1
|
Wang X, Chen D, Zou P, Zhang H, Qiu X, Xu L, Lee G. Understanding adaptive tasks in cardiac rehabilitation among patients with acute myocardial infarction: a qualitative study. Ann Med 2024; 56:2311227. [PMID: 38306095 PMCID: PMC10840589 DOI: 10.1080/07853890.2024.2311227] [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: 07/22/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND While Cardiac Rehabilitation (CR) programs have shown effectiveness in improving cardiac outcomes, there is limited understanding of how patients perceive and adapt to these interventions. Furthermore, alternative modes of delivering CR that have received positive evaluations from participants remain underexplored, yet they have the potential to enhance CR uptake. OBJECTIVES To explore the patient experience in CR programmes following Acute Myocardial Infarction (AMI) and describe their adaptive processing. PATIENTS AND METHODS This qualitative study was conducted at a nationally certified centre in China between July 2021 and September 2022, encompassing three stages: in-hospital, centre-based, and home-based CR programs. Purposive sampling was used to select eligible AMI patients for in-depth semi-structured interviews. The interview outline and analytical framework were aligned with the key concepts derived from the middle-range theory of adaptation to chronic illness and the normalization process theory. The findings were reported following the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS Forty AMI patients were recruited. Four main themes describing the process of AMI patients normalizing CR intervention were identified, including (1) experiencing CR service driving by role's responsibilities, (2) engaging in collaborative relationship based on interpersonal trust, (3) exploring a personalized rehabilitation plan by complex integration, and (4) expecting a promised outcome to shape decision-making. CONCLUSION Integrated care interventions for AMI patients could benefit from a collaborative co-designed approach to ensure that CR interventions are normalized and fit into patients' daily lives. Organizational-level CR services should align with the rehabilitation needs and expectations of patients.
Collapse
Affiliation(s)
- Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Dandan Chen
- School of Nursing, Zhejiang University School of Medicine, Zhejiang, China
| | - Ping Zou
- School of Nursing, Nipissing University, Toronto, Ontario, Canada
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People’s Hospital, Guizhou, China
| | - Xunhan Qiu
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Xu
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Geraldine Lee
- Catherine McAuley School of Nursing & Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| |
Collapse
|
2
|
Zhang Q, Liu P, Zhang Y, Yan M. The Psychological Experiences of Adolescents Who Engage in Non-Suicidal Self-Injury: A Meta-Aggregative Synthesis of Qualitative Studies. Issues Ment Health Nurs 2024:1-11. [PMID: 39106276 DOI: 10.1080/01612840.2024.2374011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
Non-suicidal self-injury (NSSI) is an international public health problem. Qualitative synthesis of the psychological experiences associated with NSSI in adolescents remains limited. This study aimed to systematically review the factors, emotional experiences, coping strategies, and help-seeking experiences of adolescents who engage in NSSI. A comprehensive search of 10 databases was conducted. Two researchers independently conducted study screening, data extraction, and quality assessment. Eighteen articles were included and analyzed using a meta-aggregation approach. Four themes were identified: (1) factors contributing to NSSI, (2) emotions associated with engaging in NSSI, (3) coping strategies, and (4) potential barriers to seeking help. Our findings provide a comprehensive picture of the psychological experiences of adolescents who engage in NSSI. They primarily adopt negative coping strategies to deal with serious problems, and there are potential barriers to seeking help. Further research is needed to explore the true needs of adolescents, as well as how schools, families, and hospitals can play a collaborative role in improving adolescents' psychological issues.
Collapse
Affiliation(s)
- Qian Zhang
- Academy of Medical Sciences, Shanxi Medical University, Taiyuan, China
| | - Panyu Liu
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Yuhan Zhang
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Meiqin Yan
- Department of Science and Education, Children's Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, China
| |
Collapse
|
3
|
Wen P, Sun L, Shen T, Wang Z. Factors impeding physical activity in older hospitalised patients: A qualitative meta-synthesis. J Clin Nurs 2024; 33:3273-3282. [PMID: 38572996 DOI: 10.1111/jocn.17158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/25/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Older hospitalised patients have low levels of physical activity and multiple impairing factors. AIMS To systematically evaluate the perceived barriers to physical activity among older patients during hospitalisation, and provide reference for future intervention programs. DESIGN Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. METHODS An exhaustive exploration was conducted across the CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science from their inception until August, 2023 to identify qualitative research on obstacles to physical activity among older hospital patients. The quality of the literature was evaluated using the Joanna Briggs Institute's critical appraisal tool for qualitative research. Meta-synthesis method was used to integrate the results. RESULTS In total, 8 literatures were included, 43 themes were extracted, and analogous research results were amalgamated to generate 10 categories and 3 syntheses: individual level, interpersonal influencing factors and hospital environment and resources level. CONCLUSION Older inpatients are faced with multiple barriers to physical activity. Medical staff should pay attention to changes in physical activity during hospitalisation, identify barriers to physical activity in older inpatients and provide references for promoting physical activity programs for the older. NO PATIENT OR PUBLIC CONTRIBUTION This study is a meta-synthesis and does not require relevant contributions from patients or the public. WHAT IS ALREADY KNOWN Older patients are at low physical activity levels during hospitalisation. Older inpatients are faced with multiple barriers to physical activity. WHAT THIS PAPER ADDS Factors of physical activity impairment in hospitalised older patients should be considered in the context of health status, psychological factors, motivation and social support. Disease-induced psychological fallout has a greater impact on physical activity in the older.
Collapse
Affiliation(s)
- Peiting Wen
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Lili Sun
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - TianTian Shen
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhaodi Wang
- Department of Nursing, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
4
|
Cuesta-Martínez R, González-Sanz P, Raventós-Torner RD, Jiménez-Herrera M, Aguarón-García MJ, Lorenzo-Allegue L, Font-Jimenez I. Experiences of nursing students in A peer mentoring program during their clinical practices. A qualitative study. NURSE EDUCATION TODAY 2024; 139:106234. [PMID: 38704946 DOI: 10.1016/j.nedt.2024.106234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Clinical placements allow nursing students to develop the skills and attitudes necessary to provide care. Peer mentoring programmes seem to facilitate these achievements, but there are very few studies on the effects of peer mentoring on clinical placements and what it can bring to both mentors and mentees. AIM To describe the perspectives of nursing students on a peer mentoring programme during their clinical placements. DESIGN A qualitative descriptive and exploratory study. SETTINGS AND PARTICIPANTS First year and third year nursing students were included. METHODS Focus groups were conducted with students after they participated in a peer mentoring programme during their clinical practice rotation. RESULTS The support received from the student mentors was very important both academically and personally. Mentors also acknowledged having improved their teaching and leadership skills. CONCLUSIONS Our results can be applied to future studies to inform peer mentoring programmes as a complementary teaching tool in clinical placements to improve leadership and empowerment in nursing students.
Collapse
Affiliation(s)
| | - Pilar González-Sanz
- Nursing Department, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Spain.
| | | | | | | | - Laura Lorenzo-Allegue
- Nursing Department, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Spain.
| | - Isabel Font-Jimenez
- Nursing Department, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Spain.
| |
Collapse
|
5
|
Hughes M, Hanna K, Wiles A, Taylor E, Giebel C. The experiences of caring for someone with dementia and a learning disability: A qualitative systematic review. DEMENTIA 2024; 23:817-849. [PMID: 38172089 PMCID: PMC11163849 DOI: 10.1177/14713012231225797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND The life expectancy of people with a learning disability is increasing and with this comes a greater risk of developing dementia. Dementia poses new challenges for both family and formal learning disability carers as they try to support dementia's progressive nature and quality of life for their care recipient. This qualitative systematic review explores the evidence base of family and formal carers' experiences and needs of caring for someone with both a learning disability and dementia. METHODS Six electronic databases (PubMed, PsycINFO, Cochrane Library, Prospero, Scopus, CINAHL), were searched in May 2022, utilising a predefined search strategy. Thirteen papers fulfilled inclusion criteria and were included in in the review. RESULTS Thematic synthesis was used to explore and synthesise the qualitative findings of the studies. Four conceptual themes were identified following analysis: Knowledge and skills, Accessing support, Repercussions of dementia for carers, Influences of continuity of caring role. CONCLUSION There are significant training and educational needs for all carers who support the dual diagnosis of dementia and learning disability. Differences between family and formal carers relate to the organisational support and process available to formal carers. Parity across services combined with sufficiently trained carers may support dementia diagnosis and improve quality of care provided. Further research is needed to address environmental, and economic barriers carers face to facilitate ageing in place for their care recipients.
Collapse
Affiliation(s)
- Michelle Hughes
- Department of Primary Care and Mental Health, University of Liverpool, UK
| | - Kerry Hanna
- School of Health Sciences, University of Liverpool, UK
| | - Akpevwoghene Wiles
- Department of Primary Care and Mental Health, University of Liverpool, UK
| | | | - Clarissa Giebel
- Department of Primary Care and Mental Health, University of Liverpool, UK; NIHR Applied Research Collaboration North West Coast, UK
| |
Collapse
|
6
|
Tummalapalli SL, Benda NC, Cukor D, Levine DM, Silberzweig J, Reading Turchioe M. Reach, Acceptability, and Patient Preferences of a Mobile Health-Based Survey to Assess COVID-19 Vaccine Hesitancy Among Patients Receiving Dialysis. Kidney Med 2024; 6:100847. [PMID: 39040544 PMCID: PMC11261113 DOI: 10.1016/j.xkme.2024.100847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024] Open
Abstract
Rationale & Objective The majority of patients with kidney failure receiving dialysis own mobile devices, but the use of mobile health (mHealth) technologies to conduct surveys in this population is limited. We assessed the reach and acceptability of a short message service (SMS) text message-based survey that assessed coronavirus disease 2019 (COVID-19) vaccine hesitancy among patients receiving dialysis. Study Design & Exposure A cross-sectional SMS-based survey conducted in January 2021. Setting & Participants Patients receiving in-center hemodialysis, peritoneal dialysis, or home hemodialysis in a nonprofit dialysis organization in New York City. Outcomes (1) Reach of the SMS survey, (2) Acceptability using the 4-item Acceptability of Intervention Measure, and (3) Patient preferences for modes of survey administration. Analytical Approach We used Fisher exact tests and multivariable logistic regression to assess sociodemographic and clinical predictors of SMS survey response. Qualitative methods were used to analyze open-ended responses capturing patient preferences. Results Among 1,008 patients, 310 responded to the SMS survey (response rate 31%). In multivariable adjusted analyses, participants who were age 80 years and above (aOR, 0.49; 95% CI, 0.25-0.96) were less likely to respond to the SMS survey compared with those aged 18 to 44 years. Non-Hispanic Black (aOR, 0.58; 95% CI, 0.39-0.86), Hispanic (aOR, 0.31; 95% CI, 0.19-0.51), and Asian or Pacific Islander (aOR, 0.46; 95% CI, 0.28-0.74) individuals were less likely to respond compared with non-Hispanic White participants. Participants residing in census tracts with higher Social Vulnerability Index, indicating greater neighborhood-level social vulnerability, were less likely to respond to the SMS survey (fifth vs first quintile aOR, 0.61; 95% CI, 0.37-0.99). Over 80% of a sample of survey respondents and nonrespondents completely agreed or agreed with the Acceptability of Intervention Measure. Qualitative analysis identified 4 drivers of patient preferences for survey administration: (1) convenience (subtopics: efficiency, multitasking, comfort, and synchronicity); (2) privacy; (3) interpersonal interaction; and (4) accessibility (subtopics: vision, language, and fatigue). Limitations Generalizability, length of survey. Conclusions An SMS text message-based survey had moderate reach among patients receiving dialysis and was highly acceptable, but response rates were lower in older (age ≥ 80), non-White individuals and those with greater neighborhood-level social vulnerability. Future research should examine barriers and facilitators to mHealth among patients receiving dialysis to ensure equitable implementation of mHealth-based technologies.
Collapse
Affiliation(s)
- Sri Lekha Tummalapalli
- Division of Healthcare Delivery Science and Innovation, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
- The Rogosin Institute, New York, NY
- Division of Nephrology and Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY
| | | | | | - Daniel M. Levine
- The Rogosin Institute, New York, NY
- Department of Biochemistry, Weill Cornell Medicine, New York, NY
| | - Jeffrey Silberzweig
- The Rogosin Institute, New York, NY
- Division of Nephrology and Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY
| | | |
Collapse
|
7
|
Smith AJB, O'Brien C, Haggerty A, Ko EM, Rendle KA. "Having cancer is very expensive": A qualitative study of patients with ovarian cancer and PARP inhibitor treatment. Gynecol Oncol 2024; 186:170-175. [PMID: 38691987 DOI: 10.1016/j.ygyno.2024.04.018] [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: 01/10/2024] [Revised: 03/26/2024] [Accepted: 04/21/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE To examine patient barriers and facilitators to PARP inhibitor (PARP-I) maintenance therapy in ovarian cancer. PARP-I improves survival in ovarian cancer, but these multi-year therapies cost around $100,000 annually and are under-prescribed. METHODS We recruited patients with ovarian cancer treated with PARP-I maintenance therapy at an academic health system for a semi-structured interview. Patient demographics, including genetics and PARP-I cost, were self-reported. We assessed patient experiences with barriers and facilitators of PARP-I usage. Two team members used a thematic approach to analyze and identify key themes. RESULTS In May 2022, we interviewed 10 patients (mean age = 65 years; 80% White; 60% with a germline genetic mutation). Patients paid on average $227.50 monthly for PARP-I, straining resources for some participants. While sampled patients were insured, all patients identified having no or inadequate insurance as a major barrier to PARP-I. At the same time, all participants prioritized clinical effectiveness over costs of care. Patients identified PARP-I delivery from specialty pharmacies, separate and different from other medications, as a potential barrier, but each had been able to navigate delivery. Patients expressed significant initial side effects of PARP-I as a potential barrier yet reported clinician communication and prompt dose reduction as facilitating continuation. CONCLUSIONS Patients identified cost, restrictive pharmacy benefits, and initial side effects as barriers to PARP-I usage. Having insurance and a supportive care team were identified as facilitators. Enhancing communication about PARP-I cost and side effects could improve patient experience and receipt of evidence-based maintenance therapy in ovarian cancer.
Collapse
Affiliation(s)
- Anna Jo Bodurtha Smith
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, PA, United States of America; Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, PA, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, United States of America; Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, United States of America.
| | - Caroline O'Brien
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Ashley Haggerty
- Division of Gynecologic Oncology, Hackensack Meridian Health, Red Bank, NJ, United States of America
| | - Emily M Ko
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, PA, United States of America; Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, PA, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Katharine A Rendle
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, United States of America; Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, United States of America
| |
Collapse
|
8
|
Razzaq A, Travaglia J, Raynes-Greenow C, Alam NA. Understanding Fijian health system challenges in the prevention of mother-to-child transmission of HIV services in the three tertiary hospitals in Fiji. AIDS Care 2024; 36:954-963. [PMID: 38507223 DOI: 10.1080/09540121.2024.2331215] [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: 08/03/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024]
Abstract
Mother-to-child transmission is the most common route of human immunodeficiency virus transmission in children, which could be prevented with proper treatment and access to care. Health system challenges can impede the effectiveness of prevention of mother-to-child transmission (PMTCT) programmes. We aim to understand the health system challenges to the provision of PMTCT services for pregnant women in three tertiary hospitals in Fiji. Data were collected using in-depth interviews in the three tertiary hospitals and associated health clinics in Fiji between April-May 2013 and February-March 2014. Ethical approvals were obtained. A total of 58 healthcare providers were interviewed including doctors (n = 12), midwives (n = 19), nurses (n = 14), laboratory technicians (n = 5) and counsellors (n = 8). The data were analysed using thematic analysis. We found that the healthcare workers faced a wide range of health system challenges including institutional and human resource challenges. Staff shortage, limited PMTCT training and shortage of supplies were barriers to the quality of PMTCT services. Our findings would be useful in developing strategies to overcome barriers as it would be imperative in improving the quality of PMTCT service provision in Fiji and other similar settings.
Collapse
Affiliation(s)
- Amina Razzaq
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Joanne Travaglia
- School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Neeloy Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
9
|
Pirzada S, Papineau K, Pankratz L, Gill G, Hensel J, Reynolds K, Bolton JM, Hiebert T, Olafson K, El-Gabalawy R, La Rivière C, Kredentser MS, Chochinov HM. The first casualty of COVID-19 for patients nearing death was human dignity: Understanding the experience of palliative care patients during the COVID-19 pandemic. DEATH STUDIES 2024:1-15. [PMID: 38950572 DOI: 10.1080/07481187.2024.2353974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
The COVID-19 pandemic changed the way people lived, but also the way they died. It accentuated the physical, psychological, social, and spiritual vulnerabilities of patients approaching death. This study explored the lived experience of palliative inpatients during the pandemic. We conducted interviews with 22 palliative inpatients registered in a Canadian urban palliative care program, aimed to uncover how the pandemic impacted participants' experiences of approaching end-of-life. The reflexive thematic analysis revealed 6 themes: putting off going into hospital, the influence of the pandemic on hospital experience, maintaining dignity in care, emotional impact of nearing death, making sense of end-of-life circumstances and coping with end-of-life. Findings highlight the vulnerability of patients approaching death, and how that was accentuated during the pandemic. Findings reveal how the pandemic strained, threatened, and undermined human connectedness. These lived experiences of palliative inpatients offer guidance for future pandemic planning and strategies for providing optimal palliative care.
Collapse
Affiliation(s)
- Salina Pirzada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kelsey Papineau
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lily Pankratz
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gagan Gill
- Department of Public Policy, McGill University, Montreal, Quebec, Canada
| | - Jennifer Hensel
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tim Hiebert
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kendiss Olafson
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christian La Rivière
- Department of Emergency Medicine and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Maia S Kredentser
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harvey Max Chochinov
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
10
|
Kreider CM, Medina S, Judycki S, Wu CY, Lan MF. Stigma and Stigma Resilience: Role of the Undergraduate and the Campus Environment. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:500-510. [PMID: 38654665 DOI: 10.1177/15394492241246233] [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: 04/26/2024]
Abstract
RATIONALE Stigma permeates disability experiences and compounds disability-related challenges. OBJECTIVE Identify individual and environmental factors of stigmatizing experiences of college students with learning disabilities (LDs) and attention-deficit/hyperactivity disorder (ADHD). METHODOLOGY A qualitative descriptive design was used with a thematic analysis of 30 transcripts from group discussions among four cohorts of undergraduates with LD/ADHD (N = 52). The Person-Environment-Occupation-Performance Model was used in interpreting the stigmatizing experiences. FINDINGS The themes Perceived Misconceptions and Stigmatizing Actions describe key social-environmental factors. The theme Overcoming Stigmatizing Experiences elucidates key skills and processes for developing stigma resilience. These skills and processes were anchored in self-awareness and personally contextualized understanding of disability-related challenges and strengths, which were fostered during positive interactions with supportive others, such as instructors and mentors. IMPLICATIONS Findings illustrate the biopsychosocial nature of stigma and highlight the role of individual and social-environmental factors in building stigma resilience among young adults with LD/ADHD.
Collapse
Affiliation(s)
| | - Sharon Medina
- University of Florida, Gainesville, FL, USA
- University of South Florida, Tampa, FL, USA
| | - Stephanie Judycki
- University of Florida, Gainesville, FL, USA
- Independent Researcher, USA
| | - Chang Yu Wu
- University of Florida, Gainesville, FL, USA
- University of Miami, Coral Gables, FL, USA
| | - Mei-Fang Lan
- University of Florida, Gainesville, FL, USA
- Independent Researcher, USA
| |
Collapse
|
11
|
Fullwood D, Fallon E, Pressey S, Bolajoko O, Young ME, Ruddy KJ, Wilkie DJ, Odedina FT. Voices of Black men: reflecting on prostate cancer survivorship care plans. J Cancer Surviv 2024:10.1007/s11764-024-01624-0. [PMID: 38914833 DOI: 10.1007/s11764-024-01624-0] [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: 09/04/2023] [Accepted: 05/29/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE This study addresses the critical issue of survivorship care for Black prostate cancer survivors. The aim was to explore their awareness of survivorship care plans to improve prostate cancer care and survivorship within this high-risk group. METHODS Utilizing a thematic analysis approach, we conducted in-depth interviews focused on analyzing post-treatment experiences of Black prostate cancer survivors by applying interpretive explanations to data collected from participants. RESULTS Participants reported a significant gap in survivorship care plan communication post-treatment, as these plans were seldom discussed. Survivors highlighted the adoption of post-treatment strategies and self-education as means to enhance their comprehension of the survivorship process. Black survivors demonstrated an intrinsic motivation, after feeling "discarded," to find suitable resources to enhance their survivorship care for a better quality of life. CONCLUSION The prioritization of post-treatment care for Black prostate cancer survivors is important. By offering comprehensive post-treatment education, improving symptom transparency, and establishing safe spaces for open discussion, the quality of life of Black survivors may be substantially improved. IMPLICATIONS FOR CANCER SURVIVORS There is a pressing need for dynamic post-treatment care coordination tailored to Black prostate cancer survivors. A lack of crucial post-treatment education for this population that experiences disproportionate burden of prostate cancer may exacerbate cancer health disparities. Addressing this care coordination gap may improve support systems, survivor well-being, and better cancer outcomes.
Collapse
Affiliation(s)
- Dottington Fullwood
- Population Sciences Research Program, Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, USA.
- iCCaRE for Black Men Consortium, Mayo Clinic, Jacksonville, FL, USA.
| | - Elizabeth Fallon
- Department of Education, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Shannon Pressey
- Population Sciences Research Program, Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, USA
- iCCaRE for Black Men Consortium, Mayo Clinic, Jacksonville, FL, USA
| | - Opeyemi Bolajoko
- Population Sciences Research Program, Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, USA
- iCCaRE for Black Men Consortium, Mayo Clinic, Jacksonville, FL, USA
| | - Mary Ellen Young
- iCCaRE for Black Men Consortium, Mayo Clinic, Jacksonville, FL, USA
| | - Kathryn J Ruddy
- College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Diana J Wilkie
- College of Nursing, Center for Palliative Care Research and Education & Florida-California Cancer Research, Education and Engagement (CaRE2) Health Equity Center, University of Florida, Gainesville, FL, USA
| | - Folakemi T Odedina
- Population Sciences Research Program, Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, USA
- iCCaRE for Black Men Consortium, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
12
|
Nevin SM, Le Marne FA, Beavis E, Macintosh R, Palmer EE, Sachdev R, Nunn K, Bye A. Psychosocial experiences of clinicians providing care for children with severe neurological impairment. Dev Med Child Neurol 2024. [PMID: 38837791 DOI: 10.1111/dmcn.15987] [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: 10/17/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
AIM To investigate clinicians' psychosocial experiences navigating interdisciplinary care for children with severe neurological impairment (SNI), for example children with a developmental epileptic encephalopathy; secondarily, to identify preferences for future interventions to support clinicians caring for children with SNI. METHOD We conducted a qualitative descriptive study with interdisciplinary clinicians by using a purposeful sampling recruitment strategy. Twenty-four participants with expertise caring for children with SNI completed in-depth, semi-structured interviews. We transcribed the interviews, de-identified them, and performed inductive thematic analysis. RESULTS Thematic analysis elicited interrelated themes. Clinicians experienced immense professional barriers providing patient-centred care across fragmented healthcare contexts. Physical, emotional, and psychological impacts were attributed to inadequate reflective practice training and a paucity of integrated resources to support clinicians over time. Multipronged strategies were prioritized by clinicians, incorporating psychoeducation, interdisciplinary peer mentorship, and psychological resources to build reflective practice skills for clinicians providing complex care in an advancing era of medicine. INTERPRETATION This study provides novel and in-depth insight into clinicians' experiences navigating care for children with SNI. The results will be used to inform future integrated and multipronged co-developed resources tailored for clinicians, on the basis of their recommendations.
Collapse
Affiliation(s)
- Suzanne M Nevin
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Fleur A Le Marne
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Erin Beavis
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rebecca Macintosh
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Elizabeth E Palmer
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rani Sachdev
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine Sydney, Children's Hospital Network, Sydney, NSW, Australia
| | - Ann Bye
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| |
Collapse
|
13
|
Knauf C, Heinrichs K, Süllwold R, Icks A, Loerbroks A. Migraine self-management at work: a qualitative study. J Occup Med Toxicol 2024; 19:22. [PMID: 38831381 PMCID: PMC11149347 DOI: 10.1186/s12995-024-00421-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Migraine is common and can be highly disabling. Adequate migraine self-management (SM) can mitigate the potentially adverse health effects of migraine. However, adequate SM can be challenging to implement in everyday life, for instance, at the workplace. We aimed to explore how migraine SM is carried out at work and which occupational factors may determine effective implementation according to employees with migraine. We also explored the potential impact of the COVID-19 pandemic and the associated re-arrangement of working conditions on migraine SM at work. METHODS We conducted semi-structured qualitative interviews (08/2020-01/2021). Participants were eligible if they have worked for at least six months with a minimum of twenty hours per week and with a migraine diagnosis. The interviews were transcribed and content-analyzed using MAXQDA. RESULTS Migraine SM was perceived to be influenced by social interactions at work (e.g., in terms of understanding vs. stigmatization), the level of job decision latitude (JDL, i.e., the extent to which one is able to influence work processes, e.g., when working from home), and workplace design (e.g., in terms of opportunities to withdraw from work). During the COVID-19 pandemic, especially increased JDL appeared to favorably influence migraine SM. CONCLUSIONS Migraine SM at work is fostered or complicated by various psychosocial working conditions. By considering these facilitators and barriers, more migraine-friendly workplaces can be created.
Collapse
Affiliation(s)
- Clara Knauf
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, Düsseldorf, 40225, Germany
| | - Katherina Heinrichs
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Andrea Icks
- Institute of Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, Düsseldorf, 40225, Germany.
| |
Collapse
|
14
|
Gallan AS, Helkkula A, McConnell WR. Why did this happen to me? Causal attributions of illness and cultural health capital. Soc Sci Med 2024; 350:116923. [PMID: 38705076 DOI: 10.1016/j.socscimed.2024.116923] [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: 10/14/2023] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
This study examines how conversations between patients and clinicians about the causes of their health conditions relate to patient engagement in care. Leveraging cultural health capital (CHC) theory, we find that patient-physician discussions of health attributions are one mechanism to build patient understanding and activate engagement. We present a qualitative interpretive analysis of data collected in three phases with adult home health care patients: phone interviews (n = 28), field observations (n = 61), and semi-structured field interviews (n = 38). We find that engaging in discussions of causal health attributions with clinicians enables patients to overcome uncertainty, envision preventive actions, and engage in setting future goals. Such discussions must be supported by acknowledgement of the co-responsibility of individual factors and structural factors such as social determinants of health. These discussions are not easy to navigate but they can potentially help patients transition from a mindset of treating the disease (pathogenic approach) to an awareness of their available capabilities to improve health (salutogenic approach). This study contributes to research on attribution theory and cultural health capital theory by demonstrating how discussing causes for poor health can enable patients resolve doubts and accrue instrumental and symbolic resources that facilitate healing.
Collapse
Affiliation(s)
- Andrew S Gallan
- Florida Atlantic University, 777 Glades Road, Fleming Hall 209, Boca Raton, FL, 33431, USA.
| | | | - William R McConnell
- Florida Atlantic University, 777 Glades Road, CU 97 Room 253, Boca Raton, FL, 33431, USA.
| |
Collapse
|
15
|
Klingberg S, Stalmeijer RE, Varpio L. Using framework analysis methods for qualitative research: AMEE Guide No. 164. MEDICAL TEACHER 2024; 46:603-610. [PMID: 37734451 DOI: 10.1080/0142159x.2023.2259073] [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: 09/23/2023]
Abstract
Framework analysis methods (FAMs) are structured approaches to qualitative data analysis that originally stem from large-scale policy research. A defining feature of FAMs is the development and application of a matrix-based analytical framework. These methods can be used across research paradigms and are thus particularly useful tools in the health professions education (HPE) researcher's toolbox. Despite their utility, FAMs are not frequently used in HPE research. In this AMEE Guide, we provide an overview of FAMs and their applications, situating them within specific qualitative research approaches. We also report the specific characteristics, advantages, and disadvantages of FAMs in relation to other popular qualitative analysis methods. Using a specific type of FAM-i.e. the framework method-we illustrate the stages typically involved in doing data analysis with an FAM. Drawing on Sandelowski and Barroso's continuum of data transformation, we argue that FAMs tend to remain close to raw data and be descriptive or exploratory in nature. However, we also illustrate how FAMs can be harnessed for more interpretive analyses. We propose that FAMs are valuable resources for HPE researchers and demonstrate their utility with specific examples from the HPE literature.
Collapse
Affiliation(s)
- Sonja Klingberg
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Renée E Stalmeijer
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Lara Varpio
- Department of Pediatrics, Children's Hospital of Philadelphia, Division of Emergency Medicine, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
16
|
Torres P, Guitelman J, Lucio A, Rini C, Molina Y. Medical Advocacy among Latina Women Diagnosed with Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:495. [PMID: 38673406 PMCID: PMC11049890 DOI: 10.3390/ijerph21040495] [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: 01/22/2024] [Revised: 04/06/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
Medical advocacy has continued to significantly impact quality of life and survivorship outcomes among Latina breast cancer survivors in the United States. However, little is known about the unique experiences of Latina survivors, including the perceived value, process, and context in which they practice medical advocacy. To help address this gap, we conducted a qualitative, secondary analysis of semi-structured focus groups with 18 Latina breast cancer survivors from Chicago, Illinois. Eligible women had to self-identify as (1) female, (2) Latina, (3) 18 years or older, and (4) having a breast cancer diagnosis 5 years ago or more. In total, 61% of participants were 50-59 years old, 83% were born in Mexico, and 100% spoke Spanish. The three emergent themes from the focus groups were (1) the cultural need for Latina advocates and support groups; (2) the process and experiences of becoming a community advocate within Latine culture; and (3) the cultural contexts for advocacy by Latina breast cancer survivors. Latina survivor advocates share strengths of receiving ongoing health education, peer support, and access to resources when being linked to a support group furthering their exposure to role models, increasing their awareness of opportunities in medical advocacy, and providing an entry to participate in medical advocacy.
Collapse
Affiliation(s)
- Paola Torres
- University of Illinois Cancer Center, University of Illinois, Chicago, IL 60612, USA;
| | - Judith Guitelman
- Asociación Latina de Asistencia y Prevención del Cáncer de Mama (ALAS-WINGS), Chicago, IL 60657, USA;
| | | | - Christine Rini
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Yamilé Molina
- University of Illinois Cancer Center, University of Illinois, Chicago, IL 60612, USA;
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
- Hospital & Health Sciences Systems Mile Square Health Center, University of Illinois, Chicago, IL 60612, USA
| |
Collapse
|
17
|
Rabben J, Vivat B, Fossum M, Rohde GE. Shared decision-making in palliative cancer care: A systematic review and metasynthesis. Palliat Med 2024; 38:406-422. [PMID: 38481012 PMCID: PMC11025308 DOI: 10.1177/02692163241238384] [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] [Indexed: 04/19/2024]
Abstract
BACKGROUND Shared decision-making is a key element of person-centred care and promoted as the favoured model in preference-sensitive decision-making. Limitations to implementation have been observed, and barriers and limitations, both generally and in the palliative setting, have been highlighted. More knowledge about the process of shared decision-making in palliative cancer care would assist in addressing these limitations. AIM To identify and synthesise qualitative data on how people with cancer, informal carers and healthcare professionals experience and perceive shared decision-making in palliative cancer care. DESIGN A systematic review and metasynthesis of qualitative studies. We analysed data using inductive thematic analysis. DATA SOURCES We searched five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL and Scopus) from inception until June 2023, supplemented by backward searches. RESULTS We identified and included 23 studies, reported in 26 papers. Our analysis produced four analytical themes; (1) Overwhelming situation of 'no choice', (2) Processes vary depending on the timings and nature of the decisions involved, (3) Patient-physician dyad is central to decision-making, with surrounding support and (4) Level of involvement depends on interactions between individuals and systems. CONCLUSION Shared decision-making in palliative cancer care is a complex process of many decisions in a challenging, multifaceted and evolving situation where equipoise and choice are limited. Implications for practice: Implementing shared decision-making in clinical practice requires (1) clarifying conceptual confusion, (2) including members of the interprofessional team in the shared decision-making process and (3) adapting the approach to the ambiguous, existential situations which arise in palliative cancer care.
Collapse
Affiliation(s)
- Jannicke Rabben
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand/Grimstad, Vest-Agder, Norway
| | - Bella Vivat
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Mariann Fossum
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand/Grimstad, Vest-Agder, Norway
| | - Gudrun Elin Rohde
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand/Grimstad, Vest-Agder, Norway
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
- Department of Clinical Research, Sorlandet hospital, Kristiansand, Vest-Agder, Norway
| |
Collapse
|
18
|
Fletcher R, Regan C, StGeorge J. Providing clinicians with 'how to' knowledge for technology-based innovation: Introducing the SMS4dads texts. Health Promot J Austr 2024; 35:481-486. [PMID: 37438881 DOI: 10.1002/hpja.778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
ISSUE ADDRESSED Male partners are key supports for women in birth preparation and postnatally. Text-messaging can deliver timely information to expectant and new fathers to increase their support of the mother. However, technological innovations in healthcare often fail to be adopted. This study aims to assess the impact of disseminating a 'taster' set of SMS messages to increase clinicians' engagement with the intervention. METHODS Example messages from SMS4dads were delivered to clinicians over a 3-week period and a link provided to an evaluation survey. Agreement to two closed questions was rated on a five-point Likert scale; the frequency of specific recalled messages was calculated for the first open-ended question. Responses to the remaining open-ended questions were analysed with a descriptive thematic approach. RESULTS A total of 418 participants (female 61.5%) working in health organisations (80.4%), mostly in nursing (33.9%) or midwifery (19.6%) enrolled. Of the 77 (18.4%) participants who provided an evaluation, 96% agreed or strongly agreed that the Professional Taster gave them a better understanding of how to explain the program, and 88% agreed or strongly agreed that they are now more likely to tell parents about the program. Analysis of the remaining two open-ended questions revealed clinicians' concerns for fathers alongside their primary focus on maternal wellbeing. CONCLUSION Providing 'how to' knowledge through receiving a sample of the intervention may increase clinicians' acceptance of technological innovation. SO WHAT?: Health-promoting digital interventions using text are increasing. Novel tested strategies for gaining buy-in from healthcare staff will be needed.
Collapse
Affiliation(s)
- Richard Fletcher
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Casey Regan
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Jennifer StGeorge
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| |
Collapse
|
19
|
Beauchemin MP, Solomon S, Michaels CL, McHenry K, Turi E, Khurana R, Sanabria G. Toward identification and intervention to address financial toxicity and unmet health-related social needs among adolescents and emerging adults with cancer and their caregivers: A cross-cultural perspective. Cancer Med 2024; 13:e7197. [PMID: 38659403 PMCID: PMC11043682 DOI: 10.1002/cam4.7197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/30/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024] Open
Abstract
PURPOSE We qualitatively explored the unique needs and preferences for financial toxicity screening and interventions to address financial toxicity among adolescents and emerging adults (younger AYAs: 15-25 years) with cancer and their caregivers. METHODS We recruited English- or Spanish-speaking younger AYAs who were treated for cancer within the past 2 years and their caregivers. Semi-structured interviews were conducted to explore preferences for screening and interventional study development to address financial toxicity. The data were coded using conventional content analysis. Codes were reviewed with the study team, and interviews continued until saturation was reached; codes were consolidated into categories and themes during consensus discussions. RESULTS We interviewed 17 participants; nine were younger AYAs. Seven of the 17 preferred to speak Spanish. We identified three cross-cutting themes: burden, support, and routine, consistent, and clear. The burden came in the form of unexpected costs such as transportation to appointments, as well as emotional burdens such as AYAs worrying about how much their family sacrificed for their care or caregivers worrying about the AYA's physical and financial future. Support, in the form of familial, community, healthcare institution, and insurance, was critical to mitigating the effects of financial toxicity in this population. Participants emphasized the importance of meeting individual financial needs by routinely and consistently asking about financial factors and providing clear guidance to navigate these needs. CONCLUSION Younger AYAs and their caregivers experience significant financial challenges and unmet health-related social needs during cancer treatment and often rely on key supports to alleviate these unmet needs. When developing interventions to mitigate financial toxicity, clinicians and health systems should prioritize clear, consistent, and tailorable approaches to support younger AYA cancer survivors and their families.
Collapse
Affiliation(s)
- Melissa P. Beauchemin
- School of NursingColumbia University Irving Medical CenterNew YorkNew YorkUSA
- Herbert Irving Comprehensive Cancer CenterColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Samrawit Solomon
- School of NursingColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Claudia L. Michaels
- School of NursingColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Kathryn McHenry
- School of MedicineColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Eleanor Turi
- Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Rhea Khurana
- School of NursingColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | | |
Collapse
|
20
|
Moro-López-Menchero P, Martín-Sanz MB, Fernandez-de-las-Peñas C, Gómez-Sanchez SM, Gil-Crujera A, Ceballos-García L, Escribano-Mediavilla NI, Fuentes-Fuentes MV, Palacios-Ceña D. Living and Coping with Olfactory and Taste Disorders: A Qualitative Study of People with Long-COVID-19. Healthcare (Basel) 2024; 12:754. [PMID: 38610176 PMCID: PMC11011467 DOI: 10.3390/healthcare12070754] [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: 02/11/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Taste and smell disorders are common symptoms of SARS-CoV-2 acute infection. In post-COVID-19 condition, symptoms can persist leading to disruption in patients' lives, to changes in their coping skills, and to the need to develop strategies for everyday life. This study aimed to describe the perspective of a group of patients with Long-COVID-19, a condition where loss of taste and/or smell was the most predominant symptom. A qualitative descriptive study was conducted. Participants who had suffered SARS-CoV-2 infection and had Long-COVID-19 loss of taste and/or smell were recruited. Purposive sampling was applied, and participants were recruited until data redundancy was reached. In-depth interviews were used for data collection and thematic analysis was applied. Twelve COVID-19 survivors (75% women) were recruited. The mean age of the participants was 55 years, and the mean duration of post-COVID-19 symptoms was 25 months. Three themes were identified: (a) Living with taste and smell disorders, describing the disorders they experience on a daily basis, how their life has changed and the accompanying emotions, (b) Changes and challenges resulting from the loss of taste and smell, changes in habits, self-care and risk in certain jobs or daily activities, (c) Coping with taste and smell disorders, describing the daily strategies used and the health care received. In conclusion, Long-COVID-19 taste and/or smell disorders limit daily life and involve changes in habits, meal preparation, and the ability to detect potentially dangerous situations.
Collapse
Affiliation(s)
- Paloma Moro-López-Menchero
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science, King Juan Carlos University, 28922 Alcorcón, Spain; (P.M.-L.-M.); (D.P.-C.)
| | - María Belén Martín-Sanz
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science, King Juan Carlos University, 28922 Alcorcón, Spain; (P.M.-L.-M.); (D.P.-C.)
| | - César Fernandez-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Manual Therapy, Dry Needling and Therapeutic Exercise, King Juan Carlos University, 28922 Alcorcón, Spain;
| | - Stella Maris Gómez-Sanchez
- Research Group GAMDES, Department of Basic Health Sciences, King Juan Carlos University, 28922 Alcorcón, Spain; (S.M.G.-S.); (A.G.-C.)
| | - Antonio Gil-Crujera
- Research Group GAMDES, Department of Basic Health Sciences, King Juan Carlos University, 28922 Alcorcón, Spain; (S.M.G.-S.); (A.G.-C.)
| | - Laura Ceballos-García
- Department of Nursing and Dentistry, IDIBO Research Group, King Juan Carlos University, 28922 Alcorcón, Spain; (L.C.-G.); (N.I.E.-M.); (M.V.F.-F.)
| | - Nuria I. Escribano-Mediavilla
- Department of Nursing and Dentistry, IDIBO Research Group, King Juan Carlos University, 28922 Alcorcón, Spain; (L.C.-G.); (N.I.E.-M.); (M.V.F.-F.)
| | - Mª Victoria Fuentes-Fuentes
- Department of Nursing and Dentistry, IDIBO Research Group, King Juan Carlos University, 28922 Alcorcón, Spain; (L.C.-G.); (N.I.E.-M.); (M.V.F.-F.)
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science, King Juan Carlos University, 28922 Alcorcón, Spain; (P.M.-L.-M.); (D.P.-C.)
| |
Collapse
|
21
|
Soepnel LM, Mabetha K, Norris SA, Motlhatlhedi M, Nkosi N, Klingberg S, Lye S, Draper CE. The role of a community health worker-delivered preconception and pregnancy intervention in achieving a more positive pregnancy experience: the Bukhali trial in Soweto, South Africa. BMC Womens Health 2024; 24:161. [PMID: 38443924 PMCID: PMC10916028 DOI: 10.1186/s12905-024-02982-8] [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: 07/04/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND A patient-centered, human-rights based approach to maternal care moves past merely reducing maternal mortality and morbidity, towards achieving a positive pregnancy experience. When evaluating an intervention, particularly in the context of the complex challenges facing maternal care in South Africa, it is therefore important to understand how intervention components are experienced by women. We aimed to qualitatively explore (i) factors influencing the pregnancy and postpartum experience amongst young women in Soweto, South Africa, and (ii) the influence of Bukhali, a preconception, pregnancy, and early childhood intervention delivered by community health workers (CHWs), on these experiences. METHODS Semi-structured, in-depth interviews were conducted with 15 purposively sampled participants. Participants were 18-28-year-old women who (i) were enrolled in the intervention arm of the Bukhali randomized controlled trial; (ii) were pregnant and delivered a child while being enrolled in the trial; and (iii) had at least one previous pregnancy prior to participation in the trial. Thematic analysis, informed by the positive pregnancy experiences framework and drawing on a codebook analysis approach, was used. RESULTS The themes influencing participants' pregnancy experiences (aim 1) were participants' feelings about being pregnant, the responsibilities of motherhood, physical and mental health challenges, unstable social support and traumatic experiences, and the pressures of socioeconomic circumstances. In terms of how support, information, and care practices influenced these factors (aim 2), four themes were generated: acceptance and mother/child bonding, growing and adapting in their role as mothers, receiving tools for their health, and having ways to cope in difficult circumstances. These processes were found to be complementary and closely linked to participant context and needs. CONCLUSION Our findings suggest that, among women aged 18-28, a CHW-delivered intervention combining support, information, and care practices has the potential to positively influence women's pregnancy experience in South Africa. In particular, emotional support and relevant information were key to better meeting participant needs. These findings can help define critical elements of CHW roles in maternal care and highlight the importance of patient-centred solutions to challenges within antenatal care. TRIAL REGISTRATION Pan African Clinical Trials Registry PACTR201903750173871, 27/03/2019.
Collapse
Affiliation(s)
- Larske M Soepnel
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Khuthala Mabetha
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - Molebogeng Motlhatlhedi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Nokuthula Nkosi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Sonja Klingberg
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Lye
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Department of Obstetrics and Gynecology, Department of Physiology and Medicine, University of Toronto, Toronto, ON, Canada
| | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
22
|
Murray CD, Havlin H, Molyneaux V. Considering the psychological experience of amputation and rehabilitation for military veterans: a systematic review and metasynthesis of qualitative research. Disabil Rehabil 2024; 46:1053-1072. [PMID: 36856319 DOI: 10.1080/09638288.2023.2182915] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE Research highlights the differences and unique experiences of military veterans experiencing amputation compared to civilians. This review aimed to synthesise qualitative research exploring the experience of amputation and rehabilitation among existing or previous members of the military. METHODS A systematic search of six databases (PsycINFO, AMED, MEDLINE, CINAHL, Web of Science and Scopus) was undertaken in March 2022. The results of 17 papers reporting 12 studies published between 2009 and 2022 were synthesised using a meta-ethnographic approach to generate new interpretations reflecting the experiences of members of the military who have experienced limb loss. RESULTS Three themes were developed from the data: (1) Making the physical and psychological transition to life after amputation; (2) The role of the military culture in rehabilitation; and (3) The impact of relationships and the gaze of others during rehabilitation and beyond. CONCLUSIONS Military veterans with limb loss experience difficulties in navigating civilian healthcare systems and gaining appropriate support away from the military. Rehabilitation professionals, with psychological training or mentoring, involved in the care of military veterans following amputation could offer psychological support during the transition to civilian life and targeted therapies to veterans experiencing high levels of pain, and facilitate peer support programmes.
Collapse
Affiliation(s)
- Craig D Murray
- Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire, UK
| | - Heather Havlin
- Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire, UK
| | | |
Collapse
|
23
|
Koatz D, Torres-Castaño A, Salrach-Arnau C, Perestelo-Pérez L, Ramos-García V, González-González AI, Pacheco-Huergo V, Toledo-Chávarri A, González-Pacheco H, Orrego C. Exploring value creation in a virtual community of practice: a framework analysis for knowledge and skills development among primary care professionals. BMC MEDICAL EDUCATION 2024; 24:121. [PMID: 38326814 PMCID: PMC10848396 DOI: 10.1186/s12909-024-05061-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Healthcare professionals traditional education reflects constraints to face the complex needs of people with chronic diseases in primary care settings. Since more innovative and practical solutions are required, Virtual Community of Practices (vCoP) seem to better respond to learning updates, improving professional and organizational knowledge. However, little is known about the value created in vCoPs as social learning environments. The objective of this project was to explore the value creation process of a gamified vCoP ("e-mpodera vCoP") aimed at improving the knowledge and attitudes of primary healthcare professionals (PCPs) (nurses and general practitioners) to the empowerment of people with chronic conditions. METHODS A framework analysis assessed the value creation process using a mixed methods approach. The framework provided awareness about knowledge and usefulness in a learning community through five cycles: (1) immediate value, (2) potential value, (3) applied value, (4) realized value, and (5) reframing value. Quantitative data included vCoP analytics such as logins, contributions, points, badges, and performance metrics. Qualitative data consisted of PCPs' forum contributions from Madrid, Catalonia, and Canary Islands over 14 months. RESULTS A total of 185 PCPs had access to the e-mpodera vCoPs. The vCoP showed the dynamic participation of 146 PCPs, along 63 content activities posted, including a total of 3,571 contributions (including text, images, links to webpages, and other files). Regarding the value creation process, the e-mpodera vCoP seems to encompass a broad spectrum of value cycles, with indicators mostly related to cycle 1 (immediate value - activities and interactions) and cycle 2 (potential value - knowledge capital); and to a lesser extent for cycle 3 (applied value - changes in practice) and for cycle 4 (realized value - performance improvement). The presence of indicators related to cycle 5 (reframing value), was minimal, due to few individual redefinitions of success. CONCLUSION To reach a wider range of value possibilities, a combination of learning objectives, competence framework, challenged-based gamified platform, and pathway model of skill development seems crucial. However, additional research is required to gain clearer insights into organizational values, professionals' lifelong educational needs in healthcare, and the long-term sustainability of performance improvement. TRIAL REGISTRATION ClinicalTrials.gov, NCT02757781. Registered on 02/05/2016.
Collapse
Affiliation(s)
- Débora Koatz
- Avedis Donabedian Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain.
| | - Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Cristina Salrach-Arnau
- Avedis Donabedian Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Ana Isabel González-González
- Innovation and International Research Unit, Directorate-General for Research and Education, Madrid Health Ministry, Madrid, Spain
- Research Institute of University Hospital Gregorio Marañón, Madrid, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Valeria Pacheco-Huergo
- Avedis Donabedian Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Atención Primaria Turó-Vilapicina, Instituto Catalán de la Salud, Barcelona, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Himar González-Pacheco
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Chronicity, Primary Care and Health Promotion Research Network (RICAPPS-RICORS), Madrid, Spain
| |
Collapse
|
24
|
Staras SAS, Wollney EN, Emerson LE, Silver N, Dziegielewski PT, Hansen MD, Sanchez G, D'Ingeo D, Johnson‐Mallard V, Renne R, Fredenburg K, Gutter M, Zamojski K, Vandeweerd C, Bylund CL. Identifying locally actionable strategies to increase participant acceptability and feasibility to participate in Phase I cancer clinical trials. Health Expect 2024; 27:e13920. [PMID: 38041447 PMCID: PMC10726272 DOI: 10.1111/hex.13920] [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: 06/26/2023] [Revised: 10/16/2023] [Accepted: 11/09/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Recruitment of cancer clinical trial (CCT) participants, especially participants representing the diversity of the US population, is necessary to create successful medications and a continual challenge. These challenges are amplified in Phase I cancer trials that focus on evaluating the safety of new treatments and are the gateway to treatment development. In preparation for recruitment to a Phase I recurrent head and neck cancer (HNC) trial, we assessed perceived barriers to participation or referral and suggestions for recruitment among people with HNC and community physicians (oncologist, otolaryngologist or surgeon). METHODS Between December 2020 and February 2022, we conducted a qualitative needs assessment via semistructured interviews with a race and ethnicity-stratified sample of people with HNC (n = 30: 12 non-Hispanic White, 9 non-Hispanic African American, 8 Hispanic and 1 non-Hispanic Pacific Islander) and community physicians (n = 16) within the University of Florida Health Cancer Center catchment area. Interviews were analyzed using a qualitative content analysis approach to describe perspectives and identify relevant themes. RESULTS People with HNC reported thematic barriers included: concerns about side effects, safety and efficacy; lack of knowledge and systemic and environmental obstacles. Physicians identified thematic barriers of limited physician knowledge; clinic and physician barriers and structural barriers. People with HNC and physicians recommended themes included: improved patient education, dissemination of trial information and interpersonal communication between community physicians and CCT staff. CONCLUSIONS The themes identified by people with HNC and community physicians are consistent with research efforts and recommendations on how to increase the participation of people from minoritized populations in CCTs. This community needs assessment provides direction on the selection of strategies to increase CCT participation and referral. PATIENT OR PUBLIC CONTRIBUTION This study focused on people with HNC and community physicians' lived experience and their interpretations of how they would consider a future Phase I clinical trial. In addition to our qualitative data reflecting community voices, a community member reviewed the draft interview guide before data collection and both people with HNC and physicians aided interpretation of the findings.
Collapse
Affiliation(s)
- Stephanie A. S. Staras
- Department of Health Outcomes and Biomedical InformaticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Easton N. Wollney
- Department of Health Outcomes and Biomedical InformaticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Lisa E. Emerson
- Department of Microbiology and Cell Science, Institute of Food and Agricultural SciencesUniversity of FloridaGainesvilleFloridaUSA
| | | | - Peter T. Dziegielewski
- Department of OtolaryngologyUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Marta D. Hansen
- Department of Health Outcomes and Biomedical InformaticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Gabriela Sanchez
- Department of Health Outcomes and Biomedical InformaticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Dalila D'Ingeo
- Department of Health Outcomes and Biomedical InformaticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | | | - Rolf Renne
- Department of Molecular Genetics and MicrobiologyUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Kristianna Fredenburg
- Department of PathologyUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Michael Gutter
- Department of Family, Youth and Community Sciences, Institute of Food and Agricultural SciencesUniversity of FloridaGainesvilleFloridaUSA
| | - Kendra Zamojski
- Department of Family, Youth and Community Sciences, Institute of Food and Agricultural SciencesUniversity of FloridaGainesvilleFloridaUSA
| | - Carla Vandeweerd
- Department of Health Outcomes and Biomedical InformaticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Carma L. Bylund
- Department of Health Outcomes and Biomedical InformaticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| |
Collapse
|
25
|
Bores-García D, Palacios-Ceña D, Jiménez-Antona C, Marconnot R. The Meaning of Physical Education Practice in Students with Attention-Deficit Hyperactivity Disorder (ADHD). RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-8. [PMID: 38290130 DOI: 10.1080/02701367.2023.2294097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 11/30/2023] [Indexed: 02/01/2024]
Abstract
Purpose: This study seeks to describe the perspective of students with attention-deficit hyperactivity disorder (ADHD) and physical education (PE) teachers concerning physical activity practice in high school. Methods: A qualitative descriptive study based on an interpretative framework was conducted with secondary school students with ADHD, and their teachers of physical education. In-depth interviews and researchers' field notes were used to collect the data. Purposive sampling and inductive thematic analysis were applied. Results: Results show that ADHD is not experienced as limiting the practice of PA and PE by students, except in motor activities that require concentration such as tactical games. On the contrary, PA and PE helps them feel better. Teachers have not had to make extensive methodological modifications in their teaching styles with students with ADHD in relation to other situations or incidents. Conclusions: Students with ADHD do not seem to show significant difficulties in PE lessons or in the practice of extracurricular PA. PE teachers do not need to make significant adaptations with these students.
Collapse
Affiliation(s)
- Daniel Bores-García
- Research Group of Humanities and Qualitative Research in Health Science, Universidad Rey Juan Carlos
| | - Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science, Universidad Rey Juan Carlos
| | - Carmen Jiménez-Antona
- Research Group of Humanities and Qualitative Research in Health Science, Universidad Rey Juan Carlos
| | - Romain Marconnot
- Research Group of Humanities and Qualitative Research in Health Science, Universidad Rey Juan Carlos
| |
Collapse
|
26
|
de Souza R, Jabbar A, Jafarpour D, Bedos C, Esfandiari S, Makhoul N, Dagdeviren D, Abi Nader S, Feine J. Single-Implant Overdentures Retained by a Novel Attachment: A Mixed Methods Crossover Randomized Clinical Trial. JDR Clin Trans Res 2024; 9:27-41. [PMID: 36127832 PMCID: PMC10725123 DOI: 10.1177/23800844221124083] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Single-implant mandibular overdentures (SIMOs) are one of the least invasive implant treatments for edentulism. The new Novaloc attachment system can improve the clinical performance of implant-retained overdentures but has not been tested for SIMOs. OBJECTIVES To compare Novaloc and a gold standard system (Locator) for SIMOs in an edentate elderly population in terms of patient-reported outcomes and device- and treatment-related complications. METHODS In this single-center crossover randomized clinical trial (RCT), 10 edentulous participants received an implant in the lower midline and had their lower complete dentures converted to SIMOs. The participants received each attachment system for 3 mo in a randomized order, followed by measurement of patient satisfaction and oral health-related quality of life via the McGill Denture Satisfaction Questionnaire and the Oral Health Impact Profile for Edentulous People questionnaire, respectively. Complications were registered throughout the RCT. Patients were interviewed for their experiences with SIMOs and preference for one of the attachment systems. Quantitative analysis employed mixed linear models and chi-square tests (α = 0.05), whereas interview data underwent thematic analysis and, in turn, integration into quantitative data (mixed methods explanatory design). RESULTS All 10 randomized participants completed the trial. Mean ± SD general satisfaction was 92% ± 8% with Novaloc versus 85% ± 13% with Locator (mean difference, 9%; 95% CI, 1% to 17%). For specific McGill Denture Satisfaction Questionnaire items, only denture stability was significantly increased for Novaloc. Seven participants preferred Novaloc over Locator at the end of the RCT (chi-square, P = 0.045). No difference was found between the attachments in terms of oral health-related quality of life based on the Oral Health Impact Profile for Edentulous People and complications. Thematic analysis revealed high patient satisfaction with SIMOs, with denture stability the main criterion for their satisfaction and attachment preference. CONCLUSION Among elderly edentulous patients wearing SIMOs, Novaloc led to increased patient satisfaction and preference. Better patient-perceived denture stability may explain this result. The attachment systems exhibited similar short-term maintenance needs. TRIAL REGISTRATION ClinicalTrials.gov: NCT03126942 (first registered on April 13, 2017). Secondary identifiers: A03-M07-17A (McGill University, Institutional Review Board) and 2018-3873 (McGill University Health Centre, Research Ethics Board). KNOWLEDGE TRANSFER STATEMENT The results of this mixed methods study can be used by clinicians when choosing which attachment system to use for SIMOs. Results suggest that edentulous patients prefer attachments with a better-defined seating position, such as that of the Novaloc system, as opposed to the nylon matrix on metallic abutment of the Locator system.
Collapse
Affiliation(s)
- R.F. de Souza
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - A.A. Jabbar
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - D. Jafarpour
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - C. Bedos
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - S. Esfandiari
- Faculty of Dentistry, Université de Montréal, Montreal, Canada
| | - N.M. Makhoul
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - D. Dagdeviren
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - S. Abi Nader
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - J.S. Feine
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| |
Collapse
|
27
|
Délétroz C, Del Grande C, Amil S, Bodenmann P, Gagnon MP, Sasseville M. Development of a patient-reported outcome measure of digital health literacy for chronic patients: results of a French international online Delphi study. BMC Nurs 2023; 22:476. [PMID: 38098112 PMCID: PMC10720110 DOI: 10.1186/s12912-023-01633-x] [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: 04/05/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND A psychometrically robust patient-reported outcome measure (PROM) to assess digital health literacy for chronic patients is needed in the context of digital health. We defined measurement constructs for a new PROM in previous studies using a systematic review, a qualitative description of constructs from patients, health professionals and an item pool identification process. This study aimed to evaluate the content validity of a digital health literacy PROM for chronic patients using an e-Delphi technique. METHODS An international three-round online Delphi (e-Delphi) study was conducted among a francophone expert panel gathering academics, clinicians and patient partners. These experts rated the relevance, improvability, and self-ratability of each construct (n = 5) and items (n = 14) of the preliminary version of the PROM on a 5-point Likert scale. Consensus attainment was defined as strong if ≥ 70% panelists agree or strongly agree. A qualitative analysis of comments was carried out to describe personal coping strategies in healthcare expressed by the panel. Qualitative results were presented using a conceptually clustered matrix. RESULTS Thirty-four experts completed the study (with 10% attrition at the second round and 5% at the third round). The panel included mostly nurses working in clinical practice and academics from nursing science, medicine, public health background and patient partners. Five items were excluded, and one question was added during the consensus attainment process. Qualitative comments describing the panel view of coping strategies in healthcare were analysed. Results showed two important themes that underpin most of personal coping strategies related to using information and communications technologies: 1) questionable patient capacity to assess digital health literacy, 2) digital devices as a factor influencing patient and care. CONCLUSION Consensus was reached on the relevance, improvability, and self-ratability of 5 constructs and 11 items for a digital health literacy PROM. Evaluation of e-health programs requires validated measurement of digital health literacy including the empowerment construct. This new PROM appears as a relevant tool, but requires further validation.
Collapse
Affiliation(s)
- Carole Délétroz
- Doctoral Candidate, Faculty of Nursing Sciences, Université Laval, Canada and School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011, Lausanne, Switzerland.
| | - Claudio Del Grande
- Doctoral Candidate, School of Public Health, University of Montreal and Research Associate, Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, 850 Rue St-Denis, Montréal, Québec, QC H2X 0A9, Canada
| | - Samira Amil
- Doctoral Candidate, Centre Nutrition, Santé Et Société (NUTRISS)-INAF, Université Laval, Québec, Canada and VITAM - Centre de Recherche en Santé Durable and Unité de Soutien Au Système de Santé Apprenant du Québec, Québec, Canada
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Unisanté, Lausanne and Faculty of Biology and Medicine, Vice-Dean Teaching and Diversity, University of Lausanne, Rue du Bugnon 44, 1011, Lausanne, Switzerland
| | - Marie-Pierre Gagnon
- Faculty of Nursing Sciences, Université Laval, 2325 Rue de L'Université, Québec, QC, G1V 0A6, Canada
| | - Maxime Sasseville
- Faculty of Nursing Sciences, Université Laval, 2325 Rue de L'Université, Québec, QC, G1V 0A6, Canada
| |
Collapse
|
28
|
Hsieh HF, Chen YM, Chen SL, Wang HH. Understanding the Workplace-Violence-Related Perceptions and Coping Strategies of Nurses in Emergency Rooms. J Nurs Res 2023; 31:e304. [PMID: 38036492 DOI: 10.1097/jnr.0000000000000581] [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: 12/02/2023] Open
Abstract
BACKGROUND Workplace violence (WPV) is a well-known and serious issue in most countries, and WPV against healthcare providers is of particular concern, especially among nurses working in emergency rooms (ERs). PURPOSE We aimed to develop a deeper understanding of nurses' perceptions and coping strategies related to WPV that took place over a 1-year period from the perspective of nursing victims still working in ERs in southern Taiwan. METHODS This is a qualitative study with in-depth and semistructured interviews. Nineteen ER nurse victims were recruited from six hospitals in southern Taiwan from June 2015 to April 2016. All of the interview recordings were analyzed using content analysis. RESULTS The content analysis identified two themes of perceptions and two themes of coping strategies toward WPV. The two themes of perceptions were "adversity" and "dilemma," with the former covering the three subthemes of "misunderstanding of health policy," "unsafe environment," and "nursing shortage" and the latter covering the two subthemes of "burnout" and "keeping or quitting the job." The two themes of coping strategies were "adjustment" and "resilience," with the former covering the three subthemes of "acceptance of the reality of WPV," "self-regulation," and "culture and belief" and the latter covering the two subthemes of "living with WPV" and "problem solving." CONCLUSIONS/IMPLICATIONS FOR PRACTICE The findings revealed that ER nurse victims of WPV experienced a complicated journey after encountering WPV. Their coping strategies may be referenced by other ER nurses to better prevent and manage violent events in ERs. To prevent and manage violence in ERs, hospital managers should create a safe working environment through, for example, assigning sufficient security personnel and staff; provide relevant training to ER nurses in communications and other skills; and implement support systems to strengthen nurse resilience.
Collapse
Affiliation(s)
- Hsiu-Fen Hsieh
- PhD, RN, Associate Professor and Adjunct Research Fellow, School of Nursing, College of Nursing, Kaohsiung Medical University, Taiwan
| | - Yao-Mei Chen
- PhD, RN, Assistant Professor, School of Nursing, College of Nursing, Kaohsiung Medical University, Taiwan
| | - Shu-Lin Chen
- MSN, RN, Head Nurse and Instructor, Department of Nursing, Kaohsiung United Municipal Hospital, Taiwan
| | - Hsiu-Hung Wang
- PhD, RN, FAAN, Professor, College of Nursing, Kaohsiung Medical University, Taiwan
| |
Collapse
|
29
|
Lee GA, Durante A, Baker EE, Vellone E, Caggianelli G, Dellafiore F, Khan M, Khatib R. Patients' perceptions on the facilitators and barriers using injectable therapies in dyslipidaemia: An empirical qualitative descriptive international study. J Adv Nurs 2023; 79:4687-4696. [PMID: 37376717 DOI: 10.1111/jan.15739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/31/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Injectable medicines are increasingly used to manage abnormal levels of lipids, which is a major risk factor for cardiovascular events. Enhancing our understanding of patients' perceptions of these injectables, can inform practice with the aim of increasing uptake and medication adherence. AIM To explore patient's experiences of using injectables and to identify potential facilitators and barriers to using injectable therapies in dyslipidaemia. DESIGN A qualitative descriptive study using semi-structured interviews was conducted with patients who were using injectables to manage their cardiovascular conditions. METHODS A total of 56 patients, 30 from the United Kingdom and 26 from Italy, were interviewed online from November 2020 to June 2021. Interviews were transcribed and schematic content analysis performed. RESULTS Four distinct themes emerged from interviews with patients and caregivers: (i) Their behaviours and personal beliefs; (ii) Knowledge and education about injectable medication; (iii) Clinical skills and previous experiences and (iv) Organizational and governance. Participants expressed initial fears such as needle phobia, and their concerns about commencing therapy were compounded by a lack of accessible information. However, patients' pre-existing knowledge of lipid lowering medication, previous experience with statins and history of adverse side effects informed their decision-making regarding using injectables. Organization and governance-related issues were primarily around the distribution and management of medication supply within primary care, and the lack of a standardized clinical support monitoring system. CONCLUSION Changes are needed in clinical practice to better educate and support patients to improve the uptake of injectables and optimize their use of these medications in the management of dyslipidaemia. IMPACT This study suggests that injectable therapies were acceptable to people with cardiovascular disease. However, healthcare professionals need to play a key role in improving education and providing support to aid patients' decision-making regarding commencing and adhering to injectable therapies. REPORTING METHOD The study adhered to the Consolidated Criteria for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
Collapse
Affiliation(s)
- Geraldine A Lee
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, James Clerk Maxwell Building, King's College London, London, UK
| | - Angela Durante
- Unidad Predepartemental de Enfermería, Univeridad de la Rioja, Logroño (La Rioja), Spain
| | - Edward E Baker
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, James Clerk Maxwell Building, King's College London, London, UK
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Poland
| | - Gabriele Caggianelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Mutiba Khan
- Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Rani Khatib
- Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust, Leeds, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| |
Collapse
|
30
|
Hwang JJ, Donnelly TT, Raffin Bouchal S, Davidson S. Factors influencing access to nonpharmacological interventions for community-dwelling seniors with mild-to-moderate dementia: An integrative review. J Psychiatr Ment Health Nurs 2023; 30:1054-1081. [PMID: 37203563 DOI: 10.1111/jpm.12932] [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: 09/28/2022] [Revised: 03/06/2023] [Accepted: 04/23/2023] [Indexed: 05/20/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT Research has shown effectiveness of nonpharmacological interventions in improving or maintaining cognition, mood, functioning, self-efficacy and quality of life for persons with mild-to-moderate dementia (PWDs). These interventions are critical during the earlier stages of dementia. However, Canadian and international literature report underutilization of and difficulty accessing the interventions. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE To our knowledge, this is the first review that explored factors influencing seniors' utilization of nonpharmacological interventions in the earlier stages of dementia. This review contributed to the discovery of unique factors such as PWDs' beliefs, fears, perceptions, and acceptability of nonpharmacological interventions and environmental influences on intervention provision. PWDs' intervention uptake may appear as a matter of personal choices related to individuals' knowledge, beliefs and perceptions. However, the analysis of the research evidence suggests that PWDs' choices are shaped by environmental factors such as formal and informal caregiver support, acceptability and accessibility of nonpharmacological interventions, dementia care workforce, community's attitudes towards dementia and funding. The complex interplay among factors highlights the importance of targeting health promotion strategies at both individuals and their environments. WHAT ARE THE IMPLICATIONS FOR PRACTICE The review findings feature opportunities for healthcare practitioners, including mental health nurses, in advocating for PWDs' evidence-informed decision-making and access to desired nonpharmacological treatments. Involvement of patients and families in care-planning through ongoing assessment of health and learning needs, as well as enablers and barriers to using interventions, continuing information provision, and personalized referrals to appropriate services can promote PWDs' rights to healthcare. ABSTRACT INTRODUCTION: Despite the significance of nonpharmacological interventions in optimal management of mild-to-moderate dementia, it remains unclear in the literature how persons with mild-to-moderate dementia (PWDs) view, understand and access nonpharmacological interventions. AIM The purpose of this review was to explore the extent and nature of evidence concerning factors that influence the use of nonpharmacological interventions for community-dwelling seniors with mild-to-moderate dementia. METHOD An integrative review was undertaken following Toronto and Remington (A step-by-step guide to conducting an integrative review, 2020)'s instruction which expanded Torraco (Human Resource Development Review, 2016, 15, 404)'s and Whittemore and Knafl (Journal of Advanced Nursing, 2005, 52, 546)'s guidance. RESULTS The review of 16 studies suggests that PWDs' use of nonpharmacological interventions is shaped by a complex interplay of various personal, interpersonal, organizational, community and political influences. DISCUSSION The findings highlight the complex, interrelated relationships among multiple factors and subsequent limitations of behaviour-oriented health promotion strategies. To assist PWDs in making healthier choices, health promotion strategies need to direct attention to both individuals' behaviours and environmental conditions impacting the behaviours. IMPLICATIONS FOR PRACTICE The findings of this review can inform multidisciplinary health practitioners' (including mental health nurses) practice with seniors living with mild-to-moderate dementia. We recommend actionable ways in which they can empower patients and their families in dementia management.
Collapse
Affiliation(s)
| | | | | | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
31
|
Graven LJ, Durante A, Abbott L, Bassi E, Howren MB, Grant JS. Self-care Problems and Management Strategies Experienced by Rural Patient/Caregiver Dyads Living With Heart Failure: A Qualitative Study. J Cardiovasc Nurs 2023:00005082-990000000-00149. [PMID: 37955387 DOI: 10.1097/jcn.0000000000001056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Rural patients with heart failure (HF) have higher mortality and hospitalization rates compared with their urban counterparts. Although research supports the inclusion of informal caregivers in daily self-care activities, data are limited regarding the problems encountered by rural patient/caregiver dyads living with HF in managing HF in the home and how these problems are managed. OBJECTIVE The aim of this study was to identify and describe HF self-care problems experienced by rural dyads in the home and how these problems are managed. METHODS Using a descriptive qualitative design, data were collected from rural patient/caregiver dyads living with HF via individual, semistructured, telephone interviews and analyzed using schematic content analysis. Interviews and data analysis occurred concurrently until data saturation was reached. RESULTS Thematic data saturation was obtained with 11 dyads. On average, patients were 65.3 (±13.9) years old, and caregivers were 62 (±12.37) years old. Four themes illustrating dyadic HF self-care problems and management strategies emerged: (1) HF self-care components, namely, maintenance, symptom monitoring, and management (diet, exercise, activities, strategies); (2) environment (rural barriers, COVID-19); (3) caregiver contributors (confidence, role); and (4) dyadic contributors (dyadic relationship). Dyads described various self-care problems, with the type of relationship and presence of mutuality influencing the problem-solving process and development of management strategies. CONCLUSIONS The identified themes emphasize the self-care problems experienced by rural dyads living with HF and the contributions of both dyad members to effectively manage these challenges. Findings support the need for culturally sensitive, tailored interventions targeting self-care in rural dyads living with HF.
Collapse
|
32
|
Draper CE, Motlhatlhedi M, Mabasa J, Headman T, Klingberg S, Pentecost M, Lye SJ, Norris SA, Nyati LH. Navigating relationship dynamics, pregnancy and fatherhood in the Bukhali trial: a qualitative study with men in Soweto, South Africa. BMC Public Health 2023; 23:2204. [PMID: 37940937 PMCID: PMC10633923 DOI: 10.1186/s12889-023-17153-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: 06/12/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND South Africa has a complex range of historical, social, political, and economic factors that have shaped fatherhood. In the context of the Bukhali randomised controlled trial with young women in Soweto, South Africa, a qualitative study was conducted with the male partners of young women who had become pregnant during the trial. This exploratory study aimed to explore individual perceptions around relationship dynamics, their partner's pregnancy, and fatherhood of partners of young women in Soweto, South Africa. METHODS Individual, in-depth interviews were conducted with male partners (fathers, n = 19, 25-46 years old) of Bukhali participants. A thematic approach was taken to the descriptive and exploratory process of analysis, and three final themes and subthemes were identified: (1) relationship dynamics (nature of relationship, relationship challenges); (2) pregnancy (feelings about the pregnancy, effect of the pregnancy on their relationship, providing support during pregnancy; and 3) fatherhood (view of fatherhood, roles of fathers, influences on views and motivation, challenges of fatherhood). RESULTS While most male participants were in a committed ("serious") relationship with their female partner, less than half of them were cohabiting. Most reported that their partner's pregnancy was not planned, and shared mixed feelings about the pregnancy (e.g., happy, excited, shocked, nervous), although their views about fatherhood were overwhelmingly positive. Many were concerned about how they would economically provide for their child and partner, particularly those who were unemployed. Participants identified both general and specific ways in which they provided support for their partner, e.g., being present, co-attending antenatal check-ups, providing material resources. For many, the most challenging aspect of fatherhood was having to provide financially. They seemed to understand the level of responsibility expected of them as a father, and that their involvement and presence related to love for and connection with their child. Participants' responses indicated that there were some changes in the norms around fatherhood, suggesting that there is a possibility for a shift in the fatherhood narrative in their context. CONCLUSIONS These findings suggest that the complex array of factors influencing fatherhood in South Africa continue to play out in this generation, although promising changes are evident.
Collapse
Affiliation(s)
- Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Molebogeng Motlhatlhedi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jackson Mabasa
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tshepang Headman
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sonja Klingberg
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle Pentecost
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Stephen J Lye
- Toronto and Departments of Obstetrics and Gynecology, Physiology and Medicine, Lunenfeld-Tanenbaum Research Institute, Sinai Health, University of Toronto, Toronto, ON, Canada
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - Lukhanyo H Nyati
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Interprofessional Education Unit, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
33
|
Tang X, Wang J, Wu B, Navarra AM, Cui X, Wang J. Lived experiences of maintaining self-identity among persons living with young-onset dementia: A qualitative meta-synthesis. DEMENTIA 2023; 22:1776-1798. [PMID: 37646673 DOI: 10.1177/14713012231193547] [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: 09/01/2023]
Abstract
BACKGROUND The self-identity of persons with young-onset dementia (YOD) is affected by the disease progression. However, the lived experience of maintaining self-identity along the disease trajectory is understudied. This meta-synthesis integrated qualitative data on the challenges, coping strategies, and needs of persons living with YOD and how their experiences affected their self-identity over time. METHODS Four English (PubMed, Scopus, CINAHL, PsycINFO) and two Chinese (CNKI and Wanfang) electronic databases were searched for published literature peer-reviewed from the time of database inception to 2022. We used thematic analysis to extract and synthesize data from the literature concerning the long-term lived experiences of persons living with YOD. RESULTS A total of five peer-reviewed publications were eligible for inclusion in this meta-synthesis study. We identified four themes: (1) declining cognitive function and a prolonged diagnostic process threaten the self-identity of persons living with YOD, (2) struggling to accept the diagnosis of YOD and maintain self-identity, (3) maintaining self-identity and the normalcy of life through social support and person-centered care, and (4) living with YOD through self-development and self-identity reshaping at a later stage of the disease. CONCLUSIONS Persons living with YOD experience challenges maintaining their self-identity throughout the disease trajectory. These challenges are affected by their cognitive function, experiences of personal and social stigma associated with the disease, perceived social support, and person-centered care. Study findings have implications for developing tailored supportive programs for persons living with YOD at various stages of the disease trajectory.
Collapse
Affiliation(s)
| | | | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | | | | | - Jing Wang
- University of New Hampshire, College of Health and Human Services, Durham, NH, USA
- Fudan University, Shanghai, China
| |
Collapse
|
34
|
James H, Nazroo J, Chatzi G, Simpson P. How Do Women and Men Negotiate Sex in Later Life Relationships? A Qualitative Analysis of Data from the English Longitudinal Study of Aging. JOURNAL OF SEX RESEARCH 2023; 60:1332-1344. [PMID: 36043890 DOI: 10.1080/00224499.2022.2112934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Later life relationships and in particular the role of sex within them, have often been neglected in research due to assumptions of decline and sexlessness. We contribute to a growing body of work which counters these stereotypes by examining sexual scripts within the socio-cultural context of later life relationships. We analyzed open-text comments from the English Longitudinal Study of Aging (ELSA) collected as part of a self-completion questionnaire. In Wave 6, 1065 participants (M age 67.5, SD 9.6 years) and in Wave 8, 922 participants (M age 69.1, SD 9.01 years) responded to an open-text box question. Across both waves, 38% of respondents were men and 62% were women. The analysis used a coding template developed from existing literature and adjusted to accommodate emerging topics. A gendered analysis of the interrelated topics of relationships, sex and sexuality resulted in themes which illustrate similarities and differences in how men and women negotiate sex in later life relationships. The findings confirm that sex remains integral to intimacy in later life relationships for many men and women. However, they also demonstrate that norms of age and gender interact to shape sex and relationship practices in later life. These norms limit some people's experiences, for example, preventing them from seeking new relationships, as well as creating challenges for intimacy in partnerships. These findings extend the theoretical understanding of relationships and sex in later life.
Collapse
Affiliation(s)
- Hayley James
- School of Social Policy, Social Work and Social Justice, University College Dublin
| | - James Nazroo
- Manchester Institute for Collaborative Research on Ageing, School of Social Sciences, The University of Manchester
| | - Georgia Chatzi
- Social Statistics Cathie Marsh Institute for Social Research, School of Social Sciences, The University of Manchester
| | - Paul Simpson
- Sociology, School of Social Sciences, The University of Manchester
| |
Collapse
|
35
|
Fletcher R, Regan C, May C, White S, St George J. Equipping fathers to support distressed mothers: What do mothers want fathers to know and do? Health Promot J Austr 2023; 34:683-690. [PMID: 37327354 DOI: 10.1002/hpja.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/30/2023] [Accepted: 06/03/2023] [Indexed: 06/18/2023] Open
Abstract
ISSUE ADDRESSED Up to one in five new mothers experience depression or anxiety, and their partners are often the first line of social and practical support. However, many fathers are unprepared for their role as support person. The SMS4dads program (www.sms4dads.com) provides text-based support to new fathers but lacks specific messages addressing maternal mental distress. METHODS A mixed methods process engaged mothers with lived experience of perinatal mental distress to identify message content for co-designing texts in SMS4dads. Participants completed surveys derived from research literature and parenting websites using the theoretical framework of support domains: emotional or affectionate support, informational support, tangible support and positive social interaction. Mothers also indicated the most appropriate timing of support: at the point of identifying the distress (emerging), with ongoing symptoms (persistent) or during recovery (easing). Free text comments from mothers were linked to survey topics to provide examples of wording suitable for text messages to fathers. RESULTS Fifty-five mothers with lived experience completed the surveys. All support items were more often endorsed as helpful rather than not helpful by mothers. Emotional support was thought helpful in the early stages, tangible support was valued with ongoing symptoms and social interaction appreciated as symptoms eased. CONCLUSIONS Mothers experiencing perinatal depression and anxiety require a range of supportive actions by their partners, including household tasks and baby-care, encouragement, listening and managing relationships with family and friends. SO WHAT?: Information provided by distressed mothers can provide guidance to professionals when designing information for fathers/partners. Digital delivery of this co-designed information to fathers across urban and rural areas may enhance the competence of fathers working to support mothers experiencing mental distress in the perinatal period.
Collapse
Affiliation(s)
- Richard Fletcher
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Casey Regan
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Chris May
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Scott White
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Jennifer St George
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| |
Collapse
|
36
|
Williams M, Kingston Miller A, Loizaga-Velder A, Files N, Lafrance A. "Getting to the Root": Ayahuasca Ceremony Leaders' Perspectives on Eating Disorders. J Psychoactive Drugs 2023; 55:425-433. [PMID: 36171638 DOI: 10.1080/02791072.2022.2113484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 10/14/2022]
Abstract
Given the mortality, chronicity, and treatment drop-out rates observed among individuals with eating disorders (EDs), innovative approaches are needed. Ayahuasca, a psychedelic plant medicine from the Amazon, is currently being investigated. This study expands on prior exploratory research by describing the perspectives of ayahuasca ceremony leaders regarding their conceptualizations of EDs and the potential therapeutic mechanisms of action of ayahuasca for individuals with EDs. Qualitative content analysis of interviews with 15 ayahuasca ceremony leaders produced two main categories, with relevant subcategories. The first category encompassed the leaders' theories of EDs from a shamanic perspective, including that EDs are symptomatic of an underlying concern, serve a function and affect health in multiple domains. The second category described leaders' perspectives on the potential mechanisms of action of ayahuasca for EDs, including that ayahuasca facilitates "energetic healing"; helps identify, process, and integrate the "root" of the ED; promotes holistic healing; and enhances and/or reorganizes relationships. From the perspectives of ceremony leaders and consistent with previous exploratory research, ceremonial ayahuasca use may offer a potentially useful, novel and complementary intervention for EDs.
Collapse
|
37
|
Stephens MA, Spratling R, Holiday D. Evaluation of the Mental Health Referral Process for African American Adolescent Patients Within a Primary Care Setting: A Quality Improvement Project. J Pediatr Health Care 2023; 37:501-510. [PMID: 37061901 DOI: 10.1016/j.pedhc.2023.03.006] [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: 01/30/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION Mental health disorders affect 18% of the U.S. POPULATION Problems with access to mental health care for the African American community are multifactorial. Provider and staff perceptions and opinions regarding factors attributing to problems with mental health access are explored. METHOD Providers and staff (N=10) completed a 26-item electronic questionnaire RESULTS: The primary barriers to screening, consultation, and follow-through were time constraints, location of services, and lack of parental support, respectively. CONCLUSIONS Integrating behavioral health into primary care is a promising way to address many reported barriers, such as time restraints, social stigma, and lack of resources.
Collapse
|
38
|
Wong JJ, SoRelle RP, Yang C, Knox MK, Hysong SJ, Dorsey LE, O'Mahen PN, Petersen LA. Nurse Leader Perceptions of Data in the Veterans Health Administration: A Qualitative Evaluation. Comput Inform Nurs 2023; 41:679-686. [PMID: 36648170 PMCID: PMC10350463 DOI: 10.1097/cin.0000000000001003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Healthcare systems and nursing leaders aim to make evidence-based nurse staffing decisions. Understanding how nurses use and perceive available data to support safe staffing can strengthen learning healthcare systems and support evidence-based practice, particularly given emerging data availability and specific nursing challenges in data usability. However, current literature offers sparse insight into the nature of data use and challenges in the inpatient nurse staffing management context. We aimed to investigate how nurse leaders experience using data to guide their inpatient staffing management decisions in the Veterans Health Administration, the largest integrated healthcare system in the United States. We conducted semistructured interviews with 27 Veterans Health Administration nurse leaders across five management levels, using a constant comparative approach for analysis. Participants primarily reported using data for quality improvement, organizational learning, and organizational monitoring and support. Challenges included data fragmentation, unavailability and unsuitability to user need, lack of knowledge about available data, and untimely reporting. Our findings suggest that prioritizing end-user experience and needs is necessary to better govern evidence-based data tools for improving nursing care. Continuous nurse leader involvement in data governance is integral to ensuring high-quality data for end-user nurses to guide their decisions impacting patient care.
Collapse
Affiliation(s)
- Janine J Wong
- Author Affiliations: Center for Innovations in Quality, Effectiveness and Safety (Mss Wong, Yang, and Knox, Mr SoRelle, and Drs Hysong, O'Mahen, and Petersen) and Patient Care Services (Dr Dorsey), Michael E. DeBakey Veterans Affairs Medical Center; and Section of Health Services Research, Department of Medicine, Baylor College of Medicine (Mss Wong, Yang, and Knox, Mr SoRelle, and Drs Hysong, O'Mahen, and Petersen), Houston, TX
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Storm IMS, Mikkelsen AKK, Holen M, Hybholt L, Austin SF, Berring LL. Social Processes of Young Adults' Recovery and Identity Formation during Life-Disruptive Mental Distress-A Meta-Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6653. [PMID: 37681793 PMCID: PMC10487737 DOI: 10.3390/ijerph20176653] [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: 06/24/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
Young people's mental health recovery is well-explored in empirical research, yet there is a lack of meta-studies synthesizing the characteristics of young people's recovery. This meta-ethnography explores young adults' recovery during life-disruptive experiences of early psychosis or schizophrenia. Based on a systematic literature review search, 11 empirical qualitative studies were included for synthesis. Inspired by young people's prominent experience of social isolation in the included studies, we applied an interpretive lens of belonging deriving from the sociology of youth. The synthesis presents five themes: (1) expectations of progression in youth in contrast with stagnation during psychosis, (2) feeling isolated, lost and left behind, (3) young adults' recovery involves belonging with other young people, (4) forming identity positions of growth and disability during psychosis, and the summarizing line of argument, (5) navigating relational complexities in the process of recovery. While suffering from social isolation, young people's recovery is conceived as getting on with life, like any other young person involving connecting and synchronizing life rhythms with their age peers. Socializing primarily with caring adults entails being stuck in the position of a child, while connecting with young people enables the identity positions of young people. This synthesis can inspire support for young people's recovery through social inclusion in youth environments.
Collapse
Affiliation(s)
- Ida Marie Skou Storm
- Research Unit, Mental Health Services East, Psychiatry Region Zealand, 16, 4000 Roskilde, Denmark; (A.K.K.M.); (L.H.); (S.F.A.)
- Institute of Regional Health Research, University of Southern Denmark, 55, 5230 Odense, Denmark;
- Psychiatric Research Unit, Psychiatry Region Zealand, 6, 4200 Slagelse, Denmark
| | - Anne Kathrine Kousgaard Mikkelsen
- Research Unit, Mental Health Services East, Psychiatry Region Zealand, 16, 4000 Roskilde, Denmark; (A.K.K.M.); (L.H.); (S.F.A.)
- Psychiatric Research Unit, Psychiatry Region Zealand, 6, 4200 Slagelse, Denmark
| | - Mari Holen
- Health and Society, Department of People and Technology, Roskilde University, 1, 4000 Roskilde, Denmark;
| | - Lisbeth Hybholt
- Research Unit, Mental Health Services East, Psychiatry Region Zealand, 16, 4000 Roskilde, Denmark; (A.K.K.M.); (L.H.); (S.F.A.)
- Institute of Regional Health Research, University of Southern Denmark, 55, 5230 Odense, Denmark;
- Psychiatric Research Unit, Psychiatry Region Zealand, 6, 4200 Slagelse, Denmark
| | - Stephen Fitzgerald Austin
- Research Unit, Mental Health Services East, Psychiatry Region Zealand, 16, 4000 Roskilde, Denmark; (A.K.K.M.); (L.H.); (S.F.A.)
- Psychiatric Research Unit, Psychiatry Region Zealand, 6, 4200 Slagelse, Denmark
- Institute for Psychology, University of Southern Denmark, 55, 5230 Odense, Denmark
| | - Lene Lauge Berring
- Institute of Regional Health Research, University of Southern Denmark, 55, 5230 Odense, Denmark;
- Psychiatric Research Unit, Psychiatry Region Zealand, 6, 4200 Slagelse, Denmark
| |
Collapse
|
40
|
Tummalapalli SL, Struthers SA, White DL, Beckrich A, Brahmbhatt Y, Erickson KF, Garimella PS, Gould ER, Gupta N, Lentine KL, Lew SQ, Liu F, Mohan S, Somers M, Weiner DE, Bieber SD, Mendu ML. Optimal Care for Kidney Health: Development of a Merit-based Incentive Payment System (MIPS) Value Pathway. J Am Soc Nephrol 2023; 34:1315-1328. [PMID: 37400103 PMCID: PMC10400097 DOI: 10.1681/asn.0000000000000163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/17/2023] [Indexed: 07/05/2023] Open
Abstract
The Merit-based Incentive Payment System (MIPS) is a mandatory pay-for-performance program through the Centers for Medicare & Medicaid Services (CMS) that aims to incentivize high-quality care, promote continuous improvement, facilitate electronic exchange of information, and lower health care costs. Previous research has highlighted several limitations of the MIPS program in assessing nephrology care delivery, including administrative complexity, limited relevance to nephrology care, and inability to compare performance across nephrology practices, emphasizing the need for a more valid and meaningful quality assessment program. This article details the iterative consensus-building process used by the American Society of Nephrology Quality Committee from May 2020 to July 2022 to develop the Optimal Care for Kidney Health MIPS Value Pathway (MVP). Two rounds of ranked-choice voting among Quality Committee members were used to select among nine quality metrics, 43 improvement activities, and three cost measures considered for inclusion in the MVP. Measure selection was iteratively refined in collaboration with the CMS MVP Development Team, and new MIPS measures were submitted through CMS's Measures Under Consideration process. The Optimal Care for Kidney Health MVP was published in the 2023 Medicare Physician Fee Schedule Final Rule and includes measures related to angiotensin-converting enzyme inhibitor and angiotensin receptor blocker use, hypertension control, readmissions, acute kidney injury requiring dialysis, and advance care planning. The nephrology MVP aims to streamline measure selection in MIPS and serves as a case study of collaborative policymaking between a subspecialty professional organization and national regulatory agencies.
Collapse
Affiliation(s)
- Sri Lekha Tummalapalli
- Division of Healthcare Delivery Science & Innovation and Division of Nephrology & Hypertension, Weill Cornell Medicine, New York, New York
- The Rogosin Institute, New York, New York
| | - Sarah A. Struthers
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
| | | | - Amy Beckrich
- Renal Physicians Association, Rockville, Maryland
| | | | - Kevin F. Erickson
- Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, Texas
| | - Pranav S. Garimella
- Division of Nephrology-Hypertension, University of California San Diego, San Diego, California
| | - Edward R. Gould
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Nupur Gupta
- Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Krista L. Lentine
- Saint Louis University Transplant Center, SSM-Saint Louis University Hopstial, St. Louis, Missouri
| | - Susie Q. Lew
- Division of Renal Diseases and Hypertension, George Washington University, Washington, DC
| | - Frank Liu
- The Rogosin Institute, New York, New York
| | - Sumit Mohan
- Department of Medicine, Division of Nephrology, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Michael Somers
- Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel E. Weiner
- Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | | | - Mallika L. Mendu
- Division of Renal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts
| |
Collapse
|
41
|
Wang H, Xiang X, Dong L. Exploring a competency framework for the chief financial officer of a hospital: a qualitative study from China. BMC Health Serv Res 2023; 23:692. [PMID: 37370142 DOI: 10.1186/s12913-023-09711-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Hospital chief financial officer (CFO) plays a vital role in supporting the effective management of organization. Understanding their competencies is essential to improve hospital development and health care services in China. This paper aims to explore competencies necessary for hospital CFOs to fulfil their management responsibilities and develop a competency framework for hospital CFOs in China. METHODS A qualitative study was applied by conducting in-depth interviews with 151 participants from 15 Chinese provinces, comprising 89 individuals from 67 hospitals, and 62 individuals from 39 medical universities. Interviews were anonymised, recorded and transcribed. Qualitative thematic analysis was applied through a multi-stage review process and modified via the Delphi process using a national panel of 36 experts. RESULTS Using content analysis, we identified 17 competencies organized into three themes (personal attitudes, leadership competencies and managerial competencies) to conduct a competency framework for hospital CFO to fulfil their management practices. Those competencies emphasized the integration of different competencies required by the hospital CFO. CONCLUSIONS This paper identified the detailed expertise, abilities and personal traits required by hospital CFOs in China, expanding the insights and perspectives of hospital CFOs currently working in China to literature. The proposed framework will help hospitals establish selection criteria, coaching tools, and development plans for CFOs.
Collapse
Affiliation(s)
- Hongzhi Wang
- Research Center of Hospital Management and Medical Prevention, Guangxi Academy of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, China.
| | - Xin Xiang
- Institute of Fiscal and Finance, Shandong Academy of Social Sciences, Jinan, China
| | - Luping Dong
- Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| |
Collapse
|
42
|
Koskela-Staples NC, Evans C, Turner EM, Black LV, Fedele DA. The Association Between Caregiver Coping and Youth Clinic Attendance and Health-related Quality of Life in Pediatric Sickle Cell Disease. J Pediatr Hematol Oncol 2023; 45:e433-e440. [PMID: 36898015 PMCID: PMC10121850 DOI: 10.1097/mph.0000000000002636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 01/11/2023] [Indexed: 03/12/2023]
Abstract
Caregivers of youth with sickle cell disease (SCD) influence the youth disease management and psychosocial outcomes. Effective caregiver coping is important for improving disease management and outcomes since caregivers often report high disease-related parenting stress. This study characterizes caregiver coping and examines its relation to youth clinic nonattendance and health-related quality of life (HRQOL). Participants were 63 youth with SCD and their caregivers. Caregivers completed the Responses to Stress Questionnaire-SCD module to assess primary control engagement (PCE; attempts to change stressors or reactions to stress), secondary control engagement (SCE; strategies to adapt to stress), and disengagement (avoidance) coping. Youth with SCD completed the Pediatric Quality of Life Inventory-SCD module. Medical records were reviewed for the hematology appointment nonattendance rates. Coping factors were significantly different ( F [1.837, 113.924]=86.071, P <0.001); caregivers reported more PCE ( M =2.75, SD =0.66) and SCE ( M =2.78, SD =0.66) than disengagement ( M =1.75, SD =0.54) coping. Responses to short-answer questions corroborated this pattern. Greater caregiver PCE coping was associated with lower youth nonattendance (β=-0.28, P =0.050), and greater caregiver SCE coping was related to higher youth HRQOL (β=0.28, P =0.045). Caregiver coping is related to improved clinic attendance and HRQOL in pediatric SCD. Providers should assess caregiver coping styles and consider encouraging engagement coping.
Collapse
Affiliation(s)
| | - Corinne Evans
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL
| | - Elise M Turner
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL
| | | | - David A Fedele
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL
| |
Collapse
|
43
|
Cortez GFP, Barbosa GZ, Tôrres LHDN, Unfer B. Reasons for and consequences of tooth loss in adults and elderly people in Brazil: a qualitative metasynthesis. CIENCIA & SAUDE COLETIVA 2023; 28:1413-1424. [PMID: 37194875 DOI: 10.1590/1413-81232023285.01632022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/18/2022] [Indexed: 05/18/2023] Open
Abstract
The objective was to analyze and systematize evidence reported in qualitative studies on the reasons and consequences of tooth loss in adults and elderly people in Brazil. A systematic review of the literature on qualitative research methods and a meta synthesis of the results were performed. The study population consisted of adults over 18 years of age and elderly people in Brazil. Searches were performed in the BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO and SciELO databases. The thematic synthesis identified 8 analytical themes regarding reasons for tooth loss and 3 analytical themes regarding consequences of tooth loss. Dental pain, care model, financial situation and desire for prosthetic rehabilitation were determining factors for extractions. There was recognition of negligence in oral care, and the naturalness of tooth loss was linked to old age. Missing teeth caused psychological and physiological impacts. It is imperative to verify whether the factors that cause tooth loss persist, and how much those factors influence decisions to extract teeth among current young and adult populations. It is necessary to change the care model through the inclusion and qualification of oral health care for the young and elderly adult populations; otherwise, the model of dental mutilation and the culture of edentulism will persist.
Collapse
Affiliation(s)
| | | | | | - Beatriz Unfer
- Universidade Federal de Santa Maria. Santa Maria RS Brasil
| |
Collapse
|
44
|
Schubert S, Buus N, Monrouxe LV, Hunt C. The development of professional identity in clinical psychologists: A scoping review. MEDICAL EDUCATION 2023. [PMID: 36922739 DOI: 10.1111/medu.15082] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/16/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Our professional identity refers to our sense of who we are and how we should behave as professionals. Professional identities are developed through socialisation processes: Established ways of knowing and doing are acquired and reproduced. The professional identities of health care professionals have implications for the realisation of health care reforms that require new ways of being and doing from clinicians. Tension and frustration can arise when professional identities are incongruent with reform directions. More knowledge is required about the professional identities of mental health care professionals-including clinical psychologists-so that they can be supported to develop professional identities that align with health care system reforms. METHOD We undertook a scoping review of existing literature aiming to (i) identify the relevant literature; (ii) review the literature quality; (iii) thematically summarise the literature findings; (iv) consult with clinical psychologists; and (v) identify recommendations for research, training and practice. RESULTS A systematic database search (PsycINFO, CINAHL, Scopus and Web of Science) identified 24 relevant published articles and dissertations. Quantitative studies were excluded due to their markedly different research focus. Included studies were independently reviewed and findings summarised. Findings were organised around three themes: 'integration of personal and professional identities', 'intersectionality' and 'changes in professional identity over time'. Research quality issues were identified. The trustworthiness of the findings was corroborated in consultation with clinical psychologists. DISCUSSION Clinical psychologists recognise their professional identities as being interrelated with their personal identities and changing over time. They recognised professional identity as important yet inadequately considered in the profession. The research area is emerging yet remains undertheorised and requires improved research methodologies. Future theoretically informed research is required to build up a credible research base to better understand the development of clinical psychologists' professional identities so that this process can be facilitated to enable the realisation of health care reforms.
Collapse
Affiliation(s)
- Samantha Schubert
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Niels Buus
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Lynn V Monrouxe
- The Faculty of Medicine and Health, The University of Sydney-Waranara, Sydney, New South Wales, Australia
| | - Caroline Hunt
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
45
|
Arévalo Velásquez CL, Ocampo Cañas JA, Buitrago Echeverri MT. Social determination of alcohol consumption among Indigenous peoples in Colombia: a qualitative meta-synthesis. BMC Public Health 2023; 23:478. [PMID: 36915079 PMCID: PMC10009970 DOI: 10.1186/s12889-023-15233-6] [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: 07/18/2022] [Accepted: 02/07/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Alcohol consumption is a social phenomenon that involves society, groups, and individuals from different cultures around the world. Among some Indigenous groups located in Colombia, South America, alcohol consumption has been present in their lives, where contradictory processes occur and generate public health attention. We aimed to analyze qualitative research findings on alcohol consumption among Indigenous peoples in Colombia. METHODS This article used the qualitative meta-synthesis methodology, which included: (a) comprehensive search strategy, (b) appraisal of qualitative research reports, (c) findings classification, and (d) synthesis. Databases were searched for papers published from 2004 to 2019 in SCOPUS, LILACS, PROQUEST, and JSTOR, among other sources of information. A total of 2,159 papers were reviewed and finally, 13 studies were included in this meta-synthesis. The synthesis of findings included a constant comparative analysis and also aimed for the articulation of its findings to alternative perspectives in a predefined matrix. RESULTS Nine Indigenous ethnic groups of Colombia were represented in the 13 articles analyzed. From the analysis emerged the symbolic approach "Alcohol: a chameleon that unpredictable society colors" as the meta-theme of this research. This reflects four social processes that influence interaction with alcohol: Dynamic Systems Mergers (Indigenous system, influence of non-Indigenous system); Diverse Authority Spheres (parenting, Indigenous authority, school, university, religious and spiritual, traditional medicine); Between Transculturation and Interculturality (cultural crises effects and dynamism); and the Paradoxes of the Normalization of Alcohol (reasons, functions, and types of alcohol consumption). Likewise, these results support the social determination of health and sociocultural epidemiology perspectives, as being an adequate way of explaining a complex phenomenon. CONCLUSION Alcohol consumption among Indigenous peoples in Colombia is a social construction. Alcohol acts as an instrument, which is present in the changing relationships and tensions of social processes. This is reflected in harmonies, or disharmonies, in the life of Indigenous Colombians, which take place in a historical, sociocultural, economic, and political context. The results provide a reference point to guide practice and research but also reiterate the need to include the social determination of health perspective in public policies, as a path to the understanding of alcohol consumption.
Collapse
Affiliation(s)
- Canma Liliana Arévalo Velásquez
- Health Systems, Childhood, Gender, Interculturality, and Tropical Diseases Research Track. Public Health, Medical Education, and Medical Professionalism Research Group. School of Medicine and School of Government, University of the Andes, Bogotá, Colombia
| | - Jovana Alexandra Ocampo Cañas
- Health Systems, Childhood, Gender, Interculturality, and Tropical Diseases Research Track. Public Health, Medical Education, and Medical Professionalism Research Group. School of Medicine and School of Government, University of the Andes, Bogotá, Colombia.
| | | |
Collapse
|
46
|
Sabatini S, Ukoumunne OC, Ballard C, Collins R, Kim S, Corbett A, Aarsland D, Hampshire A, Brooker H, Clare L. What does feeling younger or older than one's chronological age mean to men and women? Qualitative and quantitative findings from the PROTECT study. Psychol Health 2023; 38:324-347. [PMID: 34353194 DOI: 10.1080/08870446.2021.1960989] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE We explored which factors are associated with subjective age (SA), i.e. feeling younger, the same as, or older than one's chronological age, and whether these factors differ between men and women and between two age sub-groups. DESIGN Cross-sectional study using qualitative and quantitative data for 1457 individuals (mean age= 67.2 years). MAIN OUTCOME MEASURES Participants reported how old they feel they are and provided comments in relation to their SA judgments. RESULTS By using content analysis participants' comments were assigned to 13 categories, grouped into three higher-order categories (antecedents of age-related thoughts, mental processes, and issues when measuring subjective age). SA may result from the interaction between factors that increase or decrease age-related thoughts and mental processes that individuals use to interpret age-related changes. Chi-squared tests show that individuals reporting an older SA are more likely to experience significant negative changes and to engage in negative age-related thoughts than individuals reporting an age-congruent SA or a younger SA. Women experience a more negative SA and more age-salient events than men. CONCLUSION Individuals reporting an older SA may benefit from interventions promoting adaptation to negative age-related changes. There is the need to eradicate negative societal views of older women.
Collapse
Affiliation(s)
- Serena Sabatini
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Obioha C Ukoumunne
- NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, United Kingdom
| | - Clive Ballard
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Rachel Collins
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Sarang Kim
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, Australia
| | - Anne Corbett
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Dag Aarsland
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Helen Brooker
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom.,Ecog Pro Ltd, Bristol, United Kingdom
| | - Linda Clare
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom.,NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, United Kingdom
| |
Collapse
|
47
|
Patient Preferences and Satisfaction With Decisions in Stage-III Melanoma: A Mixed Methods Study. J Surg Res 2023; 283:485-493. [PMID: 36436284 DOI: 10.1016/j.jss.2022.10.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/15/2022] [Accepted: 10/07/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Rapid accumulation of data in surgical and medical oncology has changed the treatment landscape for patients with stage-III melanoma, introducing options for active surveillance and adjuvant systemic therapy; however, these options have increased the complexity of decision making. METHODS We conducted an explanatory sequential mixed-methods study consisting of surveys and semistructured interviews among patients diagnosed with stage-III melanoma at a single institution from August 2019 to December 2021. The survey included the validated 30-point satisfaction with decision scale (SWD). The interview guide was developed using a shared decision-making framework. RESULTS Twenty-six participants completed the survey (response rate 40%) and 17 were interviewed. In the survey, 69% of participants reported receiving a recommendation for active surveillance and 23% received a recommendation for adjuvant systemic therapy. Overall SWD for treatment of the lymph node basin and adjuvant systemic therapy was high at 27.94 and 26.21 out of 30, respectively. In the interviews, participants stressed the importance of the physician's recommendation as well as the desire to minimize intervention and avoid potential side effects in their decisions. However, they demonstrated persistent knowledge gaps in their understanding of the treatment options. CONCLUSIONS Like other cancer types where the option for active surveillance exists, the physician's recommendation is influential in shaping decisions for patients with stage-III melanoma. Physicians can improve shared decision making in this complex treatment landscape through improved multidisciplinary collaboration and mechanisms for ensuring patients' understanding of the treatment options.
Collapse
|
48
|
Kleiner MJ, Walton DM. A Pan-Canadian Perspective on Education and Training Priorities for Physiotherapists. Part 2: Professional Interactions and Context of Practice. Physiother Can 2023; 75:55-64. [PMID: 37250727 PMCID: PMC10211380 DOI: 10.3138/ptc-2020-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 07/05/2021] [Accepted: 07/17/2021] [Indexed: 02/11/2024]
Abstract
Purpose: Canadian physiotherapists who participated in the Physio Moves Canada (PMC) project of 2017 identified the state of training programmes as a threat facing professional growth of the discipline. One purpose of the project was to identify priority areas for physiotherapist training programmes as identified by academics and clinicians across Canada. Method: The PMC project included a series of interviews and focus groups conducted across clinical sites in every Canadian province and in Yukon Territory. Data were interpreted using descriptive thematic analysis; identified sub-themes were returned to participants for reflection. Results: Overall, 116 physiotherapists and 1 physiotherapy assistant participated in 10 focus groups and 26 semi-structured interviews. Results are presented using the curriculum guidelines of the time for organization. Here we describe two themes: Physiotherapy Professional Interactions, further defined by interpersonal and interprofessional competencies, and Context of Practice further defined by advocacy, leadership, community awareness, and business competencies. Conclusions: Participants appear to express a desire for programmes to train reflexive and adaptable primary health care practitioners with strong foundational knowledge and clinical expertise, complemented by interpersonal and interprofessional skills to empower physiotherapists to effectively care and advocate for patients, to lead health care teams, and to share ideas to inspire change towards a future of physiotherapy practice.
Collapse
Affiliation(s)
- Michelle J. Kleiner
- Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - David M. Walton
- Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| |
Collapse
|
49
|
Kleiner MJ, Walton DM. A Pan-Canadian Perspective on Education and Training Priorities for Physiotherapists. Part 1: Foundations for Clinical Practice. Physiother Can 2023; 75:42-52. [PMID: 37250737 PMCID: PMC10211381 DOI: 10.3138/ptc-2020-0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/16/2021] [Accepted: 06/06/2021] [Indexed: 02/11/2024]
Abstract
Purpose: Canadian physiotherapists who participated in the Physio Moves Canada (PMC) project of 2017 identified the current state of training programmes as a threat facing professional growth of the discipline in Canada. One purpose of this project was to identify key priority areas for physiotherapist training programmes as identified by academics and clinicians across Canada. Method: The PMC project included a series of interviews and focus groups conducted across clinical sites in every Canadian province and in the Yukon Territory. Data were interpreted using descriptive thematic analysis; identified sub-themes were returned to participants for reflection. Results: Overall, 116 physiotherapists and 1 physiotherapy assistant participated in 10 focus groups and 26 semi-structured interviews. Participants identified critical appraisal of continuing professional development options, knowledge translation, cultural fluency, professionalism, pharmaceutical knowledge, and clinical reasoning as priorities. For clinical practice specifically, participants identified practical knowledge, scope of practice, exercise prescription, health promotion, care of complex patients, and digital technologies as the priorities. Conclusion: Training priorities identified by participants may be useful to physiotherapy educators in preparing graduates to be adaptable and flexible primary health care providers for the future needs of a diverse population.
Collapse
Affiliation(s)
- Michelle J. Kleiner
- Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - David M. Walton
- Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| |
Collapse
|
50
|
Couprie C, van der Steen JT. Talking about Meaning and Loss with Relatives of Persons with Dementia: An Ethnographic Study in a Nursing Home. Geriatrics (Basel) 2023; 8:geriatrics8010023. [PMID: 36826365 PMCID: PMC9956037 DOI: 10.3390/geriatrics8010023] [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: 12/22/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/08/2023] Open
Abstract
Advance care planning (ACP) can help prepare for future losses and decisions to be taken. However, relatives of persons with dementia may wait for healthcare professionals to initiate ACP conversations which may not adequately address their individual information needs. To evaluate inducing and enhancing conversations about meaning and loss, we conducted an ethnographic study on nurse-led ACP conversations using a question prompt list (QPL) on six dementia wards of a nursing home in the Netherlands from January to September 2021. Staff received training in using the QPL, with information and sample questions to inspire relatives to ask their questions, in particular on meaning and loss. Thematic analysis was applied to transcribed interviews and memos of observations. Nursing staff in particular was concerned about having to be available to answer questions continuously. Relatives used the study as an opportunity to get in touch with professionals, and they saw the QPL as an acknowledgement of their needs. There was a mismatch in that staff wished to discuss care goals and complete a care plan, but the relatives wanted to (first) address practical matters. A QPL can be helpful to conversations about meaning and loss, but nursing staff need dedicated time and substantial training. Joint agenda setting before the conversation may help resolve a mismatch in the preferred topics and timing of conversations.
Collapse
Affiliation(s)
- Caroline Couprie
- Department of Theology and Religion Studies, Spiritual Care, VU Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands
- Pieter van Foreest, Kalfjeslaan 2, 2623 AA Delft, The Netherlands
- Correspondence:
| | - Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Gebouw 3, 2300 RC Leiden, The Netherlands
- Department of Primary and Community Care and Radboudumc Alzheimer Center, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| |
Collapse
|