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Chow YP, Wong CW, Blair M, Choi T. Transition to work: A qualitative exploration of Australian-trained international dietetic graduates' career trajectories. J Hum Nutr Diet 2024. [PMID: 39011842 DOI: 10.1111/jhn.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Interest in the role of employability in student-dietitian transitions is increasing. However, little is known about the cross-cultural transition-to-work experience of Australian-trained dietetic graduates of international backgrounds, as well as strategies to optimise work-readiness. The present study aimed to explore graduates' career narratives and identify employability capitals that enabled successful transitions to work. METHODS A qualitative interpretive approach was employed via a cultural lens. Eighteen participants from five Asian countries who had graduated from an Australian university within 3-15 years, with work experience in Australia or in their respective home countries, took part in in-depth interviews. Thematic analysis was performed, guided by the graduate capitals based approach. RESULTS Transition-to-work was dynamic and non-linear; four themes and 12 subthemes identified: (1) upon graduation, participants felt ambivalent about their decision to either stay in Australia or return home, influenced by graduate visa restrictions, and individual perceptions of their ability to mobilise cultural strengths to gain employment; (2) to get a foot in the door, participants demonstrated resilience, embraced uncertainty and utilised social networks to increase employment opportunities in Australia and their home countries; (3) regardless of which country they worked, graduates reported struggling with their cross-cultural identities in the workplace; and (4) eventually, these graduates appreciated their ethnic capital, thrived in their work and extended a helping hand to their junior cross-cultural dietitians. CONCLUSIONS Initiatives facilitating connections to the host country and supporting cultural and ethnic capital development, along with ongoing research reviewing employability capital applications, will benefit cross-cultural dietetic graduates and the communities they potentially will serve.
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Affiliation(s)
- Ying Pik Chow
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Cho Wan Wong
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Merran Blair
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Tammie Choi
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
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Subramaniam A, Mehta KK. Exploring the Lived Experiences of Caregiving for Older Family Members by Young Caregivers in Singapore: Transition, Trials, and Tribulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:182. [PMID: 38397673 PMCID: PMC10888348 DOI: 10.3390/ijerph21020182] [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: 01/14/2024] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Amidst population ageing trends and epidemiological transitions, there has been a growing emergence of young family caregivers, about whom most studies have been conducted in Western countries. Their subjective experiences and perceptions toward caregiving remain underexplored in Asia. This qualitative study explored the lived experiences of caregiving for older family members by young caregivers in Singapore. Interpretative phenomenological analysis was employed to collect and analyse data from semi-structured, in-depth interviews with six young adult caregivers aged between 23 and 29. Interviews were supplemented with photo-elicitation techniques to deepen interview discussions and uncover experiential significance. Findings illustrated transitions into caregiving, challenges across role conflicts and expectations amidst developmental tasks and transitions, and navigation of intergenerational conflicts and ambivalence. Although no definitive conclusions can be reached from this small-scale study, the findings offer important insights into the convergence and intensity of young caregivers' experiences. Given that caregiving challenges are likely to continue amidst Singapore's rapidly ageing population, these necessitate further in-depth research efforts. Implications for policy and practice across multiple stakeholders interfacing with youth and older adults are presented. A whole-of-society approach is called for to enable young caregivers to realise their full potential while contributing to their ageing families and nation.
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Affiliation(s)
- Araviinthansai Subramaniam
- S R Nathan School of Human Development, Singapore University of Social Sciences, Singapore 599494, Singapore;
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Stenkjaer RL, Egerod I, Moszkowicz M, Collet MO, Weis J, Ista E, Greisen G, Herling SF. The parent perspective on paediatric delirium and an associated care bundle: A qualitative study. J Adv Nurs 2024. [PMID: 38186225 DOI: 10.1111/jan.16048] [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: 11/12/2023] [Revised: 11/27/2023] [Accepted: 12/17/2023] [Indexed: 01/09/2024]
Abstract
AIMS To explore how parents experienced their child with delirium and how parents viewed our delirium management bundle. DESIGN We conducted a qualitative exploratory descriptive study using semi-structured individual or dyad interviews. METHODS Twelve semi-structured interviews with 16 parents of 12 critically ill children diagnosed with delirium in a paediatric intensive care unit were conducted from October 2022 to January 2023 and analysed through a reflexive thematic analysis. FINDINGS We generated five themes: (1) knowing that something is very wrong, (2) observing manifest changes in the child, (3) experiencing fear of long-term consequences, (4) adding insight to the bundle, and (5) family engagement. CONCLUSION The parents in our study were able to observe subtle and manifest changes in their child with delirium. This caused fear of lasting impact. The parents regarded most of the interventions in the delirium management bundle as relevant but needed individualization in the application. The parents requested more information regarding delirium and a higher level of parent engagement in the care of their child during delirium. IMPACT This paper contributes to understanding how parents might experience delirium in their critically ill child, how our delirium management bundle was received by the parents, and their suggestions for improvement. Our study deals with critically ill children with delirium, their parents, and staff working to prevent and manage paediatric delirium (PD) in the paediatric intensive care unit. REPORTING METHOD The consolidated criteria for reporting qualitative research guidelines were used to ensure the transparency of our reporting. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution to the research design. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL COMMUNITY?: - It increases awareness of the parent's perspective on PD in critically ill children. - It shows how PD might affect parents, causing negative emotions such as distress, frustration, and fear of permanent damage. - It shows that the parents in our study, in addition to the care bundle, requested more information on delirium and more involvement in the care of their delirious child.
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Affiliation(s)
- Rikke Louise Stenkjaer
- Department of Intensive Care for Infants and Toddlers, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ingrid Egerod
- Department of Intensive Care, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Mala Moszkowicz
- Child and Adolescent Mental Health, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marie Oxenbøll Collet
- Department of Intensive Care, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Janne Weis
- Department of Intensive Care for Infants and Toddlers, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Erwin Ista
- Division of Pediatric Intensive Care, Department of Neonatal and Pediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Gorm Greisen
- Department of Intensive Care for Infants and Toddlers, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Suzanne Forsyth Herling
- Department of Neuroanaesthesiology, Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Bailey DS, Harding D. Professional identity and role perception of Radiographers and Clinical Technologists in Nuclear Medicine - An exploratory qualitative study. Radiography (Lond) 2024; 30:73-79. [PMID: 37871368 DOI: 10.1016/j.radi.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION An awareness of Professional Identity (PI), an individual's identity in relation to their professional group, and Role Perception (RP), an individual's view of their specific role, may enable safe and effective practice by providing an understanding of professional boundaries, behaviours and activities. This research aimed to explore and gain an understanding of the PI and RP of Radiographers and Clinical Technologists working as Nuclear Medicine Technologists (NMT's). METHODS 10 NMT's were recruited from a large National Health Service (NHS) Trust. Utilising the established methodology of Qualitative Description, data was obtained using semi-structured interviews and analysed using inductive thematic analysis. RESULTS Four themes were identified: "Becoming the Unexpected" which detailed various training pathways; "Caring with Science" which described the NMT's role and defined their PI; "Same View, Different Lens" which portrayed how Radiographers and Clinical Technologists practise as team of NMT's; and "Confirmation of Professional Self" which presented how individuals view their professional status. CONCLUSION The study showed that the NMT role is highly specialised, multi-faceted and patient-centred. Their professional status is based on the nature of their role and their university level education and training. They work together under the umbrella title of NMT with a dual professional identity of "provider of care" and "user of science and technology". However, they may have an individual identity of Radiographer or Clinical Technologist that is determined by their training pathway. IMPLICATIONS FOR PRACTICE This research has provided valuable understanding of the PI and RP of NMT's. By highlighting the differences in the regulatory status of this workforce, an insight into the future implications in the context of national healthcare planning has been provided, highlighting potentially significant issues that may impact on the manner in which NMT's can practice.
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Affiliation(s)
- D S Bailey
- Workforce, Education & Professional Development Lead, Department of Nuclear Medicine, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK.
| | - D Harding
- Centre for Allied Health, St George's University of London, Cranmer Terrace, London SW17 0RE, UK.
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Stryczek KC, Honsberger M, Ball SL, Barnard JG, Young JP, Felker B, Au DH, Ho PM, Kirsh SR, Sayre GG. VA Outreach Is an Essential Area for Improving Veterans' Health Care Accessibility. Mil Med 2023; 188:e2439-e2447. [PMID: 36790439 DOI: 10.1093/milmed/usad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/05/2022] [Accepted: 01/25/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION The Veterans Health Administration (VHA) is tasked with providing access to health care to veterans of military service. However, many eligible veterans have either not yet enrolled or underutilized VHA services. Further study of barriers to access before veterans enroll in VHA care is necessary to understand how to address this issue. The ChooseVA (née MyVA Access) initiative aims to achieve this mission to improve veterans' health care access. Although veteran outreach was not specifically addressed by the initiative, it is a critical component of improving veterans' access to health care. Findings from this multisite evaluation of ChooseVA implementation describe sites' efforts to improve VHA outreach and veterans' experiences with access. MATERIALS AND METHODS This quality improvement evaluation employed a multi-method qualitative methodology, including 127 semi-structured interviews and 81 focus groups with VHA providers and staff ("VHA staff") completed during 21 VHA medical center facility site visits between July and November 2017 and 48 telephone interviews with veterans completed between May and October 2018. Interviews and focus groups were transcribed and analyzed using deductive and inductive analysis to capture challenges and strategies to improve VHA health care access (VHA staff data), experiences with access to care (veteran data), barriers and facilitators to care (staff and veteran data), contextual factors, and emerging categories and themes. We developed focused themes describing perceived challenges, descriptions of VHA staff efforts to improve veteran outreach, and veterans' experiences with accessing VHA health care. RESULTS VHA staff and veteran respondents reported a lack of veteran awareness of eligibility for VHA services. Veterans reported limited understanding of the range of services offered. This awareness gap served as a barrier to veterans' ability to successfully access VHA health care services. Veterans described this awareness gap as contributing to delayed VHA enrollment and delayed or underutilized health care benefits and services. Staff focused on community outreach and engaging veterans for VHA enrollment as part of their efforts to implement the ChooseVA access initiative. Staff and veteran respondents agreed that outreach efforts were helpful for engaging veterans and facilitating access. CONCLUSIONS Although efforts across VHA programs informed veterans about VHA services, our results suggest that both VHA staff and veterans agreed that missed opportunities exist. Gaps include veterans' lack of awareness or understanding of VHA benefits for which they qualify for. This can result in delayed access to care which may negatively impact veterans, including those separating from the military and vulnerable populations such as veterans who experience pregnancy or homelessness.
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Affiliation(s)
- Krysttel C Stryczek
- VA Northeast Ohio Healthcare System, Research & Development, Cleveland, OH 44106, USA
| | - Mark Honsberger
- VA Northeast Ohio Healthcare System, Research & Development, Cleveland, OH 44106, USA
| | - Sherry L Ball
- VA Northeast Ohio Healthcare System, Research & Development, Cleveland, OH 44106, USA
| | - Juliana G Barnard
- VA Eastern Colorado Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Aurora, CO 80045, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Jessica P Young
- VA Puget Sound Health Care System, Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA 98108, USA
| | - Bradford Felker
- VA Puget Sound Health Care System, Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA 98108, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
| | - David H Au
- VA Puget Sound Health Care System, Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA 98108, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195-6522, USA
| | - P Michael Ho
- VA Eastern Colorado Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, Aurora, CO 80045, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Susan R Kirsh
- The U.S. Department of Veterans Affairs Central Office, Washington, DC 20420, USA
| | - George G Sayre
- VA Puget Sound Health Care System, Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA 98108, USA
- Department of Health Services, University of Washington School of Public Health, Seattle, WA 98195, USA
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Eaton TL, Lewis A, Donovan HS, Davis BC, Butcher BW, Alexander SA, Iwashyna TJ, Scheunemann LP, Seaman J. Examining the needs of survivors of critical illness through the lens of palliative care: A qualitative study of survivor experiences. Intensive Crit Care Nurs 2023; 75:103362. [PMID: 36528461 DOI: 10.1016/j.iccn.2022.103362] [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: 03/29/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine the needs of adult survivors of critical illness through a lens of palliative care. RESEARCH METHODOLOGY A qualitative study of adult survivors of critical illness using semi-structured interviews and framework analysis. SETTING Participants were recruited from the post-intensive care unit clinic of a mid-Atlantic academic medical center in the United States. FINDINGS Seventeen survivors of critical illness aged 34-80 (median, 66) participated in the study. The majority of patients were female (64.7 %, n = 11) with a median length of index ICU stay of 12 days (interquartile range [IQR] 8-19). Interviews were conducted February to March 2021 and occurred a median of 20 months following the index intensive care stay (range, 13-33 months). We identified six key themes which align with palliative care principles: 1) persistent symptom burden; 2) critical illness as a life-altering experience; 3) spiritual changes and significance; 4) interpreting/managing the survivor experience; 5) feelings of loss and burden; and 6) social support needs. CONCLUSION Our findings suggest that palliative care components such as symptom management, goals of care discussions, care coordination, and spiritual and social support may assist in the assessment and treatment of survivors of critical illness.
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Affiliation(s)
- Tammy L Eaton
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, USA; National Clinician Scholars Program (NCSP), Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
| | - Anna Lewis
- School of Public Health, Department of Health Policy and Management, University of Pittsburgh, PA, USA; Care Management Department, University of Pittsburgh Medical Center Mercy Hospital, Pittsburgh, PA, USA
| | - Heidi S Donovan
- Department of Health & Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA; Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, PA, USA
| | - Brian C Davis
- School of Law, Duquesne University, Pittsburgh, PA, USA
| | - Brad W Butcher
- Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sheila A Alexander
- Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA; Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Theodore J Iwashyna
- Department of Medicine, Division of Pulmonary & Critical Care, University of Michigan, Ann Arbor, MI, USA; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Leslie P Scheunemann
- Division of Geriatric Medicine and Gerontology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer Seaman
- Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Gabay G, Ben-Asher S. An Adlerian-Based Narrative Inquiry of Temporal Awareness, Resilience, and Patient-Centeredness Among Emergency Physicians-The Gyroscope Model. QUALITATIVE HEALTH RESEARCH 2022; 32:2090-2101. [PMID: 36342077 DOI: 10.1177/10497323221134759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Although extensive research examined time perceptions among patients in the emergency department (ED), studies on temporal awareness among emergency physicians is scant. Salutogenics is the theoretical anchor. METHODS The sample comprised ten emergency resident physicians from an Israeli public tertiary hospital. Narrative interviews were conducted. To determine the theme of the study, Adlerian narrative analysis was performed. To identify categories, semantic and content analyses were performed. RESULTS Adlerian narrative analysis highlighted temporal awareness as a strong theme across interviews. Semantic and content analyses identified categories within temporal awareness. Analyses revealed a movement among three subcategories: A clinical task in which physicians rapidly shift along seven distinct times, temporal awareness shaping their work experience, and temporal awareness as inhibiting or enabling relationships with patients. Data-analyses identified two groups of physicians, one group driven by the need to control the time to avoid errors, experiencing anxiety and poor wellbeing, and the other, shifting from clinical tasks to patient-centeredness while removing the time factor from their considerations and experiencing resilience through manageability and meaningfulness. We introduce the "gyroscope model" for physicians to illustrate these findings and propose recommendations for practice. DISCUSSION Understanding the complexity of the temporal continuum and the influence of shifting from the clinical task to relationships with patients may contribute to resilience of resident physician in the ED and to their self-efficacy, enriching their professional skills and capacity to cope and grow while facing the complexity of the ED.
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Affiliation(s)
- Gillie Gabay
- 42717Achva Academic College, Multi-Disciplinary Studies, Shikmim, IsraelSmadar Ben-Asher contributed equally to this work
| | - Smadar Ben-Asher
- 42717Achva Academic College, Multi-Disciplinary Studies, Shikmim, IsraelSmadar Ben-Asher contributed equally to this work
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Mancus GC, Cimino AN, Hasan MZ, Campbell JC, Sharps P, Winch PJ, Tsuyuki K, Stockman JK. Greenness and the Potential Resilience to Sexual Violence: "Your Neighborhood Is Being Neglected Because People Don't Care. People With Power Don't Care". JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP17344-NP17368. [PMID: 34210177 DOI: 10.1177/08862605211028009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is increasing evidence that green space in communities reduces the risk of aggression and violence, and increases wellbeing. Positive associations between green space and resilience have been found among children, older adults and university students in the United States, China and Bulgaria. Little is known about these associations among predominately Black communities with structural disadvantage. This study explored the potential community resilience in predominately Black neighborhoods with elevated violent crime and different amounts of green space. This embedded mixed-methods study started with quantitative analysis of women who self-identified as "Black and/or African American." We found inequality in environments, including the amount of green space, traffic density, vacant property, and violent crime. This led to 10 indepth interviews representing communities with elevated crime and different amounts of green space. Emergent coding of the first 3 interviews, a subset of the 98 in the quantitative analysis, led to a priori coding of barriers and facilitators to potential green space supported community resilience applied to the final 7 interview data. Barriers were a combination of the physical and social environment, including traffic patterns, vacant property, and crime. Facilitators included subjective qualities of green space. Green spaces drew people in through community building and promoting feelings of calmness. The transformation of vacant lots into green spaces by community members affords space for people to come together and build community. Green spaces, a modifiable factor, may serve to increase community resilience and decrease the risk of violence.
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Affiliation(s)
| | | | - Md Zabir Hasan
- The University of British Columbia, Vancouver, British Columbia, BC, Canada
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Moore EJ, Thew M. Exploring the perspectives of ‘young adults’ (18–24) who have been in formal care and their experiences of attending a socially prescribed community allotment gardening group. Br J Occup Ther 2022. [DOI: 10.1177/03080226221117447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Young adults who have experienced periods of time being ‘in care’ are one of the most socially deprived populations within society, with their needs largely unmet and often not fully understood. Despite the significant attempts to invest in community-based ‘social prescribing’ interventions to address such health inequalities, there is a dearth of understanding regarding how such occupation-based community groups are experienced by this particular population. This UK based qualitative study aimed to explore the experiences of young adult ‘Care Leavers’ regarding their participation in a socially prescribed community gardening group. Method: Semi-structured online interviews were conducted with six young care leavers aged between 18 and 24 years who regularly participated in a community gardening group. Interviews were recorded transcribed verbatim and analysed Braun and Clarke’s Thematic Analysis process by two researchers to maximise validity. Findings: Four key themes emerged: ‘Social belonging and connection’, ‘A safe space’, ‘Sense of achievement from active engagement’ and ‘The facilitatory aspects of nature’. The findings suggested nature-based co-occupation within a local group, enhanced social capital, self-identity and wellbeing. Conclusion: This study supports the emerging scope of using community occupation-based interventions with young adult ‘Care Leavers’ and offers an insight into their particular needs.
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Affiliation(s)
- Emma J Moore
- School of Health, Leeds Beckett University, Leeds, UK
| | - Miranda Thew
- School of Health, Leeds Beckett University, Leeds, UK
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Gabay G, Ben-Asher S. An Inverted Container in Containing and Not Containing Hospitalized Patients—A Multidisciplinary Narrative Inquiry. Front Public Health 2022; 10:919516. [PMID: 35875012 PMCID: PMC9304809 DOI: 10.3389/fpubh.2022.919516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivePatient-centered care calls to contain patients in their time of crisis. This study extends the knowledge of provider patient interactions in the hectic environment of acute care applying Bion's container-contained framework from psychoanalysis.MethodsFollowing ethical approval, we performed a narrative inquiry of the experiences of ten patients upon discharge from lengthy hospitalizations in acute care. Interviews were conducted upon discharge and about one-month post-discharge.FindingsData analysis suggests four modes of containing of patients by providers. In nurturing interactions, typical of an active container-contained mode, patients experienced humanized care, symptom control, hope, and internal locus of control. This mode yielded patient gratitude toward providers, wellbeing, and post-discharge self-management of diseases. In rigid and wall-free modes of containing, patients experienced a sense of powerlessness and discomfort. A new mode of container-contained was identified, the “Inverted Container”, which extends Bion's theory and contradicts patient-centered care. In inverted containers, patients contained the providers yet reported feeling gratitude toward providers. The gratitude constitutes a defense mechanism and reflects a traumatic experience during hospitalization, which led to post-discharge distrust in providers and hospitals and poor self-management of illness.ConclusionsTo effectively provide patient-centered care, provider-patient interaction in lengthy hospitalizations must move along a clinical axis and a relationship axis. This shifting may facilitate containing patients in their time of crisis so essential processes of reflection, projection, and transference are facilitated in-hospital care.
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Affiliation(s)
- Gillie Gabay
- Multi-Disciplinary Studies, Achva Academic College, Shikmim, Israel
- *Correspondence: Gillie Gabay
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Happy Birthday? Relative Age Benefits and Decrements on the Rocky Road. Sports (Basel) 2022; 10:sports10060082. [PMID: 35736822 PMCID: PMC9230912 DOI: 10.3390/sports10060082] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: There is abundant literature in talent development investigating the relative age effect in talent systems. There is also growing recognition of the reversal of relative age advantage, a phenomenon that sees significantly higher numbers of earlier born players leaving talent systems before the elite level. However, there has been little investigation of the mechanisms that underpin relative age, or advantage reversal. This paper aimed to investigate (a) the lived experience of relative age in talent development (TD) systems, (b) compare the experience of early and late born players, and (c) explore mechanisms influencing individual experiences. (2) Methods: interviews were conducted with a cohort of near elite and elite rugby union players. Data were subsequently analysed using reflexive thematic analysis and findings considered in light of eventual career status. (3) Results: challenge was an ever-present feature of all players journeys, especially at the point of transition to senior rugby. Psycho-behavioural factors seemed to be a primary mediator of the response to challenge. (4) Conclusions: a rethink of approach to the relative age effect is warranted, whilst further investigations of mechanisms are necessary. Relative age appears to be a population-level effect, driven by challenge dynamics.
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Evaluating and Characterizing an Individually-Tailored Community Exercise Program for Older Adults With Chronic Neurological Conditions: A Mixed-Methods Study. J Aging Phys Act 2022; 30:1047-1060. [PMID: 35294924 DOI: 10.1123/japa.2021-0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/10/2022] [Accepted: 02/04/2022] [Indexed: 11/18/2022]
Abstract
A mixed-methods approach was used to study an individually-tailored community exercise program for people with a range of chronic neurological conditions (e.g., stroke, spinal cord injury, brain injury, multiple sclerosis, Parkinson's disease) and abilities. The program was delivered to older adults (mean age: 62 ± 9 years) with chronic neurological conditions across a 12-week and an 8-week term. Participants attended 88% of sessions and completed 89% of prescribed exercises in those sessions. There were no adverse events. Clinically important improvements were achieved by all evaluated participants (n = 8) in at least one testing domain (grip strength, lower-extremity strength, aerobic endurance, and balance). Interviews with participants identified key program elements as support through supervision, social connection, individualized programming, and experiential learning. Findings provide insight into elements that enable a community exercise program to meet the needs of a complex and varied group. Further study will support positive long-term outcomes for people aging with neurological conditions.
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Exploring the acceptability of a WHO school-based mental health program in Egypt: A qualitative study. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Owczarzak J, Smith KC. Implications of the Revised Common Rule for Qualitative Health Research: Opportunities, Concerns, and Recommendations. QUALITATIVE HEALTH RESEARCH 2022; 32:385-393. [PMID: 34874221 DOI: 10.1177/10497323211061101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In January 2019, revisions to federal regulations that outline requirements for ethical oversight of human subjects research (The Revised Common Rule) went into effect. These revisions reflect major changes in thinking about risk and protection of research subjects. The Revised Common Rule (RCR) considerably curtails federal oversight of social and behavioral science, with most non-interventional research and "benign" behavioral interventions becoming exempt from mandated Institutional Review Board (IRB) approval, although determination of exemption remains with IRBs. As two qualitative health researchers serving on IRBs, we consider how this contraction of federal oversight dovetails with longstanding criticisms of IRB oversight of qualitative research. We explore the passage of the RCR as a point of potentially important change in procedure and principle in relation to ethical oversight of qualitative health research. We identify challenges and opportunities with these changes at the institutional, professional, and individual levels for ethical and impactful qualitative research.
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Affiliation(s)
- Jill Owczarzak
- 1466Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Katherine C Smith
- 1466Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Merminod G, Weber O, Vaucher C, Semlali I, Terrier A, Decosterd I, Rubli Truchard E, Singy P. Communication About Chronic Pain in Older Persons' Social Networks: Study Protocol of a Qualitative Approach. Front Public Health 2021; 9:764584. [PMID: 34805077 PMCID: PMC8595239 DOI: 10.3389/fpubh.2021.764584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
A lack of social relations appears to impact on health and life expectancy among the older persons. The quality and diversity of social relations are correlated with good health and well-being in later life. Chronic pain is a crucial issue in aging population. Effective communication between the older persons with chronic pain, their relatives and the actors of the healthcare system facilitates the management of this condition. Studies on communication in later life generally do not consider the older persons' social network as a whole, focusing only a specific segment (e.g., family or medical staff). This lack of scientific data prevents the actors of the healthcare system from offering solutions to bridge clinically relevant communication gaps. As a consequence, our study has three objectives: (1) to identify how the older persons perceive communication about chronic pain with their social network; (2) to identify their unmet communication needs; (3) to develop recommendations that improve communication about chronic pain in later life. The study will be divided into two phases. The first phase will meet objectives 1 and 2. It will involve individual interviews with about 50 people over 75 years old suffering from chronic pain and without major cognitive or auditory troubles. In this phase, we will apply a multi-layered analysis. We will map the older persons' personal network and identify their communication practices and needs, by combining content and discourse analysis with social network theories. The second phase of the study will aim at recommendations based on the results of the first phase (objective 3). It will require focus groups with different sets of stakeholders (older persons, relative caregivers, health professionals, decision-makers). In the second phase, we will use content analysis to pinpoint the concerns and suggestions for action. The results will be disseminated on three levels: (1) to the scientific world (specialists in the field of health and aging and health communication); (2) to health practitioners working with older persons; (3) to society at large, with a focus on institutions and groups directly concerned by the issue.
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Affiliation(s)
- Gilles Merminod
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Orest Weber
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Carla Vaucher
- Institute of Social Sciences, Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Imane Semlali
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Anamaria Terrier
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Isabelle Decosterd
- Pain Center, Service of Anesthesiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Eve Rubli Truchard
- Geriatrics and Geriatric Rehabilitation Service and Chair of Geriatric Palliative Care, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Singy
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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Gabay G, Tarabeih M. Underground COVID-19 Home Hospitals for Haredim: Non-Compliance or a Culturally Adapted Alternative to Public Hospitalization? JOURNAL OF RELIGION AND HEALTH 2021; 60:3434-3453. [PMID: 34476658 PMCID: PMC8412871 DOI: 10.1007/s10943-021-01407-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 05/07/2023]
Abstract
This thematic study analyzed the experiences of Jewish Haredi (Lithuanian) patients in underground home hospitals during the second wave of COVID-19 in Israel. This minority comprises 12.6% of the Israeli population. Participants were 30 members of this hidden population, ages 59-78. Haredi complied with community directives rather than with the national directive of hospitalizing COVID-19 patient only at public hospitals. Compliance with community directives was driven by a distrust in health authorities and clinicians at public hospitals; by the preference of patient-centered care, a desired approach of care that public hospitals fail to implement; by the need to sustain beliefs, values, and traditions; by community leadership; and by the need to conserve political power. While health authorities view underground home hospitals as demonstrating non-compliance with the national directive, Haredi leaders view underground home hospitals as demonstrating a self-sufficient, patient-centered care alternative to public hospitalizations. Considering the benefits of patient-centered care and the growth of the multi-cultural global landscape, we call upon health authorities to explore the accommodation of patient-centered care for COVID-19 patients and the designing of an adaptive multi-cultural policy that address multi-cultural aspects of religious minorities as key to health promotion. We propose ways to implement multi-cultural policies.
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Affiliation(s)
- Gillie Gabay
- School of Multi-Disciplinary Studies, Achva Academic College, 7980400 Arugot, Israel
| | - Mahdi Tarabeih
- Faculty of Nursing, Tel-Aviv-Jaffa Academic College, Tel-Aviv, Israel
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Moriña A. When people matter: The ethics of qualitative research in the health and social sciences. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1559-1565. [PMID: 33170531 DOI: 10.1111/hsc.13221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/28/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
When research involves people, ethics are fundamental. In the health and social sciences, when qualitative methodologies are used, in addition to ensuring an ethical process approved by the ethics review board, it is also necessary to guarantee an ethical practice capable of responding adequately to the complex questions and dilemmas which arise as the study progresses. This theoretical article analyses some of the most sensitive issues involved in qualitative research and discusses the following questions: (a) How should ethics be approached when working with vulnerable groups? (b) Is informed consent enough? (c) Should we rethink anonymity? (d) What is the difference between confidentiality and anonymity? (e) What exactly do we mean by relational ethics? (f) How can we avoid hurting people, yet remain honest? In the conclusions, we discuss some basic aspects for ensuring ethical studies. This paper, therefore, may be of interest to all health and social researchers concerned about ensuring that their studies comply with ethical principles which recognise, protect and respect participants' rights.
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Affiliation(s)
- Anabel Moriña
- Departament of Teaching and Educational Organization, Faculty of Education, Universidad de Sevilla, Seville, Spain
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Scheffelaar A, Janssen M, Luijkx K. The Story as a Quality Instrument: Developing an Instrument for Quality Improvement Based on Narratives of Older Adults Receiving Long-Term Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052773. [PMID: 33803372 PMCID: PMC7967278 DOI: 10.3390/ijerph18052773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 11/25/2022]
Abstract
The individual experiences of older adults in long-term care are broadly recognized as an important source of information for measuring wellbeing and quality of care. Narrative research is a special type of qualitative research to elicit people’s individual, diverse experiences in the context of their lifeworld. Narratives are potentially useful for long-term care improvement as they can provide a rich description of an older adult’s life from their own point of view, including the provided care. Little is known about how narratives can best be collected and used to stimulate learning and quality improvement in long-term care for older adults. The current study takes a theoretical approach to developing a narrative quality instrument for care practice in order to discover the experiences of older adults receiving long-term care. The new narrative quality instrument is based on the available literature describing narrative research methodology. The instrument is deemed promising for practice, as it allows care professionals to collect narratives among older adults in a thorough manner for team reflection in order to improve the quality of care. In the future, the feasibility and usability of the instrument will have to be empirically tested.
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Grace D, Gaspar M, Klassen B, Lessard D, Anand P, Brennan DJ, Lachowsky N, Adam BD, Cox J, Lambert G, Jollimore J, Hart TA. Stepping Stones or Second Class Donors?: a qualitative analysis of gay, bisexual, and queer men's perspectives on plasma donation policy in Canada. BMC Public Health 2021; 21:444. [PMID: 33663450 PMCID: PMC7932904 DOI: 10.1186/s12889-021-10480-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background Men who have sex with men (MSM) are not eligible to donate blood or plasma in Canada if they have had sex with another man in the last 3 months. This time-based deferment has reduced since 2013; from an initial lifetime ban, to five-years, one-year, and now three-months. Our previous research revealed that gay, bisexual, queer, and other MSM (GBM) supported making blood donation policies gender-neutral and behaviour-based. In this analysis, we explored the willingness of Canadian GBM to donate plasma, even if they were not eligible to donate blood. Methods We conducted in-depth interviews with 39 HIV-negative GBM in Vancouver (n = 15), Toronto (n = 13), and Montreal (n = 11), recruited from a large respondent-driven sampling study called Engage. Men received some basic information on plasma donation prior to answering questions. Transcripts were coded in NVivo following inductive thematic analysis. Results Many GBM expressed a general willingness to donate plasma if they became eligible; like with whole blood donation, GBM conveyed a strong desire to help others in need. However, this willingness was complicated by the fact that most participants had limited knowledge of plasma donation and were unsure of its medical importance. Participants’ perspectives on a policy that enabled MSM to donate plasma varied, with some viewing this change as a “stepping stone” to a reformed blood donation policy and others regarding it as insufficient and constructing GBM as “second-class” donors. When discussing plasma, many men reflected on the legacy of blood donor policy-related discrimination. Our data reveal a significant plasma policy disjuncture—a gulf between the critical importance of plasma donation from the perspective of Canada’s blood operators and patients and the feelings of many GBM who understood this form of donation as less important. Conclusions Plasma donor policies must be considered in relation to MSM blood donation policies to understand how donor eligibility practices are made meaningful by GBM in the context of historical disenfranchisement. Successful establishment of a MSM plasma donor policy will require extensive education, explicit communication of how this new policy contributes to continued/stepwise reform of blood donor policies, and considerable reconciliation with diverse GBM communities.
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Affiliation(s)
- Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
| | - Mark Gaspar
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Benjamin Klassen
- Community-Based Research Centre, 1007-808 Nelson Street, Vancouver, BC, V6Z 2H2, Canada
| | - David Lessard
- Centre for Health Outcomes Research, McGill University Health Centre, 5252 de Maisonneuve West, Montréal, QC, H4A 3S5, Canada
| | - Praney Anand
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - David J Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada
| | - Nathan Lachowsky
- Community-Based Research Centre, 1007-808 Nelson Street, Vancouver, BC, V6Z 2H2, Canada.,School of Public Health & Social Policy, Faculty of Human & Social Development, University of Victoria, P.O. Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Barry D Adam
- Department of Sociology, Anthropology, and Criminology, University of Windsor, 401 Sunset Ave, Windsor, ON, N9B 3P4, Canada
| | - Joseph Cox
- Direction de santé publique de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 1560 Sherbrooke St E, Montreal, QC, H2L 4M1, Canada
| | - Gilles Lambert
- Direction de santé publique de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 1560 Sherbrooke St E, Montreal, QC, H2L 4M1, Canada
| | - Jody Jollimore
- Community-Based Research Centre, 1007-808 Nelson Street, Vancouver, BC, V6Z 2H2, Canada
| | - Trevor A Hart
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Department of Psychology, HIV Prevention Lab, Ryerson University, 350 Victoria St, Toronto, ON, M5B 2K3, Canada
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The Focus They Deserve: Improving Women Veterans' Health Care Access. Womens Health Issues 2021; 31:399-407. [PMID: 33582001 DOI: 10.1016/j.whi.2020.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 12/18/2020] [Accepted: 12/24/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE Veterans Health Administration (VHA) initiatives aim to provide veterans timely access to quality health care. The focus of this analysis was provider and staff perspectives on women veterans' access in the context of national efforts to improve veterans' access to care. METHODS We completed 21 site visits at Veterans Health Administration medical facilities to evaluate the implementation of a national access initiative. Qualitative data collection included semistructured interviews (n = 127), focus groups (n = 81), and observations with local leadership, administrators, providers, and support staff across primary and specialty care services at each facility. Deductive and inductive content analysis was used to identify barriers, facilitators, and contextual factors affecting implementation of initiatives and women veterans' access. RESULTS Participants identified barriers to women veterans' access and strategies used to improve access. Barriers included a limited availability of providers trained in women's health and gender-specific care services (e.g., women's specialty care), inefficient referral and coordination with community providers, and psychosocial factors (e.g., childcare). Participants also identified issues related to childcare and perceived harassment in medical facility settings as distinct access issues for women veterans. Strategies focused on increasing internal capacity to provide on-site women's comprehensive care and specialty services by streamlining provider training and credentialing, contracting providers, using telehealth, and improving access to community providers to fill gaps in women's services. Participants also highlighted efforts to improve gender-sensitive care delivery. CONCLUSIONS Although some issues affect all veterans, problems with community care referrals may disproportionately affect women veterans' access owing to a necessary reliance on community care for a range of gender-specific services.
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Shamim MS, Torda A, Baig LA, Zubairi N, Balasooriya C. Systematic development and refinement of a contextually relevant strategy for undergraduate medical ethics education: a qualitative study. BMC MEDICAL EDUCATION 2021; 21:9. [PMID: 33407410 PMCID: PMC7786930 DOI: 10.1186/s12909-020-02425-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Delivery of medical ethics education is complex due to various reasons, compounded by the context-dependent nature of the content. The scarcity of relevant resources in the contexts of some developing countries adds a further layer of difficulty to ethics education in these contexts. We used a consultative approach with students, teachers and external experts to develop a practical approach to medical ethics education. This study aimed to develop and refine a contextually relevant approach to ethics education in the region of Saudi Arabia. METHODS The study utilised an explorative qualitative methodology to seek views of students and faculty of Rabigh Faculty of Medicine, Saudi Arabia, and international experts in the field of ethics and education to review and enhance a new ethics learning strategy which included a workbook-based tool. Three focus groups with 12 students, in-depth interviews with four faculty members and qualitative feedback from eleven external experts enabled the study participants to objectively critique the WBEL and provide feedback to enhance its quality. Thematic content analysis of the data was done to draw inferences which were used to refine the educational strategy. RESULTS The analysis generated twenty-one sub-themes within four main themes: design features, content, teaching methods and assessment. These findings helped to design the educational strategy to improve its effectiveness in the given context. CONCLUSION The study drew on the views of students, faculty and external experts to systematically develop a novel approach to ethics education for countries like Saudi Arabia. It also demonstrated the use of the consultative approach for informing a culturally relevant educational strategy in the Middle East context.
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Affiliation(s)
- Muhammad Shahid Shamim
- Dow Institute of Health Professionals Education, Dow University of Health Sciences, Karachi, Pakistan
- Scholar at the University of New South Wales, Sydney, Australia
| | - Adrienne Torda
- UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Lubna A. Baig
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Nadeem Zubairi
- Lead for Ethics & Professionalism Course at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Chinthaka Balasooriya
- Medical Education Development, School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
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Grace D, Gaspar M, Klassen B, Lessard D, Brennan DJ, Lachowsky NJ, Adam BD, Cox J, Lambert G, Anand P, Jollimore J, Moore D, Hart TA. It's in Me to Give: Canadian Gay, Bisexual, and Queer Men's Willingness to Donate Blood If Eligible Despite Feelings of Policy Discrimination. QUALITATIVE HEALTH RESEARCH 2020; 30:2234-2247. [PMID: 32887538 PMCID: PMC7649935 DOI: 10.1177/1049732320952314] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Blood donation policies governing men who have sex with men have shifted significantly over time in Canada-from an initial lifetime ban in the wake of the AIDS crisis to successive phases of time-based deferment requiring periods of sexual abstinence (5 years to 1 year to 3 months). We interviewed 39 HIV-negative gay, bisexual, queer, and other sexual minority men (GBM) in Vancouver, Toronto, and Montreal to understand their willingness to donate blood if eligible. Transcripts were coded following inductive thematic analysis. We found interrelated and competing expressions of biological and sexual citizenship. Most participants said they were "safe"/"low risk" and "willing" donors and would gain satisfaction and civic pride from donation. Conversely, a smaller group neither prioritized the collectivizing biological citizenship goals associated with expanding blood donation access nor saw this as part of sexual citizenship priorities. Considerable repair work is required by Canada's blood operators to build trust with diverse GBM communities.
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Affiliation(s)
- Daniel Grace
- The University of Toronto, Toronto, Ontario, Canada
- Daniel Grace, Dalla Lana School of Public Health, The University of Toronto, 155 College Street, 5th Floor, Room 556, Toronto, Ontario, Canada M5T 3M7.
| | - Mark Gaspar
- The University of Toronto, Toronto, Ontario, Canada
| | - Benjamin Klassen
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | | | | | | | | | - Joseph Cox
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada
| | - Gilles Lambert
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada
| | - Praney Anand
- The University of Toronto, Toronto, Ontario, Canada
| | - Jody Jollimore
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - David Moore
- The University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
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Silverio SA, Bewley S, Montgomery E, Roberts C, Richens Y, Maxted F, Sandall J, Montgomery J. Disclosure of non-recent (historic) childhood sexual abuse: What should researchers do? JOURNAL OF MEDICAL ETHICS 2020; 47:medethics-2020-106343. [PMID: 33172909 PMCID: PMC8639901 DOI: 10.1136/medethics-2020-106343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 05/02/2023]
Abstract
Non-recent (historic) childhood sexual abuse is an important issue to research, though often regarded as taboo and frequently met with caution, avoidance or even opposition from research ethics committees. Sensitive research, such as that which asks victim-survivors to recount experiences of abuse or harm, has the propensity to be emotionally challenging for both the participant and the researcher. However, most research suggests that any distress experienced is usually momentary and not of any clinical significance. Moreover, this type of research offers a platform for voices which have often been silenced, and many participants report the cathartic effect of recounting their experiences in a safe, non-judgemental space. With regard to the course of such research, lines of inquiry which ask adult participants to discuss their experiences of childhood sexual abuse may result in a first-time disclosure of that abuse by the victim-survivor to the researcher. Guidance about how researchers should respond to first-time disclosure is lacking. In this article, we discuss our response to one research ethics committee which had suggested that for a qualitative study for which we were seeking ethical approval (investigating experiences of pregnancy and childbirth having previously survived childhood sexual abuse), any disclosure of non-recent (historic) childhood sexual abuse which had not been previously reported would result in the researcher being obliged to report it to relevant authorities. We assess this to be inconsistent with both law and professional guidance in the United Kingdom; and provide information and recommendations for researchers and research ethics committees to consider.
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Affiliation(s)
- Sergio A Silverio
- Department of Women & Children's Health, King's College London, Westminster, London, UK
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Bloomsbury, London, UK
| | - Susan Bewley
- Department of Women & Children's Health, King's College London, Westminster, London, UK
| | - Elsa Montgomery
- Department of Midwifery, King's College London, Waterloo, London, UK
| | - Chelsey Roberts
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Bloomsbury, London, UK
| | - Yana Richens
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, Bloomsbury, London, UK
- Maternity Services, University College London Hospitals NHS Foundation Trust, Fitzrovia, London, UK
| | - Fay Maxted
- The Survivors Trust, Rugby, Warwickshire, UK
| | - Jane Sandall
- Department of Women & Children's Health, King's College London, Westminster, London, UK
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia
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The impact of including babies on the effectiveness of dialectical behaviour therapy skills groups in a community perinatal service. Behav Cogn Psychother 2020; 49:172-184. [PMID: 33081865 DOI: 10.1017/s1352465820000673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Perinatal mental illnesses are a major public health issue, which untreated can have devastating impacts on women and their families. Problems with emotion regulation are a common feature across perinatal mental illnesses. AIMS This study sought to evaluate the impacts of dialectical behaviour therapy (DBT) skills groups for mothers and babies in a community perinatal service. We hypothesised that community perinatal DBT skills groups that included babies would reduce distress and improve emotional regulation. METHOD A mixed-methods within-subjects design was utilised with outcome measures collected pre- and post-intervention. Qualitative interviews exploring mothers' experiences of bringing their baby to group were also conducted. RESULTS Results indicated that DBT skills groups significantly improved levels of psychological distress and emotional regulation. CONCLUSIONS Community perinatal DBT skills groups are effective when babies are present. Moreover, benefits of including babies were identified, under the themes of Self as Mother, Shared Experience, and Impact of Babies.
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Rutakumwa R, Mugisha JO, Bernays S, Kabunga E, Tumwekwase G, Mbonye M, Seeley J. Conducting in-depth interviews with and without voice recorders: a comparative analysis. QUALITATIVE RESEARCH : QR 2020; 20:565-581. [PMID: 32903872 PMCID: PMC7444018 DOI: 10.1177/1468794119884806] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The use of audio recordings has become a taken-for-granted approach to generating transcripts of in-depth interviewing and group discussions. In this paper we begin by describing circumstances where the use of a recorder is not, or may not be, possible, before sharing our comparative analysis of audio-recorded transcriptions and interview scripts made from notes taken during the interview (by experienced, well-trained interviewers). Our comparison shows that the data quality between audio-recorded transcripts and interview scripts written directly after the interview were comparable in the detail captured. The structures of the transcript and script were usually different because in the interview scripts, topics and ideas were grouped, rather than being in the more scattered order of the conversation in the transcripts. We suggest that in some circumstances not recording is the best approach, not 'second best'.
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Affiliation(s)
| | | | - Sarah Bernays
- School of Public Health, University of Sydney, Australia; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, UK
| | | | | | - Martin Mbonye
- MRC/UVRI and LSHTM Uganda Research Unit, Uganda; Child Health and Development Centre, Makerere University, Uganda
| | - Janet Seeley
- Janet Seeley, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
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Tudball J, Reddel HK, Laba TL, Jan S, Flynn A, Goldman M, Lembke K, Roughead E, Marks GB, Zwar N. General practitioners' views on the influence of cost on the prescribing of asthma preventer medicines: a qualitative study. AUST HEALTH REV 2020; 43:246-253. [PMID: 29754592 DOI: 10.1071/ah17030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 01/19/2018] [Indexed: 12/25/2022]
Abstract
Objective Out-of-pocket costs strongly affect patient adherence with medicines. For asthma, guidelines recommend that most patients should be prescribed regular low-dose inhaled corticosteroids (ICS) alone, but in Australia most are prescribed combination ICS-long-acting β2-agonists (LABA), which cost more to patients and government. The present qualitative study among general practitioners (GPs) explored the acceptability, and likely effect on prescribing, of lower patient copayments for ICS alone. Methods Semistructured telephone interviews were conducted with 15 GPs from the greater Sydney area; the interviews were transcribed and thematically analysed. Results GPs reported that their main criteria for selecting medicines were appropriateness and effectiveness. They did not usually discuss costs with patients, had low awareness of out-of-pocket costs and considered that these were seldom prohibitive for asthma patients. GPs strongly believed that patient care should not be compromised to reduce cost to government. They favoured ICS-LABA combinations over ICS alone because they perceived that ICS-LABA combinations enhanced adherence and reduced costs for patients. GPs did not consider that lower patient copayments for ICS alone would affect their prescribing. Conclusion The results suggest that financial incentives, such as lower patient copayments, would be unlikely to encourage GPs to preferentially prescribe ICS alone, unless accompanied by other strategies, including evidence for clinical effectiveness. GPs should be encouraged to discuss cost barriers to treatment with patients when considering treatment choices. What is known about the topic? Australian guidelines recommend that most patients with asthma should be treated with low-dose ICS alone to minimise symptom burden and risk of flare ups. However, most patients in Australian general practice are instead prescribed combination ICS-LABA preventers, which are indicated if asthma remains uncontrolled despite treatment with ICS alone. It is not known whether GPs are aware that the combination preventers have a higher patient copayment and a higher cost to government. What does this paper add? This qualitative study found that GPs favoured combination ICS-LABA inhalers over ICS alone because they perceived ICS-LABA combinations to have greater effectiveness and promote patient adherence. This aligned with GPs' views that their primary responsibility was patient care rather than generating cost savings for government. However, it emerged that GPs rarely discussed medicine costs with patients, had low knowledge of medicine costs to patients and the health system and reported that patients rarely volunteered cost concerns. GPs believed that lower patient copayments for asthma preventer medicines would have little effect on their prescribing practices. What are the implications for practitioners? This study suggests that, when considering asthma treatment choices, GPs should empathically explore with the patient whether cost-related medication underuse is an issue, and should be aware of the option of lower out-of-pocket costs with guideline-recommended ICS alone treatment. Policy makers must be aware that differential patient copayments for ICS preventer medicines are unlikely to act as an incentive for GPs to preferentially prescribe ICS alone preventers, unless the position of these preventers in guidelines and evidence for their clinical effectiveness are also reiterated.
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Affiliation(s)
| | - Helen K Reddel
- Woolcock Institute of Medical Research, University of Sydney, 431 Glebe Point Rd, Glebe, NSW 2037, Australia. Email
| | - Tracey-Lea Laba
- The George Institute for Global Health, University of New South Wales, Sydney, Level 5, 1 King Street, Newtown NSW 2042, Australia.
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, Level 5, 1 King Street, Newtown NSW 2042, Australia.
| | - Anthony Flynn
- Asthma Australia Ltd, Level 13, 799 Pacific Hwy, Chatswood NSW 2067, Australia.
| | - Michele Goldman
- Asthma Australia Ltd, Level 13, 799 Pacific Hwy, Chatswood NSW 2067, Australia.
| | - Kirsty Lembke
- NPS MedicineWise, PO Box 1147 Strawberry Hills NSW 2012. Email
| | - Elizabeth Roughead
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, CEA-19, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Email
| | - Guy B Marks
- Woolcock Institute of Medical Research, University of Sydney, 431 Glebe Point Rd, Glebe, NSW 2037, Australia. Email
| | - Nick Zwar
- School of Public Health and Community Medicine, University of New South Wales Sydney, NSW 2052, Australia
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Luchtenberg ML, Maeckelberghe ELM, Verhagen AE. 'I actually felt like I was a researcher myself.' On involving children in the analysis of qualitative paediatric research in the Netherlands. BMJ Open 2020; 10:e034433. [PMID: 32868347 PMCID: PMC7462149 DOI: 10.1136/bmjopen-2019-034433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To evaluate the feasibility of a new approach to paediatric research whereby we involved children in analysing qualitative data, and to reflect on the involvement process. SETTING This was a single-centre, qualitative study in the Netherlands. It consisted of research meetings with individual children at home (Phase I) or group meetings at school (Phase II). In Phase I, we identified themes from a video interview during five one-on-one meetings between a child co-researcher and the adult researcher. In Phase II, during two group meetings, we explored the themes in detail using fragments from 16 interviews. PARTICIPANTS We involved 14 school children (aged 10 to 14 years) as co-researchers to analyse children's interviews about their experience while participating in medical research. Notes were taken, and children provided feedback. A thematic analysis was performed using a framework approach. RESULTS All co-researchers identified themes. The time needed to complete the task varied, as did the extent to which the meetings needed to be structured to improve concentration. The children rated time investment as adequate and they considered acting as co-researcher interesting and fun, adding that they had learnt new skills and gained new knowledge. The experience also led them to reflect on health matters in their own lives. The adult researchers considered the process relatively time intensive, but the project did result in a more critical assessment of their own work. CONCLUSION The new, two-phase approach of involving children to help analyse qualitative data is a feasible research method. The novelty lies in involving children to help identify themes from original interview data, thereby limiting preselection of data by adults, before exploring these themes in detail. Videos make it easier for children to understand the data and to empathise with the interviewees, and limits time investment.
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Affiliation(s)
- Malou L Luchtenberg
- University of Groningen, Groningen, The Netherlands
- Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Els L M Maeckelberghe
- Institute for Medical Education, University of Groningen, Groningen, The Netherlands
- University Medical Center Groningen, Groningen, The Netherlands
| | - Aa Eduard Verhagen
- University of Groningen, Groningen, The Netherlands
- Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands
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Lewis G, Rowa-Dewar N, O’Donnell R. Stigma and Smoking in the Home: Parents' Accounts of Using Nicotine Replacement Therapy to Protect Their Children from Second-Hand Smoke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4345. [PMID: 32560517 PMCID: PMC7345858 DOI: 10.3390/ijerph17124345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022]
Abstract
Evidence and campaigns highlighting smoking and second-hand smoke risks have significantly reduced smoking prevalence and denormalised smoking in the home in Scotland. However, smoking prevalence remains disproportionally high in socioeconomically disadvantaged groups. Using stigma as a theoretical lens, this article presents a thematic analysis of parents' accounts of attempting to abstain from smoking at home, using nicotine replacement therapy (NRT), in disadvantaged areas of Edinburgh and the Lothians. Smoking stigma, particularly self-stigma, underpinned accounts, with two overarching themes: interplaying barriers and enablers for creation of a smoke-free home and reconceptualisation of the study as an opportunity to quit smoking. Personal motivation to abstain or stop smoking empowered participants to reduce or quit smoking to resist stigma. For those struggling to believe in their ability to stop smoking, stigma led to negative self-labelling. Previously hidden smoking in the home gradually emerged in accounts, suggesting that parents may fear disclosure of smoking in the home in societies where smoking stigma exists. This study suggests that stigma may act both as an enabler and barrier in this group. Reductions in smoking in the home were dependent on self-efficacy and motivations to abstain, and stigma was entwined in these beliefs.
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Affiliation(s)
- Grace Lewis
- School of Healthcare, University of Leeds, Leeds LS2 9JT, UK
| | - Neneh Rowa-Dewar
- USHER Institute, University of Edinburgh, Edinburgh, H8 9AG, UK;
| | - Rachel O’Donnell
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, UK;
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Tasdik Hasan M, Adhikary G, Mahmood S, Papri N, Shihab HM, Kasujja R, Ahmed HU, Azad AK, Nasreen M. Exploring mental health needs and services among affected population in a cyclone affected area in costal Bangladesh: a qualitative case study. Int J Ment Health Syst 2020; 14:12. [PMID: 32165918 PMCID: PMC7059662 DOI: 10.1186/s13033-020-00351-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background Bangladesh, one of the most densely populated countries in the world has been ranked 9th on the Climate Risk Index for 2017: the 10 most affected countries & 7th on the Long-Term Climate Risk Index: the 10 countries most affected from 1998 to 2017. Every year it is afflicted with various climatic disasters including floods, hurricanes and cyclones. Apart from the obvious devastation of lives and property, there is a huge increase in clinical diseases when these disasters occur. Mental health of affected persons after these disasters is a topic that is often neglected by local and national level. Methods A qualitative case study was conducted on perceived need on mental health support & availability of such services in a cyclone affected area in rural Bangladesh. Ten (10) key informant interviews (KIIs) with different stakeholders and ten (10) in-depth interviews (IDIs) with affected people were taken. Findings We found that cyclones had numerous psychosocial impacts on the population including acute stress disorder, sleep disorder, post-traumatic stress disorders (PTSDs), generalized anxiety disorders, suicidal ideation and depression. The survivors had specific needs for receiving support. Children, elderly and women were perceived to be more vulnerable. The government and NGOs had no specific action plans and initiatives to address these issues and support the mental health of affected population. There was a visible gap in finding effective ways to provide affected people with the required mental health & psycho-social services (MHPSS). Conclusion Resilient, responsive and self-sustaining health systems for this vulnerable population are required. Implementation of effective mental health programs and strong mental health policies remain a challenge in Bangladesh where there is a cultural fatalistic acceptance of mental health issues.
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Affiliation(s)
- M Tasdik Hasan
- 1Department of Psychological Sciences, University of Liverpool, Liverpool, UK.,2Institute of Disaster Management & Vulnerability Studies, University of Dhaka, Dhaka, Bangladesh.,International Centre for Diarrheal Diseases Research, Dhaka, Bangladesh
| | - Gourab Adhikary
- 2Institute of Disaster Management & Vulnerability Studies, University of Dhaka, Dhaka, Bangladesh.,International Centre for Diarrheal Diseases Research, Dhaka, Bangladesh
| | - Sultan Mahmood
- 2Institute of Disaster Management & Vulnerability Studies, University of Dhaka, Dhaka, Bangladesh
| | - Nowshin Papri
- 2Institute of Disaster Management & Vulnerability Studies, University of Dhaka, Dhaka, Bangladesh.,International Centre for Diarrheal Diseases Research, Dhaka, Bangladesh
| | - Hasan M Shihab
- 4Combined Family Medicine and Preventive Medicine Program, MedStar Franklin Square Medical Centre and Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Rosco Kasujja
- 5Department of Mental Health & Community Psychology, Makerere University, Kampala, Uganda
| | | | - Abul Kalam Azad
- 2Institute of Disaster Management & Vulnerability Studies, University of Dhaka, Dhaka, Bangladesh
| | - Mahbuba Nasreen
- 2Institute of Disaster Management & Vulnerability Studies, University of Dhaka, Dhaka, Bangladesh
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O'Dwyer C, Tarzia L, Fernbacher S, Hegarty K. Health professionals' perceptions of how gender sensitive care is enacted across acute psychiatric inpatient units for women who are survivors of sexual violence. BMC Health Serv Res 2019; 19:990. [PMID: 31870375 PMCID: PMC6929426 DOI: 10.1186/s12913-019-4812-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 12/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexual violence is a global public health issue. It is a form of gender-based violence commonly experienced by women accessing mental health services. The biomedical model has been the dominant model of care in acute psychiatric units, however, there has been a global movement towards more gender-sensitive and trauma-informed models. To date, only a small amount of research has focused on evaluating these models of care and health professionals' experiences of providing this care. The aim of this study is to gain an in-depth understanding of healthcare professionals' perceptions of how Gender Sensitive Care (GSC) is enacted across acute psychiatric inpatient units for women who are survivors of sexual violence. METHODS This study used case study methodology and the Normalisation Process Theory (NPT) conceptual framework. NPT is a practical framework that can be used to evaluate the implementation of complex models of care in health settings. It included semi-structured interviews with 40 health professionals, document and policy reviews, and observations from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic and content analysis. RESULTS Themes were developed under the four NPT core constructs; 1) Understanding GSC in acute psychiatric units: "Without the corridors there's not a lot we can do", 2) Engagement and Commitment to GSC in acute psychiatric units: "There are a few of us who have that gender sensitive lens", 3) Organising, relating and involvement in GSC: "It's band aid stuff", 4) Monitoring and Evaluation of GSC in acute psychiatric units: "We are not perfect, we have to receive that feedback". DISCUSSION Many health professionals held a simplistic understanding of GSC and avoided the responsibility of implementing it. Additionally, the competing demands of the biomedical model and a lack of appraisal has resulted in an inconsistent enactment of GSC. CONCLUSIONS Health professionals in this study enacted GSC to varying levels. Our findings suggest the need to address each NPT construct comprehensively to adequately implement GSC.
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Affiliation(s)
- Carol O'Dwyer
- Department of General Practice
- Melbourne Medical School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Level 2, 780 Elizabeth Street, Melbourne, Victoria, 3010, Australia.
| | - Laura Tarzia
- Department of General Practice
- Melbourne Medical School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Level 2, 780 Elizabeth Street, Melbourne, Victoria, 3010, Australia.,The Royal Women's Hospital, Centre for Family Violence Prevention, Melbourne, 3052, Victoria, Australia
| | | | - Kelsey Hegarty
- Department of General Practice
- Melbourne Medical School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Level 2, 780 Elizabeth Street, Melbourne, Victoria, 3010, Australia.,The Royal Women's Hospital, Centre for Family Violence Prevention, Melbourne, 3052, Victoria, Australia
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A Qualitative Analysis of General Emergency Medicine Providers' Perceptions on Pediatric Emergency Telemedicine. Pediatr Emerg Care 2019; 35:856-861. [PMID: 28225376 DOI: 10.1097/pec.0000000000001067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers. METHODS Using qualitative methods, a purposeful sample of general ED providers (attending physicians and physician assistants) in 3 Connecticut hospitals participated in audio-recorded semistructured interviews. In line with grounded theory, 3 researchers independently coded transcripts, collectively refined codes, and created themes. Data collection and analysis continued in an iterative manner, past the point of theoretical saturation. RESULTS Eighteen general ED providers were interviewed. Three themes were identified: (a) familiarity with use in adult stroke patients but limited practical experience with telemedicine; (b) potential uses for pediatric telemedicine (guiding pediatric differential diagnosis and management, visual diagnosis, alleviating provider fears, low-frequency high-stakes events, determining disposition, assessing level of illness, and access to subspecialty consultation); and (c) limitations of telemedicine (infrequent need and implementation barriers). CONCLUSIONS General ED providers identified 7 specific potential uses of pediatric emergency video telemedicine. However, they also identified several limitations of telemedicine in caring for pediatric emergency patients. Further studies after implementation of telemedicine program and comparing provider perceptions with actual practice may be helpful. Furthermore, studies on telemedicine's effect on patient-related outcomes and studies on cost-effectiveness might be necessary before the widespread implementation of a telemedicine program.
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Gabay G. Patient Self-worth and Communication Barriers to Trust of Israeli Patients in Acute-Care Physicians at Public General Hospitals. QUALITATIVE HEALTH RESEARCH 2019; 29:1954-1966. [PMID: 31043144 DOI: 10.1177/1049732319844999] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Patient trust is positively related to health outcomes, but there remain barriers to patient trust in physicians. This narrative study analyzed patient experiences and highlights barriers to patient trust underlying communication with physicians in acute care. Snowball sampling was used. Informants were 12 participants, in poor physical health, upon discharge from a 3-week hospitalization in an acute-care setting at an Israeli public general hospital. Two narrative interviews were conducted with each participant upon and after discharge. Findings suggest presurgery barriers to trust (lack of acknowledgment of patient's crisis, underrating patient's autonomy, and use of unique empathy) and postsurgery barriers to trust (lack of attentive listening, lack of medical professionalism, and delegitimization to patients' self-alienation). Two common narrative identities emerged linking trust with self-worth. To build trust, physicians are called upon to extend their dedication from dedication to improve clinical outcomes to dedication to improve clinical outcomes and preserve patients' self-worth.
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Affiliation(s)
- Gillie Gabay
- The College of Management Academic Studies, Rishon LeZion, Israel
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Cescutti-Butler L, Hewitt-Taylor J, Hemingway A. Powerless responsibility: A feminist study of women's experiences of caring for their late preterm babies. Women Birth 2019; 33:e400-e408. [PMID: 31601482 DOI: 10.1016/j.wombi.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 11/28/2022]
Abstract
PROBLEM There is minimal research exploring women's experiences of caring for a late preterm baby. The emphasis in the literature is mostly baby centric. BACKGROUND The number of babies born late preterm is rising and women's views are largely unknown. AIM What are the experiences of women who are caring for a late preterm baby? METHODS A feminist lens was the key philosophical underpinning. Semi-structured interviews were undertaken with 14 women. FINDINGS Women who become mothers' of late preterm babies have a complex journey. It begins with separation, with babies being cared for in unfamiliar and highly technical environments where the perceived experts are healthcare professionals. Women's needs are side-lined, and they are required to care for their babies within parameters determined by others. Institutional and professional barriers to mothering/caring are numerous. DISCUSSION Some of the women who were separated from their babies immediately after birth had difficulties conceiving themselves as mothers, and others faced restrictions when trying to access their babies. Women described care that was centred on their babies. They were allowed and expected to care for their babies, but only with 'powerless responsibility'. Many women appeared to be excluded from decisions and were not always provided with full information about their babies. CONCLUSION Women whose babies are born late preterm would benefit from greater consideration in relation to their needs, rather than the focus being almost exclusively on their babies.
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Affiliation(s)
- Luisa Cescutti-Butler
- Bournemouth University, Faculty of Health and Social Sciences, Royal London House, Christchurch Road, Bournemouth BH1 3LT, UK.
| | - Jaque Hewitt-Taylor
- Bournemouth University, Faculty of Health and Social Sciences, Royal London House, Christchurch Road, Bournemouth BH1 3LT, UK.
| | - Ann Hemingway
- Bournemouth University, Faculty of Health and Social Sciences, Royal London House, Christchurch Road, Bournemouth BH1 3LT, UK.
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Rafeld J, Moeller-Saxone K, Cotton S, Rice S, Monson K, Harvey C, Herrman H. ‘Getting our voices out there’: acceptability of a mental health participation programme for young people with out of home care experience in Australia. Health Promot Int 2019; 35:1085-1093. [DOI: 10.1093/heapro/daz105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Youth with experience of out-of-home-care (OoHC) typically have poorer mental health than their peers in the general population, and lack opportunities to contribute to service planning. Promoting mental health through leadership training may improve young people’s mental health and facilitate system change. The Bounce Project is a pilot youth-leadership mental health training programme co-designed with young people who have experienced OoHC. In this study, we evaluated the Bounce Project from the young people’s perspectives to explore the acceptability, successes and limitations of the training to promote the participant’s mental health and their contribution to system level change. Thirteen young people aged 18–26 years old who had experienced OoHC and participated in the Bounce Project were interviewed. Semi-structured interviews were conducted and thematically analysed. Four major themes were thereby identified: making their mark; opportunities for growth; redefining roles and pitfalls of research participation. Participants valued the opportunity to have their voices heard, participate in research and learn about mental health. Perceived negative aspects included infrequent participation opportunities, interpersonal difficulties and frustration about the limitations of research including pressure to recruit and restrictive deadlines. Participating in the Bounce Project was a mostly positive experience, but young people also encountered barriers to meaningful participation. Youth with lived experience need more avenues to participate in research and leadership, but research programmes require specific designs that take into consideration the needs of participants and create opportunities for effective and meaningful participation.
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Affiliation(s)
- Jessie Rafeld
- University of Melbourne, Faculty of Medicine, Dentistry and Health Services
- Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Kristen Moeller-Saxone
- Centre for Youth Mental Health, The University of Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - Sue Cotton
- Centre for Youth Mental Health, The University of Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - Simon Rice
- Centre for Youth Mental Health, The University of Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | | | - Carol Harvey
- University of Melbourne, Faculty of Medicine, Dentistry and Health Services
- Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Australia
- NorthWestern Mental Health, Melbourne, Australia
| | - Helen Herrman
- Centre for Youth Mental Health, The University of Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
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Palar K, Lemus Hufstedler E, Hernandez K, Chang A, Ferguson L, Lozano R, Weiser SD. Nutrition and Health Improvements After Participation in an Urban Home Garden Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1037-1046. [PMID: 31601420 PMCID: PMC6949143 DOI: 10.1016/j.jneb.2019.06.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To elucidate the perceived health benefits of an urban home gardening and nutritional education program in a population at high cardiometabolic risk. DESIGN Qualitative data collected via in-depth, semistructured interviews in Spanish or English. SETTING Community-based program offering supported urban home gardening together with nutrition education in Santa Clara County, CA. PARTICIPANTS A total of 32 purposively sampled low-income participants in an urban home gardening program. Participants were primarily female (n = 24) and Latino/a (n = 22). PHENOMENON OF INTEREST Perceptions of the nutrition and health benefits of education-enhanced urban home gardening. ANALYSIS Bilingual researchers coded transcripts using a hybrid inductive and deductive approach. Two coders double coded at intervals, independently reviewed coding reports, organized content into key themes, and selected exemplary quotations. RESULTS The most salient perceived impacts were greater food access, increased consumption of fresh produce, a shift toward home cooking, and decreased fast food consumption. Participants attributed these changes to greater affordability, freshness, flavor, and convenience of their garden produce; increased health motivation owing to pride in their gardens; and improved nutritional knowledge. Participants also reported improved physical activity, mental health, and stress management; some reported improved weight and adherence to diabetes-healthy diets. CONCLUSIONS AND IMPLICATIONS Education-enhanced urban home gardening may facilitate multidimensional nutrition and health improvements in marginalized populations at high cardiometabolic risk.
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Affiliation(s)
- Kartika Palar
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA.
| | - Emiliano Lemus Hufstedler
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA; University of California, Berkeley-UCSF Joint Medical Program, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Karen Hernandez
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Annie Chang
- University of California, Berkeley-UCSF Joint Medical Program, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Laura Ferguson
- Global Health Sciences, University of California, San Francisco, San Francisco, CA
| | | | - Sheri D Weiser
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA; Institute for Global Health, Keck School of Medicine of the University of Southern California, Los Angeles, CA
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Marshall J, Kelly P, Niven A. "When I Go There, I Feel Like I Can Be Myself." Exploring Programme Theory within the Wave Project Surf Therapy Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122159. [PMID: 31216775 PMCID: PMC6617262 DOI: 10.3390/ijerph16122159] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022]
Abstract
Mental health issues in young people are a priority for health and social care. Surf therapy is an innovative intervention that may help address this health burden globally. While increasing evidence demonstrates the effectiveness of surf therapy, there has been limited exploration as to how it achieves its outcomes. Such theoretical exploration is important for service optimisation, monitoring and proliferation. This research aimed to adopt, for the first time, a rigorous grounded theory approach to explore underlying programme theory within the Wave Project surf therapy intervention. Participants (n = 22, 14 males and 8 females; mean age = 14 years, SD = 3.5, range 8-23) were interviewed about their intervention experiences. Data were analysed through constant comparative analysis and memo writing. Two core categories reflected mediators by which surf therapy may achieve its outcomes: "Self-Selected Pacing and Progression While Surfing" and "Creation of Emotional and Physical Safe Space at Beach". Three antecedent (linking known inputs to core categories) and three consequent categories (linking core categories to associated outputs) were also identified. These demonstrate theorised pathways from known inputs to associated outcomes within the intervention. These important findings provide plausible evidence on how to optimise the Wave Project's delivery in tackling mental health burden.
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Affiliation(s)
- Jamie Marshall
- School of Applied Sciences, Edinburgh Napier University, 9 Sighthill Court, Edinburgh EH11 4BN, UK.
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences The University of Edinburgh Holyrood Road, Edinburgh EH8 8AQ, UK.
| | - Paul Kelly
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences The University of Edinburgh Holyrood Road, Edinburgh EH8 8AQ, UK.
| | - Ailsa Niven
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences The University of Edinburgh Holyrood Road, Edinburgh EH8 8AQ, UK.
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Douglas LJ, Jackson D, Woods C, Usher K. Rewriting stories of trauma through peer-to-peer mentoring for and by at-risk young people. Int J Ment Health Nurs 2019; 28:744-756. [PMID: 30710411 DOI: 10.1111/inm.12579] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 11/28/2022]
Abstract
Adverse childhood experiences are strongly associated with the development of mental health disorders during the life span. When mental health issues are not effectively dealt with during the adolescent period, young people can become long-term consumers in the mental health system. A widely accepted method of intervention is the provision of mentoring. More recently, young people have been fulfilling the role of mentor to their peers and mentoring has played a large role in supporting young people who are considered at-risk of not achieving the expected psychosocial, educational, and/or developmental goals. What is not known is why young people, previously identified as being at-risk, are motivated to mentor their at-risk peers. The study aim was to examine what motivates previously recognized at-risk young people to provide mentoring to their at-risk peers. Participants were twelve previously recognized at-risk young people recruited through a formal peer-to-peer mentoring programme. Semi-structured interviews were conducted, and the data analysed through narrative inquiry and reported in accordance with the consolidated criteria for reporting qualitative research guidelines (COREQ). Results indicate that young people are motivated by their own lived experiences of trauma(s) to provide at-risk peer mentoring. The experience of mentoring afforded opportunities to rewrite individual personal journeys of trauma through mentoring their at-risk peers, thus constructing a more positive self-identity. Outcomes of developing positive peer relationships and prosocial behaviours could significantly assist mental health clinicians in providing more acceptable care to clients in an age group known to be reluctant to accept traditional mental health intervention.
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Affiliation(s)
- Lesley J Douglas
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Debra Jackson
- Faculty of Health, University of Technology, Sydney (UTS), Sydney, New South Wales, Australia
| | - Cindy Woods
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
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Douglas L, Usher K, Woods C, Jackson D. Potential challenges of using narrative inquiry with at-risk young people. Nurse Res 2019:e1619. [PMID: 31468924 DOI: 10.7748/nr.2019.e1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Being 'at risk' puts an individual in danger of future negative outcomes. Conducting qualitative research such as narrative inquiry with at-risk individuals may result in challenges for participants and researchers. AIM To present an overview of several challenges that arose when conducting narrative research with at-risk young people. DISCUSSION The main challenges were disclosure of trauma, existing relationships, insider and outsider perspectives, power relationships, and the emotional safety of participants and researchers. CONCLUSIONS It is imperative to identify potential challenges before beginning research and make plans to address them. IMPLICATION FOR PRACTICE Researchers can use this article to help plan for challenges that may arise with this kind of research with vulnerable participants.
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Affiliation(s)
- Lesley Douglas
- School of Health, University of New England, Armidale NSW, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale NSW, Australia
| | - Cindy Woods
- School of Health, University of New England, Armidale NSW, Australia
| | - Debra Jackson
- Faculty of Health and Life Sciences, Midwifery and Allied Health Research, Oxford Institute of Nursing, Oxford Brookes University, Oxford, England
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Chan SYY, Ho GWK, Bressington D. Experiences of self-stigmatization and parenting in Chinese mothers with severe mental illness. Int J Ment Health Nurs 2019; 28:527-537. [PMID: 30575250 DOI: 10.1111/inm.12558] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2018] [Indexed: 12/16/2022]
Abstract
Mental health stigma has serious ramifications on people with a severe mental illness (SMI). Stigma damages self-esteem, recovery outcomes, family relationships, socialization abilities, access to housing, and career prospects. The cultural tendencies of Chinese people have been shown to be associated with particularly high levels of stigmatization. These cultural tenets can result in high levels of self-stigma due to experiencing shame and a perceived need to keep mental illness a secret. Although there is a lack of existing evidence, it is possible that such experiences present unique challenges to Chinese mothers diagnosed with SMI when they parent their children. Therefore, this qualitative study explored the experiences of parenting and self-stigmatization of Chinese mothers with SMI. Individual semi-structured interviews were conducted with 15 mothers who were direct carers of their children aged under 18 and who were receiving community-based care in Hong Kong. Manual inductive thematic analysis was used to analyse the interview data. Three main themes related to self-stigmatization emerged from the interviews: (i) distancing and being distanced; (ii) doubting myself; and (iii) struggling for control. The experiences of self-stigmatization appeared to damage these mothers' self-efficacy, which may negatively affect their parenting self-esteem, tendency to seek professional help, and ability to manage their own mental health. Strategies to improve self-efficacy, including psychoeducation, and additional childcare support/resources are required for mothers with SMI so they can better manage and balance the demands of motherhood and their mental healthcare needs.
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Affiliation(s)
| | - Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China SAR
| | - Daniel Bressington
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China SAR
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Davis SR, Tudball J, Flynn A, Lembke K, Zwar N, Reddel HK. "You've got to breathe, you know" - asthma patients and carers' perceptions around purchase and use of asthma preventer medicines. Aust N Z J Public Health 2019; 43:207-213. [PMID: 30727033 DOI: 10.1111/1753-6405.12865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore influences on patients' purchase and use of asthma preventer medicines and the perceived acceptability of financial incentives via reduced patient co-payments. METHODS Semi-structured telephone or face-to-face interviews were conducted with adults and carers of children with asthma. Interviews were recorded, transcribed verbatim and coded. Data were analysed using thematic analysis via grounded theory. RESULTS Twenty-four adults and 20 carers for children aged 3-17 years with asthma were interviewed. For medicines choice, most participants did not consider themselves the primary decision-maker; cost of medicines was an issue for some, but effectiveness was described as more important. For adherence, cost, side-effects, perceived benefit and patient behaviours were important. CONCLUSIONS Patient barriers to adherence with asthma preventer medicines including cost are ongoing. Healthcare professionals need to encourage empathic discussion with patients about cost issues. Implications for public health: Asthma patients and carers could benefit from greater involvement and respect within shared decision-making. Healthcare professionals should be aware that cost may be a barrier for patient adherence, and provided with information about the relative costs of guideline-recommended asthma medicines. Patients and healthcare professionals need education around the efficacy of ICS-alone treatment and the rationale behind co-payments, for initiatives around quality use of medicines to succeed.
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Affiliation(s)
- Sharon R Davis
- Woolcock Institute of Medical Research, University of Sydney, New South Wales
| | | | | | | | - Nicholas Zwar
- School of Medicine; Faculty of Science, Medicine and Health University of Wollongong, New South Wales
| | - Helen K Reddel
- Woolcock Institute of Medical Research, University of Sydney, New South Wales
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Hohl SD, Ceballos R, Scott MA, Thompson B. Developing a Culturally Informed Survey Instrument to Assess Biomedical Research Participation Among Latinos on the U.S.-Mexico Border. QUALITATIVE HEALTH RESEARCH 2019; 29:445-454. [PMID: 30304993 PMCID: PMC6667166 DOI: 10.1177/1049732318801364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Racial/ethnic minorities, rural populations, and those with low socioeconomic status income are underrepresented in research in the United States (U.S.). Assessing preferences for recruitment, participation, and the role of beliefs about biomedical research in specific and unique underserved communities represents a potentially critical step in reducing barriers to biomedical research participation. We developed a culturally informed survey to measure factors related to participation, knowledge, expectations, and barriers to biomedical research participation among Latinos living in a U.S. border community. We employed a multidisciplinary team approach to a sequential, three-phase qualitative study that included interviews ( n = 35), focus groups ( n =24), and "think-aloud" cognitive interviews ( n = 5). Our study demonstrates the value of applying multiple qualitative approaches to inform a culturally relevant quantitative survey incorporating words and constructs relevant to the population of interest. The study contributes to qualitative method research paradigms by developing a research protocol that integrates the expertise and perspectives of researchers and community members from multiple disciplines and institutions.
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Affiliation(s)
- Sarah D Hohl
- 1 Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- 2 University of Washington, Seattle, Washington, USA
| | - Rachel Ceballos
- 1 Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- 2 University of Washington, Seattle, Washington, USA
| | | | - Beti Thompson
- 1 Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- 2 University of Washington, Seattle, Washington, USA
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Cescutti-Butler L, Hemingway A, Hewitt-Taylor J. “His tummy's only tiny” – Scientific feeding advice versus women's knowledge. Women's experiences of feeding their late preterm babies. Midwifery 2019; 69:102-109. [DOI: 10.1016/j.midw.2018.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/10/2018] [Accepted: 11/04/2018] [Indexed: 10/27/2022]
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Hewer R, Smith K, Fergie G. The Social Functionality of Humor in Group-Based Research. QUALITATIVE HEALTH RESEARCH 2019; 29:431-444. [PMID: 30340445 PMCID: PMC6350176 DOI: 10.1177/1049732318800675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Citizens' juries provide deliberative fora within which members of the public can debate complex policy issues. In this article, we reflect on our experience of undertaking three citizens' juries addressing health inequalities, to explore the positive and facilitative role that humor can play within group-based research focusing on sensitive health policy issues. We demonstrate how both participants and researchers engaged in the production of humor in ways which troubled prevailing power dynamics and facilitated positive relationships. We conclude by recommending that researchers, particularly health policy researchers and those pursuing the kind of lengthy group-based fora associated with deliberative research, consider the positive role humor can play when engaged reflexively. In so doing, we make a major contribution to extant literature on both deliberative fora (which is yet to consider humor's facilitative capacities) and the role of humor in qualitative (health) research (which rarely explores researcher complicity in humor production).
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Affiliation(s)
- Rebecca Hewer
- University of Edinburgh, Edinburgh,
Scotland
- Rebecca Hewer, Usher Institute, Centre for
Population Health Sciences, University of Edinburgh, Old Medical School, Teviot
Place, Edinburgh EH3 9AG, Scotland.
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Jakobsen F, Musaeus P, Kirkeby L, Hansen TB, Mørcke AM. Emotions and clinical learning in an interprofessional outpatient clinic: a focused ethnographic study. J Interprof Care 2018; 33:57-65. [PMID: 30160542 DOI: 10.1080/13561820.2018.1514372] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
During the last decade, there has been a growing recognition that emotions can be of critical importance for students' learning and cognitive development. The aim of this study was to investigate the self-reported and the observed relationship of: activity-, outcome-, epistemic-, and social emotions' role in students' learning in a clinical interprofessional context. We conducted a focused ethnography study of medical and nursing students' clinical placement in an interprofessional orthopaedic outpatient clinic where the students performed consultations with patients, together. We used content analysis to analyse observational notes and interviews. Two themes were identified. First self-regulated learning with two sub-themes: unexpected incident and reflection. The second theme was cooperative learning with three sub-themes: equality, communication, and role distribution. Participants only reported activating emotions. Negative emotions often occurred when the students together experienced an incongruity between their cognitive capability and the type of task. However, because of the possibility for students to call for a supervisor, the negative activating emotions often, in connection with reflection on the incident, resulted in a positive emotion due to the students' awareness of having acquired new knowledge and capability, and thereby, learning. It is important to be aware of the close interplay between emotions and clinical learning in an interprofessional context. The learning environment must include easy access for supervision.
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Affiliation(s)
- Flemming Jakobsen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Aarhus University, Denmark
| | - Peter Musaeus
- Centre for Health Sciences Education, Aarhus University, Denmark
| | - Lone Kirkeby
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Aarhus University, Denmark
| | - Torben Bæk Hansen
- University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Aarhus University, Denmark
| | - Anne Mette Mørcke
- Copenhagen Academy for Medical Education and Simulation, The Capital Region of Denmark
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45
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Scrine E, McFerran K. The role of a music therapist exploring gender and power with young people: Articulating an emerging anti-oppressive practice. ARTS IN PSYCHOTHERAPY 2018. [DOI: 10.1016/j.aip.2017.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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46
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Morgan K, Reidlinger DP, Sargeant S, Crane L, Campbell KL. Challenges in preparing the dietetics workforce of the future: An exploration of dietetics educators' experiences. Nutr Diet 2018; 76:382-391. [PMID: 29900652 DOI: 10.1111/1747-0080.12438] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/03/2018] [Accepted: 05/15/2018] [Indexed: 11/29/2022]
Abstract
AIM Dietetics educators represent a small but influential workforce group that has experienced significant change in recent years. The workforce development challenges faced by this group have been largely unexplored. The present study aimed to explore the experiences of, and challenges faced by, academic dietetics educators in preparing dietitians for the workforce. METHODS The approach taken in the present study was informed by qualitative description. Fifteen dietetics educators employed by 13 universities across Australia were purposively sampled. In-depth, semi-structured interviews conducted via telephone (n = 12) or face-to-face (n = 3) were digitally recorded then transcribed verbatim. Data were managed with NVivo and inductively analysed using open coding. Codes were condensed into themes through an iterative process involving multiple researchers. RESULTS The overarching theme of 'aiming for a moving target' was underpinned by the themes of: (i) striving for betterment; (ii) bridging dissonance and (iii) distressing impossibilities. Interviewees described how they were driven to enhance the preparation of dietitians but acknowledged disparity between what graduates are being prepared for and what they need to be prepared for. Heightened expectations of others, professional constraints and a lack of collegiality among the profession were among the challenges that manifested in a sense of frustration, concern and isolation. CONCLUSIONS Dietetics educators are motivated to shape and enhance the future profession. However, they face numerous challenges in their efforts to prepare graduates who are well-equipped for increasingly diverse dietetics practice. Strong leadership, academic collaboration and greater engagement of the broader workforce are required for the benefit of the entire profession.
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Affiliation(s)
- Kate Morgan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Dianne P Reidlinger
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Sally Sargeant
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Linda Crane
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Katrina L Campbell
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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Harris M, Rhodes T. "It's Not Much of a Life": The Benefits and Ethics of Using Life History Methods With People Who Inject Drugs in Qualitative Harm Reduction Research. QUALITATIVE HEALTH RESEARCH 2018; 28:1123-1134. [PMID: 29557296 DOI: 10.1177/1049732318764393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A life history approach enables study of how risk or health protection is shaped by critical transitions and turning points in a life trajectory and in the context of social environment and time. We employed visual and narrative life history methods with people who inject drugs to explore how hepatitis C protection was enabled and maintained over the life course. We overview our methodological approach, with a focus on the ethics in practice of using life history timelines and life-grids with 37 participants. The life-grid evoked mixed emotions for participants: pleasure in receiving a personalized visual history and pain elicited by its contents. A minority managed this pain with additional heroin use. The methodological benefits of using life history methods and visual aids have been extensively reported. Crucial to consider are the ethical implications of this process, particularly for people who lack socially ascribed markers of a "successful life."
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Affiliation(s)
- Magdalena Harris
- 1 London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tim Rhodes
- 1 London School of Hygiene & Tropical Medicine, London, United Kingdom
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48
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Zarhin D. Conducting Joint Interviews With Couples: Ethical and Methodological Challenges. QUALITATIVE HEALTH RESEARCH 2018; 28:844-854. [PMID: 29303049 DOI: 10.1177/1049732317749196] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Scholars have recently begun to discuss joint interviewing from a methodological perspective, generally presenting a favorable view of this mode of interviewing. In the present article, the author draws on her experiences with interviewing obstructive sleep apnea patients and their partners to shed further light on the methodological and ethical challenges of joint interviews. Specifically, it is shown that joint interviews may become a site in which one partner silences the other and enacts symbolic violence, with the interviewer as unwilling abettor, or alternatively may facilitate passivity. Joint interviewing may therefore prevent researchers from giving an equal voice to both partners, resulting in partial and fragmented data. In addition, the joint approach may generate tension between members of the couple and harm the quality of relationships, thus contravening the researcher's commitment to non-maleficence. The author points to a few possible solutions and suggests interviewing social partners as an alternative to couples.
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Kevers R, Rober P, De Haene L. Unraveling the Mobilization of Memory in Research With Refugees. QUALITATIVE HEALTH RESEARCH 2018; 28:659-672. [PMID: 29251552 DOI: 10.1177/1049732317746963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this article, we explore how narrative accounts of trauma are co-constructed through the interaction between researcher and participant. Using a narrative multiple-case study with Kurdish refugee families, we address how this process takes place, investigating how researcher and participants were engaged in relational, moral, collective, and sociopolitical dimensions of remembering, and how this led to the emergence of particular ethical questions. Case examples indicate that acknowledging the multilayered co-construction of remembering in the research relationship profoundly complicates existing deontological guidelines that predominantly emphasize the researcher's responsibility in sensitively dealing with participants' alleged autobiographical trauma narratives. Instead, our analysis invites qualitative researchers to engage in a continued, context-specific ethical reflection on the potential risks and benefits that are invoked in studies with survivors of collective violence.
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50
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Cartledge S, Feldman S, Bray JE, Stub D, Finn J. Understanding patients and spouses experiences of patient education following a cardiac event and eliciting attitudes and preferences towards incorporating cardiopulmonary resuscitation training: A qualitative study. J Adv Nurs 2018; 74:1157-1169. [PMID: 29315731 DOI: 10.1111/jan.13522] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2017] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to gain a comprehensive perspective about the experience of patient and spousal education following an acute cardiac event. The second objective was to elicit an understanding of patient and spousal attitudes, preferences and intentions towards future cardiopulmonary resuscitation training. BACKGROUND Patients with cardiovascular disease require comprehensive patient and family education to ensure adequate long-term disease management. As cardiac patients are at risk of future cardiac events, including out-of-hospital cardiac arrest, providing cardiopulmonary resuscitation training to patients and family members has long been advocated. DESIGN We conducted a qualitative study underpinned by phenomenology and the Theory of Planned Behaviour. METHODS Semi-structured interviews were conducted with cardiac patients and their spouses (N = 12 patient-spouse pairs) between March 2015-April 2016 purposively sampled from a cardiology ward. Interviews were transcribed verbatim and thematic analysis undertaken. FINDINGS Nine male and three female patients and their spouses were recruited. Ages ranged from 47-75 years. Four strongly interrelated themes emerged: the emotional response to the event, information, control and responsibility. There was evidence of positive attitudes and intentions from the TPB towards undertaking cardiopulmonary resuscitation training in the future. Only the eldest patient spouse pair were not interested in undertaking training. CONCLUSIONS Findings suggest cardiac patients and spouses have unmet education needs following an acute cardiac event. Information increased control and decreased negative emotions associated with diagnosis. Participants' preferences were for inclusion of cardiopulmonary resuscitation training in cardiac rehabilitation programs.
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Affiliation(s)
- Susie Cartledge
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,Alfred Hospital, Melbourne, Vic., Australia
| | - Susan Feldman
- School of Primary Health Care, Monash University, Melbourne, Vic., Australia
| | - Janet E Bray
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,Alfred Hospital, Melbourne, Vic., Australia.,School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
| | - Dion Stub
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,Alfred Hospital, Melbourne, Vic., Australia.,Cabrini Hospital, Melbourne, Vic., Australia.,Baker IDI Heart and Diabetes Institute, Melbourne, Vic., Australia
| | - Judith Finn
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
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