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Ngo TP, Burke Draucker C, Barnes RL, Kwon K, Reising DL. Peer Collaborative Clinical Decision Making in Nursing Simulation: A Theoretical Framework. J Nurs Educ 2024; 63:435-443. [PMID: 38979733 DOI: 10.3928/01484834-20240505-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
BACKGROUND Collaboration and decision making among nursing students are essential competencies in nursing education. However, how students collaborate and make decisions in simulation is a complex phenomenon and not well understood. This study aimed to develop a framework that describes peer collaborative clinical decision making (PCCDM) among nursing students in simulation. METHOD Charmaz's constructivist grounded theory method was used. The sample included 32 participants (16 dyads) from two nursing programs. RESULTS The PCCDM framework described three interrelated functional domains (cognition, behavior, and emotion) experienced through three interrelated processes (awareness, communication, and regulation), alternating between individual and collaborative spaces and changing across time according to the simulation's acuity levels. CONCLUSION The PCCDM framework provides a model that reflects how these processes unfold over time in simulations, which can be applied in nursing simulation, classroom, and clinical settings that require students to make collaborative decisions. [J Nurs Educ. 2024;63(7):435-443.].
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Paradis-Gagné E, Cader M, Holmes D, Bernheim E, Filion J. Exploring Social Interactions in the Context of Justice System Involvement: Perspectives of Patients and Psychiatric Nurses. Clin Nurs Res 2024:10547738241253882. [PMID: 38767250 DOI: 10.1177/10547738241253882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Psychiatric nurses who work with people who are involved with the justice system experience ethical and moral tension arising from their dual role (care and control). This is known to significantly affect the development of a therapeutic relationship between nurses and patients. (a) better understand how justice system involvement affects people living with mental disorders and the nurses who work with them; (b) explore the influence of judiciarization on social interactions between these actors. Grounded theory (GT) was used as the qualitative methodology for this research. Semi-structured interviews were conducted with participants. The study was carried out in three different units of a psychiatric institution: Psychiatric Intensive Care Unit, Emergency Department, and Brief Intervention Unit. A sample of 10 patients and 9 psychiatric nurses was recruited (n = 19). Theoretical sampling was used to recruit participants. We followed the iterative steps of qualitative GT analysis (open coding, axial coding, constant comparison, and modelization). Three main themes emerged from the qualitative analysis: (a) Experience of Justice System Involvement, (b) Crisis, (c) Relational Aspects and Importance of the Approach. These results will inform nurses and healthcare providers about the impacts of justice system involvement on people living with mental illness and how clinical practices can be better adapted to this population with complex health needs.
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Huertas-Zurriaga A, Alonso-Fernández S, Leyva-Moral JM. Reproductive Decision Making of Spanish Women Living With HIV: A Constructivist Grounded Theory Study. J Assoc Nurses AIDS Care 2024; 35:201-209. [PMID: 38417079 DOI: 10.1097/jnc.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
ABSTRACT The process of reproductive decision making among women living with HIV is intricate and multifaceted, influenced by health considerations, societal factors, and personal values. In this study, we employed Charmaz's Constructivist Grounded Theory to understand how Spanish women living with HIV make decisions regarding reproduction. We conducted 26 face-to-face interviews until data saturation was achieved. Findings suggested that social constructs such as femininity and motherhood play a significant role in the reproductive decision-making process for women living with HIV. The women's beliefs about HIV, doubts, marginalizing situations, and health barriers create challenges to making reproductive decisions. These findings provide valuable implications for designing care plans that meet the unique sexual and reproductive health needs of women with HIV. An integrated and comprehensive multidisciplinary counseling approach is necessary to improve the quality of care.
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Affiliation(s)
- Ariadna Huertas-Zurriaga
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Sergio Alonso-Fernández
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Juan M Leyva-Moral
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
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Osmanodja B, Sassi Z, Eickmann S, Hansen CM, Roller R, Burchardt A, Samhammer D, Dabrock P, Möller S, Budde K, Herrmann A. Investigating the Impact of AI on Shared Decision-Making in Post-Kidney Transplant Care (PRIMA-AI): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e54857. [PMID: 38557315 PMCID: PMC11019425 DOI: 10.2196/54857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Patients after kidney transplantation eventually face the risk of graft loss with the concomitant need for dialysis or retransplantation. Choosing the right kidney replacement therapy after graft loss is an important preference-sensitive decision for kidney transplant recipients. However, the rate of conversations about treatment options after kidney graft loss has been shown to be as low as 13% in previous studies. It is unknown whether the implementation of artificial intelligence (AI)-based risk prediction models can increase the number of conversations about treatment options after graft loss and how this might influence the associated shared decision-making (SDM). OBJECTIVE This study aims to explore the impact of AI-based risk prediction for the risk of graft loss on the frequency of conversations about the treatment options after graft loss, as well as the associated SDM process. METHODS This is a 2-year, prospective, randomized, 2-armed, parallel-group, single-center trial in a German kidney transplant center. All patients will receive the same routine post-kidney transplant care that usually includes follow-up visits every 3 months at the kidney transplant center. For patients in the intervention arm, physicians will be assisted by a validated and previously published AI-based risk prediction system that estimates the risk for graft loss in the next year, starting from 3 months after randomization until 24 months after randomization. The study population will consist of 122 kidney transplant recipients >12 months after transplantation, who are at least 18 years of age, are able to communicate in German, and have an estimated glomerular filtration rate <30 mL/min/1.73 m2. Patients with multi-organ transplantation, or who are not able to communicate in German, as well as underage patients, cannot participate. For the primary end point, the proportion of patients who have had a conversation about their treatment options after graft loss is compared at 12 months after randomization. Additionally, 2 different assessment tools for SDM, the CollaboRATE mean score and the Control Preference Scale, are compared between the 2 groups at 12 months and 24 months after randomization. Furthermore, recordings of patient-physician conversations, as well as semistructured interviews with patients, support persons, and physicians, are performed to support the quantitative results. RESULTS The enrollment for the study is ongoing. The first results are expected to be submitted for publication in 2025. CONCLUSIONS This is the first study to examine the influence of AI-based risk prediction on physician-patient interaction in the context of kidney transplantation. We use a mixed methods approach by combining a randomized design with a simple quantitative end point (frequency of conversations), different quantitative measurements for SDM, and several qualitative research methods (eg, records of physician-patient conversations and semistructured interviews) to examine the implementation of AI-based risk prediction in the clinic. TRIAL REGISTRATION ClinicalTrials.gov NCT06056518; https://clinicaltrials.gov/study/NCT06056518. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54857.
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Affiliation(s)
- Bilgin Osmanodja
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Zeineb Sassi
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University Regensburg, Regensburg, Germany
| | - Sascha Eickmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University Regensburg, Regensburg, Germany
| | - Carla Maria Hansen
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Roland Roller
- German Research Center for Artificial Intelligence, Berlin, Germany
| | | | - David Samhammer
- Institute for Systematic Theology II (Ethics), Friedrich-Alexander University Erlangen Nürnberg, Erlangen, Germany
| | - Peter Dabrock
- Institute for Systematic Theology II (Ethics), Friedrich-Alexander University Erlangen Nürnberg, Erlangen, Germany
| | - Sebastian Möller
- German Research Center for Artificial Intelligence, Berlin, Germany
- Quality and Usability Lab, Technical University of Berlin, Berlin, Germany
| | - Klemens Budde
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anne Herrmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University Regensburg, Regensburg, Germany
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
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Nardell MF, Govathson‐Mandimika C, Garnier S, Watts A, Babalola D, Ngcobo N, Long L, Lurie MN, Miot J, Pascoe S, Katz IT. "Emotional stress is more detrimental than the virus itself": A qualitative study to understand HIV testing and pre-exposure prophylaxis (PrEP) use among internal migrant men in South Africa. J Int AIDS Soc 2024; 27:e26225. [PMID: 38462755 PMCID: PMC10935710 DOI: 10.1002/jia2.26225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/07/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION South Africa has one of the highest rates of internal migration on the continent, largely comprised of men seeking labour in urban centres. South African men who move within the country (internal migrants) are at higher risk than non-migrant men of acquiring HIV yet are less likely to test or use pre-exposure prophylaxis (PrEP). However, little is known about the mechanisms that link internal migration and challenges engaging in HIV services. METHODS We recruited 30 internal migrant men (born outside Gauteng Province) during August 2022 for in-depth qualitative interviews at two sites in Johannesburg (Gauteng) where migrants may gather, a factories workplace and a homeless shelter. Interviewers used open-ended questions, based in the Theory of Triadic Influence, to explore experiences and challenges with HIV testing and/or PrEP. A mixed deductive inductive content analytic approach was used to review data and explain why participants may or may not use these services. RESULTS Migrant men come to Johannesburg to find work, but unreliable income, daily stress and time constraints limit their availability to seek health services. While awareness of HIV testing is high, the fear of a positive diagnosis often overshadows the benefits. In addition, many men lack knowledge about the opportunity for PrEP should they test negative, though they express interest in the medication after learning about it. Additionally, these men struggle with adjusting to urban life, lack of social support and fear of potential stigma. Finally, the necessity to prioritize work combined with long wait times at clinics further restricts their access to HIV services. Despite these challenges, Johannesburg also presents opportunities for HIV services for migrant men, such as greater anonymity and availability of HIV information and services in the city as compared to their rural homes of origin. CONCLUSIONS Bringing HIV services to migrant men at community sites may ease the burden of accessing these services. Including PrEP counselling and services alongside HIV testing may further encourage men to test, particularly if integrated into counselling for livelihood and coping strategies, as well as support for navigating health services in Johannesburg.
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Affiliation(s)
- Maria Francesca Nardell
- Division of Global Health EquityBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Caroline Govathson‐Mandimika
- Health Economics and Epidemiology Research Office (HE2RO)JohannesburgSouth Africa
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | | | | | | | - Nkosinathi Ngcobo
- Health Economics and Epidemiology Research Office (HE2RO)JohannesburgSouth Africa
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Lawrence Long
- Health Economics and Epidemiology Research Office (HE2RO)JohannesburgSouth Africa
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Department of Global HealthBoston University School of Public HealthBostonMassachusettsUSA
| | - Mark N. Lurie
- Brown University School of Public HealthBrown UniversityProvidenceRhode IslandUSA
| | - Jacqui Miot
- Health Economics and Epidemiology Research Office (HE2RO)JohannesburgSouth Africa
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Sophie Pascoe
- Health Economics and Epidemiology Research Office (HE2RO)JohannesburgSouth Africa
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Ingrid T. Katz
- Harvard Medical SchoolBostonMassachusettsUSA
- Division of Women's HealthBrigham and Women's HospitalBostonMassachusettsUSA
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Allen CG, Neil G, Halbert CH, Sterba KR, Nietert PJ, Welch B, Lenert L. Barriers and facilitators to the implementation of family cancer history collection tools in oncology clinical practices. J Am Med Inform Assoc 2024; 31:631-639. [PMID: 38164994 PMCID: PMC10873828 DOI: 10.1093/jamia/ocad243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/30/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION This study aimed to identify barriers and facilitators to the implementation of family cancer history (FCH) collection tools in clinical practices and community settings by assessing clinicians' perceptions of implementing a chatbot interface to collect FCH information and provide personalized results to patients and providers. OBJECTIVES By identifying design and implementation features that facilitate tool adoption and integration into clinical workflows, this study can inform future FCH tool development and adoption in healthcare settings. MATERIALS AND METHODS Quantitative data were collected using survey to evaluate the implementation outcomes of acceptability, adoption, appropriateness, feasibility, and sustainability of the chatbot tool for collecting FCH. Semistructured interviews were conducted to gather qualitative data on respondents' experiences using the tool and recommendations for enhancements. RESULTS We completed data collection with 19 providers (n = 9, 47%), clinical staff (n = 5, 26%), administrators (n = 4, 21%), and other staff (n = 1, 5%) affiliated with the NCI Community Oncology Research Program. FCH was systematically collected using a wide range of tools at sites, with information being inserted into the patient's medical record. Participants found the chatbot tool to be highly acceptable, with the tool aligning with existing workflows, and were open to adopting the tool into their practice. DISCUSSION AND CONCLUSIONS We further the evidence base about the appropriateness of scripted chatbots to support FCH collection. Although the tool had strong support, the varying clinical workflows across clinic sites necessitate that future FCH tool development accommodates customizable implementation strategies. Implementation support is necessary to overcome technical and logistical barriers to enhance the uptake of FCH tools in clinical practices and community settings.
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Affiliation(s)
- Caitlin G Allen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Grace Neil
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Chanita Hughes Halbert
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States
| | - Katherine R Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Paul J Nietert
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brandon Welch
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Leslie Lenert
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
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Kreiml V, Sauter A, Abu-Omar K, Eickmann S, Herrmann-Johns A. "That's like therapy"-A qualitative study on socially disadvantaged women's views on the effects of a community-based participatory research project on their health and health behavior. Front Public Health 2024; 12:1339556. [PMID: 38304180 PMCID: PMC10830699 DOI: 10.3389/fpubh.2024.1339556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
Background Regular physical activity has positive effects on both physical and mental health. Nevertheless, socially disadvantaged women are often insufficiently physically active. Through needs-based physical activity offers, community-based participatory research (CBPR) projects have the potential to reach these women and increase the effectiveness of physical activity interventions by supporting women's empowerment, health, and health behaviors. This study aimed to examine socially disadvantaged women's views on the effects of long-term participation in Bewegung als Investition in Gesundheit (BIG, i.e., movement as an investment in health), a long-standing German CBPR project, on their health and health behavior. Methods Semi-structured qualitative interviews were conducted with 30 participating women at five BIG sites across Germany between April and August 2022. The interviews were recorded, transcribed verbatim, and analyzed using framework analysis. Results Women reported that participation in BIG classes contributed to their physical, mental, and social health. For many women, the positive effects on their mental and social wellbeing were most important. In addition to increased fitness and improved physical endurance, many participating women were able to expand their social networks, thus receiving further social support, and improve their self-esteem, self-confidence, and self-efficacy. Furthermore, participation in BIG physical activity classes positively influenced the health awareness of many women helping them to improve their activity level and diet over time. Conclusion Our results suggest that CBPR projects, such as the BIG project, can increase physical activity among socially disadvantaged groups and contribute to their overall health and wellbeing. CBPR projects could thus be considered a key element of health promotion for this target group. Future interventional research is required to confirm and further explore the effects of CBPR interventions and to examine whether the effects can be replicated in other settings.
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Affiliation(s)
- Verena Kreiml
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Alexandra Sauter
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Sascha Eickmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
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Avery J, Campbell KL, Mosher P, Al-Awamer A, Goddard K, Edwards A, Burnett L, Hannon B, Gupta A, Howard AF. Advanced Cancer in Young Adults (YAs): Living in a Liminal Space. QUALITATIVE HEALTH RESEARCH 2024; 34:72-85. [PMID: 37844970 PMCID: PMC10714712 DOI: 10.1177/10497323231204182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Young adults (YAs), defined as individuals between the ages of 18 and 39 years, experience unique challenges when diagnosed with advanced cancer. Using the social constructivist grounded theory approach, we aimed to develop a theoretical understanding of how YAs live day to day with their diagnosis. A sample of 25 YAs (aged 22-39 years) with advanced cancer from across Canada participated in semi-structured interviews. Findings illustrate that the YAs described day-to-day life as an oscillating experience swinging between two opposing disease outcomes: (1) hoping for a cure and (2) facing the possibility of premature death. Oscillating between these potential outcomes was characterized as living in a liminal space wherein participants were unsure how to live from one day to the next. The participants oscillated at various rates, with different factors influencing the rate of oscillation, including inconsistent and poor messaging from their oncologists or treatment team, progression or regression of their cancer, and changes in their physical functioning and mental health. These findings provide a theoretical framework for designing interventions to help YAs adapt to their circumstance.
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Affiliation(s)
- Jonathan Avery
- Anew Research Collaborative: Reshaping Young Adult Cancer Care, Royal Roads University, Victoria, BC, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Kristin L. Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Pamela Mosher
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ahmed Al-Awamer
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | | | | | - Breffni Hannon
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Abha Gupta
- Division of Medical Oncology, Princess Margaret Cancer Center, Toronto, ON, Canada
| | - A. Fuchsia Howard
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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Anbari AB, Sandheinrich T, Hulett J, Salerno E. Understanding advanced practice registered nurse perspectives on providing care to people with a history of breast cancer. J Am Assoc Nurse Pract 2023; 35:804-812. [PMID: 37560998 DOI: 10.1097/jxx.0000000000000929] [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: 04/17/2023] [Accepted: 06/23/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND People with a history of breast cancer (PHBC) face a lifelong risk of treatment-related sequelae affecting their quality of life. Stakeholders advocate for improving breast cancer survivorship outcomes by increasing clinicians' knowledge of cancer survivorship issues. In Missouri, advanced practice registered nurses (APRNs) in nononcology settings provide routine survivorship care to PHBC; however, little is known about how they approach survivorship care planning for PHBC. PURPOSE Examine perspectives of Missouri APRNs practicing in nononcology settings about providing survivorship care to PHBC. METHODS A combination of grounded theory and thematic analysis techniques was used for focus groups and semistructured interviews. The interviews were audio-recorded, transcribed, and analyzed using grounded theory coding methods. RESULTS Nineteen nononcology Missouri-based APRNs (18 NPs, 1 CNS/DNP) shared their perspectives about managing care for PHBC. We identified four major themes. Our participants (1) attuned their baseline assessment techniques to a history of breast cancer; (2) were prepared to order additional evaluations; (3) were willing to proactively figure out next best steps for PHBC beyond theneed for breast cancer recurrence surveillance; and (4) suggest that streamlining cancer survivorship care resources would benefit both clinicians and PHBC. CONCLUSIONS Our findings shed light on how APRNs approach care planning for PHBC and the needs of nononcology APRNs for managing PHBC. IMPLICATIONS FOR PRACTICE Advanced practice registered nurses are well-positioned to improve cancer survivorship care. Increasing knowledge of cancer survivorship care guidelines could improve long-term health outcomes of PHBC. Access to cancer survivorship resources or experts via telehealth/technology for both APRNs and patients could improve survivorship care and overall health of PHBC.
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Affiliation(s)
- Allison B Anbari
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri
| | | | - Jennifer Hulett
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri
| | - Elizabeth Salerno
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Hoover A, Jeffries I, Thomas M, Leston J. Health Care Access and Lived Experience of American Indian/Alaska Native Two Spirit and LGBTQ+ Participants in the Pride and Connectedness Survey, 2020. Public Health Rep 2023; 138:48S-55S. [PMID: 36734193 PMCID: PMC10515980 DOI: 10.1177/00333549231151650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To better understand health experiences among Two Spirit and lesbian, gay, bisexual, transgender, and queer and questioning (LGBTQ+) American Indian/Alaska Native (AI/AN) people, we examined experiences with access to health care of 223 AI/AN Two Spirit and LGBTQ+ people. METHODS Participants of the Pride and Connectedness 2020 survey, conducted through the Northwest Portland Area Indian Health Board, were asked about barriers to seeking and accessing care through a 10-question scale. We compared cisgender and gender-diverse participant demographic and scale responses to explore potential differences based on gender identity using the Pearson χ2 test of independence and ordinal logistic regression, respectively. RESULTS Both cisgender and gender-diverse participants experienced at least some difficulties accessing health care. Finances, lack of psychologists/other mental health support, and lack of psychological support groups for Two Spirit and LGBTQ+ communities were the top 3 barriers to care experienced by all participants (84%, 82%, and 80%, respectively). Compared with cisgender participants, gender-diverse participants were more likely to report difficulties accessing care for nearly all questions on the 10-question scale and nearly 3 times more likely to report fear of being mistreated within the health care system based on their gender identity (adjusted odds ratio = 2.9; 95% CI, 1.8-4.9; P < .001). CONCLUSIONS Increased access to mental health services and improved health care provider training that focuses on culturally relevant and gender-affirming practices would benefit the health and well-being of AI/AN people who identify as Two Spirit and LGBTQ+.
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Affiliation(s)
- Ashley Hoover
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Itai Jeffries
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Morgan Thomas
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Jessica Leston
- Northwest Portland Area Indian Health Board, Portland, OR, USA
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Nardell MF, Sindelo S, Rousseau E, Siko N, Fuzile P, Julies R, Bassett IV, Mellins CA, Bekker LG, Butler LM, Katz IT. Development of "Yima Nkqo," a community-based, peer group intervention to support treatment initiation for young adults with HIV in South Africa. PLoS One 2023; 18:e0280895. [PMID: 37319250 PMCID: PMC10270624 DOI: 10.1371/journal.pone.0280895] [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: 03/17/2022] [Accepted: 01/11/2023] [Indexed: 06/17/2023] Open
Abstract
AIMS Half of young adults diagnosed with HIV in South Africa start antiretroviral therapy (ART). We developed and field tested a facilitator-guided peer support group called Yima Nkqo ("Standing Tall" in isiXhosa) to promote treatment initiation for young adults newly diagnosed with HIV in communities around Cape Town. METHODS Following an adapted version of the UK Medical Research Council's framework for developing complex interventions, we 1) identified evidence on previous interventions to improve ART uptake in sub-Saharan Africa; 2) collected and analyzed qualitative data on the acceptability of our proposed intervention; 3) proposed a theoretical understanding of the process of behavior change; and 4) developed an intervention manual and feedback tools. During field-testing, participant feedback on intervention acceptability, and team feedback on consistency of content delivery and facilitation quality, were analyzed using an iterative, rapid-feedback evaluation approach. In-depth written and verbal summaries were shared in weekly team meetings. Team members interpreted feedback, identified areas for improvement, and proposed suggestions for intervention modifications. RESULTS Based on our formative research, we developed three, 90-minute sessions with content including HIV and ART education, reflection on personal resources and strengths, practice disclosing one's status, strategies to overcome stressors, and goal setting to start treatment. A lay facilitator was trained to deliver intervention content. Two field testing groups (five and four participants, respectively) completed the intervention. Participants highlighted that strengths of Yima Nkqo included peer support, motivation, and education about HIV and ART. Team feedback to the facilitator ensured optimal consistency of intervention content delivery. CONCLUSIONS Iteratively developed in collaboration with youth and healthcare providers, Yima Nkqo is a promising new intervention to improve treatment uptake among young adults with HIV in South Africa. The next phase will be a pilot randomized controlled trial of Yima Nkqo (ClinicalTrials.gov Identifier: NCT04568460).
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Affiliation(s)
- Maria F. Nardell
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Siyaxolisa Sindelo
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Elzette Rousseau
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Nomakaziwe Siko
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Pamela Fuzile
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Robin Julies
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Ingrid V. Bassett
- Harvard Medical School, Boston, MA, United States of America
- Center for Global Health, Massachusetts General Hospital, Boston, MA, United States of America
| | - Claude A. Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, United States of America
| | - Linda-Gail Bekker
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
- Department of Medicine, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, Republic of South Africa
- Governing Council, International AIDS Society, Geneva, Switzerland
| | - Lisa M. Butler
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, United States of America
| | - Ingrid T. Katz
- Harvard Medical School, Boston, MA, United States of America
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Global Health Institute, Harvard University, Cambridge, MA, United States of America
- Division of Women’s Health, Brigham and Women’s Hospital, Boston, MA, United States of America
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12
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Heidenreich A, Elsner S, Wörler F, Hübner J, Schües C, Rehmann-Sutter C, Katalinic A, Gieseler F. Physicians' perspectives on family caregivers' roles in elderly cancer patients' therapies: a qualitative, interview-based study. Support Care Cancer 2023; 31:387. [PMID: 37296323 DOI: 10.1007/s00520-023-07857-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Clinical communication and facilitating informed and sound medical decisions become challenging as patients age and suffer from age-associated impairments. Family caregivers are perceived as essential actors in addressing these challenges. Here, we explore physicians' perspectives on family caregivers' roles and their involvement in consultations and therapy decision-making situations of elderly cancer patients. METHODS We examined 38 semi-structured interviews with physicians from different specialities (oncologists, non-oncology specialists, and general practitioners) in Germany who treated elderly cancer patients. Data were analyzed using reflexive thematic analysis. RESULTS We identified five general and distinct perspectives on the involvement of family caregivers in the therapy process. Family caregivers are seen as (1) translators of medical information; (2) providers of support for the patient; (3) providers of information about the patient; (4) stakeholders with relevant points of view regarding the treatment decision; or (5) individuals who have a disruptive influence on the consultation. The interviewed physicians rarely involved family caregivers closely in consultations. CONCLUSIONS Although physicians frequently attribute supportive roles to family caregivers, they rarely include them in consultations. Previous studies have found that a triadic setting is often better suited to agreeing upon a patient-centered and needs-based treatment decision for older cancer patients. We infer that physicians too rarely recognize the potential importance of family caregivers. Educators should further integrate family caregiver involvement and its implications in general medical education and professional training.
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Affiliation(s)
- Andreas Heidenreich
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany.
| | - Susanne Elsner
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Frank Wörler
- Institute for History of Medicine and Science Studies, University of Luebeck, Luebeck, Germany
| | - Joachim Hübner
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Christina Schües
- Institute for History of Medicine and Science Studies, University of Luebeck, Luebeck, Germany
| | | | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Frank Gieseler
- Clinic for Hematology and Oncology, University Hospital Schleswig-Holstein (UKSH), Luebeck, Germany
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Duan ZY, Tan SK, Choon SW, Zhang MY. Crafting a place-based souvenir for sustaining cultural heritage. Heliyon 2023; 9:e15761. [PMID: 37205990 PMCID: PMC10189373 DOI: 10.1016/j.heliyon.2023.e15761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/21/2023] Open
Abstract
This study aims to investigate the souvenir-person-place bonding for sustaining cultural heritage. Previous studies acknowledge souvenirs could represent a place; however, how people perceive souvenirs as representative of the place still needs to be studied. This study comprehends the traditional craft by identifying the dimensions of place-based craft souvenirs and exploring the connections between souvenirs, craft, and place. A qualitative approach was employed. In-depth interviews, participant and non-participant observations were conducted in Jinan, China, a long-history city with many traditional crafts. Thirty documents were imported into ATLAS.ti software for analysis. The 'place-based craft souvenir', 'evaluation of souvenir', 'place meaning', and 'satisfaction' emerged as the four main themes of 'souvenir-person-place bonding'. These 'souvenir-people-place' bonding motivate individuals' understanding of traditional craft and place, contributing to the sustainability of the traditional craft.
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Affiliation(s)
- Zi Yan Duan
- Faculty of Management, Multimedia University, Cyberjaya, Selangor, Malaysia
| | - Siow-Kian Tan
- Faculty of Management, Multimedia University, Cyberjaya, Selangor, Malaysia
- Corresponding author.
| | - Shay-Wei Choon
- Faculty of Management, Multimedia University, Cyberjaya, Selangor, Malaysia
| | - Meng Yao Zhang
- Faculty of Management, Multimedia University, Cyberjaya, Selangor, Malaysia
- Shandong Women's University
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14
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Avery J, Thomas R, Howell D, Dubouloz Wilner CJ. Empowering Cancer Survivors in Managing Their Own Health: A Paradoxical Dynamic Process of Taking and Letting Go of Control. QUALITATIVE HEALTH RESEARCH 2023; 33:412-425. [PMID: 36825869 PMCID: PMC10126457 DOI: 10.1177/10497323231158629] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In cancer care, gaps in support to help patients manage and live with the side-effects from cancer treatments have increased the emphasis on empowering patients to be more active and involved in managing their own health. However, empowerment in relation to promoting self-management behaviors is not well understood. Using the social constructivist grounded theory approach, our goal was to develop a theoretical understanding of this phenomenon in relation to the self-management behaviors of post-treatment cancer patients. Twenty-two post-treatment cancer patients participated in a semi-structured focused interview to co-construct with us how empowerment is defined, described, and experienced in relation to their capacity to self-manage. Through this co-construction, we defined empowerment as a process of personal growth, a display of fortitude and strength when participants confronted the impact of their illness that emerged in two dynamic and paradoxical ways: 1) establishing control over the impact of the illness as a means to maintain normalcy and to circumvent change over an eroding and changing sense of self and 2) relinquishing control over aspects of the illness deemed irrepressible and acknowledging and accepting change. When successful at establishing and/or relinquishing control, participants no longer viewed cancer as a threat, but re-interpreted their illness as also having a beneficial "empowering" experience and more capable of managing. Findings will guide the development of self-management interventions that use empowerment as a core construct.
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Affiliation(s)
- Jonathan Avery
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Roanne Thomas
- Department of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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15
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Zhang W, He X, Liu Z. Factors and Mechanism Influencing Client Experience of Residential Integrated Health and Social Care for Older People: A Qualitative Model in Chinese Institutional Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4638. [PMID: 36901645 PMCID: PMC10002276 DOI: 10.3390/ijerph20054638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND An emerging service delivery model of integrating health and social care for older people has been actively promoted by the Chinese government since 2016, but the client experience and influencing mechanism still remain unclear. METHODS this study adopts a qualitative methodology to delve deeper into the factors and mechanism shaping the client experience of residential integrated health and social care for older people in the Chinese context, so as to understand the experiences of older residents during the whole process of receiving integrated care services, and on this basis, put forward suggestions for the improvement of a high-quality aged care service system. We coded and analyzed the in-depth interview data of twenty older adults and six staff members from June 2019 to February 2020, recruited from six institutions in Changsha, one of the ninety pilot cities for integrated health and social care in China. RESULTS the findings showed that the client experience of older adults is mainly affected by factors in three dimensions (scene construction, individual minds, and interaction and communication), which are comprised of six sub-categories (social foundation, institutional functions, perception and emotion, cognition and understanding, intimacy and trust, and participation). Based on the factors and mechanism (consisting of six influencing paths), we constructed a model of the client experience of integrated health and social care for older people in the Chinese population. CONCLUSIONS the factors and mechanism influencing the client experience of integrated health and social care for older people are complex and multifaceted. Attention should be paid to the direct effects of perception and emotion, institutional functions, intimacy and trust in the client experience, and the indirect effects of social foundation and participation on the client experience.
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Affiliation(s)
- Wenya Zhang
- Center for Social Security Studies, Wuhan University, Wuhan 430072, China
- School of Public Administration, Central South University, Changsha 410075, China
| | - Xiaojiao He
- School of Public Administration, Central South University, Changsha 410075, China
| | - Zhihan Liu
- School of Public Administration, Central South University, Changsha 410075, China
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16
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Tamilselvan C, Chua SM, Chew HSJ, Devi MK. Experiences of simulation-based learning among undergraduate nursing students: A systematic review and meta-synthesis. NURSE EDUCATION TODAY 2023; 121:105711. [PMID: 36634505 DOI: 10.1016/j.nedt.2023.105711] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES We aimed to examine the experiences of simulation-based learning (SBL) among undergraduate nursing students. DESIGN We conducted a systematic review and meta-synthesis on the experiences among undergraduate nursing studies who received SBL. DATA SOURCES We searched through six databases namely PubMed, CINAHL, Scopus, Web of Science, Embase, ProQuest, for qualitative studies published from January 2011 to January 2022. REVIEW METHODS A meta-synthesis was conducted according to the three-stage framework outlined by Thomas and Harden (2008). Critical appraisal was performed using the Critical Appraisal Skills Program (CASP) checklist. A standardised data extraction form was developed with reference from JBI Qualitative Assessment and Review Instrument Data Extraction Tools for Qualitative Research (JBI-QARI) checklist for data extraction. RESULTS Fifteen studies were included, and four themes emerged from the synthesis: (1) acquiring knowledge and skills through SBL; (2) positive experiences of using high-fidelity simulation (HFS) and virtual reality simulation (VRS) methods; (3) challenges encountered while using SBL methods and (4) drawing parallels between simulation and real clinical settings. CONCLUSION SBL allowed undergraduate nursing students to gain knowledge, acquire skills and have a positive SBL experiences. However, the provision of innovative strategies and resources for nursing students to overcome SBL-based challenges are still needed.
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Affiliation(s)
| | | | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - M Kamala Devi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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17
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Slaghmuylder Y, Lauwerier E, Pype P. Survivors' perceptions regarding the follow-up of pain complaints after breast cancer treatment: Distinct coping patterns. Front Psychol 2023; 13:1063705. [PMID: 36710732 PMCID: PMC9879359 DOI: 10.3389/fpsyg.2022.1063705] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/29/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction After finishing cancer treatment, breast cancer survivors often experience both physical and psychosocial symptoms such as pain. In some, pain can persist for months or even years. Pain is a complex experience. Its occurrence and maintenance are explained through interactions between multiple factors, which are biological/physiological, psychological, and social in nature. Unaddressed needs related to this problem - such as insufficient pain relief, limited validation of the problem, and minimal physical and psychological support - may cause severe disability and negatively impact well-being and quality of life. This study investigated how breast cancer survivors perceive their (chronic) pain complaints to be addressed during follow-up care. Furthermore, we explored how they coped with the way their trajectories happened to unfold. Methods We conducted four focus groups with a total of thirty-one breast cancer survivors. Each focus group consisted of an asynchronous part with an online discussion platform and a synchronous part through video calls. Data analysis was guided by the Qualitative Analysis Guide of Leuven. Results Narratives revealed the unmet needs of survivors and showed variability in the lived experiences of having to deal with pain. Some survivors tend to ignore the pain, while others look for solutions to reduce pain. A third coping pattern is accepting pain and its impact. Furthermore, how survivors cope with pain is influenced by intrapersonal, interpersonal, and societal processes. For example, pain-related beliefs and prejudices among healthcare providers, family, friends, colleagues, other cancer survivors, and society could possibly steer a survivor towards a certain way of coping. In these processes, the role of healthcare providers seems pivotal. For instance, when survivors do not feel heard or taken seriously by healthcare providers, their acceptance of pain can be impeded. Discussion To conclude, a person's way of coping with pain and the associated needs is dynamic and influenced by factors at multiple levels such as the intrapersonal, interpersonal and societal level. To sufficiently address the problem of pain among cancer survivors, we therefore also need actions that tackle the health care system and its stakeholders, as well as the public debate concerning cancer follow-up care.
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Affiliation(s)
- Yaël Slaghmuylder
- InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium,*Correspondence: Yaël Slaghmuylder, ✉
| | - Emelien Lauwerier
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium,Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Peter Pype
- InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Mion G, Vigolo V, Bonfanti A, Tessari R. The Virtuousness of Ethical Networks: How to Foster Virtuous Practices in Nonprofit Organizations. JOURNAL OF BUSINESS ETHICS : JBE 2023; 188:1-17. [PMID: 36643016 PMCID: PMC9831017 DOI: 10.1007/s10551-023-05326-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Ethical networks are an emerging form of social alliance based on collaboration between organizations that share a common ethical commitment. Grounded in a theoretical framework of virtue-based business ethics and focusing on nonprofit alliances, this study investigates the virtuousness of ethical networks; that is, how they trigger virtuous practices in their member nonprofit organizations. Adopting a qualitative grounded theory approach, the study focuses on one of the largest Italian ethical networks of nonprofit organizations operating in the social care sector. The findings show that shared ethical values and religious beliefs are positively associated with ethical network building. Based on these findings, a circular model of virtuousness is proposed in which ethical networks foster virtuous practices among their members at four levels: (1) the strategic orientation level, (2) the institutional level, (3) the organizational level, and (4) the relational level. At each of these levels, ethical networks foster a habituation to virtues and the propagation of virtuous behaviors among their members. Theoretical, practical, and social implications of the research findings are discussed.
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Affiliation(s)
- Giorgio Mion
- Department of Business Administration, University of Verona, Via Cantarane, 24, 37129 Verona, Italy
| | - Vania Vigolo
- Department of Business Administration, University of Verona, Via Cantarane, 24, 37129 Verona, Italy
| | - Angelo Bonfanti
- Department of Business Administration, University of Verona, Via Cantarane, 24, 37129 Verona, Italy
| | - Riccardo Tessari
- Department of Business Administration, University of Verona, Via Cantarane, 24, 37129 Verona, Italy
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19
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Spännäri J, Juntunen E, Pessi AB, Ståhle P. Compassion-A key to innovation: What promotes and what prevents innovation in organizations? Front Psychol 2023; 14:1058544. [PMID: 36923144 PMCID: PMC10010191 DOI: 10.3389/fpsyg.2023.1058544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/19/2023] [Indexed: 03/03/2023] Open
Abstract
Innovation is crucial for the survival and wellbeing of organizations in volatile, rapidly changing societies. However, the role of profound human capability, compassion, and innovation has not been adequately investigated. This article sets out to explore the factors preventing and promoting innovation in organizations, asking how compassion is connected to these factors, and how compassion could boost innovation. We approach innovation as a complicated multilevel phenomenon, emerging from interactions between individuals and the work context. Our view of compassion includes both compassion and copassion-responding both to the suffering and joy of others. Our material was collected from nine focus group interviews, organized in Finland in 2017, in private, public, and third-sector organizations. The material was analyzed by two researchers, using an adapted grounded theory methodology. We found four core factors capable of either promoting or preventing innovation: (1) the strategy and structures of the organization, (2) resources, especially time, (3) working culture; and (4) the dynamics of interaction between individuals and the community. Our key conclusion, fruitful to theorizing both innovation and compassion, is that for innovation to flourish, compassion is to be cultivated throughout an organization. It is not a single variable or practice, and it is in many ways in a key position regarding innovation: the existence of it promotes innovation, but the lack of it prevents innovation. Thus, organizations aiming for innovation should seek multifaceted understanding and skills in compassion.
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Affiliation(s)
- Jenni Spännäri
- Faculty of Theology, University of Helsinki, Helsinki, Finland
| | - Elina Juntunen
- Faculty of Theology, University of Helsinki, Helsinki, Finland
| | | | - Pirjo Ståhle
- School of Engineering, Aalto University, Helsinki, Finland
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20
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Groves PS, Bunch JL, Hanrahan KM, Sabadosa KA, Sharp B, Williams JK. Patient Voices in Hospital Safety during the COVID-19 Pandemic. Clin Nurs Res 2023; 32:105-114. [PMID: 36250248 PMCID: PMC9577816 DOI: 10.1177/10547738221129711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Hospitalized patients and their families may be reluctant to express safety concerns. We aimed to describe safety and quality concerns experienced by hospitalized patients and families and factors and outcomes surrounding decisions about voicing concerns, including those related to the COVID-19 pandemic. We conducted semi-structured interviews with 19 discharged inpatients or family members in a qualitative descriptive design. Some participants reported concern about staff competency or knowledge, communication and coordination, potential treatment errors, or care environment. Factors influencing feeling safe included healthcare team member characteristics, communication and coordination, and safe care expectations. Reasoning for voicing concerns often included personal characteristics. Reasons for not voicing concerns included feeling no action was needed or the concern was low priority. Outcomes for voicing a concern were categorized as resolved, disregarded, and unknown. These findings support the vital importance of open safety communication and trustworthy response to patients and family members who voice concerns.
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Affiliation(s)
- Patricia S. Groves
- University of Iowa, IA, USA,Patricia S. Groves, College of Nursing, University of Iowa, 50 Newton Road, Iowa City, IA 52242, USA.
| | | | - Kirsten M. Hanrahan
- University of Iowa, IA, USA,University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Brittaney Sharp
- University of Iowa, IA, USA,University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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21
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Professionalism in dentistry: deconstructing common terminology. BDJ Open 2022; 8:21. [PMID: 35871067 PMCID: PMC9308814 DOI: 10.1038/s41405-022-00105-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 11/26/2022] Open
Abstract
Background There is a social expectation that dentists demonstrate professionalism. Although the General Dental Council puts it at the heart of their regulatory agenda, there is not yet consensus on the meaning and implications of the term. Objective To explore practising dentists’ understanding of the character traits commonly associated with professionalism and what these mean in practice. Method Constructivist grounded theory was employed throughout this study. Qualitative, in-depth interviews were conducted with dental professionals in England recruited through theoretical sampling to saturation point. Interviews used a topic guide informed by the literature, and analysis was conducted through constant comparison during data collection. Results The study found that traits commonly associated with professionalism in the literature were difficult for dentists to define clearly or operationalise in a clinical setting. There was disagreement over how some traits should be understood, and it was unclear to participants how, or indeed if, the listed traits were directly relevant to practice in their current form. Conclusion Rather than expecting unconditional adherence to an externally imposed definition, further exploration is required to understand how health professionals make sense of professionalism by reference to their lived experiences and worldviews. In Brief Institutional expectations of professionalism, defined through character traits and behaviours, do not appear to map neatly on to the experiences of dental professionals. Straightforward, apparently uncontroversial terms elicited a wide range of responses, including disagreement. This brought in to question whether achieving consensus is possible. Analysing how our respondents understood the terms by reference to the meanings they constructed from lived experience offers deeper insights.
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Plocha AH, Modrak SR, Hoopes MM, Priest AC, Donahoe AJ. Developmental Reengagement Without Depression: A Grounded Theory of Resilience Among Bereaved College Students. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221133585. [PMID: 36250264 DOI: 10.1177/00302228221133585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Bereavement is considered one of the most stressful experiences that young people face, and there are unique considerations for how this impacts college students. Applying a resilience framework to the experiences of bereaved college students can provide a better understanding of their experiences; however, studies on the ways that these individuals themselves define resilience are extremely limited. Furthermore, no studies to date have considered the intersection between college students' conceptualizations of resilience and the developmental features of emerging adulthood. The authors present the results of a grounded theory study in which 51 bereaved college students completed a questionnaire and 10 were interviewed to identify the age-salient tasks that they use to define resilience. Three primary themes were identified related to resilience: (a) emotional indicators, (b) behavioral indicators, and (c) fixed and/or unidentifiable factors. Findings were analyzed to reveal the bidirectional impact between grief and the developmental features of emerging adulthood.
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Affiliation(s)
| | | | - Molly M Hoopes
- Department of Psychology, Merrimack College, North Andover, MA, USA
| | | | - Amanda J Donahoe
- Department of Psychology, Merrimack College, North Andover, MA, USA
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Werner NE, Rutkowski RA, Holden RJ, Ponnala S, Gilmore-Bykovskyi A. A human factors and ergonomics approach to conceptualizing care work among caregivers of people with dementia. APPLIED ERGONOMICS 2022; 104:103820. [PMID: 35689868 PMCID: PMC9392469 DOI: 10.1016/j.apergo.2022.103820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Society relies upon informal (family, friend) caregivers to provide much of the care to the estimated 43.8 million individuals living with Alzheimer's disease and related dementias globally. Caregivers rarely receive sufficient training, resources, or support to meet the demands associated with dementia care, which is often associated with increased risk of suboptimal outcomes. Human factors and ergonomics (HFE) can address the call for new approaches to better understand caregiving and support caregiver performance through systematic attention to and design of systems that support the work of caregivers- their care work. Thus, our objective was to perform a work system analysis of care work. We conducted a qualitative study using a Critical Incident Technique interviewing approach and Grounded Dimensional Analysis analytic procedures. Our findings introduce a new conceptual framework for understanding the care work system of dementia caregivers and suggest that care work is influenced by interactions among distinct caregiver goals, the task demands of the care needs of the person with dementia, daily life needs of the caregiver and family, and contextual factors that shape caregivers' perceptions surrounding care. The initial work system model produced by this study provides a foundation from which future work can further elucidate the care work system, determine how the care work system intersects and coordinates with other work systems such as the patient work system, and design systems that address caregivers' individual caregiving context.
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Affiliation(s)
- Nicole E Werner
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, USA.
| | - Rachel A Rutkowski
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, USA.
| | | | - Siddarth Ponnala
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, USA.
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Slaghmuylder Y, Pype P, Van Hecke A, Lauwerier E. Exploring healthcare providers’ perceptions regarding the prevention and treatment of chronic pain in breast cancer survivors: A qualitative analysis among different disciplines. PLoS One 2022; 17:e0273576. [PMID: 36006950 PMCID: PMC9409579 DOI: 10.1371/journal.pone.0273576] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background The prevention and treatment of chronic pain problems in breast cancer follow-up care require an adequate response from healthcare providers. Generally, this involves the uptake of evidence-based principles regarding pain management in everyday practice. However, despite the extensive literature on effective pain interventions, systematic and coordinated follow-up care is lacking for breast cancer survivors with pain problems in Flanders, Belgium. Objective This study aimed to gather insight into healthcare providers’ perceptions of pain prevention and treatment in breast cancer follow-up care, particularly with attention to the multilevel influences on pain follow-up. Methods We conducted four online focus groups with twenty-two healthcare providers from different disciplines such as oncologists, pharmacists, nurses, physiotherapists, and psychologists. Data analysis was guided by the Qualitative Analysis Guide of Leuven. This guide is inspired by the constant comparison method, based on Grounded Theory. Results The identified influencing factors were thematically grouped into four levels: at the level of the individual healthcare provider, in interaction with the patient, in interaction with colleagues, and at the context level. At each level, we distinguished factors related to healthcare providers’ perceptions such as awareness, knowledge, attitudes, beliefs, experiences, and intentions. For example, because of a lack of knowledge and certain beliefs among healthcare providers, referral to other disciplines often does not happen in the context of pain. Conclusion This study points out the need to explore the prevention and treatment of chronic pain after breast cancer from a multidimensional point of view. This involves not only the characteristics of individual healthcare providers but is also inherently interactional and system-like in nature. This analysis provides opportunities for the development of interventions that target the influencing factors of prevention and treatment of chronic pain in breast cancer survivors.
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Affiliation(s)
- Yaël Slaghmuylder
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium
- * E-mail:
| | - Peter Pype
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium
- Nursing Department, Ghent University Hospital, Ghent, Flanders, Belgium
| | - Emelien Lauwerier
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, Ghent, Flanders, Belgium
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Flanders, Belgium
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25
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Zhao H, Su Q, Zhang L, Zhong J. Understanding the influence of dual authoritarian leadership on employee creativity: The type of leadership and the role of event. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03498-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Kokorelias KM, Gignac MAM, Naglie G, Rittenberg N, Cameron JI. Caregivers' decision-making for health service utilisation across the Alzheimer's disease trajectory. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1344-1352. [PMID: 34080740 DOI: 10.1111/hsc.13464] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
Health and social care services can enhance the community experiences of people with Alzheimer's disease and their caregivers but making decisions about service use is complex. Using a grounded theory methodology, we explored service use decision-making in 40 spousal and adult children caregivers for people with Alzheimer's disease across the caregiving and disease trajectory. Participants' perception of their initial service interactions influenced their decision-making process and use of services. Difficulties navigating the healthcare system and finding available services also influenced decision-making. Caregivers make decisions to sustain care in the community that change throughout the caregiving and disease trajectory. Two key factors influence service use (a) the goals of caregiving and (b) the practicalities of accessing services. Both factors change across caregiving phases. By expanding our understanding of how caregivers make service use decisions, we can augment future practice to help caregivers access services that can better support them across the disease trajectory.
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Affiliation(s)
- Kristina M Kokorelias
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Monique A M Gignac
- Dalla Lana School of Public Health, University of Toronto, Institute for Work and Health, Toronto, Ontario, Canada
| | - Gary Naglie
- Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Nira Rittenberg
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Dunwoodie K, Macaulay L, Newman A. Qualitative interviewing in the field of work and organisational psychology: Benefits, challenges and guidelines for researchers and reviewers. APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE 2022. [DOI: 10.1111/apps.12414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Karen Dunwoodie
- Department of Management, Deakin Business School Deakin University Geelong Victoria Australia
| | - Luke Macaulay
- Department of Management, Deakin Business School Deakin University Geelong Victoria Australia
| | - Alexander Newman
- Department of Management, Deakin Business School Deakin University Geelong Victoria Australia
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28
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Budjanovcanin A, Woodrow C. Regretting your occupation constructively: A qualitative study of career choice and occupational regret. JOURNAL OF VOCATIONAL BEHAVIOR 2022. [DOI: 10.1016/j.jvb.2022.103743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martin JL, Lee YM, Corbin LW, Colson R, Aquilante CL. Patients' perspectives of a pharmacist-provided clinical pharmacogenomics service. Pharmacogenomics 2022; 23:463-474. [PMID: 35469451 DOI: 10.2217/pgs-2022-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: To assess the perspectives and experiences of patients who participated in a pharmacist-provided clinical pharmacogenomics (PGx) service. Methods: We conducted individual semistructured interviews with 16 patients who received a pharmacist-provided PGx service. Qualitative data were analyzed to identify pertinent themes. Results: The major themes identified were: heterogeneity of patient PGx experiences and preferences, pharmacists as appropriate providers of PGx services, considerations regarding the use of PGx results in routine healthcare, and perceived applications of PGx testing. Theme-derived considerations included the need to establish appropriate pre-genotyping expectations, individualize patient education, facilitate collaboration with patients' providers and sustainably update patients' PGx information over time. Conclusion: Patient-specific perspectives such as these are important to consider when providing clinical PGx services, with intention of optimizing patient experiences.
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Affiliation(s)
- James L Martin
- Department of Pharmaceutical Sciences, University of Colorado, Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, CO 80045, USA
| | - Yee Ming Lee
- Department of Clinical Pharmacy, University of Colorado, Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, CO 80045, USA
| | - Lisa W Corbin
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Ronald Colson
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Christina L Aquilante
- Department of Pharmaceutical Sciences, University of Colorado, Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, CO 80045, USA
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Ni G, Lv L, Wang S, Miao X, Fang Y, Liu Q. Formation Mechanism and Dynamic Evolution Laws About Unsafe Behavior of New Generation of Construction Workers Based on China's Construction Industry: Application of Grounded Theory and System Dynamics. Front Psychol 2022; 13:888060. [PMID: 35558713 PMCID: PMC9087859 DOI: 10.3389/fpsyg.2022.888060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/28/2022] [Indexed: 11/26/2022] Open
Abstract
Construction workers' unsafe behavior is a major cause of safety accidents and injuries, therefore, a profound understanding of the formation process and evolution laws about construction workers' unsafe behavior is conducive to taking measures to prevent incidents. At present, the new generation of construction workers (NGCWs) born after 1980 are gradually becoming the main force at construction sites in China. Given that generational differences of construction workers can cause the discrepancies in their thoughts and attitudes when engaging in safety-related activities, this study aims to investigate the formation mechanism and dynamic evolution laws about NGCWs' unsafe behavior based on the context of China's construction industry. From the perspective of behavior motivation, in-depth semi-structured interviews with 18 NGCWs and 7 grassroots managers were conducted, and data analysis followed a three-step coding process based on grounded theory. Through continuous comparison, abstraction and analysis, the stimulus-organism-response theory was introduced and expanded to construct a three-stage formation mechanism model. On this basis, the causal diagram and stock flow diagram were developed based on system dynamics principles to reflect the dynamic feedback relationships of the factors in the static formation mechanism model, and simulation was carried out using Vensim PLE software. The results show that three types of internal needs and three types of external incentives stimulate corresponding motivations for NGCWs' unsafe behavior. Two types of individual factors, five types of situational factors and behavior result play an influencing role in the decision-making process of externalizing motivation into behavior. Under the synergistic effect of multiple factors, the level of unsafe behavior displays a downward trend, and the rate of decrease is slow first and then fast. Furthermore, among individual factors and situational factors, safety awareness and safety management system have the most significant effect on the level of unsafe behavior, while situational factors play a more obvious role. The findings can provide theoretical support and practical references to China's construction companies and government departments for the purpose of improving NGCWs' unsafe behavior.
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Affiliation(s)
- Guodong Ni
- School of Mechanics and Civil Engineering, Research Center for Digitalized Construction and Knowledge Engineering, China University of Mining and Technology, Xuzhou, China
| | - Lei Lv
- School of Mechanics and Civil Engineering, China University of Mining and Technology, Xuzhou, China
| | - Shaobo Wang
- School of Mechanics and Civil Engineering, China University of Mining and Technology, Xuzhou, China
| | - Xinyue Miao
- School of Mechanics and Civil Engineering, China University of Mining and Technology, Xuzhou, China
| | - Yaqi Fang
- School of Mechanics and Civil Engineering, China University of Mining and Technology, Xuzhou, China
| | - Qing Liu
- School of Civil Engineering, Xuzhou University of Technology, Xuzhou, China
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Waters WF, Baca M, Graham JP, Butzin-Dozier Z, Vinueza L. Antibiotic use by backyard food animal producers in Ecuador: a qualitative study. BMC Public Health 2022; 22:685. [PMID: 35395759 PMCID: PMC8991794 DOI: 10.1186/s12889-022-13073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 03/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background Antibiotics are increasingly used throughout the world in food animal production for controlling and preventing disease and for promoting growth. But this trend also has the potential for promoting antibiotic resistance, which represents a threat to human, animal, and environmental health. The use of antibiotics and the potential effects of antibiotic dependence has often been associated with large-scale food animal production. But rural households also engage in small-scale production, often operating literally in backyards. While some small-scale producers use veterinary antibiotics, many do not. This paper examines knowledge, attitudes, beliefs, and agricultural practices (KAP) that represent an alternative to dependence on antibiotics. Methods Qualitative field research was based on four focus group discussions (FGDs) with non-indigenous backyard food animal producers in four communities near Quito, Ecuador and two FGDs with veterinarians. FGDs were supplemented by structured observations and key informant interviews. They were recorded with digital audio devices and transcriptions were analyzed independently by two researchers using a three-stage coding procedure. Open coding identifies underlying concepts, while axial coding develops categories and properties, and selective coding integrates the information in order to identify the key dimensions of the collective qualitative data. Results Backyard food animal producers in the Ecuadorian highlands generally do not use antibiotics while rearing small batches of animals and poultry for predominantly non-commercial household consumption. Instead, they rely on low cost traditional veterinary remedies. These practices are informed by their Andean history of agriculture and a belief system whereby physical activity is a holistic lifestyle through which people maintain their health by participating in the physical and spiritual environment. Conclusions Backyard food animal producers in the Ecuadorian highlands implement complex strategies based on both economic calculations and sociocultural underpinnings that shape perceptions, attitudes, and practices. They use traditional veterinary remedies in lieu of antibiotics in most cases because limited production of food animals in small spaces contributes to a predictable household food supply, while at the same time conforming to traditional concepts of human and environmental health.
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Affiliation(s)
- William F Waters
- Universidad San Francisco de Quito, Diego de Robles S/N y Pampite, Cumbayá, Quito, Ecuador.
| | - Martin Baca
- Universidad San Francisco de Quito, Diego de Robles S/N y Pampite, Cumbayá, Quito, Ecuador
| | - Jay P Graham
- School of Public Health, University of California, Berkeley, CA, USA
| | | | - Lenin Vinueza
- Universidad San Francisco de Quito, Diego de Robles S/N y Pampite, Cumbayá, Quito, Ecuador
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Lamiani G, Borghi L, Bonazza F, Rebecchi D, Lazzari D, Vegni E. Adjustment Processes After the First Wave of the COVID-19 Pandemic: A Grounded Theory Study Based on Clinical Psychologists' Experience. Front Psychol 2022; 13:854745. [PMID: 35310254 PMCID: PMC8931717 DOI: 10.3389/fpsyg.2022.854745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/16/2022] [Indexed: 12/22/2022] Open
Abstract
Background Anxiety, depression, and post-traumatic stress have been reported among the general population during the first wave of the COVID-19 pandemic. However, the adjustment after the emergency phase remains under-investigated. This study aims to understand the adjustment processes of the population after the emergency phase of the pandemic. Methods We conducted a grounded theory based on the experience of 24 clinical psychologists who provided extensive support to the population during the pandemic in different Italian regions. Three online focus groups were conducted. The transcripts of the focus groups were analyzed through a process of open, axial, and selective coding. Data collection terminated once thematic saturation was reached. Results Repositioning emerged as the evolutionary task people were confronted with in the face of a New Reality. Repositioning meant dealing with and integrating unpleasant Emotional Experiences deriving from the lockdown and reopening (i.e., unsafety, emotional exhaustion, loneliness, uncertainty, loss, and disconnection) through different Coping Strategies. Repositioning was facilitated or hindered by contextual and individual Intervening Conditions and led to two Adjustment Outcomes: growth or block. Conclusion Results suggest that repositioning was the core task people had to face after the emergency phase of COVID-19. Proactive psychological interventions may support the population in repositioning in order to prevent maladjustment and encourage post-traumatic growth.
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Affiliation(s)
- Giulia Lamiani
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Federica Bonazza
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - David Lazzari
- Unit of Clinical Psychology, Hospital of Terni, Terni, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy.,Unit of Clinical Psychology, ASST Santi Paolo e Carlo Hospital, Milan, Italy
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Chakrabarti R, Markless S. More than burnout: qualitative study on understanding attrition among senior Obstetrics and Gynaecology UK-based trainees. BMJ Open 2022; 12:e055280. [PMID: 35149570 PMCID: PMC8845201 DOI: 10.1136/bmjopen-2021-055280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Workforce retention among UK-based Obstetrics and Gynaecology (O&G) trainees has been a particular concern for a number of years, with 30% trainees reportedly leaving specialty training. With specialty focused research being limited and tending to analyse the training programme as a whole. The aim of this study was to explain why senior O&G trainees within reach of completing training were leaving the specialty. DESIGN Qualitative study based on Constructivist Grounded Theory methodology using semi-structured interviews. Data collection and analysis continued until theoretical saturation was achieved. The key themes were used to build an explanatory model, in the form of a concept map for attrition. SETTING London. PARTICIPANTS Nine senior O&G trainees (ST5-7) of which six were committed to the specialty, two were not going to pursue a consultancy post once training was complete and one ex-trainee. RESULTS Five major themes emerged from the study, of which four; 'Just get on with it', 'Just a number', 'Tick-box exercise' and 'It has not happened to me but…' were described by all participants. However, the final theme, relating to the lack of professional identity, 'I did not see myself as an Obstetrician and Gynaecologist' was only demonstrated among those who had left or were not going to pursue a consultancy post once training was complete. Potential strategies for facilitating professional identity development were focused into three areas; establishing meaningful connections, adequate support mechanisms and regional initiatives. CONCLUSION Previous research on attrition in the medical profession have suggested burnout and the lack of resilience as being the key factors for leaving training. However, based on this study's findings, an alternative pathway related to the lack of professional identity has been proposed for senior O&G trainees. ETHICS This study was registered at King's College London, Kings Reference: LRU-18/19-10632 and was awarded ethical approval through the Research Ethics Committee (REMAs).
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Affiliation(s)
- Rima Chakrabarti
- Centre for Education, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Sharon Markless
- Centre for Education, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Bellè SL, Riotte J, Backhaus N, Sekhar M, Jouquet P, Abiven S. Tailor-made biochar systems: Interdisciplinary evaluations of ecosystem services and farmer livelihoods in tropical agro-ecosystems. PLoS One 2022; 17:e0263302. [PMID: 35089983 PMCID: PMC8797206 DOI: 10.1371/journal.pone.0263302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/16/2022] [Indexed: 11/25/2022] Open
Abstract
Organic matter management is key to sustain ecosystem services provided by soils. However, it is rarely considered in a holistic view, considering local resources, agro-environmental effects and harmonization with farmers' needs. Organic inputs, like compost and biochar, could represent a sustainable solution to massive current challenges associated to the intensification of agriculture, in particular for tropical regions. Here we assess the potential of agricultural residues as a resource for farmer communities in southwestern India to reduce their dependency on external inputs and sustain ecosystem services. We propose a novel joint evaluation of farmers' aspirations together with agro-environmental effects of organic inputs on soils. Our soil quality evaluation showed that biochar alone or with compost did not improve unilaterally soils in the tropics (Anthroposol, Ferralsol and Vertisol). Many organic inputs led to an initial decrease in water-holding capacities of control soils (-27.3%: coconut shell biochar with compost on Anthroposol). Responses to organic matter inputs for carbon were strongest for Ferralsols (+33.4% with rice husk biochar), and mostly positive for Anthroposols and Vertisols (+12.5% to +13.8% respectively). Soil pH responses were surprisingly negative for Ferralsols and only positive if biochar was applied alone (between -5.6% to +1.9%). For Anthroposols and Vertisols, highest increases were achieved with rice husk biochar + vermicomposts (+7.2% and +5.2% respectively). Our socio-economic evaluation showed that farmers with a stronger economical position showed greater interest towards technology like biochar (factor 1.3 to 1.6 higher for farmers cultivating Anthroposols and/or Vertisols compared to Ferralsols), while poorer farmers more skepticism, which may lead to an increased economical gap within rural communities if technologies are not implemented with long-term guidance. These results advocate for an interdisciplinary evaluation of agricultural technology prior to its implementation as a development tool in the field.
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Affiliation(s)
| | - Jean Riotte
- Géosciences Environnement Toulouse, Université Paul-Sabatier, IRD, CNRS, Toulouse, France
- Indo-French Cell for Water Science, Indian Institute of Science, Bangalore, Karnataka, India
| | - Norman Backhaus
- Department of Geography, University of Zurich, Zurich, Switzerland
- University Research Priority Programme (URPP) Global Change and Biodiversity, University of Zurich, Zurich, Switzerland
| | - Muddu Sekhar
- Indo-French Cell for Water Science, Indian Institute of Science, Bangalore, Karnataka, India
- Department of Civil Engineering, Indian Institute of Science, Bangalore, Karnataka, India
| | - Pascal Jouquet
- Indo-French Cell for Water Science, Indian Institute of Science, Bangalore, Karnataka, India
- Institut d’écologie et des Sciences de l’environnement, IESS-Paris UMR Sorbonne Université, UPEC, CNRS, IRD, INRAe, FEST Team, Bondy, France
| | - Samuel Abiven
- Département de Géosciences, Laboratoire de Géologie, CNRS – École Normale Supérieure, PSL University, Institut Pierre Simon Laplace, Paris, France
- CEREEP-Ecotron Ile De France, ENS, CNRS, PSL University, St-Pierre-lès-Nemours, France
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Cai X, Cebollada J, Cortiñas M. A grounded theory approach to understanding in-game goods purchase. PLoS One 2022; 17:e0262998. [PMID: 35085336 PMCID: PMC8794092 DOI: 10.1371/journal.pone.0262998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 01/10/2022] [Indexed: 11/30/2022] Open
Abstract
Video game companies are increasingly diversifying their profit models. Rather than relying exclusively on the sale of video game titles or the subscription model, video game companies are maximising the revenues and extending the lifecycle of their games by means of a strategy based on the sale of in-game goods. This study contributes to the theory on in-game goods purchases by explaining why and how video game players purchase different types of in-game goods. We used an inductive approach involving qualitative data analysis based on grounded theory. Six types of in-game goods are grouped into three categories: functional-based goods, probability-based goods, and ornamental-based goods. After acknowledging the heterogeneity of the categories, a conceptual framework is developed by conducting 21 in-depth interviews, from which it emerges that players purchase functional-based goods, probability-based goods, and ornamental-based goods for different motives and through the different behavioural processes. First, the purchase of functional-based goods is a strategy for entering the flow experience. Second, the purchase of probability-based goods is a compromise for purchase restrictions. Third, the purchase of ornamental goods is driven by the synergism of intrinsic motivations and exposure in the virtual world. Therefore, video game researchers should not treat in-game goods as a homogeneous concept. The findings also suggest that it is critically important for video game developers to strike a balance between the challenges of the gameplay and the skills of players because excessively raising (or lowering) the level of difficulty could pose a threat to the company’s sustainable profit.
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Affiliation(s)
- Xiaowei Cai
- Institute for Advanced Research in Business and Economics (INARBE), Public University of Navarre (UPNA), Pamplona, Spain
- Department of Business Management, Public University of Navarre (UPNA), Pamplona, Spain
- * E-mail:
| | - Javier Cebollada
- Institute for Advanced Research in Business and Economics (INARBE), Public University of Navarre (UPNA), Pamplona, Spain
- Department of Business Management, Public University of Navarre (UPNA), Pamplona, Spain
| | - Mónica Cortiñas
- Institute for Advanced Research in Business and Economics (INARBE), Public University of Navarre (UPNA), Pamplona, Spain
- Department of Business Management, Public University of Navarre (UPNA), Pamplona, Spain
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Modeling the factors affecting unsafe behaviors using the fuzzy best–worst method and fuzzy cognitive map. Appl Soft Comput 2022. [DOI: 10.1016/j.asoc.2021.108119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Momani AM, Callery P, Lin YL, Abduelkader RH, Al Akash HY. "It [Diabetes] is From God and I Need to Take Care of Myself": Type 1 Diabetes Self-Management Among Adolescents and Their Parents in Jordan. Curr Diabetes Rev 2022; 18:e140222201109. [PMID: 35156585 DOI: 10.2174/1573399818666220214114908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Type 1 diabetes is the most common endocrine condition among adolescents. Diabetes self-management can be challenging during adolescence. OBJECTIVE The objective of this study is to understand how adolescents and their parents manage type 1 diabetes in Jordan. METHODS Constructivist grounded theory methodology principles were used to achieve the study aim. A total of 48 participants were recruited using purposive and theoretical sampling techniques, including adolescents and their parents. Data were collected (October 2016 - April 2017) using 38 semi-structured, audio-recorded interviews (one-to-one or joint interviews based on participants' preferences). Data were collected and analyzed concurrently using different levels of coding, constant comparative analysis, and memo writing. This study was approved by relevant ethics committees from the University of Manchester and Jordan University Hospital. RESULTS The theme of living with diabetes is presented and discussed in this article. Culture emerged as the central theme; two aspects of culture are presented in this article: collectivism and cultural beliefs. CONCLUSION This study identified that diabetes self-management could be influenced by the culture in which Jordanian adolescents live in as well as being shaped by their religious beliefs. These findings are potentially transferable to other Arab and non-Arab countries that share similar cultural aspects and religious beliefs.
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Affiliation(s)
| | - Peter Callery
- School of Biology, Medicine and Health, Division of Nursing, Midwifery and Social Work at the University of Manchester, Manchester, UK
| | - Yin-Ling Lin
- School of Biology, Medicine and Health, Division of Dentistry at the University of Manchester, Manchester, UK
| | | | - Hekmat Y Al Akash
- School of Nursing at the Applied Science Private University, Amman, Jordan
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Momani AM, Callery P, Lin YL, Abduelkader RH, Khalil H. "I Like People to Treat Me Normally": Barriers to Type 1 Diabetes Self-Management Among Adolescents. Clin Diabetes 2022; 40:196-203. [PMID: 35669300 PMCID: PMC9160554 DOI: 10.2337/cd20-0116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Adolescents with type 1 diabetes face barriers that can have a negative influence on self-management behaviors. This study was an analysis of semi-structured interviews with adolescents, parents, and health care providers to better understand these barriers among adolescents in Jordan. Adolescents with type 1 diabetes reported individual-level barriers including feeling labeled, pitied, and stigmatized for having type 1 diabetes. They also discussed the system-level barrier of an education system that does not adapt to meet their needs. Individual- and system-level barriers are interrelated and could influence adolescents' decisions regarding whether to disclose their condition to others.
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Affiliation(s)
- Aaliyah M. Momani
- Applied Science Private University, Amman, Jordan
- School of Biology, Medicine and Health, University of Manchester, Manchester, U.K
- Corresponding author: Aaliyah M. Momani,
| | - Peter Callery
- School of Biology, Medicine and Health, University of Manchester, Manchester, U.K
| | - Yin-Ling Lin
- School of Biology, Medicine and Health, University of Manchester, Manchester, U.K
| | | | - Heba Khalil
- Faculty of Health Sciences, Higher Colleges of Technology, Fujairah, United Arab Emirates
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Noda M, Oyama Y. How Can We Understand and Describe “
Non‐Narrative
” Narratives? A Qualitative Study of Workers with Recurring Sick Leave. JAPANESE PSYCHOLOGICAL RESEARCH 2021. [DOI: 10.1111/jpr.12319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Engagement between adults in suicidal crises and nurses in mental health wards: a qualitative study of patients' perspectives. Arch Psychiatr Nurs 2021; 35:541-548. [PMID: 34561071 DOI: 10.1016/j.apnu.2021.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/01/2021] [Accepted: 07/11/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To understand how patients in suicidal crises perceive their engagement with nurses in mental hospitals. METHODS A qualitative study based on grounded theory was conducted. Semi-structured interviews were used with 11 hospitalised adults living through suicidal crises. The data were analysed by multiple researchers, using the constant comparison method, coding, and memo writing. FINDINGS The core process was: 'Feeling nurtured through an interpersonal engagement'. This process underpinned two categories: 'Feeling safe and cared for while struggling to trust' and 'Working toward alleviation and change of my suicidal ideation'. The patients valued nurses who integrated caring approaches of building trust, demonstrating compassion, and promoting safety, with healing approaches of helping them to express and explore their suicidal ideations, and develop new insights and ways of coping. This interpersonal engagement could nurture patients' feelings of being accepted and understood, and being hopeful and capable of overcoming their suicidal ideations. CONCLUSION The conceptual insights can inform strategies to reframe overly instrumental approaches to prevent suicide and treat suicidal ideation, and instead promote an interpersonal orientation in nursing practice that integrates caring-healing approaches.
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Ancker JS, Benda NC, Reddy M, Unertl KM, Veinot T. Guidance for publishing qualitative research in informatics. J Am Med Inform Assoc 2021; 28:2743-2748. [PMID: 34537840 PMCID: PMC8633663 DOI: 10.1093/jamia/ocab195] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022] Open
Abstract
Qualitative research, the analysis of nonquantitative and nonquantifiable data through methods such as interviews and observation, is integral to the field of biomedical and health informatics. To demonstrate the integrity and quality of their qualitative research, authors should report important elements of their work. This perspective article offers guidance about reporting components of the research, including theory, the research question, sampling, data collection methods, data analysis, results, and discussion. Addressing these points in the paper assists peer reviewers and readers in assessing the rigor of the work and its contribution to the literature. Clearer and more detailed reporting will ensure that qualitative research will continue to be published in informatics, helping researchers disseminate their understanding of people, organizations, context, and sociotechnical relationships as they relate to biomedical and health data.
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Affiliation(s)
- Jessica S Ancker
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natalie C Benda
- Department of Population Health Sciences, Weill Cornell Medicine, New York, USA
| | - Madhu Reddy
- Department of Informatics, University of California, Irvine, Irvine, California, USA
| | - Kim M Unertl
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Tiffany Veinot
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
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Malakoutikhah M, Jahangiri M, Alimohammadlou M, Faghihi SA, Kamalinia M. The Factors Affecting Unsafe Behaviors of Iranian Workers: A Qualitative Study Based on Grounded Theory. Saf Health Work 2021; 12:339-345. [PMID: 34527394 PMCID: PMC8430429 DOI: 10.1016/j.shaw.2021.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/04/2021] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
Background Some researchers state that they are not yet able to provide a deep understanding of the underlying causes of unsafe behaviors (UBs). Therefore, the present study was conducted to investigate the attitudes and experiences of Iranian workers of UBs. Methods This present study was conducted in 35 industries using a semistructured interview based on grounded theory. Forty participants were interviewed, including 13 industrial safety and health experts and 27 workers and supervisors. The analysis of the present study consisted of a three-step coding process including open, axial, and selective coding. Results The results showed that the factors affecting UBs could be classified into three categories: organizational, individual, and socioeconomic factors. Organizational factors were divided into 6 parts: procedure and environmental conditions, communications, monitoring, organizational safety culture, resource allocation, and human resources. Socioeconomic factors had three subcategories: community safety culture, type of organizational ownership, and economic problems. Finally, the individual factors were classified into two categories of personality traits and individual competence. Conclusion The results showed that organizational factors were the most categorized, and it is estimated that this factor has a more important role in the UBs. Of course, to better understand the close relationship between these factors and find the weight and importance of each factor, it needs to measure it with multicriteria decision systems.
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Affiliation(s)
- Mahdi Malakoutikhah
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Jahangiri
- Department of Occupational Health Engineering, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Moslem Alimohammadlou
- Department of Management, Faculty of Economic, Management and Social Science, Shiraz University, Shiraz, Iran
| | - Seyed Aliakbar Faghihi
- School of Medicine, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Kamalinia
- Department of Occupational Health and Safety Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Kohlhoff J, Tooke S, Cibralic S, Hickinbotham R, Knox C, Roach V, Barnett B. Antenatal psychosocial assessment and depression screening in an Australian Private Hospital setting: A qualitative examination of women's perspectives. Midwifery 2021; 103:103129. [PMID: 34487949 DOI: 10.1016/j.midw.2021.103129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Australia, clinical practice guidelines have been developed to support the implementation of antenatal psychosocial assessment and depression screening in routine clinical obstetric care. While there has been widespread uptake of such programs in Australian public hospitals, implementation in private hospitals has been slower. However, the situation in this regard may be changing, with the emergence of examples of midwife delivered screening programs in a number of private hospital settings. At present, patient experiences of these programs are largely unknown. AIM The aim of this study was to gain feedback from women who participated in the 'Pre-admission midwife appointment' program at an Australian private hospital about their experiences of, and perspectives about, the program. METHODS Semi-structured interviews were conducted with 20 women (Mage 36.04 years, range 30-48) who had given birth to a child between 9 and 14 months prior to the interview (M = 11.87 months, SD = 1.76) and who had attended the Pre-admission midwife appointment program during the pregnancy. Interviews were transcribed and analysed using an inductive thematic analysis approach with an essentialist-realistic theoretical framework. FINDINGS Data analysis revealed five major themes: 'increased awareness and support for perinatal mental health issues', 'enhanced quality of care provided at the hospital', 'experience with the midwife impacts perceptions of the program'; 'partners', and 'preparation for the program'. DISCUSSION This study provides useful information from the perspective of consumers, about a psychosocial assessment and depression screening program at an Australian private hospital. It highlights a number of program benefits for pregnant women, their partners, and the hospital, as well as factors facilitating program success.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney Australia; Karitane, Sydney Australia.
| | | | - Sara Cibralic
- School of Psychiatry, University of New South Wales, Sydney Australia
| | | | - C Knox
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists; University of Sydney, Sydney Australia
| | - V Roach
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists
| | - B Barnett
- Gidget Foundation Australia; Australasian Birth Trauma Association
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Encouraging Undergraduate Marketing Students to Reflect on Critical Thinking and the Digital Gender Divide. Eur J Investig Health Psychol Educ 2021; 11:933-952. [PMID: 34563082 PMCID: PMC8544228 DOI: 10.3390/ejihpe11030069] [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: 07/28/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
In today’s society where there is an abundance of accessible, complex, and often false information, critical thinking (CT) is an essential skill so that citizens in general and students in particular can make complex decisions based on scientific evidence, rather than on prejudices, biases, and pre-established beliefs. In this context, the purpose of this study is to discover whether Active Learning (AL) methodology, using different technologies, contributes to improving the CT of the student body, applying it to the Digital Gender Divide (DGD). Three questionnaires were used to collect information, using both a quantitative and a qualitative approach. Open-ended questions are included for fuller answers, which are complemented by content analysis of the recordings and virtual presentations made. The results show that the AL methodology favours the development of CT in the DGD in a remarkable way. Likewise, the various technologies implemented in the methodology (e.g., the Google Applications Site, online round table discussions, role-plays, virtual presentations, and forms) are relevant to improving CT in DGD. It concludes by recommending the implementation of AL with CT as in the one carried out, to help prepare better professionals and raise awareness of how to reduce the DGD.
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45
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Yehene E, Steinberg P, Gerner M, Brezner A, Landa J. "Concurrent Ropes and Ladders": Mapping and Conceptualizing the Emotional Loss Experience of Parents Following Pediatric Acquired Brain Injury. QUALITATIVE HEALTH RESEARCH 2021; 31:1518-1533. [PMID: 34024215 PMCID: PMC8278457 DOI: 10.1177/10497323211012384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This grounded theory study aims to map, conceptualize, and theorize the emotional loss experienced by parents following their child's pediatric acquired brain injury (pABI). Data were obtained from 47 semi-structured interviews conducted with parents (72% mothers) at least 1 year following pABI. The study's theory of "concurrent ropes and ladders" emerged from a process of initial in vivo coding followed by focused and thematic coding. Codes were consolidated into five thematic categories capturing parents' emotional continuous loss experience: (a) comparing life before and after, (b) struggling to construct new realities, (c) recognizing instability and permanency, (d) adjusting and readjusting, and (e) grieving as an emotional shadow. These categories are at work simultaneously in parents' accounts, thus supporting a model of dynamic concurrency within and across their lived experiences. Recommendations for practitioners were derived from the theory to support parents' emotional coping with living loss throughout the chronic stage.
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Affiliation(s)
- Einat Yehene
- The Academic College of Tel Aviv–Yaffo, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | | | | | | | - Jana Landa
- Sheba Medical Center, Ramat Gan, Israel
- Tel Aviv University, Tel Aviv, Israel
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Watson K, Mills TA, Lavender T. Experiences and outcomes on the use of telemetry to monitor the fetal heart during labour: findings from a mixed methods study. Women Birth 2021; 35:e243-e252. [PMID: 34219033 DOI: 10.1016/j.wombi.2021.06.004] [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: 01/27/2021] [Revised: 05/09/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Wireless continuous electronic fetal monitoring (CEFM) using telemetry offers potential for increased mobility during labour. United Kingdom national recommendations are that telemetry should be offered to all women having CEFM during labour. There is limited contemporary evidence on experiences of telemetry use or impacts it may have. AIM To gather in-depth knowledge about the experiences of women and midwives using telemetry, and to assess any impact that its use may have on clinical outcomes, mobility in labour, control or satisfaction. METHODS A convergent parallel mixed-methods study was employed. Grounded theory was adopted for interviews and analysis of 13 midwives, 10 women and 2 partners. Satisfaction, positions during labour and clinical outcome data was analysed from a cohort comparing telemetry (n = 64) with wired CEFM (n = 64). Qualitative and quantitative data were synthesised to give deeper understanding. FINDINGS Women using telemetry were more mobile and adopted more upright positions during labour. The core category A Sense of Normality encompassed themes of 'Being Free, Being in Control', 'Enabling and Facilitating' and 'Maternity Unit Culture'. Greater mobility resulted in increased feelings of internal and external control and increased perceptions of autonomy, normality and dignity. There was no difference in control or satisfaction between cohort groups. CONCLUSIONS When CEFM is used during labour, telemetry provides an opportunity to improve experience and support physiological capability. The use of telemetry during labour contributes to humanising birth for women who have CEFM and its use places them at the centre and in control of their birth experience.
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Affiliation(s)
- Kylie Watson
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, United Kingdom; Manchester University NHS Foundation Trust, United Kingdom.
| | - Tracey A Mills
- Department of International Public Health, Liverpool School of Tropical Medicine, United Kingdom. https://twitter.com/@traceymills18
| | - Tina Lavender
- Department of International Public Health, Liverpool School of Tropical Medicine, United Kingdom. https://twitter.com/@DameTina1
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Herrmann A, Holler E, Edinger M, Eickmann S, Wolff D. A qualitative study on patients' and their support persons' preferences for receiving one longer consultation or two shorter consultations when being informed about allogeneic hematopoietic stem cell transplantation. BMC Health Serv Res 2021; 21:623. [PMID: 34187476 PMCID: PMC8241532 DOI: 10.1186/s12913-021-06632-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the only potentially curative treatment option for many patients with hematological disorders but it includes a significant risk of mortality and long-term morbidity. Many patients and their support persons feel overwhelmed when being informed about alloHSCT and may benefit from improvements in consultation style and timing. Aims To explore, qualitatively, in a sample of hematological cancer patients and their support persons, their preferences for receiving one longer consultation or two shorter consultations when being informed about alloHSCT. Participants’ perceptions of when and how different consultation styles should be offered were also examined. Methods Semi-structured face-to-face and phone interviews were conducted. A purposeful sampling frame was used. Data were analysed using framework analysis. Results Twenty patients and 13 support persons were recruited (consent rate: 96%, response rate: 91%). Most patients (60%) and support persons (62%) preferred two shorter consultations over one longer consultation. This helped them digest and recall the information provided, remember questions they had, involve significant others and search for additional information. Patients would have liked to be offered paper and pen to take notes, take a break after 30 min and have their understanding checked at the end of the first consultation, e.g. using question prompt lists. Some patients and support persons preferred both consultations to happen on the same day to reduce waiting times as well as travel times and costs. Others preferred having a few days in-between both consultations to better help them prepare the second consultation. Participants reported varying preferences for different consultation styles depending on personal and disease-related characteristics, such as age, health literacy level and previous treatment. Conclusion To our knowledge, this is the first qualitative study to explore patients’ and their support persons’ preferences for having one longer consultation or two shorter consultations when being informed about alloHSCT. Receiving two shorter consultations may help patients process and recall the information provided and more actively involve their support persons. Clinicians should consider offering patients and their support persons to take a break after 30 min, provide paper and pen as well as question prompt lists.
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Affiliation(s)
- Anne Herrmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany. .,School of Medicine and Public Health/University of Newcastle and Hunter Medical Research Institute, New Lambton Heights, Australia.
| | - Ernst Holler
- Department of Haematology and Internal Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Edinger
- Department of Haematology and Internal Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Sascha Eickmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Daniel Wolff
- Department of Haematology and Internal Oncology, University Hospital Regensburg, Regensburg, Germany
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Women's Usage Behavior and Perceived Usefulness with Using a Mobile Health Application for Gestational Diabetes Mellitus: Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126670. [PMID: 34205744 PMCID: PMC8296439 DOI: 10.3390/ijerph18126670] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 12/17/2022]
Abstract
The prevalence of gestational diabetes mellitus (GDM) is increasing, and only a few mobile health (mHealth) applications are specifically designed to manage GDM. In this mixed-methods study, a follow-up study of a randomized controlled trial (RCT) analyzed a largely automated mHealth application-based lifestyle coaching program to (a) measure the application's usage behavior and (b) explore users' perceptions of its usefulness in GDM management. Quantitative data were collected from the 170 application users who had participated in the intervention arm of the RCT. Semi-structured interviews (n = 14) captured users' experiences when using the application. Data were collected from June 2019 to January 2020. Quantitative data were analyzed descriptively, and interviews were analyzed thematically. Only 57/170 users (34%) logged at least one meal, and only 35 meals on average were logged for eight weeks because of the incorrectly worded food items and limited food database. On the contrary, an average of 1.85 (SD = 1.60) weight values were logged per week since the weight tracking component was easy to use. Many users (6/14 (43%)) mentioned that the automatic coach messages created an immediate sense of self-awareness in food choices and motivated behavior. The findings suggest that for GDM management, a largely automated mHealth application has the potential to promote self-awareness of healthy lifestyle choices, reducing the need for intensive human resources. Additionally, several gaps in the application's design were identified which need to be addressed in future works.
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Song T, Liu F, Deng N, Qian S, Cui T, Guan Y, Arnolda L, Zhang Z, Yu P. A Comprehensive 6A Framework for Improving Patient Self-Management of Hypertension Using mHealth Services: Qualitative Thematic Analysis. J Med Internet Res 2021; 23:e25522. [PMID: 34152272 PMCID: PMC8277389 DOI: 10.2196/25522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/12/2021] [Accepted: 04/27/2021] [Indexed: 12/16/2022] Open
Abstract
Background Hypertension affects over 15% of the world’s population and is a significant global public health and socioeconomic challenge. Mobile health (mHealth) services have been increasingly introduced to support hypertensive patients to improve their self-management behaviors, such as adherence to pharmacotherapy and lifestyle modifications. Objective This study aims to explore patients’ perceptions of mHealth services and the mechanisms by which the services support them to self-manage their hypertension. Methods A semistructured, in-depth interview study was conducted with 22 outpatients of the General Hospital of Ningxia Medical University from March to May 2019. In 2015, the hospital introduced an mHealth service to support community-dwelling outpatients with self-management of hypertension. Content analysis was conducted by following a grounded theory approach for inductive thematic extraction. Constant comparison and categorization classified the first-level codes with similar meanings into higher-level themes. Results The patient-perceived mechanisms by which the mHealth service supported their self-management of hypertension were summarized as 6A: access, assessment, assistance, awareness, ability, and activation. With the portability of mobile phones and digitization of information, the mHealth service provided outpatients with easy access to assess their vital signs and self-management behaviors. The assessment results gave the patients real-time awareness of their health conditions and self-management performance, which activated their self-management behaviors. The mHealth service also gave outpatients access to assistance, which included health education and self-management reminders. Both types of assistance could also be activated by abnormal assessment results, that is, uncontrolled or deteriorating blood pressure values, discomfort symptoms, or not using the service for a long period. With its scalable use to handle any possible information and services, the mHealth service provided outpatients with educational materials to learn at their own pace. This led to an improvement in self-management awareness and ability, again activating their self-management behaviors. The patients would like to see further improvements in the service to provide more useful, personalized information and reliable services. Conclusions The mHealth service extended the traditional hypertension care model beyond the hospital and clinician’s office. It provided outpatients with easy access to otherwise inaccessible hypertension management services. This led to process improvement for outpatients to access health assessment and health care assistance and improved their awareness and self-management ability, which activated their hypertension self-management behaviors. Future studies can apply the 6A framework to guide the design, implementation, and evaluation of mHealth services for outpatients to self-manage chronic conditions.
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Affiliation(s)
- Ting Song
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Fang Liu
- Department of Health Examination, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Ning Deng
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Siyu Qian
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.,Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Tingru Cui
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Yingping Guan
- Department of Health Examination, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Leonard Arnolda
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Zhenyu Zhang
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
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Kohlhoff J, Cibralic S, Tooke S, Hickinbotham R, Knox C, Roach V, Barnett B. Health professional perspectives on an antenatal mental health screening program in a private hospital. Aust N Z J Obstet Gynaecol 2021; 61:891-897. [PMID: 34121178 DOI: 10.1111/ajo.13394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/11/2021] [Accepted: 04/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Perinatal mental ill-health is a global health priority. Mental health screening during pregnancy is a routine part of clinical practice in many public hospital obstetric services across Australia, but implementation in the private hospital system has lagged. AIMS This study explored health professionals' perspectives on the Pre-admission Midwife Appointment Program (PMAP), an antenatal mental health screening program at the Mater Hospital, Sydney. MATERIALS AND METHODS Nine midwives and three medical specialists participated in focus groups or individual interviews; key themes were determined using thematic qualitative analysis. RESULTS Five major themes and three sub-themes were identified: immediate benefits to women (identifying women at risk; referrals to support services; supporting and educating women); enhanced overall quality of care at the hospital; the dilemma of partners attending; factors that make the program successful; and recommendations for improvement. CONCLUSIONS Results will inform the implementation of antenatal mental health screening programs at other private hospitals across Australia.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Karitane, Sydney, New South Wales, Australia
| | - Sara Cibralic
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Sarah Tooke
- The Mater Hospital, Sydney, New South Wales, Australia
| | - Rachael Hickinbotham
- North Shore Private Hospital and the Mater Hospital, Sydney, New South Wales, Australia
| | | | - Vijay Roach
- North Shore Private Hospital and the Mater Hospital, Sydney, New South Wales, Australia
| | - Bryanne Barnett
- Gidget Foundation Australia, Sydney, New South Wales, Australia
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