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Zhang E, Steel J, Togher L, Fromm D, MacWhinney B, Bogart E. Insights From Important Event Recounts Told by People With Traumatic Brain Injury. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-17. [PMID: 39116308 DOI: 10.1044/2024_jslhr-23-00595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
PURPOSE Communication can be chronically impacted by severe traumatic brain injury (TBI), yet there is a critical lack of research investigating communication recovery beyond 12 months postinjury with discourse measures. This longitudinal study aimed to investigate quantitative and qualitative changes in important event recounts produced by a group of people with severe TBI up to 2 years postinjury. METHOD A prospective observational design with an inception cohort was adopted. Thirty-four participants with severe TBI were asked to produce an important event recount at 6, 12, and 24 months postinjury. A mixed-methods approach comprised a quantitative analysis of microlinguistic and macrostructural measures, using the automated discourse command EVAL in Computerized Language Analysis (CLAN) and the CLAN Collaborative Commentary tool, respectively. Statistical analysis included a repeated-measures analysis of variance and the Friedman test. An independent qualitative content analysis was also conducted. RESULTS The measures revealed significant differences between 6 and 24 months, indicating a protracted recovery trajectory. The microlinguistic analysis showed increased use of revision and repetition over time. The macrostructural analysis indicated changes with orientation to recount characters, evaluative comments, and the number of events or complexity of the recount. The content analysis revealed categories of (a) childhood events, (b) family and relationships, (c) career and education, and (d) grief and loss. Topics at 6 months focused on childhood events and holidays, whereas career and education predominated at 24 months. CONCLUSIONS This is the first study to explore important event recounts told by people with severe TBI as they recovered. Participants showed discourse recovery beyond 12 months, highlighting the need for equivalent timing of service provision. The important event recount shows good potential as an ecologically valid assessment tool to evaluate communication recovery that can also be integrated with advances in computerized analysis. Analyses additionally provided insights into potential therapy targets and content categories for chronic discourse impairments. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26499271.
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Affiliation(s)
- Erica Zhang
- The University of Sydney, New South Wales, Australia
| | - Joanne Steel
- The University of Newcastle, New South Wales, Australia
| | - Leanne Togher
- The University of Sydney, New South Wales, Australia
| | | | | | - Elise Bogart
- The University of Sydney, New South Wales, Australia
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Kipfer S, Mabire C, Vézina J, Koppitz A, Pihet S. Relationship quality perceived by family caregivers of people with dementia in the context of a psychoeducational intervention: A qualitative exploration. DEMENTIA 2024:14713012241264611. [PMID: 39104330 DOI: 10.1177/14713012241264611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Caring for a person with dementia can be a challenging experience, often associated with chronic stress and a heavy burden on family caregivers. Dementia also impacts the relationship between the caregiver and the person with dementia. The quality of this relationship is, in turn, an important factor influencing the well-being of both dyad members. The psychoeducational intervention "Learning to feel better . . . and help better" has shown positive results regarding family caregivers' subjective burden, psychological distress, and self-efficacy. However, relationship quality has not been addressed in the context of this intervention. METHODS A longitudinal constructivist grounded theory approach was used to explore relationship quality as perceived by caregivers, possible changes and intervention components facilitating or preventing such changes. Three qualitative, semi-structured interviews (before, during and after the intervention) were performed with 13 family caregivers from three different intervention groups. The resulting 39 interviews were analysed regarding individual caregiver trajectories, per time point for all caregivers and regarding specific caregiver subgroups. FINDINGS A model focusing on sustaining relationship quality in dementia was developed. It shows strategies that family caregivers develop and apply to facilitate positive interactions and feelings of connectedness with their family members with dementia. It also indicates that mastering such strategies requires reflective skills based on specific knowledge of dementia and coping strategies, which can be enhanced through active skills training, in which caregivers are guided to work on their individual stressful situations. Factors hampering change included difficulties in accepting dementia-related changes. CONCLUSION Findings suggest that psychoeducation, with active skills training based on caregivers' current daily life situations, providing systematic procedures to handle daily challenges and specific knowledge about the impact of the disease, could support them in developing and applying supportive strategies to sustain or improve their relationship to their family member with dementia.
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Affiliation(s)
- Stephanie Kipfer
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Switzerland
| | - Cedric Mabire
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Switzerland
| | - Jean Vézina
- School of psychology, University Laval, Québec, Canada
| | - Andrea Koppitz
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland
| | - Sandrine Pihet
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland
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Edi IS, Luthfiyah S, Triwiyanto T, Utomo B. Role of C1q/TNF-Related Protein 6 for the Evaluation of Coronary Heart Disease Associated with Type 2 Diabetes [Letter]. Ther Clin Risk Manag 2024; 20:449-450. [PMID: 39050409 PMCID: PMC11268738 DOI: 10.2147/tcrm.s481485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 06/23/2024] [Indexed: 07/27/2024] Open
Affiliation(s)
- Imam Sarwo Edi
- Department of Dental Health, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia
| | - Sari Luthfiyah
- Department of Nursing, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia
| | - Triwiyanto Triwiyanto
- Department of Medical Electronics Technology, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia
| | - Bedjo Utomo
- Department of Medical Electronics Technology, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia
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Yu J, Chen J, Wang B, Wen H, Li H, Wu Y, Hu R. Symptom experience and self-management strategies of adults undergoing hematopoietic stem cell transplantation after hospital discharge: A longitudinal qualitative study. Eur J Oncol Nurs 2024; 72:102666. [PMID: 39163757 DOI: 10.1016/j.ejon.2024.102666] [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: 01/31/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 08/22/2024]
Abstract
PURPOSE To explore the symptom experience and self-management strategies of adults undergoing hematopoietic stem cell transplantation after hospital discharge. METHODS A longitudinal qualitative study was employed. A heterogeneous sample of 22 patients who underwent hematopoietic stem cell transplantation from August 2022 to April 2023 were included. Semi-structured interviews were conducted at three time points post-discharge and provided a dataset of 56 interviews. The content analysis method was used for manual analysis. This study followed the COREQ checklist. RESULTS The data from this study were categorized into four themes and 14 subthemes: (1) complexity and multidimensionality of symptom experience: diversity, dynamism, continuity, relatedness, and functional loading; (2) multiple variations in symptom self-management; (3) barriers to symptom self-management: limited access to information resources, insufficient awareness and skills in symptom self-management, lack of economic and social support, and difficulties in medical visits and reviews; and (4) facilitators of symptom self-management: perceived benefits, experience-driven, and peer experiences. CONCLUSION Patients undergoing hematopoietic stem cell transplantation experience multiple and complex symptom experiences after hospital discharge, and their symptom self-management remains challenging. The findings underscore the necessity for healthcare professionals to regularly and consistently evaluate the symptoms and self-management practices of patients undergoing hematopoietic stem cell transplantation and execute focused interventions to alleviate their symptom load and enhance their long-term well-being.
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Affiliation(s)
- Jiejie Yu
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jingyi Chen
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Binbin Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hongmei Wen
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hao Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China.
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Broomfield K, Judge S, Sage K, Jones GL, James D. Using longitudinal qualitative research to explore the experience of receiving and using augmentative and alternative communication. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1043-1065. [PMID: 37962244 DOI: 10.1111/1460-6984.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND People who have communication difficulties may benefit from using augmentative and alternative communication (AAC). Understanding and measuring outcomes from the use of AAC is an important part of evaluating the impact of devices and services. Outcome measurement needs to reflect the changing nature of the impact of using AAC on an individual's ability to participate in activities of daily life. There is a limited understanding of the concepts that should inform the evaluation of outcomes from AAC device provision, nor how people's expectations from AAC may change over time. AIMS To inform the development of a patient-reported outcome measure for AAC by understanding more about people's expectations from AAC and how these change over time. METHODS & PROCEDURES A longitudinal qualitative research study was designed and carried out with seven participants over a period of 2 years. Participants were recruited from a regional specialist assessment service for AAC in the south-west of the UK. Four semi-structured interviews were carried out: (1) before assessment for AAC, (2) after assessment, (3) directly after provision of an AAC device and (4) between 6 and 12 months after provision. An original analytic method was used in this study that built on the principles of longitudinal interpretative phenomenology analysis, applied with a dialogic theoretical lens. This approach enabled the inclusion of a range of multimodal and embodied data collected to this study and allowed the research team to draw out salient themes across the cohort group while attending to the influence of time and context on experience. OUTCOMES & RESULTS The results confirm and extend the three core concepts that were used to guide analysis: changes; contexts; future possibilities. The contextual and temporal influences on outcomes attainable from AAC for this cohort were also identified and illustrated through cross-case comparison. Deeper, analytic, and conceptual engagement with theory, which was then applied to analysis of the data, provided methodological rigour in the study. The results enhance our understanding of people's hopes and expectations from AAC and how these change over time. CONCLUSIONS & IMPLICATIONS This qualitative longitudinal research study provides new insights into the journeys of people who experience communication disability, and the shifting nature of their sense of identity as they engage with, and learn from using, AAC. The study is significant as it attends to the dynamic nature of experience and how contextual and experiential factors influence people's hopes and expectations from AAC. The paper presents an original application of longitudinal qualitative research methodology with people who use AAC which can be further applied and tested in the field of communication disability research. WHAT THIS PAPER ADDS What is already known on this subject We did not know the impact that time has on the concepts that have been identified to represent important outcomes from AAC. The existing concepts used to define outcomes from AAC were not adequately conceptualized to develop a patient-reported outcome measure. This study sought to extend our knowledge about outcomes from AAC. What this paper adds to the existing knowledge This study adds to the methodological toolkit available for qualitative inquiry in the field of communication disability research by presenting a longitudinal qualitative research methodology. It adds depth to our understanding of the concepts that underpin outcomes from AAC and highlights the dynamic nature of contexts and how this influences desired outcomes. What are the potential or actual clinical implications of this work? This longitudinal qualitative research study provides a broader perspective on the experience of getting AAC. It will enable clinicians to better navigate the contextual and transitionary factors that influence people's experience of acquiring AAC devices. The enhanced concepts described will also support clinical conversations that consider the wider facets of communication and what AAC can add to existing communicative tool kits beyond getting a message across.
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Affiliation(s)
- Katherine Broomfield
- School of Health and Social Care, University of Gloucestershire, Cheltenham, UK
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, UK
| | - Simon Judge
- Barnsley Assistive Technology Team, Barnsley Hospitals NHS Foundation Trust, Barnsley, UK
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Karen Sage
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | | | - Deborah James
- Faculty of Education, Manchester Metropolitan University, Manchester, UK
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Neve KL, Coleman P, Hawkes C, Vogel C, Isaacs A. What shapes parental feeding decisions over the first 18 months of parenting: Insights into drivers towards commercial and home-prepared foods among different socioeconomic groups in the UK. Appetite 2024; 196:107260. [PMID: 38403201 DOI: 10.1016/j.appet.2024.107260] [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: 09/18/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024]
Abstract
Infants born into families experiencing socioeconomic disadvantage follow a high-risk trajectory for obesity and poor health in later life. Differences in early childhood food experiences may be contributing to these inequalities. This study aimed to explore the factors that influence parental decisions on when, how and what food to introduce over the first 18 months of their child's life and identify differences according to families' social position. Particular attention was given to social and environmental determinants within and outside the home. This research utilised a longitudinal qualitative methodology, with interviews and photo-elicitation exercises completed by participants when their children were 4-6; 10-12 and 16-18 months of age. Participants were parents (61 mothers; 1 father), distributed across low, medium and high socioeconomic position (SEP). During analysis, observable differences in factors directing parents to home-prepared or commercial foods were identified. Factors that undermined the provision of home-prepared meals included lack of time after returning to work, insufficient support from partners, uncertainty around infant and young child feeding (defined as the introduction and provision of solids) and an implicit trust in the messaging on branded products. These factors directed parents towards commercial foods and were most persistent among families experiencing socioeconomic disadvantage due to barriers accessing formal childcare, less flexible working conditions and fathers being less involved in infant feeding. To facilitate an enabling environment for healthy infant and young child feeding practices and address dietary inequalities, immediate steps that policy makers and healthcare providers can take include: i) changing the eligibility criteria for shared parental leave, ii) aligning claims on commercial infant food labels with international best practices, and iii) improving access to formal childcare.
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Affiliation(s)
- Kimberley L Neve
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK.
| | - Paul Coleman
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Corinna Hawkes
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Christina Vogel
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Anna Isaacs
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
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Lau WY, Liao Q, Lian J, Yap M. Barriers in older adults' decision-making process to use routine eye examinations in Hong Kong. Clin Exp Optom 2024; 107:442-448. [PMID: 37557167 DOI: 10.1080/08164622.2023.2237971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/26/2023] [Accepted: 07/13/2023] [Indexed: 08/11/2023] Open
Abstract
CLINICAL RELEVANCE The decision to have a routine eye examination involves individual- and service-level judgement. A deeper understanding of patient access barriers and expectations could facilitate the design of better-aligned service models in optometric practice, improving the utilisation rate of an important facet of primary healthcare services. BACKGROUND Routine eye examinations achieve several health objectives, including mitigation of sight-threatening risk factors. However, there are barriers to service uptake. Through the qualitative approach, a deeper understanding of these barriers can be realised and enhanced strategies designed to improve the uptake of the routine eye examination. A qualitative study was conducted to identify the factors influencing the decision-making process of older adults to use the routine eye examination service. METHODS This study was guided by the grounded theory approach. Participants were purposively recruited from six community elderly centres. Semi-structured interviews were conducted with 25 community-dwelling adults aged 65 years or above in Hong Kong. Data were transcribed and constant comparison techniques were used for data analysis. RESULTS Difficulty in prioritising and including the routine eye examination in the existing health service utilisation was the central theme associated with its lower use. Four sub-themes were identified to explain this phenomenon: (1) previous health care service utilisation as a reference for judging primary eye care; (2) low perceived primary eye care service needs; (3) low perceived self-efficacy on routine eye care utilisation; (4) service expectations. CONCLUSION Multiple modifiable factors influence decision-making by older adults, suggesting that their routine eye care seeking behaviour might be altered through behaviour change intervention. The context in which services are delivered requires further study, with a focus on exploring the factors influencing service experience and its subsequent impact on regular eye care seeking behaviour.
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Affiliation(s)
- Wing Yan Lau
- Public Health Research Group, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Qiuyan Liao
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Jinxiao Lian
- Public Health Research Group, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Maurice Yap
- Public Health Research Group, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Su X, Zhang Y, Zhou H, Ma F, Jin X, Bai Y, Wei W, Zhang X, Zhou M. Perceived Determinants of Health-Related Behaviors Among Patients with Coronary Heart Disease After Percutaneous Coronary Intervention: A Longitudinal Qualitative Study. Patient Prefer Adherence 2024; 18:591-606. [PMID: 38463399 PMCID: PMC10924927 DOI: 10.2147/ppa.s452943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/24/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose Studies had reported some influencing factors of health behavior among patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI). However, considering that human perceptions are complex, unrestricted and dynamically changing. A longitudinal qualitative study was conducted to explore the determinants of health-related behaviors of patients after PCI and dynamic changes of these determinants at the 1st, 3rd, and 6th months. Patients and Methods Using purposive sampling, 18 patients undergoing PCI were interviewed. The conventional content analysis method was used to identify categories and subcategories. Semi-structured, face-to-face or telephone in-depth interviews were conducted at the cardiology unit of a tertiary referral hospital in Yunnan Province, China from March 2022 to January 2023. Results Seven categories with some subcategories were constructed from the data, categorized into three domains. Firstly, individual factors include (i) Personal coping with healthy lifestyle requirements (tried but failed; I can do it), (ii) individual perception and feeling toward disease (knowing about the disease; belief of cure; fears of relapse), and (iii) personal benefits (improved health; meaning of life). Secondly, social factors include (i) social facilitators (family resources; healthcare support), (ii) social barriers (inconvenient medical care service; conflicting information). Finally, cultural factors include (i) way of living (dietary habits; key roles of yan (cigarette) and jiu (alcohol) in Chinese society), (ii) way of thinking (fatalism and Confucian familism). Conclusion The determinants of health-related behaviors of patients after PCI are multifaceted and dynamic. Different interventions should be formulated to promote patients' adherence to health behaviors. Moreover, priority should be given to the impact of traditional Chinese philosophy on the health behaviors of patients after PCI, and the health promotion program for these patients should be culturally sensitive. In addition, future research should further explore the determinants of health behaviors among diverse ethnic minorities after PCI, which has not been fully inquired in this study.
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Affiliation(s)
- Xu Su
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Yimei Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Huilin Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Xiaorong Jin
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Wei Wei
- Digestive Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Xiong Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
| | - Min Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China
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Lin S, Chen S, Tu Q, Xu X, Xie S, Yang B, Zhang Q, Chen L. Barriers and facilitators to the formation of professional identity among nursing students: A four-year longitudinal qualitative study. NURSE EDUCATION TODAY 2024; 134:106087. [PMID: 38232627 DOI: 10.1016/j.nedt.2023.106087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/02/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Nursing professional identity (NPI) is essential for nurses to develop their nursing profession. It reflects the competencies consistent with the professional practices of nurses and contributes to them providing better healthcare and public health. The formation process of NPI started with undergraduate nursing education and continued throughout the nursing career. OBJECTIVE To explore nursing students' perceptions of facilitators and barriers to the formation of NPI during their study. METHODS A 4-year longitudinal, qualitative research design with yearly semi-structured interviews undertaken from 2019 to 2022. The reflexive thematic analysis methodology was applied for the data analysis. RESULTS Ninety-three nursing students were recruited, joining a group or individual interview. The four-year nursing baccalaureate program revealed a dynamic formation process of NPI: "Outsider of nursing", "Entering the nursing courses", "Building nursing competence", and "Thinking and acting like a nurse". A total of 12 themes were identified to present the barriers and facilitators to the NPI formation at different stages. Specifically, the six barriers include conflict between their ideals and reality, sociocultural stereotypes about nursing, the negative impact of COVID-19, the pre-internship concerns, struggling to meet expectations, and potential danger and discrimination in the healthcare settings. The enablers were: self-motivation and inner belief towards the nursing profession, the power of role models, the improvement of nursing capacity, well integration into the healthcare professional teams, understanding of the clinical environment, and recognition and encouragement from others. CONCLUSIONS The formation of nursing students' NPI is an ever-changing process, with various intrinsic and extrinsic influences during their four-year study. Nursing educators are suggested to prepare and develop students' professional comportment in their theoretical and clinical practice to develop their professional identity as a nurse.
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Affiliation(s)
- Shuanglan Lin
- Nursing College of Chongqing Medical University, Chongqing, China
| | - Shucheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Qiang Tu
- Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Xinyu Xu
- Nursing College of Chongqing Medical University, Chongqing, China
| | - Shiqi Xie
- Nursing College of Chongqing Medical University, Chongqing, China.
| | - Bing Yang
- Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Quanzhi Zhang
- School of Nursing, Harbin Medical University, Heilongjiang Province, China
| | - Liping Chen
- Nursing College of Chongqing Medical University, Chongqing, China.
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Lee YH, Siao CL, Yang HY, Lai YH, Liang YH, Chen YF, Wu MC. Immunotherapy-associated symptoms, distress, financial toxicity and unmet supportive care needs of patients with cancer. Eur J Oncol Nurs 2024; 68:102486. [PMID: 38219473 DOI: 10.1016/j.ejon.2023.102486] [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: 09/25/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE To examine the unmet care needs (i.e., overall needs and need subdomains [physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and informational needs]) of patients with cancer undergoing immunotherapy alone or in combination with other anticancer therapies, as well as related influencing factors. METHODS A cross-sectional design was adopted. Cancer patients who received immunotherapy completed consent and questionnaires. Unmet care needs were evaluated with the Chinese version of the Supportive Care Needs Survey Screening Tool, symptom severity with the Symptom Severity Scale, distress severity with the Distress Thermometer Scale, and financial toxicity using the Financial Toxicity - Functional Assessment of Chronic Illness Therapy Questionnaire. RESULTS In total, 105 patients were surveyed. The most frequently reported unmet needs were psychological and emotional needs (56.2%) followed by health-system and informational needs (36.2%). The major factors associated with unmet care needs and their subdomains were years of education, symptoms, distress, and financial toxicity. Years of education predicted overall unmet care needs, psychological and emotional needs, and care and support needs; symptoms predicted overall unmet care needs and all four subdomains; distress predicted psychological and emotional needs and health-system and informational needs; and financial toxicity predicted overall needs and psychological and emotional needs. CONCLUSIONS Patients with higher education, severe symptoms, distress, and financial toxicity reported more unmet care needs. The findings of this study could be incorporated into immunotherapy-related clinical practice guidelines and future interventions to improve the quality of cancer care.
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Affiliation(s)
- Yun-Hsiang Lee
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chia-Li Siao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Hui-Ying Yang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Yi-Hsin Liang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Yu-Fan Chen
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Mei-Chih Wu
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
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Younginer NA, Draper CL. Capacity, Communication, and Coordination Are Key to Successful Implementation of Policy, Systems, and Environmental Strategies at SNAP-Ed Partner Sites in One Southeastern US State: A Qualitative Approach. J Acad Nutr Diet 2024; 124:169-180. [PMID: 37482267 DOI: 10.1016/j.jand.2023.07.016] [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: 05/28/2022] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The United States Department of Agriculture expanded the Supplemental Nutrition Assistance Program (SNAP)-Ed program to all 50 states in 2004. In 2010, the Healthy, Hunger-Free Kids Act required that agencies implementing SNAP-Ed support policy, systems, and environmental (PSE) strategies, in addition to providing direct education (DE). Research has evaluated the impact of PSEs on health, but few studies have investigated the process of PSE implementation. OBJECTIVE The objective of this study was to identify facilitators and barriers to PSE implementation at SNAP-Ed partner sites from the perspectives of site contacts and SNAP-Ed implementers. DESIGN This study employed a qualitative longitudinal design. The PSE planning and implementation process was observed over 1 year at SNAP-Ed partner sites. Semistructured interviews were conducted with site contacts and SNAP-Ed implementers throughout the year. PARTICIPANTS/SETTING Participants were SNAP-Ed implementers (n = 8) and site contacts (n = 18) from 18 partner sites where both PSE and direct education were occurring. SNAP-Ed implementers were debriefed once, and site contacts were interviewed three times over the course of the study. This study was conducted in a Southern US state with SNAP-Ed partner sites that intended to implement PSEs. The duration of data collection was October 2017 through September 2018. ANALYSIS A thematic analysis of barriers and facilitators to PSE implementation across sites was conducted. RESULTS The PSE implementation barriers were lack of site or implementer readiness or capacity; breakdowns in communication; and DE prioritized over PSE. Facilitators were effective communication; site capacity or readiness; and alignment between site and SNAP-Ed goals. CONCLUSIONS Communication, capacity, and coordination between SNAP-Ed and partner sites were key components over the timeline of PSE planning and potential implementation.
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Jung W, Vogel M, Figuracion KCF, Byun E, Thompson H. The Perceived Meaning of Traumatic Brain Injury for Older Adults: A Longitudinal-Multiple Case Study. Rehabil Nurs 2024; 49:14-23. [PMID: 38156950 DOI: 10.1097/rnj.0000000000000445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
PURPOSE The aim of this study was to explore the perceived meaning of traumatic brain injury (TBI) over the first-year postinjury among older adults and to explore if and how meaning changes. DESIGN A longitudinal multiple-case study design was used. METHODS Semistructured face-to-face interviews were completed at 1 week and 1, 3, 6, and 12 months postinjury. Transcripts were analyzed using inductive thematic analysis. RESULTS Fifty-five interviews were conducted with 12 participants. Four themes were identified: gratitude, vulnerability and dependence, slowing down and being more careful, and a chance for reflecting on life. Most participants' perceptions of their TBI remained either consistently positive or negative over the first-year postinjury. CLINICAL RELEVANCE Nurses should elicit and support patients' positive illness perceptions regarding their brain injury, which can contribute to a higher quality of life. For those patients with negative illness perceptions, nurses should provide resources in order to support coping and resilience following brain injury. CONCLUSIONS This study is the first study to explore individual perceptions over time of the meaning made from experiencing TBI among older adults. Findings can serve as a foundation for tailored supportive interventions among older adults following TBI to maximize quality of life.
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Affiliation(s)
- Wonkyung Jung
- RESILIENCE Center, School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Mia Vogel
- Center for Public Health Systems Science, Institute for Clinical and Translational Science, Brown School, Washington University in St. Louis, St Louis, MO, USA
| | - Karl Cristie F Figuracion
- School of Nursing, Alvord Brain Tumor Center, Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Eeeseung Byun
- Department of Biobehavioral Nursing & Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Hilaire Thompson
- Department of Biobehavioral Nursing & Health Informatics, School of Nursing, Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
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Tuthill EL, Maltby AE, Odhiambo BC, Akama E, Dawson-Rose C, Weiser SD. Resilient Mothering: An Application of Transitions Theory From Pregnancy to Motherhood Among Women Living With HIV in Western Kenya. ANS Adv Nurs Sci 2024; 47:E20-E39. [PMID: 36656116 PMCID: PMC10354209 DOI: 10.1097/ans.0000000000000478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Efficacious strategies can now prevent the transmission of HIV from mother to child. However, transmission rates remain unacceptably high, especially in sub-Saharan Africa. Understanding women's perinatal transitions can inform interventions to support adherence to preventive strategies. Therefore, we applied Transitions Theory in a longitudinal qualitative study to explore perinatal transitions among women living with HIV in western Kenya. We conducted in-depth interviews with 30 women living with HIV at 3 key time points and, using our findings, described the theory's concepts in terms of participants' experiences. We then proposed theory-based interventions that could support smooth transition processes and positive outcomes.
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Affiliation(s)
- Emily L. Tuthill
- Department of Community Health Systems, School of Nursing University of California, San Francisco, CA, USA
| | - Ann E. Maltby
- Department of Community Health Systems, School of Nursing University of California, San Francisco, CA, USA
| | | | - Eliud Akama
- Kenya Medical Research Institute- Center for Microbiology Research, Nairobi Kenya
| | - Carol Dawson-Rose
- Department of Community Health Systems, School of Nursing University of California, San Francisco, CA, USA
| | - Sheri D. Weiser
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California San Francisco
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McCormick A, Pedmanson P, Jane B, Watson P. How do new runners maintain their running, and what leads to others stopping? A qualitative, longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102515. [PMID: 37717492 DOI: 10.1016/j.psychsport.2023.102515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023]
Abstract
Many people who start running do not maintain their behaviour change. We used qualitative, longitudinal methods to explore and interpret the experiences of new runners and answer the question, "What experiences explain how new runners maintain their running or explain why they stop?" We interviewed 20 new runners (all White British, 14 women, 6 men) about their experiences; we interviewed 10 until they stopped running and 10 until they maintained running for 6-12 months (65 interviews in total). We also conducted nine participant observations at a running club, invited external reflections at a running club, and analysed six sets of participant diaries. Four themes were constructed using a reflexive thematic analysis: (1) Identifying a meaningful "why"; (2) "Life gets in the way" of running; (3) Learning that I can run; and (4) Opportunities are unequal and experiences contrast. The runners' reasons for running helped us to interpret changes in their experiences through time. Meaningful reasons helped runners to learn that they can run, prioritise running, and prevent life getting in the way. These reasons tended to be reasons to run, as opposed to reasons to be physically active, and they related to their identity, values, special memories, relationships, enjoyment of running, or a personal goal. Nevertheless, social inequalities like gendered experiences, wealth, and health differences meant that opportunities and experiences of running differed, creating more barriers for some runners. When runners faced substantial barriers, having a meaningful reason was helpful but it was sometimes insufficient for maintenance. The analysis illustrates how people's reasons for exercise influence their experiences through time, the dynamic nature of people's exercise barriers and facilitators, and the unequal nature of opportunities and experiences.
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Affiliation(s)
- Alister McCormick
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK.
| | - Pille Pedmanson
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Ben Jane
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Paula Watson
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Made Up to Move Ltd, Liverpool, UK
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15
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McNicholl A, Desmond D, Gallagher P. Feeling valued: the interplay of assistive technology and identity. Disabil Rehabil Assist Technol 2023:1-12. [PMID: 38116935 DOI: 10.1080/17483107.2023.2294987] [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: 04/18/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The aim of this study was to explore the impact of AT in identity for students with disabilities in higher education and if/how this changes over time. METHODS Using a longitudinal qualitative research design, semi-structured interviews were conducted with students with disabilities (n = 13) in higher education in Ireland on two occasions during an academic year. A trajectory approach to longitudinal analysis was employed. This involved the use of matrices and identification of a through line for the study, which connects participant change over time. RESULTS The through line identified was feeling valued, which was central in the negotiation of identity over time across three themes: feelings of autonomy and competence; claiming disability; and feeling like you belong as a student. AT impacted experiences across the three themes which subsequently promoted or undermined students' sense of value. Reciprocally, feeling valued influenced use and perceptions of AT. Factors specific to a higher education context were also identified which influenced meanings attached to AT over time. CONCLUSION Creating an environment where students feel valued is key in promoting use of and positive perceptions of AT. This should form an integral part of AT and disability policy in higher education.
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Affiliation(s)
- Aoife McNicholl
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | - Deirdre Desmond
- Department of Psychology and Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
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Khougar A, Baba Ahmadi P, Ranjbar H, Ahadi M, Ahadi P. Exploring the varied manifestations of structural violence in the lives of children on the autism spectrum and their families: a qualitative longitudinal study in Kurdistan, Iran. Int J Equity Health 2023; 22:263. [PMID: 38110989 PMCID: PMC10729435 DOI: 10.1186/s12939-023-02078-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND There are many dimensions regarding autism that are closely connected to social structures, policies, and power dynamics, silently impacting the well-being of individuals within the autism spectrum. This research aims to explore these overlooked aspects using a theoretical framework called "structural violence." METHODS The study was conducted in Kurdistan, Iran, and a qualitative longitudinal approach was chosen. A purposive sampling method was employed to select the participants, with 11 parents taking part. The study data comprised 29 interviews using a topic guide conducted over a span of 2 years. Thematic analysis and a matrix-based approach were utilized for data analysis. To enhance the scientific rigor of this research, four criteria, including Guba and Lincoln's principles, were implemented to ensure methodological accuracy. RESULTS The research findings highlight four primary forms through which structural violence impacts children on the autism spectrum and their families: access to healthcare, geographic disparities, awareness and stigma, and poverty and financial burden. Additionally, the study identified 11 subthemes related to structural violence in the context of autism and families. CONCLUSIONS We illustrated how structural forces create barriers to accessing adequate healthcare services, exacerbate discrimination based on ethnicity and geography, perpetuate stigma, and contribute to poverty and the inability to meet basic needs. These factors not only worsen health issues but also deepen existing disparities in healthcare access and outcomes for children on the autism spectrum and families. We emphasize the urgent need for systemic changes to address these issues. It is essential to promote public awareness, provide better access to health and support services, and address economic and political factors that contribute to these inequalities.
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Affiliation(s)
- Ansar Khougar
- Primary Health Care Center, Iran University of Medical Science, Shahryar, Iran
| | - Paria Baba Ahmadi
- Student Research Committee, School of Medicine, Shirza University of Medical Sciences, Shiraz, Iran
| | - Hadi Ranjbar
- Mental Health Research Center, Iran University of Medical Science, Tehran, Iran
| | - Mahsa Ahadi
- Student Research Committee, School of Medicine, Shirza University of Medical Sciences, Shiraz, Iran
| | - Parisa Ahadi
- Department of Pharmacy, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran.
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Audulv Å, Westergren T, Ludvigsen MS, Pedersen MK, Fegran L, Hall EOC, Aagaard H, Robstad N, Kneck Å. Time and change: a typology for presenting research findings in qualitative longitudinal research. BMC Med Res Methodol 2023; 23:284. [PMID: 38057741 PMCID: PMC10698947 DOI: 10.1186/s12874-023-02105-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Qualitative longitudinal research (QLR) is an emerging methodology used in health research. The method literature states that the change in a phenomenon through time should be the focus of any QLR study, but in empirical studies, the analysis of changes through time is often poorly described, and the emphasis on time/change in the findings varies greatly. This inconsistency might depend on limitations in the existing method literature in terms of describing how QLR studies can present findings. The aim of this study was to develop and describe a typology of alternative approaches for integrating time and/or change in QLR findings. METHODS In this method study, we used an adapted scoping review design. Articles were identified using EBSCOhost. In total, methods and results sections from 299 QLR articles in the field of health research were analyzed with inspiration from content analysis. RESULTS We constructed a typology of three types and seven subtypes. The types were based on the underlying structural principles of how time/change was presented: Type A) Findings have a low utilization of longitudinal data, Type B) Findings are structured according to chronological time, and Type C) Findings focus on changes through time. These types differed in 1) the way the main focus was on time, change or neither; 2) the level of interpretation in the findings; and 3) how theoretical understandings of time/change were articulated in the articles. Each type encompassed two or three subtypes that represented distinct approaches to the aim and results presentation of QLR findings. CONCLUSIONS This method study is the first to describe a coherent and comprehensive typology of alternative approaches for integrating time/change into QLR findings in health research. By providing examples of various subtypes that can be used for results presentations, it can help researchers make informed decisions suitable to their research intent.
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Affiliation(s)
- Åsa Audulv
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - Thomas Westergren
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
- Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Mette Spliid Ludvigsen
- Department of Clinical Medicine, Randers Regional Hospital, Aarhus University, Aarhus, Denmark
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Mona Kyndi Pedersen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Liv Fegran
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Elisabeth O C Hall
- Faculty of Health, Aarhus University, Aarhus, Denmark
- Faculty of Health Sciences and Nursing, University of Faroe Islands, Torshavn, Faroe Islands
| | - Hanne Aagaard
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Nastasja Robstad
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Åsa Kneck
- Department of Health Care Sciences, Marie Cederschöld University, Stockholm, Sweden
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Erikson A, Ranner M, Guidetti S, von Koch L. In search of self after stroke: a longitudinal qualitative study in the context of client-centred rehabilitation. Int J Qual Stud Health Well-being 2023; 18:2282513. [PMID: 38010156 PMCID: PMC11000675 DOI: 10.1080/17482631.2023.2282513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE The aim was to illuminate the experiences of stroke survivors returning to everyday life in the year following stroke, in the context of client-centred rehabilitation. METHODS Four men who participated in a client-centred rehabilitation program were followed during the first year after stroke. Semi-structured interviews were conducted, allbut the first in the participants' home. The data were analysed using a grounded theory approach. RESULTS The results revealed a process with the overarching core category; The "new" self becomes reality through challenging everyday experiences, and five main categories driving the process: 1) Striving for structure in a "new" chaotic world, 2) Homecoming an ambiguous experience, 3) Reaching the "new" self through reflections of self-understanding, 4) Socialising in new circumstances, and 5) Realising a new reality. CONCLUSIONS While in hospital, stroke survivors can have unrealistic expectations. When at home they can begin to realise their actual capacity . To find a "new" self after a stroke can involve time-consuming and taxing processes of reflections of self-understanding. Engagement in self-selected meaningful and valued activities can support stroke survivors' reconstruction of the "new" self but not all stroke survivors may succeed in finding their "new" self during the first year after stroke.
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Affiliation(s)
- Anette Erikson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Ranner
- Health Medicine and Rehabilitation, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Susanne Guidetti
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, and Karolinska University Hospital, Women’s Health and Allied Health Professionals Theme, Stockholm, Sweden
| | - Lena von Koch
- Division of Family Medicine and Primary Health Care, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Karolinska University Hospital, Theme Heart & Vascular and Neuro, Stockholm, Sweden
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Tuthill EL, Maltby AE, Odhiambo BC, Akama E, Dawson-Rose C, Cohen CR, Weiser SD. Financial and Food Insecurity are Primary Challenges to Breastfeeding for Women Living with HIV in Western Kenya: A Longitudinal Qualitative Investigation. AIDS Behav 2023; 27:3258-3271. [PMID: 37043052 PMCID: PMC10577374 DOI: 10.1007/s10461-023-04046-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 04/13/2023]
Abstract
Exclusive breastfeeding for the first 6 months and continued breastfeeding for 24 months or longer is recommended for all mothers world-wide, including women living with HIV (WLWH). Given evidence of suboptimal infant feeding and the need to understand context specific barriers, we explored experiences of perinatal WLWH in Kisumu, Kenya. We applied a longitudinal qualitative approach (4 in-depth interviews) with 30 women from pregnancy to 14-18 months postpartum. Cross-sectional profiling led to a narrative description of infant feeding across time. The majority of women breastfed exclusively for 6 months and weaned by 18 months. Severe financial and food insecurity were primary challenges as women worked through when/how to breastfeed or stop breastfeeding in the setting of multiple competing priorities/pressures across time. Financial and food support and increased support for breastfeeding beyond 18 months have the potential to reduce women's stress and uncertainty associated with infant feeding as well as optimize infant health and nutrition in this setting.
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Affiliation(s)
- Emily L Tuthill
- Department of Community Health Systems, School of Nursing, University of California, 2 Koret Way, San Francisco, CA, 94143, USA.
| | - Ann E Maltby
- Department of Community Health Systems, School of Nursing, University of California, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Belinda C Odhiambo
- Global Programs for Research and Training - Kenya, University of California, San Francisco, CA, USA
| | - Eliud Akama
- Kenya Medical Research Institute- Center for Microbiology Research, Nairobi, Kenya
| | - Carol Dawson-Rose
- Department of Community Health Systems, School of Nursing, University of California, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Craig R Cohen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Jack SM, Orr E, Campbell KA, Whitmore C, Cammer A. A framework for selecting data generation strategies in qualitative health research studies. J Hum Nutr Diet 2023; 36:1480-1495. [PMID: 36617529 DOI: 10.1111/jhn.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/03/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Qualitative health research has the potential to answer important applied health research questions to inform nutrition and dietetics practice, education and policy. Qualitative health research is a distinct subdiscipline of qualitative inquiry that purposefully draws upon the context of healthcare and emphasises health and wellness. METHODS Qualitative health research is defined by two parameters: (1) the focus of the study and (2) the methods used. When considering the methods to be used, decisions are required about the type of data to be generated (e.g., transcripts, images and notes) and the process involved in data generation (e.g., interviews, elicitation strategies and observations) to answer the research question(s). Drawing upon examples from nutrition and dietetics literature, this paper provides a framework to support decision-making for nutrition and dietetics researchers and clinician researchers designing conducting qualitative health research. RESULTS The guiding questions of the framework include: What types of data will be generated? Who is involved in data generation? Where will data generation occur? When will data generation occur? How will data be recorded and managed? and How will participants' and researchers' emotional safety be promoted? CONCLUSION Questions about the types of data, those involved, where and when, as well as how safety can be maintained in data generation, not only support a more robust design and description of data generation methods but also keep the person at the centre of the research.
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Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Orr
- Department of Nursing, Brock University, St. Catharines, Ontario, Canada
| | | | - Carly Whitmore
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Allison Cammer
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Michel AS, Kamudoni P, Marrel A, Adiutori R, Desvignes-Gleizes C, Lanar S, Schache P, Spies E, Park J. Integrating qualitative interviews in drug development and the use of qualitative evidence in product labelling and health technology assessments: a review. Front Med (Lausanne) 2023; 10:1197529. [PMID: 37415771 PMCID: PMC10322192 DOI: 10.3389/fmed.2023.1197529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
Objective Including qualitative research in clinical trial design is an innovative approach to understanding patients' perspective and incorporate the patient's voice in all stages of drug development and evaluation. This review aims to explore current practices, lessons learned from the literature, as well as how qualitative interviews are considered by health authorities for marketing authorization and reimbursement. Methods A targeted literature review of Medline and Embase databases was conducted in February 2022 to identify publications on qualitative methods embedded in clinical trial of pharmaceutical products. An additional search of guidelines and labeling claims of approved products regarding qualitative research was performed in various sources of grey literature. Results From the 24 publications and nine documents reviewed, we identified the research questions addressed with qualitative methods during clinical trials (e.g., change in quality of life, symptoms assessment, treatment benefit), preferred data collection methods (e.g., interviews), and data collection points (e.g., baseline and exit interviews). Moreover, the data from labels and HTAs demonstrate that qualitative data can play an important role in approval processes. Conclusion The use of in-trial interviews is still emerging and is not yet common practice. Although the industry, scientific community, regulatory agencies and HTAs are showing an increasing interest in the use of evidence generated via in-trial interviews, guidance from regulators and HTAs would be helpful. Developing new methods and technologies to address the common challenges for such interviews is key to progress.
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Affiliation(s)
| | - Paul Kamudoni
- Merck KgaA, Clinical Measurement Sciences, Global Research and Development, Healthcare, Darmstadt, Germany
| | | | | | | | - Sally Lanar
- ICON Plc, Patient Centered Outcomes, Lyon, France
| | | | - Erica Spies
- EMD Serono Research and Development Institute Inc., A Business of Merck KGaA, Patient Centered Outcomes Research, Global Research and Development Healthcare, Darmstadt, Germany
| | - Josephine Park
- EMD Serono Research and Development Institute Inc., A Business of Merck KGaA, Patient Centered Outcomes Research, Global Research and Development Healthcare, Darmstadt, Germany
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Relster M, Nielsen SH, Thrysøe L, Dieperink KB, Nielsen DS, Tolstrup LK. Transition from masters of nursing to clinical practice. NURSE EDUCATION TODAY 2023; 128:105882. [PMID: 37356185 DOI: 10.1016/j.nedt.2023.105882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Research indicates that nurses with a Master's degree can contribute to an increasing quality of care, thereby improving care pathways in hospitals. In 2014, the Master's programme in Nursing at the University of Southern Denmark was established to create a relationship between the university and clinical practice to improve nurses' ability to function at a higher clinical level. Therefore, this study aimed to explore the significance of the Master's degree on nurses' self-perceived competencies and their return to clinical practice. DESIGN AND METHODS A longitudinal qualitative design was used with six focus groups including graduates from the Master's programme in Nursing. The study was conducted in two phases: The first phase in 2017 (n = 16) investigated how the Master's degree affected the graduates' self-perceived competences and their working life. The second phase in 2021-2022 (n = 10) was a follow-up and included a subset of the participants from the first phase. Data were analysed with an inductive approach inspired by Malterud's systematic text condensation. RESULTS The analysis revealed two main categories: Transition to Practice and The Impact of the Master's Degree, along with five underlying sub-categories. CONCLUSION Graduates perceived themselves as better nurses because of the Master's degree. The Master's programme in Nursing enhanced their competencies enabling them to provide more qualified and evidence-based nursing for the benefit of clinical practice. The transition and the conditions under which the graduates were employed, such as the ward culture and the ward management, had a significant impact on how they experienced their return to clinical practice.
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Affiliation(s)
- Michelle Relster
- Department of Clinical Research, University of Southern Denmark, Denmark; Department of Surgery, Odense University Hospital, Denmark.
| | - Sofie Hald Nielsen
- Department of Clinical Research, University of Southern Denmark, Denmark; Department of Surgery, Odense University Hospital, Denmark.
| | - Lars Thrysøe
- Department of Cardiology, Odense University Hospital, Denmark
| | - Karin Brochstedt Dieperink
- Department of Clinical Research, University of Southern Denmark, Denmark; Department of Oncology, Odense University Hospital, Denmark
| | - Dorthe Susanne Nielsen
- Department of Clinical Research, University of Southern Denmark, Denmark; Research unit of Geriatric medicine, Odense University Hospital, Denmark
| | - Lærke Kjær Tolstrup
- Department of Clinical Research, University of Southern Denmark, Denmark; Department of Oncology, Odense University Hospital, Denmark
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Tolstrup LK, Ditzel HM, Giger AKW, Jørgensen TL, Ryg J, Dieperink KB. Determinants of poor quality of life in older patients with cancer: A longitudinal mixed methods study (PROGNOSIS-Q). J Geriatr Oncol 2023; 14:101500. [PMID: 37084630 DOI: 10.1016/j.jgo.2023.101500] [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: 01/03/2023] [Revised: 02/21/2023] [Accepted: 04/05/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Patient-reported outcomes are becoming more employed in oncologic research because many older patients with cancer prioritize preserved health-related quality of life (HRQoL) over prolonged survival. However, few studies have examined the determinants of poor HRQoL in older patients with cancer. This study aims to determine whether HRQoL findings are truly reflective of cancer disease and treatment, as opposed to external factors. MATERIALS AND METHODS This longitudinal, mixed-methods study included outpatients, age 70 years or more, with a solid cancer, who reported poor HRQoL (EORTC QLQ-C30 Global health status/QoL (GHS) score ≤ 33.3), at treatment initiation. A convergent design was employed, in which HRQoL survey data and telephone interview data was collected in parallel at baseline and three-months follow-up. Survey and interview data was analyzed separately and subsequently compared. Thematic analysis of interview data was conducted according to Braun & Clarke, and changes in patients GHS score were calculated using mixed model regression. RESULTS Twenty-one patients with a mean age of 74.7 years were included (12 men and 9 women) and data saturation was achieved at both time intervals. Baseline interviews (n = 21) showed that poor HRQoL at cancer treatment initiation was primarily reflective of participants' initial shock upon receiving their cancer diagnosis and their change in circumstance and sudden functional independence. At three months, three participants were lost to follow-up and two provided only partial data. Most participants experienced an increase in HRQoL, with 60% showing a clinically significant improvement in GHS scores. Interviews showed that this was due to lessening functional dependency and disease acceptance achieved by mental and physical adjustment. HRQoL measures were less reflective of cancer disease and treatment in older patients with preexisting highly disabling comorbidity. DISCUSSION This study showed good alignment between survey responses and in-depth interviews, demonstrating that both methodologies are highly relevant measures during oncologic treatment. However, for patients with severe comorbidity, HRQoL findings are often more reflective of the steady state of their disabling comorbidity. Response shift may play a part in how participants adjusted to their new circumstances. Promoting caregiver involvement from the time of diagnosis may increase patients´ coping strategies.
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Affiliation(s)
- Lærke Kjær Tolstrup
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark; OPEN- Odense Patient data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Helena Møgelbjerg Ditzel
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark; OPEN- Odense Patient data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
| | - Ann-Kristine Weber Giger
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark; Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark; OPEN- Odense Patient data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Trine Lembrecht Jørgensen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
| | - Jesper Ryg
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark; Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Karin Brochstedt Dieperink
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
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Nguyen N, Koester KA, Kim M, Watkins SL, Ling PM. "I'm both smoking and vaping": a longitudinal qualitative study of US young adults who tried to quit smoking cigarettes by using electronic cigarettes. Tob Control 2023:tc-2022-057804. [PMID: 37072166 PMCID: PMC10582197 DOI: 10.1136/tc-2022-057804] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE To describe how young adults use electronic cigarettes (electronic nicotine delivery systems (ENDS)) for smoking cessation and reasons why they may or may not successfully quit smoking. METHODS Longitudinal qualitative data were collected annually from 2017 to 2019 for 25 young adult tobacco users (aged 18-29 years) in California (USA) who used ENDS to quit/reduce smoking. Thematic and trajectory analyses were used to identify key within-person and between-person changes in tobacco/nicotine use over time. RESULTS Five types of tobacco use transition were identified among baseline dual users of cigarettes and ENDS: sustained dual use without reduced smoking (n=8), transition to exclusive daily ENDS use (n=6), sustained dual use with reduced smoking (n=5), transition back to exclusive smoking (n=4) and transition to neither smoking nor vaping (n=2). Participants' ENDS use behaviour varied over time in terms of vaping quantity and device characteristics (eg, changing nicotine concentrations/flavours, switching between multiple devices). Three themes that related to successfully replacing cigarettes with ENDS were perceived positive physical effects, perceived satisfaction and enjoyment and context changes. Four themes for unsuccessful replacement were perceived negative physical discomforts, perceived addictiveness and harm, unsatisfactory substitution for cigarettes and device malfunction. CONCLUSIONS Young adults' experiences with using ENDS as a smoking cessation aid were highly variable. Adequate nicotine delivery and perceived safety and benefits contributed to successfully reducing or quitting cigarettes. Providing behavioural counselling and standardising ENDS products may enhance cessation for young adults.
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Affiliation(s)
- Nhung Nguyen
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kimberly A Koester
- Center for AIDS Prevention Studies, Division of Prevention Science, University of California San Francisco, San Francisco, California, USA
| | - Minji Kim
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Shannon Lea Watkins
- Department of Community and Behavioral Health, University of Iowa, Iowa City, Iowa, USA
| | - Pamela M Ling
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, University of California San Francisco, San Francisco, California, USA
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Hanna K, Clarke P, Woolfall K, Hassan S, Abba K, Hajj TE, Deja E, Ahmed S, Joseph N, Ring A, Allen G, Byrne P, Gabbay M. The perception of risk in contracting and spreading COVID-19 amongst individuals, households and vulnerable groups in England: a longitudinal qualitative study. BMC Public Health 2023; 23:653. [PMID: 37020218 PMCID: PMC10074336 DOI: 10.1186/s12889-023-15439-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 03/14/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Social distancing restrictions to manage the COVID-19 pandemic were put in place from March 2020 in the United Kingdom (UK), with those classed as "highly clinically vulnerable" advised to shield entirely and remain at home. However, personal risk perception has been shown to comprise of various elements beyond those outlined in the national pandemic guidance. It is unclear whether those deemed COVID-19 vulnerable identified as high-risk to COVID-19 and thus complied with the relevant advice. The aim of this research is to explore the perception of risk in catching and spreading COVID-19, amongst individuals from individual households, and vulnerable groups in a region of the UK. METHODS Two individual, semi-structured interviews were conducted, four-weeks apart, with adults living in households in the Liverpool City Region. At the follow-up interview, participants were given the option of using photo-elicitation to guide the discussion. Reflexive thematic analysis was employed to conceptualise themes. The qualitative analysis was underpinned with symbolic interactionism. RESULTS Twenty-seven participants (13:14 males:females, and 20 with a vulnerable risk factor to COVID-19) completed a baseline interview, and 15 of these completed a follow-up interview four-weeks later. Following thematic analysis, two overarching themes were conceptualised, with subthemes discussed: theme 1) Confusion and trust in the risk prevention guidance; and theme 2) Navigating risk: compliance and non-compliance with public health guidance. CONCLUSION Participants developed their own understanding of COVID-19 risk perception through personal experience and comparison with others around them, irrespective of vulnerability status. COVID-19 guidance was not complied with as intended by the government, and at times even rejected due to lack of trust. The format in which future pandemic guidance is conveyed must be carefully considered, and take into account individuals' experiences that may lead to non-compliance. The findings from our study can inform future public health policy and interventions for COVID-19 and future pandemics.
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Affiliation(s)
- Kerry Hanna
- Health Sciences, University of Liverpool, Thompson Yates Building, Brownlow Hill, Liverpool, L69 3GB, UK.
| | - Pam Clarke
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Kerry Woolfall
- Department of Public Health, Policy and Systems, University of Liverpool, Whelan Building, Liverpool, UK
| | - Shaima Hassan
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration NWC, Liverpool, UK
| | - Katharine Abba
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Department of Public Health, Policy and Systems, University of Liverpool, Whelan Building, Liverpool, UK
- NIHR Applied Research Collaboration NWC, Liverpool, UK
| | | | - Elizabeth Deja
- Department of Public Health, Policy and Systems, University of Liverpool, Whelan Building, Liverpool, UK
| | - Saiqa Ahmed
- NIHR Applied Research Collaboration NWC, Liverpool, UK
| | - Neil Joseph
- NIHR Applied Research Collaboration NWC, Liverpool, UK
| | - Adele Ring
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Gerry Allen
- NIHR Applied Research Collaboration NWC, Liverpool, UK
| | - Paula Byrne
- Department of Public Health, Policy and Systems, University of Liverpool, Whelan Building, Liverpool, UK
| | - Mark Gabbay
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration NWC, Liverpool, UK
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Herron DL, Runacres J, Danton I, Beardmore J. Carers' experiences of caring for a friend or family member with dementia during the Covid-19 pandemic. DEMENTIA 2023; 22:576-593. [PMID: 36630524 PMCID: PMC9843153 DOI: 10.1177/14713012221150298] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES This study aimed to explore carers' experiences of supporting a family member or friend with dementia through COVID-19 and experiences of hope and resilience during this time. METHODS Qualitative longitudinal research was undertaken in the UK, with 13 unpaid carers of people living with dementia who took part in two semi-structured interviews 8 weeks apart between June and October 2020. All transcripts were analysed using reflexive thematic analysis. FINDINGS Four themes were developed and included: COVID-19 impacted negatively upon everyday living; carer resilience: adapting to COVID-19; analysis of risk: safeguarding the person living with dementia; and thinking about the future with COVID-19. CONCLUSIONS The results illustrated how the sudden changes which occurred during the pandemic negatively impacted on carers and people living with dementia in several ways, including additional responsibilities and taking away hope. The importance of continued formal and informal support for carers and people living with dementia during COVID-19 were highlighted. Formal services, care homes, and organisations need to be supported to implement procedures to ensure a safe environment during future lockdowns or periods of social restrictions. This will enable carers to remain visiting their family members and increase their confidence in accessing services and allowing paid carers to support their family member with dementia. These results have also illustrated the resilience of carers, who adapted to sudden changes which impacted negatively on their wellbeing and the wellbeing of the person living with dementia.
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Affiliation(s)
- Daniel L Herron
- Department of Psychology, School of Health, Science and Wellbeing, 7703Staffordshire University, Stoke-on-Trent, UK
| | - Jessica Runacres
- Midwifery and Allied Health, School of Health, Science and Wellbeing, Centre of Excellence in Healthcare Education, 7703Staffordshire University, Stoke-on-Trent, UK
| | - Ian Danton
- School of Psychology, 2939University of Derby, Derby, UK
| | - Jack Beardmore
- Department of Psychology, School of Health, Science and Wellbeing, 7703Staffordshire University, Stoke-on-Trent, UK
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Werner-Lin A, Forbes Shepherd R, Rising CJ, Thompson AS, Huelsnitz C, Wilsnack C, Boyd P, Sleight AG, Hutson S, Khincha PP. How do young people with a hereditary cancer predisposition syndrome understand and experience cancer survivorship? "With Li-Fraumeni syndrome, it's just an intermission". Psychooncology 2023; 32:375-382. [PMID: 36514197 DOI: 10.1002/pon.6080] [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: 09/22/2022] [Revised: 11/15/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Adolescents and young adult (AYA) cancer survivors face unique medical and psychosocial sequalae, including chronic health conditions, late effects of treatment and fear of recurrence. The meaning of cancer survivorship may be further complicated for AYAs with hereditary cancer predisposition syndromes. This study used a patient-centered framework to investigate how AYAs with Li-Fraumeni syndrome (LFS) consider cancer survivorship. METHODS An interprofessional team conducted 30 semi-structured interviews with AYAs (aged 18-41, mean 31 years) enrolled in the National Cancer Institute's LFS Study (NCT01443468). Twenty had experienced at least one cancer diagnosis. Interview data were thematically analyzed by an inter-professional team using interpretive description and grounded theory methods. FINDINGS Participants viewed "survivorship" as a period marked by no evidence of formerly diagnosed disease. By contrast, participants felt the label "survivor" was tenuous since LFS is characterized by multiple primary malignancies and uncertainty about intervals between one diagnosis and the next. Many AYAs viewed survivorship as requiring a high degree of suffering. Though many personally rejected "survivor" identities, almost all articulated its various functions including positive, negative, and more complicated connotations. Instead, they chose language to represent a range of beliefs about survival, longevity, prognosis, and activism. CONCLUSIONS AYAs with LFS struggle with the term "survivor" due to their multi-organ cancer risk, short intervals between malignancies, and evolving identities. Loved ones' cancer-related suffering informed perspectives on survivorship. Survivorship care for AYAs with cancer risk syndromes requires interprofessional interventions that address their unique biomedical and psychosocial needs.
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Affiliation(s)
- Allison Werner-Lin
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rowan Forbes Shepherd
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Camella J Rising
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Ashley S Thompson
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Chloe Huelsnitz
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Catherine Wilsnack
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Patrick Boyd
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Alix G Sleight
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Sadie Hutson
- Department of Nursing, University of Tennessee, Knoxville, Tennessee, USA
| | - Payal P Khincha
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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Richards AB, Sheldrick MP, Swindell N, Barker HG, Hudson J, Stratton G. Qualitative changes in children's physical activity and sedentary behaviours throughout the COVID-19 pandemic: The HomeSPACE project. PLoS One 2023; 18:e0280653. [PMID: 36662771 PMCID: PMC9858462 DOI: 10.1371/journal.pone.0280653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
Opportunities for children to be physically active during the COVID-19 pandemic were limited, resulting in a decrease in overall physical activity and an increase in sedentary behaviour during the lockdown restrictions of the pandemic. This study further explored these changes across various stages of the restrictions, starting during the first UK-wide lockdown in March 2020 through to the "new normal" in December 2021. Nine families, consisting of eleven children (36% girls, 64% boys; aged 13.38 years ± 1.14), eight mothers and one father were tracked throughout this time, using semi-structured interviews to explore the fluctuations in physical activity and sedentary behaviour in the home environment in the context of self-determination theory. Findings indicate that as restrictions eased, physical activity within the home decreased, as children were exposed to more opportunities at school and in the community; these opportunities seemingly increased children's motivation to be physically active through increasing levels of their basic psychological needs of autonomy, competence, and relatedness. Some children's physical activity levels have returned to pre-COVID-19 levels, with a newfound enjoyment for being physically active. Whilst others now prefer to pursue more sedentary behaviours that became habitual during the lockdown restrictions. Accessible opportunities now need to be promoted to drive up children's motivations to be physically active following the years of uncertainty around the COVID-19 pandemic.
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Affiliation(s)
- Amie B. Richards
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, United Kingdom
| | - Michael P. Sheldrick
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, United Kingdom
| | - Nils Swindell
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, United Kingdom
| | - Harriet G. Barker
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, United Kingdom
| | - Joanne Hudson
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, United Kingdom
| | - Gareth Stratton
- Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, United Kingdom
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Töbelmann L, Hahne I, Schulze T, Bergmann N, Fuchs L, Zierhut M, Hahn E, Böge K. Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study. Front Psychiatry 2023; 14:1086468. [PMID: 36824673 PMCID: PMC9941680 DOI: 10.3389/fpsyt.2023.1086468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Research exploring the effects of yoga therapy (YT) on individuals with schizophrenia spectrum disorders (SSD) is scarce. Therefore, the current study aimed to explore possible mechanisms of actions and processes, as well as adverse effects of a novel yoga-based group intervention (YoGI) for in-patients with SSD in a German university hospital setting. MATERIAL AND METHODS A longitudinal qualitative study was integrated into a rater-blinded randomized controlled trial, exploring the impact of a 4-week YoGI as add-on treatment. In-depth interviews were conducted with participants receiving YoGI (n = 19) in addition to treatment as usual (TAU) and a control group (n = 14) which only received TAU. Interviews were conducted at baseline (n = 33) and 4 weeks post-intervention (N = 28) to assess the participant's experiences and how they changed over time. The interviews (N = 61) were audio-taped, translated, coded, and analyzed by means of inductive thematic analysis. Separate case summaries were prepared for each participant to analyze longitudinal changes within subjects. The research team members collaboratively discussed the final list of themes and subcodes. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Personal and Social Performance Scale (PSP) were administered at baseline to assess clinical outcomes. RESULTS At baseline, participants reported a desire to improve their stress- and symptom management. A minority of participants expressed reservations toward yoga, and several psychosocial barriers were named, including worries about symptom exacerbation. At post-intervention, four mechanisms of change became evident from the interviews: (1) acquiring competence in relaxation, (2) increased interoceptive awareness, (3) feeling connected, and (4) a sense of spiritual wellbeing. A small number of participants reported difficulties with YoGI. CONCLUSION Generally, YoGI positively influenced participants' experiences of their inpatient stay, regarding distress, self- and body awareness, social connectedness, and spiritual wellbeing. However, participants also illuminated necessary adjustments to improve the intervention. YoGI will therefore be adapted and further developed in an iterative process based on a participant involvement approach. The efficacy regarding outcomes and processes needs to be investigated in a future larger-scaled randomized controlled trial.
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Affiliation(s)
- Laura Töbelmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Theresa Schulze
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Lukas Fuchs
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Marco Zierhut
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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Egerod I, Knudsen VE, Andersson AE, Fagerdahl A. Patient and family experience 2 years after necrotizing soft‐tissue infection: A longitudinal qualitative investigation. J Adv Nurs 2022. [DOI: 10.1111/jan.15535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 10/18/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Ingrid Egerod
- Department of Intensive Care Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
- Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Vibeke E. Knudsen
- Department of Intensive Care Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Annette E. Andersson
- Institute of Health Care Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Orthopedics Sahlgrenska University Hospital/Mölndal Gothenburg Sweden
| | - Ann‐Mari Fagerdahl
- Department of Clinical Science and Education Wound Centre, Södersjukhuset Stockholm Sweden
- Karolinska Institute Stockholm Sweden
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Isaacs A, Neve K, Hawkes C. Why do parents use packaged infant foods when starting complementary feeding? Findings from phase one of a longitudinal qualitative study. BMC Public Health 2022; 22:2328. [PMID: 36510175 PMCID: PMC9744586 DOI: 10.1186/s12889-022-14637-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The first 1000 days in a child's life, from conception to age two, are a critical period for establishing a child's health and development. One important element is the diet that children receive during this time. Dietary intake of infants in the UK has been shown to be high in sugar and salt, with overall energy intakes exceeding recommendations by the time they are two years of age. Commercial infant food, which forms approximately 40-60% of infants' dietary intake, was identified in 2011 as the main contributor to sugar intake for infants aged 4-9 months in the United Kingdom. Further, evidence demonstrates inconsistencies between national recommendations on infant feeding and some of these products in terms of the type available, their nutritional value and product labelling and marketing. Given their role in infants' diets, it is important to understand parental perceptions of these products and why they are chosen. METHODS The study comprised the first phase of an in-depth, longitudinal qualitative study which explored parents' experiences of introducing solid foods to their infants over the first year of feeding. 62 parents/ carers were recruited to this phase when their infants were four-six months old. Data collection involved semi-structured interviews and a photo-elicitation exercise. Data from interview transcripts which focused on the purchase and use of packaged purees and commercial snacks were analysed thematically. RESULTS Parents/ carers drew on a range of reasons for buying both packaged purees and commercial snacks for their infants. These included anxiety over food preparation, food safety, convenience, cost effectiveness, the pull of brand eco-systems for packaged purees, and the way in which commercial snacks provide opportunities for safe development of motor skills, keep infants occupied, and allow them to take part in family rituals. CONCLUSION In considering the use of packaged products as a food source for infants in public health nutrition policy, it is important to understand the broad range of factors that shape parents decisions ranging from the way that products are advertised and perceived, to the non-nutritive roles that they play.
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Affiliation(s)
- Anna Isaacs
- grid.28577.3f0000 0004 1936 8497Centre for Food Policy, City, University of London, Northampton Square, EC1V 0HB London, UK
| | - Kimberley Neve
- grid.28577.3f0000 0004 1936 8497Centre for Food Policy, City, University of London, Northampton Square, EC1V 0HB London, UK
| | - Corinna Hawkes
- grid.28577.3f0000 0004 1936 8497Centre for Food Policy, City, University of London, Northampton Square, EC1V 0HB London, UK
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Pehlke-Milde J, Radu I, Gouilhers S, Hammer R, Meyer Y. Women's views on moderate and low alcohol consumption: stages of the subjective transition from pregnancy to postpartum. BMC Pregnancy Childbirth 2022; 22:902. [PMID: 36464711 PMCID: PMC9721071 DOI: 10.1186/s12884-022-05247-0] [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: 08/12/2022] [Accepted: 11/25/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Alcohol consumption during pregnancy and breastfeeding is associated with a risk for the child's healthy development. Nevertheless, about 16 to 25% of all women in the European region, including Switzerland, consume alcohol during pregnancy and probably even more during breastfeeding. Little is known about how women perceive this risk and how risk perception changes during the transition to motherhood. The present study aims to explore the subjective transition from the woman's perspective, focusing on perceptions of alcohol as a risk, changes in alcohol consumption in daily life and experienced support from health professionals in this period. METHODS The longitudinal qualitative, semi-structured interview study was jointly designed and conducted by health sociologists and midwifery researchers. Using the theoretical framework of sociocultural risk and life course transition, we interviewed 46 women from the French and German speaking part of Switzerland during pregnancy and until six months after birth. RESULTS In our study, we found that pregnant and breastfeeding women perceive alcohol consumption as a risk to the health of the child. Abstinence is sought especially during pregnancy, but this does not preclude occasional and low-level consumption according to some women. Alcohol consumption and risk perception change during the transition to motherhood. We identified five stages that characterise this transition in terms of alcohol consumption and risk perception. From the women's perspective, there was a lack of counselling from health professionals, and the women expressed a desire for respectful and more individualised counselling. CONCLUSION Many women express a need for guidance and counselling by health care professionals at some stages of the transition to motherhood. The stages identified can be used as pointers to address the subject of alcohol consumption in professional practice. The stage around conception and early pregnancy should be taken more into account, as women experience themselves as particularly vulnerable during this time. Low-threshold counselling services should be therefore offered to women before or in the stage around conception and be continued until the end of the breastfeeding period.
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Affiliation(s)
- Jessica Pehlke-Milde
- grid.19739.350000000122291644Research Institute of Midwifery, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Irina Radu
- grid.19739.350000000122291644Research Institute of Midwifery, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Solène Gouilhers
- grid.5681.a0000 0001 0943 1999School of Health Sciences (Haute Ecole de Santé Vaud - HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Raphaël Hammer
- grid.5681.a0000 0001 0943 1999School of Health Sciences (Haute Ecole de Santé Vaud - HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Yvonne Meyer
- grid.5681.a0000 0001 0943 1999School of Health Sciences (Haute Ecole de Santé Vaud - HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Yıldırım DF, Serçekuş P, Özkan S. Reasons for Individuals' COVID-19 vaccine hesitations and changing decisions over time: A longitudinal qualitative study. VACUNAS 2022; 23:S1-S7. [PMID: 35813990 PMCID: PMC9250900 DOI: 10.1016/j.vacun.2022.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Abstract
Objective COVID-19 is a serious public health problem. Therefore, it is important to vaccinate the community. This study was aimed at examining the reasons for individuals' COVID-19 vaccine hesitations, and decisions that have changed over time. Material and methods This was a prospective longitudinal qualitative study. Results Confidence, fear, conspiracy theories, belief, and social pressure play a role in vaccine hesitancy. The most important factor in the changing decisions of individuals who are hesitant about vaccination is pressure. Confidence and fear also lead to a change of decision. However, it was remarkable that most of the participants who were vaccinated due to pressure did not want to be revaccinated. Conclusions Governments, media, vaccine companies, health professionals, and scientists should act together to increase the vaccination rates of individuals.
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Affiliation(s)
- Dicle Filiz Yıldırım
- Research Assisstant, Faculty of Health Sciences, Pamukkale University, Kınıklı / Denizli/, Turkey
| | - Pınar Serçekuş
- Professor, Faculty of Health Sciences, Pamukkale University, Kınıklı / Denizli/, Turkey
| | - Sevgi Özkan
- Professor, Faculty of Health Sciences, Pamukkale University, Kınıklı / Denizli/, Turkey
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Evans S, Olive L, Dober M, Knowles S, Fuller-Tyszkiewicz M, O E, Gibson P, Raven L, Gearry R, McCombie A, van Niekerk L, Chesterman S, Romano D, Mikocka-Walus A. Acceptance commitment therapy (ACT) for psychological distress associated with inflammatory bowel disease (IBD): protocol for a feasibility trial of the ACTforIBD programme. BMJ Open 2022; 12:e060272. [PMID: 35688593 PMCID: PMC9189839 DOI: 10.1136/bmjopen-2021-060272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Inflammatory bowel disease (IBD) involves an abnormal immune response to healthy gut bacteria. When a person develops IBD, their susceptibility to anxiety and/or depression increases. The ACTforIBD programme, specifically designed for people with IBD and comorbid psychological distress, draws on acceptance and commitment therapy (ACT), which promotes acceptance of situations that cannot be solved such as persistent physical symptoms. There are no ACT trials for IBD using an active control group or a telemedicine approach, which is important to improve accessibility, particularly in the context of the ongoing COVID-19 pandemic. The ACTforIBD programme is administered online with a 4-hour therapist involvement per participant only; if successful it can be widely implemented to improve the well-being of many individuals with IBD. METHODS AND ANALYSIS Our team have codesigned with consumers the ACTforIBD programme, an 8-week intervention of 1-hour sessions, with the first three sessions and the last session delivered one-to-one by a psychologist, and the other sessions self-directed online. This study aims to evaluate the feasibility and preliminary efficacy of ACTforIBD to reduce psychological distress in patients with IBD. Using a randomised controlled trial, 25 participants will be randomised to ACTforIBD, and 25 patients to an active control condition. ETHICS AND DISSEMINATION This protocol has been approved by Deakin University Research Ethics Committee in September 2021 (Ref. 2021-263) and the New Zealand Central Health and Disability Ethics Committee in December 2021 (Ref. 2021 EXP 11384). The results of this research will be published in peer-reviewed journals and shared with various stakeholders, including community members, policy-makers and researchers, through local and international conferences. TRIAL REGISTRATION NUMBER ACTRN12621001316897.
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Affiliation(s)
- Subhadra Evans
- Psychology, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Lisa Olive
- School of Pyschology, Deakin, Geelong, Victoria, Australia
| | - Madeleine Dober
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Simon Knowles
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | | | - Eric O
- Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Peter Gibson
- Gastroenterology, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Leanne Raven
- Crohn's and Colitis Australia, Camberwell, Victoria, Australia
| | - Richard Gearry
- Department of Medicine, Christchurch School of Medicine and Health Sciences, Medicine, Christchurch, New Zealand
| | - Andrew McCombie
- Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Leesa van Niekerk
- School of Psychological Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Daniel Romano
- School of Pyschology, Deakin, Geelong, Victoria, Australia
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Nyberg A, Lundell S, Pesola UM, Audulv Å, Wadell K. Evaluation of a Digital COPD Education Program for Healthcare Professionals in Long-Term Care – A Mixed Methods Study. Int J Chron Obstruct Pulmon Dis 2022; 17:905-918. [PMID: 35497374 PMCID: PMC9045592 DOI: 10.2147/copd.s353187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Purpose Methods Results Conclusion
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Affiliation(s)
- André Nyberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Correspondence: André Nyberg, Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, 901 87, Sweden, Tel +46 90 786 66 39, Email
| | - Sara Lundell
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Ulla-Maija Pesola
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Åsa Audulv
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Karin Wadell
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
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Becoming Safe, Legal, Mature, Moderate, and Self-Reflexive: Trajectories of Drinking and Abstinence among Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063591. [PMID: 35329278 PMCID: PMC8953176 DOI: 10.3390/ijerph19063591] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022]
Abstract
In recent years, a vast body of research has investigated trends of declining alcohol consumption among youths. However, the extent to which restrictive-youth approaches towards drinking are maintained into adulthood is unclear. The aim of this study is to explore how young people's relation to alcohol changes over time. Our data are based on longitudinal qualitative in-depth interviews with 28 participants aged 15 to 23 conducted over the course of three years (2017-2019). The study draws on assemblage thinking by analysing to what kinds of heterogeneous elements young people's drinking and abstinence are related and what kinds of transformations they undergo when they get older. Five trajectories were identified as influential. Alcohol was transformed from unsafe to safe assemblages, from illegal to legal drinking assemblages, from performance-orientated to enjoyment-orientated assemblages, and from immature to mature assemblages. These trajectories moved alcohol consumption towards moderate drinking. Moreover, abstinence was transformed from authoritarian assemblages into self-reflexive assemblages. Self-control, responsibility, and performance orientation were important mediators in all five trajectories. As the sober generation grows older, they will likely start to drink at more moderate levels than previous generations.
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Byun M, Feller H, Ferrie M, Best S. Living with a genetic, undiagnosed or rare disease: A longitudinal journalling study through the COVID-19 pandemic. Health Expect 2022; 25:2223-2234. [PMID: 35122367 PMCID: PMC9111564 DOI: 10.1111/hex.13405] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/04/2021] [Accepted: 11/21/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction COVID‐19 changed the way we lived with uncertainty from the outset as the pandemic impacted every aspect of our lives from well‐being, socializing to accessing healthcare. For people in vulnerable populations, such as those with genetic, undiagnosed and rare disorders, the experience was heightened. Aim The aim of this study was to identify how the rapidly changing COVID‐19 environment impacted the lives of the Genetic, Undiagnosed and Rare Disease community. Methods From June 2020 to May 2021, we collected monthly open‐ended journals from people living in Australia with genetic, undiagnosed and rare disorders. Data analysis was deductive, using the Resilience Scale for Adults, and inductive using thematic analysis. Results We recruited 29 people (average of n = 9.7 submissions each month). Responses changed over the year, with initial journals focusing on the importance of developing new structures for day‐to‐day lives, while later journals started to focus on mental well‐being. Throughout the project, participants reported challenges in accessing health and social care that was compounded by fear and concern over being exposed to the virus. Later journals highlight inconsistent messaging for vaccinations for this vulnerable community. Discussion/Conclusion In parallel with the waves of the COVID‐19 pandemic, there need to be waves of targeted support for vulnerable communities. The first support wave needs to focus on facilitating the identification of new frameworks to structure day‐to‐day lives. A later second wave needs to focus on mental well‐being and coping with isolation, while consistent communication relating to health and social care throughout was essential. Patient/Public Contribution This study was co‐designed, co‐led and analysed with a patient support network.
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Affiliation(s)
- Malia Byun
- California Lutheran University, California, USA
| | - Hollie Feller
- Genetic Support Network Victoria, Melbourne, Victoria, Australia
| | - Monica Ferrie
- Genetic Support Network Victoria, Melbourne, Victoria, Australia
| | - Stephanie Best
- Australian Genomics Health Alliance, Murdoch Childrens Research Institute, Melbourne, Australia.,Australian Institute of Health Innovation, Sydney, Australia
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Implementation of a Mobile DBT App and Its Impact on Suicidality in Transitional Age Youth with Borderline Personality Disorder: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020701. [PMID: 35055523 PMCID: PMC8775851 DOI: 10.3390/ijerph19020701] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/28/2021] [Accepted: 01/05/2022] [Indexed: 01/27/2023]
Abstract
Contemporary performance and accessibility are features that enable mobile devices to be increasingly beneficial in the context of optimizing the treatment of psychiatric disorders. Smartphones have the potential to effectively support psychotherapeutic interventions among adolescents and young adults who require them. In the present study, the use and subjective influence of a smartphone app with content from dialectical behavior therapy (DBT) was investigated among transitional age youth (TAY) with borderline personality disorder, focusing on suicidality and non-suicidal self-injury (NSSI), in a natural setting. A longitudinal qualitative approach was used by means of individual semi-structured interviews, where participants were asked about their experiences and associated emotions before and after a testing period of 30 days. A total of 13 TAY with a diagnosed borderline personality disorder between the ages of 18 and 23 were included. Six overarching themes were identified through qualitative text analysis: (1) experiences with DBT skills, (2) phenomenon of self-harm, (3) feelings connected with self-harm, (4) dealing with disorder-specific symptoms, (5) prevention of self-harm, and (6) attitude toward skills apps. In general, the provision of an app with DBT content achieved a positive response among participants. Despite a small change in the perception of suicidality and NSSI, participants could imagine its benefits by integrating their use of the app as a supportive measure for personal psychotherapy sessions.
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Terzis LD, Saltzman LY, Logan DA, Blakey JM, Hansel TC. Utilizing a Matrix Approach to Analyze Qualitative Longitudinal Research: A Case Example During the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2022; 21:16094069221123723. [PMID: 36091640 PMCID: PMC9442150 DOI: 10.1177/16094069221123723] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Qualitative Longitudinal Research (QLR) is an evolving methodology used in understanding the rich and in-depth experiences of individuals over time. QLR is particularly conducive to pandemic or disaster-related studies, where unique and rapidly changing environments warrant fuller descriptions of the human condition. Despite QLR's usefulness, there are a limited number of articles that detail the methodology and analysis, especially in the social sciences, and specifically social work literature. As researchers adjust their focus to incorporate the impact of the COVID-19 global pandemic, there is a growing need in understanding the progression and adaptation of the pandemic on individuals' lives. This article provides a process and strategy for implementing QLR and analyzing data in online diary entries. In the provided case example, we explore a phenomenological QLR conducted with graduate level students during the COVID-19 pandemic (Saltzman et al., 2021), and outline a matrix framework for QLR analysis. This paper provides an innovative way in which to engage in qualitative data collection and analysis for social science research.
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Affiliation(s)
| | | | - Dana A. Logan
- School of Social Work, Tulane University, New Orleans, LA, USA
| | - Joan M. Blakey
- School of Social Work, University of Minnesota, Minneapolis, MN, USA
| | - Tonya C. Hansel
- School of Social Work, Tulane University, New Orleans, LA, USA
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Bloom I, Zhang J, Hammond J, Bevilacqua G, Lawrence W, Ward KA, Cooper C, Dennison EM. Impact of the COVID-19 pandemic on community-dwelling older adults: A longitudinal qualitative study of participants from the Hertfordshire Cohort Study. PLoS One 2022; 17:e0275486. [PMID: 36240147 PMCID: PMC9565385 DOI: 10.1371/journal.pone.0275486] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Older adults have been especially vulnerable to adverse effects from the COVID-19 pandemic including higher mortality and more severe disease complications. At the same time, social isolation, malnutrition and physical inactivity are serious concerns among older adults. The pandemic and associated restrictions may serve to exacerbate these issues, presenting increased risks to physical and mental health. The aims of this qualitative study were: i) to explore how community-living older people in the UK experienced the first wave of the COVID-19 pandemic, specifically how it impacted their well-being and associated health behaviours; ii) to explore how older people's experiences and behaviours changed over time throughout the first wave. METHODS Qualitative data were collected by conducting serial telephone interviews, with an interval of approximately three months. Participants were from the Hertfordshire Cohort Study, all aged over 80 years. Discussions were audio-recorded, information related to the COVID-19 pandemic was transcribed verbatim and transcripts analysed thematically. Interviews were conducted from March to October 2020. RESULTS Data for twelve participants (7 men and 5 women) from a total of 35 interviews were used, comprising two or three timepoints per participant. Analysis identified five overarching themes: 1) shopping strategies and food accessibility, 2) limitations on activities and going out, 3) disruption to healthcare, 4) social and psychological repercussions, and 5) coping strategies. Findings highlight challenges associated with accessing shops, healthcare, and usual activities due to pandemic-related restrictions. Longitudinal findings showed that for some, the ongoing pandemic and related restrictions appeared to aggravate mental health issues (low mood, anxiety) over time, as well as greater feelings of isolation or loneliness, reduced activity and functional limitations; this was despite some relaxation of restrictions later on. Coping strategies used by participants included finding ways to keep busy and to do physical activity safely, maintaining social contact remotely, and having an optimistic or positive outlook, a 'do what you can' attitude. CONCLUSIONS Interventions are likely to be needed in the wake of the COVID-19 pandemic to support health behaviours, such as increasing physical activity, social engagement and improving mental health among community-living older adults.
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Affiliation(s)
- Ilse Bloom
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- * E-mail:
| | - Jean Zhang
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Julia Hammond
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Gregorio Bevilacqua
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Wendy Lawrence
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Kate A. Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, United Kingdom
| | - Elaine M. Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- Victoria University of Wellington, Wellington, New Zealand
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McTigue G, Swartz A, Brittain K, Rini Z, Colvin CJ, Harrison A, Myer L, Pellowski J. Contraceptive trajectories postpartum: A longitudinal qualitative study of women living with HIV in Cape Town, South Africa. Soc Sci Med 2022; 292:114555. [PMID: 34776286 PMCID: PMC8748387 DOI: 10.1016/j.socscimed.2021.114555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 06/28/2021] [Accepted: 11/05/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Supporting the ability of women living with HIV (WLWH) to avoid unintended pregnancy during the postpartum period decreases the number of new pediatric HIV infections, reduces pregnancy-related morbidity and mortality, and is a cost-effective strategy for the elimination of mother-to-child transmission. However, little is currently known about the contraceptive intentions and experiences of reinitiating family planning use among mothers living with HIV as they transition from pregnancy into postpartum. STUDY OBJECTIVES To (1) understand the contraceptive trajectories of women living with HIV during pregnancy and postpartum in Cape Town, South Africa, and (2) identify factors shaping differing contraceptive trajectories during the postpartum period. METHODS Thirty pregnant WLWH were interviewed during their eighth month of pregnancy and completed follow-up interviews at 6-8 weeks and 9-12 months postpartum (n = 81 total interviews). Interview topics included postpartum contraception intentions, contraceptive use, and experiences accessing family planning services. Trajectory analysis of contraceptive intentions was applied after initial thematic coding. RESULTS While nearly half of women interviewed during pregnancy expressed an intention to utilize a non-injectable contraceptive option after childbirth (e.g. implant, IUD, sterilization, oral contraceptive pills), all women interviewed at one year postpartum had received at least one injection. Three main contraceptive trajectories were identified. (1) realization of contraceptive intentions postpartum; (2) unrealized contraceptive intentions postpartum; and (3) change in contraceptive intention over time. Provider influence, coordination of services, and low contraceptive inventory were identified as potential factors shaping the contraceptive trajectories of participants enrolled in the study. CONCLUSION Disparities between contraceptive method intentions articulated by WLWH during pregnancy and methods attained postpartum suggest that significant barriers remain for women who are unsatisfied with injectable contraception. Failing to provide postpartum mothers living with HIV their intended family planning method undermines efforts to prevent unintended pregnancy, a key pillar of elimination of mother-to-child transmission.
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Affiliation(s)
- Georgiana McTigue
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, Providence, RI, 02912, USA
| | - Alison Swartz
- Division of Social and Behavioural Sciences, University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa
| | - Kirsty Brittain
- Division of Epidemiology and Biostatistics, University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa
| | - Zanele Rini
- Division of Epidemiology and Biostatistics, University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa
| | - Christopher J Colvin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, Providence, RI, 02912, USA; Division of Social and Behavioural Sciences, University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa; Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Abigail Harrison
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, Providence, RI, 02912, USA
| | - Landon Myer
- Division of Epidemiology and Biostatistics, University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa
| | - Jennifer Pellowski
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, Providence, RI, 02912, USA; Division of Epidemiology and Biostatistics, University of Cape Town School of Public Health and Family Medicine, Cape Town, South Africa.
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Tuthill EL, Maltby AE, Odhiambo BC, Akama E, Pellowski JA, Cohen CR, Weiser SD, Conroy AA. "I Found Out I was Pregnant, and I Started Feeling Stressed": A Longitudinal Qualitative Perspective of Mental Health Experiences Among Perinatal Women Living with HIV. AIDS Behav 2021; 25:4154-4168. [PMID: 33997940 PMCID: PMC8126180 DOI: 10.1007/s10461-021-03283-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 11/03/2022]
Abstract
Globally, depressive symptoms among pregnant and postpartum (i.e., perinatal) women living with HIV (WLWH) are alarmingly high and associated with poor outcomes such as suboptimal adherence to antiretroviral therapy (ART), and early cessation of exclusive breastfeeding (EBF). Few qualitative studies have described the experience of perinatal depression among WLWH to identify the underlying social-structural determinants of poor mental health and potential strategies to intervene. We conducted a longitudinal qualitative study applying semi-structured interviews with 30 WLWH at three timepoints (28-38 weeks pregnant, 6-weeks postpartum and 5-7 months postpartum) to understand mental health experiences of perinatal WLWH in western Kenya. Financial insecurity emerged as the central theme impacting the mental health of women across time. Financial insecurity was often attributed to the loss of employment, related to pregnancy and the demands of breastfeeding and caring for an infant, as well as a lack of support from male partners. The loss of income and subsequent financial strain contributed to worsening levels of food insecurity and relationship stress and challenged engagement in HIV care. In this way, increased financial strain during the perinatal period negatively impacted the mental health of perinatal WLWH. Our findings suggest support to meet basic needs and remain engaged in HIV care during pregnancy and postpartum could improve perinatal mental health for WLWH in this setting.
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Affiliation(s)
- Emily L Tuthill
- Department of Community Health Systems, School of Nursing, University of California, 2 Koret Way, San Francisco, CA, 94143, USA.
| | - Ann E Maltby
- Department of Community Health Systems, School of Nursing, University of California, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Belinda C Odhiambo
- Department of Community Health Systems, School of Nursing, University of California, 2 Koret Way, San Francisco, CA, 94143, USA
- Global Programs, University of California, San Francisco, CA, USA
| | - Eliud Akama
- Kenya Medical Research Institute- Center for Microbiology Research, Nairobi, Kenya
| | - Jennifer A Pellowski
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- International Health Institute, Brown University School of Public Health, Providence, RI, USA
- Department of Epidemiology and Biostatistics, University of Cape Town, Cape Town, South Africa
| | - Craig R Cohen
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Amy A Conroy
- Division of Prevention Sciences, Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
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Jensen CM, Serritslev R, Abrahamsen C. Patients perspective on treatment and early rehabilitation after an ankle fracture: A longitudinal qualitative study. Int J Orthop Trauma Nurs 2021; 46:100916. [PMID: 34802956 DOI: 10.1016/j.ijotn.2021.100916] [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] [Received: 09/07/2021] [Revised: 10/15/2021] [Accepted: 10/26/2021] [Indexed: 12/29/2022]
Abstract
Worldwide, ankle fractures are among the most common fractures encountered in emergency departments. To inform healthcare professionals about what is important to patients when organizing an individualized, high-quality treatment plan, patient perspectives on treatment, care, and early rehabilitation are highly relevant. This longitudinal interview study aims to explore the perspectives of patients with surgically (ST) and conservatively (CT) treated ankle fractures within ten days and six weeks after an ankle fracture. Fourteen patients were interviewed using a semi-structured interview guide. Data were analyzed according to qualitative content analysis. Findings revealed themes regarding pain, independence, information, and worries about the future. Initially, all patients had a pragmatic attitude toward the future, but this attitude was significantly different after 6 weeks as many of the ST patients were still in pain and were more worried about the future. Patients' feelings of uncertainty were linked to a lack of information. Our findings indicate a need for further research to develop a more specific description of symptoms patients should expect as treatment progresses for patients with ankle fractures. With the goal of decreasing psycho-social concerns regarding mobility, autonomy, and working ability post fracture.
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Affiliation(s)
- Charlotte Myhre Jensen
- Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Denmark. Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Rikke Serritslev
- Department of Orthopedic Surgery and Traumatology, Hospital Lillebaelt - University Hospital of Southern Denmark, Kolding Hospital, Denmark
| | - Charlotte Abrahamsen
- Department of Orthopedic Surgery and Traumatology, Hospital Lillebaelt - University Hospital of Southern Denmark, Kolding Hospital, Denmark. Department of Public Health, University of Southern Denmark, Odense, Denmark
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The experience of nutritional care according to patients with head and neck cancer involved with a combined dietitian, specialist nurse and speech pathologist clinic in a regional Australia: a qualitative longitudinal study. Support Care Cancer 2021; 29:4329-4337. [PMID: 33415362 DOI: 10.1007/s00520-020-05917-9] [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] [Received: 08/28/2020] [Accepted: 11/25/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Malnutrition is a co-morbidity of head and neck cancer (HNC) that has negative consequences for patients. Evidence-based guidelines (EBGs) provide recommendations to prevent and manage malnutrition. A clinic that combines the services of a dietitian, specialist oncology nurse and speech pathologist may promote the implementation of nutritional EBGs in regional Australia. This study aimed to explore the nutritional care experience that patients with HNC had in this setting. METHODS A qualitative longitudinal study collected data via semi-structured interviews with HNC patients who were treated in one regional cancer care network in Australia. Interviews were conducted at key points in their HNC journey from diagnosis to 4 months post-radiotherapy. Data was analysed using a grounded theory approach. RESULTS Ten participants completed a total of thirty-six interviews. The findings were grouped into four categories: "preparing for nutritional challenges", "multidisciplinary care directed by patient needs", "the battle to eat", and "incongruence between patient values and nutritional priorities". CONCLUSION These findings highlight the nutritional burden associated with HNC and barriers to patients accepting nutritional support from healthcare professionals. Information provided by doctors and nurses prior to treatment may help patients prepare for the nutritional challenges ahead and accept support from dietitians. Furthermore, clinics that promote continuity through treatment and allow dietitians to lead aspects of nutritional care, in collaboration with nurses, speech pathologists and doctors, may also enhance the nutritional care experience. More qualitative research within HNC teams would provide further insight on enhancing the implementation of nutritional EBGs to improve outcomes for these patients.
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