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Parsons Leigh J, FitzGerald EA, Moss SJ, Cherak MS, Brundin-Mather R, Dodds A, Stelfox HT, Dubé È, Fiest KM, Halperin DM, Ahmed SB, MacDonald SE, Straus SE, Manca T, Ng Kamstra J, Soo A, Longmore S, Kupsch S, Sept B, Halperin SA. The evolution of vaccine hesitancy through the COVID-19 pandemic: A semi-structured interview study on booster and bivalent doses. Hum Vaccin Immunother 2024; 20:2316417. [PMID: 38390696 PMCID: PMC10896168 DOI: 10.1080/21645515.2024.2316417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
We sought in-depth understanding on the evolution of factors influencing COVID-19 booster dose and bivalent vaccine hesitancy in a longitudinal semi-structured interview-based qualitative study. Serial interviews were conducted between July 25th and September 1st, 2022 (Phase I: univalent booster dose availability), and between November 21st, 2022 and January 11th, 2023 (Phase II: bivalent vaccine availability). Adults (≥18 years) in Canada who had received an initial primary series and had not received a COVID-19 booster dose were eligible for Phase I, and subsequently invited to participate in Phase II. Twenty-two of twenty-three (96%) participants completed interviews for both phases (45 interviews). Nearly half of participants identified as a woman (n = 11), the median age was 37 years (interquartile range: 32-48), and most participants were employed full-time (n = 12); no participant reported needing to vaccinate (with a primary series) for their workplace. No participant reported having received a COVID-19 booster dose at the time of their interview in Phase II. Three themes relating to the development of hesitancy toward continued vaccination against COVID-19 were identified: 1) effectiveness (frequency concerns; infection despite vaccination); 2) necessity (less threatening, low urgency, alternate protective measures); and 3) information (need for data, contradiction and confusion, lack of trust, decreased motivation). The data from interviews with individuals who had not received a COVID-19 booster dose or bivalent vaccine despite having received a primary series of COVID-19 vaccines highlights actionable targets to address vaccine hesitancy and improve public health literacy.
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Affiliation(s)
- Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | - Emily A FitzGerald
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephana Julia Moss
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- CRISMA Center, Department of Critical Care, University of Pittsburgh, Pittsburgh, USA
| | - Michal S Cherak
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | | | - Alexandra Dodds
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ève Dubé
- Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
- Département d'anthropologie, Université Laval, Québec, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna M Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Sofia B Ahmed
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shannon E MacDonald
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Terra Manca
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
- Sociology and Social Anthropology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Josh Ng Kamstra
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea Soo
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Health Services, Calgary, Alberta, Canada
| | - Shelly Longmore
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shelly Kupsch
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Sept
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Solorzano-Barrera C, Rodriguez-Patarroyo M, Tórres-Quintero A, Guzman-Tordecilla DN, Franco-Rodriguez AN, Maniar V, Shrestha P, Vecino-Ortiz AI, Pariyo GW, Gibson DG, Ali J. Recruiting hard-to-reach populations via respondent driven sampling for mobile phone surveys in Colombia: a qualitative study. Glob Health Action 2024; 17:2297886. [PMID: 38205794 PMCID: PMC10786427 DOI: 10.1080/16549716.2023.2297886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Uptake of mobile phone surveys (MPS) is increasing in many low- and middle-income countries, particularly within the context of data collection on non-communicable diseases (NCDs) behavioural risk factors. One barrier to collecting representative data through MPS is capturing data from older participants.Respondent driven sampling (RDS) consists of chain-referral strategies where existing study subjects recruit follow-up participants purposively based on predefined eligibility criteria. Adapting RDS strategies to MPS efforts could, theoretically, yield higher rates of participation for that age group. OBJECTIVE To investigate factors that influence the perceived acceptability of a RDS recruitment method for MPS involving people over 45 years of age living in Colombia. METHODS An MPS recruitment strategy deploying RDS techniques was piloted to increase participation of older populations. We conducted a qualitative study that drew from surveys with open and closed-ended items, semi-structured interviews for feedback, and focus group discussions to explore perceptions of the strategy and barriers to its application amongst MPS participants. RESULTS The strategy's success is affected by factors such as cultural adaptation, institutional credibility and public trust, data protection, and challenges with mobile phone technology. These factors are relevant to individuals' willingness to facilitate RDS efforts targeting hard-to-reach people. Recruitment strategies are valuable in part because hard-to-reach populations are often most accessible through their contacts within their social network who can serve as trust liaisons and drive engagement. CONCLUSIONS These findings may inform future studies where similar interventions are being considered to improve access to mobile phone-based data collection amongst hard-to-reach groups.
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Affiliation(s)
| | | | | | - Deivis Nicolas Guzman-Tordecilla
- Institute of Public Health, Pontificia Universidad Javeriana, Bogota, Colombia
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Vidhi Maniar
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Prakriti Shrestha
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrés I Vecino-Ortiz
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - George W Pariyo
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dustin G Gibson
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joseph Ali
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
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He Q, Lei J, Chong D, Luk P, Chan E, Shen X, Tipoe GL, Chan L, Manio MM, Dizon JIWT, Ganotice FA. Unpacking the perceptions and experiences of student facilitators in interprofessional education: a qualitative study. Med Educ Online 2024; 29:2330257. [PMID: 38493489 PMCID: PMC10946269 DOI: 10.1080/10872981.2024.2330257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
Enhancing health professional students' effective learning and collaborative practice requires a deep understanding of strategies for facilitating interprofessional learning. While faculty members and clinical preceptors are recognized as facilitators in interprofessional education (IPE), there is limited knowledge about the impact of student facilitators' engagement in IPE. Accordingly, this study aims to explore the perceptions and experiences of student facilitators in IPE. Thirteen student facilitators were recruited to lead an interprofessional learning program, and they were subsequently invited to participate in one-on-one interviews. An interview guide was developed to explore their motivations, expectations, engagement, effectiveness, and achievements in IPE facilitation. Thematic analysis was conducted using MAXQDA software to analyze the student facilitators' experiences and perceptions. Eight interviewees from various disciplines, including Medicine, Nursing, Pharmacy, Speech and Hearing Sciences, and Social Work, took part in the study. The findings revealed that student facilitators highly valued their IPE facilitation experience, which aligned with their expectations and led to the creation of social networks, increased confidence, improved understanding of other professions, and the development of lifelong skills. Furthermore, the student facilitators demonstrated cognitive and social congruence by establishing a relaxed learning environment, displaying empathetic and supportive behaviors, and using inclusive language to engage IPE learners in group discussions. This study provides a comprehensive understanding of the role of student facilitators in IPE, contributing to the evolving literature on IPE. A conceptual framework was developed to explore the entire facilitation experience, encompassing the motivations and expectations of student facilitators, their engagement and effectiveness, and the observed achievements. These findings can inform the development of peer teaching training in IPE and stimulate further research in identifying relevant facilitator competencies for optimal delivery of IPE.
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Affiliation(s)
- Qing He
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Junru Lei
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Doris Chong
- Department of Physiotherapy, School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Pauline Luk
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Medical Ethic and Humanities Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Enoch Chan
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xiaoai Shen
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - George Lim Tipoe
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Linda Chan
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Family Medicine and Primary Care, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Michael M. Manio
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - John Ian Wilzon T. Dizon
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Fraide A. Ganotice
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Sim CSL, Asharani PV, Subramaniam M, Yi H. Roles and Dynamics within Community Mental Health Systems During the COVID-19 Pandemic: A Qualitative Systematic Review and Meta-Ethnography. Health Syst Reform 2024; 10:2314525. [PMID: 38598726 DOI: 10.1080/23288604.2024.2314525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/01/2024] [Indexed: 04/12/2024] Open
Abstract
Globally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare's approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users' needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries' disaster mental health response and to invest in quality care, particularly for marginalized groups.
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Affiliation(s)
- Cheryl Su Ling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - P V Asharani
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
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KC A, Rönnbäck M, Humgain U, Basnet O, Bhattarai P, Axelin A. Implementation barriers and facilitators of Moyo foetal heart rate monitor during labour in public hospitals in Nepal. Glob Health Action 2024; 17:2328894. [PMID: 38577869 PMCID: PMC11000597 DOI: 10.1080/16549716.2024.2328894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Globally, every year, approximately 1 million foetal deaths take place during the intrapartum period, fetal heart monitoring (FHRM) and timely intervention can reduce these deaths. OBJECTIVE This study evaluates the implementation barriers and facilitators of a device, Moyo for FHRM. METHODS The study adopted a qualitative study design in four hospitals in Nepal where Moyo was implemented for HRM. The study participants were labour room nurses and convenience sampling was used to select them. A total of 20 interviews were done to reach the data saturation. The interview transcripts were translated to English, and qualitative content analysis using deductive approach was applied. RESULTS Using the deductive approach, the data were organised into three categories i) changes in practice of FHRM, ii) barriers to implementing Moyo and iii) facilitators of implementing Moyo. Moyo improved adherence to intermittent FHRM as the device could handle higher caseloads compared to the previous devices. The implementation of Moyo was hindered by difficulty to organise training ondevice during non-working hours, technical issue of the device, nurse mistrust towards the device and previous experience of poor implementation to similar innovations. Facilitators for implementation included effective training on how to use Moyo, improvement in intrapartum foetal monitoring and improvement in staff morale, ease of using the device, Plan Do Study Act (PDSA) meetings to improve use of Moyo and supportive leadership. CONCLUSION The change in FHRM practice suggests that the implementation of innovative solution such as Moyo was successful with adequate facilitation, supportive staff attitude and leadership.
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Affiliation(s)
- Ashish KC
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Mikaela Rönnbäck
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Urja Humgain
- Research Division, Golden Community, Lalitpur, Nepal
| | - Omkar Basnet
- Research Division, Golden Community, Lalitpur, Nepal
| | | | - Anna Axelin
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Nursing Science, University of Turku, Turku, Finland
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Niekrenz L, Spreckelsen C. How to design effective educational videos for teaching evidence-based medicine to undergraduate learners - systematic review with complementing qualitative research to develop a practicable guide. Med Educ Online 2024; 29:2339569. [PMID: 38615337 PMCID: PMC11017999 DOI: 10.1080/10872981.2024.2339569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND eLearning can be an effective tool to achieve learning objectives. It facilitates asynchronous distance learning, increasing flexibility for learners and instructors. In this context, the high educational value of videos provides an invaluable primary component for longitudinal digital curricula, especially for maintaining knowledge on otherwise rarely taught subjects. Although literature concerning eLearning evaluation exists, research comprehensively describing how to design effective educational videos is lacking. In particular, studies on the requirements and design goals of educational videos need to be complemented by qualitative research using grounded theory methodology. METHODS Due to the paucity of randomized controlled trials in this area, there is an urgent need to generate recommendations based on a broader fundament than a literature search alone. Thus, the authors have employed grounded theory as a guiding framework, augmented by Mayring's qualitative content analysis and commonly used standards. An adaptive approach was conducted based on a literature search and qualitative semi-structured interviews. Drawing on these results, the authors elaborated a guide for creating effective educational videos. RESULTS The authors identified 40 effective or presumedly effective factors fostering the success of video-based eLearning in teaching evidence-based medicine, providing a ready-to-use checklist. The information collected via the interviews supported and enriched much of the advice found in the literature. DISCUSSION To the authors' knowledge, this type of comprehensive guide for video-based eLearning needs has not previously been published. The interviews considerably contributed to the results. Due to the grounded theory-based approach, in particular, consensus was achieved without the presence of a formal expert panel. Although the guide was created with a focus on teaching evidence-based medicine, due to the general study selection process and research approach, the recommendations are applicable to a wide range of subjects in medical education where the teaching aim is to impart conceptual knowledge.
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Affiliation(s)
- Lukas Niekrenz
- Institute of Medical Informatics, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Cord Spreckelsen
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
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Newman PA, Dinh DA, Massaquoi N, Williams CC, Lacombe-Duncan A, Tepjan S, Nyoni T. "Going vaccine hunting": Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults-a qualitative study. Hum Vaccin Immunother 2024; 20:2301189. [PMID: 38346919 PMCID: PMC10863362 DOI: 10.1080/21645515.2023.2301189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
High levels of COVID-19 vaccine hesitancy have been reported among Black and Latinx populations, with lower vaccination coverage among racialized versus White sexual and gender minorities. We examined multilevel contexts that influence COVID-19 vaccine uptake, barriers to vaccination, and vaccine hesitancy among predominantly racialized sexual and gender minority individuals. Semi-structured online interviews explored perspectives and experiences around COVID-19 vaccination. Interviews were recorded, transcribed, uploaded into ATLAS.ti, and reviewed using thematic analysis. Among 40 participants (mean age, 29.0 years [SD, 9.6]), all identified as sexual and/or gender minority, 82.5% of whom were racialized. COVID-19 vaccination experiences were dominated by structural barriers: systemic racism, transphobia and homophobia in healthcare and government/public health institutions; limited availability of vaccination/appointments in vulnerable neighborhoods; absence of culturally-tailored and multi-language information; lack of digital/internet access; and prohibitive indirect costs of vaccination. Vaccine hesitancy reflected in uncertainties about a novel vaccine amid conflicting information and institutional mistrust was integrally linked to structural factors. Findings suggest that the uncritical application of "vaccine hesitancy" to unilaterally explain undervaccination among marginalized populations risks conflating structural and institutional barriers with individual-level psychological factors, in effect placing the onus on those most disenfranchised to overcome societal and institutional processes of marginalization. Rather, disaggregating structural determinants of vaccination availability, access, and institutional stigma and mistrust from individual attitudes and decision-making that reflect vaccine hesitancy, may support 1) evidence-informed interventions to mitigate structural barriers in access to vaccination, and 2) culturally-informed approaches to address decisional ambivalence in the context of structural homophobia, transphobia, and racism.
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Affiliation(s)
- Peter A. Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Duy Anh Dinh
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Notisha Massaquoi
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Department of Health and Society, University of Toronto, Scarborough, Ontario, Canada
| | - Charmaine C. Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Thabani Nyoni
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- School of Social Work, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Khisa AM, Wao H, Brizuela V, Compaoré R, Baguiya A, López Gómez A, Bonet M, Kouanda S, Thorson A, Gitau E. Embedding research capacity strengthening in multi-country studies in low-and middle-income countries: learnings from sexual and reproductive health research. Glob Health Action 2024; 17:2338634. [PMID: 38607331 PMCID: PMC11018088 DOI: 10.1080/16549716.2024.2338634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 03/31/2024] [Indexed: 04/13/2024] Open
Abstract
Research capacity strengthening (RCS) can empower individuals, institutions, networks, or countries to define and prioritize problems systematically; develop and scientifically evaluate appropriate solutions; and reinforce or improve capacities to translate knowledge into policy and practice. However, how to embed RCS into multi-country studies focusing on sexual and reproductive health and rights (SRHR) is largely undocumented. We used findings from a qualitative study, from a review of the literature, and from a validation exercise from a panel of experts from research institutions that work on SRHR RCS. We provide a framework for embedded RCS; suggest a set of seven concrete actions that research project planners, designers, implementers, and funders can utilise to guide embedded RCS activities in low- and middle-income countries; and present a practical checklist for planning and assessing embedded RCS in research projects.
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Affiliation(s)
- Anne M. Khisa
- Capacity Strengthening and SRHR Research, African Population and Health Research Center, Nairobi, Kenya
| | - Hesborn Wao
- Capacity Strengthening and SRHR Research, African Population and Health Research Center, Nairobi, Kenya
| | - Vanessa Brizuela
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Rachidatou Compaoré
- Department of Biomedical and Public Health, Research Institute for Health Sciences, Ouagadougou, Burkina Faso
| | - Adama Baguiya
- Department of Biomedical and Public Health, Research Institute for Health Sciences, Ouagadougou, Burkina Faso
| | | | - Mercedes Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Seni Kouanda
- Department of Biomedical and Public Health, Research Institute for Health Sciences, Ouagadougou, Burkina Faso
- African Institute of Public Health, Ouagadougou, Burkina Faso
| | - Anna Thorson
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Evelyn Gitau
- Capacity Strengthening and SRHR Research, African Population and Health Research Center, Nairobi, Kenya
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Brune C, Agerholm J, Burström B, Liljas A. Experience of moral distress among doctors at emergency departments in Stockholm during the Covid-19 pandemic: a qualitative interview study. Int J Qual Stud Health Well-being 2024; 19:2300151. [PMID: 38258523 PMCID: PMC10810614 DOI: 10.1080/17482631.2023.2300151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
PURPOSE The COVID-19 pandemic and consequent strain on healthcare globally shed light on the concept of moral distress among healthcare workers, albeit to a smaller extent among doctors at emergency departments. This study aimed to examine moral distress as perceived by medical doctors working at emergency departments in Stockholm during the pandemic, with the purpose of investigating causes of moral distress and methods to manage moral distress. METHODS Semi-structured interviews were conducted with twelve doctors working at two emergency departments. A questionnaire was developed based on previous research and the interviews were analysed qualitatively through thematic analysis. RESULTS The themes "The factors that precipitated moral distress", "Experience of workplace support" and "Coping strategies" as well as seven subthemes and 15 codes were identified. The informants reported on various situations with different causes of moral distress. Common causes were resource depletion, such as hospital bed shortages, and following stricter triage criteria. Informants reported varying ways of managing moral distress. CONCLUSIONS Informants experienced moral distress when faced with challenges such as resource depletion, rules and regulations, and colleagues' decisions. The informants who chose to seek support received it from their workplace, which helped them cope with their experiences. Some informants chose to not seek support.
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Affiliation(s)
- Clara Brune
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Janne Agerholm
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Bo Burström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ann Liljas
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Neller SA, Hebdon MT, Wickens E, Scammon DL, Utz RL, Dassel KB, Terrill AL, Ellington L, Kirby AV. Family caregiver experiences and needs across health conditions, relationships, and the lifespan: a Qualitative analysis. Int J Qual Stud Health Well-being 2024; 19:2296694. [PMID: 38213230 PMCID: PMC10791097 DOI: 10.1080/17482631.2023.2296694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024] Open
Abstract
PURPOSE The purpose of this study was to understand the lived experiences of family caregivers who provide care to individuals across a broad range of ages, caregiving relationships, and health conditions and/or disabilities. Family caregiver research is typically siloed by health condition or by caregiving relationship, leaving gaps in understanding similarities and differences among caregivers. METHODS We hosted three virtual focus groups with diverse family caregivers (n = 26) caring for an individual with a long-term disability and/or health condition(s). We conducted a qualitative thematic analysis using an iterative, inductive process. RESULTS Participants primarily expressed shared experiences, despite having unique caregiving situations. We identified themes among a) caregiver experiences: Trying to Do It All, Balancing Complex Emotions, Managing Expectations, and Adjusting to Changes Over Time and b) caregiver needs: Longing for Breaks and Self-Care; Lacking Help, Support and Resources; and Desiring Understanding and Recognition. CONCLUSIONS These findings emphasize that many elements of the caregiving experience transcend care recipient age, condition, and relationship and are applicable to clinicians, researchers, and policy makers. The evidence of shared caregiver experiences can guide efficiencies in policy and practice (e.g., pooling of existing resources, expansion of interventions) to meet the needs of a broader population of caregivers.
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Affiliation(s)
- Sarah A. Neller
- College of Nursing, University of Tennessee, Knoxville, TN, USA
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Emily Wickens
- College of Social and Behavioral Sciences, University of Utah, Salt Lake City, UT, USA
| | - Debra L. Scammon
- David Eccles School of Business, University of Utah, Salt Lake City, UT, USA
| | - Rebecca L. Utz
- College of Social and Behavioral Sciences, University of Utah, Salt Lake City, UT, USA
| | - Kara B. Dassel
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Anne V. Kirby
- College of Health, University of Utah, Salt Lake City, UT, USA
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11
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Wilmont I, Loeffen M, Hoogeboom T. A qualitative study on the facilitators and barriers to adopting the N-of-1 trial methodology as part of clinical practice: potential versus implementation challenges. Int J Qual Stud Health Well-being 2024; 19:2318810. [PMID: 38417032 PMCID: PMC10903748 DOI: 10.1080/17482631.2024.2318810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/10/2024] [Indexed: 03/01/2024] Open
Abstract
PURPOSE To investigate opinions among healthcare stakeholders whether implementation of the N-of-1 trial approach in clinical practice is a feasible way to optimize evidence-based treatment results for unique patients. METHODS We interviewed clinicians, researchers, and a patient advocate (n = 13) with an interest in or experience with N-of-1 trials on the following topics: experience with N-of-1, measurement, validity and reliability, informally gathered data usability, and influence on physician-patient relationship. Interviews were analysed using qualitative, thematic analysis. RESULTS The N-of-1 approach has the potential to shift the current healthcare system towards embracing personalized medicine. However, its application in clinical practice carries significant challenges in terms of logistics, time investment and acceptability. New skills will be required from patients and healthcare providers, which may alter the patient-physician relationship. The rise of consumer technology enabling self-measurement may leverage the uptake of N-of-1 approaches in clinical practice. CONCLUSIONS There is a strong belief that the N-of-1 approach has the potential to play a prominent role in transitioning the current healthcare system towards embracing personalized medicine. However, there are many barriers deeply ingrained in our healthcare system that hamper the uptake of the N-of-1 approach, making it momentarily only interesting for research purposes.
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Affiliation(s)
- Ilona Wilmont
- Data & Knowledge Engineering, HAN University of Applied Sciences, Arnhem, the Netherlands
- Institute for Computing and Information Sciences, Data Science, Radboud University Nijmegen, Nijmegen, the Netherlands
| | | | - Thomas Hoogeboom
- IQ healthcare, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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12
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Matrook KA, Cowman S, Pertl M, Whitford D. Nurse-led family-based approach in primary health care for patients with type 2 diabetes mellitus: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2323060. [PMID: 38446054 PMCID: PMC10919304 DOI: 10.1080/17482631.2024.2323060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE The prevalence of Type 2 diabetes is rapidly increasing, with 537 million people estimated to have diabetes in 2021. The literature suggests that nurses can deliver effective person-centred diabetes care and that families can be essential in supporting patients. Thus, a Nurse-led Family-based (NLFB) approach may be particularly effective. This study aims to explore the perceptions of nurses, adults with type 2 diabetes, and family members regarding the NLFB intervention. METHODS Guided by the UK Medical Research Council Framework, this seminal study adopted a qualitative, descriptive approach with content analysis. Data were obtained through 16 semi-structured, in-depth interviews. Themes emerged based on an inductive process using constant comparison (Graneheim and Lundman 2004). The COREQ checklist was used in ensuring rigour. RESULTS Three main themes emerged includes: (1) nurses' experiences with current diabetes care practices, (2) stakeholders' views on the development of a NLFB approach, and (3) merging the nurse-led family aspects into the diabetes care. The key challenges are the dominant medical model, lack of specialist nurses, and time. The key facilitators are knowledge and social support. CONCLUSION The study recommends stakeholders embrace nursing empowerment strategies and involve families to enhance the nurses' advanced roles and family inclusion in healthcare.
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Affiliation(s)
- Khadija A. Matrook
- Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen, Bahrain
| | - Seamus Cowman
- School of Nursing and Midwifery, Faculty of Medicine and Health Sciences Royal College of Surgeons, Dublin 2, Ireland
| | - Maria Pertl
- Department of Health Psychology, Faculty of Medicine and Health Sciences Royal College of Surgeons, Dublin 2, Ireland
| | - David Whitford
- Department of General Practice, RCSI & UCD Malaysia Campus, George Town, Pulau Pinang, Malaysia
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13
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Vatne ME, Lohne V, Nåden D. "You get tired of remaining in a state of fear"- professionals' experiences of self-care facing suicidality in psychiatric wards. Int J Qual Stud Health Well-being 2024; 19:2292184. [PMID: 38112269 DOI: 10.1080/17482631.2023.2292184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Abstract
AIM The aim of this study is to explore mental healthcare professionals (MHCPs) experiences related to own emotions when encountering patients at risk of suicide in psychiatric wards and their family members. METHODOLOGY AND METHODS, PARTICIPANTS AND RESEARCH CONTEXT This study has a qualitative explorative design. Data consist of texts from twelve in-depth interviews with MHCPs belonging to six units in two psychiatric wards. Data were interpreted using a hermeneutical approach based on Gadamer's philosophical hermeneutics. FINDINGS Through an interpretation process, three themes emerged: Enduring own emotions, Balancing emotional engagement and the need to rest, and Being together in the community of colleagues. CONCLUSION This study shows the importance of being aware of own anxiety facing suicidality. MHCPs have to work emotionally and cognitively so that care is not guided by anxiety but by collaboration with the patient and his family members. The study highlights the need for a culture in the mental health service in which the MHCP can reflect on own emotional reactions and thoughts in a collegial environment characterized by openness, generosity and collaboration.
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Affiliation(s)
- May Elise Vatne
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
| | - Vibeke Lohne
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
| | - Dagfinn Nåden
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
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14
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Håkansson T, Svensson H, Karlsson S. Living with a person with young onset dementia - spousal experience. Int J Qual Stud Health Well-being 2024; 19:2330233. [PMID: 38493492 PMCID: PMC10946261 DOI: 10.1080/17482631.2024.2330233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 03/11/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE Being of working age while at the same time needing to help a partner with young onset dementia has specific consequences for spouses. Research to date has been sparse concerning this particular group of spouses. The aim of the study was to explore spouses' everyday experiences when living with a person with young onset dementia. METHOD The study had a descriptive qualitative design with semi-structured interviews with nine spouses. The interviews were analysed using content analysis. RESULT The interviewed spouses experienced emotions that varied from feelings of loneliness, frustration, and worry to peace of mind. They said that they used coping strategies, which included adopting a positive mindset, adapting to inabilities, adopting an avoidant approach, and finding ways to recharge. Spouses also felt that they could use more support, both formal and informal. CONCLUSION The spouse of a person with young onset dementia has a range of emotional experiences and has resourceful ways of handling everyday life. Various types of support are offered to spouses, however, they seemed to desire more from health care services.
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Affiliation(s)
- Tania Håkansson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Hilda Svensson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Staffan Karlsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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15
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Avraham R, Simon-Tuval T, Van Dijk D. Determinants of physical activity habit formation: a theory-based qualitative study among young adults. Int J Qual Stud Health Well-being 2024; 19:2341984. [PMID: 38605587 PMCID: PMC11018029 DOI: 10.1080/17482631.2024.2341984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE Engagement in physical activity significantly contributes to reducing the onset and severity of chronic diseases. Nonetheless, establishing habits around this behaviour remains a persistent challenge. This research endeavours to discern the determinants influencing the formation of physical activity habit among young adults in Israel, drawing upon a socio-ecological model. METHODS A qualitative approach with phenomenological-hermeneutical method was used. In-depth interviews were carried to cover four levels of the socio-ecological model. RESULTS Interviewees were categorized into three subgroups according to their physical activity habit strength: Habitually physically active (n = 8), Variably physically active (n = 11), and physically inactive (n = 6). The content analysis yielded four overarching themes associated with physical activity habit formation. Intrapersonal determinants encompassed personal traits, perceptions and attitudes, perceived benefits, and emotional responses related to physical activity. Interpersonal determinants encompassed social support, modelling support, and peer pressure. Community determinants pertained to social norms, resource availability, and accessibility. Finally, public policy considerations encompassed educational policies as well as workplace policies and cultural influences. CONCLUSIONS This study highlights the unique determinants contributing to the formation of physical activity habit. As intrapersonal and interpersonal factors are significant determinants, interventions should focus on these elements in order to promote this behaviour among young adults.
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Affiliation(s)
- Rinat Avraham
- Department of Nursing, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Tzahit Simon-Tuval
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dina Van Dijk
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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16
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Galbusera L, Endres R, Scholz T, Jirku E, Thoma S. Therapeutic stance towards persons with psychosis - a Grounded Theory study. Int J Qual Stud Health Well-being 2024; 19:2333064. [PMID: 38552196 PMCID: PMC10984242 DOI: 10.1080/17482631.2024.2333064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/17/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Over the last decades, psychotherapy of psychosis has increasingly gained attention. The quality of the therapeutic alliance has been shown to have an impact on therapy outcome. Yet, little is know about the influence of the therapeutic stance on the alliance. In this study, we explore psychotherapists' stance towards persons with psychosis with the aim of better understanding its characteristic-hindering and helpful-aspects. METHOD 6 semi-structured interviews with psychotherapists from three different schools (CBT, PD, ST) were analysed with Grounded Theory. Credibility was checked through external and peer-researcher-supported debriefing. RESULTS 4 core categories were generated and interrelated in a theoretical model. Therapists' stance was initially characterized by insecurity. Diffent ways of dealing with insecurity yielded different stances: a monological and an open one. A helpful stance was conceived as stemming from openness and was characterized by a dialogical structure. A co-presence (or "dosing") of you and I was conceived as its core aspect. CONCLUSION These findings specify the interpersonal dynamics arising from different stances and their impact on the therapeutic alliance and process. Research is still needed to further understand the characteristics of helpful and hindering therapeutic stances, which should also inform the training of psychotherapists.
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Affiliation(s)
- Laura Galbusera
- Department of Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, Brandenburg Medical School, Rüdersdorf, Germany
| | - Ralph Endres
- Department of Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, Brandenburg Medical School, Rüdersdorf, Germany
| | | | - Emilia Jirku
- Department for Social Psychiatry, University Medicine Halle (Saale), Halle, Germany
| | - Samuel Thoma
- Department of Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, Brandenburg Medical School, Rüdersdorf, Germany
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17
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de Korte AM, de Rooij BH, Boll D, van Loon I, Vincent N, Hoedjes M, Lammens CRM, Mols F, van der Lee ML, Vos MC, Ezendam NPM. Barriers and facilitators for healthy lifestyle and recommendations for counseling in endometrial cancer follow-up care: a qualitative study. J Psychosom Obstet Gynaecol 2024; 45:2340465. [PMID: 38622864 DOI: 10.1080/0167482x.2024.2340465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVES Lifestyle promotion during follow-up consultations may improve long-term health and quality of life in endometrial cancer patients. This study aimed to identify barriers and facilitators to improve and sustain a healthy lifestyle that can be translated to behavioral methods and strategies for lifestyle counseling. METHODS Endometrial cancer patients from three hospitals were recruited to participate in a semi-structured interview. The data were transcribed and coded. Thematic analysis was applied to identify themes and the behavior change wheel was used as a theoretical framework. Data saturation was confirmed after 18 interviews. RESULTS Barriers included knowledge gaps as well as lack of motivation and environmental opportunities to engage in health-promoting behavior. Facilitators included applying incremental lifestyle changes, social support, positive reinforcements, and the ability to overcome setbacks. CONCLUSIONS We propose the following intervention functions: education, persuasion, training, environmental restructuring, and enablement. Suitable behavior change techniques to deliver the intervention functions include information about the consequences of certain behavior, feedback on behavior, credible source, graded tasks, habit formation, restructuring of the environment, prompts/cues, goal setting, action planning, and social support. Including these recommendations in lifestyle counseling could aid lasting lifestyle change since it suits the needs and preferences of patients.
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Affiliation(s)
- Anne M de Korte
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Belle H de Rooij
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Dorry Boll
- Department of Gynecology, Catharina Hospital, Eindhoven, The Netherlands
| | - Ingrid van Loon
- Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands
| | - Noor Vincent
- Department of Gynecology, Catharina Hospital, Eindhoven, The Netherlands
| | - Meeke Hoedjes
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | | | - Floor Mols
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Marije L van der Lee
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Bilthoven, The Netherlands
| | - M Caroline Vos
- Department of Obstetrics and Gynecology, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, The Netherlands
| | - Nicole P M Ezendam
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Centre of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
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Alzahrani NS, Almarwani AM. The effect of HIV on patients' lives: a phenomenological qualitative study. Int J Qual Stud Health Well-being 2024; 19:2315634. [PMID: 38340013 PMCID: PMC10860465 DOI: 10.1080/17482631.2024.2315634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/04/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Human immunodeficiency virus (HIV) infection poses a significant threat to the immune system, compromising the body's ability to combat diseases and infections. The Ministry of Health in Saudi Arabia reported an HIV incidence rate of 3 cases per 10,000 individuals. This study aimed to gain insight into the lived experience of Saudi patients living with HIV. METHODS Employing a qualitative phenomenological approach, this study conducted in-depth interviews with 16 HIV patients (10 men, 6 women) between January 2023 and May 2023. RESULTS Thematic data analysis highlighted three overarching themes and four subthemes. "Fear of the Future" encompassed subthemes including the fear of infecting a family member, fear of marriage, fear of employment recruitment, and fear of scandals. "Hopelessness" reflected the profound emotional state experienced by patients. "Overcoming Adversity" captured the resilience and strength demonstrated by individuals facing the challenges of living with HIV. CONCLUSION Saudi patients diagnosed with HIV encounter numerous obstacles in their daily lives. The fear of the future, including concerns such as infecting family members, marriage prospects, employment opportunities, and potential social repercussions, significantly impacts their overall well-being. By understanding the lived experience of HIV patients in Saudi Arabia, healthcare providers and policymakers can better support and enhance the quality of life for this population.
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Affiliation(s)
- Naif S. Alzahrani
- Department of Medical Surgical Nursing, College of Nursing, Taibah University, Medina, Saudi Arabia
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Nygaard HS, Øen KG. Public health nurses' experiences following up children with overweight and obesity according to national guidelines. A qualitative study. Int J Qual Stud Health Well-being 2024; 19:2306658. [PMID: 38262000 PMCID: PMC10810652 DOI: 10.1080/17482631.2024.2306658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 01/14/2024] [Indexed: 01/25/2024] Open
Abstract
PURPOSE This study aimed to develop knowledge of how the follow-up regarding overweight and obesity among children in primary school is experienced by the PHN and how the guidelines may be used to improve health services in this follow-up. METHODS We analysed semi-structured interviews of 9 PHNs using qualitative content analysis. RESULTS Two themes emerged: Following up with children with overweight and obesity is an important but challenging duty; The PHNs call for clearer guidelines. Following five sub-themes: PHNs strive to adhere to the guidelines, show compassion in the follow-up, have difficulty handling parents' feelings and reactions, feel alone with the responsibility, and have suggestions for clearer guidelines. CONCLUSIONS PHNs call for enough resources to communicate the results of the child's weight in a sufficient form. PHNs and families should establish common goals. The PHN should avoid one-way communication but meet the parents' concerns and needs. This requires the PHN to focus on building a secure relation to the child and the families, as described by Peplau. Guidelines must include instructions and tools on how to communicate and meet the family's concerns. Political action and increased funding could strengthen the follow-up and thereby prevent more obesity among children, which can be a predictor of poorer health outcomes later in life.
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Affiliation(s)
- Hanna Skjelbred Nygaard
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kirsten Gudbjørg Øen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Nielsen MH, Jensen AL, Pedersen ML, Seibæk L. Living with chronic obstructive pulmonary disease or type 2 diabetes in Greenland - a qualitative interpretive description study. Int J Circumpolar Health 2024; 83:2296706. [PMID: 38127836 PMCID: PMC10763871 DOI: 10.1080/22423982.2023.2296706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Non-communicable diseases such as chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) represent major challenges for health systems all over the world. In an interview study, we explored patient experiences and perspectives of being diagnosed and living with COPD or T2D in Greenland. Participants (n = 24) were selected by purposeful sampling and recruited by phone. We conducted individual semi-structured interviews at the National Hospital in Nuuk and the four regional hospitals. Interviews were audio-recorded, transcribed verbatim, and analysed using interpretive description. Three themes emerged: shock and shame on receiving the diagnosis, coping with a changed life, and varying needs for care and communication. We found that being diagnosed with COPD or T2D required a rapid change in the participants' everyday lives and lifestyle behaviours. Some self-managed their disease well and were able to transfer their knowledge and integrate it into their daily lives, while others struggled to make lifestyle changes. Additionally, living with COPD or T2D could be related to silence and shame. The findings contribute to a better understanding of living with COPD or T2D in the Arctic region and the development of future, culturally-adapted patient education initiatives.
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Affiliation(s)
- Maja Hykkelbjerg Nielsen
- Queen Ingrid’s Hospital, Steno Diabetes Center Greenland, Nuuk, Greenland
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Annesofie Lunde Jensen
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Lynge Pedersen
- Queen Ingrid’s Hospital, Steno Diabetes Center Greenland, Nuuk, Greenland
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lene Seibæk
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
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Almevall A, Juuso P, Melander C, Zingmark K. Exploring the meaning of a good life for older widows with extensive need of care: a qualitative in-home interview study. Int J Qual Stud Health Well-being 2024; 19:2322757. [PMID: 38431864 PMCID: PMC10911179 DOI: 10.1080/17482631.2024.2322757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Studies of older women's life transitions is rare but gains relevance as the aging population, with older women as the majority, expands. PURPOSE To explore the meaning of a good life for older widows with extensive home care needs. MATERIALS AND METHODS Semi-structured interviews were carried out with eleven women, aged 80 and over (82-95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5-6 hours, mean 3). Data were analysed by reflexive thematic analysis. RESULTS The theme "This Day in My Home, the frame of my life" reflects the women's experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely. CONCLUSION A day at home may seem static, yet it mirrors life's dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.
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Affiliation(s)
- Ariel Almevall
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Päivi Juuso
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Catharina Melander
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Karin Zingmark
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
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Kozak AT, Garber N, Uhley V. Undergraduates' knowledge, attitudes, and behaviours associated with fad diets. Int J Qual Stud Health Well-being 2024; 19:2309687. [PMID: 38290052 PMCID: PMC10829839 DOI: 10.1080/17482631.2024.2309687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
PURPOSE We aimed to determine undergraduate students' use and knowledge of fad diets as well as examine how appealing students found these diets given the goal of rapid weight loss and/or improved health. Twenty-three students from a Midwestern university (mean age = 19.2, mean BMI = 27.35, 69.6% female) were recruited through new student orientations for this qualitative study. Approximately 52% of participants identified as White, 30% as Black, 13% as Asian, and 4% as multi-racial. METHODS Knowledge and opinions about fad diets were collected via focus groups and individual interviews. Coding of transcripts was conducted by hand using the constant comparative method and data were analysed based on grounded theory. RESULTS Two primary themes emerged: very negative views of fad diets and the importance of healthy eating. Although few participants had tried fad diets, they thought these diets: 1) did not lead to sustained weight loss, 2) were associated with disappointment and health issues, and 3) were money-making schemes delivered heavily through social media. Participants also valued healthy eating. CONCLUSION Experimental studies are needed to examine how healthy eating among university students can be supported through credible sources, accurate information, and established connections via innovative social media platforms.
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Affiliation(s)
- Andrea T. Kozak
- Department of Psychology, Oakland University, Rochester, MI, USA
| | - Noah Garber
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Virginia Uhley
- Department of Foundational Medical Studies and Family Medicine & Community Health, Oakland University, Rochester, MI, USA
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Abstract
In this article, we present the results of 30 ethnographic interviews in which we asked STEM graduate and undergraduate students at a Midwest university in the United States about topics related to the culture of their research group, how group members communicate and interact, and their experience with ethical issues that arise within the laboratory. Here we focus on the culture of research laboratories and describe the key categories that emerged through analysis, including communication, community structure, governance, and collaboration that influence and shape lab culture. We also consider the critical role of the principal investigator (PI) to influence conditions in the lab that facilitate or inhibit lab culture and the subsequent effects on student feelings and behaviors, interpersonal communication, collaboration, work output, and ethics. Our findings suggest that the quality of research and the wellbeing of the lab members depend not only on purely scientific factors and routine research practices but are also dependent on the culture of the lab as it manifests in interpersonal relationships. The interviews reveal the critical role students ascribe to the PI in shaping the lab culture. Based on this study, we suggest how ethical lab cultures might be encouraged.
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Affiliation(s)
- Elisabeth Hildt
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Kelly Laas
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Christine Z Miller
- Design Management, School of Business Innovation, Savannah College of Art and Design, Atlanta, Georgia, USA
| | - Stephanie Taylor
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, Illinois, USA
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Larsson AL, Beck I, Janlöv AC, Einberg EL. Nurse assistants' experiences of encountering patients in grief due to the death of a loved one - a qualitative study in municipal health and social care. Int J Qual Stud Health Well-being 2024; 19:2330116. [PMID: 38493488 PMCID: PMC10946262 DOI: 10.1080/17482631.2024.2330116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/08/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE The aim was to explore nurse assistants´ experiences of paying attention to and encountering patients receiving municipal health and social care, who are in grief due to the death of a loved one. METHODS A qualitative study with focus group interviews (n = 6) was conducted with nurse assistants (NAs) (n = 28) in municipal health and social care (n = 5) in southern Sweden. The data were analysed inductively using qualitative content analysis. RESULTS Three categories (1) Noticing changes in the patient, (2) Using different strategies to create a dialogue with the patient, (3) Experiencing challenges when encountering patients in grief, included eight sub-categories were identified. The result is captured in the theme of Having to be attentive to signs of grief after patients´ loss of loved ones, sensing the right time to approach and comfort, while having to cope with emotional challenges. CONCLUSIONS The NAs encountered expressions of strong emotions from patients in grief, and even expressions of a desire to end their lives. Additionally, the NAs had to deal with their own emotions that were evoked when meeting patients in grief. These challenges indicate the need for enhanced conditions in the work culture, and improved training and supervision in health and social care.
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Affiliation(s)
- Anne-Lie Larsson
- The Research Platform for Collaboration for Health, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
| | - Ingela Beck
- The Research Platform for Collaboration for Health, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
- The Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden
| | - Ann-Christin Janlöv
- The Research Platform for Collaboration for Health, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
| | - Eva-Lena Einberg
- The Research Platform for Collaboration for Health, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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25
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Magnussen HJ, Kjeken I, Pinxsterhuis I, Sjøvold TA, Feiring M. Dialogued into being: Constructing knowledge about hand osteoarthritis from a polyphony of voices in healthcare encounters. Int J Qual Stud Health Well-being 2024; 19:2330221. [PMID: 38498812 PMCID: PMC10949837 DOI: 10.1080/17482631.2024.2330221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/11/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE Multiple knowledge sources inform healthcare. In healthcare encounters, patients and health professionals' ideas intersect to understand illness and disease. Exploring what is thought of as legitimate knowledge, and where those reflections come from is central to the process of improving and developing healthcare. Within this context, we aim to explore how knowledge about hand osteoarthritis (OA) is constructed and negotiated in clinical consultations. METHODOLOGY The article is based on interviews with 21 patients and 14 health professionals in combination with observation in 16 clinical consultations. Reflexive thematic analysis was used to interpret the data. RESULTS We generated four themes from codes to tell an interpretive story about how hand OA meaning-making is "talked into being" in patient-provider encounters: from the dominant voice of health professionals, from patients as knowers in the chronic healthcare dialogue, from health professionals and patients constructing knowledge together and from the construction of knowledge in hybrid positions when patients are health professionals and health professionals have hand OA. CONCLUSION New knowledge about hand OA is co-constructed in the situated context of the clinical encounter through a polyphony of voices-some of which are dominant, while others occupy the periphery-within and between the interactants in dialgue.
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Affiliation(s)
- Hege Johanne Magnussen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingvild Kjeken
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- REMEDY - Centre for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
| | - Irma Pinxsterhuis
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | | | - Marte Feiring
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- REMEDY - Centre for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
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Alharbi BFH, Baker P, Pavey T, Alharbi MF. Investigating the beliefs of Saudi females regarding physical activity: a qualitative exploration. Int J Qual Stud Health Well-being 2024; 19:2296696. [PMID: 38127866 PMCID: PMC10763862 DOI: 10.1080/17482631.2023.2296696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Saudi women have been deprived of equal access to and opportunities for an active lifestyle due to sociocultural restrictions. Using the theory of planned behaviour, this elicitation study aimed to explore the salient beliefs of young Saudi women aged 18-35 regarding physical activity (PA). METHODS A descriptive qualitative methodology was utilized using a semi-structured interview. A total of 25 transcribed interviews were coded. Content analysis was used to identify the salient beliefs and to rank-order the beliefs using an adaptation of Burnard's model. FINDINGS Thirty-five salient beliefs were identified as dominant factors in the decision to engage in PA. The salient beliefs about PA are classified as positive (related to advantages, social approval, and enabling) and negative (related to disadvantages, social disapproval, and barriers). These included behavioural beliefs (concerning physical/psychological well-being and social opportunities), normative beliefs (concerning family, community, international and local media influencers' expectations), and control beliefs (concerning personal, social, natural, and built environment enablers as well as constraints). CONCLUSIONS Due to the elicited beliefs, young women may be able to adopt more active lifestyles and change their inactive behaviour. Addressing negative beliefs can help change their inactive behaviour. Strengthening positive beliefs and facilitators is also beneficial.
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Affiliation(s)
- Basmah Fehaid H Alharbi
- Basic Health Science Department, Qassim University, Applied Medical Science College, Al-Qassim Province, Kingdom of Saudi Arabia
| | - Philip Baker
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove
| | - Toby Pavey
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology
| | - Manal F. Alharbi
- Maternal & Child Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
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Leibring I, Kihlgren A, Anderzén Carlsson A. Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia. Int J Qual Stud Health Well-being 2024; 19:2310147. [PMID: 38324664 PMCID: PMC10851796 DOI: 10.1080/17482631.2024.2310147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To describe experiences of fear, coping, and support in 10-17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). METHODS A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. RESULTS The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals' attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. CONCLUSIONS Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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Affiliation(s)
- Ingela Leibring
- Faculty of Health, Science and Technology, Institution for Health, Karlstad University, Karlstad, Sweden
| | - Annica Kihlgren
- Faculty of Health and Medicine, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Agneta Anderzén Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Koivisto T, Paavolainen M, Olin N, Korkiakangas E, Laitinen J. Strategies to mitigate moral distress as reported by eldercare professionals. Int J Qual Stud Health Well-being 2024; 19:2315635. [PMID: 38373153 PMCID: PMC10878340 DOI: 10.1080/17482631.2024.2315635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 02/03/2024] [Indexed: 02/21/2024] Open
Abstract
Eldercare workers experience higher levels of moral distress than other health and social care service workers. Moral distress is a psychological response to a morally challenging event. Very little is known about moral distress in the context of eldercare and about the mechanisms of preventing or mitigating moral distress. This qualitative study was conducted as part of the "Ensuring the availability of staff and the attractiveness of the sector in eldercareservices" project in Finland in 2021. The data were from 39 semi-structured interviews. This qualitative interview data were examined using two-stage content analysis. The key finding of this study, as reported by eldercare professionals, is that strategies to mitigate moral distress can be found at all organizational levels : organizational, workplace and individual. The tools that emerged from the interviews fell into four main categories:) organizational support and education 2) peer support 3) improving self-care and competence and 4) defending patients. The main identified categories confirmed the earlier findings but the qualitative, rich research interview data provided new insights into a little-studied topic: mitigating moral distress in eldercare. The main conclusion is that, in order to mitigate moral distress, ethical competence needs to be strengthened at all organizational levels.
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Affiliation(s)
- Tiina Koivisto
- CONTACT Tiina Koivisto Finnish Institute of Occupational Health, PO Box 40, Helsinki00032, Finland
| | | | - Nina Olin
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Jaana Laitinen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Gribačiauskaitė A, Žilinskienė J. Professional becoming of male nurses: a qualitative study in Lithuania. Int J Qual Stud Health Well-being 2024; 19:2341448. [PMID: 38603642 PMCID: PMC11011223 DOI: 10.1080/17482631.2024.2341448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/06/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE To reveal the features of Lithuanian male nurses' professional becoming. METHODS The participants were six men who had been working as nurses for over a year, and one man who had been formerly employed as a nurse for over a year. Data was collected using semi-structured interviews and analysed using inductive thematic analysis by Braun & Clarke. RESULTS 17 themes emerged after analysis: nursing not being the first choice, weird feelings of being in the minority during studies, having a vague initial idea of the work and a hard time starting the job; desire to help and interact with people, a tiring but fascinating variety of work, wide professional opportunities and love for the job; the challenges of high pace and workload, undervaluation and stereotypes, coping by standing up for oneself and separating work and life; the importance of a good team, gender being of little significance and joy that the number of men is increasing. CONCLUSION These findings contribute to the growing knowledge of male nurses' experiences. The study sheds light on the challenges and rewards of being a male nurse in Lithuania, providing guidance for future research and highlighting the need to raise public awareness.
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Affiliation(s)
- Aušrinė Gribačiauskaitė
- Department of Health Psychology, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jolanta Žilinskienė
- Department of Health Psychology, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
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30
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Sundar TKB, Sargenius H, Kvarme LG, Sparboe-Nilsen B. Norwegian pre-service teacher students' and public health nursing students' views on health - a qualitative study of students' perceptions. Int J Qual Stud Health Well-being 2024; 19:2322705. [PMID: 38431882 PMCID: PMC10911246 DOI: 10.1080/17482631.2024.2322705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/18/2024] [Indexed: 03/05/2024] Open
Abstract
PURPOSE In 2020, the Norwegian school curriculum was revised, introducing a new cross-curricular subject, Public Health, and Life Skills. The curriculum emphasizes collaboration between teachers and the school health service. Subsequently, a research project, Literacies for Health and Life Skills, was initiated at Oslo Metropolitan University. The aim was to develop a new approach to the subject. A part of the research was to explore perceptions about good and poor health among teacher students and public health nursing students. METHODS This study has a qualitative design using auto-photography, group discussions and photo-elicitation interviews as methods to explore the students' views on health. RESULTS A analysis revealed three themes about good health in both student groups: Relaxation and tranquillity, belonging and relations, and enjoyment as important to health. Three themes about poor health emerged in both student groups: The ideal body and self-perception, you are as healthy as you feel, and the best in life is also the worst. The students' statements were characterized by underlying assumptions about health in society, with a focus on "healthism". No major differences between the student groups were found. CONCLUSION This study serves as a step towards increased understanding of health perceptions among future professionals working with children and adolescents.
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Affiliation(s)
- Turid Kristin Bigum Sundar
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Hanna Sargenius
- Department of Psychology, section of cognition and neurosciences, University of Oslo, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Bente Sparboe-Nilsen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Karlsson I, Sandman L, Axén I, Kwak L, Sernbo E, Björk Brämberg E. Ethical challenges from a problem-solving intervention with workplace involvement: a qualitative study among employees with common mental disorders, first-line managers, and rehabilitation coordinators. Int J Qual Stud Health Well-being 2024; 19:2308674. [PMID: 38324667 PMCID: PMC10851822 DOI: 10.1080/17482631.2024.2308674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE This study aims to explore ethical challenges potentially arising from a problem-solving intervention with workplace involvement (PSI-WPI) in primary health care (with first-line manager involvement) for employees on sickness absence due to common mental disorders. METHODS A qualitative design guided by the theoretical framework for systematic identification of ethical aspects of healthcare technologies. Semi-structured interviews were performed with coordinators (n = 6), employees (n = 13), and first-line managers (n = 8). Reflexive thematic analysis was used to analyse and interpret themes. RESULTS A main theme was identified "the workplace and healthcare hold different organizational value logics" and four sub-themes: "the PSI-WPI challenged the organizational goals and values of the workplace and healthcare", "the PSI-WPI challenged organizational values on fairness", "the PSI-WPI challenged the professional roles of first-line managers and rehabilitation coordinators" and "the PSI-WPI introduced a need for the employee to juggle the employee and patient roles". CONCLUSION Different organizational value logics, values, and goals can introduce ethical challenges. We advise clarifying stakeholders' roles and preparing employees and managers for the return to work process by providing sufficient information. The ethical challenges and suggested measures to minimize them, should be considered when planning return to work interventions that involve several stakeholders.
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Affiliation(s)
- Ida Karlsson
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Lars Sandman
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Iben Axén
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Elisabet Sernbo
- Faculty of Social Sciences, Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| | - Elisabeth Björk Brämberg
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
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McLaughlin E, Arshad N, Ellis K, Chen A, Fougere K, Culos-Reed SN, Wurz A. Experiences of young adults affected by cancer within an 8-week yoga intervention delivered by videoconference: a qualitative interview study. Ann Med 2024; 56:2309275. [PMID: 38289977 PMCID: PMC10829813 DOI: 10.1080/07853890.2024.2309275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Yoga may reduce negative cancer- and treatment-related effects and help improve a range of outcomes, including flexibility, mindfulness, and quality of life among adults affected by cancer. Yet there is little evidence for the role of yoga among young adults (18-39 years) affected by cancer. PURPOSE The purpose of this study was to explore the experiences of young adults affected by cancer in an 8-week yoga intervention delivered by videoconference. METHODS Young adults who were diagnosed with cancer between the ages of 18 and 39 years, at any stage of the cancer trajectory, who were living in Canada, and who completed an 8-week yoga intervention were approached to complete a semi-structured interview. A social constructivist paradigm was adopted. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS Twenty-eight young adults (Mean age = 34.67 ± 5.11 years; n = 25 female) with varied cancer diagnoses participated. Participants' perspectives were represented across 6 themes: (1) I was juggling a number of challenges and changes throughout the yoga intervention; (2) I noticed some improvements in my mental and physical health; (3) I made time to discover new strategies to take care of myself; (4) I was able to see what my body is capable of; (5) I was held accountable and I appreciated that, and; (6) I was able to be around similar others in a safe (virtual) space. CONCLUSIONS Findings suggest that an 8-week yoga intervention may offer some benefits for young adults affected by cancer. Self-care, self-compassion, mindfulness, feelings of physical competence, establishing a routine, and being around similar others were viewed as important components of the intervention and may have contributed to the benefits experienced. Findings underscore the potential utility of yoga as a supportive care intervention for young adults affected by cancer.
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Affiliation(s)
- Emma McLaughlin
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Nafeel Arshad
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada
| | - Kelsey Ellis
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Amy Chen
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kate Fougere
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, Canada
| | - Amanda Wurz
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada
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Goodwin J, McSherry E, Goulding R, O'Mahony J, O'Callaghan R, Chambers C. "People want better": a qualitative exploration of stakeholders' views on introducing well-being coordinators in the screen industry. Int J Qual Stud Health Well-being 2024; 19:2326681. [PMID: 38465627 DOI: 10.1080/17482631.2024.2326681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/29/2024] [Indexed: 03/12/2024] Open
Abstract
PURPOSE There are several factors that negatively impact the well-being of those working in the screen industry. Consequently, the need to introduce Well-being Coordinators has been identified. This study explored the experiences of participants who undertook a Well-being Coordination course tailored for the screen sector. Additionally, it sought to delve into perspectives regarding well-being within the screen industry. METHODS Semi-structured interviews were conducted. The study was guided by an interpretive descriptive approach. Reflexive thematic analysis was used to analyse data. FINDINGS Five themes were identified: Opportunities and challenges working in the screen industry, co-existing with harassment, the need for change: importance of wellbeing, becoming a well-being co-ordinator: learning from the course, and the future of the well-being co-ordinator role: opportunities and challenges. The reality that cast and crew co-exist with several forms of harassment within the industry was noted. Despite this, there is hope for the future of the screen sector, particularly the positive impact the role of the Well-being Coordinator could have. CONCLUSIONS The experiences of professionals across the screen industry vary; however, a pervasive culture of bullying and harassment is commonplace. Through the introduction of Well-being Coordinators, there is the potential to enact positive change.
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Affiliation(s)
- John Goodwin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Eleanor McSherry
- Adult and Continuing Education, University College Cork, Cork, Ireland
| | - Ryan Goulding
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - James O'Mahony
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Rachael O'Callaghan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Ciara Chambers
- Department of Film & Screen Media, University College Cork, Cork, Ireland
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Salzmann-Erikson M. The intersection between logical empiricism and qualitative nursing research: a post-structuralist analysis. Int J Qual Stud Health Well-being 2024; 19:2315636. [PMID: 38346230 PMCID: PMC10863514 DOI: 10.1080/17482631.2024.2315636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE To shed light on and analyse the intersection between logical empiricism and qualitative nursing research, and to emphasize a post-structuralist critique to traditional methodological constraints. METHODS In this study, a critical examination is conducted through a post-structuralist lens, evaluating entrenched methodologies within nursing research. This approach facilitates a nuanced exploration of the intersection between logical empiricism and qualitative nursing research, challenging traditional methodological paradigms. RESULTS The article focusing on the "what abouts" of sample size, analytic framework, data source, data analysis, and rigour and methodological considerations, challenging the predominance of semi-structured interviews and the reliance on spoken voice as primary data sources, and re-evaluating the conventional notion of "rigour". CONCLUSIONS I advocate for a shift from qualitative positivism towards more interpretive and post-qualitative inquiries, this work proposes new trajectories through interpretive, critical, post-qualitative, and artistic turns in nursing research, aiming to transcend positivist limitations and foster a plurality of perspectives and research as praxis. Implications emphasize the need for nursing researchers to expand methodological horizons, incorporating visual and artistic methods to enrich understanding and representation of health experiences, moving beyond positivist norms towards a more inclusive and ethically sound research paradigm.
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Affiliation(s)
- Martin Salzmann-Erikson
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Dragosits A, Martinsen B, Hemingway A, Norlyk A. Coming home: older patients' and their relatives' experiences of well-being in the transition from hospital to home after early discharge. Int J Qual Stud Health Well-being 2024; 19:2300154. [PMID: 38166522 PMCID: PMC10769116 DOI: 10.1080/17482631.2023.2300154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/25/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND This study aims to investigate the lived experience of well-being among older patients and their relatives in the transition from hospital to home after early discharge. Research has shown that the transition brings severe challenges to their everyday lives. However, to date, there has been a lack of research focusing on the lived experiences of well-being during this process. METHODS The data collection and analysis followed the phenomenological approach of Reflective Lifeworld Research. Ten in-depth interviews with older patients and their relatives were conducted in Austria up to 2-5 days after hospital discharge. RESULTS The essential meaning of the phenomenon of well-being in the transition from hospital to home is marked by security and confidence to face the challenges following the discharge. Four constituents emerged: being calm and in alignment with the homecoming, being in familiar surroundings at home-a sense of belonging, striving towards independence-continuity of life and having faith in the future. CONCLUSION Our findings point to the importance of recognizing the vulnerability associated with the transition from hospital to home, as it impacts the existential aspects of space and time. Facilitating a sense of continuity and belonging can foster well-being during this critical period.
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Affiliation(s)
- Aline Dragosits
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus C, Denmark
| | - Bente Martinsen
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Ann Hemingway
- Department of Medical Science & Public Health, Bournemouth University, Bournemouth, Dorset, UK
| | - Annelise Norlyk
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus C, Denmark
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, Agder University, Grimstad, Norway
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Dahlberg J, Nylander E, Persson M, Shayesteh A. An uncertain uphill battle - experiences and consequences of living with lipedema. Int J Qual Stud Health Well-being 2024; 19:2300152. [PMID: 38159285 PMCID: PMC10763886 DOI: 10.1080/17482631.2023.2300152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE To describe and analyse experiences of living with lipedema. Methods: Individual, semi-structured interviews with a purposive sample of 12 women diagnosed with lipedema and analysed by qualitative content analysis utilizing an inductive approach. RESULTS The overarching theme, "An uncertain uphill battle against a divergent body and societal ignorance", covers the experiences of living with lipedema and is based on five categories; "Captivated by a disintegrating body", "Face the impairments of a chronic condition", "Experience social exclusion", "Need emotional support to go on" and "Mull over an insecure future". The women felt entrapped within their bodies and experienced social exclusion due to the chronic symptoms and the progressive body shape alteration caused by their illness. Having experienced deficient information on the illness, varying support from other people, and a deteriorating economic situation, the women face an uncertain future. CONCLUSIONS Symptoms and restrictions caused by lipedema affect women's livelihood and future, as there are no indications for disease improvement. Preventive work aimed at reducing health deterioration should be a priority. More research is needed to raise healthcare awareness regarding difficulties experienced by patients with lipedema.
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Affiliation(s)
- Johan Dahlberg
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Elisabet Nylander
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | | | - Alexander Shayesteh
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
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Lieberwerth M, Niemeijer A. Lost and changed meaning in life of people with Long Covid: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2289668. [PMID: 38055787 DOI: 10.1080/17482631.2023.2289668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023] Open
Abstract
Long Covid (LC) has been called the greatest mass-disabling event in human history. For patients, LC not only has implications for quality of life but also for meaning in life: how one's life and the world are understood and what is seen as valuable in one's life. This qualitative empirical study used a Constructivist Grounded Theory approach to investigate the meaning in life of people struggling with LC through ten patient interviews. This study shows that patients lose their prior understanding of life and come to a changed meaning in life, in part due to the experienced (social) isolation and loss of (both physical and cognitive) abilities caused by LC. Moreover, patients struggled with acceptance, uncertainty, and the inherent incomprehensibility and uncontrollability that living with LC entails, though this simultaneously co-existed with hope, optimism and acceptance. Additionally, dimensions of meaning intersect; a patient having some understanding of their illness (dimension of meaning: comprehension) required an understanding Other (dimension of meaning: connection). Emerging from lockdown brought the challenge and isolation of adjusting to chronic illness in society as usual (albeit divided about COVID-19 measures). This study thus offers novel insights regarding changed, present, and sought meaning in life for LC patients.
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Affiliation(s)
| | - Alistair Niemeijer
- Department of Ethics of Care, University of Humanistic Studies, Utrecht, Netherlands
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Lee NP, Pearson ES, Sanzo P, Klarner T. Exploring the personal stroke and rehabilitation experiences of older adults with chronic stroke during the COVID-19 pandemic: a qualitative descriptive study. Int J Qual Stud Health Well-being 2024; 19:2331431. [PMID: 38511399 PMCID: PMC10962289 DOI: 10.1080/17482631.2024.2331431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 03/13/2024] [Indexed: 03/22/2024] Open
Abstract
PURPOSE The purpose of this study was to explore the personal stroke and rehabilitation experiences of older adults with chronic stroke living in a mid-sized Northwestern Ontario city in Canada during the COVID-19 pandemic. METHODS A qualitative descriptive approach with a constructivist worldview was used. In addition, a semi-structured interview guide was used to gather the participants' perspectives on their experiences throughout stroke recovery. Ten participants were interviewed, including six males and four females. The interviews were completed, transcribed, and analysed using inductive and deductive content analysis. Multiple steps were taken to enhance data trustworthiness. RESULTS Six main themes and eight related subthemes emerged. These included: getting help is complex, the effects of stroke are multifaceted, losing rehabilitation services during the COVID-19 pandemic, overcoming hardships but not alone, "If you don't use it, you lost it": rehabilitative success is based on one's actions, and "look at me now": the importance of taking pride in one's successes. CONCLUSIONS One unique finding was that the participants used this study as an opportunity to teach and advocate for future stroke survivors which is not often seen in qualitative stroke rehabilitation research. Future stroke research should place emphasis on both the positive and negative experiences of this population.
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Affiliation(s)
- Nicole P. Lee
- CONTACT Nicole P. Lee School of Kinesiology, Lakehead University, 955 Oliver Rd, Thunder Bay, OntarioP7B5E1, Canada
| | | | - Paolo Sanzo
- School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Taryn Klarner
- School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
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Chow EHY, Tiwari A. Perceptions of abused Chinese women on community-based participatory approach programme in addressing their needs. Int J Qual Stud Health Well-being 2024; 19:2331107. [PMID: 38564773 PMCID: PMC10989199 DOI: 10.1080/17482631.2024.2331107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The community-based participatory approach (CBPA) has gained increasing recognition worldwide for enhancing the effectiveness of intervention. It is relatively new in Chinese societies and participants' perceptions are underexplored. This study aims to explore abused Chinese women's perceptions on the CBPA programme in addressing their needs. METHODS A total of 11 abused Chinese women were recruited for a focus group and individual interviews. A semi-structured interview guide was used. All interviews were audio-recorded and data were transcribed verbatim. Conventional content analysis was used for analysis. RESULTS Four themes were identified regarding the women's perceptions and experiences of the community-based participatory approach programme: (1) Women's perceived acceptability of the CBPA programme; (2) Women's perceived usefulness of the CBPA programme; (3) Women's perceived feasibility of the CBPA programme; and (4) Empowering the women through participating in CBPA. CONCLUSIONS Abused Chinese women had high perceived acceptance and positive experiences towards the community-based participatory approach. Women benefited from their robust participation throughout the process. The findings confirm the potential of using the community-based participatory approach in designing interventions for future programme planning and intervention to address the needs of abused Chinese women.
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Affiliation(s)
| | - Agnes Tiwari
- School of Nursing, Hong Kong Sanatorium & Hospital Limited, Hong Kong, China
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Gerritse K, Martens C, Bremmer MA, Kreukels BPC, de Boer F, Molewijk BC. "I Should've Been Able to Decide for Myself, but I Didn't Want to Be Left Alone." A Qualitative Interview Study of Clients' Ethical Challenges and Norms Regarding Decision-Making in Gender-Affirming Medical Care. J Homosex 2024; 71:1757-1781. [PMID: 37097132 DOI: 10.1080/00918369.2023.2201972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This qualitative study aimed to map and provide insight into the ethical challenges and norms of adult transgender and gender diverse (TGD) clients in gender-affirming medical care (GAMC). By doing so, we seek to make an empirical and constructive contribution to the dialogue on and moral inquiry into what good decision-making in GAMC should entail. We conducted 10 semi-structured interviews with adult Dutch TGD people who received GAMC. In our thematic analysis, we (1) included both ethical challenges and norms, (2) differentiated between explicit and implicit ethical challenges and norms, and (3) ascertained the specific context in which the latter emerged. We identified the following themes: (1) clients should be in the lead, (2) harm should be prevented, and (3) the decision-making process should be attuned to the individual client. These themes arose in the context of (1) a precarious client-clinician relationship and (2) distinct characteristics of GAMC. Our findings highlight divergent and dynamic decisional challenges and normative views-both within individual clients and among them. We conclude that there is no single ideal model of good decision-making in GAMC and argue that elucidating and jointly deliberating on decisional norms and challenges should be an inherent part of co-constructing good decision-making.
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Affiliation(s)
- Karl Gerritse
- Department of Ethics, Law, and Humanities, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Liaison Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Casper Martens
- Department of Ethics, Law, and Humanities, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marijke A Bremmer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Liaison Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Baudewijntje P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fijgje de Boer
- Department of Ethics, Law, and Humanities, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bert C Molewijk
- Department of Ethics, Law, and Humanities, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Månsson Sandberg H, Tjulin Å, Brulin E, Landstad BJ. How general practitioners used job crafting strategies during the COVID-19 pandemic in Sweden. Scand J Prim Health Care 2024; 42:276-286. [PMID: 38315554 PMCID: PMC11003318 DOI: 10.1080/02813432.2024.2309633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE General practitioners (GPs) played a crucial role in limiting the impact of the COVID-19 pandemic, and many GPs experienced they did not have the prerequisites to provide adequate care. However, GPs developed approaches that helped them to provide care to patients through various job crafting strategies. The aim of this study is to identify how job crafting strategies were deployed by GPs at the beginning of the COVID-19 pandemic in Sweden and the significance of the strategies on their work situation. DESIGN A qualitative design with semi-structured interviews. The data was analysed using qualitative content analysis with job crafting as the conceptual framework for the analysis process. SETTING Primary healthcare in five healthcare regions in Sweden. SUBJECTS Fourteen GPs participated in individual interviews. RESULTS In their endeavours to organise and provide care, GPs shaped the task, relational and cognitive boundaries of their work. GPs felt proud about finding new ways of working when given room to manoeuvre. Intensified collaboration between healthcare professionals made GPs more confident in their clinical work. GPs expressed that they consequently felt stronger in their professional role through what they accomplished in the organisation of care. CONCLUSIONS/IMPLICATIONS The results suggest that the job crafting strategies GPs used were meaningful to them in clinical practice. Knowledge about how GPs' job crafting strategies were deployed might be useful for healthcare organisations in preparing for future health crises. Taking advantage of GPs' experiences and strategies is considered important for promoting sustainable working conditions for GPs in the future.
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Affiliation(s)
- Helena Månsson Sandberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Tjulin
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Emma Brulin
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bodil J. Landstad
- Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
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Yoo HJ, Shin S. Moving forwards to patient-centred care for patients with ventricular assist devices: A mixed methods study of nurses' perspectives. Intensive Crit Care Nurs 2024; 82:103635. [PMID: 38340544 DOI: 10.1016/j.iccn.2024.103635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To identify nurses' caring behaviours toward patients with left ventricular assist devices and deepen their understanding of experiences in nursing care. Patients with left ventricular assist devices require care in many aspects, but there is limited in-depth research about caring behaviours and experiences from the perspective of nurses providing care. RESEARCH METHODOLOGY/DESIGN Mixed methods study with a sequential explanatory design. Data were collected from clinical nurses with experience caring for patients using left ventricular assist devices in South Korea between May-August 2022. MAIN OUTCOME MEASURES Quantitative data (n = 79) were collected through an online survey of the Caring Behaviours Inventory - 24 and analysed using descriptive statistics. For qualitative data (n = 15), nurses' caring experiences were collected through individual interviews and analysed using Colaizzi's phenomenological method. RESULTS The overall average of caring behaviours was 4.80 ± 0.85, specifically, 'knowledge and skill' (5.04 ± 0.78), 'assurance' (5.01 ± 0.79), 'respect' (4.85 ± 0.90), and 'connectedness' (4.04 ± 0.99), respectively. The experience of caring was trapped in the uncomfortable reality of left ventricular assist device nursing, causing device-focused care, and approaching the essence of nursing through care focused on the patient's wholeness. CONCLUSIONS Caring for patients with a left ventricular assist devices was challenging for nurses. However, through the care process, they realised the meaning of patient-centred care, reflected in the essence of nursing, and sublimated it into an opportunity to grow. IMPLICATIONS FOR CLINICAL PRACTICE Nurses must focus on patient-centred care for left ventricular assist devices. To achieve this, it is essential to create a clinical environment and educational system for nurses to provide effective nursing care and enhance patient participation.
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Affiliation(s)
- Hye Jin Yoo
- College of Nursing, Dankook University, Cheonan, South Korea
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Jiang J, Liu Y, Chi C, Wang L, Liu Y, Liu S, Dai Z, Zeng L, Shi Y. Newly graduated registered nurses' experiences of the pre-service safety training program: A qualitative study. Nurse Education Today 2024; 137:106165. [PMID: 38522255 DOI: 10.1016/j.nedt.2024.106165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/23/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patient safety is a top priority for the global healthcare system and a prerequisite for high-quality nursing care. In China, newly graduated registered nurses are required to receive two years of standardized training to ensure patient safety. The pre-service safety training program aims to provide safe, high-quality, and effective nursing care. However, perceptions and experiences of newly graduated registered nurses on pre-service safety training programs have not yet been explored. OBJECTIVES To investigate newly graduated registered nurses' perceptions and experiences of the pre-service safety training program in a tertiary hospital in China. DESIGN A phenomenological approach was used for this qualitative study. SETTINGS Tertiary hospital in Shanghai, China. PARTICIPANTS A total of 19 newly graduated registered nurses who participated in the pre-service safety training program. METHODS Data were collected using semi-structured, face-to-face, in-depth interviews and analyzed using the Colaizzi seven-step framework. RESULTS Three themes and nine sub-themes emerged: (1) satisfaction with the approaches and content of the training, (2) gaining benefits and growth, and (3) suggestions for the training. CONCLUSION It is meaningful for newly graduated registered nurses to receive safety training before entering clinical practice and was praised by participants for helping them improve safety competence and change safety behaviors. Continuing safety training and optimizing the training modules and evaluation methods will maximize the effectiveness of safety training.
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Affiliation(s)
- Jinxia Jiang
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Yue Liu
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Chunwei Chi
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Li Wang
- Nursing Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Yi Liu
- Department of Rehabilitation Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Shuyang Liu
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Zhenjuan Dai
- Emergency department, Song Jiang District Central Hospital, Shanghai 201699, China
| | - Li Zeng
- Nursing Department, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China.
| | - Yan Shi
- Nursing Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China.
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Rodríguez-Ramallo H, Báez-Gutiérrez N, Villalba-Moreno Á, Jaramillo Ruiz D, Santos-Ramos B, Prado-Mel E, Sanchez-Fidalgo S. Reducing the drug burden of sedative and anticholinergic medications in older adults: a scoping review of explicit decision criteria. Arch Gerontol Geriatr 2024; 121:105365. [PMID: 38364710 DOI: 10.1016/j.archger.2024.105365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/27/2024] [Accepted: 02/04/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To describe the extent, characteristics, and knowledge gaps regarding explicit decision criteria for deprescribing drugs with anticholinergic or sedative properties (Ach/Sed) in older adults. DESIGN Scoping review. SETTING AND PARTICIPANTS Original studies, clinical trial protocols, grey literature, and Summaries of Product Characteristics. METHODS Searches targeting explicit decision criteria for deprescribing Ach/Sed were performed across MEDLINE, EMBASE, CINAHL, and Web of Science, including trial registries (clinicaltrials.gov, ICTRP, EU-CTR, ANZCTR) for pertinent articles, study protocols. Additionally, to encompass non-traditional or 'grey literature' sources, Google searches and relevant agency websites were explored, alongside the summary of product characteristics for Ach/Sed. RESULTS The initial literature search identified 8,192 unique data sources. After review, 188 original articles or books, 79 internet sources, and 127 SmPCs were included. Examining these sources for explicit criteria for 154 Ach/Sed, overall, 1,271 explicit criteria guidance for identifying clinical scenarios warranting deprescription of Ach/Sed across 145/154 Ach/Sed were identified. These criteria were identified mainly from qualitative research and Summaries of Product Characteristics. Additionally, 455 criteria-based recommendations suggesting approaches for tapering implementation across 76/154 Ach/Sed were identified, mostly from sources classified as expert opinions. Significant heterogeneity was found across the approaches for tapering Ach/Sed. CONCLUSIONS This scoping review provides a comprehensive overview of the literature providing guidance for clinical scenarios where Ach/Sed should be deprescribed and highlights the existing knowledge gaps regarding comprehensive guidance on tapering these drugs which warranties future research and development.
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Affiliation(s)
- Hector Rodríguez-Ramallo
- Pharmacy Department, Virgen del Rocío University Hospital, Seville, Spain; Clinical Unit of Pneumology and Thoracic Surgery, Institute of Biomedicine of Seville, Hospital Universitario Virgen del Rocío/CSIC/University of Seville, Seville, Spain
| | | | | | - Didiana Jaramillo Ruiz
- Pharmacy Department, Virgen del Rocío University Hospital, Seville, Spain; Andalusian Public Foundation for Health Research Management of Seville, Seville, Spain
| | | | - Elena Prado-Mel
- Pharmacy Department, Virgen del Rocío University Hospital, Seville, Spain
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Fasting A, Hetlevik I, Mjølstad BP. Put on the sidelines of palliative care: a qualitative study of important barriers to GPs' participation in palliative care and guideline implementation in Norway. Scand J Prim Health Care 2024; 42:254-265. [PMID: 38289262 PMCID: PMC11003325 DOI: 10.1080/02813432.2024.2306241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/11/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Demographic changes, the evolvement of modern medicine and new treatments for severe diseases, increase the need for palliative care services. Palliative care includes all patients with life-limiting conditions, irrespective of diagnosis. In Norway, palliative care rests on a decentralised model where patient care can be delivered close to the patient's home, and the Norwegian guideline for palliative care describes a model of care resting on extensive collaboration. Previous research suggests that this guideline is not well implemented among general practitioners (GPs). In this study, we aim to investigate barriers to GPs' participation in palliative care and implementation of the guideline. METHODS We interviewed 25 GPs in four focus groups guided by a semi-structured interview guide. The interviews were recorded and transcribed verbatim. Data were analysed qualitatively with reflexive thematic analysis. RESULTS We identified four main themes as barriers to GPs' participation in palliative care and to implementation of the guideline: (1) different established local cultures and practices of palliative care, (2) discontinuity of the GP-patient relationship, (3) unclear clinical handover and information gaps and (4) a mismatch between the guideline and everyday general practice. CONCLUSION Significant structural and individual barriers to GPs' participation in palliative care exist, which hamper the implementation of the guideline. GPs should be involved as stakeholders when guidelines involving them are created. Introduction of new professionals in primary care needs to be actively managed to avoid inappropriate collaborative practices. Continuity of the GP-patient relationship must be maintained throughout severe illness and at end-of-life.
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Affiliation(s)
- Anne Fasting
- General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Unit for Palliative Care and Chemotherapy Treatment, Oncology Department, Møre og Romsdal Hospital Trust, Kristiansund Hospital, Norway
| | - Irene Hetlevik
- General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bente Prytz Mjølstad
- General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Saksvik legekontor, Saxe Viks veg 4, N-7562 Hundhammeren, Norway
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Buchanan K, Ross C, Bloxsome D, Hocking J, Bayes S. Development of a Midwifery Student Peer Debriefing Tool: An interpretive descriptive study. Nurse Education Today 2024; 137:106167. [PMID: 38513304 DOI: 10.1016/j.nedt.2024.106167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Psychosocial traumatisation associated with giving birth, can occur in those present with the woman giving birth, a phenomenon known as vicarious trauma. It has been identified that there are currently no interventions available for midwifery students who have experienced vicarious trauma following difficult birth experiences. OBJECTIVE To explore whether the counselling intervention developed by Gamble et al. (2005), can be adapted for midwifery students to be appropriately and feasibly used as a counselling intervention with peers who have experienced midwifery practice-related vicarious trauma. DESIGN Interpretive descriptive methodology. SETTING This study was set at two Australian universities from which pre-registration midwifery courses are delivered. PARTICIPANTS The work of reviewing the original tool and adapting it for use by and with midwifery students associated with this project was conducted by a key stakeholder group of seven representative midwifery students and five midwifery academics. METHODS Ethics were approved. Data were collected via one face to face and two online conversations using the Microsoft Teams™ platform. Reflexive Thematic analysis were applied to revise the tool following each round of data collection and to finalise the adaptation of the intervention for its new intended purpose. RESULTS The Midwifery Student Peer Debriefing Tool is presented as a six-step intervention that guides the midwifery student through a process of debriefing with their peer. The feasibility of the tool resulted in an overarching theme labelled "I want this to mean something" and captures the therapeutic power of peer debriefing toward a meaningful outcome that fostered growth, and a deeper understanding of the profession. CONCLUSION Vicarious trauma is widely recognised as a core reason for midwives and midwifery students leaving the workforce. The peer debriefing tool helps midwifery students move through the process of recovering from adversity but also fostered learnings about midwifery practice and the profession.
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Affiliation(s)
- Kate Buchanan
- Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027, Australia; Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, Western Australia 6150, Australia.
| | - Carolyn Ross
- Australian Catholic University, 8 - 14 Brunswick St, Fitzroy VIC 3065, Australia.
| | - Dianne Bloxsome
- Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027, Australia.
| | - Jen Hocking
- Australian Catholic University, 8 - 14 Brunswick St, Fitzroy VIC 3065, Australia.
| | - Sara Bayes
- Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027, Australia; Australian Catholic University, 8 - 14 Brunswick St, Fitzroy VIC 3065, Australia; Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, Western Australia 6150, Australia.
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Lorenc T, Stokes G, Fulbright H, Sutcliffe K, Sowden A. Communicating cardiovascular risk: Systematic review of qualitative evidence. Patient Educ Couns 2024; 123:108231. [PMID: 38471312 DOI: 10.1016/j.pec.2024.108231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Cardiovascular risk prediction models are widely used to help individuals understand risk and make decisions. METHODS Systematic review of qualitative evidence. We searched MEDLINE, Embase, PsycINFO and CINAHL. We included English-language qualitative studies on the communication of cardiovascular risk. We assessed study quality using Hawker et al.'s tool and synthesised data thematically. RESULTS Thirty-seven studies were included. Many patients think that risk scores are of limited practical value. Other sources of information feed into informal estimates of risk, which may lead patients to reject the results of clinical risk assessment when the two conflict. Clinicians identify a number of barriers to risk communication, including patients' limited understanding of risk and excessive anxiety. They use a range of strategies for adapting risk communication. Both clinicians and individuals express specific preferences for risk communication formats. DISCUSSION Ways of communicating risk that provide some comparison or reference point seem more promising. The broader context of communication around risk may be more important than the risk scoring instrument. Risk communication interventions, in practice, may be more about appeals to emotion than a rationalistic model of decision-making.
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Affiliation(s)
- Theo Lorenc
- Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK.
| | - Gillian Stokes
- EPPI-Centre, Social Science Research Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - Helen Fulbright
- Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK
| | - Katy Sutcliffe
- EPPI-Centre, Social Science Research Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - Amanda Sowden
- Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK
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Chen KX, Pai MC, Hong WP, Wang CJ, Wang JJ. Exploring nurses' difficulties and strategies when caring for patients with dementia in a neurological ward. Nurs Health Sci 2024; 26:e13119. [PMID: 38626947 DOI: 10.1111/nhs.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/29/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
Nurses in neurological wards face numerous challenges when caring for patients with dementia, particularly those who also present other acute illnesses. However, studies focusing on this area are limited. This study aimed to explore the difficulties and strategies in caring for patients with dementia among nurses working in a neurological ward. A qualitative descriptive design was adopted. Twelve nurses from a neurology ward participated in individual semi-structured interviews. The data collected through these interviews were subjected to qualitative content analysis. Two main themes emerged from the analysis: (i) various shortcomings and concerns, which include subthemes: insufficient support, worry about patient safety, inadequate care ability of the caregiver, and insufficient self-competence, and (ii) unique clinical strategies, which include subthemes: cooperate with the caregiver, improve self-competence in dementia care, and employ meticulous resorts. The findings highlighted the nurses' dedication to minimizing patient risks and utilizing available resources as well as stakeholders to provide optimal care. To enhance patient care quality, it is essential to support nurses by addressing care-related barriers, offering continuous education, and establishing care pathways.
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Affiliation(s)
- Ko-Xin Chen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Min-Chi Pai
- Division of Behavioral Neurology, Department of Neurology, National Cheng Kung University Hospital, Tainan City, Taiwan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Wei-Pin Hong
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chi-Jane Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Jing-Jy Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Cypress B, Gharzeddine R, Rosemary Fu M, Ransom M, Villarente F, Pitman C. Healthcare professionals perspective of the facilitators and barriers to family engagement during patient-and-family-centered-care interdisciplinary rounds in intensive care unit: A qualitative exploratory study. Intensive Crit Care Nurs 2024; 82:103636. [PMID: 38301418 DOI: 10.1016/j.iccn.2024.103636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES Family engagement in care for critically ill patients remains an inconsistent practice and an understudied area of nursing science. Rounds for this study is an interdisciplinary activity conducted at the bedside in partnership with patients, their families, and the health care professionals involved in providing the care. We sought to explore and describe the facilitators and barriers to family engagement during patient and family-centered interdisciplinary rounds in the intensive care unit. RESEARCH METHODOLOGY/DESIGN This qualitative exploratory study is part of a multisite experimental study (#Pro2020001614; NCT05449990). We analyzed the narrative data from the qualitative questions added in the survey from 52 healthcare professionals involved in a multisite experimental study using Braun and Clarke's (2006) constructionist, contextualist approach to thematic analysis. SETTING The study was conducted in the intensive care unit of two medical centers. MAIN OUTCOME MEASURES The findings presented are themes illuminated from thematic analysis namely communication gaps, family's lack of resources, familial and healthcare providers' characteristics, lack of leadership, interprofessional support, policy, and guidelines. FINDINGS Family engagement in critical care during interdisciplinary rounds occurred within the intersectionality among families, healthcare professionals' practice, and organizational factors. The facilitators for family engagement include supported, championed, and advocated-for family adaptation, teams, and professional practice, and organizational receptivity, and support. Communication and leadership are the precursors to family engagement. CONCLUSIONS The findings added new knowledge for exploring the nature and scope of family engagement in critical care. Family engagement must be incorporated into the organizational vision and mission, and healthcare delivery systems. IMPLICATIONS FOR CLINICAL PRACTICE There is a need to further investigate the resources, organizational support mechanisms, and systems that affect patients, families, and healthcare professionals, and the establishment of policies that will aid in reducing barriers to family engagement in the intensive care unit.
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Vázquez Canales LDM, Pereiró Berenguer I, Aguilar García-Iturrospe E, Rodríguez C. Dealing with fibromyalgia in the family context: a qualitative description study. Scand J Prim Health Care 2024; 42:327-337. [PMID: 38445639 PMCID: PMC11003319 DOI: 10.1080/02813432.2024.2322103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/14/2024] [Indexed: 03/07/2024] Open
Abstract
Headings purpose: Fibromyalgia (FM) is a chronic, nondegenerative disease with important limitations in patients. Its average global prevalence is 1.78%, and women are more affected than men (3:1). Due to the lack of objective diagnostic tools, it is a complex medical condition that is frequently unseen by patients' relatives and doctors, which might nonetheless have a noticeable impact on the patient's entourage. Material and Methods: This qualitative descriptive study aimed to elicit family members' views on how FM affects their lives. It was conducted in two community health centers (one rural and one urban) from the Sagunto Health Department (Valencia Community, Spain). We included seven focus groups with 41 family members. We analyzed the data gathered with an inductive thematic semantic analysis approach using NVivo 12 software. Results: We identified four major themes: (1) fibromyalgia as a nosological entity or an invention that is always burdensome; (2) children and spouses as caregivers (or not); (3) adverse effects of fibromyalgia on the couple's sexual life; and (4) harmful consequences of FM on the family economy. The findings showed a negative impact of the disease within the family context. Family members face complex and changing roles and difficulties when living with women with fibromyalgia. Conclusions: Relatives' better understanding of the disease, greater acceptance of new family roles, and improvement of patients' work conditions are all interventions that may help reduce the negative impact of FM in the family context.
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Affiliation(s)
- Luz de Myotanh Vázquez Canales
- Primary Care Center Serreria, Community Health Center Serrería 1, Valencia, Spain
- INCLIVA Primary Care Research Group, Valencia, Spain
| | | | - Eduardo Aguilar García-Iturrospe
- Hospital Clínico de Valencia, Valencia, Spain
- Research Foundation Hospital Clínico de Valencia, INCLIVA, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBERSAM, ISCIII: Spanish National Network for Research in Mental Health, Madrid, Spain
| | - Charo Rodríguez
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
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