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Pretorius D, Mlambo MG, Couper ID. "We Are Not Truly Friendly Faces": Primary Health Care Doctors' Reflections on Sexual History Taking in North West Province. Sex Med 2022; 10:100565. [PMID: 36122542 PMCID: PMC9780778 DOI: 10.1016/j.esxm.2022.100565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Doctors experience barriers in consultations that compromise engaging with patients on sensitive topics and impede history taking for sexual dysfunction. AIM The aim of the study was to identify barriers to and facilitators of sexual history taking that primary care doctors experience during consultations involving patients with chronic illnesses. METHODS This qualitative study formed part of a grounded theory study and represents individual interviews with 20 primary care doctors working in the rural North West Province, South Africa. The doctors were interviewed on the barriers and facilitators of sexual history taking they experienced during 151 recorded consultations with patients at risk of sexual dysfunction. Interviews were transcribed and line-by-line verbatim coding was done. A thematic analysis was performed using MaxQDA 2018 software for qualitative research. The study complied with COREQ requirements. OUTCOME Doctors' reflections on sexual history taking. RESULTS Three themes identifying barriers to sexual history taking emerged, namely personal and health system limitations, presuppositions and assumptions, and socio-cultural barriers. The fourth theme that emerged was the patient-doctor relationship as a facilitator of sexual history taking. Doctors experienced personal limitations such as a lack of training and not thinking about taking a history for sexual dysfunction. Consultations were compromised by too many competing priorities and socio-cultural differences between doctors and patients. The doctors believed that the patients had to take the responsibility to initiate the discussion on sexual challenges. Competencies mentioned that could improve the patient-doctor relationship to promote sexual history taking, include rapport building and cultural sensitivity. CLINICAL IMPLICATIONS Doctors do not provide holistic patient care at primary health care settings if they do not screen for sexual dysfunction. STRENGTH AND LIMITATIONS The strength in this study is that recall bias was limited as interviews took place in a real-world setting, which was the context of clinical care. As this is a qualitative study, results will apply to primary care in rural settings in South Africa. CONCLUSION Doctors need a socio-cognitive paradigm shift in terms of knowledge and awareness of sexual dysfunction in patients with chronic illness. Pretorius D, Mlambo MG, Couper ID. "We Are Not Truly Friendly Faces": Primary Health Care Doctors' Reflections on Sexual History Taking in North West Province. Sex Med 2022;10:100565.
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Affiliation(s)
- Deidré Pretorius
- Division Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa,Corresponding Author: Deidré Pretorius, Division Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, Room 412 4th Floor, The Phillip Tobias Health Sciences Building, 29 Princess of Wales Street (corner York Road), Parktown, 2193, South Africa. Tel: +27825553597
| | - Motlatso G. Mlambo
- Division Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa,Department of Institutional Intelligence, University of South Africa, Pretoria, South Africa
| | - Ian D. Couper
- Division Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa,Ukwanda Centre for Rural Health, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
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Svendsen EJ, Bjørk IT. Health care provider's responses to children's resistance to peripheral vein cannulation: A qualitative observational study. J Clin Nurs 2021; 30:1325-1334. [PMID: 33529357 DOI: 10.1111/jocn.15681] [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: 07/03/2020] [Revised: 12/16/2020] [Accepted: 01/22/2021] [Indexed: 12/27/2022]
Abstract
AIMS AND OBJECTIVES Health care and treatment should be voluntary, but restraint is often used during treatment of children. Knowledge about how health care providers respond to preschool children's resistance is lacking and can help understand current paediatric care in hospitals. The aim of the present article was to provide knowledge about how healthcare providers respond to preschool children's resistance during the clinical procedure of peripheral vein cannulation. DESIGN An explorative qualitative research design was developed for this study. METHODS Observations with video recording were used to collect data. Eight nurses and seven physicians participated in the study (n = 15). Their responses to preschool children's (n = 6) resistance were studied during 14 attempts of peripheral vein cannulation. Consolidated criteria for reporting qualitative research (COREQ) were used. RESULTS The healthcare providers made 380 responses to children's resistive expressions, interpreted within four main types, responses to acknowledge the child, responses to distract the child, responses to persuade the child and responses to reject the child. All main types of responses were used by both nurses and physicians. Regardless of the amount of resistance the children expressed, all children received distracting and acknowledging responses. Rejecting responses were used approximately twice as much in the implementation phase as in the preparation phase. Distraction, persuasion and rejection began in the preparation phase and increased in the implementation phase. CONCLUSIONS The main types and sub-types of responses showed how healthcare providers use a wide array of responses to meet children's resistance during peripheral vein cannulation. RELEVANCE TO CLINICAL PRACTICE The results can enable health care providers to become aware of their own practices during peripheral vein cannulation and other clinical procedures and to elaborate on their use of responses that can be considered intrinsically less child-friendly.
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Affiliation(s)
- Edel J Svendsen
- Department of Nursing, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ida T Bjørk
- Department of Nursing, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Akers C, Plant H, Riley V, Alnajjar H, Muneer A. Exploring penile cancer survivors' motivations and experiences of attending a support group:
eUROGEN
study. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2021. [DOI: 10.1111/ijun.12259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Akers
- Department of Urology University College London Hospitals NHS Foundation Trust London UK
| | - H. Plant
- Macmillan Support and Information Service University College London Hospitals NHS Foundation Trust London UK
| | - V. Riley
- Macmillan Support and Information Service University College London Hospitals NHS Foundation Trust London UK
| | - H.M. Alnajjar
- Department of Urology University College London Hospitals NHS Foundation Trust London UK
| | - A. Muneer
- Department of Urology University College London Hospitals NHS Foundation Trust London UK
- NIHR Biomedical Research Centre University College London Hospital London UK
- Division of Surgery and Interventional Science University College London London UK
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Manne SL, Kashy DA, Zaider T, Kissane D, Lee D, Kim IY, Heckman CJ, Penedo FJ, Murphy E, Virtue SM. Couple-focused interventions for men with localized prostate cancer and their spouses: A randomized clinical trial. Br J Health Psychol 2019; 24:396-418. [PMID: 30852854 DOI: 10.1111/bjhp.12359] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/11/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Few couple-focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy-enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators. DESIGN This study was a randomized clinical trial with three study arms and four assessment time points. METHODS A total of 237 patients and partners were randomly assigned to receive IET, GHW, or UC. Participants completed measures of psychological functioning and relationship satisfaction at baseline, 5 weeks, 3 months, and 6 months post-baseline. Primary outcomes were psychological adjustment, depression, cancer-specific distress, cancer concerns, and relationship satisfaction. RESULTS Spouses in IET showed greater increases in relationship satisfaction than spouses in GHW and UC between the baseline and 5-week follow-up. Among patients in longer relationships, significant increases in psychological adjustment were found in both treatments compared to UC. Among spouses in longer relationships, psychological adjustment increased in both IET and UC but declined in GHW. CONCLUSIONS Intimacy-enhancing therapy did not show an impact on general or cancer-specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple-focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. Statement of contribution What is already known on this subject? Men diagnosed with localized prostate cancer report lower health-related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples' psychological adaptation to prostate cancer. Couple-focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple-focused interventions. What does this study add? Intimacy-enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relationship outcomes. Intimacy-enhancing therapy was superior to no treatment for patients in longer-term relationship. The general health and wellness intervention was not beneficial for men in shorter relationships and for men who did not endorse traditional masculine norms.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | - Talia Zaider
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - David Kissane
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Psychiatry, Monash Medical Center, Monash University, Clayton, Victoria, Australia
| | - David Lee
- Penn Urology, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
| | - Isaac Y Kim
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.,Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Frank J Penedo
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, USA
| | - Evangelynn Murphy
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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Dietz P, Quermann A, van Poppel MNM, Striegel H, Schröter H, Ulrich R, Simon P. Physical and cognitive doping in university students using the unrelated question model (UQM): Assessing the influence of the probability of receiving the sensitive question on prevalence estimation. PLoS One 2018; 13:e0197270. [PMID: 29763428 PMCID: PMC5953456 DOI: 10.1371/journal.pone.0197270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 04/30/2018] [Indexed: 11/19/2022] Open
Abstract
STUDY OBJECTIVES In order to increase the value of randomized response techniques (RRTs) as tools for studying sensitive issues, the present study investigated whether the prevalence estimate for a sensitive item [Formula: see text] assessed with the unrelated questionnaire method (UQM) is influenced by changing the probability of receiving the sensitive question p. MATERIAL AND METHODS A short paper-and-pencil questionnaire was distributed to 1.243 university students assessing the 12-month prevalence of physical and cognitive doping using two versions of the UQM with different probabilities for receiving the sensitive question (p ≈ 1/3 and p ≈ 2/3). Likelihood ratio tests were used to assess whether the prevalence estimates for physical and cognitive doping differed significantly between p ≈ 1/3 and p ≈ 2/3. The order of questions (physical doping and cognitive doping) as well as the probability of receiving the sensitive question (p ≈ 1/3 or p ≈ 2/3) were counterbalanced across participants. Statistical power analyses were performed to determine sample size. RESULTS The prevalence estimate for physical doping with p ≈ 1/3 was 22.5% (95% CI: 10.8-34.1), and 12.8% (95% CI: 7.6-18.0) with p ≈ 2/3. For cognitive doping with p ≈ 1/3, the estimated prevalence was 22.5% (95% CI: 11.0-34.1), whereas it was 18.0% (95% CI: 12.5-23.5) with p ≈ 2/3. Likelihood-ratio tests revealed that prevalence estimates for both physical and cognitive doping, respectively, did not differ significantly under p ≈ 1/3 and p ≈ 2/3 (physical doping: χ2 = 2.25, df = 1, p = 0.13; cognitive doping: χ2 = 0.49, df = 1, p = 0.48). Bayes factors computed with the Savage-Dickey method favored the null ("the prevalence estimates are identical under p ≈ 1/3 and p ≈ 2/3") over the alternative ("the prevalence estimates differ under p ≈ 1/3 and p ≈ 2/3") hypothesis for both physical doping (BF = 2.3) and cognitive doping (BF = 5.3). CONCLUSION The present results suggest that prevalence estimates for physical and cognitive doping assessed by the UQM are largely unaffected by the probability for receiving the sensitive question p.
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Affiliation(s)
- Pavel Dietz
- Research Group Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
- * E-mail:
| | - Anne Quermann
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sports Science, University of Mainz, Mainz, Germany
- Institute of Exercise and Public Health, Faculty of Sport Science, University of Leipzig, Leipzig, Germany
| | | | - Heiko Striegel
- Department of Sports Medicine, University of Tuebingen, Tuebingen, Germany
| | | | - Rolf Ulrich
- Department of Psychology, University of Tuebingen, Tuebingen, Germany
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sports Science, University of Mainz, Mainz, Germany
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Hounsome L, Dowling S. 'The mum has to live with the decision much more than the dad'; a qualitative study of men's perceptions of their influence on breastfeeding decision-making. Int Breastfeed J 2018; 13:3. [PMID: 29371876 PMCID: PMC5771101 DOI: 10.1186/s13006-018-0145-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 01/02/2018] [Indexed: 01/12/2023] Open
Abstract
Background Although breastfeeding is widely acknowledged as the normal method of infant feeding, there are large variations in rates of initiation and duration. Several factors are linked to the likelihood of breastfeeding initiation, including the influence and opinion of the child's father. There is limited research into men's perception of their influence, or if they feel it appropriate to be involved in deciding how to feed their children. The aim of this study was to investigate, using a qualitative methodology, fathers' perceptions of their influence on the decision to feed their child breastmilk or formula. Methods Six men were recruited through Children's Centres in Bristol, United Kingdom, and a phenomenological research methodology implemented using semi-structured interviews. Specific objectives were: to understand participants' views on breastfeeding; understand if and how these views were discussed with their partner; to determine if participants believed involvement in the feeding decision is appropriate; to understand how they felt about the decision made; and to see if their views changed after the birth of their child. Results Multiple themes emerged during analysis, including deferring of responsibility to the mother; breastfeeding as normal practice; change in attitude; involvement in parenting; and, advantages for the father. The men in the study accepted breastfeeding as normal behaviour, probably because of their upbringing in households where breastfeeding was practiced. There was consensus that women had more say in deciding to breastfeed, which was explained as a consequence of their greater involvement. It could also be interpreted as an unwillingness to interfere in an area perceived as 'owned' by women. Participants acknowledged that breastfeeding was more difficult than they had perceived. Conclusions The key themes emerging from the interviews are suggestive of an impact on breastfeeding interventions that use the father as an intermediary. If they do not feel that they are 'permitted' to comment on their partner's breastfeeding, then simply increasing knowledge of breastfeeding benefits in these men is likely to have minimal impact.
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Affiliation(s)
- Luke Hounsome
- Public Health England, Rivergate House, 2 Rivergate, Bristol, UK
| | - Sally Dowling
- 2University of the West of England, Bristol, Glenside Campus, Blackberry Hill, Stapleton, Bristol, UK
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Suárez-Obando F, Gómez-Restrepo C. Aspectos éticos de la investigación etnográfica en salud. El papel del comité de ética de la investigación. PERSONA Y BIOÉTICA 2017. [DOI: 10.5294/pebi.2017.21.2.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
La presencia e integración de la investigación cualitativa a los protocolos de investigación biomédica ha cobrado cada vez mayor relevancia, por la importancia de la antropología cultural. El caso particular de la etnografía adquiere aún más preeminencia en relación con la definición de riesgo para el sujeto de investigación. El presente artículo expone las principales características de la investigación etnográfica que deben ser evaluadas por un comité de ética de la investigación, y define una serie de recomendaciones para la evaluación del riesgo para los sujetos que se someten a este tipo de estudio. Los miembros de los Comités de Ética en Investigación deben tener en cuenta la etnografía para realizar a cabalidad su función.
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Dempsey L, Dowling M, Larkin P, Murphy K. Sensitive Interviewing in Qualitative Research. Res Nurs Health 2016; 39:480-490. [DOI: 10.1002/nur.21743] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Laura Dempsey
- Lecturer, School of Nursing & Midwifery; National University of Ireland; Galway Ireland
| | - Maura Dowling
- Lecturer, School of Nursing & Midwifery; National University of Ireland; Galway Ireland
| | - Philip Larkin
- Associate Professor, School of Nursing, Midwifery & Health Systems; Health Sciences Centre; Belfield, Dublin 4 Ireland
| | - Kathy Murphy
- Professor, School of Nursing & Midwifery; National University of Ireland; Galway Ireland
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Hanna E, Gough B. Emoting infertility online: A qualitative analysis of men's forum posts. Health (London) 2016; 20:363-82. [PMID: 27246813 DOI: 10.1177/1363459316649765] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Relatively little research on infertility focuses exclusively or significantly on men's experiences, particularly in relation to emotional aspects. Evidence that does exist around male infertility suggests that it is a distressing experience for men, due to stigma, threats to masculinity and the perceived need to suppress emotions, and that men and women experience infertility differently. Using thematic analysis, this article examines the online emoting of men in relation to infertility via forum posts from a men-only infertility discussion board. It was noted that men 'talked' to each other about the emotional burdens of infertility, personal coping strategies and relationships with others. Three major themes were identified following in-depth analysis: 'the emotional rollercoaster', 'the tyranny of infertility' and 'infertility paranoia'. This article then offers insights into how men experience infertility emotionally, negotiate the emotional challenges involved (especially pertaining to diagnosis, treatment outcomes and their intimate relationships) and how they share (and find value in doing so) with other men the lived experience of infertility.
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