, there has been significant development of qualitative research and related methods in healthcare. Theoretical frameworks support researchers in selecting appropriate research approaches, procedures and analytical tools. However, the implications of the choice of theory are sparsely elucidated. Based on a text excerpt from a public debate article, the study aimed to show how different theory-inspired analytical perspectives produced varied understandings of the same text. The study presented three subanalyses inspired by Bourdieu's sociological theory, Lazarus and Folkman's psychological theory and utilitarian ethics, respectively. The analyses showed that by using different theoretical analytical perspectives in inductive processes, an immediate interpretation of the text was not obvious. It became possible to spot the underlying meta-theoretical assumptions, as the interpretations were not taken for granted or indisputable. Our analyses suggest that different theoretical lenses lead to different interpretations of the same empirical material, recognising the existence of multiple truths or realities. Thus, utilising a theoretical perspective in inductive analyses can enhance transparency and rigour because the analytical optics are made explicit to the reader. This allows the reader to follow the analysis processes and comprehend from which theoretical starting point a truth arises.
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Affiliation(s)
- Stinne Glasdam
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Hongxuan Xu
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Ragnhild J A Gulestø
- Department of Health Sciences, Institute of Nursing, VID Specialized University, Oslo, Norway
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Holden J, O'Halloran P, Davidson M, Breckon J, Rahayu W, Monfries M, Taylor NF. Embedded motivational interviewing combined with a smartphone application to increase physical activity in people with sub-acute low back pain: a cluster randomised controlled trial. Braz J Phys Ther 2024; 28:101091. [PMID: 38943741 PMCID: PMC11260563 DOI: 10.1016/j.bjpt.2024.101091] [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: 06/05/2023] [Revised: 05/16/2024] [Accepted: 06/05/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Moderately vigorous physical activity (PA) may be beneficial for people with sub-acute low back pain (LBP), but may initially be painful for patients and challenging for physical therapists to facilitate. OBJECTIVES This study investigated motivational interviewing (MI) delivered by physical therapists and a smartphone app for increasing PA in people with LBP. METHODS A mixed methods cluster randomised controlled trial involving 46 adults with LBP in Melbourne, Australia. Participants attended weekly 30-min physical therapy consultations for 6 weeks. Experimental group physical therapists were taught to embed MI into consultations and patients were provided with a self-directed app. The primary outcome was accelerometer-derived moderately vigorous PA. Secondary outcomes were LBP disability (Oswestry Disability Index), functional capacity (Patient Specific Functional Scale), and self-efficacy (Pain Self-Efficacy Questionnaire). Between-group differences were analysed by ANCOVA post-intervention. RESULTS There was no statistically significant difference between the experimental group and control group for PA. Between-group differences in LBP disability (MD= 19.4 units, 95% CI: 8.5, 30.3), functional capacity (primary MD= -4.1 units, 95% CI: -6.9, -1.3; average MD= -3.1, 95% CI: -4.9, -1.2) and self-efficacy (MD -11.3 units, 95%CI -20.2, -2.5) favoured the control group with small to moderate effect sizes. There were low levels of overall engagement with the app. CONCLUSION The embedded MI intervention was no more beneficial than physical therapy alone for PA and was associated with poorer LBP disability, function, and self-efficacy. The effectiveness of embedding MI and a smartphone app into usual care for LBP was not supported.
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Affiliation(s)
- Jason Holden
- La Trobe University, School of Allied Health, Bundoora, Victoria, Australia.
| | - Paul O'Halloran
- La Trobe University, School of Psychology and Public Health, Bundoora, Victoria, Australia
| | - Megan Davidson
- La Trobe University, School of Allied Health, Bundoora, Victoria, Australia
| | - Jeff Breckon
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, United Kingdom
| | - Wenny Rahayu
- La Trobe University, Office of Engineering and Mathematical Sciences, Bundoora, Victoria, Australia
| | - Melissa Monfries
- La Trobe University, School of Psychology and Public Health, Bundoora, Victoria, Australia
| | - Nicholas F Taylor
- La Trobe University, School of Allied Health, Human Services and Sport, Bundoora, Victoria, Australia; Eastern Health, Arnold St, Box Hill, Victoria, Australia
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Turbitt E, Bourne M, McEwen A, Amor DJ. Parents' preferences for receiving and discussing prognostic genetic information regarding their children's neurodevelopmental condition: A qualitative study. Dev Med Child Neurol 2024; 66:872-881. [PMID: 38111102 DOI: 10.1111/dmcn.15830] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023]
Abstract
AIM To investigate parents' preferences and motivations for receiving and discussing prognostic genetic test results. METHOD We used a cross-sectional, interpretive description qualitative study design. We collected data through semi-structured interviews with Australian parents, which we analysed using reflexive thematic analysis. RESULTS Parents (n = 32) had a child or children with a genetic neurodevelopmental condition, such as fragile X syndrome, DiGeorge (22q11.2 deletion) syndrome, or Angelman syndrome. Parents of mildly impacted or older children were tolerant to prognostic uncertainty. Parents found conversations about their child's prognosis emotional and preferred to discuss their child's potential strengths and challenges. While most were enthusiastic about prognostic tests and described many motivations for testing, the potential for prognostic information to contribute to a loss of hope and stigmatizing societal views were also discussed. INTERPRETATION Parents had mixed preferences and motivations for acquiring prognostic genetic information about their child, contrasting evidence in other contexts such as cancer where parents typically have minimal tolerance of uncertainty. Health professionals should consider strength-based framing of prognostic information gained from current and emerging technologies when returning results to families. WHAT THIS PAPER ADDS Parents had varied views about receiving prognostic information on their children's neurodevelopmental condition. Some parents preferred prognostic uncertainty about their children's genetic neurodevelopmental condition.
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Affiliation(s)
- Erin Turbitt
- Discipline of Genetic Counselling, University of Technology Sydney, Ultimo, NSW, Australia
| | - Meg Bourne
- Discipline of Genetic Counselling, University of Technology Sydney, Ultimo, NSW, Australia
| | - Alison McEwen
- Discipline of Genetic Counselling, University of Technology Sydney, Ultimo, NSW, Australia
| | - David J Amor
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
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Abild CB, Vestergaard ET, Bruun JM, Kristensen K, Støving RK, Clausen L. Mechanisms underlying the development of eating disorders and disordered eating in adolescent females with type 1 diabetes. Diabet Med 2024:e15397. [PMID: 38946057 DOI: 10.1111/dme.15397] [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: 01/23/2024] [Revised: 05/29/2024] [Accepted: 06/17/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE People with Type 1 diabetes (T1D) face an increased risk of eating disorders/disordered eating (ED/DE), with adolescents being particularly vulnerable. Empirical knowledge on the mechanisms underlying development of ED/DE in T1D is crucial for evolving prevention strategies. RESEARCH DESIGN AND METHODS Fourteen semi-structured interviews with adolescent females with T1D and ED/DE between 14 and 18 years were conducted and analyzed using reflexive thematic analysis. RESULTS Analyses identified four main themes; 'Interconnected afflictions', 'Judgment', 'Feeling Different', and 'Chaos & Control', These themes explore the interconnectedness of T1D and ED/DE, with shame and guilt emerging as common underlying mechanism. The development of a biopsychosocial model was based on the integration of these data with existing models. CONCLUSIONS The study extends previous developmental pathways of ED/DE in adolescents with T1D. We propose a biopsychosocial model that incorporates various factors: predisposing factors such as parental management of T1D and weight gain during adolescence; precipitating factors including comments on weight, frequency of weighing, perceptions of surveillance; the perpetuating bilateral influence of ED/DE and T1D and finally highlighting the protective mechanisms of disease acceptance encompassing parental handling of diagnosis and the contribution of healthcare professionals (HCP's) role in psychoeducation. The present study highlight the vulnerability of adolescence in the presence of T1D, particularly concerning issues related to eating, weight, and body. It offers clinically relevant insights, with the aim to improve communication and management strategies for this very specific group.
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Affiliation(s)
- Caroline Bruun Abild
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Danish National Center for Obesity, Aarhus, Denmark
| | - Esben Thyssen Vestergaard
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Meldgaard Bruun
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Danish National Center for Obesity, Aarhus, Denmark
| | - Kurt Kristensen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Rene Klinkby Støving
- Center for Eating Disorders, Odense University Hospital, Odense, Denmark
- Research Unit for Medical Endocrinology, Odense University Hospital, Odense, Denmark
- Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Loa Clausen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Child and Adolescent Psychiatry-Research unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark
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Katmeh T, Gardner DM, Kiepek N, Macdonald M, Murphy AL. Sleep should not be this difficult: An interpretive descriptive study of older adults' perspectives on behaviour change elements in Sleepwell and experiences with benzodiazepine discontinuation. J Sleep Res 2024:e14282. [PMID: 38945830 DOI: 10.1111/jsr.14282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 05/07/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024]
Abstract
Benzodiazepine receptor agonists are often used for insomnia in older adults contrary to current evidence. The harms outweigh the benefits, which are limited. Cognitive behavioural therapy for insomnia is the first-line recommended treatment. Sleepwell was created as a repository of evidence-based resources to promote cognitive behavioural therapy for insomnia and limit benzodiazepine receptor agonist use. This qualitative study uses an interpretive description design and reflexive thematic analysis to explore older adults' perspectives on behavioural change techniques used in Sleepwell resources. It also explores challenges and opportunities towards benzodiazepine receptor agonist discontinuation and cognitive behavioural therapy for insomnia use. Participants were recruited from the Sleepwell arm of a randomized controlled trial. Data were collected from 15 older adults using semi-structured interviews. Two main themes were developed: (1) sleep should not be this difficult; and (2) whether you know it, or learn it, drugs are bad. Two sub-themes were created within the first theme: (1) justification of benzodiazepine receptor agonist use to achieve sleep goals; (2) efforts of committing to cognitive behavioural therapy for insomnia. Several behavioural change techniques (e.g. information about consequences, anticipated regret, salience of consequences) were enablers of benzodiazepine receptor agonist-related behaviour change. For committing to cognitive behavioural therapy for insomnia, several behavioural change techniques (e.g. self-monitoring of behaviour, distraction, stimulus substitution) were beneficial, but social support, which was perceived as useful, was absent. Older adults experienced tension with benzodiazepine receptor agonist use and deprescribing, despite knowing or learning the potential consequences of benzodiazepine receptor agonists. Cognitive behavioural therapy for insomnia implementation was challenging. Embedded behavioural change techniques in the Sleepwell booklets were identified as helpful, but more (e.g. social support) are needed to optimize cognitive behavioural therapy for insomnia use.
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Affiliation(s)
- Tulayla Katmeh
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David M Gardner
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Niki Kiepek
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marilyn Macdonald
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andrea L Murphy
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
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Trail K, O'Gorman K, Seidler Z, Oliffe J, Hunt T, Rice S. "Put your personality into the call": A qualitative interview study illuminating strategies for improving men's engagement on crisis helplines. BMC Public Health 2024; 24:1720. [PMID: 38937734 PMCID: PMC11212170 DOI: 10.1186/s12889-024-19242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Crisis telephone helplines are an integral part of community suicide prevention. Despite high male suicide rates, men's experiences of these services are poorly understood. The current study explored men's perspectives of their interactions with helpline counsellors to understand how their engagement on helplines can be enhanced. METHOD Sixteen men (19-71 years) who had previously used a mental health or crisis helpline in Australia completed individual semi-structured interviews about their experiences. Data were analysed using interpretive descriptive methodologies. RESULTS Two themes derived from the data related to how men engaged with counsellors on helpline services. First, men emphasized the importance of helpline counsellors creating and maintaining an authentic connection across the call, providing suggestions for strategies to secure connection. Second, men discussed how counsellors can facilitate outcomes through offering space for their narratives and aiding in referrals to other support services when required. CONCLUSIONS Findings highlight the value of crisis helplines for men's suicide prevention services while identifying target areas to improve engagement. We discuss implications for the findings including suggestions for gender-sensitive care within crisis helplines.
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Affiliation(s)
- Katherine Trail
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Kieran O'Gorman
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Zac Seidler
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - John Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
- Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Tara Hunt
- Lifeline Research Foundation, Lifeline Australia, Sydney, NSW, Australia
| | - Simon Rice
- Orygen, Parkville, Melbourne, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
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Billiau L, Bolliger L, Clays E, Eeckloo K, Ketels M. Flemish critical care nurses' experiences regarding the influence of work-related demands on their health: a descriptive interpretive qualitative study. BMC Nurs 2024; 23:387. [PMID: 38844928 PMCID: PMC11155134 DOI: 10.1186/s12912-024-02032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 05/21/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Critical care nurses (CCNs) around the globe face other health challenges compared to their peers in general hospital nursing. Moreover, the nursing workforce grapples with persistent staffing shortages. In light of these circumstances, developing a sustainable work environment is imperative to retain the current nursing workforce. Consequently, this study aimed to gain insight into the recalled experiences of CCNs in dealing with the physical and psychosocial influences of work-related demands on their health while examining the environments in which they operate. The second aim was to explore the complex social and psychological processes through which CCNs navigate these work-related demands across various CCN wards. METHODS A qualitative study following Thorne's interpretive descriptive approach was conducted. From October 2022 to April 2023, six focus groups were organised. Data from a diverse sample of 27 Flemish CCNs engaged in physically demanding roles from three CCN wards were collected. The Qualitative Analysis Guide of Leuven was applied to support the constant comparison process. RESULTS Participants reported being exposed to occupational physical activity, emotional, quantitative, and cognitive work-related demands, adverse patient behaviour, and poor working time quality. Exposure to these work-related demands was perceived as harmful, potentially resulting in physical, mental, and psychosomatic strain, as well as an increased turnover intention. In response to these demands, participants employed various strategies for mitigation, including seeking social support, exerting control over their work, utilising appropriate equipment, recognising rewards, and engaging in leisure-time physical activity. CONCLUSIONS CCNs' health is challenged by work-related demands that are not entirely covered by the traditional quantitative frameworks used in research on psychologically healthy work. Therefore, future studies should focus on improving such frameworks by exploring the role of psychosocial and organisational factors in more detail. This study has important implications for workplace health promotion with a view on preventing work absenteeism and drop-out in the long run, as it offers strong arguments to promote sufficient risk management strategies, schedule flexibility, uninterrupted off-job recovery time, and positive management, which can prolong the well-being and sustainable careers of the CCN workforce.
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Affiliation(s)
- Lukas Billiau
- Strategic Policy Cell, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Larissa Bolliger
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium
| | - Els Clays
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium
| | - Kristof Eeckloo
- Strategic Policy Cell, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, 9000, Belgium
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium
| | - Margo Ketels
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium
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Pauly BB, Kurz M, Dale LM, Macevicius C, Kalicum J, Pérez DG, McCall J, Urbanoski K, Barker B, Slaunwhite A, Lindsay M, Nosyk B. Implementation of pharmaceutical alternatives to a toxic drug supply in British Columbia: A mixed methods study. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 161:209341. [PMID: 38490334 DOI: 10.1016/j.josat.2024.209341] [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: 09/10/2023] [Revised: 01/15/2024] [Accepted: 03/12/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND North America has been in an unrelenting overdose crisis for almost a decade. British Columbia (BC), Canada declared a public health emergency due to overdoses in 2016. Risk Mitigation Guidance (RMG) for prescribing pharmaceutical opioids, stimulants and benzodiazepine alternatives to the toxic drug supply ("safer supply") was implemented in March 2020 in an attempt to reduce harms of COVID-19 and overdose deaths in BC during dual declared public health emergencies. Our objective was to describe early implementation of RMG among prescribers in BC. METHODS We conducted a convergent mixed methods study drawing population-level linked administrative health data and qualitative interviews with 17 prescribers. The Consolidated Framework for Implementation Research (CFIR) informs our work. The study utilized seven linked databases, capturing the characteristics of prescribers for people with substance use disorder to describe the characteristics of those prescribing under the RMG using univariate summary statistics and logistic regression analysis. For the qualitative analysis, we drew on interpretative descriptive methodology to identify barriers and facilitators to implementation. RESULTS Analysis of administrative databases demonstrated limited uptake of the intervention outside large urban centres and a highly specific profile of urban prescribers, with larger and more complex caseloads associated with RMG prescribing. Nurse practitioners were three times more likely to prescribe than general practitioners. Qualitatively, the study identified five themes related to the five CFIR domains: 1) RMG is helpful but controversial; 2) Motivations and challenges to prescribing; 3) New options and opportunities for care but not enough to 'win the arms race'; 4) Lack of implementation support and resources; 5) Limited infrastructure. CONCLUSIONS BC's implementation of RMG was limited in scope, prescriber uptake and geographic scale up. Systemic, organizational and individual barriers and facilitators point to the importance of engaging professional regulatory colleges, implementation planning and organizational infrastructure to ensure effective implementation and adaptation to context.
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Affiliation(s)
- Bernadette Bernie Pauly
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada; University of Victoria School of Nursing, Box 1700 Stn CSC, Victoria, BC 250, Canada.
| | - Megan Kurz
- Centre for Advancing Health Outcomes, Providence Health Care, 570-1081 Burrard Street, Vancouver, BC V6Z IY6b, Canada.
| | - Laura M Dale
- Centre for Advancing Health Outcomes, Providence Health Care, 570-1081 Burrard Street, Vancouver, BC V6Z IY6b, Canada.
| | - Celeste Macevicius
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada; University of Victoria School of Public Health and Social Policy, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
| | - Jeremy Kalicum
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada; University of Victoria School of Public Health and Social Policy, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
| | - Daniel Gudiño Pérez
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada; University of Victoria School of Public Health and Social Policy, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
| | - Jane McCall
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada
| | - Karen Urbanoski
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada; University of Victoria School of Public Health and Social Policy, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
| | - Brittany Barker
- School of Public Health and Social Policy, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada; First Nations Health Authority, 501 - 100 Park Royal South, 170-6371 Crescent Road, Coast Salish Territory (West Vancouver), BC V7T 1A2, Canada; Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, B.C. V5A 1S6, Canada.
| | - Amanda Slaunwhite
- BC Centre for Disease Control, 655 W 12th Ave, Vancouver, BC V5Z 4R4, Canada; School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z3, Canada; Centre for Advancing Health Outcomes, 570-1081 Burrard Street, St. Paul's Hospital, Vancouver, BC V6Z1Y6, Canada.
| | - Morgan Lindsay
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada.
| | - Bohdan Nosyk
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, B.C. V5A 1S6, Canada; Centre for Advancing Health Outcomes, Providence Health Care, 570-1081 Burrard Street, St. Paul's Hospital, Vancouver, BC V6Z1Y6, Canada.
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Groller KD, Adamshick PZ, Hoffman LM. Pandemic Footprints of Nursing Professionals: Processing Early Experiences. J Holist Nurs 2024; 42:168-181. [PMID: 37670518 DOI: 10.1177/08980101231198714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Purpose: This study interpreted journaled experiences of registered nurses (RNs) who were working at the bedside early in the pandemic as they were simultaneously enrolled in a baccalaureate (RN-BSN) completion program. Design: This qualitative interpretive descriptive study used purposive sampling. Methods: Eighteen students participated in the journal assignment. Fifteen students consented to participate in journal analyses. Journals were de-identified and a code book was used to document the entirety of journal reflections to identify meaningful text, and, ultimately, assert thematic codes. Thorne's interpretive description guided analysis. Researchers coded four journals together to obtain trustworthiness and rigor. Each doctorally prepared researcher independently coded a subset of the remaining journals. Emerging significant statements and subthemes were discussed and verified as a team. Results: Researchers identified the essence of pandemic footprints as the following themes emerged: Physical Threats to Safety, Emotional Threats to Safety, Workplace Culture, Healing Energies, and Professional Identity. Conclusions: Compared to previously published research conducted at later points of the pandemic this study is unique. Study data captured nurses' expressed voices through journaling at the brink (March 2020) of what became a global reality. Results illuminated dichotomies that existed then, particularly in response to their own and others' safety and security, leaving profound imprints on their identities extending beyond care environments.
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Engeda EH, Aldersey HM, Davison CM, Gelaye KA, Fayed N. Severe malaria-related disability in Ethiopian children from the perspectives of caregivers: an interpretive description study. Disabil Rehabil 2024; 46:2327-2337. [PMID: 37303154 DOI: 10.1080/09638288.2023.2221457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/28/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE This study explored severe malaria-related disability in children from the perspectives of their caregivers. MATERIALS AND METHODS The interpretive description qualitative approach was employed. The participants were selected using the purposive sampling technique considering the child's history of severe malaria, age (0-10 years), and location (urban/rural). Data were collected through face-to-face interviews with sixteen caregivers. Reflexive thematic data analysis was utilized. Through prolonged engagement, reflective journaling, an audit trail, and co-authors' review, trustworthiness was enhanced. RESULTS The study generated five themes from the interviews: mitigators of disability, contributors of disability, impact on body function, impact on activities and participation, and uncertainties about future well-being. The findings revealed previously unstudied social components of disability and environmental factors. Furthermore, the research uncovered health-related quality of life aspects that are out of the scope of the current comprehensive disability framework. CONCLUSIONS The study contributes to a deeper understanding of severe malaria-related disability in children from the biopsychosocial perspective. The findings could help policymakers, researchers, and clinicians who want to design rehabilitation interventions for the affected children or examine the components of disability on a large scale using quantitative methods.IMPLICATIONS FOR REHABILITATIONVarious contextual factors interacted with severe malaria and influenced functioning either as facilitators or barriers, implying disability related to malaria can be prevented or created.The long-term impacts of severe malaria are not limited to functioning and disability but also affect the health-related quality of life of children who survive severe malaria.Rehabilitation professionals should consider applying comprehensive functioning and disability frameworks such as the ICF when designing (or applying) screening tools, planning interventions, and evaluating the outcomes of intervention for children with severe malaria-related disability.Rehabilitation interventions for children with severe malaria-related disability should consider patient- or caregiver-reported outcomes (components of disability).
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Affiliation(s)
- Eshetu Haileselassie Engeda
- Department of Pediatric and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Queen's University School of Rehabilitation Therapy, Kingston, Canada
| | | | - Colleen M Davison
- Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nora Fayed
- Queen's University School of Rehabilitation Therapy, Kingston, Canada
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Zhou Y, Weng L, Wang M, Huang G. Male nursing students' experiences of their clinical internships: A qualitative study. Heliyon 2024; 10:e31075. [PMID: 38778997 PMCID: PMC11109802 DOI: 10.1016/j.heliyon.2024.e31075] [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: 08/18/2023] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
Background Nursing has traditionally been a predominantly female profession; however, there has been a gradual increase in the proportion of male nursing students in recent years. Male nursing students may encounter distinct challenges within clinical settings, potentially impacting their physical and mental well-being. Aim This study aims to explore the clinical internship experiences of male nursing students and provide them with adequate support for their successful adaptation to clinical roles. Methods This study used a descriptive design and qualitative approach. The participants were enrolled using a convenience sampling method. Data were collected using individual face-to-face semi-structured interviews. Results Male nursing students' experiences of their clinical internships were described through the following themes: (1) dynamics of working as a nurse, (2) not just a male nursing student, (3) gender-based stereotypes, (4) balance between forte and failing, (5) difficulties and challenges when working in hospitals, and (6) lessons learned and knowledge needs. Conclusions Our research findings have significantly enhanced our comprehension of male nursing students' experiences and offered valuable recommendations for both nursing education and clinical practice. Simultaneously, these results provide essential information support for nursing educators and hospital administrators.
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Affiliation(s)
- Yitao Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Lingyan Weng
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital, Ningbo University, Ningbo City, China
| | - Menglu Wang
- Neurology Department, Chinese Medicine Hospital of Zhenhai District, Ningbo City, China
| | - Ganying Huang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
- Department of Emergency, Hangzhou First People's Hospital, China
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Chen A, Wyatt CCL. The scope of practice of geriatric dentistry in British Columbia (Canada): An exploratory study. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38794789 DOI: 10.1111/scd.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
AIMS The oral health needs of frail older adults are increasing with an aging population in Canada. The objective of this study was to explore the perceptions of dentists in British Columbia regarding their view of geriatric dentistry as a distinct scope of practice and in relation to special needs dentistry. METHODS AND RESULTS Qualitative data were gathered thorough semi guided interviews of a purposeful sample of dental clinicians, educators and members of organized dentistry with specialized knowledge of oral health for frail older adults. Interviews were transcribed, coded, and analyzed using a thematic approach. Thematic saturation was reached with the 10 participants in this study. Through the method of interpretative description, patient, dentist, and systemic factors that shaped scope of practice for geriatric dentistry were identified as well as the broader skill sets required for geriatric dentistry. CONCLUSION The study found that participants perceived geriatric dentistry as unique scope of practice from general dentistry requiring special knowledge in the management of challenges associated with aging with frailty as well as the ability to work in long-term care. Similar to special needs dentistry, geriatric dentistry requires person-centered care and emphasized the need for interprofessional collaboration in alternative care settings.
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Affiliation(s)
- Alice Chen
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Chris C L Wyatt
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Palmryd L, Rejnö Å, Alvariza A, Godskesen T. Critical care nurses' experiences of ethical challenges in end-of-life care. Nurs Ethics 2024:9697330241252975. [PMID: 38775348 DOI: 10.1177/09697330241252975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
BACKGROUND In Swedish intensive care units, nine percent of patients do not survive despite receiving advanced life-sustaining treatments. As these patients transition to end-of-life care, ethical considerations may become paramount. AIM To explore the ethical challenges that critical care nurses encounter when caring for patients at the end of life in an intensive care context. RESEARCH DESIGN The study used a qualitative approach with an interpretive descriptive design. RESEARCH CONTEXT AND PARTICIPANTS Twenty critical care nurses from eight intensive care units in an urban region in Sweden were interviewed, predominately women with a median age of fifty-one years. ETHICAL CONSIDERATIONS This study was approved by The Swedish Ethics Review Authority. FINDINGS Critical care nurses described encountering ethical challenges when life-sustaining treatments persisted to patients with minimal survival prospects and when administering pain-relieving medications that could inadvertently hasten patients' deaths. Challenges also arose when patients expressed a desire to withdraw life-sustaining treatments despite the possibility of recovery, or when family members wanted to shield patients from information about a poor prognosis; these wishes occasionally conflicted with healthcare guidelines. The critical care nurses also encountered ethical challenges when caring for potential organ donors, highlighting the balance between organ preservation and maintaining patient dignity. CONCLUSION Critical care nurses encountered ethical challenges when caring for patients at the end of life. They described issues ranging from life-sustaining treatments and administration of pain-relief, to patient preferences and organ donation considerations. Addressing these ethical challenges is essential for delivering compassionate person-centered care, and supporting family members during end-of-life care in an intensive care context.
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Affiliation(s)
- Lena Palmryd
- Marie Cederschiöld University
- Karolinska University Hospital
| | - Åsa Rejnö
- University West
- Skaraborg Hospital Skövde
- Skaraborg institute for Research and Development
| | | | - Tove Godskesen
- Nord University
- Uppsala University
- Marie Cederschiöld University
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Liu C, Chong MC, Lee WL, Zhang HY, Zhang JH. Perceptions and self-management of a healthy diet among middle-aged adults with risk of stroke in North China: a qualitative exploration. BMJ Open 2024; 14:e081840. [PMID: 38772896 PMCID: PMC11110585 DOI: 10.1136/bmjopen-2023-081840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/08/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVE Although stroke is prevalent among older people, there is a rising incidence among the younger subpopulations, particularly middle-aged adults. A healthy diet is one of the key modifiable factors to primary prevention of stroke among these subpopulations, yet there is limited understanding of the dietary habits among middle agers who have the risk factor(s) but no occurrence of stroke. This study aims to explore the views on perceptions and the self-management of middle-aged adults at risk of stroke on a healthy diet and to identify the enablers and barriers that could inform the future development of dietary interventions. DESIGN This study used an interpretive descriptive qualitative design, employing semistructured purposive sampling for focus group discussions. Thematic analysis was conducted on the transcribed interviews and field notes, facilitated by NVivo 12.0 Plus software. SETTING Community settings in Zhengzhou City, Henan Province. PARTICIPANTS Middle-aged adults (aged 45-59) were identified as at risk of stroke due to the presence of one or more modifiable risk factors. RESULT A total of seven focus group discussions were audio recorded. Four main themes emerged, which were: (1) cognitive understanding of a healthy diet; (2) dietary practices; (3) knowledge acquisition and (4) barriers to dietary adherence. CONCLUSIONS The middle-aged adults at risk of stroke were generally aware of the risk and attempted to practise healthy eating. The existing educational programmes on following a healthy diet in the prevention of disease need to be made more comprehensible, accessible and equitable, especially for those from socioeconomically disadvantaged communities.
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Affiliation(s)
- Cui Liu
- Department of Nursing Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Wan Ling Lee
- Department of Nursing Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Hai Yan Zhang
- Faculty of Nursing, Xinxiang Medical University, Xinxiang City, China
| | - Jin Hua Zhang
- Faculty of Nursing, Xinxiang Medical University, Xinxiang City, China
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Doherty M, Abdullah QK. Using Project ECHO to deliver a tele-mentoring and teaching program on palliative care in South Asia: Interpretive description of participants' experiences with a community of practice for learning. Palliat Support Care 2024:1-9. [PMID: 38736371 DOI: 10.1017/s1478951524000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
OBJECTIVES To explore the learning experiences of participants (learners and teachers), in a yearlong tele-teaching and mentoring program on pediatric palliative care, which was conducted using the Project ECHO (Extension for Community Healthcare Outcomes) model and consisted of 27 teaching and clinical case discussion sessions for palliative medicine residents in India and Bangladesh. The goal of the study is to explore how participation and learning is motivated and sustained for both residents and teachers, including the motivators and challenges to participation and learning in a novel online format. METHODS Qualitative interviews with ECHO participants, including learners and teachers were conducted. Interviews were recorded and transcribed. Thematic analysis of interview data was conducted within an interpretive description approach. RESULTS Eleven physicians (6 residents, 5 teachers) participated in interviews. Key elements of the ECHO program which participants identified as supporting learning and participation include small group discussions, a flipped classroom, and asynchronous interactions through social media. Individual learner characteristics including effective self-reflection and personal circumstances impact learning. Providing opportunities for a diverse group of learners and teachers, to interact in communities of practice (COP) enhances learning. Three major themes and 6 subthemes describing learning processes were identified. Themes included (1) ECHO program structure, (2) learner characteristics, and (3) COP. Subthemes included flipped classroom, breakout rooms, learning resources, personal circumstances, self-awareness of learning needs, and community interactions. SIGNIFICANCE OF RESULTS Project ECHO suggests a novel model to train health providers, which is effective in low- and middle-income countries. Online learning programs can lead to learning through community of practice when learners and teachers are able to interact and engage in peer support and reflective practice. Educators should consider incorporating small group discussions, a flipped classroom design, and opportunities for asynchronous interactions to enhance learning for participants in online learning programs.
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Affiliation(s)
- Megan Doherty
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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Connolly M, Iohom G, O'Brien N, Volz J, O'Muircheartaigh A, Serchan P, Biculescu A, Gadre KG, Soare C, Griseto L, Shorten G. Delivering clinical tutorials to medical students using the Microsoft HoloLens 2: A mixed-methods evaluation. BMC MEDICAL EDUCATION 2024; 24:498. [PMID: 38704522 PMCID: PMC11070104 DOI: 10.1186/s12909-024-05475-2] [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: 03/09/2023] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Mixed reality offers potential educational advantages in the delivery of clinical teaching. Holographic artefacts can be rendered within a shared learning environment using devices such as the Microsoft HoloLens 2. In addition to facilitating remote access to clinical events, mixed reality may provide a means of sharing mental models, including the vertical and horizontal integration of curricular elements at the bedside. This study aimed to evaluate the feasibility of delivering clinical tutorials using the Microsoft HoloLens 2 and the learning efficacy achieved. METHODS Following receipt of institutional ethical approval, tutorials on preoperative anaesthetic history taking and upper airway examination were facilitated by a tutor who wore the HoloLens device. The tutor interacted face to face with a patient and two-way audio-visual interaction was facilitated using the HoloLens 2 and Microsoft Teams with groups of students who were located in a separate tutorial room. Holographic functions were employed by the tutor. The tutor completed the System Usability Scale, the tutor, technical facilitator, patients, and students provided quantitative and qualitative feedback, and three students participated in semi-structured feedback interviews. Students completed pre- and post-tutorial, and end-of-year examinations on the tutorial topics. RESULTS Twelve patients and 78 students participated across 12 separate tutorials. Five students did not complete the examinations and were excluded from efficacy calculations. Student feedback contained 90 positive comments, including the technology's ability to broadcast the tutor's point-of-vision, and 62 negative comments, where students noted issues with the audio-visual quality, and concerns that the tutorial was not as beneficial as traditional in-person clinical tutorials. The technology and tutorial structure were viewed favourably by the tutor, facilitator and patients. Significant improvement was observed between students' pre- and post-tutorial MCQ scores (mean 59.2% Vs 84.7%, p < 0.001). CONCLUSIONS This study demonstrates the feasibility of using the HoloLens 2 to facilitate remote bedside tutorials which incorporate holographic learning artefacts. Students' examination performance supports substantial learning of the tutorial topics. The tutorial structure was agreeable to students, patients and tutor. Our results support the feasibility of offering effective clinical teaching and learning opportunities using the HoloLens 2. However, the technical limitations and costs of the device are significant, and further research is required to assess the effectiveness of this tutorial format against in-person tutorials before wider roll out of this technology can be recommended as a result of this study.
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Affiliation(s)
- Murray Connolly
- Cork University Hospital and University College Cork, Cork, Ireland.
| | - Gabriella Iohom
- Cork University Hospital and University College Cork, Cork, Ireland
| | | | | | | | | | | | | | - Corina Soare
- Cork University Hospital and University College Cork, Cork, Ireland
| | | | - George Shorten
- Cork University Hospital and University College Cork, Cork, Ireland
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Kowalski KL, Gillis H, Henning K, Parikh P, Sadi J, Rushton A. Use of the International IFOMPT Cervical Framework to inform clinical reasoning in postgraduate level physiotherapy students: a qualitative study using think aloud methodology. BMC MEDICAL EDUCATION 2024; 24:486. [PMID: 38698376 PMCID: PMC11064242 DOI: 10.1186/s12909-024-05399-x] [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: 02/11/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Vascular pathologies of the head and neck are rare but can present as musculoskeletal problems. The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) Cervical Framework (Framework) aims to assist evidence-based clinical reasoning for safe assessment and management of the cervical spine considering potential for vascular pathology. Clinical reasoning is critical to physiotherapy, and developing high-level clinical reasoning is a priority for postgraduate (post-licensure) educational programs. OBJECTIVE To explore the influence of the Framework on clinical reasoning processes in postgraduate physiotherapy students. METHODS Qualitative case study design using think aloud methodology and interpretive description, informed by COnsolidated criteria for REporting Qualitative research. Participants were postgraduate musculoskeletal physiotherapy students who learned about the Framework through standardized delivery. Two cervical spine cases explored clinical reasoning processes. Coding and analysis of transcripts were guided by Elstein's diagnostic reasoning components and the Postgraduate Musculoskeletal Physiotherapy Practice model. Data were analyzed using thematic analysis (inductive and deductive) for individuals and then across participants, enabling analysis of key steps in clinical reasoning processes and use of the Framework. Trustworthiness was enhanced with multiple strategies (e.g., second researcher challenged codes). RESULTS For all participants (n = 8), the Framework supported clinical reasoning using primarily hypothetico-deductive processes. It informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests, to inform clarity and support for diagnosis and management. Most participant's clinical reasoning processes were characterized by high-level features (e.g., prioritization), however there was a continuum of proficiency. Clinical reasoning processes were informed by deep knowledge of the Framework integrated with a breadth of wider knowledge and supported by a range of personal characteristics (e.g., reflection). CONCLUSIONS Findings support use of the Framework as an educational resource in postgraduate physiotherapy programs to inform clinical reasoning processes for safe and effective assessment and management of cervical spine presentations considering potential for vascular pathology. Individualized approaches may be required to support students, owing to a continuum of clinical reasoning proficiency. Future research is required to explore use of the Framework to inform clinical reasoning processes in learners at different levels.
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Affiliation(s)
- Katie L Kowalski
- School of Physical Therapy, Western University, London, Ontario, Canada.
| | - Heather Gillis
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Katherine Henning
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Paul Parikh
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Jackie Sadi
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Alison Rushton
- School of Physical Therapy, Western University, London, Ontario, Canada
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Brundell K, Vasilevski V, Farrell T, Sweet L. Sustainability of rural Victorian maternity services: 'We can work together'. Women Birth 2024; 37:101596. [PMID: 38492507 DOI: 10.1016/j.wombi.2024.101596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/21/2024] [Accepted: 03/04/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Rural maternity service closures and service level reductions are continually increasing across Victoria. There is limited understanding of how rural board members and executives make decisions about their maternity service's operations and sustainability. AIM To examine perspectives of rural Victorian board members and executives on the sustainability of rural maternity services. METHODS This was a qualitative study. Interviews were conducted via Zoom™ with 16 rural Victorian hospital board members and executives. Data were thematically analysed. FINDINGS Severe shortages in the rural maternity workforce, primarily midwives, have contributed to service sustainability decisions. Challenges in offering midwifery workforce incentives cause difficulty in overcoming workforce shortages. A rural maternity workforce strategy harnessing connection with regional services was called for. Innovative models of maternity care were often actioned at the point of service suspension or closure. Participants requested a government policy position and funding for innovative, safe, and sustainable models of care in rural settings. DISCUSSION There is an opportunity for workforce planning to occur between regional and rural services to ensure the development of sustainable maternity models such as midwifery group practice and incentivise the workforce to address current deficits and sustain service provision. CONCLUSION Models of care developed with rural communities, in collaboration with regional services, have the potential to strengthen the delivery of safe, sustainable maternity services. Workforce modelling and centralised government policies aimed at arresting workforce deficits are suggested to provide rural health service leaders with strategic and operational directions to support the delivery of safe, sustainable maternity services.
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Affiliation(s)
- Kath Brundell
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Institute of Health and Wellbeing, Federation University, Victoria, Australia.
| | - Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Tanya Farrell
- Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia; School of Nursing and Midwifery, Latrobe University, Victoria, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
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Maragha T, Chehroudi B. Assessment of the students' performance and support needs in a novel digital carving exercise. J Dent Educ 2024; 88:614-622. [PMID: 38321648 DOI: 10.1002/jdd.13469] [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: 07/13/2023] [Revised: 10/24/2023] [Accepted: 01/06/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVES In recent years, digital technology has been rapidly expanding in dental practice, which entails an early integration of digital dentistry into the preclinical dental curriculum. This study introduces first-year dental students to a digital carving exercise and investigates its role in enhancing their understanding and performance in traditional wax carving activities. Another objective was to explore the students' challenges and needs for support in the digital carving activity. METHODS Digital carving exercise was introduced into the first-year dental morphology curriculum in 2020. Students' performance in anterior wax carving was quantitively compared prior to and following the implementation of the exercise. The students' grades in the digital carving exercise were also compared across three academic years: 2020, 2021, and 2022. Qualitatively, an interpretive description approach using focus group with 31 first-year dental students was utilized to explore their perspectives regarding the digital exercise. RESULTS A statistically significant improvement was found in the students wax carving performance following the incorporation of the digital carving activity (p-value = 0.0001). Students' performance in the digital carving exercise also statistically improved over the years. Students' challenges included the technology's unfamiliarity, and a perceived irrelevance of the exercise. Additional guidance, resources, and timely feedback were reported among the students' support needs during the exercise. CONCLUSION Digital carving is a promising tool in anatomical education that can improve the students' spatial understanding and manual dexterity. However, educators need to carefully integrate it into the curriculum to address the students' challenges and optimize their learning experience.
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Affiliation(s)
- Tala Maragha
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, British Columbia, Vancouver, Canada
| | - Babak Chehroudi
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, British Columbia, Vancouver, Canada
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Tay T, James KS. Exploring the Experiences of Undergraduate Medical Students on Surgical Placement - A Qualitative Study. JOURNAL OF SURGICAL EDUCATION 2024; 81:671-679. [PMID: 38556437 DOI: 10.1016/j.jsurg.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/25/2024] [Accepted: 02/03/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Multiple elements in the clinical learning environment have been found to influence medical students' learning experiences. A rich area of research, many factors are already known to influence students' experiences of learning which go on to impact later training choices. However, there is a knowledge gap specifically related to undergraduate medical students' experiences of surgical placement. This study aims to explore the lived experiences of medical students in their surgery rotation(s). DESIGN A phenomenological study using semistructured interviews was conducted. Transcribed interview recordings were thematically analyzed using an iterative approach. SETTING Participants were studying in a large medical school in the north of England. PARTICIPANTS Fitting with the method, 6 undergraduate medical students, with at least 1 surgery placement took part in the study. RESULTS Participants described issues including knowing the details of clinical opportunities, the clinical environment, and the portfolio; having a sense of involvement and previous surgical experiences; teaching and assessments; observation; and interactions. These experiences were also found to influence later career aspirations. CONCLUSIONS The findings suggest that undergraduate surgical learning experiences can be influenced by various themes: knowing the details of progression, the clinical environment, having a sense of involvement and previous experiences, constructive alignment of teaching and assessment, and professional identity formation. Future studies can explore methods such as personalized learning outcomes to enhance the overall learning experience of medical students.
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Affiliation(s)
- Tricia Tay
- Royal Lancaster Infirmary, Lancaster University, Ashton Road, Lancaster, United Kingdom.
| | - Kirstin Stuart James
- Edinburgh Surgery Online: Clinical Sciences Teaching Organisation, The University of Edinburgh, Simon Laurie House, Edinburgh, United Kingdom; Edinburgh Medical School: Medical Education, The University of Edinburgh, Chancellor's Building, Little France Crescent, EH16 4SB, UK
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Martin A, DiGiovanni M, Acquaye A, Ponticiello M, Chou DT, Neto EA, Michel A, Sibeoni J, Piot MA, Spodenkiewicz M, Benoit L. Pathways and identity: toward qualitative research careers in child and adolescent psychiatry. Child Adolesc Psychiatry Ment Health 2024; 18:49. [PMID: 38685108 PMCID: PMC11059710 DOI: 10.1186/s13034-024-00738-8] [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] [Received: 01/21/2024] [Accepted: 03/28/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE Qualitative research methods are based on the analysis of words rather than numbers; they encourage self-reflection on the investigator's part; they are attuned to social interaction and nuance; and they incorporate their subjects' thoughts and feelings as primary sources. Despite appearing well suited for research in child and adolescent psychiatry (CAP), qualitative methods have had relatively minor uptake in the discipline. We conducted a qualitative study of CAPs involved in qualitative research to learn about these investigators' lived experiences, and to identify modifiable factors to promote qualitative methods within the field of youth mental health. METHODS We conducted individual, semi-structured 1-h long interviews through Zoom. Using purposive sample, we selected 23 participants drawn from the US (n = 12) and from France (n = 11), and equally divided in each country across seniority level. All participants were current or aspiring CAPs and had published at least one peer-reviewed qualitative article. Ten participants were women (44%). We recorded all interviews digitally and transcribed them for analysis. We coded the transcripts according to the principles of thematic analysis and approached data analysis, interpretation, and conceptualization informed by an interpersonal phenomenological analysis (IPA) framework. RESULTS Through iterative thematic analysis we developed a conceptual model consisting of three domains: (1) Becoming a qualitativist: embracing a different way of knowing (in turn divided into the three themes of priming factors/personal fit; discovering qualitative research; and transitioning in); (2) Being a qualitativist: immersing oneself in a different kind of research (in turn divided into quality: doing qualitative research well; and community: mentors, mentees, and teams); and (3) Nurturing: toward a higher quality future in CAP (in turn divided into current state of qualitative methods in CAP; and advocating for qualitative methods in CAP). For each domain, we go on to propose specific strategies to enhance entry into qualitative careers and research in CAP: (1) Becoming: personalizing the investigator's research focus; balancing inward and outward views; and leveraging practical advantages; (2) Being: seeking epistemological flexibility; moving beyond bibliometrics; and the potential and risks of mixing methods; and (3) Nurturing: invigorating a quality pipeline; and building communities. CONCLUSIONS We have identified factors that can support or impede entry into qualitative research among CAPs. Based on these modifiable findings, we propose possible solutions to enhance entry into qualitative methods in CAP (pathways), and to foster longer-term commitment to this type of research (identity).
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Affiliation(s)
- Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA.
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France.
| | - Madeline DiGiovanni
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
| | - Amber Acquaye
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
| | - Matthew Ponticiello
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
| | - Débora Tseng Chou
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Departamento de Psiquiatria da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | - Emilio Abelama Neto
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Departamento de Psiquiatria da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | - Alexandre Michel
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Inserm U1018, CESP, Team DevPsy, Paris-Saclay University, Villejuif, France
| | - Jordan Sibeoni
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Inserm U1018, CESP, Team DevPsy, Paris-Saclay University, Villejuif, France
| | - Marie-Aude Piot
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Inserm U1018, CESP, Team DevPsy, Paris-Saclay University, Villejuif, France
| | - Michel Spodenkiewicz
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
- Department of Psychiatry, McGill University Faculty of Medicine, Montréal, QC, Canada
| | - Laelia Benoit
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- QUALab, Qualitative and Mixed Methods Lab, a collaboration between the Yale Child Study Center, 230 South Frontage Road, New Haven, CT, 06520, USA
- CESP, The Centre de Recherche en Épidémiologie et Santé des Populations, Paris, France
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Mak S, Thomas A, Razack S, Root K, Hunt M. Unraveling attrition and retention: A qualitative study with rehabilitation professionals. Work 2024:WOR230531. [PMID: 38669505 DOI: 10.3233/wor-230531] [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: 04/28/2024] Open
Abstract
BACKGROUND Health human resources are scarce worldwide. In occupational therapy (OT), physical therapy (PT), and speech-language pathology (S-LP), attrition and retention issues amplify this situation and contribute to the precarity of health systems. OBJECTIVE To investigate the phenomena of attrition and retention with OTs, PTs and S-LPs who stayed in, or left their profession. METHODS Cultural-historical activity theory provided the theoretical scaffolding for this interpretive description study. We used purposeful sampling (maximum variation approach) to recruit OTs, PTs, and S-LPs from Quebec, Canada. Individual interviews were conducted with 51 OTs, PTs, and S-LPs from Quebec, Canada, in English or French (2019-2020). Inductive and deductive approaches, and constant comparative techniques were used for data analysis. RESULTS Six themes were developed: 1) characteristics of work that made it meaningful; 2) aspects of work that practitioners appreciate; 3) factors of daily work that weigh on a practitioner; 4) factors that contribute to managing work; 5) relationships with different stakeholders that shape daily work; and 6) perceptions of the profession. Meaningfulness was tied to participants' sense that their values were reflected in their work. Factors outside work shaped participants' work experiences. Recurrent negative experiences led some to leave their profession. CONCLUSION Findings underscore a critical need to address contributing factors to attrition and retention which are essential to ensuring the availability of OTs, PTs and SLPs for present and future rehabilitation needs.
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Affiliation(s)
- Susanne Mak
- School of Physical and Occupational Therapy, McGill University, Pine Avenue West, Montréal, Québec, Canada
- Institute of Health Sciences Education, McGill University, Pine Avenue West, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Institut Universitaire Sur la Réadaptation en Déficence Physique de Montréal (Lindsay Pavillon), Hudson, Montréal, Québec, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, Pine Avenue West, Montréal, Québec, Canada
- Institute of Health Sciences Education, McGill University, Pine Avenue West, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Institut Universitaire Sur la Réadaptation en Déficence Physique de Montréal (Lindsay Pavillon), Hudson, Montréal, Québec, Canada
| | - Saleem Razack
- Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada
- Centre for Health Education Scholarship, University of British Columbia, P. A. Woodward Instructional Resources Centre (IRC), Health Sciences Mall, Vancouver, British Columbia, Canada
| | - Kelly Root
- School of Communication Sciences and Disorders, Dalhousie University, College Street, Halifax, Nova Scotia, Canada
| | - Matthew Hunt
- School of Physical and Occupational Therapy, McGill University, Pine Avenue West, Montréal, Québec, Canada
- Institute of Health Sciences Education, McGill University, Pine Avenue West, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Institut Universitaire Sur la Réadaptation en Déficence Physique de Montréal (Lindsay Pavillon), Hudson, Montréal, Québec, Canada
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