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Zhang Q, Ge S, Zhang Z, Wang W, Wang S, Yoong SQ, Lin B, Mei Y. The experience of mutual support during hospitalization of co-morbid couples with recurrent older stroke survivors - A descriptive phenomenological study. Geriatr Nurs 2024; 59:187-195. [PMID: 39024735 DOI: 10.1016/j.gerinurse.2024.06.048] [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: 01/25/2024] [Revised: 06/13/2024] [Accepted: 06/27/2024] [Indexed: 07/20/2024]
Abstract
The phenomenon of the experiences of mutual support of co-morbid couples of recurrent older stroke survivors during hospitalization is receiving increased interest from nursing scholars. However, little is known about how they support each other. The aim of this study was to explore the experiences of co-morbid couples of older stroke survivors with recurrent stroke who support each other during hospitalization. A descriptive phenomenology study was employed. 21 co-morbid couples with recurrent older stroke survivors were recruited. The interviews were analyzed with Colaizzi's descriptive analysis framework. Three themes emerged from the data analysis: (1) maintaining the couple's relationship through mutual support, (2) mutual support so as not to drag the children down, and (3) providing support while struggling between ideals and reality. It is crucial to provide them with individualized, tailored support and interventions that can help these couples achieve a more optimal balance in their mutual support.
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Affiliation(s)
- Qingqing Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston TX 77002, USA
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hongkong, PR China
| | - Si Qi Yoong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Beilei Lin
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China.
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Allen LP, Kelly C, Hatala AR. Answering tough questions: Why is qualitative research essential for public health? Aust N Z J Public Health 2024; 48:100157. [PMID: 38797134 DOI: 10.1016/j.anzjph.2024.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 04/09/2024] [Accepted: 04/21/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Lindsay P Allen
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Christine Kelly
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Andrew R Hatala
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
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Mouchabac S, Adrien V, Diot T, Renaud MC, Carrié A, Bourla A, Ferreri F. Insights into medical students' perceptions of work culture during the COVID-19 pandemic: a mixed method study. BMC MEDICAL EDUCATION 2024; 24:21. [PMID: 38172850 PMCID: PMC10765811 DOI: 10.1186/s12909-023-04936-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The COVID-19 pandemic brought about profound social changes that affected students worldwide. These changes had both psychological and economic consequences, and also led to the adoption of new teaching methods. It can also have an impact on work culture, which is the collective set of values, norms, and practices within a specific profession, shaping how individuals in that field behave, communicate, and identify with their work. The aim of the study was to examine medical students' perception of professional culture during the COVID-19 crisis when they voluntarily participated in the healthcare network established, outside of university placements, for the management of COVID patients. METHODS A questionnaire study based on the vignette methodology was conducted among third-year medical students. Drawing from three scenarios in which students were variably engaged in crisis management, it included questions about their perceptions of the medical profession, their motivation, and their sense of belonging to the profession. RESULTS 352 students responded to the survey. The pandemic had both a positive and a negative impact on students' perceptions of the medical profession. Cluster analysis using a k-means algorithm and principal component analysis revealed three clusters of students with different perceptions of the medical profession. The first cluster, which represented the majority of students, corresponded to a relatively positive perception of the profession that was reinforced during the pandemic. In the second cluster, students' perceptions were reinforced still further, and particular importance was attached to field experience. Students in the third cluster had the most negative perceptions, having been shaken the most by the pandemic, and they attached little importance to field experience. CONCLUSIONS The analysis highlighted the importance of students being able to adapt and draw on a range of resources during the COVID-19 pandemic. This underscores the need for work cultures that support adaptability and coping. Further research is needed to understand its long-term effects on students' perceptions of the medical profession and to identify interventions that could support students in the aftermath of this difficult period.
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Affiliation(s)
- Stephane Mouchabac
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France.
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France.
| | - Vladimir Adrien
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
| | - Thomas Diot
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
| | | | - Alain Carrié
- Faculty of Medicine, Sorbonne University, Paris, France
| | - Alexis Bourla
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
| | - Florian Ferreri
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
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Josma D, Morris J, Hopkins R, Quamina A, Siegler AJ, Holland D, Sullivan P, Harrington KRV, Alohan DI, Crawford ND. Comparing open-ended question methods to vignette methods to explore willingness to obtain pre-exposure prophylaxis access in pharmacies among black men who have sex with men. AIDS Care 2023; 35:1955-1962. [PMID: 36892947 PMCID: PMC10491733 DOI: 10.1080/09540121.2023.2185193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 02/21/2023] [Indexed: 03/10/2023]
Abstract
Black men who have sex with men (BMSM) are at higher risk of HIV transmission than any other group; however, their uptake of the highly effective HIV prevention medication, pre-exposure prophylaxis (PrEP), is low. In collaboration with a communitybased organization in Atlanta, Georgia, we explored ten HIV-negative BMSM's willingness to obtain PrEP in pharmacies using standard open-ended and vignette qualitative methods. Three overarching themes were identified: privacy, patient-pharmacist interactions, and HIV/STI screening. While open-ended questions allowed participants to provide broad answers on their willingness to receive prevention services at a pharmacy, the vignette drew out specific responses to facilitate in-pharmacy PrEP delivery. Using both openended questions and vignette data collection strategies, BMSM reported high willingness to screen for and uptake PrEP in pharmacies. However, the vignette method allowed for greater depth. Open-ended questions elicited responses that highlighted general barriers and facilitators of PrEP dispensing in pharmacies. However, the vignette allowed participants to customize a plan of action that would best fit their needs. Vignette methods are underutilized in HIV research and may be helpful in supplementing standard open-ended interview questions to uncovering unknown challenges about health behaviors and obtain more robust data on highly sensitive research topics in HIV research.
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Affiliation(s)
| | - Joseph Morris
- National Center for Emerging, Zoonotic, and Infectious Diseases, Office of Innovation, Development, Analytics, and Evaluation, Centers for Disease Control and Prevention
| | - Roderick Hopkins
- Division of Global Migration and Quarantine (DGMQ), Community Interventions for Infection Control Unit (CI-ICU), Centers for Disease Control and Prevention
| | | | - Aaron J. Siegler
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Patrick Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Daniel I. Alohan
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, GA, USA
| | - Natalie D. Crawford
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, GA, USA
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Wang G, Liu X, Zhu S, Lei J. Experience of mental health in women with Polycystic Ovary Syndrome: a descriptive phenomenological study. J Psychosom Obstet Gynaecol 2023; 44:2218987. [PMID: 37267127 DOI: 10.1080/0167482x.2023.2218987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/04/2023] Open
Abstract
Purpose: This study aims to investigate the experiences, emotional coping strategies, and help-seeking needs of women with PCOS from their perspective, considering common psychological issues such as stress, anxiety, and depression that are prevalent among individuals with PCOS. Materials and Methods: The study recruited 14 women with PCOS for semi-structured interviews between October and November 2022, using a descriptive phenomenology method design. The interviews were analyzed using NVivo 12 software. Results: Four themes and eleven subthemes were derived from the semi-structured interviews: (1) Negative Mental Health Status; (2) Four Patterns of Emotion Regulation; (3) The Psychological Double-Edged Sword: Family Social Network; (4) Strong Demands for Psychological Counseling and Lifestyle Guidance. Conclusion: The study suggests that interventions should focus on fostering internalized self-efficacy and emotional expression, promoting constructive familial support, and providing psychological counseling and lifestyle recommendations to alleviate psychological distress experienced by women with PCOS.
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Affiliation(s)
- Guangpeng Wang
- The Third Xiangya Hospital of Central South University, Changsha, China
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xueyan Liu
- School of Nursing, Shandong University, Jinan, China
| | - Shujuan Zhu
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jun Lei
- The Third Xiangya Hospital of Central South University, Changsha, China
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Bayes N, Mason C, Haycraft E, Holley CE. Exploring the feasibility of using evidence-based feeding practices to promote children's healthy eating in holiday clubs. Public Health Nutr 2023; 26:2868-2881. [PMID: 37886798 PMCID: PMC10755445 DOI: 10.1017/s1368980023002276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 09/17/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVE Encouraging healthy eating is a public health priority in the United Kingdom (UK), given the high prevalence of poor diet and overweight/obesity among school-aged children. Holiday clubs are organisations providing childcare and activities during the school holidays and frequently provide food to children at risk of food insecurity, primarily through government-funded programmes like the Holiday Activities and Food programme. However, the research suggests that holiday clubs could do more to maximise opportunities to promote children's healthy eating by using evidence-based feeding practices. DESIGN During August-September 2020, video-based interviews were conducted exploring staff perceptions of the feasibility of using four evidence-based feeding practices to promote children's healthy eating: modelling; involvement in food choice; involvement in food preparation and cooking and involvement in meal planning. Feasibility was assessed using four dimensions of a feasibility framework (acceptability, demand, practicality and implementation). SETTING UK holiday clubs. PARTICIPANTS Twenty-five staff actively involved in delivering UK holiday clubs (project leaders, coordinators, cooks and coaches/youth workers). RESULTS Staff generally reported good acceptability (dimension 1) and demand (dimension 2) for the feeding practices. However, the practicality (dimension 3) of using the practices was dependent on various factors (logistics, resources, staff readiness, children, peers and parents). Promisingly, in the fourth feasibility dimension (implementation), staff provided numerous practical solutions to overcome these barriers. CONCLUSIONS Evidence-based feeding practices can be implemented in numerous ways and are therefore generally feasible in holiday clubs. Holiday clubs should be empowered to use evidence-based feeding practices through training resources, sharing networks and provision of sustainable funding.
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Affiliation(s)
- Natasha Bayes
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, LiverpoolL69 7ZA, UK
| | - Carolynne Mason
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK
| | - Clare E Holley
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK
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Byrne GR, Shafran R, Whadcock K, Bennett SD. The Influence of Comorbidity and Perceived Complexity on Outcomes of Referrals to Children and Young Person Mental Health Services (UK): A Mixed Methods Vignette Study. Clin Child Psychol Psychiatry 2023; 28:1393-1407. [PMID: 36843314 DOI: 10.1177/13591045231155990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Children and young people (CYP) with long-term physical conditions (LTCs) are four times more likely to develop mental health disorders yet many cannot access Children and Young People's Mental Health Services (CYPMHS) or evidence-based interventions. This study aimed to understand the reasons for this; presence of an LTC neurodevelopmental disorder, or service requirements. 79 CYP mental health practitioners were randomly assigned to read vignettes depicting a hypothetical referral letter for a child with a mental health condition alone (n = 27), mental health condition and LTC (n = 25), or mental health condition and neurodevelopmental disorder (Autism Spectrum Disorder-ASD) (n = 27), answering questions about their likelihood of accepting the referral and proposed treatment plan. There were no significant differences between accessing CYPMHS or being offered first line evidence-based interventions in those with a LTC or ASD compared to those without. However, additional perceived complexity was frequently provided as a reason for rejecting referrals and not offering evidence-based intervention, with clinicians' predicted success of intervention significantly lower for these CYP. Clinicians were significantly more likely to suggest adapting the intervention in the LTC and the ASD groups to account for additional perceived complexity. The research suggests a need for additional services for CYP with LTCs and those with neurodevelopmental disorders, as well as training/awareness for clinicians.
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Lauretta ML, Jarmolowicz A, Amor DJ, Best S, Morgan AT. An Investigation of Barriers and Enablers for Genetics in Speech-Language Pathology Explored Through a Case Study of Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-15. [PMID: 37713535 DOI: 10.1044/2023_jslhr-22-00714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
PURPOSE Advancements in genetic testing and analysis have allowed improved identification of the genetic basis of childhood apraxia of speech, a rare speech presentation. This study aimed to understand speech-language pathologists' (SLPs') consideration of incorporation of genetics in clinical practice using a theory-informed qualitative approach. METHOD Semistructured interviews were conducted with 12 pediatric SLPs using a behavior change theory (Theoretical Domains Framework [TDF]) within a case study describing a child with complex co-occurring features, including childhood apraxia of speech. Interviews focused on three stages of the patient journey (prereferral, referral, and postreferral). Interviews were analyzed to identify barriers and enablers to considering incorporation of genetics in current clinical practice. Barriers and enablers were grouped and mapped onto a contextually relevant TDF-coded analysis framework. RESULTS Barriers were identified across several TDF domains, through all stages of the patient journey. Lack of confidence, relevance, and level of experience were most common prereferral, and connection to and awareness of genetics services and contextual factors were barriers in the referral stage. Perception of professional role, knowledge, and beliefs about effects on families were barriers postreferral. Associated enablers were also identified, including seeing value in genetic diagnosis, support from other health care professionals, supervision, and relationships with genetics services. CONCLUSIONS Results of this qualitative study highlight barriers and enablers to incorporating genetics into speech-language pathology clinical practice. These findings will assist in the development of theory-informed implementation strategies to support SLPs into the future. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24112800.
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Affiliation(s)
| | - Anna Jarmolowicz
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - David J Amor
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Royal Children's Hospital, Parkville, Victoria, Australia
| | - Stephanie Best
- Australian Genomics, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Victorian Comprehensive Cancer Centre Alliance, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Royal Children's Hospital, Parkville, Victoria, Australia
- The University of Queensland, St. Lucia, Australia
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Yu H, Sun YJ, Qin MN, Ren JX, Yu K, Song J, Zhou YQ, Liu L. Perception of risk of relapse among patients with first episode and recurrent schizophrenia: a descriptive phenomenological study. BMC Psychiatry 2023; 23:582. [PMID: 37563579 PMCID: PMC10413637 DOI: 10.1186/s12888-023-05023-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/12/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Patients suffering from schizophrenia are at a higher risk of relapse. The perception of the risk of relapse in patients is critical for relapse prevention. In the field of psychiatry, the study of risk perception of relapse has been neglected. METHODS We carried out a qualitative study using a descriptive phenomenological approach. Data were collected at two psychiatric hospitals in China. In total, 22 patients with schizophrenia were recruited through purposive sampling. Face to face semi-structured in-depth interviews were conducted. Interview recordings were transcribed by the research team, and transcripts were analysed by two independent coders with Colaizzi's descriptive analysis framework. The consolidated criteria for reporting qualitative research checklist were used for reporting. RESULTS The data of first-episode patients yielded three themes: (i) lack of knowledge about disease recognition and medical treatment; (ii) overoptimistic estimation of the risk of relapse; (iii) perceived importance of treatment. For first-relapse patients : (i) initial awareness of relapse warning signs; (ii) lack of systematic and accurate assessment of disease information; (iii) the perception that drug withdrawal is related to relapse. Patients with multiple relapses: (i) susceptibility to relapse: confusion and powerlessness; (ii) the severity of relapse: suicidal thoughts and behavior; (iii) effects of perceived benefits and barriers of medication behaviour. CONCLUSIONS In schizophrenic patients with first-episode, first-relapse, and multiple relapses, there were dynamic changes in the perception of disease relapse risk and medication behaviour. Medical workers must improve risk awareness education. They should provide patients with scientific, accurate, and timely communication channels, and dynamically assess and manage the risk of relapse in various patients.
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Affiliation(s)
- Hong Yu
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Yu-Jing Sun
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Meng-Nan Qin
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Jia-Xin Ren
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Kai Yu
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Jin Song
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Yu-Qiu Zhou
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China.
| | - Li Liu
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
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Pu D, Bonnici R, Haines T. Engaging the consumer in disinvestment in public healthcare: Concerns, perspectives and attitudes of older adults. J Eval Clin Pract 2023; 29:320-328. [PMID: 36165636 DOI: 10.1111/jep.13769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022]
Abstract
RATIONALE Low-value care in public health can be addressed via disinvestment with the support of disinvestment research generated evidence. Consumers' views of disinvestment have rarely been explored despite the potential effects of this process on the care they will receive and the importance of consumer participation in decision-making in public healthcare. AIMS AND OBJECTIVES This study aimed to understand consumer concerns, perceptions and attitudes towards disinvestment processes, with the goal of providing recommendations to health service researchers and managers to more effectively engage consumers in shared decision-making in public healthcare. METHOD We conducted semistructured interviews using four scenarios describing the principles of disinvestment, how and why it could be undertaken, and a fifth scenario that described a real-life application of these principles. These scenarios were presented to participants in a written word document or a digital story during semistructured interviews. Participants were 18 community-dwelling older adults who were recruited via convenience sampling. Questions were addressed to the participants regarding their feelings and concerns towards disinvestment, their participation as consumers in disinvestment processes, as well as their preference for communicating information about disinvestment to patients and families. RESULTS Four major themes emerged around the negative perception of disinvestment and positive perception of research. Participants were concerned that the removal of a clinical activity was mainly the result of financial constraints in hospital systems. At times, participants indicated that disinvestment and its justifications were not easily understood. Participants expressed a need for consumer advocacy not always through themselves, but via others with more expertize; a single consumer is insufficient in representing the broader consumer perspective. Participants stressed the importance of transparency in relation to research evidence and decision-making outcomes. Face-to-face dissemination of information by expert staff was preferred, which could be supplemented with clear and concise written materials. CONCLUSION Consumers' main perception of disinvestment processes was that the removal of a clinical care activity depended on financial imperatives from hospital administration and political agendas. This tended to cause suspicion about reasons behind the removal of care, which overshadowed comprehension of the ineffective/inconclusive evidence that were key to disinvestment.
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Affiliation(s)
- Dai Pu
- National Centre for Healthy Ageing and School of Primary and Allied Healthcare, Monash University Peninsula Campus, Frankston, Victoria, Australia
| | - Rachel Bonnici
- National Centre for Healthy Ageing and School of Primary and Allied Healthcare, Monash University Peninsula Campus, Frankston, Victoria, Australia.,Better Place Australia, Cheltenham, Australia
| | - Terry Haines
- National Centre for Healthy Ageing and School of Primary and Allied Healthcare, Monash University Peninsula Campus, Frankston, Victoria, Australia
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Wang JN, Liu LM, Dela Rosa R, Sun MJ, Qian YM, Sun MYZ, Xu TY. Experiences of family caregivers of patients with post-traumatic hydrocephalus from hospital to home: a qualitative study. BMC Health Serv Res 2022; 22:1132. [PMID: 36071481 PMCID: PMC9454203 DOI: 10.1186/s12913-022-08502-4] [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: 06/14/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Post-traumatic hydrocephalus (PTH) is a complication of traumatic brain injury (TBI) that requires treatment and postoperative care. The shunt is one of the main treatments for PTH, which presents with dysfunction and infection. Considering brain injury, hydrocephalus shunt malfunction, and infection, family caregivers need to be responsible for caring for PTH patients, recognizing shunt malfunction and infection, and managing those patients accordingly from hospital to home. Understanding the experiences and needs of caregivers is beneficial for knowing their competency and quality of health care, ameliorating and ensuring future transition care. The study aimed to explore the feelings, experiences, and needs of family caregivers when caring for patients with TBI, PTH and shunts. Methods This was exploratory research of a purposive sample of 12 family caregivers of adult patients with TBI, PTH and shunts in five neurosurgery departments at a general hospital in Zhengzhou, Henan Province, China, using a semi-structured interview method. Data were collected from October 2021 to March 2022 before being analyzed by content analysis methods. Results Caregivers required professional and social knowledge and support in the areas of TBI, PTH and shunts, caregiving interventions, psychological care needs, and health insurance, just as caregivers do, but unlike other general caregivers, care for patients with TBI, PTH, and shunt is fraught with uncertainty and the need to manage shunt setting, and caregivers often experience 'complex emotional reaction' during the transitional period, where care needs and complex emotions may lead to a lack of caregiver confidence, which in turn may affect caregiving behaviors, and experiences that affect care may be mediated through caregiving confidence. The perceived availability of resources, particularly those that are still available to them when they return home, has a significant impact on participants' emotional response and sense of confidence. Conclusions The emotional response and the impact of stressor caregivers after TBI, PTH, and shunt was important, and sometimes confidence in care appeared to be an intermediate and useful factor that needed to be considered as health professionals prepared to develop care resources on how to manage and empower patients with TBI, PTH, and shunt. Meanwhile, there may be gaps and inequities in supportive care for patients diagnosed with TBI, PTH, and shunt in China.
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Affiliation(s)
- Jia-Nan Wang
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech district, Zhengzhou City, 450000, Henan province, China
| | - La-Mei Liu
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech district, Zhengzhou City, 450000, Henan province, China.
| | - Ronnell Dela Rosa
- School of Nursing, Philippine Women's University, 1743 Taft Avenue, 1004, Malate, Manila, Philippines.,Bataan Peninsula State University, College of Nursing and Midwifery, City of Balanga, 2100, Bataan, Philippines
| | - Meng-Jie Sun
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech district, Zhengzhou City, 450000, Henan province, China
| | - Yu-Meng Qian
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech district, Zhengzhou City, 450000, Henan province, China
| | - Meng-Yao Zhuan Sun
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech district, Zhengzhou City, 450000, Henan province, China
| | - Tong-Yao Xu
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech district, Zhengzhou City, 450000, Henan province, China
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Smith C, Goss HR, Issartel J, Meegan S, Belton S. LifeLab: Co-Design of an Interactive Health Literacy Intervention for Socioeconomically Disadvantaged Adolescents’. CHILDREN 2022; 9:children9081230. [PMID: 36010120 PMCID: PMC9406774 DOI: 10.3390/children9081230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022]
Abstract
Low socioeconomic populations, when compared to more affluent groups, are at greater risk of initiating risky behaviours and consequently developing health complications. Health literacy has been identified as a possible means to improve and sustain positive health behaviours, with adolescence being a time point when such behaviours can be embedded. To develop a meaningful health intervention, it has been recommended that relevant stakeholders be included in the design phase. This formative evaluation study was the second phase of co-design of an engaging health literacy intervention ‘LifeLab’ with, and for, socioeconomically disadvantaged adolescents in Ireland. In Spring 2021, a series of co-design workshops (n = 17) were facilitated with a convenience sample of adolescents from socially disadvantaged areas (n = 22) to gather their perceptions, feedback, and suggested changes on the LifeLab learning activities that had emerged from Phase 1 of the work. The data was analysed using reflexive thematic analysis, resulting in the development of three themes: (i) preferred learning engagement strategies, (ii) practical and logistical considerations and (iii) ideas for LifeLab content. The results highlight the value in adopting a participatory approach, as participants offered an array of suggestions and details to maximise the potential for LifeLab to be contextually relevant and engaging; suggestions which will directly inform the development and implementation of the intervention.
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Yu K, Wang Y, Wang XQ, Ma R, Li YL, Zhou YQ. Experience of reproductive concerns in women with schizophrenia: A descriptive phenomenological study. Int J Nurs Stud 2022; 135:104343. [PMID: 36029550 DOI: 10.1016/j.ijnurstu.2022.104343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/01/2022] [Accepted: 08/02/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Reproductive concerns significantly affect the mental health of people, causing more serious psychological stress than disease. The reproductive concerns faced by women with schizophrenia are issues that have been neglected in the areas of psychiatry and women's health. OBJECTIVES To explore the experience of reproductive concerns through the perspective of women with schizophrenia. DESIGN Descriptive phenomenology interview study. SETTING Data collection was carried out in a psychiatric hospital in China. PARTICIPANTS 15 women with schizophrenia were recruited with a prospective sampling. All participants were 26-40 years old. METHODS The interview recordings were transcribed by the research team, and transcripts were analyzed by two independent coders with Colaizzi's descriptive analysis framework. The process employed NVivo 12 software. RESULTS Data analysis identified 9 subthemes falling into the 4 macrothemes: (a) Potential risks of reproduction; (b) The difficulties in raising children; (c) Significance of reproduction; (d) Multiparty cooperation is needed to relieve reproductive concerns. CONCLUSION Women with schizophrenia have reproductive concerns under the conflict between the significance of reproduction and obstacles. Interventions to address the reproductive problems of women with schizophrenia should be developed in three areas: the women themselves, the women's spouses and the medical staff.
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Affiliation(s)
- Kai Yu
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Yu Wang
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Xiao-Qing Wang
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Rui Ma
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Ying-Li Li
- Medicine College Jiaxing University, Jiaxing, Zhejiang, 314001, China
| | - Yu-Qiu Zhou
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China.
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De Alwis S, Hernwall P, Adikaram AS. “It is ok to be interrupted; it is my job” – perceptions on technology-mediated work-life boundary experiences; a sociomaterial analysis. QUALITATIVE RESEARCH IN ORGANIZATIONS AND MANAGEMENT: AN INTERNATIONAL JOURNAL 2022. [DOI: 10.1108/qrom-01-2021-2084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study aims to explore how and why employees perceive technology-mediated interruptions differently and the role of sociocultural factors in this process using sociomaterial analysis.Design/methodology/approachData were gathered from 34 Sri Lankan knowledge workers using a series of workshop-based activities. The concept of sociomateriality is employed to understand how sociocultural elements are entangled with technology in work-life boundary experiences.FindingsThe findings of the thematic analyses suggest how culture is intertwined in the way employees perceive technology-mediated interruptions and how they manage information communication technologies (ICTs) to balance their work and nonwork demands. Participants have been unable to avoid technology-mediated boundary interruptions from work, as organisations have created norms to keep employees connected to organisations using information communication technologies. Traditional gender roles are specifically found to be entangled in employees' boundary management practices, disadvantaging women more.Practical implicationsThe findings highlight how national culture and gender norms create challenging work-life experiences for female employees than males. This could create a disadvantageous position for female employees in their career progression. It is crucial to consider factors such as boundary preferences and family concerns when deciding on family-friendly work policies. Also, organisations have to consider the development of explicit guidelines on after-hours communication expectations.Originality/valueUsing the lens of sociomateriality, researchers can understand the contextual entanglement of ICTs with national culture and gender norms in creating different work-life boundary experiences. It seems ICTs are creating a disadvantage for female employees when managing work–nonwork boundaries, especially in power distant and collectivist cultures where traditional gender norms are highly valued and largely upheld. This study also contributes to the current discourse on work-life boundaries by providing insights from non-western perspectives.
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Tremblay D, Turcotte A, Touati N, Poder TG, Kilpatrick K, Bilodeau K, Roy M, Richard PO, Lessard S, Giordano É. Development and use of research vignettes to collect qualitative data from healthcare professionals: a scoping review. BMJ Open 2022; 12:e057095. [PMID: 35105654 PMCID: PMC8804653 DOI: 10.1136/bmjopen-2021-057095] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To clarify the definition of vignette-based methodology in qualitative research and to identify key elements underpinning its development and utilisation in qualitative empirical studies involving healthcare professionals. DESIGN Scoping review according to the Joanna Briggs Institute framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. DATA SOURCES Electronic databases: Academic Search Complete, CINAHL Plus, MEDLINE, PsycINFO and SocINDEX (January 2000-December 2020). ELIGIBILITY CRITERIA Empirical studies in English or French with a qualitative design including an explicit methodological description of the development and/or use of vignettes to collect qualitative data from healthcare professionals. Titles and abstracts were screened, and full text was reviewed by pairs of researchers according to inclusion/exclusion criteria. DATA EXTRACTION AND SYNTHESIS Data extraction included study characteristics, definition, development and utilisation of a vignette, as well as strengths, limitations and recommendations from authors of the included articles. Systematic qualitative thematic analysis was performed, followed by data matrices to display the findings according to the scoping review questions. RESULTS Ten articles were included. An explicit definition of vignettes was provided in only half the studies. Variations of the development process (steps, expert consultation and pretesting), data collection and analysis demonstrate opportunities for improvement in rigour and transparency of the whole research process. Most studies failed to address quality criteria of the wider qualitative design and to discuss study limitations. CONCLUSIONS Vignette-based studies in qualitative research appear promising to deepen our understanding of sensitive and challenging situations lived by healthcare professionals. However, vignettes require conceptual clarification and robust methodological guidance so that researchers can systematically plan their study. Focusing on quality criteria of qualitative design can produce stronger evidence around measures that may help healthcare professionals reflect on and learn to cope with adversity.
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Affiliation(s)
- Dominique Tremblay
- School of Nursing, Université de Sherbrooke, Longueuil, Quebec, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
| | - Annie Turcotte
- School of Nursing, Université de Sherbrooke, Longueuil, Quebec, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
| | - Nassera Touati
- École Nationale d'Administration Publique, Montreal, Quebec, Canada
| | - Thomas G Poder
- School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Kelley Kilpatrick
- Ingram School of Nursing, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Susan E. French Chair in Nursing Research and Innovative Practice, Montreal, Quebec, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Mathieu Roy
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Patrick O Richard
- Department of Surgery, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sylvie Lessard
- Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
| | - Émilie Giordano
- Centre de recherche Charles-Le Moyne, Longueuil, Quebec, Canada
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Gamboa CJ, Julion WA, Fogg L, Bounds DT. Using Vignette-Based Methodology to Examine Study Recruitment in Older African American Adults: A Methods Paper. J Urban Health 2021; 98:103-114. [PMID: 34322834 PMCID: PMC8501170 DOI: 10.1007/s11524-021-00567-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 10/20/2022]
Abstract
This study's objective was to assess which caring recruitment behaviors correlate with the successful recruitment of older African-American adults-a two-step cross-sectional design employing a vignette-based survey methodology. Kristen Swanson's middle-range theory of caring was used to guide the examination of African-American adults' (65 years of age and older) perceptions of research-study-recruiter recruitment behaviors. This study's main findings are twofold: Step 1: Seven of ten invited experts identified major revisions of the two core vignettes, written at an eighth-grade reading level and high school comprehension. Step 2: A 51% response rate yielded findings that this methodology successfully captured older African-American adults' perception of research study recruiters' behavioral characteristics during the recruitment process. Older African-Americans who received the hypothetical caring vignette were twice as likely to indicate their willingness to enroll in a research study with a high commitment (i.e., brain donation) compared to their counterparts who received the hypothetical uncaring recruitment scenario. Vignette-based survey methodology holds promise as a tool for informing the recruitment of older African-American adults and other minorities into federally funded health-related research studies.
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Affiliation(s)
- Charlene J Gamboa
- College of Nursing, Rush University Medical Center, 600 S. Paulina Street | Suite 1080, Chicago, Illinois, 60612, USA.
| | - Wrenetha A Julion
- College of Nursing, Rush University Medical Center, 600 S. Paulina Street | Suite 1080, Chicago, Illinois, 60612, USA
| | - Louis Fogg
- College of Nursing, Rush University Medical Center, 600 S. Paulina Street | Suite 1080, Chicago, Illinois, 60612, USA
| | - Dawn T Bounds
- University of California, Irvine, Sue & Bill Gross School of Nursing, California, CA, USA
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Parkes T, Carver H, Matheson C, Browne T, Pauly B. ‘It’s like a safety haven’: considerations for the implementation of managed alcohol programs in Scotland. DRUGS: EDUCATION, PREVENTION AND POLICY 2021. [DOI: 10.1080/09687637.2021.1945536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Tessa Parkes
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Hannah Carver
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Catriona Matheson
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Tania Browne
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Bernie Pauly
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
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Yasobant S, Bruchhausen W, Saxena D, Falkenberg T. Systemic factors for enhancing intersectoral collaboration for the operationalization of One Health: a case study in India. Health Res Policy Syst 2021; 19:75. [PMID: 33947418 PMCID: PMC8097865 DOI: 10.1186/s12961-021-00727-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/13/2021] [Indexed: 01/13/2023] Open
Abstract
Background One Health is a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment. Operationalization of the One Health approach is still unclear for various local health systems with their respective targets. In this scenario, the empirical study of intersectoral collaboration between the human and animal health systems provides an opportunity to investigate the appropriate strategies and their enabling factors at the local health system level. Thus, this study documented and validated the innovative strategy for intersectoral collaboration, focusing on effectual prevention and control of zoonotic diseases with its enabling factors for a city in western India, Ahmedabad. Methods This case study was conducted in three phases: phase I (qualitative data collection, i.e., vignette interview), phase II (quantitative data collection through modified policy Delphi), and phase III (participatory workshop). The vignette data were handled for content analysis, and the Delphi data, like other quantitative data, for descriptive statistics. The participatory workshop adapts the computerized Sensitivity Model® developed by Vester to analyse the health system dynamics. Result Out of the possible 36 strategies, this study validated the top 15 essential (must-have) and five preferred (should-have) strategies for the study area. For operationalization of the One Health approach, the enabling factors that were identified through the systems approach are micro-level factors at the individual level (trust, leadership, motivation, knowledge), meso-level factors at the organizational level (human resource, capacity-building, shared vision, decision-making capacity, laboratory capacity, surveillance), macro-level factors at the system level (coordinated roles, relationships, common platform), and external factors outside of the system (guidelines/policies, community participation, a specific budget, political will, smart technology). Discussion This study reveals that the micro-level factors at the individual level are potential levers of the health system. More attention to these factors could be beneficial for the operationalization of the One Health approach. This study recommends a systems approach through a bottom-up exploration to understand the local health system and its enabling factors, which should be accounted for in formulating future One Health policies. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00727-9.
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Affiliation(s)
- Sandul Yasobant
- Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113, Bonn, Germany. .,Global Health, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127, Bonn, Germany.
| | - Walter Bruchhausen
- Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113, Bonn, Germany.,Global Health, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127, Bonn, Germany
| | - Deepak Saxena
- Indian Institute of Public Health Gandhinagar (IIPHG), 382042, Gandhinagar, India.,Datta Meghe Institute of Medical Sciences, Jawaharlal Nehru Medical College, 442004, Wardha, India
| | - Timo Falkenberg
- Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113, Bonn, Germany.,GeoHealth Centre, Institute for Hygiene and Public Health (IHPH), University Hospital Bonn, 53127, Bonn, Germany
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19
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Ndumu A. Critical Perspectives on Diversity and Equality in U.S. LIS Practice: Four HBCU-affiliated Leaders Weigh in. LIBRI 2021. [DOI: 10.1515/libri-2019-0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Historically Black colleges and universities (HBCUs) have trained Black librarians and strengthened the library profession since 1927 when the first HBCU-based library school was founded at Hampton University. However, HBCU professors, library directors, and alumni are often overlooked in conversations on librarian professionalization. In this article, four distinguished HBCU-affiliated library leaders provide critical perspectives on LIS practice. Their collective insight illustrates the value of HBCUs in LIS and demonstrates opportunities for new directions.
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Affiliation(s)
- Ana Ndumu
- College of Information , University of Maryland , 4125 Hornbake Library South , College Park , Maryland , 20770 , USA
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20
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Understanding disadvantaged adolescents' perception of health literacy through a systematic development of peer vignettes. BMC Public Health 2021; 21:593. [PMID: 33765994 PMCID: PMC7992854 DOI: 10.1186/s12889-021-10634-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/15/2021] [Indexed: 01/11/2023] Open
Abstract
Background Adolescence represents a crucial phase of life where health behaviours, attitudes and social determinants can have lasting impacts on health quality across the life course. Unhealthy behaviour in young people is generally more common in low socioeconomic groups. Nevertheless, all adolescents should have a fair opportunity to attain their full health potential. Health literacy is positioned as a potential mediating factor to improve health, but research regarding health literacy in adolescents and socially disadvantaged populations is limited. As part of Phase one of the Ophelia (OPtimising HEalth LIterAcy) framework, The purpose of this study was to explore the perceptions of socially disadvantaged Irish adolescents in relation to health literacy and related behaviours, and utilise this data to develop relevant vignettes. Methods A convergent mixed method design was used to co-create the vignettes. Questionnaires were completed by 962 adolescents (males n = 553, females n = 409, Mean age = 13.97 ± 0.96 years) from five participating disadvantaged schools in Leinster, Ireland. Focus groups were also conducted in each school (n = 31). Results were synthesised using cluster and thematic analysis, to develop nine vignettes that represented typical male and female subgroups across the schools with varying health literacy profiles. These vignettes were then validated through triangular consensus with students, teachers, and researchers. Discussion The co-creation process was a participatory methodology which promoted the engagement and autonomy of the young people involved in the project. The vignettes themselves provide an authentic and tangible description of the health issues and health literacy profiles of adolescents in this context. Application of these vignettes in workshops involving students and teachers, will enable meaningful engagement in the discussion of health literacy and health-related behaviours in Irish young people, and the potential co-designing of strategies to address health literacy in youth. Conclusion As guided by the Ophelia framework, the use of authentic, interactive and participatory research methods, such as the co-creation of vignettes, is particularly important in groups that are underserved by traditional research methods. The approach used in this study could be adapted to other contexts to represent and understand stakeholders’ perceptions of health, with a view to explore, and ultimately improve, health literacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10634-x.
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Hirt J, Karrer M, Adlbrecht L, Saxer S, Zeller A. Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers. BMC Geriatr 2021; 21:159. [PMID: 33663417 PMCID: PMC7932832 DOI: 10.1186/s12877-021-02120-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02120-1.
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Affiliation(s)
- Julian Hirt
- Competence Center Dementia Care, Institute of Applied Nursing Sciences, Department of Health, Eastern Switzerland University of Applied Sciences (formerly FHS St.Gallen), Rosenbergstrasse 59, 9000, St.Gallen, Switzerland.,International Graduate Academy, Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06112, Halle (Saale), Germany
| | - Melanie Karrer
- Competence Center Dementia Care, Institute of Applied Nursing Sciences, Department of Health, Eastern Switzerland University of Applied Sciences (formerly FHS St.Gallen), Rosenbergstrasse 59, 9000, St.Gallen, Switzerland
| | - Laura Adlbrecht
- Competence Center Dementia Care, Institute of Applied Nursing Sciences, Department of Health, Eastern Switzerland University of Applied Sciences (formerly FHS St.Gallen), Rosenbergstrasse 59, 9000, St.Gallen, Switzerland
| | - Susi Saxer
- Competence Center Dementia Care, Institute of Applied Nursing Sciences, Department of Health, Eastern Switzerland University of Applied Sciences (formerly FHS St.Gallen), Rosenbergstrasse 59, 9000, St.Gallen, Switzerland
| | - Adelheid Zeller
- Competence Center Dementia Care, Institute of Applied Nursing Sciences, Department of Health, Eastern Switzerland University of Applied Sciences (formerly FHS St.Gallen), Rosenbergstrasse 59, 9000, St.Gallen, Switzerland.
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St Marie B, Jimmerson A, Perkhounkova Y, Herr K. Developing and Establishing Content Validity of Vignettes for Health Care Education and Research. West J Nurs Res 2020; 43:677-685. [PMID: 33150841 DOI: 10.1177/0193945920969693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The use of vignettes in research and education is well documented. Documentation of how vignettes are developed and content validity is established, however, are rare. The purpose of this paper is to describe a method for development and establishing content validity of vignettes that can be used to assess student performance and research participant outcomes. This three-phase method was designed to validate seven vignettes for a future research project. Content validity index survey and expert panel interviews were used to inform improvements in validity. Findings showed that clinical vignettes were improved with respect to content relevance (from 0.93 to 0.96) and importance (from 0.68 to 0.93). Developing validated vignettes is essential when used to measure outcomes in education and in research. This three-phase method of vignette development and validation is feasible and effective in improving content validity of vignettes and can be used in other education and research projects.
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Affiliation(s)
| | | | | | - Keela Herr
- College of Nursing, University of Iowa, Iowa City, IA, USA
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Carver H, Parkes T, Browne T, Matheson C, Pauly B. Investigating the need for alcohol harm reduction and managed alcohol programs for people experiencing homelessness and alcohol use disorders in Scotland. Drug Alcohol Rev 2020; 40:220-230. [PMID: 33006255 DOI: 10.1111/dar.13178] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION AND AIMS Managed alcohol programs (MAP) are a harm reduction approach for those experiencing alcohol use disorders (AUD) and homelessness. These programs were developed in Canada and have had positive results; very few exist in the UK and Ireland. The aim of this study was to scope the feasibility and acceptability of implementing MAPs in Scotland. DESIGN AND METHODS Using mixed-methods, we conducted two linked phases of work. Quantitative data were collected from the case records of 33 people accessing eight third sector services in Scotland and analysed in SPSS using descriptive and inferential statistics. Qualitative data were collected in Scotland via semi-structured interviews with 29 individuals in a range of roles, including strategic informants (n = 12), service staff (n = 8) and potential beneficiaries (n = 9). Data were analysed using Framework Analysis in NVivo. RESULTS The case record review revealed high levels of alcohol use, related health and social harms, illicit drug use, withdrawal symptoms, and mental and physical health problems. Most participants highlighted a lack of alcohol harm reduction services and the potential of MAPs to address this gap for this group. DISCUSSION AND CONCLUSIONS Our findings highlight the potential for MAPs in Scotland to prevent harms for those experiencing homelessness and AUDs, due to high levels of need. Future research should examine the implementation of MAPs in Scotland in a range of service contexts to understand their effectiveness in addressing harms and promoting wellbeing for those experiencing AUDs and homelessness.
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Affiliation(s)
- Hannah Carver
- Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Tessa Parkes
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Tania Browne
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
| | | | - Bernie Pauly
- School of Nursing, University of Victoria, Victoria, Canada
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Lawless MT, Archibald M, Pinero de Plaza MA, Drioli-Phillips P, Kitson A. Peer-to-Peer Health Communication in Older Adults' Online Communities: Protocol for a Qualitative Netnographic Study and Co-Design Approach. JMIR Res Protoc 2020; 9:e19834. [PMID: 32924960 PMCID: PMC7522734 DOI: 10.2196/19834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/02/2020] [Accepted: 07/26/2020] [Indexed: 12/22/2022] Open
Abstract
Background Online communities provide an environment in which people with similar health concerns can interact and access content that can support the self-management of long-term conditions (LTCs). Recently, the importance of online social networks as sources of health information and social support has been brought into focus with the emergence and widespread societal impacts of COVID-19. Although online communities exist for older adults, little is known about the specific health and self-care topics that older people discuss in such environments and how these relate to users’ support needs and outcomes. A better understanding of users’ needs and peer-to-peer communication in these communities is necessary to inform the design of information and communication technology (ICT) interventions that are relevant to older people and their peer supporters. Objective This study aims to use a two-phase, web-based ethnographic (netnography) and co-design approach to explore specific health care and self-care topics that older adults discuss in a UK-based online community and how peer supporters respond to these queries with informational and/or social support and engage with stakeholders to define the needs and requirements for new ICT-based interventions capable of reducing social isolation and facilitating LTC self-management support. Methods The first phase of the research will involve a qualitative netnographic analysis of posts in discussion forums in a publicly accessible online community. The second phase will involve co-design workshops with health care consumers (ie, older adults and carers) and service providers to determine the needs and requirements for new ICT-based interventions and digital innovations. Constructivist grounded theory will be used in the first phase; in the second phase, the co-design workshops will be audiorecorded and analyzed thematically. Results This research project is in progress. Permission was obtained from the website administrator to use materials from the social media forum; data collection for the first phase began in April 2020. The second phase of the study is expected to begin in late 2020. This study is due to be completed by the end of 2021. Conclusions This study is the first, to the best of our knowledge, to combine qualitative netnography with an iterative co-design framework to specify the needs and requirements for new ICT-based interventions. The findings from this study will inform the next phase of the multiphase knowledge translation project and will provide insights into the potential of online peer health communities to reduce social isolation and facilitate chronic illness self-management support and self-care. International Registered Report Identifier (IRRID) PRR1-10.2196/19834
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Affiliation(s)
- Michael Thomas Lawless
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.,National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, Australia
| | - Mandy Archibald
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.,National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, Australia.,College of Nursing, Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Maria Alejandra Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.,National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, Australia
| | | | - Alison Kitson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.,National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, Australia
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25
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Traina G, Feiring E. 'There is no such thing as getting sick justly or unjustly' - a qualitative study of clinicians' beliefs on the relevance of personal responsibility as a basis for health prioritisation. BMC Health Serv Res 2020; 20:497. [PMID: 32493300 PMCID: PMC7268691 DOI: 10.1186/s12913-020-05364-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 05/25/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Concerns have been raised regarding the reasonableness of using personal health responsibility as a principle or criterion for setting priorities in healthcare. While this debate continues, little is known about clinicians' views on the role of patient responsibility in clinical contexts. This paper contributes to the knowledge on the empirical relevance of personal responsibility for priority setting at the clinical level. METHODS A qualitative study of Norwegian clinicians (n = 15) was designed, using semi-structured interviews with vignettes to elicit beliefs on the relevance of personal responsibility as a basis for health prioritisation. Sampling was undertaken purposefully. The interviews were conducted in three hospital trusts in South-Eastern Norway between May 2018 and February 2019 and were analysed with conceptually driven thematic analysis. RESULTS The findings suggest that clinicians endorsed a general principle of personal health responsibility but were reluctant to introduce personal health responsibility as a formal priority setting criterion. Five main objections were cited, relating to avoidability, causality, harshness, intrusiveness, and inequity. Still, both retrospective and prospective attributions of personal responsibility were perceived as relevant in specific clinical settings. The most prominent argument in favour of personal health responsibility was grounded in the idea that holding patients responsible for their conduct would contribute to the efficient use of healthcare resources. Other arguments included fairness to others, desert and autonomy, but such standpoints were controversial and held only marginal relevance. CONCLUSIONS Our study provides important novel insights into the clinicians' beliefs about personal health responsibility improving the empirical knowledge concerning its fairness and potential applications to healthcare prioritisation. These findings suggest that although personal health responsibility would be difficult to implement as a steering criterion within the main priority setting framework, there might be clinical contexts where it could figure in prioritisation practices. Additional research on personal health responsibility would benefit from considering the multiple clinical encounters that shape doctor-patient relationships and that create the information basis for eligibility and prioritisation for treatment.
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Affiliation(s)
- Gloria Traina
- Department of Health Management and Health Economics, University of Oslo, Post box 1089 Blindern, 0317, Oslo, Norway.
| | - Eli Feiring
- Department of Health Management and Health Economics, University of Oslo, Post box 1089 Blindern, 0317, Oslo, Norway
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Adolescents' Views on Seeking Help for Emotional and Behavioral Problems: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010191. [PMID: 31892118 PMCID: PMC6981849 DOI: 10.3390/ijerph17010191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 11/25/2022]
Abstract
This study aimed to get insight into adolescents’ views on help-seeking for emotional and behavioral problems. Fourteen focus groups were conducted. Two vignettes, depicting one healthy adolescent with few issues and one adolescent with severe psychosocial problems, were used to structure the focus groups. The focus groups were framed within a youth help-seeking model. Adolescents (mean age of 15.0 years) generally reported seeking help from friends or the internet for mild issues and from a person they trust like a parent or school mentor, for more severe problems. Adolescents correctly recognized the issues in vignette one as surmountable and the problems in vignette two as severe. A bond of trust with a help source was regarded as the main facilitator for the decision to seek help. Adolescents reported a preference for help sources who clearly displayed their expertise for the issue at hand and for informal help-sources, particularly friends.
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Coco L, Ingram M, Marrone N. Qualitative research methods to investigate communication within a group aural rehabilitation intervention. Int J Audiol 2019; 58:651-660. [PMID: 31329481 PMCID: PMC6917821 DOI: 10.1080/14992027.2019.1608377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
Objective: Aural Rehabilitation (AR) aims to minimise negative effects of hearing loss. However, there has been limited study of the lived experience of clients receiving Aural Rehabilitation services, particularly for disparity populations. The purpose of this study is to demonstrate the use of an innovative qualitative approach to investigating communication in an AR setting among Hispanic/Latino older adult dyads. Design: We developed a qualitative phenomenology approach using observation methods to document and analyse how individuals experience living with acquired hearing loss within group AR. Trained observers collected systematic, detailed notes on observations of participants over the course of a 5-week community-based AR intervention. In partnership with audiologists, Community Health Workers facilitated the intervention, which focussed on decreasing negative communication impacts of hearing loss for families. Audiometric data and subjective hearing disability results, using the HHIE-S Spanish version, are presented as additional context for observation outcomes. Study sample: Participants were older Hispanic/Latino adults with hearing loss and their frequent communication partners (five dyads). Results: Four themes related to the experience of communication emerged among dyads in the intervention: (i) emotions related to hearing loss (ii) communication dynamics, (iii) self-management of hearing loss, and (iv) hearing health advocacy. Conclusions: A mixed methods approach that includes group observation would contribute substantially to comprehensively evaluating group AR interventions.
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Affiliation(s)
- Laura Coco
- Department of Speech, Language, and Hearing Sciences, College of Science, University of Arizona, Tucson, AZ
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Maia Ingram
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Nicole Marrone
- Department of Speech, Language, and Hearing Sciences, College of Science, University of Arizona, Tucson, AZ
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Blum RW, Sheehy G, Li M, Basu S, El Gibaly O, Kayembe P, Zuo X, Ortiz J, Chan KS, Moreau C. Measuring young adolescent perceptions of relationships: A vignette-based approach to exploring gender equality. PLoS One 2019; 14:e0218863. [PMID: 31247045 PMCID: PMC6597075 DOI: 10.1371/journal.pone.0218863] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 06/11/2019] [Indexed: 11/18/2022] Open
Abstract
This paper reports the development and baseline data of a vignettes-based measure of gender equality. METHODS Vignettes were developed through 3-day long focus groups. After piloting in 13 sites and repiloting a revised version in 6 countries, responses were categorized by the construct tapped and a scoring system developed. Finalized vignettes were then tested in DR Congo, Ecuador and China. RESULTS Young adolescents can successfully respond to vignettes; and can differentiate self from hypothetical protagonists of same and opposite sex. Response differences by sex of respondent and protagonist were statistically significant across a range of scenarios and settings. CONCLUSION This is the first vignettes-based measure for young adolescents assessing young adolescent perceptions of relationships differentiated by sex of the protagonist.
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Affiliation(s)
- Robert W. Blum
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Grace Sheehy
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Mengmeng Li
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Sharmistha Basu
- Deutsche Gesellschaft fur Internationale Zusammenarbeit (GIZ), New Delhi, India
| | | | - Patrick Kayembe
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Xiayun Zuo
- Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - Jose Ortiz
- Faculty of Medical Sciences of the University of Cuenca-Ecuador, Cuenca, Ecuador
| | - Kitty S. Chan
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Caroline Moreau
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Tully L, Allen-Walker V, Spyreli E, McHugh S, Woodside JV, Kearney PM, McKinley MC, Dean M, Kelly C. Solid advice: Complementary feeding experiences among disadvantaged parents in two countries. MATERNAL AND CHILD NUTRITION 2019; 15:e12801. [PMID: 30806025 DOI: 10.1111/mcn.12801] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 01/23/2019] [Accepted: 02/18/2019] [Indexed: 12/11/2022]
Abstract
The initiation of complementary feeding (CF; introducing infants to food/drink other than milk) is recommended close to 6 months and not before 4 months of age. Low socio-economic status (SES) is a determinant of nonadherence to CF recommendations, but there is an evidence gap around reasons for nonadherence among these parents. This study investigated knowledge, attitudes, and practices of disadvantaged families (in terms of SES and social support) and use of guidance for CF, in the Republic of Ireland and Northern Ireland. Parents of infants aged 3-14 months were recruited via community groups. Semistructured focus groups aided by vignettes were used. Data were analysed using an inductive thematic approach. Nineteen focus groups took place with parents (n = 83). A range of factors influence parents when introducing solids. Sources of guidance extend to family, friends, the internet, and commercial resources. Parents experience uncertainty and anxiety during this time, driven by lack of knowledge and conflicting advice. Five major themes were identified: (a) more guidance that is accessible, timely, and respectfully needed; (b) the challenge of choosing safe, nutritious food; (c) "everybody has an opinion"; (d) feelings of inadequacy, embarrassment, and guilt; and (e) decisions are ultimately based on individual circumstances. CF advice should be culturally appropriate, practical, and empowering, emphasising the rationale behind updates to recommendations and consequences of nonadherence. Future training of health professionals for delivery of CF advice and guidance should consider these findings. Compliance with CF recommendations is influenced by health professionals, the wider family, and the commercial baby-food sector.
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Affiliation(s)
- Louise Tully
- Health Promotion Research Centre, National University of Ireland, Galway, Ireland
| | - Virginia Allen-Walker
- Nutrition Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Eleni Spyreli
- School of Biological Sciences, Institute for Global Food Security, Queen's University Belfast, Belfast, UK
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - Jayne V Woodside
- Nutrition Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | | | - Michelle C McKinley
- Nutrition Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Moira Dean
- School of Biological Sciences, Institute for Global Food Security, Queen's University Belfast, Belfast, UK
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland, Galway, Ireland
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Blackburn M, Stathi A. Moral discourse in general practitioners' accounts of obesity communication. Soc Sci Med 2019; 230:166-173. [PMID: 31030008 DOI: 10.1016/j.socscimed.2019.03.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/23/2019] [Accepted: 03/21/2019] [Indexed: 10/27/2022]
Abstract
Obesity is not addressed with a large proportion of patients presenting in general practice. An increasing body of evidence suggests that health professionals view body weight as a sensitive topic to include in routine consultations and face barriers in initiating weight loss discussions. This study examined the discursive power relations that shape how general practitioners (GPs) understand and talk about obesity using a novel methodology to elicit responses from GPs about raising the topic of weight. Twenty GPs from the South West of England reflected upon novel trigger films simulating doctor-patient interactions, in which a doctor either acknowledged or ignored their patient's body weight. Underpinned by a discourse analytic approach, our findings suggest that GPs both reproduce and resist moral discourse surrounding body weight. They construct obesity as an individual behavioural problem whilst simultaneously drawing on socio-cultural discourse which positions body weight as central to social identity, situating obesity within a context of stigma and positioning patients as powerless to lose weight. Our findings highlight a need for increased reflexivity about competing discursive frameworks at play during medical consultations about obesity, which we suggest, contribute to increased tension and powerlessness for GPs. Trigger films are an innovative method to elicit information and discuss competing discourses.
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Affiliation(s)
- Maxine Blackburn
- University of Bath, Department for Health, Bath, BA2 7AY, UK; University of Edinburgh, Usher Institute of Population Health Sciences and Informatics, Edinburgh, EH8 9AG, UK.
| | - Afroditi Stathi
- University of Bath, Department for Health, Bath, BA2 7AY, UK; University of Birmingham, School of Sport, Exercise and Rehabilitation Sciences, Birmingham, B15 2TT, UK.
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31
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Vähäniemi A, Välimäki M, Pekurinen V, Anttila M, Lantta T. Quality and utilization of the Finnish clinical practice guideline in schizophrenia: evaluation using AGREE II and the vignette approach. Neuropsychiatr Dis Treat 2019; 15:1239-1248. [PMID: 31190830 PMCID: PMC6512783 DOI: 10.2147/ndt.s192752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE This study aims to evaluate the quality of the Finnish clinical practice guideline related to schizophrenia care and how it can be utilized in psychiatric services. PARTICIPANTS AND METHODS The data were collected from one psychiatric ward and seven psychiatric outpatient units situated in two cities in Southern Finland. A total of 49 professionals working in these sites participated in this study. A descriptive study design was adopted. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument with six domains including 23 items was used to assess the quality of the guideline, whereas a vignette was implemented to describe how staff would use the guideline in hypothetical cases in daily practice. The analysis of AGREE II was based on rating each of the 23 items on a seven-point scale and calculating a quality score for the six domains. To describe the utilization of the guideline, eight key recommendations of the guideline were deductively rated out of the respondents' answers. RESULTS The results showed that the "scope and purpose" of the guideline were well described, but "applicability" was insufficient. The overall quality of the guideline was high (73%). Almost one fifth of the respondents were in agreement with key recommendations. CONCLUSION The overall quality of Guideline for Schizophrenia was good, but its "applicability" and utilization should be improved.
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Affiliation(s)
- Anu Vähäniemi
- Department of Nursing Science, University of Turku, Turku, Finland, .,Mental Health and Substance Abuse Services, City of Tampere, Tampere, Finland,
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland, .,Turku University Hospital, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Virve Pekurinen
- Department of Nursing Science, University of Turku, Turku, Finland,
| | - Minna Anttila
- Department of Nursing Science, University of Turku, Turku, Finland,
| | - Tella Lantta
- Department of Nursing Science, University of Turku, Turku, Finland,
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32
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Yasobant S, Bruchhausen W, Saxena D, Falkenberg T. Convergence model for effectual prevention and control of zoonotic diseases: a health system study on 'One Health' approach in Ahmedabad, India. Health Res Policy Syst 2018; 16:124. [PMID: 30567599 PMCID: PMC6299981 DOI: 10.1186/s12961-018-0398-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 11/27/2018] [Indexed: 11/30/2022] Open
Abstract
The complexity and increasing burden of zoonotic diseases create challenges for the health systems of developing nations. Public health systems must therefore be prepared to face existing and future disease threats at the human–animal interface. The key for this is coordinated action between the human and the animal health systems. Although some studies deal with the question of how these two systems interact during unforeseen circumstances such as outbreaks, a dearth of literature exists on how these systems interact on early detection, prevention and control of zoonotic diseases; assessing this problem from the health system perspective in a developing nation adds further complexity. Systems thinking is one of the promising approaches in understanding the factors that influence the system’s complexity and dynamics of health maintenance. Therefore, this study aims to understand the generic structure and complexity of interaction between these actors within the domain of One Health for the effectual prevention and control of zoonotic diseases in India. The present study will be executed in Ahmedabad, located on the Western part of India, in Gujarat state, using a mixed methods approach. For the first step, zoonotic diseases will be prioritised for the local context through semi-quantitative tools. Secondly, utilising semi-structured interviews, stakeholders from the human and animal health systems will be identified and ranked. Thirdly, the identified stakeholders will be questioned regarding the current strength of interactions at various levels of the health system (i.e. managerial, provider and community level) through a quantitative network survey. Fourthly, utilising a vignette method, the ideal convergence strategies will be documented and validated through policy Delphi techniques. Finally, through a participatory workshop, the factors that influence convergence for the control and prevention of zoonotic diseases will be captured. This study will provide a comprehensive picture of the current strength of collaboration and network depth at various levels of the health system. Further, it will assist different actors in identifying the relevance of possible One Health entry points for participation, i.e. it will not only contribute but will also develop a system convergence model for the effectual prevention and control of zoonotic diseases.
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Affiliation(s)
- Sandul Yasobant
- Center for Development Research (ZEF), University of Bonn, Bonn, Germany.
| | - Walter Bruchhausen
- Center for Development Research (ZEF), University of Bonn, Bonn, Germany.,University of Cologne, Köln, Germany
| | - Deepak Saxena
- Indian Institute of Public Health Gandhinagar, Gujarat, India
| | - Timo Falkenberg
- Center for Development Research (ZEF), University of Bonn, Bonn, Germany
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Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, Burroughs H, Jinks C. Saturation in qualitative research: exploring its conceptualization and operationalization. QUALITY & QUANTITY 2018. [PMID: 29937585 DOI: 10.1007/s11135-017-0574-8.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation-as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
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Affiliation(s)
- Benjamin Saunders
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Julius Sim
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Tom Kingstone
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Shula Baker
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Jackie Waterfield
- 2School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Bernadette Bartlam
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Heather Burroughs
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Clare Jinks
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
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Holley J, Gillard S. Developing and Using Vignettes to Explore the Relationship Between Risk Management Practice and Recovery-Oriented Care in Mental Health Services. QUALITATIVE HEALTH RESEARCH 2018; 28:371-380. [PMID: 28836488 DOI: 10.1177/1049732317725284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research.
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Affiliation(s)
| | - Steven Gillard
- 2 St. George's, University of London, London, United Kingdom
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Anguera MT, Portell M, Chacón-Moscoso S, Sanduvete-Chaves S. Indirect Observation in Everyday Contexts: Concepts and Methodological Guidelines within a Mixed Methods Framework. Front Psychol 2018; 9:13. [PMID: 29441028 PMCID: PMC5797623 DOI: 10.3389/fpsyg.2018.00013] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 01/04/2018] [Indexed: 01/25/2023] Open
Abstract
Indirect observation is a recent concept in systematic observation. It largely involves analyzing textual material generated either indirectly from transcriptions of audio recordings of verbal behavior in natural settings (e.g., conversation, group discussions) or directly from narratives (e.g., letters of complaint, tweets, forum posts). It may also feature seemingly unobtrusive objects that can provide relevant insights into daily routines. All these materials constitute an extremely rich source of information for studying everyday life, and they are continuously growing with the burgeoning of new technologies for data recording, dissemination, and storage. Narratives are an excellent vehicle for studying everyday life, and quantitization is proposed as a means of integrating qualitative and quantitative elements. However, this analysis requires a structured system that enables researchers to analyze varying forms and sources of information objectively. In this paper, we present a methodological framework detailing the steps and decisions required to quantitatively analyze a set of data that was originally qualitative. We provide guidelines on study dimensions, text segmentation criteria, ad hoc observation instruments, data quality controls, and coding and preparation of text for quantitative analysis. The quality control stage is essential to ensure that the code matrices generated from the qualitative data are reliable. We provide examples of how an indirect observation study can produce data for quantitative analysis and also describe the different software tools available for the various stages of the process. The proposed method is framed within a specific mixed methods approach that involves collecting qualitative data and subsequently transforming these into matrices of codes (not frequencies) for quantitative analysis to detect underlying structures and behavioral patterns. The data collection and quality control procedures fully meet the requirement of flexibility and provide new perspectives on data integration in the study of biopsychosocial aspects in everyday contexts.
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Affiliation(s)
- M. Teresa Anguera
- Faculty of Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Mariona Portell
- Faculty of Psychology, Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Salvador Chacón-Moscoso
- Facultad de Psicología, Universidad de Sevilla, Seville, Spain
- Departamento de Psicología, Universidad Autónoma de Chile, Santiago, Chile
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Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, Burroughs H, Jinks C. Saturation in qualitative research: exploring its conceptualization and operationalization. ACTA ACUST UNITED AC 2017; 52:1893-1907. [PMID: 29937585 PMCID: PMC5993836 DOI: 10.1007/s11135-017-0574-8] [Citation(s) in RCA: 3863] [Impact Index Per Article: 551.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
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Affiliation(s)
- Benjamin Saunders
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Julius Sim
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Tom Kingstone
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Shula Baker
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Jackie Waterfield
- 2School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Bernadette Bartlam
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Heather Burroughs
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Clare Jinks
- 1Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
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Hansson A, Svensson A, Ahlström BH, Larsson LG, Forsman B, Alsén P. Flawed communications: Health professionals' experience of collaboration in the care of frail elderly patients. Scand J Public Health 2017; 46:680-689. [PMID: 28699383 DOI: 10.1177/1403494817716001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Frail elderly patients who have multiple illnesses do not fare well in modern health care systems, mainly due to a lack of care planning and flawed communication between health professionals in different care organisations. This is especially noticeable when patients are discharged from hospital. The aim of this study was to explore health care professionals' experience of obstacles and opportunities for collaboration. METHODS Health professionals were invited to participate in three focus groups, each consisting of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist and a patient or a family member representative. These individual people were then asked to discuss the obstacles and opportunities for communication between themselves and with the patients and their relatives when presented with the case report of a fictitious patient. Content analysis was used to identify categories. RESULTS Several obstacles were identified for effective communication and care planning: insufficient communication with patients and relatives; delayed collaboration between care-givers; the lack of an adequate responsible person for care planning; and resources not being distributed according to the actual needs of patients. The absence of an overarching responsibility for the patient, beyond organisational borders, was a recurring theme. These obstacles could also be seen as opportunities. CONCLUSIONS Obstacles for collaboration were found on three levels: societal, organisational and individual. As health care professionals are well aware of the problems and also see solutions, management for health care should support employees' own initiatives for changes that are of benefit in the care of frail elderly patients with multiple illnesses.
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Affiliation(s)
- Anders Hansson
- 1 University Health Care Research Centre, Region Örebro County and School of Medical Sciences, Örebro University, Sweden.,2 Academy of Sahlgrenska, Institute of Medicine, University of Gothenburg, Sweden
| | - Ann Svensson
- 3 School of Business, Economics and IT, University West, Sweden
| | - Britt Hedman Ahlström
- 4 Department of Health Science, Section for Health Promotion and Care Sciences, University West, Sweden
| | - Lena G Larsson
- 2 Academy of Sahlgrenska, Institute of Medicine, University of Gothenburg, Sweden
| | - Berit Forsman
- 5 Department of Health Sciences, Section for Nursing, Graduate Level, University West, Sweden
| | - Pia Alsén
- 5 Department of Health Sciences, Section for Nursing, Graduate Level, University West, Sweden
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