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Cambra-Rufino L, Müller AE, Parra Casado M, Pedraz Marcos A. [Impact of hospital architecture on the birthing experience: a phenomenological study with mothers-to-be who are design experts]. An Sist Sanit Navar 2024; 47:e1059. [PMID: 38349143 PMCID: PMC11066952 DOI: 10.23938/assn.1059] [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: 06/20/2023] [Revised: 08/07/2023] [Accepted: 11/02/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND The birthplace has a crucial role in shaping the childbirth experience and mothers' satisfaction levels. This study aimed to identify the experiences and perceptions that may have an impact in the long-term on mothers' birthing experience, considering hospital design features in the birthing environment until discharge. METHODS Inductive thematic analysis of twenty-five hospital labor testimonies employing a phenomenological research approach and utilizing a biographical method. Participants were women with a professional background in architecture, landscape architecture, engineering, or interior design. RESULTS The results are organized into four themes and seven subthemes. The first theme is "First sight and long term impression" which is subdivided into the subthemes "Depersonalized itinerary in entrances and corridors" and "Instinctive search for connection with nature". The second theme deals with "Accompaniment and tucking in during the birthing process", subdivided into "Hotel-like: space for movement and personalized adaptation" and "Helplessness, cold and uncertainty: spaces to be against one's will". The third theme is "Damage in collateral rooms", which includes "The integration of toilets in the birthing process", "Operating rooms unchangeable in the face of cesarean delivery" and "Neonatal units that do not integrate families". Finally, the fourth theme includes "Improvement proposals for new designs". CONCLUSIONS This study contributes to the existing literature by deepening the understanding of the design features identified in hospitals in recent studies. Further research incorporating the experiences of women in the birthing process is needed to facilitate evidence-based design policies.
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Affiliation(s)
- Laura Cambra-Rufino
- Universidad Politécnica de Madrid. Escuela Técnica Superior de Arquitectura. Departamento de Construcción y Tecnologías Arquitectónicas. Madrid. España.
| | | | | | - Azucena Pedraz Marcos
- Instituto de Salud Carlos III. Unidad de investigación en cuidados y servicios de salud (Investén). Madrid. España..
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da Silva JB, Henriques NL, Rigo FL, Guerreiro GMCD, Fernandes SJD, Duarte ED. The child's experience of becoming ill with COVID-19. Rev Esc Enferm USP 2024; 57:e20230165. [PMID: 38315804 PMCID: PMC10849679 DOI: 10.1590/1980-220x-reeusp-2023-0165en] [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: 05/30/2023] [Accepted: 11/01/2023] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE To understand the experience of children when they become ill with COVID-19. METHOD Qualitative-descriptive and exploratory study, guided by the World Health Organization's concept of Quality of Life. Twenty-four children participated, aged between seven and nine years, 11 months and 29 days, diagnosed with COVID-19. Data were collected through semi-structured interviews and underwent deductive thematic analysis. RESULTS The children understood what COVID-19 is, its high lethality and transmissibility, and its forms of contagion and prevention. COVID-19 has been identified as something negative. The experience of children becoming ill with COVID-19 was permeated by changes in their routines, especially due to having activities limited to the home, emotional changes, and physical symptoms due to infection with the virus. CONCLUSION The children understood the seriousness of the pandemic and identified the changes that had occurred. They also expressed understanding about the disease and its control. Knowing children's experience of illness can guide care actions aimed at them, recognizing that children's adequate understanding of what they experience can contribute to coping with illness and their participation in control actions.
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Affiliation(s)
- Juliana Barony da Silva
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Nayara Luiza Henriques
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Felipe Leonardo Rigo
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | | | - Sérgio Joaquim Deodato Fernandes
- Universidade Católica Portuguesa, Faculdade de Ciências da Saúde e Enfermagem, Centro de Investigação Interdisciplinar em Saúde, Lisboa, Portugal
| | - Elysangela Dittz Duarte
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-infantil e Saúde Pública, Belo Horizonte, MG, Brazil
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Gonçalves H, Soares ALG, Domingues MR, Bertoldi AD, Santos MGD, Silveira MFD, Coll CDVN. Why are pregnant women physically inactive? A qualitative study on the beliefs and perceptions about physical activity during pregnancy. CAD SAUDE PUBLICA 2024; 40:e00097323. [PMID: 38198382 PMCID: PMC10775962 DOI: 10.1590/0102-311xen097323] [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: 05/26/2023] [Revised: 08/25/2023] [Accepted: 09/29/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to describe the beliefs and perceptions of pregnant women and healthcare providers about physical activity during pregnancy. Using a qualitative approach, 30 pregnant women and the 14 healthcare providers caring for them were interviewed in the second trimester of pregnancy. We included women who maintained, decreased, or stopped physical activity since becoming pregnant. They were divided into low (≤ 8 years) and high schooling (> 8 years). Semi-structured, in-depth interviews were conducted and guided by three key questions: (1) When does physical activity during pregnancy start to be considered a wrong behavior?; (2) What are the main barriers (biological or others) to physical activity?; and (3) Do the actions of healthcare providers and people close to pregnant women reinforce barriers? Interviews were audio recorded, transcribed, and analyzed based on recurring themes. All women changed their physical activity behavior (decreased or stopped) when they discovered their pregnancy. Fear of miscarriage, contractions, bleeding, and of causing malformations in the baby were the most reported reasons for decreasing or stopping physical activity. Participants also lacked access to consistent information and healthcare providers' support on the benefits of physical activity. Despite the current international recommendations to regular physical activity during pregnancy, uncertainty regarding its benefits remains. Interventions to promote physical activity during this period should include the training of healthcare providers so they can advise and discard ideas contrary to mother-child health benefits.
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Villanueva Borbolla MÁ, Pernia A, Campos Rivera M. Determinación social de la obesidad, la diabetes y la hipertensión arterial desde las narrativas de mujeres de una comunidad indígena en el sur de Morelos, México. Glob Health Promot 2023:17579759231211232. [PMID: 38050380 DOI: 10.1177/17579759231211232] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
OBJETIVO comprender los procesos críticos (PC) de determinación social de la obesidad, la diabetes y la hipertensión (ODH) en una comunidad nahua de México. METODOLOGÍA estudio cualitativo de registros de un taller de fotovoz, donde las participantes fotografiaron su entorno y analizaron las causas y posibles soluciones a la ODH. Para analizar los PC de la ODH utilizamos como método la investigación narrativa y, como referente teórico, la epidemiología crítica. RESULTADOS la ODH se reproduce social e históricamente a través de PC destructivos vinculados con las relaciones de producción global y de género. Estas determinan modos de vida deteriorantes que limitan la atención a la salud, comprometen la salud mental, producen contaminación y diferenciación de uso de espacios, y reducen oportunidades para alimentarse nutritivamente y realizar actividad física. Todo ello se expresa como ODH y problemas de salud mental. Los PC protectores ante estas expresiones incluyen la atención estatal, las oportunidades de trabajo, y la promoción de dispositivos culturales y comunitarios. CONCLUSIONES nuestros resultados aportan a la discusión global sobre cómo las condiciones históricas de vida son parte de la determinación social de la ODH. Comprender los PC y sus expresiones locales puede orientarnos hacia la descolonización de la forma de pensar y hacer promoción de la salud.
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Affiliation(s)
| | - Agustín Pernia
- Universidad Autónoma Metropolitana, División de Ciencias Biológicas y de la Salud, Coyoacán, Ciudad de México, México
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Mendes LMC, da Silva AS, Barbosa NG, Cardoso LDF, de Andrade RF, Gomes-Sponholz FA. Representations of COVID-19: the pandemic in the context of international commuting migration from mining. Rev Esc Enferm USP 2023; 57:e20220382. [PMID: 37992302 PMCID: PMC10665081 DOI: 10.1590/1980-220x-reeusp-2022-0382en] [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: 10/03/2022] [Accepted: 09/16/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVE To analyze the conceptions about COVID-19 among Brazilians who carry out commuting to work in clandestine mines located on the borders between Brazil, French Guiana and Suriname. METHOD This is qualitative research, from an analytical perspective, based on Social Representation Theory. Semi-structured, audio-recorded interviews were carried out with 10 Brazilians who experience work routine in clandestine mining on the border between Brazil, French Guiana and Suriname. RESULTS Two analytical categories emerged: "The disease of otherness"; and "Health access dimension". CONCLUSION Disease severity was attributed to another or a human body organ, and not to individuals as a whole. Access to health services was established on issues of inequity, violence and illegal practices. The nature of a transient population, which carries out commuting and informal and clandestine work, demonstrates vulnerability to COVID-19 and a lower propensity to receive care.
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Affiliation(s)
- Lise Maria Carvalho Mendes
- Universidade de São Paulo, Programa de Pós-Graduação em Enfermagem em Saúde Pública, Ribeirão Preto, SP, Brazil
| | | | - Nayara Gonçalves Barbosa
- Universidade Federal de Juiz de Fora, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Juiz de Fora, MG, Brazil
| | - Larissa de Freitas Cardoso
- Universidade de São Paulo, Programa de Pós-Graduação em Enfermagem em Saúde Pública, Ribeirão Preto, SP, Brazil
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Barreto MDS, Marques FRDM, Gallo AM, Garcia-Vivar C, Carreira L, Salci MA. Striking a new balance: A qualitative study of how family life has been affected by COVID-19. Rev Lat Am Enfermagem 2023; 31:e4043. [PMID: 37937598 PMCID: PMC10631297 DOI: 10.1590/1518-8345.6705.4043] [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: 02/06/2023] [Accepted: 08/07/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVE to examine the repercussions of the pandemic on the family system by focusing on the perspective of family members who contracted and experienced COVID-19. METHOD an exploratory study with a qualitative approach conducted with 27 individuals who had COVID-19. Data collection took place through telephone interviews that were audio-recorded and guided by a semi-structured instrument. Data analysis was based on an inductive process supported by Reflexive Thematic Analysis. RESULTS the pandemic and illness of a family member acted as driving forces generating new and intense movements in the family system. Initially, they noticed negative repercussions such as concerns, fear, anguish, stress, distancing and social isolation. As time progressed and by using technologies to ease communication, they began to perceive positive repercussions such as increased proximity, strengthening of ties, development of new roles and care. The families also identified recovery of a balanced position, with return of certain readjustment in family dynamics and functioning. CONCLUSION health professionals need to recognize that the COVID-19 disease has imposed repercussions on family systems, proposing interventions that help families face this moment and more easily recover a balanced position for their functioning.
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Affiliation(s)
| | - Francielle Renata Danielli Martins Marques
- Universidade Estadual de Maringá, Departamento de Enfermagem, Maringá, PR, Brasil
- Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Adriana Martins Gallo
- Universidade Estadual de Maringá, Departamento de Enfermagem, Maringá, PR, Brasil
- Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Cristina Garcia-Vivar
- Universidad Pública de Navarra, Departamento de Ciencias de la Salud, Pamplona, NA, España
| | - Lígia Carreira
- Universidade Estadual de Maringá, Departamento de Enfermagem, Maringá, PR, Brasil
- Bolsista do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasil
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Padrón GJ, Flores YYR. Perspectives and practices of personnel involved in family planning with women at reproductive risk. Rev Esc Enferm USP 2023; 57:e20230001. [PMID: 37930234 PMCID: PMC10631745 DOI: 10.1590/1980-220x-reeusp-2023-0001en] [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: 01/23/2023] [Accepted: 07/20/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE To analyze the perspectives and practices of personnel involved in family planning with women at reproductive risk due to chronic diseases. METHOD Qualitative study in which physicians and nurses from primary care centers in a state in central Mexico were interviewed. Interviews were transcribed and analyzed under the Grounded Theory proposal. RESULTS The perspectives and practices in family planning interventions are unilaterally framed in the biomedical model. Three categories of analysis emerged: "The battle", "Convince by imposing", "Monitor them and catch them". CONCLUSION It is necessary to promote competencies in interculturality, gender perspective and human rights to make the intervention more of a counseling and less of a prescription for life projects.
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Affiliation(s)
| | - Yesica Yolanda Rangel Flores
- Universidad Autónoma de San Luis Potosí, Facultad de Enfermería y Nutrición. Maestría en Salud Pública, San Luis Potosí, México
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de Souza DM, Fernandes RDF, Costa CTDS, Borghi CA, Rossato LM. From theory to practice: the inclusion of hospitalized children's families in painful procedures. Rev Esc Enferm USP 2023; 57:e20230152. [PMID: 37624383 PMCID: PMC10453425 DOI: 10.1590/1980-220x-reeusp-2023-0152en] [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: 05/23/2023] [Accepted: 06/29/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE To understand nursing team professionals' strategies to include the family in painful procedures performed on hospitalized children. METHOD An exploratory-descriptive, qualitative study, carried out with nursing professionals. Data were collected through semi-structured interviews, guided by a script of topics, transcribed and submitted to thematic content analysis, in the light of Symbolic Interactionism, discussed considering the Family-Centered Care philosophy assumptions. RESULTS Two central categories emerged, "Theoretical perspective: the family as a care agent in painful procedures" and "Practical perspective: experiences, challenges and strategies in painful procedures for family inclusion", with their respective subcategories. CONCLUSION Nursing professionals have theoretical knowledge about family inclusion in painful procedures based on the assumptions: Family-Centered Care: dignity and respect; information sharing; joint participation; and family collaboration. However, knowledge is not applied in clinical practice; consequence of the interaction between beliefs and attitudes unfavorable to family presence.
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Affiliation(s)
- Danton Matheus de Souza
- Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, São Paulo, SP, Brazil
| | | | | | | | - Lisabelle Mariano Rossato
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brazil
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Gurgel RB, Silva JLPD, Monteiro EMLM, da Silva SL, Lima TRDME, Coriolano-Marinus MWDL. Parenting of mothers of children in early childhood during the COVID-19 pandemic: qualitative research. Rev Bras Enferm 2023; 76Suppl 1:e20220478. [PMID: 37531482 PMCID: PMC10389648 DOI: 10.1590/0034-7167-2022-0478] [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: 09/23/2022] [Accepted: 02/06/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES to understand practices of mothers of children in early childhood who live in contexts of poverty in the face of the COVID-19 pandemic. METHODS an exploratory, descriptive and qualitative study. Participants were selected in the community context, composing an intentional sample to be collected through semi-structured online interviews. Data were analyzed inductively and anchored in the Bioecological Model of Human Development. RESULTS eight mothers participated in the research. Mothers highlighted pleasure in taking care of their children, although they were overloaded with activities and comprehensive care at the time of the pandemic. Children, in mothers' perception, showed a higher frequency of challenging behaviors, which may be related to negative parenting practices, such as punishment and physical violence. FINAL CONSIDERATIONS interventions to support parenting become urgent in the face of changes brought about by the COVID-19 pandemic in families living in a context of poverty.
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Affiliation(s)
| | | | | | - Suzana Lins da Silva
- Instituto de Medicina Integral Professor Fernando Figueira. Recife, Pernambuco, Brazil
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Kramar MJF, García-Caro MP, Ternero AM, Martí-García C. Migrant women caregivers' experiences in end-of-life formal care. Rev Esc Enferm USP 2023; 57:e20230031. [PMID: 37552833 PMCID: PMC10414973 DOI: 10.1590/1980-220x-reeusp-2023-0031en] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/27/2023] [Accepted: 06/01/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE To describe and understand the experience of Latin American migrant women as caregivers of elderly people in situations of advanced illness and end of life. METHOD Qualitative study using Gadamer's hermeneutic phenomenology. Data were collected in 2019 through 9 semi-structured interviews with Latin American women caregivers, who had cared for people at the end of life, in the Province of Granada (Spain). RESULTS Two themes emerged: "Migrant caregiver at the end of life" and "And now, what should I do?": the impact of the loss at the economic, emotional and labor level. CONCLUSION Care during the end of life of the cared person generates an additional overload to the situation of migrant women. The experience of this stage is related to the bond with the persons cared and their families, which may affect the development of complicated grief and personal problems related to the loss of employment and the absence of economic support.
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Affiliation(s)
| | - María Paz García-Caro
- Universidad de Granada, Facultad de Ciencias de la Salud, Departamento de Enfermería, Granada, España
| | | | - Celia Martí-García
- Universidad de Málaga, Facultad de Ciencias de la Salud, Departamento de Enfermería, Málaga, España
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Henriques NL, Silva JBD, Charepe ZB, Braga PP, Duarte ED. Factors that promote and threaten Hope in caregivers of children with chronic conditions. Rev Lat Am Enfermagem 2023; 31:e3896. [PMID: 37194892 PMCID: PMC10202231 DOI: 10.1590/1518-8345.6366.3896] [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: 07/04/2022] [Accepted: 11/26/2022] [Indexed: 05/18/2023] Open
Abstract
to identify the factors that promote and threaten Hope in family caregivers of 2- to 3-year-old children with chronic conditions. qualitative study with 46 family caregivers of children between 2 and 3 years old with a chronic condition, discharged from two Neonatal Intensive Care Units. Data was collected through semi-structured interviews guided by the Model for Intervention in Mutual Help Promoter of Hope. Data were submitted to deductive thematic analysis. the following were identified as factors that promote Hope: The experience shared with members of the social support network; The relationship with the child; Clinical improvement of the child; Spirituality; Positive guidance for the future. The following were identified as factors that threaten Hope: Conflictual relationships and discredit of the child by close people; Uncertainties about the future; Insecurities about the ability to care for the child. the threatening factors of Hope generated suffering, pain, anguish, anxiety, and loneliness in caregivers. The promoting factors of Hope generated comfort, motivation, strength and joy. The findings allow Nurses to recognize the strengths and weaknesses of caregivers and adopt behaviors that promote Hope in caregivers of children with chronic conditions.
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Affiliation(s)
| | - Juliana Barony da Silva
- Universidade Federal de Minas Gerais, Grupo de Estudos sobre o Recém-nascido, Criança, Adolescentes e suas Famílias (RECRIA). Belo Horizonte, MG, Brasil
| | | | - Patrícia Pinto Braga
- Universidade Federal de São João del-Rei, Faculdade de Enfermagem. Belo Horizonte, MG, Brasil
| | - Elysângela Dittz Duarte
- Universidade Federal de São João del-Rei, Núcleo de Estudos sobre Criança e Adolescente (NECA). Divinópolis, MG, Brasil
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Orlando-Romero L, Vives-Vergara A, Valdebenito R, Cortinez-O'Ryan A, Baeza F, Rasse A. ["My life will be much better than before": a qualitative study on the relationship between renewal of public housing, quality of life, and health]. CAD SAUDE PUBLICA 2023; 39:e00149822. [PMID: 37162114 PMCID: PMC10549979 DOI: 10.1590/0102-311xes149822] [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: 08/23/2022] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 05/11/2023] Open
Abstract
The objective was to understand the link between housing, health and quality of life in a context of social housing regeneration, through the experiences and perceptions of its inhabitants, exploring the mechanisms that sustain this link before regeneration, and those elements derived from housing regeneration that result in improvements in quality of life and potentially in health. Between 1980 and the 2000s, Chile faced a massive quantitative housing deficit through a policy that delivered more than 120,000 low-cost social housing apartments. Today, thousands present severe habitability problems, generating negative consequences for their inhabitants, their health and well-being. Seeking to solve the deterioration of housing and neighborhoods, the Chilean Ministry of Housing and Urbanism developed the Housing Complex Regeneration Program. The RUCAS project seeks to evaluate the effects of the program on health and to assess the impact of interventions such as these on vulnerable populations in Latin America. We present results of 8 interviews and 2 focus groups conducted in a social housing complex in process of intervention in Viña del Mar. Using discursive content analysis, results show that the poor material quality of housing is perceived as harmful to health. Regenerated housing, on the other hand, promotes the recovery and re-appropriation of spaces and their uses, sociability, new healthy practices, positive feelings and psychological well-being, bringing to the fore the psychosocial component of people's relationship with their house. It is concluded that housing regeneration has the potential to benefit physical and mental health through both direct mechanisms, derived from the renovated materiality, and indirect mechanisms related to the practices and experiences of the lived space.
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Affiliation(s)
- Laura Orlando-Romero
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandra Vives-Vergara
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Desarrollo Urbano Sustentable, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roxana Valdebenito
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Fernando Baeza
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Instituto de Geografía, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandra Rasse
- Centro de Desarrollo Urbano Sustentable, Pontificia Universidad Católica de Chile, Santiago, Chile
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Alonso-Naranjo L, Berna-Rico E, Blanco Abbad-Jaime de Aragón C, Castañeda-Vozmediano R, Prieto-López L, Sánchez-Moya AI, Pérez-Hortet C, González-Cantero Á. Spanish Version of Teenagers’ Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation. Actas Dermosifiliogr 2023; 114:T299-T307. [PMID: 36868511 DOI: 10.1016/j.ad.2023.02.013] [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: 11/30/2022] [Accepted: 01/15/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS A prospective study with 133 patients (between 12-19 years old), attended at the dermatology department of Toledo University Hospital, Spain, (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The Confirmatory Factor Analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test-retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. CONCLUSION Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.
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Affiliation(s)
- L Alonso-Naranjo
- Departamento de Dermatología, Hospital Universitario de Toledo, Toledo, España
| | - E Berna-Rico
- Departamento de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España
| | | | | | - L Prieto-López
- Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España
| | - A I Sánchez-Moya
- Departamento de Dermatología, Hospital Universitario de Toledo, Toledo, España
| | - C Pérez-Hortet
- Departamento de Dermatología, Hospital Universitario de Toledo, Toledo, España
| | - Á González-Cantero
- Departamento de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España; Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España.
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14
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de Mattos CX, da Silva LF, Braga TRL, Bubadué RDM, Partelli ANM, Cabral IE. Family caregivers' itineraries of preschool children who survived leukemia: implications for primary healthcare nursing. Rev Bras Enferm 2023; 76:e20220193. [PMID: 36753256 PMCID: PMC9901353 DOI: 10.1590/0034-7167-2022-0193] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/01/2022] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVES to analyze the path taken by family caregivers of preschool children who survived leukemia and discuss the implications for primary healthcare nursing. METHODS the narrative interview guided by a talking map and body knowledge was used with family members of children who survived leukemia, living in Rio de Janeiro (capital) and São Paulo (countryside). Conversation analysis was applied to the data. RESULTS five family groups (seven people) of five children started their journey in the professional subsystem of private services; four were assisted in the private sector since the onset of the illness; one was assisted in public and private services. Living conditions reduced barriers to accessing supplementary health, facilitating coordination, and listening to a reference professional. FINAL CONSIDERATIONS the itinerary was marked by attentive listening to family caregivers by reference professionals, favoring early diagnosis, initiation of treatment, and resolution of leukemia with the cure of children.
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15
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Jerez Molina C, Lahuerta Valls L, Fernandez Villegas V, Santos Ruiz S. Nursing evaluation of pediatric preoperative anxiety: a qualitative study. Rev Lat Am Enfermagem 2023; 31:e3738. [PMID: 36888788 PMCID: PMC9991007 DOI: 10.1590/1518-8345.6230.3738] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 07/15/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE to explore and describe how perioperative nurses assess and interpret the child's behavior before entering the operating room, identifying the strategies they use to reduce anxiety and the proposals for improvements. METHOD descriptive qualitative study using semi-structured interviews and participant observation of daily routines. Thematic analysis of data. This study follows the recommended criteria for publication of articles of the qualitative methodology Consolidated Criteria for Reporting Qualitative Research. RESULTS four topics emerged from the data: a) assessment of anxiety or close communication with the child and their family; b) evaluating what was observed; c) managing anxiety and d) improving the assessment or proposals for improvements in daily practice. CONCLUSION nurses assess anxiety in their daily practice through observation using their clinical judgment. The nurse's experience is decisive for the appropriate assessment of the preoperative anxiety in child. Insufficient time between waiting and entering the operating room, lack of information from child and their parents about the surgical procedure, and parental anxiety make it difficult to assess and properly manage anxiety.
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Affiliation(s)
- Carmen Jerez Molina
- Campus Docent Sant Joan de Déu, School of Nursing, Barcelona, Spain.,Hospital Sant Joan de Déu, Nursing Department, Ambulatory Surgery, Barcelona, Spain
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16
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Wisnesky UD, Olson J, Paul P, Dahlke S. Older people's perceptions and experiences of older people with the Sit-to-stand activity: An ethnographic pre-feasibility study. Rev Lat Am Enfermagem 2023; 31:e3813. [PMID: 36722635 PMCID: PMC9886074 DOI: 10.1590/1518-8345.6128.3813] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/18/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE the purpose of this pre-feasibility study was to examine perceptions and experiences of a Sit-to-stand activity with urban Brazilian community-dwelling older people in their homes. METHOD the exploration method was focused ethnography. Purposive sampling was used to recruit 20 older people. Five means of data generation were used, namely: socio-demographic surveys, participant observations, informal interviews, formal semi-structured interviews, and field notes. Data analysis was qualitative content analysis. RESULTS the experience of mobility-challenged older people with the Sit-to-stand activity was dependent on their mobility expectations involving many factors that worked together to influence their beliefs and attitudes towards the activity, preferences, behaviors, and cultural perceptions. The participants of this study seemed to find the activity enjoyable; however, the most noticeable shortcomings for their engagement in the Sit-to-stand activity emerged as gaps in their personal and intrapersonal needs. CONCLUSION the recommendations generated from the study findings call for the design of implementation strategies for the Sit-to-stand intervention that are tailored to this particular population's needs.
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Affiliation(s)
- Uirá Duarte Wisnesky
- University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada., University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada., Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, Uirá Duarte Wisnesky E-mail:
| | - Joanne Olson
- University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada
| | - Pauline Paul
- University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada
| | - Sherry Dahlke
- University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada
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17
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Gill N, Chisholm L, Atchison J, Graham S, Hawkes G, Head L, McKiernan S. Scaling up qualitative research to harness the capacity of lay people in invasive plant management. Conserv Biol 2022; 36:e13929. [PMID: 35481684 PMCID: PMC10087763 DOI: 10.1111/cobi.13929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/21/2021] [Accepted: 04/15/2022] [Indexed: 04/13/2023]
Abstract
Successful management of invasive plants (IPs) requires the active participation of diverse communities across land tenures. This can be challenging because communities do not always share the views of scientists and managers. They may directly disagree, have alternative views, or be unwilling to manage IPs. Reviews of IP social science identify opportunities to better understand the role of cultural processes and everyday practices to address these challenges. To scale up and leverage the insights of existing qualitative social science IP research, we used meta-ethnography to unlock accounts and interpretations of lay perspectives. Meta-ethnography is a form of qualitative research synthesis increasingly used beyond its origins in health and education to produce interpretive syntheses of an area of research. In the 7 phases of meta-ethnography, we systematically identified and synthesized 19 qualitative articles pertinent to lay experience and knowledge of IPs in diverse settings. Action and meaning regarding IPs were influenced by 6 meta-themes in personal and social life: dissonance, priorities, difference, agency, responsibility, and future orientations. Through descriptions and examples of each meta-theme, we demonstrated how the meta-themes are higher level structuring concepts across the qualitative research that we analyzed and we retained grounding in the in-depth qualitative research. We characterized the meta-themes as leverage points and tensions by which we reframed lay people in terms of capacity for reflective IP management rather than as obstacles. The meta-ethnography synthesis shows how leverage points and tensions emerge from everyday life and can frame alternative and meaningful starting points for both research and public engagement and deliberation regarding IP management. These insights are not a panacea, but open up new space for reflective and mutual consideration of how to effectively navigate often complex IP problems and address conservation and social and livelihood issues in dynamic social and physical environments.
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Affiliation(s)
- Nicholas Gill
- School of Geography and Sustainable Communities, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Laurie Chisholm
- School of Earth, Atmospheric, and Life Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jennifer Atchison
- School of Geography and Sustainable Communities, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sonia Graham
- School of Geography and Sustainable Communities, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Gina Hawkes
- School of Geography and Sustainable Communities, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lesley Head
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, The University of Melbourne, Parkville, Victoria, Australia
| | - Shaun McKiernan
- School of Geography and Sustainable Communities, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
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18
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Arias Valencia MM. Principles, Scope, and Limitations of the Methodological Triangulation. Invest Educ Enferm 2022; 40:e03. [PMID: 36264691 PMCID: PMC9714985 DOI: 10.17533/udea.iee.v40n2e03] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This article sought to collect basic and relevant information about methodological triangulation and make a first approach to the principles underlying its use, potentiality and scope, advances and limitations, and some alternative proposals to surpass them. In that sense, it is an attempt to operationalize concepts and present the procedures to conduct it rigorously. In the first place, conceptual aspects and types of triangulation are presented, and in the second place, the principles, uses and difficulties. But, beyond what must be done, an approach is made to how to do it. The assumption underlying through the article is the complementarity among methods. It is emphasized in the principle through which the nature of objects must guide the selection of the methods and of the most effective techniques to approach and account for phenomena that are socially pertinent of being studied.
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19
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Backes DS, Gomes EB, Rangel RF, Rolim KMC, Arrusul LS, Abaid JLW. Meaning of the spiritual aspects of health care in pregnancy and childbirth. Rev Lat Am Enfermagem 2022; 30:e3774. [PMID: 36629729 PMCID: PMC9818247 DOI: 10.1590/1518-8345.5980.3774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/26/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE to know the importance of the spiritual aspects of health care during pregnancy and childbirth, in the light of complexity thinking. METHOD qualitative research, based on complexity thinking. Twenty-seven postpartum women with children between one month and six months old participated in the study. The data were collected between August and November 2021, based on individual interviews with guiding questions. Thematic analysis was used for data analysis. RESULTS three themes were obtained: The inseparability of spiritual care and emotional care; Connection between spirituality and the uterus - sacred temple; Alternative techniques for spiritual health care. CONCLUSION the spiritual aspect of health care during pregnancy and childbirth can be considered an essential resource in the support of autonomy, security, and comfort. In addition, it can enable favorable outcomes in childbirth by strengthening the maternal-fetal attachment.
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Affiliation(s)
- Dirce Stein Backes
- Universidade Franciscana, Saúde/Enfermagem, Santa Maria, RS, Brazil.,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
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20
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Leite ACAB, García-Vivar C, DeMontigny F, Nascimento LC. Waves of family hope: narratives of families in the context of pediatric chronic illness. Rev Lat Am Enfermagem 2021; 29:e3504. [PMID: 34816873 PMCID: PMC8616230 DOI: 10.1590/1518-8345.5515.3504] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/06/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze narratives about the experience of hope of families in the context of pediatric chronic illness. METHOD a narrative research using Family Systems Nursing as a conceptual framework. Three families of children and adolescents diagnosed with complex chronic illness participated in this study, totaling 10 participants. Data collection was developed using family photo-elicitation interviews. Family narratives were constructed and analyzed according to inductive thematic analysis with theoretical data triangulation. RESULTS the analytical theme - Waves of Family Hope in the Context of Pediatric Chronic Illness - is composed of four different types of hope: uncertain hope, caring hope, latent hope, and expectant hope. Movement through these hopes generates a driving energy and depends on a number of factors: support, information, searching for normality, and thoughts and comparisons. CONCLUSION the results highlight the interaction and reciprocities of the members of the family unit, and the dynamics of hope, and illustrate the different types of hope and the factors that influence them. This study highlights the experience of hope as a family resource rather than just an individual resource, and supports health professionals in the planning of family care considering hope as an essential and dynamic family resource.
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Affiliation(s)
- Ana Carolina Andrade Biaggi Leite
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal
de Nível Superior (CAPES), Brazil
| | - Cristina García-Vivar
- Universidad Pública de Navarra, Departamento de Ciencias de la
Salud, Pamplona, Navarra, Spain
| | - Francine DeMontigny
- Université du Québec en Outaouais, Department of Nursing, Gatineau,
Quebec, Canada
| | - Lucila Castanheira Nascimento
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
- Scholarship holder at the Conselho Nacional de Desenvolvimento
Científico e Tecnológico (CNPq), Brazil
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21
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Maxwell AM, Reay RE, Huber A, Hawkins E, Woolnough E, McMahon C. Parent and practitioner perspectives on Circle of Security Parenting (COS-P): A qualitative study. Infant Ment Health J 2021; 42:452-468. [PMID: 33852163 DOI: 10.1002/imhj.21916] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Circle of Security Parenting (COS-P) is an attachment-theory-informed program for parents of infants and young children. Designed for scalability, COS-P has been widely adopted internationally. Evidence for the program's effectiveness is limited, however, restricting capacity to make informed decisions about program allocation, and threatening ongoing program funding. To help address this evidence gap, this qualitative study explored the experiences and perceptions of 20 COS-P facilitators and 14 parent recipients in Australia, where COS-P uptake has been particularly widespread. Thematic analysis of combined interview and focus group data revealed a perception that COS-P primarily changes the lens through which parents view (a) their child, (b) themselves in the parenting role, and (c) the parent-child relationship, and that this was a pathway to increased empathy, compassion, and parenting confidence. Participants identified four components that underpinned program impact: key content, skills practice, group processes, and facilitator support. Although COS-P was considered suitable for broad application, limitations were noted. Findings can guide clinical application of COS-P and inform empirical research.
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Affiliation(s)
- Anne-Marie Maxwell
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Rebecca E Reay
- Academic Unit of Psychiatry and Addiction Medicine, ANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Anna Huber
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Erinn Hawkins
- Menzies Health Institute Queensland, School of Applied Psychology, Griffith University, Gold Coast, Queensland, Australia
| | - Erin Woolnough
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Catherine McMahon
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
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22
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Tseliou E, Burck C, Forbat L, Strong T, O'Reilly M. How is Systemic and Constructionist Therapy Change Process Narrated in Retrospective Accounts of Therapy? A Systematic Meta-synthesis Review. Fam Process 2021; 60:64-83. [PMID: 32602564 DOI: 10.1111/famp.12562] [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: 07/05/2019] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
Despite the considerable potential of qualitative approaches for studying the systemic and constructionist therapy process due to shared theoretical and epistemological premises, to date there is lack of a comprehensive qualitative synthesis of how change process is experienced and conceptualized by clients and therapists. To address this evidence gap, we performed a systematic meta-synthesis review of 30 studies reporting clients' and therapists' retrospective narratives of change process across systemic and constructionist models and across a range of client configurations, including individuals, couples, families, and groups. The studies were identified following a systematic search in PsycINFO and MEDLINE resulting in 2,977 articles, which were screened against eligibility criteria. Thematic analysis led to the identification of four main themes: (1) navigating through differences, (2) toward nonpathologizing construction of problems, (3) navigating through power imbalances, and (4) toward new and trusting ways of relating. Findings illustrate the multifaceted aspects of systemic and constructionist change process, the importance for their reflexive appraisal, and the need for further research contributing to the understanding of the challenges inherent in the systemic and constructionist therapeutic context.
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Affiliation(s)
- Eleftheria Tseliou
- Laboratory of Psychology, Department of Early Childhood Education, University of Thessaly, Volos, Greece
| | - Charlotte Burck
- Family Therapy and Systemic Research Centre, Tavistock Clinic, London, UK
| | - Liz Forbat
- Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Tom Strong
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Michelle O'Reilly
- The Greenwood Institute of Child Health, University of Leicester, Leicester, UK
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23
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Santens T, Hannes K, Levy S, Diamond G, Bosmans G. Barriers and Facilitators to Implementing Attachment-based Family Therapy into a Child Welfare Setting: A Qualitative Process Evaluation. Fam Process 2020; 59:1483-1497. [PMID: 31823356 DOI: 10.1111/famp.12504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/10/2023]
Abstract
Child welfare systems (CWSs) worldwide show increased interest in adopting empirically informed clinical strategies to increase treatment effectiveness. Many empirically supported treatments (ESTs) exist, but little is known about EST implementation barriers and facilitators in CWS. This study explored CWS providers' experiences of implementing attachment-based family therapy (ABFT) in home-based services of the Flemish CWS (in Belgium). Sixteen CWS providers (twelve counselors and four supervisors) involved in three home-based services were interviewed. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection, coding, and analysis of interview data. Findings revealed that implementation success was related to ABFT's fit with the CWS's mission, philosophy, and existing practices. CWS providers' belief in the compatibility between ABFT and CWS increased investment in implementation efforts and persistence to overcome challenges and setbacks. Some barriers pertained to the learning of ABFT and some barriers pertained to systems level challenges such as lack of leadership and support, poor coordination with referral sources and other youth care partners, and lack of policy support. For successful expansion of ESTs into CWS settings, various barriers at multiple systemic levels need to be addressed.
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Affiliation(s)
- Tara Santens
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
| | - Karin Hannes
- Center for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Suzanne Levy
- Center for Family Intervention Science, Drexel University, Philadelphia, PA
| | - Guy Diamond
- Center for Family Intervention Science, Drexel University, Philadelphia, PA
| | - Guy Bosmans
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
- Clinical Psychology, KU Leuven, Leuven, Belgium
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Abstract
This exploratory qualitative study examines the experiences and meanings associated with family therapy trainees' participation in the narrative practice of Outsider Witness Groups (OWG). At the Barcai Institute in Tel Aviv, we incorporate OWGs into our live clinical supervision courses. In some sessions, we offer the families undergoing therapy the opportunity to listen to the reflections of the group of trainees regarding what they witnessed during the session. Twenty-nine family therapy trainees participated in the study in five focus group interviews. Analysis of the interviews yielded four core themes regarding the trainees' experiences: (i) Exploring the stance of the therapist; (ii) The art of listening; (iii) Reflection on hierarchy and boundary setting; and (iv) Negotiating self-disclosure. The findings indicate that family therapy trainees stand to benefit significantly in their professional journey, development, and growth from integrating OWG practices into their training. OWG fosters the development of critical reflectivity in trainees, including the deconstruction of common and taken-for-granted assumptions. It also fosters practices related to family therapy, and perhaps also to therapy in general. The findings also suggest that taking part in OWGs during training may contribute to family therapy trainees' development of critical reflectivity as a means of introducing a more critical and political approach to therapy and developing their own preferred stories as therapists.
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Affiliation(s)
- Yochay Nadan
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
- Barcai Institute for the Family, Tel Aviv, Israel
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25
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Cooper DK, Wieling E, Domenech Rodríguez MM, Garcia-Huidobro D, Baumann A, Mejia A, Le HN, Cardemil EV, Acevedo-Polakovich ID. Latinx Mental Health Scholars' Experiences with Cultural Adaptation and Implementation of Systemic Family Interventions. Fam Process 2020; 59:492-508. [PMID: 30830697 DOI: 10.1111/famp.12433] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/09/2023]
Abstract
An increasing number of culturally adapted family-level interventions address mental health disparities with marginalized populations in the United States. However, with these developments many barriers have arisen, such as challenges with degree of cultural fit, engagement, and sustainability. We conducted 12 elite phenomenological interviews with mental health scholars involved in prevention and intervention family research with various Latinx communities within and outside of the United States. These scholars discussed their experiences of overcoming barriers in their research. We used thematic analysis to code and analyze participant responses, and our findings support the gaps in previous literature and highlight potential pathways to overcoming barriers in cultural adaptation research. Themes included the need for: (a) better understanding of the intersection between culture and context; (b) community-centered approaches to addressing implementation challenges; and (c) structural changes within institutional, governmental, and political levels. We discuss implications for researchers and practitioners working with Latinx families.
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Affiliation(s)
- Daniel K Cooper
- Department of Family Social Science, University of Minnesota, St. Paul, MN
| | - Elizabeth Wieling
- Department of Family Social Science, University of Minnesota, St. Paul, MN
| | | | - Diego Garcia-Huidobro
- Department of Family Medicine, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Ana Baumann
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO
| | | | - Huynh-Nhu Le
- Department of Psychology, The George Washington University, Washington, DC
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26
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Wolford SN, Holtrop K. Examining the Emotional Experience of Mothers Completing an Evidence-Based Parenting Intervention: A Grounded Theory Analysis. Fam Process 2020; 59:445-459. [PMID: 30883721 DOI: 10.1111/famp.12441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/09/2023]
Abstract
Parenting interventions are a well-established treatment for addressing child behavior problems that have also been shown to improve parent psychosocial health. Yet, little is known about how caregiver emotional experiences change over time during treatment. In response, the purpose of this study was to explore the emotional experiences of mothers following their participation in an evidence-based parenting intervention. Researchers conducted a secondary analysis of existing qualitative data. The study sample included semi-structured interview data from 17 mothers who previously completed the GenerationPMTO parenting intervention. Data analysis followed the grounded theory approach and included a sequential process of open, axial, and selective coding using the constant comparative method. Findings indicate mothers progressed through three distinct, yet interrelated stages of emotional experience: Before PMTO, their experiences were characterized by parenting through crisis (Stage 1); during PMTO, they transitioned to crisis stabilization (Stage 2); and following PMTO, they described experiences of emerging recovery and resilience (Stage 3). Maternal emotional experiences in each stage occurred across three contextual realms: (a) the individual (intrapersonal) level, (b) the parent-child relationship level, and the broader systemic level. Results highlight the dynamic and evolving nature of maternal emotional experience throughout various stages of the intervention process and suggest how these experiences may be associated with promoting effective parenting practices and positive child outcomes.
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Affiliation(s)
- Sarah N Wolford
- Department of Family and Child Sciences, The Florida State University, Tallahassee, FL
| | - Kendal Holtrop
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI
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Hochman Y, Segev E, Levinger M. Five Phases of Dyadic Analysis: Stretching the Boundaries of Understanding of Family Relationships. Fam Process 2020; 59:681-694. [PMID: 31237687 DOI: 10.1111/famp.12466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/09/2023]
Abstract
In the last decade, an increasing number of qualitative studies sought to investigate the dynamics of various dyads by conducting in-depth, multiple family member interviews. The emphasis in the methodological literature dealing with this type of research is primarily on the data collection process, and much less on the development of methods suitable for the analysis of the data thus derived, especially with regard to dyads consisting of family members belonging to different systems: families of origin or nuclear families. The purpose of this paper is to propose a model for dyadic analysis based on examining the dynamics of the evolving relationships between key caregivers of a family member with brain injury. The model includes inductive and abductive phases of analysis, and it is based on an ecological-systemic perspective. The benefits of this model are highlighted, and its potential contribution is further discussed.
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Affiliation(s)
- Yael Hochman
- School of Social Work, Sapir Academic College, D.N. Hof Ashkelon, Israel
| | - Einav Segev
- School of Social Work, Sapir Academic College, D.N. Hof Ashkelon, Israel
| | - Miriam Levinger
- School of Social Work, Sapir Academic College, D.N. Hof Ashkelon, Israel
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Angelo BHDB, Pontes CM, Sette GCS, Leal LP. Knowledge, attitudes and practices of grandmothers related to breastfeeding: a meta-synthesis. Rev Lat Am Enfermagem 2020; 28:e3214. [PMID: 32074204 PMCID: PMC7021479 DOI: 10.1590/1518-8345.3097.3214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 08/04/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Evaluate the knowledge, attitudes and practices of grandmothers that support or discourage the breastfeeding process. METHOD This is a meta-synthesis based on the theoretical and methodological framework of meta-ethnography developed by Noblit and Hare. A critical evaluation of the articles was conducted using the consolidated criteria for reporting qualitative research (Coreq). Primary and secondary constructs derived from the results of nine articles were grouped into a new theory, leading to tertiary constructs that were presented in a diagram based on the functionality of Sanicola's Social Network Theory. RESULTS Grandmothers know the benefits of breastfeeding, the importance of a special diet and proper hydration for the production of good quality milk, but report inadequacies in the treatment of breast complications and the need for breast milk complementation before the sixth month of life. These aspects were also observed: religious interference, opposition of ideas about breastfeeding, and family decisions based on the grandmother figure. CONCLUSION Through knowledge, attitudes and practices, grandmothers, central figures in breastfeeding support, support their daughters and daughters-in-law in breastfeeding or discourage breastfeeding with contrary opinions and inadequate guidance.
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Affiliation(s)
- Bárbara Helena de Brito Angelo
- Universidade Federal de Pernambuco, Recife, PE, Brasil
- Universidade Federal de Pernambuco, Hospital das Clínicas, Núcleo
Interno de Regulação, Recife, PE, Brasil
| | - Cleide Maria Pontes
- Universidade Federal de Pernambuco, Departamento de Enfermagem,
Recife, PE, Brasil
| | | | - Luciana Pedrosa Leal
- Universidade Federal de Pernambuco, Departamento de Enfermagem,
Recife, PE, Brasil
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Laza-Vásquez C, Cortés-Martínez KV, Cano-Rivillas JP. "It was God's will": Continuing pregnancy after perinatal infection by Zika virus. Rev Lat Am Enfermagem 2020; 28:e3310. [PMID: 32876288 PMCID: PMC7458580 DOI: 10.1590/1518-8345.3485.3310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 03/27/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to understand the influence of the religious beliefs on the decision of a group of women residing in the Huila Department to continue their pregnancies despite perinatal infection by the Zika virus. METHOD a focused ethnography. The participants were 21 women who had presented a perinatal infection by the Zika virus and whose babies were born with congenital microcephaly. 2 discussion groups and 6 semi-structured interviews were conducted, and thematic analysis was used for data treatment. RESULTS three themes emerged, namely: "God, why me?" is the initial questioning of the women to God for the prenatal diagnosis of microcephaly in their babies, "Clinging to a divine miracle" describes how the women did not lose their faith and begged for a divine miracle for their babies to be born healthy, and "It was God's will" means acceptance, resignation, and respect for God's will, as well as the denial to abort despite the medical recommendations. CONCLUSION religiosity and religious beliefs were determinant factors in the women's decision to continue their pregnancies. It becomes necessary to continue investigating this theme to understand their experiences and to generate follow-up and support actions from nursing care.
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Affiliation(s)
- Celmira Laza-Vásquez
- Facultad de Enfermería y Fisioterapia, Universitat de Lleida, Lleida, Cataluña, Spain
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Gudaitė G. Psychotherapy research: an interplay between inner and outer and a succession of meanings. J Anal Psychol 2019; 64:512-529. [PMID: 31418832 DOI: 10.1111/1468-5922.12518] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual's experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the 'Centre for research on the psychodynamics of personality'. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re-authoring one's life narrative is accepted as part of a productive therapy as well as discovering one's inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.
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Rosado-Pérez G, Varas-Díaz N. EXPERIENCIAS Y PROCESO DE DUELO ENTRE PROFESIONALES DE ENFERMERÍA ONCOLÓGICA PEDIÁTRICA: EXPERIENCES AND GRIEVING PROCESS AMONG PEDIATRIC CANCER NURSES. Rev Puertorriquena Psicol 2019; 30:290-306. [PMID: 32362997 PMCID: PMC7195809] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Explore how nursing professionals handle the death of a pediatric patient with cancer under their care and identify needs that they face in the workplace. An exploratory qualitative design was used, under the phenomenological framework and the Model of Information, Motivation and Behavioral Skills (IMHB). The data was obtained through semi-structured interviews with a sample of ten pediatric oncology nursing professionals. Each interview was transcribed and analyzed to identify thematic axes in the narrative of the participants. The findings revealed four categories that alluded to professional experiences in the face of the death of a patient and their handling of the grieving process. These were: Perception of nursing professionals about cancer; management of the pediatric patient in the terminal phase, coping strategies and areas of professional need. According to the findings, limitations were identified in knowledge about the subject of death and the grieving process of these health professionals. These limitations reflect being an obstacle in their clinical skills and in their capacity for assertive management. It is essential to educate these professionals about Thanatology and its benefits; as well as, to enable them access to psychological interventions for emotional management.
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Clua-García R, Bañuls-Oncina E, Imbernón-Casas M, Jiménez-Vinaja R. The discourses of risk of drug users in prison. Rev Esp Sanid Penit 2019; 21:28-37. [PMID: 31498857 PMCID: PMC6788205] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/24/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES In the last twenty years, sociological changes and actions aimed at improving the health of inmates have contributed to decrease the prevalence of infectious diseases and overdoses among prison population. Currently, however, drug addictions treatment penitentiary programs are questioned for lacking of innovation and deficiencies in coverage. In order to investigate this issue we analyzed the discourses of imprisonned people regarding drug use and drug addiction programs. MATERIALS AND METHODS We applied a qualitative phenomenological method. We carried out four discussion groups with 29 encarcerated drug users and made an analysis of the discourse about different possitionings towards drug use and drug addiction treatment programs. RESULTS From the combination of positions regarding drug use and drug addiction treatment programs emerged three kind of discourses respectively called: a) "reckless", characteristic of people implied in risk practices without taking preventive measures; b) "adventourous", tipical of those that take drugs both keeping the benefits of these practices and controls its negative consequences using prevention measures; c) "prudent", of abstainers or occasionally users that minimize risks and damages. DISCUSSION Encarcerated population accept drug use practices based on three risk discourses. The present study shows out that, in order to increase the effectiveness of drug policies in prison, drug treatement programs goals must be adapted to drug users particular economization of risk strategies.
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Affiliation(s)
- R Clua-García
- Brians 1 Prison. Sant Esteve Sesrovires. Barcelona.Brians 1 PrisonSant Esteve SesroviresBarcelonaSpain,Faculty of Health Sciences of Manresa. University of Catalunya.Universitat Internacional de CatalunyaFaculty of Health Sciences of ManresaUniversity of CatalunyaSpain
| | - E Bañuls-Oncina
- Brians 1 Prison. Sant Esteve Sesrovires. Barcelona.Brians 1 PrisonSant Esteve SesroviresBarcelonaSpain
| | - M Imbernón-Casas
- Brians 1 Prison. Sant Esteve Sesrovires. Barcelona.Brians 1 PrisonSant Esteve SesroviresBarcelonaSpain
| | - R Jiménez-Vinaja
- Brians 1 Prison. Sant Esteve Sesrovires. Barcelona.Brians 1 PrisonSant Esteve SesroviresBarcelonaSpain
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Sabey AK, Rauer AJ, Haselschwerdt ML, Volling B. Beyond "Lots of Hugs and Kisses": Expressions of Parental Love From Parents and Their Young Children in Two-Parent, Financially Stable Families. Fam Process 2018; 57:737-751. [PMID: 29057469 DOI: 10.1111/famp.12327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Given that parental love is essential for children's optimal development, the current study gathered examples of how parental love was demonstrated within parent-child relationships. Fifty-eight two-parent, financially stable families consisting of a mother, father, and young child (3-7 years old) from the Midwest were interviewed regarding how they demonstrated or perceived parental love. Results from an inductive thematic analysis revealed considerable variability in how parental love was demonstrated, with five themes emerging that overlapped between parents and their children: playing or doing activities together, demonstrating affection, creating structure, helping or supporting, and giving gifts or treats. Some gendered patterns among these themes were found with mothers emphasizing physical and verbal affection and fathers highlighting their more prominent role as playmates. The lay examples provided by parents and children in this exploratory study extend previous conceptualizations of parental love and underscore the importance of parents being attuned and responsive to the specific needs of their children.
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Affiliation(s)
- Allen K Sabey
- The Family Institute at Northwestern University, Evanston, IL
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Abstract
The present review examines how stepfamily members without a shared history co-construct a shared family identity and what family processes are relevant in this stepfamily formation. Three databases (Web of Science, PsycInfo, and ProQuest) were systematically searched, resulting in 20 included qualitative studies. The meta-ethnography approach of Noblit and Hare allowed synthesizing these qualitative studies and constructing a comprehensive framework of stepfamilies doing family. Three interdependent family tasks were identified: (a) honoring the past, (b) marking the present, and (c) investing in the future. Stepfamily members' experiences of these family tasks are strongly affected by the dominant societal perspectives and characterized by an underlying dialectical tension between wanting to be like a first-time family and feeling the differences in their family structure at the same time. These findings clearly demonstrate the family work that all stepfamily members undertake and provide a broader context for interpreting stepfamilies' co-construction of a new family identity.
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Affiliation(s)
- Charlotte Pylyser
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Ann Buysse
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, University of Ghent, Ghent, Belgium
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Abstract
Within Western cultural traditions, the idea that parents should talk about the death of their child with each other is deeply rooted. However, across bereaved parent couples there are wide variations in communication about their grief with each other. In this study, we explored the experiences of bereaved couples related to the process of talking and not talking. We used a thematic coding approach to analyze 20 interviews with 26 bereaved parents (11 interviewed as couples, four as individuals). Four main meanings emerged out of our analysis: not talking because of the inadequacy and pointlessness of words in grief, not talking as a way to regulate emotions in daily life, not talking as an expression of a personal, intimate process, and not talking because the partner has the same loss but a different grief process. In addition, we found that the process of talking and not talking can partly be understood as an emotional responsive process on an intrapersonal and interpersonal level. In this process partners search for a bearable distance from their own grief and their partner's, and attune with their relational context. A better understanding of this process is sought in a dialectical approach, emphasizing the value of both talking and not talking in a tense relationship with each other. Implications for clinical work are described.
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Affiliation(s)
- An Hooghe
- University of Leuven, KU Leuven, Leuven, Belgium
- Context, UPC KU Leuven, Leuven, Belgium
| | - Paul C Rosenblatt
- Department of Family Social Science, University of Minnesota, St. Paul, MN
| | - Peter Rober
- Department of Neurosciences, Institute for Family and Sexuality Studies, KU Leuven, Leuven, Belgium
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Abstract
Schizophrenia is a complex biopsychosocial condition in which expressed emotion in family members is a robust predictor of relapse. Not surprisingly, family interventions are remarkably effective and thus recommended in current treatment guidelines. Their key elements seem to be common therapeutic factors, followed by education and coping skills training. However, few studies have explored these key elements and the process of the intervention itself. We conducted a qualitative and quantitative analysis of the records from a pioneering family intervention trial addressing expressed emotion, published by Leff and colleagues four decades ago. Records were analyzed into categories and data explored using descriptive statistics. This was complemented by a narrative evaluation using an inductive approach based on emotional markers and markers of change. The most used strategies in the intervention were addressing needs, followed by coping skills enhancement, advice, and emotional support. Dealing with overinvolvement and reframing were the next most frequent. Single-family home sessions seemed to augment the therapeutic work conducted in family groups. Overall the intervention seemed to promote cognitive and emotional change in the participants, and therapists were sensitive to the emotional trajectory of each subject. On the basis of our findings, we developed a longitudinal framework for better understanding the process of this treatment approach.
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Affiliation(s)
- Jaime Grácio
- Chronic Diseases Research Center (CEDOC), Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
- Clínica Psiquiátrica de S. José, Sisters Hospitallers, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- Chronic Diseases Research Center (CEDOC), Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Julian Leff
- King's College London, London, UK
- University College London, London, UK
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Colón-López V, Fernández-Espada N, Vélez C, Gonzalez VJ, Diaz-Toro EC, Calo WA, Savas LS, Pattatucci A, Fernández ME. Communication about sex and HPV among Puerto Rican mothers and daughters. Ethn Health 2017; 22:348-360. [PMID: 27882783 PMCID: PMC5557394 DOI: 10.1080/13557858.2016.1246938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Although opportunities to vaccinate against human papillomavirus (HPV) are available, vaccination rates in Puerto Rico remain low. Communication between parents and adolescents about sexual topics may influence decisions about HPV vaccination uptake, particularly among young women; yet, few studies have addressed this issue. This qualitative study explored Puerto Rican mothers' and daughters' communication on sex-related topics, and HPV, including the HPV vaccine. DESIGN Thirty participants, including 9 mothers and 21 daughters, participated in seven focus groups. Participants were divided into groups of mothers and daughters, and further stratified by vaccination status. Transcripts were analyzed using a modified grounded theory approach to identify emergent themes. RESULTS Focus group data revealed four main themes: (1) limited parent-daughter communication about sex-related topics; (2) daughters' discomfort discussing sex-related topics with their parents; (3) parental focus on abstinence; and, (4) limited parent-daughter communication about HPV and the HPV vaccine. CONCLUSION Although daughters in this study struggled with feelings of embarrassment, invasion of privacy, encouragement of abstinence, and the fear of parents' reaction to them being sexually active prior to marriage, they also recognized the need to increase the parent-daughter communication about sex-related topics including HPV and the HPV vaccine. Educational efforts should target both daughters and parents to increase communication skills and self-efficacy and to enable them to discuss sexual health in open and nonjudgmental conversations.
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Affiliation(s)
- Vivian Colón-López
- Division of Population Health Sciences, PR Comprehensive Cancer Center, University of Puerto Rico, Medical Sciences Campus, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344 787-772-8300 ext. 1225
- Health Services Administration, Evaluation Program, Graduate School of Public Health, University of Puerto Rico; PMB 371 P.O. Box 70344 San Juan, PR 00936-8344, 787-772-8300 ext. 1225
| | - Natalie Fernández-Espada
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin Street, 25 floor, Houston, Texas 77030-3875. 713-500-9659, 713-500-9626, 713-500-9638
| | - Camille Vélez
- UPR-MDACC Partnership for Excellence in Cancer Research Program, University of Puerto Rico, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344, 787-772-8300 ext. 1150
| | - Velda J. Gonzalez
- School of Nursing, University of Puerto Rico, Medical Sciences Campus, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344, 787-758-2525 ext. 1986
| | - Elba C. Diaz-Toro
- Division of Population Health Sciences, PR Comprehensive Cancer Center, University of Puerto Rico, Medical Sciences Campus, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344 787-772-8300 ext. 1225
- Department of Restorative Sciences, School of Dental Medicine, University of Puerto Rico; PMB 371 P.O. Box 70344 San Juan, PR 00936-8344, 787-772-8300 ext. 1101
| | - William A. Calo
- University of North Carolina, Gillings School of Global Public Health, Department of Health Policy and Management, 1104-I McGavran-Greenberg Bldg, CB 7411, Chapel Hill, NC 27599, (919) 966-4784
| | - Lara S. Savas
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin Street, 25 floor, Houston, Texas 77030-3875. 713-500-9659, 713-500-9626, 713-500-9638
| | - Angela Pattatucci
- UPR-MDACC Partnership for Excellence in Cancer Research Program, University of Puerto Rico, PMB 371 P.O. Box 70344, San Juan, PR 00936-8344, 787-772-8300 ext. 1150
- Health Services Administration, Evaluation Program, Graduate School of Public Health, University of Puerto Rico; PMB 371 P.O. Box 70344 San Juan, PR 00936-8344, 787-772-8300 ext. 1225
| | - María E. Fernández
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin Street, 25 floor, Houston, Texas 77030-3875. 713-500-9659, 713-500-9626, 713-500-9638
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Kageyama M, Yokoyama K, Nakamura Y, Kobayashi S. Changes in Families' Caregiving Experiences through Involvement as Participants then Facilitators in a Family Peer-Education Program for Mental Disorders in Japan. Fam Process 2017; 56:408-422. [PMID: 28591461 DOI: 10.1111/famp.12194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 06/07/2023]
Abstract
A family peer-education program for mental disorders was developed in Japan, similar to existing programs in the United States and Hong Kong. Families that serve as facilitators in such programs may enhance their caregiving processes and, thereby, their well-being. This study's aim was to describe how families' caregiving experiences change, beginning with the onset of a family member's mental illness, through their involvement in a family group or peer-education program as participants then facilitators. Thus, this study was conducted in a family peer-education program for mental disorders in Japan. Group interviews were conducted with 27 facilitators from seven program sites about their experiences before, during, and after becoming facilitators. Interview data were coded and categorized into five stages of caregiving processes: (1) withdrawing and suppressing negative experiences with difficulty and regret; (2) finding comfort through being listened to about negative experiences; (3) supporting participants' sharing as facilitators; (4) understanding and affirming oneself through repeated sharing of experiences; and (5) finding value and social roles in one's experiences. The third, fourth, and fifth stages were experienced by the facilitators. The value that the facilitators placed on their caregiving experiences changed from negative to positive, which participants regarded as helpful and supportive. We conclude that serving as facilitators may improve families' caregiving processes.
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Affiliation(s)
- Masako Kageyama
- Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiko Yokoyama
- Department of Nursing, Faculty of Health Sciences, Saitama Prefectural University, Saitama, Japan
| | - Yukako Nakamura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Sayaka Kobayashi
- National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
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Wyverkens E, Provoost V, Ravelingien A, Pennings G, De Sutter P, Buysse A. The Meaning of the Sperm Donor for Heterosexual Couples: Confirming the Position of the Father. Fam Process 2017; 56:203-216. [PMID: 25908536 DOI: 10.1111/famp.12156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 06/04/2023]
Abstract
In the literature, relatively little attention has been paid to the meaning of donor involvement in the intimate couple dyad. The current study aimed to enrich our understanding of couples' meaning-making regarding the anonymous sperm donor and how they dealt with the donor involvement. Semi-structured interviews were conducted with nine couples, who had at least one child conceived through sperm donation. Our thematic analysis showed that the donor conception was seen as a different path to create a normal family. Once the family was formed, most couples avoided talking about the donor because it was perceived as disrupting men's growing confidence in their position as father. Participants tried to confirm the position of the father to protect the family relationships. Uncertainties about how they were perceived as parents showed the continuing dominance of genetic ties within our social discourse. Participants also dealt with reminders of the donor in their daily life. Overall, they tried to manage the space taken up by the donor and to protect the position of the father. We relate our findings to literature on topic avoidance and shared obliviousness in families. For counseling practice, it could be useful to explore couples' meaning-making about the donor as this seemed to serve family functioning.
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Affiliation(s)
- Elia Wyverkens
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Veerle Provoost
- Department of Philosophy, Bioethics Institute Ghent, Ghent University, Gent, Belgium
| | - An Ravelingien
- Department of Philosophy, Bioethics Institute Ghent, Ghent University, Gent, Belgium
| | - Guido Pennings
- Department of Philosophy, Bioethics Institute Ghent, Ghent University, Gent, Belgium
| | - Petra De Sutter
- Department of Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - Ann Buysse
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Yakushko O, Miles P, Rajan I, Bujko B, Thomas D. Cultural unconscious in research: integrating multicultural and depth paradigms in qualitative research. J Anal Psychol 2016; 61:656-675. [PMID: 27763664 DOI: 10.1111/1468-5922.12257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 06/10/2016] [Accepted: 07/27/2016] [Indexed: 11/28/2022]
Abstract
Culturally focused research has gained momentum in many disciplines, including psychology. However, much of this research fails to pay attention to the unconscious dynamics that underlie the study of culture and culturally influenced human beings. Such dynamics may be especially significant when issues of marginalization and oppression are present. Therefore, this paper seeks to contribute a framework for understanding cultural dynamics, especially unconscious cultural dynamics, within depth psychological qualitative research influenced by Jungian and post-Jungian scholarship. Inquiry that is approached with a commitment to making the unconscious conscious seeks to empower and liberate not only the subject/object studied but also the researchers themselves. Following a brief review of multiculturalism in the context of analytically informed psychology, this paper offers several case examples that focus on researchers' integration of awareness of the cultural unconscious in their study of cultural beings and topics.
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Vischer N, Pfeiffer C, Joller A, Klingmann I, Ka A, Kpormegbe SK, Burri C. The Good Clinical Practice guideline and its interpretation - perceptions of clinical trial teams in sub-Saharan Africa. Trop Med Int Health 2016; 21:1040-1048. [PMID: 27260671 DOI: 10.1111/tmi.12734] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To explore the advantages and challenges of working with the Good Clinical Practice (GCP)-International Conference of Harmonization (ICH) E6 guideline and its interpretation from the perspective of clinical trial teams based in sub-Saharan Africa. METHODS We conducted 60 key informant interviews with clinical trial staff at different levels in clinical research centres in Kenya, Ghana, Burkina Faso and Senegal and thematically analysed the responses. RESULTS Clinical trial teams perceived working with ICH-GCP as highly advantageous and regarded ICH-GCP as applicable to their setting and efficiently applied. Only for informed consent did some clinical trial staff (one-third) perceive the guideline as insufficiently applicable. Specific challenges included meeting the requirements for written and individual consent, conditions for impartial witnesses for illiterates or legally acceptable representatives for children, guaranteeing voluntary participation and ensuring full understanding of the consent given. It was deemed important to have ICH-GCP compliance monitored by relevant ethics committees and regulatory authorities, without having guidelines applied overcautiously. CONCLUSION Clinical trial teams in sub-Saharan Africa perceived GCP as a helpful guideline, despite having been developed by northern organisations and despite the high administrative burden of implementing it. To mitigate consent challenges, we suggest adapting GCP and making use of the flexibility it offers.
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Affiliation(s)
- N Vischer
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - C Pfeiffer
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - A Joller
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - I Klingmann
- European Forum for Good Clinical Practice, Brussels, Belgium
| | - A Ka
- Département de Sociologie, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - S K Kpormegbe
- Department of Sociology, University of Ghana, Legon, Ghana
| | - C Burri
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Sundnes A, Andenaes A. PARENTAL REGULATION OF INFANT SLEEP: ROUND-THE-CLOCK EFFORTS FOR SOCIAL SYNCHRONIZATION. Infant Ment Health J 2016; 37:247-58. [PMID: 27098285 DOI: 10.1002/imhj.21568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 01/10/2016] [Accepted: 01/28/2016] [Indexed: 11/08/2022]
Abstract
The sleep-cycle development of infants is influenced by familial and sociocultural conditions, but there is a lack of knowledge on how parental regulation of infant sleep is related to the specific life situation of a family. This article describes a context-sensitive study of parental regulation of infant sleep that includes the whole 24-hr day, parents' intentions, and familial and sociocultural conditions. The results are based on a longitudinal qualitative study in Norway of 51 families. Parents were interviewed in the infants' first year of life and approximately 18 months later. An interpretive analysis in four steps was conducted, informed by cultural psychological perspectives on development. The parents were found to perform five types of regulatory actions: facilitating sleep, letting sleep, letting be awake, keeping awake, and waking. These actions were performed continuously throughout the 24-hr day, each to different extents and at different hours in individual families, forming a regulation cycle. We describe patterns and variations in regulation cycles, changes over time as increased social synchronization, and how the regulation cycle is embedded in familial and sociocultural conditions. Finally, implications for clinical practice are discussed.
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Drew S, Lavy C, Gooberman-Hill R. What factors affect patient access and engagement with clubfoot treatment in low- and middle-income countries? Meta-synthesis of existing qualitative studies using a social ecological model. Trop Med Int Health 2016; 21:570-89. [PMID: 26892686 DOI: 10.1111/tmi.12684] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To conduct a systematic synthesis of previous research to identify factors that affect treatment-seeking for clubfoot and community-level interventions to improve engagement in low- and middle-income counties. METHODS A search of five databases was conducted, and articles screened using six criteria. Quality was appraised using the Critical Appraisal Skills Programme checklist. Eleven studies were identified for inclusion. Analysis was informed by a social ecological model, which specifies five inter-related factors that may affect treatment-seeking: intrapersonal, interpersonal, institutional, community or socio-cultural factors and public policy. RESULTS Intrapersonal barriers experienced were a lack of income and additional responsibilities. At the interpersonal level, support from fathers, the extended family and wider community affected on treatment-seeking. Institutional or organisational factors included long distances to treatment centres, insufficient information about treatments and challenges following treatment. Guardians' beliefs about the causes of clubfoot shaped behaviour. At the level of public policy, two-tiered healthcare systems made it difficult for some groups to access timely care. Interventions to address these challenges included counselling sessions, outreach clinics, brace recycling and a range of education programmes. CONCLUSIONS This study identifies factors that affect access and engagement with clubfoot treatment across diverse settings and strategies to address them.
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Affiliation(s)
- Sarah Drew
- Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Christopher Lavy
- Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
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Grácio J, Gonçalves-Pereira M, Leff J. What do We Know about Family Interventions for Psychosis at the Process Level? A Systematic Review. Fam Process 2016; 55:79-90. [PMID: 25900627 DOI: 10.1111/famp.12155] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 06/04/2023]
Abstract
The evidence regarding effectiveness of family interventions for psychosis (FIP) is strong and consistent. However, there is a gap in the research on the process of these interventions, and little is known about their active ingredients. This review aims to identify the active ingredients of FIP. We conducted a systematic literature review, focusing on qualitative research, and analyzed 22 papers in total. We found a single study comprehensively exploring the process of FIP. All other studies focused on particular aspects of process-related variables. The key elements of FIP seem to be the so-called "common therapeutic factors", followed by education about the illness and coping skills training. This review supports the value of a stepped model of intervention according to the needs of the families. However, the evidence reviewed also reveals a gap in the research findings based on the limited research available. FIP are complex, psychosocial interventions with multiple components, and more intensive, qualitative research is needed to establish linkages between process and outcome.
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Affiliation(s)
- Jaime Grácio
- Clínica Psiquiátrica de S. José, Sisters Hospitallers, Lisbon, Portugal
- Department of Mental Health and Centro de Estudos de Doenças Crónicas, NOVA Medical School / Faculdade de Ciências Médicas (NMS/FCM), CEDOC, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- Department of Mental Health and Centro de Estudos de Doenças Crónicas, NOVA Medical School / Faculdade de Ciências Médicas (NMS/FCM), CEDOC, Lisbon, Portugal
| | - Julian Leff
- Department of Mental Health Sciences, University College London, London, UK
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Van Parys H, Wyverkens E, Provoost V, De Sutter P, Pennings G, Buysse A. Family Communication about Donor Conception: A Qualitative Study with Lesbian Parents. Fam Process 2016; 55:139-154. [PMID: 25393909 DOI: 10.1111/famp.12112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 06/04/2023]
Abstract
In this qualitative study of 10 lesbian couples who built their families through anonymous donor conception, we explore how lesbian parents experience communication about the donor conception within the family. While for these families "disclosure" of donor conception is often seen as evident, the way parents and children discuss this subject and how this is experienced by the parents themselves has not received much research attention. To meet this gap in the literature, in-depth interviews with lesbian couples were conducted. An Interpretative Phenomenological Analysis showed that this family communication process can be understood within the broader relational context of parent-child relationships. Even though parents handled this family communication in many different ways, these were all inspired by the same motives: acting in the child's best interest and-on a more implicit level-maintaining good relations within the family. Furthermore, parents left the initiative for talking about the DC mostly to the child. Overall, parents aimed at constructing a donor conception narrative that they considered acceptable for both the children and themselves. They used different strategies, such as gradual disclosure, limiting the meaning of the donor, and justifying the donor conception. Building an acceptable donor conception narrative was sometimes challenged by influences from the social environment. In the discussion, we relate this qualitative systemic study to the broader issues of selective disclosure and bidirectionality within families.
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Affiliation(s)
- Hanna Van Parys
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Elia Wyverkens
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | | | - Petra De Sutter
- Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Guido Pennings
- Bioethics Institute Ghent, Ghent University, Ghent, Belgium
| | - Ann Buysse
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Abstract
The process of leaving an abusive partner has been theorized using the Stages of Change Model. Although useful, this model does not account for changes in relational boundaries unique to the process of leaving. Using family stress and feminist perspectives, this study sought to integrate boundary ambiguity into the Stages of Change Model. Boundary ambiguity is defined as a perception of uncertainty as to who is in or out of a family system (Boss & Greenberg, 1984). Twenty-five mothers who had temporarily or permanently left their abusers were interviewed. Data were analyzed using constructivist grounded theory methods. Results identify types, indicators of, and mothers' responses to boundary ambiguity throughout the five stages of change. Most mothers and abusers fluctuated between physical and psychological presence and absence over multiple separations. The integration of boundary ambiguity into the Stages of Change Model highlights the process of leaving an abusive partner as systemic, fluid, and nonlinear.
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Affiliation(s)
- Lyndal Khaw
- Family and Child Studies, Montclair State University, Montclair, NJ
| | - Jennifer L Hardesty
- Human and Community Development, University of Illinois at Urbana-Champaign, Urbana, IL
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Morgan A, Jimenez Soto E, Bhandari G, Kermode M. Provider perspectives on the enabling environment required for skilled birth attendance: a qualitative study in western Nepal. Trop Med Int Health 2014; 19:1457-65. [PMID: 25252172 DOI: 10.1111/tmi.12390] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES In Nepal, where difficult geography and an under-resourced health system contribute to poor health care access, the government has increased the number of trained skilled birth attendants (SBAs) and posted them in newly constructed birthing centres attached to peripheral health facilities that are available to women 24 h a day. This study describes their views on their enabling environment. METHODS Qualitative methods included semi-structured interviews with 22 SBAs within Palpa district, a hill district in the Western Region of Nepal; a focus group discussion with ten SBA trainees, and in-depth interviews with five key informants. RESULTS Participants identified the essential components of an enabling environment as: relevant training; ongoing professional support; adequate infrastructure, equipment and drugs; and timely referral pathways. All SBAs who practised alone felt unable to manage obstetric complications because quality management of life-threatening complications requires the attention of more than one SBA. CONCLUSIONS Maternal health guidelines should account for the provision of an enabling environment in addition to the deployment of SBAs. In Nepal, referral systems require strengthening, and the policy of posting SBAs alone, in remote clinics, needs to be reconsidered to achieve the goal of reducing maternal deaths through timely management of obstetric complications.
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Affiliation(s)
- Alison Morgan
- Nossal Institute for Global Health, University of Melbourne, Carlton, Vic., Australia
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Abstract
Family researchers have long recognized the utility of incorporating interview data from multiple family members. Yet, relatively few contemporary scholars utilize such an approach due to methodological underdevelopment. This article contributes to family scholarship by providing a roadmap for developing and executing in-depth interview studies that include more than one family member. Specifically, it outlines the epistemological frames that most commonly underlie this approach, illustrates thematic research questions that it best addresses, and critically reviews the best methodological practices of conducting research with this approach. The three most common approaches are addressed in depth: separate interviews with each family member, dyadic or group interviews with multiple family members, and a combined approach that uses separate and dyadic or group interviews. This article speaks to family scholars who are at the beginning stages of their research project but are unsure of the best qualitative approach to answer a given research question.
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Affiliation(s)
- Corinne Reczek
- Departments of Sociology and Women's, Gender, and Sexuality Studies, The Ohio State University, Columbus, OH
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Mahtani-Chugani V, Sanz-Alvarez E, de Las Cuevas-Castresana C. [Antidepressant management strategy from the patient perspective: struggling internally and externally]. Aten Primaria 2012; 44:463-70. [PMID: 22209297 PMCID: PMC7025173 DOI: 10.1016/j.aprim.2011.10.003] [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: 08/29/2011] [Revised: 10/19/2011] [Accepted: 10/19/2011] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE To identify the consumption pathway and strategies of coping with antidepressants use from the patients perspective. DESIGN Qualitative research. SETTING Tenerife. SAMPLING Theoretical sampling until saturation. METHOD A total of 17 open interviews with patients who consumed antidepressants whether combined with tranquilisers or not. The age range was between 35-85 years, and there were 13 women. Ten lived in a more urban setting and the rest in rural areas. Interviews were audio-recorded, transcribed verbatim and analysed using a modified Grounded Theory supported by the software program ATLAS.ti. RESULTS The process identified as coping with antidepressants, was called "struggling internally and externally." It consisted of the individual assessment of the benefits and risks of medication use (internal struggle), addressing stigma and social pressure (external struggle). The outcome of the assessment made by patients may lead to different strategies for adjusting to drug treatment: "unconditional acceptance", "resigned acceptance" or "forced acceptance". CONCLUSIONS Understanding the evaluation process that the patient needs to go through, given the internal and external struggle in which they are immersed, can be useful to develop interventions that improve medication use. In fact, physicians have an important role, although not always explicitly sought in resolving the dilemma posed by patients using antidepressant drugs and, therefore, reducing the length of patient suffering.
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Affiliation(s)
- Vinita Mahtani-Chugani
- Unidad de Investigación, Hospital Universitario Nuestra Señora de la Candelaria y Gerencia de Atención Primaria, Tenerife, Spain.
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Jiménez-De Gracia L, Ruiz-Moral R, Gavilán-Moral E, Hueso-Montoro C, Cano-Caballero Gálvez D, Alba-Dios MA. [Opinions of family doctors on the involvement of patients in the taking of decisions: a study with focus groups]. Aten Primaria 2012; 44:379-84. [PMID: 22019060 PMCID: PMC7025227 DOI: 10.1016/j.aprim.2011.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 06/09/2011] [Accepted: 07/18/2011] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To determine what family doctors think about various aspects of patient involvement in clinical decision making in Primary Care. DESIGN Qualitative study using focus groups. LOCATION Primary Care. PARTICIPANTS Family physicians with and without expertise in clinical communication. METHODS Three focus groups were developed, involving 6-8 professionals per group, and took part in two meetings. The conversations were recorded and transcribed verbatim. The discussion was analysed using literature-based categories and other emerging from the text, encoding the information and making an inductive interpretation. RESULTS Family physicians refer mainly to involving the patient in decisions by proposing a plan tailored to the knowledge of patient problems and then verifying their approval or rejection. However, some professionals ponder whether this could be classified as patient involvement, questioning the real role that both players would take at the time of deciding. CONCLUSIONS The explanation of how family physicians would involve the patient in decisions clashes with the most widespread theories on the subject and, also opposes the view of patients who would like to be involved more actively. Taking into account discordant reflections on the relevance of considering this process as real patient involvement, it is necessary to describe a realistic theoretical model that allows further development of strategies to improve the attitude and training of professionals to patient involvement in clinical decisions.
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Affiliation(s)
- Laura Jiménez-De Gracia
- Medicina de Familia y Comunitaria, Centro Sociosanitario San Francisco, Servicio Extremeño de Promoción de la Autonomía y Atención a la Dependencia
| | - Roger Ruiz-Moral
- Medicina de Familia y Comunitaria, Unidad Docente Provincial de Medicina de Familia y Comunitaria de Córdoba, Facultad de Medicina de Córdoba, Córdoba, España
| | - Enrique Gavilán-Moral
- Medicina de Familia y Comunitaria, Gerencia de Salud de Plasencia, Servicio Extremeño de Salud
| | - Cesar Hueso-Montoro
- Departamento de Enfermería, Universidad de Granada, Colaborador de la Fundación Index, Granada, España
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