Quality of life domains important and relevant to family caregivers of advanced cancer patients in an Asian population: a qualitative study.

PubMed

Lee, Geok Ling; Ow, Mandy Yen Ling; Akhileswaran, Ramaswamy; Pang, Grace Su Yin; Fan, Gilbert Kam Tong; Goh, Brandon Huat Heng; Wong, Cai Fong; Cheung, Yin Bun; Wee, Hwee Lin

2015-04-01

This study aims to identify domains of quality of life (QoL) that are culturally relevant to Chinese caregivers of advanced cancer patients in Singapore and to evaluate content adequacy of currently available instruments for use in the target population. English- and Chinese-speaking caregivers of advanced cancer patients receiving care under a tertiary cancer center and/or a community hospice home care/day care provider were recruited for in-depth interviews. The interviews were analyzed using thematic analysis. The identified domains, themes and sub-themes were compared to concepts addressed by items from five existing cancer-specific caregiver QoL instruments. Eighteen female and eight male caregivers aged 28-74 years participated in the study. Twenty-nine QoL themes and 59 sub-themes were identified in six domains, namely physical health, mental health, social health, spiritual health, financial health and daily life. Collectively, but not individually, the content of the five existing instruments adequately cover the physical health domain, social health domain and some themes on mental health domain for the study population. Content gaps were identified in the domains of mental health, spiritual health, daily life and financial health. The present study found culturally and contextually specific themes and sub-themes about positive emotional health, spiritual health and financial health.

The experience of hepatitis C treatment for people with a history of mental health problems: An interpretative phenomenological analysis.

PubMed

Ware, K; Davies, J; Rowse, G; Whittaker, S

2015-07-01

This qualitative study explores the experience of hepatitis C virus treatment for people with pre-existing mental health problems within a large city hospital. Four men and four women with pre-existing mental health problems who had received hepatitis C virus treatment took part in semi-structured interviews which were analysed using interpretative phenomenological analysis. A central theme of 'Self, stigma and change' was identified which interlinked with three other main themes of 'Coping and responding to treatment', 'Connectedness to others' and 'The impact of information'. These themes and their sub-themes are discussed in relation to existing literature and clinical practice guidelines. © The Author(s) 2013.

How equity is addressed in clinical practice guidelines: a content analysis

PubMed Central

Shi, Chunhu; Tian, Jinhui; Wang, Quan; Petkovic, Jennifer; Ren, Dan; Yang, Kehu; Yang, Yang

2014-01-01

Objectives Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs). Setting Content analysis of methodological publications. Eligibility criteria for selecting studies Methodological publications were included if they provided checklists/frameworks on when, how and to what extent equity should be incorporated in CPGs. Data sources We electronically searched MEDLINE, retrieved references, and browsed guideline development organisation websites from inception to January 2013. After study selection by two authors, general characteristics and checklists items/framework components from included studies were extracted. Based on the questions or items from checklists/frameworks (unit of analysis), content analysis was conducted to identify themes and questions/items were grouped into these themes. Primary outcomes The primary outcomes were methodological themes and processes on how to address equity issues in guideline development. Results 8 studies with 10 publications were included from 3405 citations. In total, a list of 87 questions/items was generated from 17 checklists/frameworks. After content analysis, questions were grouped into eight themes (‘scoping questions’, ‘searching relevant evidence’, ‘appraising evidence and recommendations’, ‘formulating recommendations’, ‘monitoring implementation’, ‘providing a flow chart to include equity in CPGs’, and ‘others: reporting of guidelines and comments from stakeholders’ for CPG developers and ‘assessing the quality of CPGs’ for CPG users). Four included studies covered more than five of these themes. We also summarised the process of guideline development based on the themes mentioned above. Conclusions For disadvantaged population-specific CPGs, eight important methodological issues identified in this review should be considered when including equity in CPGs under the guidance of a scientific guideline development manual. PMID:25479795

Space Station Systems Analysis Study. Volume 1: Executive summary, part 1 and 2

NASA Technical Reports Server (NTRS)

1977-01-01

The elements of space station programs required to support an operational base theme, a space laboratory theme, and advanced missions relatable to public needs/national interests are defined. Missions satisfying the foregoing requirements are identified, program scenarios/options are established. System options are evaluated for a selected number of program options. Subsystem analysis and programmatic comparisons are performed for selected primary concepts.

Construction of negative images of menstruation in Indian TV commercials.

PubMed

Yagnik, Arpan Shailesh

2012-01-01

Menstruation is a perfectly normal physiological process; however, it is problematized in TV commercials. In the current study, a thematic analysis of 50 Indian TV commercials was conducted to identify the latent themes. Social captivity, restrictions, professional inefficiency, and physical and mental discomfort emerged as major themes after the analysis. The knowledge that manufacturers use such themes for image building and creating a conducive buying environment may prevent the reinforcement of menstrual taboos in Indian society. It can also guide the manufacturers in ideating and creating positive and healthier ways of advertising female hygiene products.

Transforming user needs into functional requirements for an antibiotic clinical decision support system: explicating content analysis for system design.

PubMed

Bright, T J

2013-01-01

Many informatics studies use content analysis to generate functional requirements for system development. Explication of this translational process from qualitative data to functional requirements can strengthen the understanding and scientific rigor when applying content analysis in informatics studies. To describe a user-centered approach transforming emergent themes derived from focus group data into functional requirements for informatics solutions and to illustrate these methods to the development of an antibiotic clinical decision support system (CDS). THE APPROACH CONSISTED OF FIVE STEPS: 1) identify unmet therapeutic planning information needs via Focus Group Study-I, 2) develop a coding framework of therapeutic planning themes to refine the domain scope to antibiotic therapeutic planning, 3) identify functional requirements of an antibiotic CDS system via Focus Group Study-II, 4) discover informatics solutions and functional requirements from coded data, and 5) determine the types of information needed to support the antibiotic CDS system and link with the identified informatics solutions and functional requirements. The coding framework for Focus Group Study-I revealed unmet therapeutic planning needs. Twelve subthemes emerged and were clustered into four themes; analysis indicated a need for an antibiotic CDS intervention. Focus Group Study-II included five types of information needs. Comments from the Barrier/Challenge to information access and Function/Feature themes produced three informatics solutions and 13 functional requirements of an antibiotic CDS system. Comments from the Patient, Institution, and Domain themes generated required data elements for each informatics solution. This study presents one example explicating content analysis of focus group data and the analysis process to functional requirements from narrative data. Illustration of this 5-step method was used to develop an antibiotic CDS system, resolving unmet antibiotic prescribing needs. As a reusable approach, these techniques can be refined and applied to resolve unmet information needs with informatics interventions in additional domains.

“An Effect That is Deeper Than Beating” Family Violence in Jordanian Women

PubMed Central

Morse, Diane S; Paldi, Yael; Egbarya, Samah Salaime; Clark, Cari Jo

2012-01-01

This study informs healthcare approaches to gender-based family violence through focus groups with Jordanian women. The authors conducted a thematic qualitative analysis of 12 focus groups among 70 married, divorced, or widowed women about their experiences and beliefs regarding family violence. Five themes relevant to healthcare providers were identified. Three of the themes addressed participant-perceived causes of gender-based family violence: 1) unmet gender role expectations, 2) stigma and social norms, and 3) extended family roles. The fourth theme reflects effects on victims. The fifth theme reflects protective qualities and help seeking behaviors. The themes identified in the analysis reveal multiple ways that gender-based family violence can contribute to health problems and that it can be kept secret by Jordanian women as patients. Potential clues are described for the violence which may not be typically explored in a medical encounter. Additional ways that Jordanian families may seek help from other family or clergy instead of police and family violence agencies are described. Implications of these results for healthcare providers who care both for Jordanians and Arab immigrants in Western cultures are discussed. PMID:22329396

An exploration of the nature of caring relationships in the writings of Florence Nightingale.

PubMed

Wagner, Debra J; Whaite, Bonnie

2010-12-01

The purpose of this qualitative, historical field study was to identify the nature and attributes of caring relationships as depicted in the writings of Florence Nightingale. Latent content analysis was the methodology used for the discovery and analysis of words, ideas, and themes from selected Nightingale works. Five themes were identified that represented a caring relationship: attend to, attention to, nurture, competent, and genuine. These themes are congruent with Nightingale's threefold concept of nursing. Watson's carative factors were used to cross-validate the results. The findings of this study indicate that the phenomenon of caring relationships in nursing has been a part of our professional language since Victorian times. Historical research provides a sense of connectedness to nursing's past and contributes to the ongoing education of nurses and further development of the nursing profession.

Themes and Interplay of Beliefs in Mathematical Reasoning

ERIC Educational Resources Information Center

Sumpter, Lovisa

2013-01-01

Upper secondary students' task solving reasoning was analysed with a focus on arguments for strategy choices and conclusions. Passages in their arguments for reasoning that indicated the students' beliefs were identified and, by using a thematic analysis, categorized. The results stress three themes of beliefs used as arguments for…

Trends in Literacy Software Publication and Marketing: Multicultural Themes.

ERIC Educational Resources Information Center

Balajthy, Ernest

This article provides data and discussion of multicultural theme-related issues arising from analysis of a detailed database of commercial software products targeted to reading and literacy education. The database consisted of 1152 titles, representing the offerings of 104 publishers and distributors. Of the titles, 62 were identified as having…

The Changing Landscape of One Primary School's Mathematics Curriculum

ERIC Educational Resources Information Center

Dent, Wendy; McChesney, Jane

2016-01-01

This paper describes a period of substantial changes in the mathematics curriculum of one primary school in Christchurch. Using retrospective analysis, we identified two important conceptual themes: equity of mathematical learning and opportunities for all students to learn to be a mathematician. Access to research about these themes prompted two…

Pharmaceutical strategic purchasing requirements in Iran: Price interventions and the related effective factors.

PubMed

Bastani, Peivand; Dinarvand, Rasoul; SamadBeik, Mahnaz; Pourmohammadi, Kimia

2016-01-01

Pharmaceutical access for the poor is an essential factor in developing countries that can be improved through strategic purchasing. This study was conducted to identify the elements affecting price in order to enable insurance organizations to put strategic purchasing into practice. This was a qualitative study conducted through content analysis with an inductive approach applying a five-stage framework analysis (familiarization, identifying a thematic framework, indexing, mapping, and interpretation). Data analysis was started right after transcribing each interview applying ATLAS.ti. Data were saturated after 32 semi-structured interviews by experts. These key informants were selected purposefully and through snowball sampling. Findings showed that there are four main themes as Pharmaceutical Strategic Purchasing Requirements in Iran as follows essential and structural factors, international factors, economical factors, and legal factors. Moreover, totally 14 related sub-themes were extracted in this area as the main effective variables. It seems that paying adequate attention to the four present themes and 14 sub-themes affecting price can enable health system policy-makers of developing countries like Iran to make the best decisions through strategic purchasing of drugs by the main insurers in order to improve access and health in the country.

Exploring trends of nonmedical use of prescription drugs and polydrug abuse in the Twittersphere using unsupervised machine learning.

PubMed

Kalyanam, Janani; Katsuki, Takeo; R G Lanckriet, Gert; Mackey, Tim K

2017-02-01

Nonmedical use of prescription medications/drugs (NMUPD) is a serious public health threat, particularly in relation to the prescription opioid analgesics abuse epidemic. While attention to this problem has been growing, there remains an urgent need to develop novel strategies in the field of "digital epidemiology" to better identify, analyze and understand trends in NMUPD behavior. We conducted surveillance of the popular microblogging site Twitter by collecting 11 million tweets filtered for three commonly abused prescription opioid analgesic drugs Percocet® (acetaminophen/oxycodone), OxyContin® (oxycodone), and Oxycodone. Unsupervised machine learning was applied on the subset of tweets for each analgesic drug to discover underlying latent themes regarding risk behavior. A two-step process of obtaining themes, and filtering out unwanted tweets was carried out in three subsequent rounds of machine learning. Using this methodology, 2.3M tweets were identified that contained content relevant to analgesic NMUPD. The underlying themes were identified for each drug and the most representative tweets of each theme were annotated for NMUPD behavioral risk factors. The primary themes identified evidence high levels of social media discussion about polydrug abuse on Twitter. This included specific mention of various polydrug combinations including use of other classes of prescription drugs, and illicit drug abuse. This study presents a methodology to filter Twitter content for NMUPD behavior, while also identifying underlying themes with minimal human intervention. Results from the study track accurately with the inclusion/exclusion criteria used to isolate NMUPD-related risk behaviors of interest and also provides insight on NMUPD behavior that has a high level of social media engagement. Results suggest that this could be a viable methodology for use in big data substance abuse surveillance, data collection, and analysis in comparison to other studies that rely upon content analysis and human coding schemes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Exploratory Analysis of Marketing and Non-marketing E-cigarette Themes on Twitter

PubMed Central

Han, Sifei

2017-01-01

Electronic cigarettes (e-cigs) have been gaining popularity and have emerged as a controversial tobacco product since their introduction in 2007 in the U.S. The smoke-free aspect of e-cigs renders them less harmful than conventional cigarettes and is one of the main reasons for their use by people who plan to quit smoking. The US food and drug administration (FDA) has introduced new regulations early May 2016 that went into effect on August 8, 2016. Given this important context, in this paper, we report results of a project to identify current themes in e-cig tweets in terms of semantic interpretations of topics generated with topic modeling. Given marketing/advertising tweets constitute almost half of all e-cig tweets, we first build a classifier that identifies marketing and non-marketing tweets based on a hand-built dataset of 1000 tweets. After applying the classifier to a dataset of over a million tweets (collected during 4/2015 – 6/2016), we conduct a preliminary content analysis and run topic models on the two sets of tweets separately after identifying the appropriate numbers of topics using topic coherence. We interpret the results of the topic modeling process by relating topics generated to specific e-cig themes. We also report on themes identified from e-cig tweets generated at particular places (such as schools and churches) for geo-tagged tweets found in our dataset using the GeoNames API. To our knowledge, this is the first effort that employs topic modeling to identify e-cig themes in general and in the context of geo-tagged tweets tied to specific places of interest. PMID:28782062

Exploratory Analysis of Marketing and Non-marketing E-cigarette Themes on Twitter.

PubMed

Han, Sifei; Kavuluru, Ramakanth

2016-11-01

Electronic cigarettes (e-cigs) have been gaining popularity and have emerged as a controversial tobacco product since their introduction in 2007 in the U.S. The smoke-free aspect of e-cigs renders them less harmful than conventional cigarettes and is one of the main reasons for their use by people who plan to quit smoking. The US food and drug administration (FDA) has introduced new regulations early May 2016 that went into effect on August 8, 2016. Given this important context, in this paper, we report results of a project to identify current themes in e-cig tweets in terms of semantic interpretations of topics generated with topic modeling. Given marketing/advertising tweets constitute almost half of all e-cig tweets, we first build a classifier that identifies marketing and non-marketing tweets based on a hand-built dataset of 1000 tweets. After applying the classifier to a dataset of over a million tweets (collected during 4/2015 - 6/2016), we conduct a preliminary content analysis and run topic models on the two sets of tweets separately after identifying the appropriate numbers of topics using topic coherence. We interpret the results of the topic modeling process by relating topics generated to specific e-cig themes. We also report on themes identified from e-cig tweets generated at particular places (such as schools and churches) for geo-tagged tweets found in our dataset using the GeoNames API. To our knowledge, this is the first effort that employs topic modeling to identify e-cig themes in general and in the context of geo-tagged tweets tied to specific places of interest.

Innovation and entrepreneurship programs in US medical education: a landscape review and thematic analysis

PubMed Central

Niccum, Blake A; Sarker, Arnab; Wolf, Stephen J; Trowbridge, Matthew J

2017-01-01

ABSTRACT Background: Training in innovation and entrepreneurship (I&E) in medical education has become increasingly prevalent among medical schools to train students in complex problem solving and solution design. Objective: We aim to characterize I&E education in US allopathic medical schools to provide insight into the features and objectives of this growing field. Design: I&E programs were identified in 2016 via structured searches of 158 US allopathic medical school websites. Program characteristics were identified from public program resources and structured phone interviews with program directors. Curricular themes were identified via thematic analysis of program resources, and themes referenced by >50% of programs were analyzed. Results: Thirteen programs were identified. Programs had a median age of four years, and contained a median of 13 students. Programs were led by faculty from diverse professional backgrounds, and all awarded formal recognition to graduates. Nine programs spanned all four years of medical school and ten programs required a capstone project. Thematic analysis revealed seven educational themes (innovation, entrepreneurship, technology, leadership, healthcare systems, business of medicine, and enhanced adaptability) and two teaching method themes (active learning, interdisciplinary teaching) referenced by >50% of programs. Conclusions: The landscape of medical school I&E programs is rapidly expanding to address newfound skills needed by physicians due to ongoing changes in healthcare, but programs remain relatively few and small compared to class size. This landscape analysis is the first review of I&E in medical education and may contribute to development of a formal educational framework or competency model for current or future programs. Abbreviations: AAMC: American Association of Medical Colleges; AMA: American Medical Association; I&E: Innovation and entrepreneurship PMID:28789602

Innovation and entrepreneurship programs in US medical education: a landscape review and thematic analysis.

PubMed

Niccum, Blake A; Sarker, Arnab; Wolf, Stephen J; Trowbridge, Matthew J

2017-01-01

Training in innovation and entrepreneurship (I&E) in medical education has become increasingly prevalent among medical schools to train students in complex problem solving and solution design. We aim to characterize I&E education in US allopathic medical schools to provide insight into the features and objectives of this growing field. I&E programs were identified in 2016 via structured searches of 158 US allopathic medical school websites. Program characteristics were identified from public program resources and structured phone interviews with program directors. Curricular themes were identified via thematic analysis of program resources, and themes referenced by >50% of programs were analyzed. Thirteen programs were identified. Programs had a median age of four years, and contained a median of 13 students. Programs were led by faculty from diverse professional backgrounds, and all awarded formal recognition to graduates. Nine programs spanned all four years of medical school and ten programs required a capstone project. Thematic analysis revealed seven educational themes (innovation, entrepreneurship, technology, leadership, healthcare systems, business of medicine, and enhanced adaptability) and two teaching method themes (active learning, interdisciplinary teaching) referenced by >50% of programs. The landscape of medical school I&E programs is rapidly expanding to address newfound skills needed by physicians due to ongoing changes in healthcare, but programs remain relatively few and small compared to class size. This landscape analysis is the first review of I&E in medical education and may contribute to development of a formal educational framework or competency model for current or future programs. AAMC: American Association of Medical Colleges; AMA: American Medical Association; I&E: Innovation and entrepreneurship.

Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

PubMed

Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-11-16

Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

"My Greatest Joy and My Greatest Heart Ache:" Parents' Own Words on How Having a Child in the Autism Spectrum Has Affected Their Lives and Their Families' Lives

ERIC Educational Resources Information Center

Myers, Barbara J.; Mackintosh, Virginia H.; Goin-Kochel, Robin P.

2009-01-01

Parents of children in the autism spectrum wrote an open-ended answer via an online questionnaire to the question, "How has your child in the autism spectrum affected your life and your family's life?" (N = 493). Using a qualitative content analysis, 15 negative themes and 9 positive themes were identified. Themes are subsumed into five clusters:…

Transforming User Needs into Functional Requirements for an Antibiotic Clinical Decision Support System

PubMed Central

Bright, T.J.

2013-01-01

Summary Background Many informatics studies use content analysis to generate functional requirements for system development. Explication of this translational process from qualitative data to functional requirements can strengthen the understanding and scientific rigor when applying content analysis in informatics studies. Objective To describe a user-centered approach transforming emergent themes derived from focus group data into functional requirements for informatics solutions and to illustrate these methods to the development of an antibiotic clinical decision support system (CDS). Methods The approach consisted of five steps: 1) identify unmet therapeutic planning information needs via Focus Group Study-I, 2) develop a coding framework of therapeutic planning themes to refine the domain scope to antibiotic therapeutic planning, 3) identify functional requirements of an antibiotic CDS system via Focus Group Study-II, 4) discover informatics solutions and functional requirements from coded data, and 5) determine the types of information needed to support the antibiotic CDS system and link with the identified informatics solutions and functional requirements. Results The coding framework for Focus Group Study-I revealed unmet therapeutic planning needs. Twelve subthemes emerged and were clustered into four themes; analysis indicated a need for an antibiotic CDS intervention. Focus Group Study-II included five types of information needs. Comments from the Barrier/Challenge to information access and Function/Feature themes produced three informatics solutions and 13 functional requirements of an antibiotic CDS system. Comments from the Patient, Institution, and Domain themes generated required data elements for each informatics solution. Conclusion This study presents one example explicating content analysis of focus group data and the analysis process to functional requirements from narrative data. Illustration of this 5-step method was used to develop an antibiotic CDS system, resolving unmet antibiotic prescribing needs. As a reusable approach, these techniques can be refined and applied to resolve unmet information needs with informatics interventions in additional domains. PMID:24454586

Understanding Unintended Consequences and Health Information Technology:. Contribution from the IMIA Organizational and Social Issues Working Group.

PubMed

Kuziemsky, C E; Randell, R; Borycki, E M

2016-11-10

No framework exists to identify and study unintended consequences (UICs) with a focus on organizational and social issues (OSIs). To address this shortcoming, we conducted a literature review to develop a framework for considering UICs and health information technology (HIT) from the perspective of OSIs. A literature review was conducted for the period 2000- 2015 using the search terms "unintended consequences" and "health information technology". 67 papers were screened, of which 18 met inclusion criteria. Data extraction was focused on the types of technologies studied, types of UICs identified, and methods of data collection and analysis used. A thematic analysis was used to identify themes related to UICs. We identified two overarching themes. One was the definition and terminology of how people classify and discuss UICs. Second was OSIs and UICs. For the OSI theme, we also identified four sub-themes: process change and evolution, individual-collaborative interchange, context of use, and approaches to model, study, and understand UICs. While there is a wide body of research on UICs, there is a lack of overall consensus on how they should be classified and reported, limiting our ability to understand the implications of UICs and how to manage them. More mixed-methods research and better proactive identification of UICs remain priorities. Our findings and framework of OSI considerations for studying UICs and HIT extend existing work on HIT and UICs by focusing on organizational and social issues.

Understanding Unintended Consequences and Health Information Technology:

PubMed Central

Randell, R.; Borycki, E. M.

2016-01-01

Summary Objective No framework exists to identify and study unintended consequences (UICs) with a focus on organizational and social issues (OSIs). To address this shortcoming, we conducted a literature review to develop a framework for considering UICs and health information technology (HIT) from the perspective of OSIs. Methods A literature review was conducted for the period 2000-2015 using the search terms “unintended consequences” and “health information technology”. 67 papers were screened, of which 18 met inclusion criteria. Data extraction was focused on the types of technologies studied, types of UICs identified, and methods of data collection and analysis used. A thematic analysis was used to identify themes related to UICs. Results We identified two overarching themes. One was the definition and terminology of how people classify and discuss UICs. Second was OSIs and UICs. For the OSI theme, we also identified four sub-themes: process change and evolution, individual-collaborative interchange, context of use, and approaches to model, study, and understand UICs. Conclusions While there is a wide body of research on UICs, there is a lack of overall consensus on how they should be classified and reported, limiting our ability to understand the implications of UICs and how to manage them. More mixed-methods research and better proactive identification of UICs remain priorities. Our findings and framework of OSI considerations for studying UICs and HIT extend existing work on HIT and UICs by focusing on organizational and social issues. PMID:27830231

Protocol for a thematic synthesis to identify key themes and messages from a palliative care research network.

PubMed

Nicholson, Emma; Murphy, Tara; Larkin, Philip; Normand, Charles; Guerin, Suzanne

2016-10-21

Research networks that facilitate collaborative research are increasing both regionally and globally and such collaborations contribute greatly to knowledge transfer particularly in health research. The Palliative Care Research Network is an Irish-based network that seeks to create opportunities and engender a collaborative environment to encourage innovative research that is relevant for policy and practice. The current review outlines a methodology to identify cross-cutting messages to identify how dissemination outputs can be optimized to ensure that key messages from this research reaches all knowledge users. Preferred reporting items for systematic review and meta-analysis protocol guidelines will inform the search and analysis plan to ensure that the synthesis of the data is as rigorous as possible. An approach based on critical interpretative synthesis will be adapted to include a thematic synthesis for the identification of higher-order themes and messages from a body of dissemination products generated by the Palliative Care Research Network. The thematic synthesis outlined in the present protocol offers a novel method of synthesising data from a focused research network that employs a variety of dissemination materials as a means of identifying key themes and messages from a specific body of research. The high-level themes and messages will be identified from the thematic synthesis, widely disseminated and targeted towards a range of stakeholders and knowledge users such as carers, health and social care professionals, policy makers and researchers.

Forensic Learning Disability Nursing Role Analysis

ERIC Educational Resources Information Center

Mason, Tom; Phipps, Dianne; Melling, Kat

2011-01-01

This article reports on a study carried out on the role constructs of forensic and nonforensic Learning Disability Nursing in relation to six binary themes. The aims were to identify if there were differences in perceptions of forensic learning disability nurses and nonforensic learning disability nurses in relation to the six binary themes of the…

A Theoretical Framework for Media Law Courses (Approaches to Teaching Freedom of Expression).

ERIC Educational Resources Information Center

Helle, Steven

1991-01-01

Suggests that most students prefer teachers have a theme that provides coherence and cohesiveness to media law courses. Explains how libertarian and neoliberal themes can guide learning and enumerates some of the principles of the two theories. Identifies drawbacks of the case analysis approach to such courses. (SG)

Examining ISIS Support and Opposition Networks on Twitter

DTIC Science & Technology

2016-01-01

interactive communities of Twitter users , lexical analysis that can identify key themes and content for large data sets, and social network analysis...Twitter data, we lexically analyzed the content and key themes of users who mostly employ Daesh versus those who mostly use Islamic State in their tweets...As predicted, we found that frequent users of Daesh had content that was highly critical of ISIS, with users using such terms as Terrorist Daesh

Key principles to guide development of consumer medicine information--content analysis of information design texts.

PubMed

Raynor, David K; Dickinson, David

2009-04-01

Effective written consumer medicines information is essential to support safe and effective medicine taking, but the wording and layout of currently provided materials do not meet patients' needs. To identify principles from the wider discipline of information design for use by health professionals when developing or assessing written drug information for patients. Six experts in information design nominated texts on best practice in information design applicable to consumer medicines information. A content analysis identified key principles that were tabulated to bring out key themes. Six texts that met the inclusion criteria, were identified, and content analysis indentified 4 themes: words, type, lines, and layout. Within these main themes, there were 24 subthemes. Selected principles relating to these subthemes were: use short familiar words, short sentences, and short headings that stand out from the text; use a conversational tone of voice, addressing the reader as "you"; use a large type size while retaining sufficient white space; use bullet points to organize lists; use unjustified text (ragged right) and bold, lower-case text for emphasis. Pictures or graphics do not necessarily improve a document. Applying the good information design principles identified to written consumer medicines information could support health professionals when developing and assessing drug information for patients.

A Characterization of Student Reflections in an Introductory Pharmacy Practice Experience Discussion Course.

PubMed

Dinkins, Melissa M; Haltom, Wesley R

2018-04-01

Objective. To characterize weekly student reflections in an introductory pharmacy practice experience (IPPE) discussion course meeting concurrently with IPPE rotations in institutional pharmacy. Methods. A qualitative analysis was conducted to identify themes within weekly reflective statements submitted by second year pharmacy students (P2) enrolled in an IPPE rotation and concurrent discussion course. Weekly reflections from the 2015-2016 offering of the course were reviewed by investigators to identify common themes via an iterative process. Subsequently, investigators coded each submission into one of the identified categories. Initial agreement between investigators was assessed using the Cohen kappa coefficient. Discrepancies between coding were resolved through discussion to reach consensus. Results. A total of 402 reflection assignments were reviewed from 85 P2 students enrolled in the IPPE course. Ten themes were identified, with the most common themes being interprofessional teamwork, pharmacist and technician roles and responsibilities, and policies and procedures. Substantial initial agreement between investigators was found, with the most discrepancies arising within the themes of medication distribution and pharmacy administration/organizational structure. Conclusion. Student reflections on IPPEs centered on 10 key topics, primarily related to distributive, legal, and regulatory functions of institutional pharmacy practice. Structuring an IPPE rotation longitudinally in an academic term, with a concurrent discussion course, builds a framework for regular student reflection.

Graduating student pharmacists' perspectives on e-professionalism and social media: qualitative findings.

PubMed

Ness, Genevieve Lynn; Sheehan, Amy Heck; Snyder, Margie E

2014-01-01

OBJECTIVE To characterize students' views and opinions of professionalism on popular social media sites and compare responses about social media behavior among students in different groups. DESIGN Cross-sectional survey. SETTING Four colleges of pharmacy in midwestern United States. PARTICIPANTS 516 graduating student pharmacists. INTERVENTIONS Online survey with open-ended questions. MAIN OUTCOME MEASURES Qualitative analysis of responses and themes. RESULTS A total of 212 student pharmacists completed surveys (41% response rate). Mean (± SD) age was 25.2 ± 4.6 years, and 72% of respondents were women. Major overarching themes identified in the qualitative analysis were separation of personal and professional lives, how accountability for actions should vary by severity, and the extent of representation of the students' character on social media. CONCLUSION Identified themes provided important insights into the ways in which student pharmacists view social media and use this widely accessible means of personal communication.

Process for massage therapy practice and essential assessment.

PubMed

Kennedy, Ann Blair; Cambron, Jerrilyn A; Sharpe, Patricia A; Travillian, Ravensara S; Saunders, Ruth P

2016-07-01

Little evidence exists about processes in massage therapy practice. Investigating current frameworks is warranted. This qualitative study is a secondary data analysis using grounded theory to understand how massage therapy experts describe massage therapy practice. 31 massage therapy experts were invited to a 2-day symposium to discuss best practices for the profession. Through qualitative analysis, memoing, and discussion, the data were summarized into themes. Three themes were identified around massage therapy practice: 1) client centered, 2) structure for practice, and 3) influencing factors. Each theme is clarified and expanded. Conceptual models were developed for research and clinical practice and a definition for massage therapy practice was identified. Challenges and limitations are discussed. The goal of providing these models is to give massage therapists tools to deliver the best possible care. The models need testing to see if they help advance the profession. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Health, Stigma, and the Burden of Smoking in College: A Thematic Analysis.

PubMed

Palmer, Amanda M; Correa, John B; Heckman, Bryan W; Brandon, Thomas H; Simmons, Vani N

2016-05-01

Authorities estimate that 16.7% of adults 18-24 smoke, and many initiate or increase cigarette smoking while in college. Thus, college represents a critical time for intervention. Simmons et al developed and tested an interactive Web-based intervention that includes a component for inducing dissonance through creating video testimonials about the negatives of smoking. We applied thematic analysis to video content to identify smoking's negative consequences as reflected in testimonials from 78 college smokers. We identified common themes and calculated the amount of time spent discussing each theme and the strength of language used. Social stigma and health consequences of smoking emerged as multidimensional themes; other common topics included financial burden, chemicals in cigarettes, and cravings/addiction. These results provide insight into the attitudes of college student smokers. Addressing these topics may be important for message development in intervention and prevention studies.

Documentary analysis as an assessment tool.

PubMed

Lawson, Lauren V

2018-05-29

Documentary analysis of existing information, such as newspaper articles, is an identified method for use in an assessment to provide a descriptive explanation of existing problems or assets. The intention of this case study is to explore the effectiveness of documentary analysis of newspaper articles as a tool to inform an assessment of factors influencing the implementation of a medical respite for the homeless. Two questions framed the assessment; (a) What was occurring or might occur that will affect the development of a medical respite; and (b) What opportunities or threats are generated as a result? Articles from two local newspapers identified themes related to the three external forces of change that impact medical respites; (a) funding; (b) community resistance; and (c) the health care system. Three themes emerged: a) uncertain funding; b) neighborhood resistance, and c) improved access to healthcare would result from the Affordable Care Act. Use of documentary analysis of newspaper articles provided applicable content for the assessment. Themes from the assessment informed strategic planning, such as addressing potential neighborhood resistance. © 2018 Wiley Periodicals, Inc.

Mind the Gap

PubMed Central

Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-01-01

Summary Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical work-flow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation. PMID:27847961

Spatial Paradigm for Information Retrieval and Exploration

DOE Office of Scientific and Technical Information (OSTI.GOV)

The SPIRE system consists of software for visual analysis of primarily text based information sources. This technology enables the content analysis of text documents without reading all the documents. It employs several algorithms for text and word proximity analysis. It identifies the key themes within the text documents. From this analysis, it projects the results onto a visual spatial proximity display (Galaxies or Themescape) where items (documents and/or themes) visually close to each other are known to have content which is close to each other. Innovative interaction techniques then allow for dynamic visual analysis of large text based information spaces.

SPIRE1.03. Spatial Paradigm for Information Retrieval and Exploration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adams, K.J.; Bohn, S.; Crow, V.

The SPIRE system consists of software for visual analysis of primarily text based information sources. This technology enables the content analysis of text documents without reading all the documents. It employs several algorithms for text and word proximity analysis. It identifies the key themes within the text documents. From this analysis, it projects the results onto a visual spatial proximity display (Galaxies or Themescape) where items (documents and/or themes) visually close to each other are known to have content which is close to each other. Innovative interaction techniques then allow for dynamic visual analysis of large text based information spaces.

Barriers and facilitators for implementing a new screening tool in an emergency department: A qualitative study applying the Theoretical Domains Framework.

PubMed

Kirk, Jeanette W; Sivertsen, Ditte M; Petersen, Janne; Nilsen, Per; Petersen, Helle V

2016-10-01

The aim was to identify the factors that were perceived as most important as facilitators or barriers to the introduction and intended use of a new tool in the emergency department among nurses and a geriatric team. A high incidence of functional decline after hospitalisation for acute medical illness has been shown in the oldest patients and those who are physically frail. In Denmark, more than 35% of older medical patients acutely admitted to the emergency department are readmitted within 90 days after discharge. A new screening tool for use in the emergency department aiming to identify patients at particularly high risk of functional decline and readmission was developed. Qualitative study based on semistructured interviews with nurses and a geriatric team in the emergency department and semistructured single interviews with their managers. The Theoretical Domains Framework guided data collection and analysis. Content analysis was performed whereby new themes and themes already existing within each domain were described. Six predominant domains were identified: (1) professional role and identity; (2) beliefs about consequences; (3) goals; (4) knowledge; (5) optimism and (6) environmental context and resources. The content analysis identified three themes, each containing two subthemes. The themes were professional role and identity, beliefs about consequences and preconditions for a successful implementation. Two different cultures were identified in the emergency department. These cultures applied to different professional roles and identity, different actions and sense making and identified how barriers and facilitators linked to the new screening tool were perceived. The results show that different cultures exist in the same local context and influence the perception of barriers and facilitators differently. These cultures must be identified and addressed when implementation is planned. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance.

PubMed

Le Boutillier, Clair; Leamy, Mary; Bird, Victoria J; Davidson, Larry; Williams, Julie; Slade, Mike

2011-12-01

Recovery is a multifaceted concept, and the need for operationalization in practice has been identified. Although guidance on recovery-oriented practice exists, it is from disparate sources and is difficult to apply. The aims of the study were to identify the key characteristics of recovery-oriented practice guidance on the basis of current international perspectives and to develop an overarching conceptual framework to aid the translation of recovery guidance into practice. A qualitative analysis of 30 international documents offering recovery-oriented practice guidance was conducted. Inductive, semantic-level, thematic analysis was used to identify dominant themes. Interpretive analysis was then undertaken to group the themes into practice domains. The guidance documents were diverse; from six countries-the United States, England, Scotland, Republic of Ireland, Denmark, and New Zealand-and varied in document type, categories of guidance, and level of service user involvement in guidance development. The emerging conceptual framework consists of 16 dominant themes, grouped into four practice domains: promoting citizenship, organizational commitment, supporting personally defined recovery, and working relationship. A key challenge for mental health services is the lack of clarity about what constitutes recovery-oriented practice. The conceptual framework contributes to this knowledge gap and provides a synthesis of recovery-oriented practice guidance.

Evidence-based medicine teaching requirements in the USA: taxonomy and themes.

PubMed

Shaughnessy, Allen F; Torro, John R; Frame, Kara A; Bakshi, Munish

2016-05-01

In the USA, recent changes to oversight of residency training codify the requirements for teaching evidence-based medicine and information mastery (lifelong learning) knowledge, skills, and attitudes. The goal of this project is to determine current requirements for teaching of evidence-based medicine (EBM) and information mastery (IM) in specialty residency education in the USA. The project was a qualitative thematic analysis using content analysis. The source of the requirements for EBM and IM were the "milestone" statements for all 28 major specialties and transition year programs. Milestone descriptors related to EBM/IM were extracted and codes were developed and applied to each descriptor by four researchers. The resulting codes were coalesced into themes and tested against the milestone descriptors. The coding process identified 15 content areas comprising five themes. Two themes related to the knowledge and skills of EBM and three themes related to the knowledge, skills, and attitudes of IM. EBM themes encompassed basic critical appraisal skills and knowledge of clinical epidemiology principles and statistics. IM themes centered on identifying one's information needs for patient-specific information, using information sources, and using current awareness services to remain abreast of changes in medicine. In general, they align well with the Sicily Statement on Evidence-Based Practice. No specialty required competence in all areas. New training requirements for specialties in the USA require the development of both classic EBM skills as well as skills for managing information. However, there is marked variation in the requirements among specific specialties. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Using a SWOT analysis to inform healthy eating and physical activity strategies for a remote First Nations community in Canada.

PubMed

Skinner, Kelly; Hanning, Rhona M; Sutherland, Celine; Edwards-Wheesk, Ruby; Tsuji, Leonard J S

2012-01-01

To plan community-driven health promotion strategies based on a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the healthy eating and physical activity patterns of First Nation (FN) youth. Cross-sectional qualitative and quantitative data used to develop SWOT themes and strategies. Remote, subarctic FN community of Fort Albany, Ontario, Canada. Adult (n  =  25) and youth (n  =  66, grades 6-11) community members. Qualitative data were collected using five focus groups with adults (two focus groups) and youth (three focus groups), seven individual interviews with adults, and an environmental scan of 13 direct observations of events/locations (e.g., the grocery store). Quantitative data on food/physical activity behaviors were collected using a validated Web-based survey with youth. Themes were identified from qualitative and quantitative data and were analyzed and interpreted within a SWOT matrix. Thirty-two SWOT themes were identified (e.g., accessibility of existing facilities, such as the gymnasium). The SWOT analysis showed how these themes could be combined and transformed into 12 strategies (e.g., expanding and enhancing the school snack/breakfast program) while integrating suggestions from the community. SWOT analysis was a beneficial tool that facilitated the combination of local data and community ideas in the development of targeted health promotion strategies for the FN community of Fort Albany.

Network methods to support user involvement in qualitative data analyses: an introduction to Participatory Theme Elicitation.

PubMed

Best, Paul; Badham, Jennifer; Corepal, Rekesh; O'Neill, Roisin F; Tully, Mark A; Kee, Frank; Hunter, Ruth F

2017-11-23

While Patient and Public Involvement (PPI) is encouraged throughout the research process, engagement is typically limited to intervention design and post-analysis stages. There are few approaches to participatory data analyses within complex health interventions. Using qualitative data from a feasibility randomised controlled trial (RCT), this proof-of-concept study tests the value of a new approach to participatory data analysis called Participatory Theme Elicitation (PTE). Forty excerpts were given to eight members of a youth advisory PPI panel to sort into piles based on their perception of related thematic content. Using algorithms to detect communities in networks, excerpts were then assigned to a thematic cluster that combined the panel members' perspectives. Network analysis techniques were also used to identify key excerpts in each grouping that were then further explored qualitatively. While PTE analysis was, for the most part, consistent with the researcher-led analysis, young people also identified new emerging thematic content. PTE appears promising for encouraging user led identification of themes arising from qualitative data collected during complex interventions. Further work is required to validate and extend this method. ClinicalTrials.gov, ID: NCT02455986 . Retrospectively Registered on 21 May 2015.

Building Scholarly Writers: Student Perspectives on Peer Review in a Doctoral Writing Seminar

ERIC Educational Resources Information Center

Adamek, Margaret Ellen

2015-01-01

Peer review was used as a primary pedagogical tool in a scholarly writing course for social work doctoral students. To gauge student response to peer review and learning as a result of peer review, the instructor used narrative analysis to organize student comments into themes. Themes identified included initial trepidation, "no pain, no…

The Perceptions and Experiences of Taiwanese Parents Who Have Children with an Intellectual Disability

ERIC Educational Resources Information Center

Chang, Mei-Ying; McConkey, Roy

2008-01-01

Most research into family care-giving has been undertaken in western, English-speaking societies with little cognisance taken of possible differences across cultures. Home-based interviews were conducted with 117 mothers and fathers in Taipei City, Taiwan and five main themes were identified using content analysis. Three themes expressed the…

Applying Common Latino Magazine Cover Line Themes to Health Communications

ERIC Educational Resources Information Center

Delaney, Colleen L.; Barrios, Pamela; Lozada, Carolina; Soto-Balbuena, Kenlly; Martin-Biggers, Jennifer; Byrd-Bredbenner, Carol

2016-01-01

This study aimed to describe strategies used in magazine cover lines to capture the attention of Latino consumers. A content analysis of cover lines (n = 581) from six top-selling Latino women's and parenting magazines (n = 217 issues) sold in the United States identified 12 common themes: great/inspiring, beauty/health, bad/negative,…

Pharmaceutical strategic purchasing requirements in Iran: Price interventions and the related effective factors

PubMed Central

Bastani, Peivand; Dinarvand, Rasoul; SamadBeik, Mahnaz; Pourmohammadi, Kimia

2016-01-01

Objective: Pharmaceutical access for the poor is an essential factor in developing countries that can be improved through strategic purchasing. This study was conducted to identify the elements affecting price in order to enable insurance organizations to put strategic purchasing into practice. Methods: This was a qualitative study conducted through content analysis with an inductive approach applying a five-stage framework analysis (familiarization, identifying a thematic framework, indexing, mapping, and interpretation). Data analysis was started right after transcribing each interview applying ATLAS.ti. Data were saturated after 32 semi-structured interviews by experts. These key informants were selected purposefully and through snowball sampling. Findings: Findings showed that there are four main themes as Pharmaceutical Strategic Purchasing Requirements in Iran as follows essential and structural factors, international factors, economical factors, and legal factors. Moreover, totally 14 related sub-themes were extracted in this area as the main effective variables. Conclusion: It seems that paying adequate attention to the four present themes and 14 sub-themes affecting price can enable health system policy-makers of developing countries like Iran to make the best decisions through strategic purchasing of drugs by the main insurers in order to improve access and health in the country. PMID:26985434

Decision fatigue: A conceptual analysis.

PubMed

Pignatiello, Grant A; Martin, Richard J; Hickman, Ronald L

2018-03-01

Decision fatigue is an applicable concept to healthcare psychology. Due to a lack of conceptual clarity, we present a concept analysis of decision fatigue. A search of the term "decision fatigue" was conducted across seven research databases, which yielded 17 relevant articles. The authors identified three antecedent themes (decisional, self-regulatory, and situational) and three attributional themes (behavioral, cognitive, and physiological) of decision fatigue. However, the extant literature failed to adequately describe consequences of decision fatigue. This concept analysis provides needed conceptual clarity for decision fatigue, a concept possessing relevance to nursing and allied health sciences.

How do people with body dysmorphic disorder view themselves? A thematic analysis.

PubMed

Silver, Joanna; Reavey, Paula; Anne Fineberg, Naomi

2010-09-01

Abstract Objectives. To examine the accounts of people with body dysmorphic disorder (BDD) and qualitatively explore self perceptions. Methods. Eleven people with BDD were interviewed using a semi-structured schedule. Participants brought photographs of themselves and drew a self-portrait. Transcribed interviews were analysed using a thematic analysis. Results. The most common theme was increased threat perception resulting in disordered interpersonal relationships. Other themes included the wish for regularity and symmetry in appearance, an idealised childhood self, the duty to look good, and a focus on specific "defective" features rather than general ugliness. Conclusions. Using thematic analysis and visual methods, we identified core themes that appear to characterise the way individuals with BDD perceive themselves and their interpersonal relationships. Thematic analysis offers promise as a tool to explore the overlap between BDD and other putatively related mental health problems.

A Thematic Analysis of Online Discussion Boards for Brachial Plexus Injury.

PubMed

Morris, Marie T; Daluiski, Aaron; Dy, Christopher J

2016-08-01

Patients with brachial plexus injury (BPI) and their family members contribute to Internet discussion groups dedicated to BPI. We hypothesized that a thematic analysis of posts from BPI Internet discussion groups would reveal common themes related to the BPI patient experience, providing topics for patient education and counseling. Internet discussion boards were identified using the search term "brachial plexus injury support group" in Google, Bing, and Yahoo! search engines. Two discussion boards had substantially more posts than other Web sites and were chosen for analyses. Posts from January 1, 2015, through January 1, 2016, were examined. Using an iterative and established process, 2 investigators (M.T.M. and C.J.D) independently analyzed each post using thematic analysis in 3 steps (open coding, axial coding, and selective coding) to determine common themes. In this process, each post was reviewed 3 times. A total of 328 posts from the 2 leading discussion boards were analyzed. Investigators reached a consensus on themes for all posts. One central theme focused on emotional aspects of BPI. Four other central themes regarding information support were identified: BPI disease, BPI treatment, recovery after BPI treatment, and process of seeking care for BPI. Examination of posts on Internet support groups for BPI revealed recurring concerns, questions, and opinions of patients and their family members. The most common themes related to disease information, treatment, recovery, and the emotional element of BPI. These findings provide a helpful starting point in refining topics for patient education and support that are targeted on patients' interests and concerns. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Continuing professional development needs of nursing and allied health professionals with responsibility for prescribing.

PubMed

Weglicki, Robert S; Reynolds, Julie; Rivers, Peter H

2015-01-01

Continuing professional development (CPD) for non-medical prescribers is recognised as being pivotal in maintaining up -to -date knowledge and skills influencing prescribing competence. This study was, therefore, designed to ascertain the aspirations, priorities and preferred mode of CPD for non-medical prescribers. Qualitative data were derived from semi-structured in-depth interviews and a focus group given by 16 allied health professionals working in primary and secondary care settings. A topic guide was used to cover clinical decision-making (including difficult decisions), legal aspects of prescribing and diagnostic issues. A content analysis of the verbatim transcripts enabled four key emerging themes to be identified, thus offering a basis for developing a greater understanding of the CPD needs of non-medical prescribers. The four key emerging themes identified are the following: Theme 1: "Personal anxiety undermining confidence to prescribe", Theme 2: "External barriers and other factors that exacerbate anxiety", Theme 3: "Need for support identified through coping strategies", and Theme 4: "Preferred mode or style of learning". The findings suggest that anxiety and lack of confidence in non-medical prescribing pose a significant challenge for CPD. Strategies that are most likely to improve prescribing confidence are through a blended learning approach. Local higher education and workplace employer collaboration is an appropriate step forward to achieve this. Copyright © 2014 Elsevier Ltd. All rights reserved.

Qualitative thematic analysis of the phenomenology of near-death experiences.

PubMed

Cassol, Helena; Pétré, Benoît; Degrange, Sophie; Martial, Charlotte; Charland-Verville, Vanessa; Lallier, François; Bragard, Isabelle; Guillaume, Michèle; Laureys, Steven

2018-01-01

Near-death experiences (NDEs) refer to profound psychological events that can have an important impact on the experiencers' (NDErs) lives. Previous studies have shown that NDEs memories are phenomenologically rich. In the present study, we therefore aimed to extract the common themes (referred to as "features" in the NDE literature) reported by NDErs by analyzing all the concepts stored in the narratives of their experiences. A qualitative thematic analysis has been carried out on 34 cardiac arrest survivors' NDE narratives. Our results shed the light on the structure of the narratives by identifying 10 "time-bounded" themes which refer to isolated events encountered during the NDE and 1 "transversal" theme which characterizes the whole narrative and generally appears as a retrospective comment of self-reflection on the experience. The division of narratives into themes provides us with detailed information about the vocabulary used by NDErs to describe their experience. This established thematic method enables a rigorous description of the phenomenon, ensuring the inclusion of all self-reported manifestations of themes in narratives.

Identifying common values among seven health professions: An interprofessional analysis.

PubMed

Grace, Sandra; Innes, Ev; Joffe, Beverly; East, Leah; Coutts, Rosanne; Nancarrow, Susan

2017-05-01

This article reviews the competency frameworks of seven Australian health professions to explore relationships among health professions of similar status as reflected in their competency frameworks and to identify common themes and values across the professions. Frameworks were compared using a constructivist grounded theory approach to identify key themes, against which individual competencies for each profession were mapped and compared. The themes were examined for underlying values and a higher order theoretical framework was developed. In contrast to classical theories of professionalism that foreground differentiation of professions, our study suggests that the professions embrace a common structure and understanding, based on shared underpinning values. We propose a model of two core values that encompass all identified themes: the rights of the client and the capacity of a particular profession to serve the healthcare needs of clients. Interprofessional practice represents the intersection of the rights of the client to receive the best available healthcare and the recognition of the individual contribution of each profession. Recognising that all health professions adhere to a common value base, and exploring professional similarities and differences from that value base, challenges a paradigm that distinguishes professions solely on scope of practice.

The science of ecological economics: a content analysis of Ecological Economics, 1989-2004.

PubMed

Luzadis, Valerie A; Castello, Leandro; Choi, Jaewon; Greenfield, Eric; Kim, Sung-kyun; Munsell, John; Nordman, Erik; Franco, Carol; Olowabi, Flavien

2010-01-01

The Ecological Economics journal is a primary source for inquiry on ecological economics and sustainability. To explore the scholarly pursuit of ecological economics, we conducted a content analysis of 200 randomly sampled research, survey, and methodological articles published in Ecological Economics during the 15-year period of 1989-2004. Results of the analysis were used to investigate facets of transdisciplinarity within the journal. A robust qualitative approach was used to gather and examine data to identify themes representing substantive content found within the span of sampled journal papers. The extent to which each theme was represented was counted as well as additional data, such as author discipline, year published, etc. Four main categories were revealed: (1) foundations (self-reflexive themes stemming from direct discussions about ecological economics); (2) human systems, represented by the themes of values, social indicators of well-being, intergenerational distribution, and equity; (3) biophysical systems, including themes, such as carrying capacity and scarcity, energy, and resource use, relating directly to the biophysical aspects of systems; and (4) policy and management encompassing themes of development, growth, trade, accounting, and valuation, as well as institutional structures and management. The results provide empirical evidence for discussing the future direction of ecological economic efforts.

Transition to Puberty as Experienced by 12-Year-Old Swedish Girls

ERIC Educational Resources Information Center

Rembeck, Gun I.; Hermansson, Evelyn

2008-01-01

The purpose of this study was to describe 12-year-old girls' experiences of entering puberty. A qualitative approach was used to gather data from focus group interviews, and content analysis was used to identify common themes from the responses of 18 girls. Findings revealed four main themes: (a) growing up--awareness, bodily changes, longing; (b)…

Chaotic Careers: A Narrative Analysis of Career Transition Themes and Outcomes Using Chaos Theory as a Guiding Metaphor

ERIC Educational Resources Information Center

Peake, Sharon; McDowall, Almuth

2012-01-01

In a rapidly changing world of work, little research exists on mid-career transitions. We investigated these using the open-systems approach of chaos theory as a guiding metaphor and conducted interviews with seven mid-career individuals chosen for their experience of a significant mid-career transition. Four common themes were identified through…

Barriers and Strategies for Healthy Food Choices among American Indian Tribal College Students: A Qualitative Analysis.

PubMed

Keith, Jill F; Stastny, Sherri; Brunt, Ardith; Agnew, Wanda

2018-06-01

American Indian and Alaskan Native individuals experience disproportionate levels of chronic health conditions such as type 2 diabetes and overweight and obesity that are influenced by dietary patterns and food choices. Understanding factors that influence healthy food choices among tribal college students can enrich education and programs that target dietary intake. To build an understanding of factors that influence healthy food choices among tribal college students at increased risk for college attrition. A nonexperimental cohort design was used for qualitative descriptive analysis. Participants (N=20) were purposively sampled, newly enrolled, academically underprepared tribal college students enrolled in a culturally relevant life skills course at an upper Midwest tribal college between September 2013 and May 2015. Participant demographic characteristics included various tribal affiliations, ages, and number of dependents. Participant responses to qualitative research questions about dietary intake, food choices, self-efficacy for healthy food choices, psychosocial determinants, and barriers to healthy food choices during telephone interviews were used as measures. Qualitative analysis included prestudy identification of researcher bias/assumptions, audiorecording and transcription, initial analysis (coding), secondary analysis (sorting and identifying meaning), and verification (comparative pattern analysis). Qualitative analysis revealed a variety of themes and subthemes about healthy food choices. Main themes related to barriers included taste, food gathering and preparation, and difficulty clarifying healthy food choices. Main themes related to strategies included taste, cultural traditions and practices, and personal motivation factors. Qualitative analysis identified barrier and strategy themes that may assist nutrition and dietetics practitioners working with tribal/indigenous communities, tribal college educators and health specialists, and tribal community health workers who target health and dietary intake of American Indian and Alaskan Native students. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Identifying the Ethical Challenges Encountered by Information Technology Professionals Working within the Nevada Casino Industry

ERIC Educational Resources Information Center

Essig, Michael R.

2014-01-01

A thematic analysis qualitative study was used to identify the unethical challenges encountered by Information Technology (IT) professionals working within the Nevada casino industry. Fourteen current and former IT leaders working or who worked in the Nevada casino industry were interviewed. Using thematic analysis, nine themes regarding ethical…

Evidence-based management - healthcare manager viewpoints.

PubMed

Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

2018-06-11

Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

The experience of return to work in individuals with traumatic brain injury (TBI): A qualitative study.

PubMed

Libeson, Lauren; Downing, Marina; Ross, Pamela; Ponsford, Jennie

2018-05-10

Traumatic Brain Injury (TBI) is a leading cause of disability in young people, with return to work (RTW) a major goal of recovery. This qualitative study aimed to understand the RTW experience of individuals with TBI who received comprehensive vocational rehabilitation, and to identify facilitating and limiting factors in the RTW process. Semi-structured interviews were conducted with 15 individuals (mean age = 47.33 years) approximately 4.5 years post-injury, of whom 14 had moderate to severe TBI. Twelve individuals had successfully returned to work. Thematic analysis of transcribed interviews identified three key factors affecting RTW: client, work and rehabilitation factors. Across these factors, 12 themes reported to be critical to the success or failure of the RTW programme were identified. Client themes included social support, cognitive difficulties and motivation, with RTW too early associated with unfavourable outcomes. Work themes included work modifications, employer support and financial incentives. Rehabilitation themes included the RTW programme, the role of the vocational occupational therapist and work preparation. These key factors were reported to have impacted the RTW outcome, comprising three further themes: work satisfaction, future vocational outlook, and quality of life. Consideration of these factors can inform vocational rehabilitation programmes, potentially improving employment outcomes following TBI.

Studer Group® ' s evidence-based leadership initiatives.

PubMed

Schuller, Kristin A; Kash, Bita A; Gamm, Larry D

2015-01-01

The purpose of this paper is to analyze the implementation of an organizational change initiative--Studer Group®'s Evidence-Based Leadership (EBL)--in two large, US health systems by comparing and contrasting the factors associated with successful implementation and sustainability of the EBL initiative. This comparative case study assesses the responses to two pairs of open-ended questions during in-depth qualitative interviews of leaders and managers at both health systems. Qualitative content analysis was employed to identify major themes. Three themes associated with success and sustainability of EBL emerged at both health systems: leadership; culture; and organizational processes. The theme most frequently identified for both success and sustainability of EBL was culture. In contrast, there was a significant decline in salience of the leadership theme as attention shifts from success in implementation of EBL to sustaining EBL long term. Within the culture theme, accountability, and buy-in were most often cited by interviewees as success factors, while sense of accountability, buy-in, and communication were the most reported factors for sustainability. Cultural factors, such as accountability, staff support, and communication are driving forces of success and sustainability of EBL across both health systems. Leadership, a critical factor in several stages of implementation, appears to be less salient as among factors identified as important to longer term sustainability of EBL.

The child welfare system: through the eyes of public health nurses.

PubMed

Schneiderman, Janet U

2005-01-01

This qualitative descriptive study investigates how public health nurses working within the child welfare system view the organization and the organization's effect on their case management practice. Semistructured interviews were conducted utilizing the Bolman-Deal Organizational Model. This model identifies four frames of an organization: symbolic, human resources, political, and structural. A purposive sample of nine nurses and one social worker was selected to participate in comprehensive interviews. Data analysis identified two main themes. The first theme was the presence of organizational structural barriers to providing case management. The second theme was the lack of political influence by the nurses to change the structure of the organization; hence, their skills could be more completely utilized. Public health nurses who work in child welfare will need to systematically analyze their role within the organization and understand how to work in "host settings." Nursing educators need to prepare public health nurses to work in non-health care settings by teaching organizational analysis.

A better currency for investing in a sustainable future

NASA Astrophysics Data System (ADS)

Carbajales-Dale, Michael; Barnhart, Charles J.; Brandt, Adam R.; Benson, Sally M.

2014-07-01

Net energy analysis should be a critical energy policy tool. We identify five critical themes for realizing a low-carbon, sustainable energy future and highlight the key perspective that net energy analysis provides.

A qualitative description of successful aging through different decades of older adulthood.

PubMed

Carr, Kelly; Weir, Patricia L

2017-12-01

To qualitatively examine factors that contribute to successful aging during different decades of older adulthood. Fundamental qualitative description was adopted as the methodological framework. Through purposeful sampling, 42 community dwelling older adults (mean age = 79.6 years, age range = 65-97 years; 19 males) were recruited. Focus groups (6) segmented by decade of life were conducted with participants 65-74 (n = 17) and 75-84 (n = 17) years of age. Semi-structured interviews (16) were conducted with four participants from each decade, as well as participants 85 years of age and older (n = 8). Data analyses were conducted independently for each decade of life and included inductive analysis of textual data through continuous comparisons of meaning units. Three primary themes related to successful aging were identified across all decades of older adulthood: (1) staying healthy (secondary themes: genetics and lifestyle choices), (2) maintaining an active engagement in life (secondary themes: social engagement and cognitive engagement), and (3) keeping a positive outlook on life. Participants in specific decades of older adulthood identified three additional secondary themes related to maintaining an active engagement in life: finances (65-74 and 85+ years), social support (75+ years), and successful marriage (75+ years). Similarly, only adults 65-84 years of age identified a secondary theme for keeping a positive outlook on life: acceptance and adaptation. Primary themes related to successful aging were agreed upon by participants in all decades of older adulthood, while age-based differences existed among secondary themes. Thus, what it means to age successfully may be age-dependent.

Evaluation of Dermatology Practice Online Reviews: Lessons From Qualitative Analysis.

PubMed

Smith, Robert J; Lipoff, Jules B

2016-02-01

Patient satisfaction is an increasingly important component of health care quality measures. Online reviews of physicians represent a promising platform for capturing patient perspectives of care. To identify qualitative themes associated with patient reviews of dermatologic care on consumer reporting websites. A qualitative analysis was conducted of patient-generated reviews of dermatology practices on 2 consumer review platforms. Yelp is an online consumer portal for users to review their experience with local businesses; ZocDoc is an online patient-scheduling portal that provides opportunity for patients to write reviews of physician practices. A total of 518 reviews from 45 dermatology practices on Yelp and 4921 reviews from 45 dermatology providers on ZocDoc were collected from 3 geographically diverse cities: Philadelphia, Pennsylvania; Houston, Texas; and Seattle, Washington. The study was conducted from January 15 to July 15, 2015. Reviews were separated into high-scoring and low-scoring groups. An inductive qualitative method was used to code and identify key themes associated with positive and negative patient experiences. Analysis was completed upon reaching thematic saturation. Reported as mean (95% CI), the overall Yelp score for the 45 selected practices was 3.46 of 5 stars (3.17-3.75) and overall ZocDoc score for the 45 selected practices was 4.72 of 5 stars (4.47-4.80). The proportion of individual reviews giving a score of 5.0 was significantly higher on ZocDoc (3986 [81.0%]) than on Yelp (229 [44.2%]) (P < .001). Qualitative themes centered on characteristics of the physician and the practice. Themes that emerged from the high-scoring and low-scoring reviews were similar in content but opposite in valence. Physician-specific themes included temperament, knowledge and competency, physical examination, communication abilities, and mindfulness of cost. Practice-specific themes included scheduling, staff temperament, office cleanliness, waiting room, and insurance. Patients appreciated physicians who are kind, respectful, and thorough with the physical examination; empathetic about the emotional difficulty of skin disease; and cognizant of cost. Negative experiences were frequently affected by considerations outside of the physician-patient interaction, such as curt interactions with staff, difficulty with scheduling, practice cleanliness, and insurance problems. Patients reported relying on consumer websites to identify dermatology providers. Online consumer review websites are designed to facilitate instantaneous and public communication among patients. These platforms provide elaborate and timely data for dermatologists to garner insight into their patients' experiences. The themes identified in this study are consistent with past satisfaction studies and may aid dermatologists in optimizing the patient care experience.

Reactions on Twitter to updated alcohol guidelines in the UK: a content analysis

PubMed Central

Bignardi, Giacomo; Hollands, Gareth J; Marteau, Theresa M

2017-01-01

Objectives In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter. Methods Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis. Results A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding. Conclusions This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media. PMID:28246145

Contribution of Targeted Subsidies Law to the Equity in Healthcare Financing in Iran: Exploring the Challenges of Policy Process

PubMed Central

Zandian, Hamed; Olyaeemanesh, Alireza; Takian, Amirhossein; Hosseini, Mostafa

2016-01-01

Introduction The Targeted Subsidies Law (TSL) was implemented in 2010 with a platform of improving equity in the Iran’s society. One of the objectives of the TSL was improving equity in Healthcare Financing (HCF), but a significant change has not occurred since then. The aim of this study was to analyze the challenges of the TSL to equity in the HCF in Iran. Methods In this interpretive qualitative study, 31 policy makers and health system experts were interviewed face to face from September 2014 to June 2015. A purposeful and snowball sampling method was used to select participants. Also, a document analysis was conducted on upstream documents. Assisted by MAXQDA 10, recorded interviews were transcribed verbatim and analyzed based on Framework Approach. Results Content analysis identified two themes and five sub-themes. Lack of justice in the healthcare system and lack of equity in the total socioeconomic structure of Iran were sub-themes identified as barriers to equity in HCF. Shortcomings in the formulation, implementation, and evaluation of the TSL were sub-themes identified as barriers in the policy process. The TSL did not achieve its intended objectives in the health sector because of the above-mentioned barriers, Conclusion The TSL, according to established goals, had no effect on the equity in HCF in Iran because of problems in the structure of the health system, socioeconomic status, and the policy process. To reach a more equitable HCF, it is advised that, when defining the related policies, various barriers be considered, such as those identified in our research. PMID:27053996

An assessment of US microbiome research.

PubMed

Stulberg, Elizabeth; Fravel, Deborah; Proctor, Lita M; Murray, David M; LoTempio, Jonathan; Chrisey, Linda; Garland, Jay; Goodwin, Kelly; Graber, Joseph; Harris, M Camille; Jackson, Scott; Mishkind, Michael; Porterfield, D Marshall; Records, Angela

2016-01-11

Genome-enabled technologies have supported a dramatic increase in our ability to study microbial communities in environments and hosts. Taking stock of previously funded microbiome research can help to identify common themes, under-represented areas and research priorities to consider moving forward. To assess the status of US microbiome research, a team of government scientists conducted an analysis of federally funded microbiome research. Microbiomes were defined as host-, ecosystem- or habitat-associated communities of microorganisms, and microbiome research was defined as those studies that emphasize community-level analyses using 'omics technologies. Single pathogen, single strain and culture-based studies were not included, except symbiosis studies that served as models for more complex communities. Fourteen governmental organizations participated in the data call. The analysis examined three broad research themes, eight environments and eight microbial categories. Human microbiome research was larger than any other environment studied, and the basic biology research theme accounted for half of the total research activities. Computational biology and bioinformatics, reference databases and biorepositories, standardized protocols and high-throughput tools were commonly identified needs. Longitudinal and functional studies and interdisciplinary research were also identified as needs. This study has implications for the funding of future microbiome research, not only in the United States but beyond.

Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study.

PubMed

Cederwall, Carl-Johan; Olausson, Sepideh; Rose, Louise; Naredi, Silvana; Ringdal, Mona

2018-06-01

To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Gender determinants of smoking practice in Indigenous communities: an exploratory study.

PubMed

Knott, V E; Gilligan, G; Maksimovic, L; Shen, D; Murphy, M

2016-03-01

Despite the need to urgently reduce smoking rates among Indigenous Australians, in order to close-the-gap in life expectancy, little is known regarding how this can be achieved. This study aimed to explore whether a focus on gender specific determinants of smoking among Indigenous Australians could be identified, thus providing a potentially novel approach to underpin future efforts at intervention. A qualitative research design was employed. Eighty-two participants, comprised of 43 Indigenous women (mean age 32.15, SD, 12.47) and 39 Indigenous men (mean age 34.91, SD, 11.26), participated in one of 12 focus groups held in metropolitan, regional and rural locations in South Australia. Facilitators prompted discussion in response to the question: 'What is it like being a smoker these days?' Two experienced coders assessed data for themes using Attride-Stirling's (2002) method of analysis. Two global themes emerged for men and women. The first theme, 'It's Harder to Smoke Nowadays', encompassed sub-themes capturing changed smoking practices in response to tobacco control strategies implemented in Australia. Sub-themes of 'smoking in secrecy' coupled with an 'awareness of the effects of passive smoking' were identified among women. Among men, sub-themes that depicted tension between 'a desire to be a role model' and 'guilt about smoking' emerged. The second theme, 'Push and Pull Factors', identified a range of gender specific determinants of smoking. While similar reasons for smoking ('pull factors') were identified in men and women (e.g. addiction, boredom, stress, pleasure, mood stabiliser), different 'push factors' (reasons for not wanting to smoke) emerged. For men, sport, fitness and children were identified as reasons for not wanting to smoke, whereas women identified factors such as respect for non-smokers, and body image concerns. The current findings suggest that there may be fundamental differences in the determinants of smoking (pull factors) as well as reasons for wanting to quit (push factors) between Indigenous men and women. A focus on interventions that target gender specific determinants, or motivators of smoking, offers a novel, and potentially efficacious approach to reduce smoking rates among Indigenous Australians. © 2016 John Wiley & Sons Ltd.

Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis.

PubMed

El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan

2014-08-20

Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary studies conducted in the region. There are still gaps in the production of systematic reviews addressing policymakers' and stakeholders' priorities in the Eastern Mediterranean region. Efforts should be directed towards better aligning systematic review production with policy needs and priorities. Study findings can inform the agendas of researchers, research institutions, and international funding agencies of priority areas where systematic reviews are required.

Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis

PubMed Central

2014-01-01

Background Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. Methods We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors’ affiliations, and countries where included primary studies were conducted. Results Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary studies conducted in the region. Conclusions There are still gaps in the production of systematic reviews addressing policymakers’ and stakeholders’ priorities in the Eastern Mediterranean region. Efforts should be directed towards better aligning systematic review production with policy needs and priorities. Study findings can inform the agendas of researchers, research institutions, and international funding agencies of priority areas where systematic reviews are required. PMID:25139256

Cultural implications of mentoring in sub-Saharan Africa: a qualitative study.

PubMed

Sawatsky, Adam P; Parekh, Natasha; Muula, Adamson S; Mbata, Ihunanya; Bui, Thuy

2016-06-01

Although many studies have demonstrated the benefits of mentoring in academic medicine, conceptual understanding has been limited to studies performed in North America and Europe. An ecological model of mentoring in academic medicine can provide structure for a broader understanding of the role of culture in mentoring. The goal of this study was to explore the role of culture in the development and maintenance of mentoring relationships within the context of the University of Malawi College of Medicine. A qualitative study using in-depth, semi-structured interviews and thematic analysis was conducted to explore the meaning of mentorship at the study institution. Criterion sampling was used to identify and recruit medical students, interns, registrars and faculty members. Study team members developed a codebook through open coding and applied it to all interview transcripts. Thematic analysis was used to identify and categorise themes according to an ecological model. A total of 46 participants from two major centres in Malawi were interviewed. Themes were identified within three domains: the intrapersonal; the interpersonal, and the institutional. Intrapersonal themes included Malawian politeness, mentoring needs, and friendliness and willingness to help. Interpersonal themes included understanding the role of the mentor, respect for elders, personal and professional boundaries, and perceptions of others. Institutional themes included the supervisor versus mentor, time pressures, tension about the scope of training, and the mentoring cycle. This study highlights the strengths of and challenges imposed by culture to the provision of mentoring relationships at the study institution. It also highlights the central role of culture in mentoring and proposes an updated model for mentoring in academic medicine. This model can inform future research on mentoring and may serve as a model in the larger effort to provide faculty development in mentoring across sub-Saharan Africa. © 2016 John Wiley & Sons Ltd.

The Use of Online Posts to Identify Barriers to and Facilitators of HIV Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men: A Comparison to a Systematic Review of the Peer-Reviewed Literature.

PubMed

Hannaford, Alisse; Lipshie-Williams, Madeleine; Starrels, Joanna L; Arnsten, Julia H; Rizzuto, Jessica; Cohen, Phillip; Jacobs, Damon; Patel, Viraj V

2018-04-01

Pre-exposure prophylaxis (PrEP) remains an under-utilized HIV prevention tool among men who have sex with men (MSM). To more comprehensively elucidate barriers and facilitators to PrEP use among US MSM, we conducted a systematic review of peer-reviewed published articles and content analysis of online posts about PrEP. We searched peer-reviewed databases (Medline, Web of Science, Google Scholar) using MESH headings and keywords about PrEP and/or HIV prevention from 2005 to 2015. We included original studies among MSM in the US that reported on barriers, facilitators, or other factors related to PrEP use. We also searched online posts and associated comments (news articles, opinion pieces, blogs and other social media posts) in diverse venues (Facebook, Slate Outward, Huffington Post Gay Voices, Queerty, and My PrEP Experience blog) to identify posts about PrEP. We used content analysis to identify themes and compare potential differences between the peer-reviewed literature and online posts. We identified 25 peer-reviewed articles and 28 online posts meeting inclusion criteria. We identified 48 unique barriers and 46 facilitators to using PrEP. These 94 themes fit into six overarching categories: (1) access (n = 14), (2) attitudes/beliefs (n = 24), (3) attributes of PrEP (n = 13), (4) behaviors (n = 11), (5) sociodemographic characteristics (n = 8), and (6) social network (n = 6). In all categories, analysis of online posts resulted in identification of a greater number of unique themes. Thirty-eight themes were identified in the online posts that were not identified in the peer-reviewed literature. We identified barriers and facilitators to PrEP in online posts that were not identified in a systematic review of the peer-reviewed literature. By incorporating data both from a systematic review of peer-reviewed articles and from online posts, we have identified salient and novel information about barriers to and facilitators of PrEP use. Traditional research approaches may not comprehensively capture current factors important for designing and implementing PrEP related interventions.

Qualitative thematic analysis of the phenomenology of near-death experiences

PubMed Central

Degrange, Sophie; Martial, Charlotte; Charland-Verville, Vanessa; Lallier, François; Bragard, Isabelle; Guillaume, Michèle; Laureys, Steven

2018-01-01

Near-death experiences (NDEs) refer to profound psychological events that can have an important impact on the experiencers’ (NDErs) lives. Previous studies have shown that NDEs memories are phenomenologically rich. In the present study, we therefore aimed to extract the common themes (referred to as “features” in the NDE literature) reported by NDErs by analyzing all the concepts stored in the narratives of their experiences. A qualitative thematic analysis has been carried out on 34 cardiac arrest survivors’ NDE narratives. Our results shed the light on the structure of the narratives by identifying 10 “time-bounded” themes which refer to isolated events encountered during the NDE and 1 “transversal” theme which characterizes the whole narrative and generally appears as a retrospective comment of self-reflection on the experience. The division of narratives into themes provides us with detailed information about the vocabulary used by NDErs to describe their experience. This established thematic method enables a rigorous description of the phenomenon, ensuring the inclusion of all self-reported manifestations of themes in narratives. PMID:29444184

Exploring experienced nurses' attitudes, views and expectations of new graduate nurses: a critical review.

PubMed

Freeling, Michelle; Parker, Steve

2015-02-01

This critical review evaluates the existing primary research literature to identify experienced registered nurses' attitudes, views and expectations of graduate nurses which may create a barrier for optimal graduate nurse performance. Relevant primary studies were identified by searching online databases using a wide variety of appropriate keyword combinations. Online databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO and Google Scholar were comprehensively searched for relevant research. The selected studies were subjected to a rigorous critical appraisal to evaluate the studies and to determine if the findings were applicable to practice. A manual method of thematic analysis was conducted to highlight explicit and implicit themes from the reviewed studies. Themes were grouped and continually reduced until only essential themes remain. Themes and subthemes emerged which were then compared and contrasted to analyse results. The four major themes identified include nursing skills, inadequate preparation during academic program, attitudes and ward culture and concerns with confidence. Subthemes were identified within these categories. Findings indicate experienced registered nurses discussed themes including 'nursing skills', 'inadequate preparation during academic program', 'attitudes and ward culture' and 'concerns with confidence'. Concerns were raised including the value of traditional training versus tertiary education programs, coping with unprofessional behaviour and inadequate preparation for practice. Further research is required to fully address management of the theory-practice gap, as well as the attitudes of experienced registered nurses educated in traditional programs versus those in tertiary education programs. Nurse managers should be aware of the possible occurrence of unprofessional behaviour, and increased workplace training regarding lateral violence would assist in raising awareness regarding negative and unacceptable behaviour. Copyright © 2014 Elsevier Ltd. All rights reserved.

Racial Microaggressions against Black Americans: Implications for Counseling

ERIC Educational Resources Information Center

Sue, Derald Wing; Nadal, Kevin L.; Capodilupo, Christina M.; Lin, Annie I.; Torino, Gina C.; Rivera, David P.

2008-01-01

Racial microaggression themes were identified using a focus-group analysis of self-identified Black participants. Six categories of demeaning and invalidating messages reflected beliefs of White supremacy that were unintentionally conveyed by perpetrators. Implications for counselors and the counseling process are discussed.

Strategies for enhancing information, motivation, and skills for self-management behavior changes: a qualitative study of diabetes care for older adults in Korea.

PubMed

Choi, Suyoung; Song, Misoon; Chang, Sun Ju; Kim, Se-An

2014-01-01

To describe strategies for enhancing information, motivation, and skills related to changes in diabetes self-management behavior among community-dwelling older adults in Korea. A total of five focus group interviews (three separate focus groups) were conducted with 12 older adults with type 2 diabetes and five diabetes educators. Qualitative content analysis was used. "One's own willingness and ability" emerged as a fundamental belief about the strategies for diabetes self-management. Six major themes under three categories were identified. Under the information category, the recurrent themes were: 1) repeatedly offering detailed knowledge regarding self-management, 2) providing information about current health status, and 3) identifying experiential knowledge of blood glucose control. The recurrent themes in the motivation category were: 1) ensuring a positive attitude regarding self-management, and 2) encouragement or feedback from significant others. Furthermore, in the skills category, we found that the following theme emerged: hands-on skills training with numerical standards. This study identified six tailored strategies for enhancing information, motivation, and skills for diabetes self-management behavior changes. These strategies can be used in the development of a culturally sensitive diabetes self-management program for older adults.

"Tras de un Amoroso Lance" como Estructura Expresiva (The Poem, "Behind the Amorous Cast" as an Expressive Structure).

ERIC Educational Resources Information Center

Bratosevich, Nicolas

1967-01-01

An analysis of a poem by San Juan de la Cruz (St. John of the Cross), the sixteenth century Spanish mystic, identifies symbols and images, explains themes, and offers a synthesis of his structural patterns. The poem, "Tras de amoroso lance", deals with the theme of the search of the beloved (i.e., the soul) for the lover, and…

The experience of agency nurses working in a London teaching hospital.

PubMed

Hass, Helen; Coyer, Fiona M; Theobald, Karen A

2006-06-01

This Husserlian phenomenological study explored the lived experience of eight full-time agency nurses working in the environment of intensive care in London, United Kingdom. In-depth interviews were used to ascertain the participants' experiences of full-time agency nursing in intensive care. Colaizzi's [Colaizzi P. Psychological research as the phenomenologist views it. In: Vale R, King M, editors. Existential-phenomenological alternatives for psychology. London: Oxford University Press; 1978, p. 48-71] method of data analysis was utilised. Thematic analysis identified three cluster themes: the shared experience of lacking confidence; the shared experience of deskilling; and the shared experience of feelings of isolation. The theme of the shared experience of lacking confidence identified the importance of support and understanding of agency nurses' needs in the ICU. The theme of the shared experience of deskilling illuminated participants concern at not having the opportunity to care for patients of higher acuity. The theme of the shared experience of feelings of isolation highlighted that often participants did not feel they "belonged to a team". Study findings suggest the need to include: the implementation of protocols within the clinical setting; the provision of performance feedback to agency nurses; and the consideration of ongoing structured professional development and education for ICU agency nurses.

Organ donation in the ICU: A document analysis of institutional policies, protocols, and order sets.

PubMed

Oczkowski, Simon J W; Centofanti, John E; Durepos, Pamela; Arseneau, Erika; Kelecevic, Julija; Cook, Deborah J; Meade, Maureen O

2018-04-01

To better understand how local policies influence organ donation rates. We conducted a document analysis of our ICU organ donation policies, protocols and order sets. We used a systematic search of our institution's policy library to identify documents related to organ donation. We used Mindnode software to create a publication timeline, basic statistics to describe document characteristics, and qualitative content analysis to extract document themes. Documents were retrieved from Hamilton Health Sciences, an academic hospital system with a high volume of organ donation, from database inception to October 2015. We retrieved 12 active organ donation documents, including six protocols, two policies, two order sets, and two unclassified documents, a majority (75%) after the introduction of donation after circulatory death in 2006. Four major themes emerged: organ donation process, quality of care, patient and family-centred care, and the role of the institution. These themes indicate areas where documented institutional standards may be beneficial. Further research is necessary to determine the relationship of local policies, protocols, and order sets to actual organ donation practices, and to identify barriers and facilitators to improving donation rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

"The Whole Family Suffered, so the Whole Family Needs to Recover": Thematic Analysis of Substance-Abusing Mothers' Family Therapy Sessions.

PubMed

Brakenhoff, Brittany; Slesnick, Natasha

2015-03-01

Substance abusing mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study analyzed 12 sessions of family therapy using thematic analysis to identify common themes that arose during substance abusing mothers and their children's discussion during family therapy. Mothers' ages ranged from 28 to 35 years and the children's ages ranged from 12 to 14 years. Four therapy sessions from three families were coded for a total of 12 therapy sessions. An ecological framework was used to classify themes, in which themes related to each level of the families' ecological systems were identified. Thematic analysis of the therapy sessions indicated that mothers and their children primarily discussed topics related to their relational and emotional needs. The findings indicated that substance use disordered mothers and their children have unique treatment needs that should be addressed when the mother seeks treatment. More research is needed to further clarify and confirm the observations in this study. In particular, future research should include a larger sample and quantitative methodology.

Through our eyes: exploring African-American men's perspective on factors affecting transition to manhood.

PubMed

Bharmal, Nazleen; Kennedy, David; Jones, Loretta; Lee-Johnson, Charles; Morris, D'Ann; Caldwell, Ben; Brown, Anthony; Houston, Tina; Meeks, Charlene; Vargas, Roberto; Franco, Idalid; Razzak, A Rab; Brown, Arleen F

2012-02-01

Premature mortality and disparities in morbidity observed in African-American men may be associated with factors in their social, economic, and built environments that may be especially influential during the transition to adulthood. To have young, African-American men from Los Angeles County identify and prioritize factors associated with their transition to manhood using photovoice methodology and pile-sorting exercises. Qualitative study using community-based participatory research (CBPR) and photovoice Twelve African-American men, ages 16-26 years, from Los Angeles County, California. We used CBPR principles to form a community advisory board (CAB) whose members defined goals for the partnered project, developed the protocols, and participated in data collection and analysis. Participants were given digital cameras to take 50-300 photographs over three months. Pile-sorting techniques were used to facilitate participants' identification and discussion of the themes in their photos and selected photos of the group. Pile-sorts of group photographs were analyzed using multidimensional scaling and hierarchical cluster analysis to systematically compare participants' themes and identify patterns of associations between sorted photographs. Sub-themes and related quotes were also elicited from the pile-sorting transcripts. The CAB and several study participants met periodically to develop dissemination strategies and design interventions informed by study findings. Four dominant themes emerged during analysis: 1) Struggles face during the transition to manhood, 2) Sources of social support, 3) Role of sports, and 4) Views on Los Angeles lifestyle. The project led to the formation of a young men's group and community events featuring participants. CBPR and photovoice are effective methods to engage young, African-American men to identify and discuss factors affecting their transition to manhood, contextualize research findings, and participate in intervention development.

A content analysis of emotional concerns expressed at the time of receiving a cancer diagnosis: An observational study of consultations with adolescent and young adult patients and their family members.

PubMed

Korsvold, Live; Mellblom, Anneli Viktoria; Finset, Arnstein; Ruud, Ellen; Lie, Hanne Cathrine

2017-02-01

Little is known about the emotional concerns expressed by adolescent and young adult (AYA) patients in consultations when a diagnosis of cancer is delivered. Here, we investigated the content of such concerns and how health care providers respond to them. We audio-recorded nine consultations with AYA cancer patients (ages: 12-25 years) at the time of diagnosis. We have previously identified and coded 135 emotional concerns and the responses to these in the nine consultations using the Verona Coding Definitions of Emotional Sequences (VR-CoDES) framework. Here, we used qualitative content analysis to study these emotional concerns and categorize them according to overarching themes. We then quantitatively explored associations between the themes of the concerns and whether the responses to them varied according to their themes. We identified four themes for the content of concerns: "Side-effects/late-effects" (39%), "What happens in the near future/practical aspects" (16%), "Fear" (27%) and "Sadness" (17%) (e. g. crying, sighing or other sounds that expressed sadness). Health care providers' responses did not appear to vary according to the different themes of concerns, but typically consisted of providing medical information. The content analysis revealed that patients and family members expressed a wide range of emotional concerns. Health care providers tended to respond to the content-aspect of the concerns, but did rarely explicitly acknowledge the affective-aspect of the concerns. The effect of responses to patients' emotional concerns in the important first consultations about the cancer diagnosis and planned treatment should be investigated in future studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Suitability of a Group Behavioural Therapy Module for Workplace Smoking Cessation Programs in Malaysia: a Pilot Study.

PubMed

Maarof, Muhammad Faizal; Ali, Adliah Mhd; Amit, Noh; Bakry, Mohd Makmor; Taha, Nur Akmar

2016-01-01

In Malaysia, data on components suitability the established smoking cessation module is limited. This exploratory study aimed to evaluate the suitability of the components developed in the module for group behavioural therapy in workplace smoking cessation programs. Twenty staff were identified but only eight individuals were selected according to the study criteria during the recruitment period in May 2014. Focus group discussion was conducted to identify themes relevant to the behavioural issues among smokers. Thematic analysis yielded seven major themes which were reasons for regular smoking, reasons for quitting, comprehending smoking characteristics, quit attempt experiences, support and encouragement, learning new skills and behaviour, and preparing for lapse/relapse or difficult situations. As a result, the developed module was found to be relevant and suitable for use based on these themes.

Attention without intention: explicit processing and implicit goal-setting in family medicine residents' written reflections.

PubMed

Shaughnessy, Allen F; Allen, Lucas; Duggan, Ashley

2017-05-01

Reflection, a process of self-analysis to promote learning through better understanding of one's experiences, is often used to assess learners' metacognitive ability. However, writing reflective exercises, not submitted for assessment, may allow learners to explore their experiences and indicate learning and professional growth without explicitly connecting to intentional sense-making. To identify core components of learning about medicine or medical education from family medicine residents' written reflections. Family medicine residents' wrote reflections about their experiences throughout an academic year. Qualitative thematic analysis to identify core components in 767 reflections written by 33 residents. We identified four themes of learning: 'Elaborated reporting' and 'metacognitive monitoring' represent explicit, purposeful self-analysis that typically would be characterised as reflective learning about medicine. 'Simple reporting' and 'goal setting' signal an analysis of experience that indicates learning and professional growth but that is overlooked as a component of learning. Identified themes elucidate the explicit and implicit forms of written reflection as sense-making and learning. An expanded theoretical understanding of reflection as inclusive of conscious sense-making as well as implicit discovery better enables the art of physician self-development.

Failure Mode and Effects Analysis: views of hospital staff in the UK.

PubMed

Shebl, Nada; Franklin, Bryony; Barber, Nick; Burnett, Susan; Parand, Anam

2012-01-01

To explore health care professionals' experiences and perceptions of Failure Mode and Effects Analysis (FMEA), a team-based, prospective risk analysis technique. Semi-structured interviews were conducted with 21 operational leads (20 pharmacists, one nurse) in medicines management teams of hospitals participating in a national quality improvement programme. Interviews were transcribed, coded and emergent themes identified using framework analysis. Themes identified included perceptions and experiences of participants with FMEA, validity and reliability issues, and FMEA's use in practice. FMEA was considered to be a structured but subjective process that helps health care professionals get together to identify high risk areas of care. Both positive and negative opinions were expressed, with the majority of interviewees expressing positive views towards FMEA in relation to its structured nature and the use of a multidisciplinary team. Other participants criticised FMEA for being subjective and lacking validity. Most likely to restrict its widespread use were its time consuming nature and its perceived lack of validity and reliability. FMEA is a subjective but systematic tool that helps identify high risk areas, but its time consuming nature, difficulty with the scores and perceived lack of validity and reliability may limit its widespread use.

Thematic analysis of tiles painted by blood and marrow transplant patients during treatment.

PubMed

Mische Lawson, L; Chau, J; Schoel, A

2016-11-01

The majority of research on understanding the illness focuses on analysing the written or verbal content. Thematic analysis of images is a novel qualitative approach that can enhance knowledge of the experience of illness. This study used thematic analysis to examine 171 tiles painted by patients through the Tiles of Hope programme in an outpatient blood and marrow transplant unit. Major themes identified in this study were Faith, Hope, Positive Attitude, Nature and Social Support. These themes provided a better understanding of patients' perceptions in relation to their experience with illness through the art-making process. © 2015 John Wiley & Sons Ltd.

Ask an anatomist: Identifying global trends, topics and themes of academic anatomists using twitter.

PubMed

Marsland, Madeleine J; Lazarus, Michelle D

2018-05-06

Social media (SoMe) is increasingly used in higher education (HE) to access knowledge and enable global communication. The SoMe platform Twitter ® is particularly beneficial in these contexts because it is readily accessible, easily searchable (via hashtags) and global. Given these advantages, the twitter platform @AskAnatomist was created to foster a global weekly tweet chat, where students and academics can ask and address anatomy-related questions. The aim of this study was to identify themes arising in the early stages of the @AskAnatomy Twitter community to gain insights into current needs/key areas for academic anatomists, students, and other followers. A qualitative analysis of tweets including the hashtag #AnatQ, (the associated @AskAnatomist hashtag), was undertaken to achieve this aim. Thematic analysis revealed three core themes arising in the formative stages of the @AskAnatomist Twitter site: (1) anatomical education modalities, (2) specific anatomy content, and (3) research motivations. These themes reveal controversies within the field of anatomical sciences, areas for potential education resource improvement and research, as well as the humor of anatomists. Though the original intent of the @AskAnatomist site was to engage the general public in anatomy content and knowledge, tweet analysis suggests that academic anatomists were the primary active "tweeters". Interestingly, this analysis reveals that the @AskAnatomist site progressed into a web-based community of practice (CoP), suggesting an additional benefit of SoMe communities in the field of anatomy. Anat Sci Educ 11: 270-281. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

What are we ‘tweeting’ about obesity? Mapping tweets with Topic Modeling and Geographic Information System

PubMed Central

Ghosh, Debarchana (Debs); Guha, Rajarshi

2014-01-01

Public health related tweets are difficult to identify in large conversational datasets like Twitter.com. Even more challenging is the visualization and analyses of the spatial patterns encoded in tweets. This study has the following objectives: How can topic modeling be used to identify relevant public health topics such as obesity on Twitter.com? What are the common obesity related themes? What is the spatial pattern of the themes? What are the research challenges of using large conversational datasets from social networking sites? Obesity is chosen as a test theme to demonstrate the effectiveness of topic modeling using Latent Dirichlet Allocation (LDA) and spatial analysis using Geographic Information System (GIS). The dataset is constructed from tweets (originating from the United States) extracted from Twitter.com on obesity-related queries. Examples of such queries are ‘food deserts’, ‘fast food’, and ‘childhood obesity’. The tweets are also georeferenced and time stamped. Three cohesive and meaningful themes such as ‘childhood obesity and schools’, ‘obesity prevention’, and ‘obesity and food habits’ are extracted from the LDA model. The GIS analysis of the extracted themes show distinct spatial pattern between rural and urban areas, northern and southern states, and between coasts and inland states. Further, relating the themes with ancillary datasets such as US census and locations of fast food restaurants based upon the location of the tweets in a GIS environment opened new avenues for spatial analyses and mapping. Therefore the techniques used in this study provide a possible toolset for computational social scientists in general and health researchers in specific to better understand health problems from large conversational datasets. PMID:25126022

What are we 'tweeting' about obesity? Mapping tweets with Topic Modeling and Geographic Information System.

PubMed

Ghosh, Debarchana Debs; Guha, Rajarshi

2013-01-01

Public health related tweets are difficult to identify in large conversational datasets like Twitter.com. Even more challenging is the visualization and analyses of the spatial patterns encoded in tweets. This study has the following objectives: How can topic modeling be used to identify relevant public health topics such as obesity on Twitter.com? What are the common obesity related themes? What is the spatial pattern of the themes? What are the research challenges of using large conversational datasets from social networking sites? Obesity is chosen as a test theme to demonstrate the effectiveness of topic modeling using Latent Dirichlet Allocation (LDA) and spatial analysis using Geographic Information System (GIS). The dataset is constructed from tweets (originating from the United States) extracted from Twitter.com on obesity-related queries. Examples of such queries are 'food deserts', 'fast food', and 'childhood obesity'. The tweets are also georeferenced and time stamped. Three cohesive and meaningful themes such as 'childhood obesity and schools', 'obesity prevention', and 'obesity and food habits' are extracted from the LDA model. The GIS analysis of the extracted themes show distinct spatial pattern between rural and urban areas, northern and southern states, and between coasts and inland states. Further, relating the themes with ancillary datasets such as US census and locations of fast food restaurants based upon the location of the tweets in a GIS environment opened new avenues for spatial analyses and mapping. Therefore the techniques used in this study provide a possible toolset for computational social scientists in general and health researchers in specific to better understand health problems from large conversational datasets.

Strengths, weaknesses, opportunities, and threats analysis of integrating the World Health Organization patient safety curriculum into undergraduate medical education in Pakistan: a qualitative case study.

PubMed

Misbah, Samreen; Mahboob, Usman

2017-01-01

The purpose of this study was to conduct a strengths, weaknesses, opportunities, and threats (SWOT) analysis of integrating the World Health Organization (WHO) patient safety curriculum into undergraduate medical education in Pakistan. A qualitative interpretive case study was conducted at Riphah International University, Islamabad, from October 2016 to June 2017. The study included 9 faculty members and 1 expert on patient safety. The interviews were audiotaped, and a thematic analysis of the transcripts was performed using NVivo software. Four themes were derived based on the need analysis model. The sub-themes derived from the collected data were arranged under the themes of strengths, weaknesses, opportunities, and threats, in accordance with the principles of SWOT analysis. The strengths identified were the need for a formal patient safety curriculum and its early integration into the undergraduate program. The weaknesses were faculty awareness and participation in development programs. The opportunities were an ongoing effort to develop an appropriate curriculum, to improve the current culture of healthcare, and to use the WHO curricular resource guide. The threats were attitudes towards patient safety in Pakistani culture, resistance to implementation from different levels, and the role of regulatory authorities. The theme of patient safety needs to be incorporated early into the formal medical education curriculum, with the main goals of striving to do no harm and seeing mistakes as opportunities to learn. Faculty development activities need to be organized, and faculty members should to be encouraged to participate in them. The lack of a patient safety culture was identified as the primary reason for resistance to this initiative at many levels. The WHO curriculum, amended according to local institutional culture, can be implemented appropriately with support from the corresponding regulatory bodies.

Aligning Education With Health Care Transformation: Identifying a Shared Mental Model of "New" Faculty Competencies for Academic Faculty.

PubMed

Gonzalo, Jed D; Ahluwalia, Amarpreet; Hamilton, Maria; Wolf, Heidi; Wolpaw, Daniel R; Thompson, Britta M

2018-02-01

To develop a potential competency framework for faculty development programs aligned with the needs of faculty in academic health centers (AHCs). In 2014 and 2015, the authors interviewed 23 health system leaders and analyzed transcripts using constant comparative analysis and thematic analysis. They coded competencies and curricular concepts into subcategories. Lead investigators reviewed drafts of the categorization themes and subthemes related to gaps in faculty knowledge and skills, collapsed and combined competency domains, and resolved disagreements via discussion. Through analysis, the authors identified four themes. The first was core functional competencies and curricular domains for conceptual learning, including patient-centered care, health care processes, clinical informatics, population and public health, policy and payment, value-based care, and health system improvement. The second was the need for foundational competency domains, including systems thinking, change agency/management, teaming, and leadership. The third theme was paradigm shifts in how academic faculty should approach health care, categorized into four areas: delivery, transformation, provider characteristics and skills, and education. The fourth theme was the need for faculty to be aware of challenges in the culture of AHCs as an influential context for change. This broad competency framework for faculty development programs expands existing curricula by including a comprehensive scope of health systems science content and skills. AHC leaders can use these results to better align faculty education with the real-time needs of their health systems. Future work should focus on optimal prioritization and methods for teaching.

Healing Environments: What Design Factors Really Matter According to Patients? An Exploratory Analysis.

PubMed

Schreuder, Eliane; Lebesque, Layla; Bottenheft, Charelle

2016-10-01

The main aim of this research was to identify the impact of design characteristics (DCs) of a patient room on self-reported patient well-being. This knowledge enables the construction of healing environments focusing on DCs that maximize well-being. Six themes were identified in literature that create healing environments: spatial comfort, safety and security, autonomy, sensory comfort, privacy, and social comfort. We wondered what themes and associated DCs should be prioritized if needed to maximize well-being. The physical environment of patient rooms in four hospital locations was measured and patients who stayed in these rooms were asked to evaluate the room design on above mentioned themes and its contribution to their well-being. We used a machine-learning technique and regression analysis to find relations between the physical environment of a patient room and patient well-being. We found that spatial comfort, safety and security, autonomy, and associated DCs have the strongest ability to influence patient's self-reported well-being in a patient room. Privacy appears to have the smallest influence. © The Author(s) 2016.

Complex evolutionary footprints revealed in an analysis of reused protein segments of diverse lengths

PubMed Central

Nepomnyachiy, Sergey; Ben-Tal, Nir; Kolodny, Rachel

2017-01-01

Proteins share similar segments with one another. Such “reused parts”—which have been successfully incorporated into other proteins—are likely to offer an evolutionary advantage over de novo evolved segments, as most of the latter will not even have the capacity to fold. To systematically explore the evolutionary traces of segment “reuse” across proteins, we developed an automated methodology that identifies reused segments from protein alignments. We search for “themes”—segments of at least 35 residues of similar sequence and structure—reused within representative sets of 15,016 domains [Evolutionary Classification of Protein Domains (ECOD) database] or 20,398 chains [Protein Data Bank (PDB)]. We observe that theme reuse is highly prevalent and that reuse is more extensive when the length threshold for identifying a theme is lower. Structural domains, the best characterized form of reuse in proteins, are just one of many complex and intertwined evolutionary traces. Others include long themes shared among a few proteins, which encompass and overlap with shorter themes that recur in numerous proteins. The observed complexity is consistent with evolution by duplication and divergence, and some of the themes might include descendants of ancestral segments. The observed recursive footprints, where the same amino acid can simultaneously participate in several intertwined themes, could be a useful concept for protein design. Data are available at http://trachel-srv.cs.haifa.ac.il/rachel/ppi/themes/. PMID:29078314

The Massachusetts BMI letter: A qualitative study of responses from parents of obese children

PubMed Central

Moyer, Lindsay J.; Carbone, Elena T.; Anliker, Jean A.; Goff, Sarah L.

2015-01-01

Objectives Massachusetts (MA) public schools conduct mandated body-mass index (BMI) screening and until recently, communicated results in a letter to parents/caregivers, to encourage primary care visits and provide aggregate data to the state Department of Public Health. This study assessed the letter's readability and qualitatively explored parents’ responses to it. Methods Readability of the BMI letter was calculated. Audio-taped 1-h focus groups were conducted with parents/caregivers of 8- to 14-year-old obese (≥95th BMI-for-age percentile) children. A semistructured interview guide was used to elicit responses. Qualitative content analysis was conducted on transcripts to identify emergent themes. Results Readability analysis showed higher grade levels than recommended. Eight focus groups consisting of two to six parents each were conducted (n = 29); 83% were female, mean age 41 ± 9 years, and 65% self-identified as Hispanic/Latino. Key themes identified included usefulness of the BMI letter, concerns about utility of BMI for screening, concerns about impacting self-esteem, and failure to understand the letter. Conclusions The MA BMI letter may not have been achieving its desired goal with some parents. Practice implications: Emergent themes from this study could be used to test effectiveness of similar BMI letters nationwide and develop strategies to improve communication to parents. PMID:24290240

Twelve possible strategies for enhancing interprofessional socialisation in higher education: Findings from an interpretive phenomenological study.

PubMed

Stanley, Karen; Dixon, Kathryn; Warner, Paul; Stanley, David

2016-07-01

The aim of this study was to investigate the interprofessional socialisation experiences of health professional educators (HPEs) across five health science faculties in Perth, Australia. Evidence supported the importance of educators teaching and learning together, although there was minimal evidence with regard to the type of support HPEs received or required in order to socialise interprofessionally within higher education. Interview participants comprised 26 HPEs from various health-related professions across Western Australia. An interpretive phenomenological framework was used to discover the phenomena of interprofessional socialisation. The examination of the data was undertaken via qualitative content analysis with the aid of NVivo 10 software. Content coding led to the development of categories, sub-categories, and then themes. Five themes were identified; however, only one of these themes, "interprofessional socialisation strategies within higher education," is explored within this article. Based on the data within this theme, 12 possible socialisation strategies (formal and informal) were identified for HPEs, which could be implemented within health science faculties, taking into account the organisation's culture and strategic intent towards interprofessional collaboration and education.

Qualitative Analysis of Written Reflections during a Teaching Certificate Program

PubMed Central

Castleberry, Ashley N.; Payakachat, Nalin; Ashby, Sarah; Nolen, Amanda; Carle, Martha; Neill, Kathryn K.

2016-01-01

Objective. To evaluate the success of a teaching certificate program by qualitatively evaluating the content and extent of participants’ reflections. Methods. Two investigators independently identified themes within midpoint and final reflection essays across six program years. Each essay was evaluated to determine the extent of reflection in prompted teaching-related topic areas (strengths, weaknesses, assessment, feedback). Results. Twenty-eight themes were identified within 132 essays. Common themes encompassed content delivery, student assessment, personal successes, and challenges encountered. Deep reflection was exhibited, with 48% of essays achieving the highest level of critical reflection. Extent of reflection trended higher from midpoint to final essays, with significant increases in the strengths and feedback areas. Conclusion. The teaching certificate program fostered critical reflection and self-reported positive behavior change in teaching, thus providing a high-quality professional development opportunity. Such programs should strongly consider emphasizing critical reflection through required reflective exercises at multiple points within program curricula. PMID:26941436

Protective factors for HIV infection among Mexican American men who have sex with men.

PubMed

Meyer, Mark A; Champion, Jane Dimmitt

2010-01-01

Latinos in the United States have been disproportionately affected by the HIV epidemic. The purpose of this study was to identify potential themes for inclusion in effective HIV prevention interventions for Mexican American men who have sex with men (MSM). The authors used a phenomenological design to explore the lived experiences of Mexican American MSM who had grown up in Dallas, Texas, regarding protective factors for HIV infection. A total of 20 30- to 60-year-old Mexican American MSM participated in semistructured interviews. During data analysis, the following themes concerning protective behaviors for HIV emerged: (a) accepting one's sexuality; (b) machismo; (c) being in love; (d) respect for family, self, and life; and (e) having HIV-living now. Strategies for potential inclusion in HIV prevention interventions geared toward Mexican American MSM were identified based on these themes. The recommendations encompass modification of behavioral interventions and related social policies.

Case study of a survivor of suicide who lost all family members through parent-child collective suicide.

PubMed

Lee, Eunjin; Won Kim, Sung; Enright, Robert D

2015-01-01

South Korea is characterized by a high percentage of parent-child collective suicide. This case study explores one individual's personal experience as an adult survivor of suicide who lost his wife and his only son through parent-child collective suicide in South Korea. The study reports data from a semistructured interview, which were analyzed using interpretive phenomenological analysis (IPA). Two themes were identified through the analysis of the narratives of the survivor. The first theme provides a detailed picture of the survivor's explanation of why the parent-child collective suicide occurred. The second theme examines how the participant experienced complicated bereavement after his heart-breaking loss of both wife and son. We discuss the importance of support from other people or grief experts for the survivors of suicide who lose family to collective suicide.

Whale song analyses using bioinformatics sequence analysis approaches

NASA Astrophysics Data System (ADS)

Chen, Yian A.; Almeida, Jonas S.; Chou, Lien-Siang

2005-04-01

Animal songs are frequently analyzed using discrete hierarchical units, such as units, themes and songs. Because animal songs and bio-sequences may be understood as analogous, bioinformatics analysis tools DNA/protein sequence alignment and alignment-free methods are proposed to quantify the theme similarities of the songs of false killer whales recorded off northeast Taiwan. The eighteen themes with discrete units that were identified in an earlier study [Y. A. Chen, masters thesis, University of Charleston, 2001] were compared quantitatively using several distance metrics. These metrics included the scores calculated using the Smith-Waterman algorithm with the repeated procedure; the standardized Euclidian distance and the angle metrics based on word frequencies. The theme classifications based on different metrics were summarized and compared in dendrograms using cluster analyses. The results agree with earlier classifications derived by human observation qualitatively. These methods further quantify the similarities among themes. These methods could be applied to the analyses of other animal songs on a larger scale. For instance, these techniques could be used to investigate song evolution and cultural transmission quantifying the dissimilarities of humpback whale songs across different seasons, years, populations, and geographic regions. [Work supported by SC Sea Grant, and Ilan County Government, Taiwan.

Classroom Dialogue and Science Achievement.

ERIC Educational Resources Information Center

Clarke, John A.

This study reports the application to classroom dialogue of the Thematic and Structural Analysis (TSA) Technique which has been used previously in the analysis of text materials. The TSA Technique identifies themes (word clusters) and their structural relationship throughout sequentially organized material. Dialogues from four Year 8 science…

Superintendent Leadership Style: A Gendered Discourse Analysis

ERIC Educational Resources Information Center

Wallin, Dawn C.; Crippen, Carolyn

2007-01-01

Using a blend of social constructionism, critical feminism, and dialogue theory, the discourse of nine Manitoba superintendents is examined to determine if it illustrates particular gendered assumptions regarding superintendents' leadership style. Qualitative inquiry and analysis methods were utilized to identify emerging themes, or topics of…

Finding meaning in social media: content-based social network analysis of QuitNet to identify new opportunities for health promotion.

PubMed

Myneni, Sahiti; Cobb, Nathan K; Cohen, Trevor

2013-01-01

Unhealthy behaviors increase individual health risks and are a socioeconomic burden. Harnessing social influence is perceived as fundamental for interventions to influence health-related behaviors. However, the mechanisms through which social influence occurs are poorly understood. Online social networks provide the opportunity to understand these mechanisms as they digitally archive communication between members. In this paper, we present a methodology for content-based social network analysis, combining qualitative coding, automated text analysis, and formal network analysis such that network structure is determined by the content of messages exchanged between members. We apply this approach to characterize the communication between members of QuitNet, an online social network for smoking cessation. Results indicate that the method identifies meaningful theme-based social sub-networks. Modeling social network data using this method can provide us with theme-specific insights such as the identities of opinion leaders and sub-community clusters. Implications for design of targeted social interventions are discussed.

What motivates individuals with ADHD? A qualitative analysis from the adolescent's point of view.

PubMed

Morsink, Sarah; Sonuga-Barke, Edmund; Mies, Gabry; Glorie, Nathalie; Lemiere, Jurgen; Van der Oord, Saskia; Danckaerts, Marina

2017-08-01

Individuals with ADHD appear to respond differently to incentives than their peers. This could be due to a general altered sensitivity to reinforcers. However, apart from differences in the degree of motivation, individuals with ADHD might also be motivated by qualitatively different factors. This study aimed to harvest a range of motivational factors and identify ADHD-related qualitative differences in motivation, from the adolescent's point of view. Semi-structured interviews allowing participants to describe what motivates them in daily life were conducted with young adolescents (9-16 years) with and without ADHD. Thematic analysis was undertaken using NVivo software. Major themes relating to motivation were identified from the interview data. These were: (1) achieving a sense of togetherness; (2) feeling competent; (3) fulfilling a need for variation; (4) gaining pleasure from applying effort to achieve a goal; (5) valuing social reinforcement; (6) desiring to be absorbed/forget problems; (7) feeling free and independent, (8) attaining material reinforcement; and (9) an enjoyment of bodily stimulation. The theme structure was very similar for both groups. However, individuals with ADHD differed in some specifics: their focus on the passing of time, the absence of preference for predictable and familiar tasks, and their less elaborate description of the togetherness theme. A broad range of motivational themes was identified, stretching beyond the current focus of ADHD research and motivational theories. Similarities and differences in motivational values of individuals with and without ADHD should be taken into account in reward sensitivity research, and in psychological treatment.

Global Educators' Personal Attribution of a Global Perspective

ERIC Educational Resources Information Center

Carano, Kenneth Thomas

2013-01-01

This case study of self-identifying global educators investigated factors that they attributed to the development of their global perspective and how it influenced curricular decision-making. Analysis resulted in seven themes identified by the participants as having attributed to the development of a global perspective: (a) family, (b) exposure to…

The Metaphor of the Triangle in Theories of Human Development

ERIC Educational Resources Information Center

Zittoun, Tania; Gillespie, Alex; Cornish, Flora; Psaltis, Charis

2007-01-01

Developmental psychologists have a long history of using triangle metaphors to conceptualise the social constitution of psychological development. In this paper, we present a genealogy of triadic theories, to clarify their origins, distinctions between them, and to identify key themes for theoretical development. The analysis identifies three core…

Pillars of Support: A Functional Asset-Based Framework for ABE Learners

ERIC Educational Resources Information Center

Reynolds, Sharon; Johnson, Jerry

2014-01-01

This paper reported results from a qualitative analysis of assets and supports disclosed in the narratives of adult basic education students. These students were identified as exemplary by their instructors for academic achievement, hours of program attendance, or community service. Themes were identified using the "Four Pillars"…

Exploring experiences of cancer care in Wales: a thematic analysis of free-text responses to the 2013 Wales Cancer Patient Experience Survey (WCPES).

PubMed

Bracher, Michael; Corner, Dame Jessica; Wagland, Richard

2016-09-02

To provide the first systematic analysis of a national (Wales) sample of free-text comments from patients with cancer, to determine emerging themes and insights regarding experiences of cancer care in Wales. Thematic analysis of free-text data from a population-based survey. Adult patients with a confirmed cancer diagnosis treated within a 3-month period during 2012 in the 7 health boards and 1 trust providing cancer care in Wales. Free-text categorised by theme, coded as positive or negative, with ratios. Overarching themes are identified incorporating comment categories. 4672 respondents (of n=7352 survey respondents) provided free-text comments. Data were coded using a multistage approach: (1) coding of comments into general categories (eg, nursing, surgery, etc), (2) coding of subcategories within main categories (eg, nursing care, nursing communication, etc), (3) cross-sectional analysis to identify themes cutting across categories, (4) mapping of categories/subcategories to corresponding closed questions in the Wales Cancer Patient Experience Survey (WCPES) data for comparison. Most free-text respondents (82%, n 3818) provided positive comments about their cancer care, with 49% (n=2313) giving a negative comment (ratio 0.6:1, negative-to-positive). 3172 respondents (67.9% of free-text respondents) provided a comment mapping to 1 of 4 overarching themes: communication (n=1673, 35.8% free-text respondents, a ratio of 1.0:1); waiting during the treatment and/or post-treatment phase (n=923, 19.8%, ratio 1.5:1); staffing and resource levels (n=671, 14.4% ratio 5.3:1); speed and quality of diagnostic care (n=374, 8.0%, ratio 1.5:1). Within these areas, constituent subthemes are discussed. This study presents specific areas of concern for patients with cancer, and reveals a number of themes present across the cancer journey. While the majority of comments were positive, analysis reveals concerns shared by significant numbers of respondents. Timely communication can help to manage these anxieties, even where delays or difficulties in treatment may be encountered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Review of influential articles in surgical education: 2002-2012.

PubMed

Wohlauer, Max V; George, Brian; Lawrence, Peter F; Pugh, Carla M; Van Eaton, Erik G; Darosa, Debra

2013-06-01

Exploring the trends in surgical education research offers insight into concerns, developments, and questions researchers are exploring that are relevant to teaching and learning in surgical specialties. We conducted a review of the surgical education literature published between 2002 and 2012. The purpose was 2-fold: to provide an overview of the most frequently cited articles in the field of surgical education during the last decade and to describe the study designs and themes featured in these articles. Articles were identified through Web of Science by using "surgical education" and "English language" as search terms. Using a feature in Web of Science, we tracked the number of citations of any publication. Of the 800 articles produced by the initial search, we initially selected 23 articles with 45 or more citations, and ultimately chose the 20 articles that were most frequently cited for our analysis. Analysis of the most frequently cited articles published in US journals between the years 2002-2012 identified 7 research themes and presented them in order of frequency with which they appear: use of simulation, issues in student/resident assessment, specialty choice, patient safety, team training, clinical competence assessment, and teaching the clinical sciences, with surgical simulation being the central theme. Researchers primarily used descriptive methods. Popular themes in surgical education research illuminate the information needs of surgical educators as well as topics of high interest to the surgical community.

Recruitment of older women: lessons learned from the Baltimore Hip Studies.

PubMed

Resnick, Barbara; Concha, Betty; Burgess, Judy Graham; Fine, Mary Louise; West, Linda; Baylor, Karen; Nahm, Eun Shim; Buie, Verita Custis; Werner, Michelle; Orwig, Denise; Magaziner, Jay

2003-01-01

This study used a qualitative approach in which participants were asked to write about their experiences in recruiting older women into either one of two exercise intervention studies that are part of the Baltimore Hip Studies. The sample included 8 researcher nurses all women, White, and 42-53 years of age. Older adults, particularly older women, are less likely to participate in research studies when compared to their younger counterparts. The purpose of this study was to explore the techniques successfully used by research nurses in the Baltimore Hip Studies to recruit older women after hip fracture into exercise intervention studies. Data analysis was performed using basic content analysis (Crabtree & Miller, 1992; Miles & Huberman, 1984) "in vivo" coding (Dowd, 1991), or "grounded" coding (Glaser & Strauss, 1967), which involves using the informants' own words to capture a particular idea. A total of 16 codes were identified and reduced to nine themes. Seven themes focused on techniques that facilitated recruitment: (a) caring for individuals; (b) emphasizing benefits; (c) eliciting support from others; (d) being an expert; (e) using role models; (f) using good timing; and (g) giving good first impressions. The remaining two themes identified barriers to recruitment: (a) time commitment and (b) lack of support. Based on these themes, specific recruitment techniques are recommended. Ongoing research, however, is needed to establish the most effective recruitment procedures with older women.

Normative study of theme identifiability: Instructions with and without explanation of the false memory effect.

PubMed

Beato, Maria Soledad; Cadavid, Sara

2016-12-01

False-memory illusions have been widely studied using the Deese/Roediger-McDermott paradigm (DRM). In this paradigm, words semantically related to a single nonpresented critical word are studied. In a later memory test, critical words are often falsely recalled and recognized. The present normative study was conducted to measure the theme identifiability of 60 associative word lists in Spanish that include six words (e.g., stove, coat, blanket, scarf, chill, and bonnet) that are simultaneously associated with three critical words (e.g., HEAT, COLD, and WINTER; Beato & Díez, Psicothema, 26, 457-463, 2011). Different levels of backward associative strength were used in the construction of the DRM lists. In addition, we used two types of instructions to obtain theme identifiability. In the without-explanation condition, traditional instructions were used, requesting participants to write the theme list. In the with-explanation condition, the false-memory effect and how the lists were built were explained, and an example of a DRM list and critical words was shown. Participants then had to discover the critical words. The results showed that all lists produced theme identifiability. Moreover, some lists had a higher theme identifiability rate (e.g., 61 % for the critical words LOVE, BOYFRIEND, COUPLE) than others (e.g., 24 % for CITY, PLACE, VILLAGE). After comparing the theme identifiabilities in the different conditions, the results indicated higher theme identifiability when the false-memory effect was explained than without such an explanation. Overall, these new normative data provide a useful tool for those experiments that, for example, aim to analyze the wide differences observed in false memory with DRM lists and the role of theme identifiability.

Prenatal whole exome sequencing: the views of clinicians, scientists, genetic counsellors and patient representatives.

PubMed

Quinlan-Jones, Elizabeth; Kilby, Mark D; Greenfield, Sheila; Parker, Michael; McMullan, Dominic; Hurles, Matthew E; Hillman, Sarah C

2016-10-01

Focus groups were conducted with individuals involved in prenatal diagnosis to determine their opinions relating to whole exome sequencing in fetuses with structural anomalies. Five representatives of patient groups/charities (PRGs) and eight clinical professionals (CPs) participated. Three focus groups occurred (the two groups separately and then combined). Framework analysis was performed to elicit themes. A thematic coding frame was identified based on emerging themes. Seven main themes (consent, analysis, interpretation/reinterpretation of results, prenatal issues, uncertainty, incidental findings and information access) with subthemes emerged. The main themes were raised by both groups, apart from 'analysis', which was raised by CPs only. Some subthemes were raised by PRGs and CPs (with different perspectives). Others were raised either by PRGs or CPs, showing differences in patient/clinician agendas. Prenatal consent for whole exome sequencing is not a 'perfect' process, but consent takers should be fully educated regarding the test. PRGs highlighted issues involving access to results, feeling that women want to know all information. PRGs also felt that patients want reinterpretation of results over time, whilst CPs felt that interpretation should be performed at the point of testing only. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

“The Whole Family Suffered, so the Whole Family Needs to Recover”: Thematic Analysis of Substance-Abusing Mothers’ Family Therapy Sessions

PubMed Central

Brakenhoff, Brittany; Slesnick, Natasha

2014-01-01

Substance abusing mothers and their children are more likely to experience a range of social, behavioral, and psychological difficulties. Despite the significant challenges faced by these families, little is known about their experiences in treatment. The current study analyzed 12 sessions of family therapy using thematic analysis to identify common themes that arose during substance abusing mothers and their children’s discussion during family therapy. Mothers’ ages ranged from 28 to 35 years and the children’s ages ranged from 12 to 14 years. Four therapy sessions from three families were coded for a total of 12 therapy sessions. An ecological framework was used to classify themes, in which themes related to each level of the families’ ecological systems were identified. Thematic analysis of the therapy sessions indicated that mothers and their children primarily discussed topics related to their relational and emotional needs. The findings indicated that substance use disordered mothers and their children have unique treatment needs that should be addressed when the mother seeks treatment. More research is needed to further clarify and confirm the observations in this study. In particular, future research should include a larger sample and quantitative methodology. PMID:25729116

A systematic review of service-learning in medical education: 1998-2012.

PubMed

Stewart, Trae; Wubbena, Zane C

2015-01-01

PHENOMENON: In the United States, the Affordable Care Act has increased the need for community-centered pedagogy for medical education such as service-learning, wherein students connect academic curriculum and reflections to address a community need. Yet heterogeneity among service-learning programs suggests the need for a framework to understand variations among service-learning programs in medical education. A qualitative systematic review of literature on service-learning and medical education was conducted for the period between 1998 and 2012. A two-stage inclusion criteria process resulted in articles (n = 32) on service-learning and Doctor of Medicine or Doctor of Osteopathic Medicine being included for both coding and analysis. Focused and selective coding were employed to identify recurring themes and subthemes from the literature. The findings of the qualitative thematic analysis of service-learning variation in medical education identified a total of seven themes with subthemes. The themes identified from the analysis were (a) geographic location and setting, (b) program design, (c) funding, (d) participation, (e) program implementation, (f) assessment, and (g) student outcomes. Insights: This systematic review of literature confirmed the existence of program heterogeneity among service-learning program in medical education. However, the findings of this study provide key insights into the nature of service-learning in medical education building a framework for which to organize differences among service-learning programs. A list of recommendations for future areas of inquiry is provided to guide future research.

Staying in the ‘sweet spot’: A resilience-based analysis of the lived experience of low-risk drinking and abstention among British youth

PubMed Central

Graber, Rebecca; de Visser, Richard; Abraham, Charles; Memon, Anjum; Hart, Angie; Hunt, Kate

2016-01-01

Objective: The aim of this study was to understand how and why young people drink less or not at all when with their peers. Understanding the subjective experiences of moderate or non-drinkers may help identify protective processes facilitating resilience to cultural norm and influences that encourage excessive alcohol consumption among young people. Design: Semi-structured interviews were conducted with 25 moderate- or non-drinkers aged 17–25 years (13 young women) living in South East England. Interviews explored recent experiences of social situations and encounters that did or did not involve alcohol. Transcripts were analysed using Interpretative Phenomenological Analysis. Results: Analysis identified six conceptually coherent themes clustering within a superordinate theme of a healthy experience of moderate alcohol use or abstention: ‘the sweet spot’. These themes were: feeling good in the body, feeling like you can be who you are, feeling like you belong, making a free choice, enjoying the moment, and feeling safe and secure. Conclusions: This resilience-based analysis showed how non-drinking and moderate-drinking may be experienced as a positive and proactive choice. Understanding the subjective experiences of young people may aid development of specific, realistic interventions to promote moderate drinking and abstention among young people in drinking cultures. PMID:26155742

Spiritual well-being in long-term colorectal cancer survivors with ostomies.

PubMed

Bulkley, Joanna; McMullen, Carmit K; Hornbrook, Mark C; Grant, Marcia; Altschuler, Andrea; Wendel, Christopher S; Krouse, Robert S

2013-11-01

Spiritual well-being (SpWB) is integral to health-related quality of life. The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Two-hundred-eighty-three long-term (≥ 5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents' greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the three-item SpWB sub-scale. Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as "positive attitude", "I am fortunate", "appreciate life more", and "strength through religious faith". Negative themes, expressed by only 29% of respondents, included "struggling to cope", "not feeling 'normal' ", and "loss". Fifty-five percent of respondents expressed ambivalent themes including "learning acceptance", "an ostomy is the price for survival", "reason to be around despite suffering", and "continuing to cope despite challenges". The majority (64%) had a high SpWB sub-scale score. Although CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes were often mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter connectedness, and belonging. Copyright © 2013 John Wiley & Sons, Ltd.

SPIRITUAL WELL-BEING IN LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMIES

PubMed Central

Bulkley, Joanna; McMullen, Carmit K.; Hornbrook, Mark C.; Grant, Marcia; Altschuler, Andrea; Wendel, Christopher S.; Krouse, Robert S.

2014-01-01

Objective Spiritual well-being (SpWB) is integral to health-related quality of life (HRQOL). The challenges of colorectal cancer (CRC) and subsequent bodily changes can affect SpWB. We analyzed the SpWB of CRC survivors with ostomies. Methods Two-hundred-eight-three long-term (≥5 years) CRC survivors with permanent ostomies completed the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O) questionnaire. An open-ended question elicited respondents’ greatest challenge in living with an ostomy. We used content analysis to identify SpWB responses and develop themes. We analyzed responses on the 3-item SpWB sub-scale. Results Open-ended responses from 52% of participants contained SpWB content. Fifteen unique SpWB themes were identified. Sixty percent of individuals expressed positive themes such as “positive attitude”, “I am fortunate”, “appreciate life more”, and “strength through religious faith”. Negative themes, expressed by only 29% of respondents, included “struggling to cope”, “not feeling ‘normal’”, and “loss”. Fifty-five percent of respondents expressed ambivalent themes including “learning acceptance”, “an ostomy is the price for survival”, “reason to be around despite suffering”, and “continuing to cope despite challenges”. The majority (64%) had a high SpWB sub-scale score. Conclusions While CRC survivors with ostomies infrequently mentioned negative SpWB themes as a major challenge, ambivalent themes were common. SpWB themes often were mentioned as a source of resilience or part of the struggle to adapt to an altered body after cancer surgery. Interventions to improve the quality of life of cancer survivors should contain program elements designed to address SpWB that support personal meaning, inner peace, inter-connectedness, and belonging. PMID:23749460

Reactions on Twitter to updated alcohol guidelines in the UK: a content analysis.

PubMed

Stautz, Kaidy; Bignardi, Giacomo; Hollands, Gareth J; Marteau, Theresa M

2017-02-28

In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter. Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis. A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding. This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

What is involved in medicines management across care boundaries? A qualitative study of healthcare practitioners' experiences in the case of acute kidney injury

PubMed Central

Morris, Rebecca L; Blakeman, Tom; Ashcroft, Darren M

2017-01-01

Objectives To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. Design Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. Setting Primary, secondary and intermediate care in England. Participants 12 General practitioners, 10 community pharmacists, 7 hospital doctors and 7 hospital pharmacists, all with experience of involvement in preventing or treating AKI. Results We identified three main themes concerning participants' experiences of managing medicines in AKI. In the first theme, challenges arising from the clinical context, AKI is identified as a technically complex condition to identify and treat, often requiring judgements to be made about renal functioning against the context of the patient's general well-being. In the second theme, challenges arising from the organisational context, the crossing of professional and organisational boundaries is seen to introduce problems for the coordination of clinical activities, for example by disrupting information flows. In the third theme, meeting the challenges, participants identify ways in which they overcome the challenges they face in order to ensure effective medicines management, for example by adapting their work practices and tools. Conclusions These themes indicate the critical role of cognitive work on the part of healthcare practitioners, as individuals and as teams, in ensuring effective medicines management during AKI. Our findings suggest that the capabilities underlying this work, for example decision-making, communication and team coordination, should be the focus of training and work design interventions to improve medicines management for AKI or for other conditions. PMID:28100559

Graduate medical education competencies for international health electives: A qualitative study.

PubMed

Nordhues, Hannah C; Bashir, M Usmaan; Merry, Stephen P; Sawatsky, Adam P

2017-11-01

Residency programs offer international health electives (IHEs), providing multiple educational benefits. This study aimed to identify how IHEs fulfill the Accreditation Council for Graduate Medical Education (ACGME) core competencies. We conducted a thematic analysis of post-rotation reflective reports from residents who participated in IHEs through the Mayo International Health Program. We coded reports using a codebook created from the ACGME competencies. Using a constant comparative method, we identified significant themes within each competency. Residents from 40 specialties participated in 377 IHEs in 56 countries from 2001 to 2014. Multiple themes were identified within each of the six ACGME core competencies: Patient Care and Procedural Skills (4), Medical Knowledge (5), Practice-Based Learning and Improvement (3), Interpersonal and Communication Skills (5), Professionalism (4), and Systems-Based Practice and Improvement (3). Themes included improving physical exam and procedural skills, providing care in resource-limited setting, gaining knowledge of tropical and non-tropical diseases, identifying socioeconomic determinants of health, engaging in the education of others, and increasing communication across cultures and multidisciplinary teams. Through IHEs, residents advanced their knowledge, skills, and attitudes in each of the six ACGME competencies. These data can be used for development of IHE competencies and milestones for resident assessment.

Barriers to Breast and Cervical Cancer Screening in Singapore: a Mixed Methods Analysis.

PubMed

Malhotra, Chetna; Bilger, Marcel; Liu, Joy; Finkelstein, Eric

2016-01-01

In order to increase breast and cervical cancer screening uptake in Singapore, women's perceived barriers to screening need to be identified and overcome. Using data from both focus groups and surveys, we aimed to assess perceived barriers and motivations for breast and cervical cancer screening. We conducted 8 focus groups with 64 women, using thematic analysis to identify overarching themes related to women's attitudes towards screening. Based on recurring themes from focus groups, several hypotheses regarding potential barriers and motivations to screen were generated and tested through a national survey of 801 women aged 25-64. Focus group participants had misconceptions related to screening, believing that the procedures were painful. Cost was an issue, as well as efficacy and fatalism. By identifying barriers to and motivators for screening through a mixed-method design that has both nuance and external validity, this study offers valuable suggestions to policymakers to improve breast and cervical cancer screening uptake in Singapore.

Factors influencing quality of life in patients with active tuberculosis.

PubMed

Marra, Carlo A; Marra, Fawziah; Cox, Victoria C; Palepu, Anita; Fitzgerald, J Mark

2004-10-20

With effective treatment strategies, the focus of tuberculosis (TB) management has shifted from the prevention of mortality to the avoidance of morbidity. As such, there should be an increased focus on quality of life (QoL) experienced by individuals being treated for TB. The objective of our study was to identify areas of QoL that are affected by active TB using focus groups and individual interviews. English, Cantonese, and Punjabi-speaking subjects with active TB who were receiving treatment were eligible for recruitment into the study. Gender-based focus group sessions were conducted for the inner city participants but individual interviews were conducted for those who came to the main TB clinic or were hospitalized. Facilitators used open-ended questions and participants were asked to discuss their experiences of being diagnosed with tuberculosis, what impact it had on their lives, issues around adherence to anti-TB medications and information pertaining to their experience with side effects to these medications. All data were audio-recorded, transcribed verbatim, and analyzed using constant comparative analysis. 39 patients with active TB participated. The mean age was 46.2 years (SD 18.4) and 62% were male. Most were Canadian-born being either Caucasian or Aboriginal. Four themes emerged from the focus groups and interviews. The first describes issues related to the diagnosis of tuberculosis and sub-themes were identified as 'symptoms', 'health care provision', and 'emotional impact'. The second theme discusses TB medication factors and the sub-themes identified were 'adverse effects', 'ease of administration', and 'adherence'. The third theme describes social support and functioning issues for the individuals with TB. The fourth theme describes health behavior issues for the individuals with TB and the identified sub-themes were "behavior modification" and "TB knowledge." Despite the ability to cure TB, there remains a significant impact on QOL. Since much attention is spent on preventative or curative mechanisms, the impact of this condition on QoL is often not considered. Attention to the issues experienced by patients being treated for TB may optimize adherence and treatment success.

The Most Common Feedback Themes in Communication Skills Training in an Internal Medicine Residency Program: Lessons from the Resident Audio-Recording Project.

PubMed

Han, Heeyoung; Papireddy, Muralidhar Reddy; Hingle, Susan T; Ferguson, Jacqueline Anne; Koschmann, Timothy; Sandstrom, Steve

2018-07-01

Individualized structured feedback is an integral part of a resident's learning in communication skills. However, it is not clear what feedback residents receive for their communication skills development in real patient care. We will identify the most common feedback topics given to residents regarding communication skills during Internal Medicine residency training. We analyzed Resident Audio-recording Project feedback data from 2008 to 2013 by using a content analysis approach. Using open coding and an iterative categorization process, we identified 15 emerging themes for both positive and negative feedback. The most recurrent feedback topics were Patient education, Thoroughness, Organization, Questioning strategy, and Management. The residents were guided to improve their communication skills regarding Patient education, Thoroughness, Management, and Holistic exploration of patient's problem. Thoroughness and Communication intelligibility were newly identified themes that were rarely discussed in existing frameworks. Assessment rubrics serve as a lens through which we assess the adequacy of the residents' communication skills. Rather than sticking to a specific rubric, we chose to let the rubric evolve through our experience.

"It was pretty scary": the theme of fear in young adult women's descriptions of a history of adolescent dating abuse.

PubMed

Burton, Candace W; Halpern-Felsher, Bonnie; Rehm, Roberta S; Rankin, Sally; Humphreys, Janice C

2013-11-01

The mental health impact of abusive adolescent dating relationships has not been well described, but fear related to abuse has been reported. We elaborate the theme of fear in women's descriptions of a history of adolescent dating abuse. A sample of community-based women, ages 19-34, who experienced an abusive dating relationship during adolescence (ages 11-20) was used. Data were analyzed via thematic analysis. Fear was a consistent and resonant theme. Three types of fear were identified: fear for self, fear for other relationships, and fearful expectation. These results offer important insights into the impact of abusive adolescent relationships on women's mental health.

The Role of Involvement and Use in Multisite Evaluations

ERIC Educational Resources Information Center

Lawrenz, Frances; King, Jean A.; Ooms, Ann

2011-01-01

A cross-case analysis of four National Science Foundation (NSF) case studies identified both unique details and common themes related to promoting the use and influence of multisite evaluations. The analysis provided evidence of diverse evaluation use by stakeholders and suggested that people taking part in the multisite evaluations perceived…

Strategic Analysis of Family Support in EHDI Systems

ERIC Educational Resources Information Center

Bradham, Tamala S.; Houston, K. Todd; Guignard, Gayla Hutsell; Hoffman, Jeff

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. For the family support area, 47 EHDI coordinators listed 255 items, and themes were identified within each category. A threats,…

A Systematic Analysis of Audiological Services in EHDI

ERIC Educational Resources Information Center

Munoz, Karen F.; Bradham, Tamala S.; Nelson, Lauri

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. For audiological evaluation and services, 299 items were listed by 49 coordinators, and themes were identified within each SWOT category.…

Newborn Hearing Screening: An Analysis of Current Practices

ERIC Educational Resources Information Center

Houston, K. Todd; Bradham, Tamala S.; Munoz, Karen F.; Guignard, Gayla Hutsell

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the newborn hearing screening area, a total of 293 items were listed by 49 EHDI coordinators, and themes were identified within…

A mobile system for the improvement of heart failure management: Evaluation of a prototype.

PubMed

Haynes, Sarah C; Kim, Katherine K

2017-01-01

Management of heart failure is complex, often involving interaction with multiple providers, monitoring of symptoms, and numerous medications. Employing principles of user-centered design, we developed a high- fidelity prototype of a mobile system for heart failure self-management and care coordination. Participants, including both heart failure patients and health care providers, tested the mobile system during a one-hour one-on-one session with a facilitator. The facilitator interviewed participants about the strengths and weaknesses of the prototype, necessary features, and willingness to use the technology. We performed a qualitative content analysis using the transcripts of these interviews. Fourteen distinct themes were identified in the analysis. Of these themes, integration, technology literacy, memory, and organization were the most common. Privacy was the least common theme. Our study suggests that this integration is essential for adoption of a mobile system for chronic disease management and care coordination.

THROUGH THE LENS OF RACE: BLACK AND WHITE WOMEN'S PERCEPTIONS OF WOMANHOOD.

PubMed

Settles, Isis H; Pratt-Hyatt, Jennifer S; Buchanan, NiCole T

2008-01-01

The intersection of race and gender may create unique experiences for Black and White women in terms of work, family, domestic roles, and interpersonal relationships. Dissimilar gender-role norms may foster different perceptions of gender for these two groups of women. In the current study, we examined similarities and differences in Black and White women's perceptions of their gender using qualitative focus group methodology and grounded theory data analysis. The results identified five themes that were common to Black and White women: Gender-Based Mistreatment, Perceived Advantage, Friendships and Community, Caretaking, and Work and Family Options. One additional theme, Inner Strength, emerged only for Black women. Although many of the broad perceptions of womanhood were similar for Black and White women, analysis of the content within each theme highlighted important differences. We discuss the results in terms of how they may reflect socio-historical factors, gender discrimination, stereotypes, and gender-role norms.

Listening to the Reactions of People in the Midst of Change

ERIC Educational Resources Information Center

Friestad-Tate, Jill; McCoy, Craig

2012-01-01

The purpose of the study was to listen to reactions of key stakeholders experiencing profound organizational change. A case study was used to gather data from participants' interview responses. Data analysis identified research-supported reactions; in addition, two unique themes were identified: constructive critique and ill-effects of good…

Children and parents' experiences of cognitive behavioral therapy for dental anxiety--a qualitative study.

PubMed

Shahnavaz, Shervin; Rutley, Sara; Larsson, Karin; Dahllöf, Göran

2015-09-01

There is a high prevalence of dental anxiety in children and adolescents. Cognitive behavioral therapy is emerging as a treatment option. The purpose of this study is to explore how children with dental anxiety and their parents experience cognitive behavioral therapy (CBT) in dentistry. We interviewed 12 children and one of their parents and conducted a thematic analysis of the transcribed interviews. Perspective shift emerged as overarching theme in our thematic analysis. This theme consisted of three main themes, which were mastery, safety, and reduced fear. Six subthemes were also identified according to our analyses. Mastery includes two subthemes, gradual exposure and autonomy and control. Subthemes and sources for safety feeling were therapeutic alliance and changed appraisal. The theme reduced fear also consisted of two subthemes; reduced anticipatory anxiety and coping. The results show that parents and children had positive experiences of CBT and its outcome and were able to benefit from this psychological treatment when dealing with dental anxiety. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Enjoyment of exercise among people with arthritis: An inductive thematic analysis.

PubMed

Kibblewhite, Julia R; Treharne, Gareth J; Stebbings, Simon; Hegarty, Roisin Sm

2017-09-01

Past research into exercise among people with long-term health conditions has paid surprisingly little attention to the concept of enjoyment. This study explored enjoyment of exercise among people with arthritis. Semi-structured interviews were held with 12 participants aged 20-85 years. The transcripts were analysed using inductive thematic analysis. Four themes were identified: enjoyment of exercise in relation to other people, benefits of exercise in relation to enjoyment, working around barriers to enjoy exercise and finding an enjoyable balance to exercise. These themes highlight the relevance of enjoyment and how it could feature in advice about exercise for people with arthritis.

Students' experiences and perceived benefits of a sex education curriculum: a qualitative analysis.

PubMed

Smith, Peggy B; Realini, Janet P; Buzi, Ruth S; Martinez, Mario

2011-01-01

A qualitative evaluation explored the experiences and perceived benefits of students who participated in an abstinence-plus sex education program at enrollment and conclusion. The sample included 1130 inner-city high school students, 73.7% of whom were Hispanic. Thematic analysis was used to identify main themes in responses made by students to 3 open-ended questions. The most common preparticipation request was for information about sexually transmitted infections. At program conclusion, the most common response theme involved the quality of course delivery. Students indicated that they appreciated the facilitators who allowed open conversations. The implications of these findings to sex education programs are discussed.

A collective case study of nursing students with learning disabilities.

PubMed

Kolanko, Kathrine M

2003-01-01

This collective case study described the meaning of being a nursing student with a learning disability and examined how baccalaureate nursing students with learning disabilities experienced various aspects of the nursing program. It also examined how their disabilities and previous educational and personal experiences influenced the meaning that they gave to their educational experiences. Seven nursing students were interviewed, completed a demographic data form, and submitted various artifacts (test scores, evaluation reports, and curriculum-based material) for document analysis. The researcher used Stake's model for collective case study research and analysis (1). Data analysis revealed five themes: 1) struggle, 2) learning how to learn with LD, 3) issues concerning time, 4) social support, and 5) personal stories. Theme clusters and individual variations were identified for each theme. Document analysis revealed that participants had average to above average intellectual functioning with an ability-achievement discrepancy among standardized test scores. Participants noted that direct instruction, structure, consistency, clear directions, organization, and a positive instructor attitude assisted learning. Anxiety, social isolation from peers, and limited time to process and complete work were problems faced by the participants.

Recent Themes in Social Networking Service Research.

PubMed

Liu, John S; Ho, Mei Hsiu-Ching; Lu, Louis Y Y

2017-01-01

The body of literature addressing the phenomenon related to social networking services (SNSs) has grown rather fast recently. Through a systematic and quantitative approach, this study identifies the recent SNS research themes, which are the issues discussed by a coherent and growing subset of this literature. A set of academic articles retrieved from the Web of Science database is used as the basis for uncovering the recent themes. We begin the analysis by constructing a citation network which is further separated into groups after applying a widely used clustering method. The resulting clusters all consist of articles coherent in citation relationships. This study suggests eight fast growing recent themes. They span widely encompassing politics, romantic relationships, public relations, journalism, and health. Among them, four focus their issues largely on Twitter, three on Facebook, and one generally on both. While discussions on traditional issues in SNSs such as personality, motivations, self-disclosure, narcissism, etc. continue to lead the pack, the proliferation of the highlighted recent themes in the near future is very likely to happen.

Recent Themes in Social Networking Service Research

PubMed Central

Liu, John S.; Ho, Mei Hsiu-Ching; Lu, Louis Y. Y.

2017-01-01

The body of literature addressing the phenomenon related to social networking services (SNSs) has grown rather fast recently. Through a systematic and quantitative approach, this study identifies the recent SNS research themes, which are the issues discussed by a coherent and growing subset of this literature. A set of academic articles retrieved from the Web of Science database is used as the basis for uncovering the recent themes. We begin the analysis by constructing a citation network which is further separated into groups after applying a widely used clustering method. The resulting clusters all consist of articles coherent in citation relationships. This study suggests eight fast growing recent themes. They span widely encompassing politics, romantic relationships, public relations, journalism, and health. Among them, four focus their issues largely on Twitter, three on Facebook, and one generally on both. While discussions on traditional issues in SNSs such as personality, motivations, self-disclosure, narcissism, etc. continue to lead the pack, the proliferation of the highlighted recent themes in the near future is very likely to happen. PMID:28107541

Fear of (re)injury and return to work following compensable injury: qualitative insights from key stakeholders in Victoria, Australia.

PubMed

Bunzli, Samantha; Singh, Nabita; Mazza, Danielle; Collie, Alex; Kosny, Agnieszka; Ruseckaite, Rasa; Brijnath, Bianca

2017-04-11

Return to work (RTW) is important for recovery post-injury. Fear of (re)injury is a strong predictor of delayed RTW, and therefore much attention has been given to addressing injured workers' fear beliefs. However, RTW is a socially-negotiated process and it may be important to consider the wider social context of the injured worker, including the beliefs of the key people involved in their RTW journey. This paper involves data collected as part of a wider study in which semi-structured interviews explored RTW from the perspectives of 93 key stakeholders: injured workers, GPs, employers and insurance case managers in Victoria, Australia. Inductive analysis of interview transcripts identified fear of (re)injury as a salient theme across all stakeholder groups. This presented an opportunity to analyse how the wider social context of the injured worker may influence fear and avoidance behaviour. Two co-authors performed inductive analysis of the theme 'fear of (re)injury'. Codes identified in the data were grouped into five categories. Between and within category analysis revealed three themes describing the contextual factors that may influence fear avoidance and RTW behaviour. Theme one described how injured workers engaged in a process of weighing up the risk of (re)injury in the workplace against the perceived benefits of RTW. Theme two described how workplace factors could influence an injured workers' perception of the risk of (re)injury in the workplace, including confidence that the source of the injury had been addressed, the availability and suitability of alternative duties. Theme three described other stakeholders' reluctance to accept injured workers back at work because of the fear that they might reinjure themselves. Our findings illustrate the need for a contextualised perspective of fear avoidance and RTW behaviour that includes the beliefs of other important people surrounding the injured worker (e.g. employers, family members, GPs). Existing models of health behaviour such as The Health Beliefs Model may provide useful frameworks for interventions targeting the affective, cognitive, social, organisational and policy factors that can influence fear avoidance or facilitate RTW following injury.

The goal of making friends for youth with disabilities: creating a goal menu.

PubMed

Gerhardt, S; McCallum, A; McDougall, C; Keenan, S; Rigby, P

2015-11-01

Clinicians working with youth with disabilities have acknowledged making friends as a commonly identified client goal. Clinicians find this goal difficult to address, as there are no measures that provide a breakdown of making friends into functional steps. In addition, research on friendship has traditionally focused on characteristics and quality of friendships rather than the friend-making process as a whole. A goal menu, comprised of a variety of steps that address the goal of making friends, would provide guidance to clinicians challenged with this goal in practice. To develop an understanding of the friend-making process as a first step towards the development of a goal menu for the goal of making friends. A literature review, youth focus group and expert clinician semi-structured interviews and consultation were used to generate a comprehensive data set. Established qualitative methods were used to sort and group the data into categories. A thematic analysis of the categories was performed. Analysis revealed four themes integral to the friend-making process: person factors influencing friend-making, making friend-making a priority, opportunity for friend-making and motivation to make friends. An additional theme identified as occasionally involved in the process was a little bit of luck in making friends. The themes generated by this research indicate that actionable target areas exist for the somewhat abstract notion of friend-making and the authors recommend that clinicians explore beyond person factors when addressing the goal of making friends. As a next step, the identified themes will provide the foundation for a goal menu, ultimately enabling clinicians to address the goal of making friends in a more efficient and effective manner. © 2015 John Wiley & Sons Ltd.

Explanations and information-giving: clinician strategies used in talking to parents of preterm infants.

PubMed

Redshaw, M E; Harvey, M E

2016-02-11

The study is part of a larger research programme on neonatal brain imaging in the trial element of which parents were randomised to receive prognostic information based upon either magnetic resonance imaging (MRI) or ultrasound findings (ePrime study). The aim of this study was to investigate the strategies used by clinicians in communicating with parents following imaging at term age of the brain of preterm infants born before 33 weeks gestation, focusing on explanations and information-giving about prognosis  Audio recordings of discussions between parents and clinicians were made following MRI and ultrasound assessment. Parents were given the scan result and the baby's predicted prognosis. A framework was developed based on preliminary analysis of the recordings and findings of other studies of information-giving in healthcare. Communication of scan results by the clinicians was further explored in qualitative analysis with 36 recordings using NVivo 10 and the specifically developed framework. Emerging themes and associated sub-themes were identified. The ways in which clinicians gave information and helped parents to understand were identified. Within the over-arching theme of clinician strategies a wide range of approaches were used to facilitate parental understanding. These included orienting, checking on previously acquired information, using analogies, explaining terminology, pacing the information, confirming understanding, inviting clarification, answering parents' questions and recapping at intervals. Ultimately four key themes were identified: 'Framing the information-giving', 'What we are looking at', 'Presenting the numbers and explaining the risk' and 'Appreciating the position of parents'. The interviews represent a multifaceted situation in which there is a tension between the need to explain and inform and the inherent complexity of neurological development, potential problems following preterm birth and the technology used to investigate and monitor these.

Work-family balance by women GP specialist trainees in Slovenia: a qualitative study.

PubMed

Petek, Davorina; Gajsek, Tadeja; Petek Ster, Marija

2016-01-28

Women physicians face many challenges while balancing their many roles: doctor, specialist trainee, mother and partner. The most opportune biological time for a woman to start a family coincides with a great deal of demands and requirements at work. In this study we explored the options and capabilities of women GP specialist trainees in coordinating their family and career. This is a phenomenological qualitative research. Ten GP specialist trainees from urban and rural areas were chosen by the purposive sampling technique, and semi-structured in-depth interviews were conducted, recorded, transcribed and analysed by using thematic analysis process. Open coding and the book of codes were formed. Finally, we performed the process of code reduction by identifying the themes, which were compared, interpreted and organised in the highest analytical units--categories. One hundred fifty-five codes were identified in the analysis, which were grouped together into eleven themes. The identified themes are: types, causes and consequences of burdens, work as pleasure and positive attitude toward self, priorities, planning and help, and understanding of superiors, disburdening and changing in specialisation. The themes were grouped into four large categories: burdens, empowerment, coordination and needs for improvement. Women specialist trainees encounter intense burdens at work and home due to numerous demands and requirements during their specialisation training. In addition, there is also the issue of the work-family conflict. There are many consequences regarding burden and strain; however, burnout stands out the most. In contrast, reconciliation of work and family life and needs can be successful. The key element is empowerment of women doctors. The foremost necessary systemic solution is the reinforcement of general practitioners in primary health care and their understanding of the specialisation training scheme with more flexible possibilities for time adaptations of specialist training.

Adult survivors' lived experience of burns and post-burn health: A qualitative analysis.

PubMed

Abrams, Thereasa E; Ogletree, Roberta J; Ratnapradipa, Dhitinut; Neumeister, Michael W

2016-02-01

The individual implications of major burns are likely to affect the full spectrum of patients' physical, emotional, psychological, social, environmental, spiritual and vocational health. Yet, not all of the post-burn health implications are inevitably negative. Utilizing a qualitative approach, this heuristic phenomenological study explores the experiences and perceptions early (ages 18-35) and midlife (ages 36-64) adults providing insight for how participants perceived their burns in relationship to their post-burn health. Participants were interviewed using semi-structured interview questions framed around seven domains of health. Interview recordings were transcribed verbatim then coded line by line, identifying dominant categories related to health. Categories were analyzed identifying shared themes among the study sample. Participants were Caucasian, seven males and one female. Mean age at time of interviews was 54.38 and 42.38 at time of burns. Mean time since burns occurred was 9.38 years with a minimum of (20%) total body surface area (TBSA) burns. Qualitative content analysis rendered three emergent health-related categories and associated themes that represented shared meanings within the participant sample. The category of "Physical Health" reflected the theme physical limitations, pain and sensitivity to temperature. Within the category of "Intellectual Health" were themes of insight, goal setting and self-efficacy, optimism and humor and within "Emotional Health" were the themes empathy and gratitude. By exploring subjective experiences and perceptions of health shared through dialog with experienced burned persons, there are opportunities to develop a more complete picture of how holistic health may be affected by major burns that in turn could support future long-term rehabilitative trajectories of early and midlife adult burn patients. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Assessing fitness-to-practice of overseas-trained health practitioners by Australian registration & accreditation bodies

PubMed Central

2012-01-01

Background Assessment of fitness-to-practice of health professionals trained overseas and who wish to practice in Australia is undertaken by a range of organisations. These organisations conduct assessments using a range of methods. However there is very little published about how these organisations conduct their assessments. The purpose of the current paper is to investigate the methods of assessment used by these organisations and the issues associated with conducting these assessments. Methods A series of semi-structured interviews was undertaken with a variety of organisations who undertake assessments of overseas-trained health professionals who wish to practice in Australia. Content analysis of the interviews was used to identify themes and patterns. Results Four themes were generated from the content analysis of the interviews: (1) assessing; (2) process; (3) examiners; and (4) cost-efficiency. The themes were interconnected and each theme also had a number of sub-themes. Conclusions The organisations who participated in the present study used a range of assessment methods to assess overseas trained health professionals. These organisations also highlighted a number of issues, particularly related to examiners and process issues, pre- and post-assessment. Organisations demonstrated an appreciation for ongoing review of their assessment processes and incorporating evidence from the literature to inform their processes and assessment development. PMID:23020885

Qualitative investigation of the reasons behind opposition to water fluoridation in regional NSW, Australia.

PubMed

Knox, Matthew C; Garner, Alexander; Dyason, Alan; Pearson, Thomas; Pit, Sabrina W

2017-02-15

To investigate reasons behind strong opposition to water fluoridation in regional New South Wales, Australia, and to make recommendations to improve community engagement. Few studies have used qualitative methodologies to understand the reasons for strong antifluoridation views. An understanding of these reasons could be useful when designing public campaigns to combat the strong antifluoridation message. The qualitative study used semistructured interviewing and thematic analysis. Ten participants were recruited using purposive and snowball sampling methods until data saturation was reached. Thematic analysis and graphical representation of themes assisted in analysing the data for logical connections and relationships. Six dominant themes and numerous subthemes were identified. Five of the major themes were reasons for opposition: scepticism, health effects, ethics, environmental impacts and economics. Each of these was inextricably linked to a sixth major theme: alternatives to fluoridation. All participants had strongly held antifluoridation views, and provided a unique insight into their perceptions and reasons for opposing water fluoridation. Concerns about 'fraudulent research' and the influence of industry on government bodies were novel themes. The concerns raised could be used to inform future population health campaigns, research, public education and resource-allocation decisions. Open community consultation may be able to address the issues raised in a nonjudgemental and collaborative manner.

Quality in the pharmaceutical industry - A literature review.

PubMed

Haleem, Reham M; Salem, Maissa Y; Fatahallah, Faten A; Abdelfattah, Laila E

2015-10-01

The aim of this study is to:a.Highlight the most important guidelines and practices of quality in the pharmaceutical industry.b.Organize such guidelines and practices to create a guide to pave the way for other researchers who would like to dig deeper into these guidelines and practices. A review was conducted of 102 publications; 56 publications were concerned with the pharmaceutical quality directly while 46 publications were concerned with the general quality practices. The content of those sources was analyzed and the following themes were identified:a.Research theme 1: Guidelines of the pharmaceutical quality.b.Research theme 2: General practices recently applied in the pharmaceutical industry. The following guidelines were identified and reviewed: WHO guidelines, FDA guidelines, EU guidelines and ICH guidelines in the research theme I. In research theme II; the following topics were identified and reviewed: quality risk management, quality by design, corrective actions and preventive actions, process capability analysis, Six Sigma, process analytical technology, lean manufacturing, total quality management, ISO series and HACCP. Upon reviewing the previously highlighted guidelines and the practices that are widely applied in the pharmaceutical industry, it was noticed that there is an abundant number of papers and articles that explain the general guidelines and practices but the literature lack those describing application; case studies of the pharmaceutical factories applying those guidelines and significance of those guidelines and practices. It is recommended that the literature would invest more in the area of application and significance of guidelines and practices. New case studies should be done to prove the feasibility of such practices.

Implementing a Just Culture: Perceptions of Nurse Managers of Required Knowledge, Skills and Attitudes.

PubMed

Freeman, Michelle; Morrow, Linda A; Cameron, Margo; McCullough, Karen

2016-01-01

Healthcare organizations have been challenged to create a just culture as part of their culture of safety. To explore perceptions of nurse managers in developing personal competencies in order to enable them to effectively implement a just culture in their units. Qualitative content analysis of semi-structured interviews with nine nurse managers identified themes. Data were independently analyzed by three members of the research team. Analysis of interview transcripts identified the following four themes: need for education of managers and employees, need for a variety of new skills for nurse managers, need to change attitudes from the long-standing punitive culture and fault of individual and challenges in implementation because of time constraints. Implementing a just culture is complex. Education of nurse managers is crucial. A series of educational strategies is recommended. Findings support the need for new competencies to enable nurse managers to effectively implement a just culture in their units.

Strategies for enhancing medical student resilience: student and faculty member perspectives.

PubMed

Farquhar, Julia; Kamei, Robert; Vidyarthi, Arpana

2018-01-12

To improve programs aimed to enhance medical student resiliency, we examined both medical student and faculty advisor perspectives on resiliency-building in an Asian medical school. In two separate focus groups, a convenience sample of 8 MD-PhD students and 8 faculty advisors were asked to identify strategies for enhancing resilience. Using thematic analysis, two researchers independently examined discussion transcripts and field notes and determined themes through a consensus process. They then compared the themes to discern similarities and differences between these groups. Themes from the student suggestions for increasing resilience included "Perspective changes with time and experience", "Defining effective advisors," and "Individual paths to resiliency". Faculty-identified themes were "Structured activities to change student perspectives," "Structured teaching of coping strategies", and "Institution-wide social support". Students described themselves as individuals building their own resilience path and preferred advisors who were not also evaluators. Faculty, however, suggested systematic, structural ways to increase resilience. Students and advisors identified some common, and many distinct strategies for enhancing medical student resilience. Student/advisor discrepancies may exemplify a cultural shift in Singapore's medical education climate, where students value increased individualism and autonomy in their education. As medical schools create interventions to enhance resilience and combat potential student burnout, they should consider individually-tailored as well as system-wide programs to best meet the needs of their students and faculty.

A qualitative study exploring public perceptions on the role of community pharmacists in Dubai

PubMed Central

Rayes, Ibrahim Khalid; Hassali, Mohamed Azmi; Abduelkarem, Abduelmula R.

Background The role of community pharmacists is very important due to their access to primary care patients and expertise. For this reason, the interaction level between pharmacists and patients should be optimized to ensure enhanced delivery of pharmacy services. Objective To gauge perceptions and expectations of the public on the role of community pharmacists in Dubai, United Arab Emirates (UAE). Methods Twenty five individuals were invited to participate in 4 separate focus group discussions. Individuals came from different racial groups and socio-economic backgrounds. Interviews were audio-recorded and transcribed. Using thematic analysis, two reviewers coded all transcripts to identify emerging themes. Appropriate measures were taken to ensure study rigor and validity. Results All facilitators and barriers that were identified were grouped into 5 distinct themes. The pharmacist as a healthcare professional in the public mind was the most prominent theme that was discussed in all 4 focus groups. Other themes identified were, in decreasing order of prevalence, psychological perceptions towards pharmacists, important determinants of a pharmacist, the pharmacy as a unique healthcare provider, and control over pharmacies by health authorities. Conclusions This study provided insight into the way that the public looks at the role of community pharmacists in Dubai. Determinants that influence their perception are the media, health authorities, pharmacist’s knowledge level, attire, nationality, age, and pharmacy location. PMID:24644519

Strengths, weaknesses, opportunities, and threats analysis of integrating the World Health Organization patient safety curriculum into undergraduate medical education in Pakistan: a qualitative case study

PubMed Central

2017-01-01

Purpose The purpose of this study was to conduct a strengths, weaknesses, opportunities, and threats (SWOT) analysis of integrating the World Health Organization (WHO) patient safety curriculum into undergraduate medical education in Pakistan. Methods A qualitative interpretive case study was conducted at Riphah International University, Islamabad, from October 2016 to June 2017. The study included 9 faculty members and 1 expert on patient safety. The interviews were audiotaped, and a thematic analysis of the transcripts was performed using NVivo software. Results Four themes were derived based on the need analysis model. The sub-themes derived from the collected data were arranged under the themes of strengths, weaknesses, opportunities, and threats, in accordance with the principles of SWOT analysis. The strengths identified were the need for a formal patient safety curriculum and its early integration into the undergraduate program. The weaknesses were faculty awareness and participation in development programs. The opportunities were an ongoing effort to develop an appropriate curriculum, to improve the current culture of healthcare, and to use the WHO curricular resource guide. The threats were attitudes towards patient safety in Pakistani culture, resistance to implementation from different levels, and the role of regulatory authorities. Conclusion The theme of patient safety needs to be incorporated early into the formal medical education curriculum, with the main goals of striving to do no harm and seeing mistakes as opportunities to learn. Faculty development activities need to be organized, and faculty members should to be encouraged to participate in them. The lack of a patient safety culture was identified as the primary reason for resistance to this initiative at many levels. The WHO curriculum, amended according to local institutional culture, can be implemented appropriately with support from the corresponding regulatory bodies. PMID:29284217

Applying findings from a systematic review of workplace-based e-learning: implications for health information professionals.

PubMed

Booth, Andrew; Carroll, Christopher; Papaioannou, Diana; Sutton, Anthea; Wong, Ruth

2009-03-01

To systematically review the UK published literature on e-learning in the health workplace and to apply the findings to one of the most prolific UK e-learning initiatives in the health sector--the National Library for Health Facilitated Online Learning Interactive Opportunity (FOLIO) Programme. Sensitive searches were conducted across ASSIA, Australian Education Index, British Education Index, cinahl, CSA Abstracts, Dissertation Abstracts, Emerald, ERIC, IBSS, Index to Theses, LISA, MEDLINE, PSYCINFO and Social Science Citation Index. Additional citations were identified from reference lists of included studies and of relevant reviews; citation tracking and contact with experts. Twenty-nine studies met the inclusion criteria and were coded and analysed using thematic analysis as described by Miles & Huberman (Qualitative Data Analysis: A Sourcebook of New Methods. Newbury Park, CA: Sage, 1984). Five broad themes were identified from the 29 included studies: (i) peer communication; (ii) flexibility; (iii) support; (iv) knowledge validation; and (v) course presentation and design. These broad themes were supported by a total of eleven sub-themes. Components from the FOLIO Programme were analysed and existing and proposed developments were mapped against each sub-theme. This provides a valuable framework for ongoing course development. Librarians involved in delivering and supporting e-learning can benefit from applying the findings from the systematic review to existing programmes, exemplified by the FOLIO Programme. The resultant framework can also be used in developing new e-learning programmes.

Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings.

PubMed

Iheduru-Anderson, Kechinyere C; Wahi, Monika M

2018-04-01

Successful transition to practice of internationally educated nurses (IENs) can critically affect quality of care. The aim of this study was to characterize the facilitators and barriers to transition of Nigerian IENs (NIENs) to the United States health care setting. Using a descriptive phenomenology approach, 6 NIENs were interviewed about their transitional experiences in the United States. Thematic methods were used for data analysis. The three major themes identified from the participants' stories were "fear/anger and disappointment" (FAD), "road/journey to success/overcoming challenges" (RJO), and "moving forward" (MF). The FAD theme predominated, including experiences of racism, bullying, and inequality. The RJO theme included resilience, and the MF theme encompassed personal growth. NIENs face personal and organizational barriers to adaptation, especially fear, anger and disappointment. Future research should seek to develop a model for optimal adaptation that focuses on improving both personal and organizational facilitators and decreasing barriers.

Returning to Work after Cancer: Quantitative Studies and Prototypical Narratives

PubMed Central

Steiner, John F.; Nowels, Carolyn T.; Main, Deborah S.

2009-01-01

Objective A combination of quantitative data and illustrative narratives may allow cancer survivorship researchers to disseminate their research findings more broadly. We identified recent, methodologically rigorous quantitative studies on return to work after cancer, summarized the themes from these studies, and illustrated those themes with narratives of individual cancer survivors. Methods We reviewed English-language studies of return to work for adult cancer survivors through June, 2008, and identified 13 general themes from papers that met methodological criteria (population-based sampling, prospective and longitudinal assessment, detailed assessment of work, evaluation of economic impact, assessment of moderators of work return, and large sample size). We drew survivorship narratives from a prior qualitative research study to illustrate these themes. Results Nine quantitative studies met 4 or more of our 6 methodological criteria. These studies suggested that most cancer survivors could return to work without residual disabilities. Cancer site, clinical prognosis, treatment modalities, socioeconomic status, and attributes of the job itself influenced the likelihood of work return. Three narratives - a typical survivor who returned to work after treatment, an individual unable to return to work, and an inspiring survivor who returned to work despite substantial barriers - illustrated many of the themes from the quantitative literature while providing additional contextual details. Conclusion Illustrative narratives can complement the findings of cancer survivorship research if researchers are rigorous and transparent in the selection, analysis, and retelling of those stories. PMID:19507264

Parental Experiences of Caring for a Child with Intellectual Disabilities: A UK Perspective

ERIC Educational Resources Information Center

Willingham-Storr, Gemma Louise

2014-01-01

A structured literature search and thematic analysis of six research articles relating to stress and parenting of a child with an intellectual disability in the United Kingdom identified four key themes: impact upon families, service provision and support networks, coping and transition. The findings identified that parenting a child with an…

A Phenomenological Study of Non-LGBT Students with LGBQ Parents

ERIC Educational Resources Information Center

Bourdon, Thomas

2013-01-01

There is a lack of qualitative research that has sought to uncover the lived experiences of students who identify as heterosexual/cisgender (i.e., non-LGBT) but have at least one parent who identifies as LGBQ. This phenomenological analysis aimed to uncover common themes for students who have gone through their educational journey with this…

Body image perceptions in women with pelvic organ prolapse: a qualitative study.

PubMed

Lowder, Jerry L; Ghetti, Chiara; Nikolajski, Cara; Oliphant, Sallie S; Zyczynski, Halina M

2011-05-01

To describe perceptions of prolapse-specific body image in women with symptomatic prolapse. Women with symptomatic pelvic organ prolapse quantification stage ≥ II prolapse participated in semistructured focus groups or self-report questionnaire. Transcripts were independently reviewed and body image themes were identified and confirmed by consensus. Twenty-five women participated in focus groups and 27 in online questionnaires. Transcript analysis revealed 3 central themes and 25 body-image related subthemes. Women living with prolapse were more likely to feel self-conscious, isolated, "different," less feminine, and less attractive. Women often changed sexual intimacy practices because of embarrassment or discomfort, and many avoided intimacy all together. Prolapse greatly affected women's personal and professional activities causing some women to adjust routines or stop activities. Women reported loss of interest in activities, distraction while performing daily/work-related tasks, and embarrassment when asking for help with activities. Themes identified in this qualitative study demonstrate the profound effect of prolapse on a woman's body image. Copyright © 2011 Mosby, Inc. All rights reserved.

Factors influencing workers to follow food safety management systems in meat plants in Ontario, Canada.

PubMed

Ball, Brita; Wilcock, Anne; Aung, May

2009-06-01

Small and medium sized food businesses have been slow to adopt food safety management systems (FSMSs) such as good manufacturing practices and Hazard Analysis Critical Control Point (HACCP). This study identifies factors influencing workers in their implementation of food safety practices in small and medium meat processing establishments in Ontario, Canada. A qualitative approach was used to explore in-plant factors that influence the implementation of FSMSs. Thirteen in-depth interviews in five meat plants and two focus group interviews were conducted. These generated 219 pages of verbatim transcripts which were analysed using NVivo 7 software. Main themes identified in the data related to production systems, organisational characteristics and employee characteristics. A socio-psychological model based on the theory of planned behaviour is proposed to describe how these themes and underlying sub-themes relate to FSMS implementation. Addressing the various factors that influence production workers is expected to enhance FSMS implementation and increase food safety.

Effective Practices in the Delivery of Research Ethics Education: A Qualitative Review of Instructional Methods.

PubMed

Todd, E Michelle; Torrence, Brett S; Watts, Logan L; Mulhearn, Tyler J; Connelly, Shane; Mumford, Michael D

2017-01-01

In order to delineate best practices for courses on research ethics, the goal of the present effort was to identify themes related to instructional methods reflected in effective research ethics and responsible conduct of research (RCR) courses. By utilizing a qualitative review, four themes relevant to instructional methods were identified in effective research ethics courses: active participation, case-based activities, a combination of individual and group approaches, and a small number of instructional methods. Three instructional method themes associated with less effective courses were also identified: passive learning, a group-based approach, and a large number of instructional methods. Key characteristics of each theme, along with example courses relative to each theme, are described. Additionally, implications regarding these instructional method themes and recommendations for best practices in research ethics courses are discussed.

Biotechnology: the language of multiple views in Māori communities.

PubMed

Te Momo, O H Fiona

2007-09-01

In Aotearoa (New Zealand), the government funded studies on communicating biotechnology to different sectors in the community from 2003 to 2006. Subsequently, a researcher covering the Māori sector performed a content analysis of data gathered in the community. Qualitative analysis methods included examining text from participant interviews, focus groups, government documents, newspapers, Internet sites, and current literature. Content was coded by identifying common themes in the English and the Māori language. Words like genetic modification (GM), genetic engineering (GE), and biotechnology were explained to provide a basic understanding between the communities and researcher. The terminology applied in the research was essential to achieve communication between the researcher and the community. The resultant themes represented seven views to interpret the communities association with biotechnology: purist Māori, religious Māori, anti Māori, pro Māori, no Māori, uncertain Māori, and middle Māori views. The themes are taken from the analysis of data compiled after 3 years of completing different stages of a research project. The views indicate that a common understanding can be achieved in the diverse range of Māori tribal communities providing those communicating biotechnology can identify the view and interpretations communities associate with biotechnology. This knowledge is essential for government agencies, researchers, community practitioners, scientist, and businesses that desire to dialogue with Māori communities in the language of biotechnology.

What the Tweets Say: A Critical Analysis of Twitter Research in Language Learning from 2009 to 2016

ERIC Educational Resources Information Center

Hattem, David; Lomicka, Lara

2016-01-01

This study presents an overview and critical analysis of the literature related to Twitter and language learning published from 2009 to 2016. Seventeen studies were selected for inclusion based on a four-phase identification procedure, which helped us to identify published studies that resulted in a content analysis of themes in the articles…

Surveyor Management of Hospital Accreditation Program: A Thematic Analysis Conducted in Iran.

PubMed

Teymourzadeh, Ehsan; Ramezani, Mozhdeh; Arab, Mohammad; Rahimi Foroushani, Abbas; Akbari Sari, Ali

2016-05-01

The surveyors in hospital accreditation program are considered as the core of accreditation programs. So, the reliability and validity of the accreditation program heavily depend on their performance. This study aimed to identify the dimensions and factors affecting surveyor management of hospital accreditation programs in Iran. This qualitative study used a thematic analysis method, and was performed in Iran in 2014. The study participants included experts in the field of hospital accreditation, and were derived from three groups: 1. Policy-makers, administrators, and surveyors of the accreditation bureau, the ministry of health and medical education, Iranian universities of medical science; 2. Healthcare service providers, and 3. University professors and faculty members. The data were collected using semi-structured in-depth interviews. Following text transcription and control of compliance with the original text, MAXQDA10 software was used to code, classify, and organize the interviews in six stages. The findings from the analysis of 21 interviews were first classified in the form of 1347 semantic units, 11 themes, 17 sub-themes, and 248 codes. These were further discussed by an expert panel, which then resulted in the emergence of seven main themes - selection and recruitment of the surveyor team, organization of the surveyor team, planning to perform surveys, surveyor motivation and retention, surveyor training, surveyor assessment, and recommendations - as well as 27 sub-themes, and 112 codes. The dimensions and variables affecting the surveyors' management were identified and classified on the basis of existing scientific methods in the form of a conceptual framework. Using the results of this study, it would certainly be possible to take a great step toward enhancing the reliability of surveys and the quality and safety of services, while effectively managing accreditation program surveyors.

Substance Abuse and Prison Recidivism: Themes from Qualitative Interviews

ERIC Educational Resources Information Center

Phillips, Lindsay A.

2010-01-01

This qualitative analysis explores the role of substance abuse in reentry from prison to society. Participants who recidivated (N = 20) in an urban prison system identified substance abuse as their primary reason for recidivism. Treatment implications are discussed.

Rebuilding lives and identities: The role of place in recovery among persons with complex needs.

PubMed

Tran Smith, Bikki; Padgett, Deborah K; Choy-Brown, Mimi; Henwood, Benjamin F

2015-05-01

Photo-elicitation interviews (PEIs) were conducted to explore the role of place in recovery - specifically, narrative identity reconstruction - among persons with complex needs. PEIs with 17 formerly homeless adults with co-occurring disorders in New York City produced 243 photos. Content analysis of photos revealed three categories - apartment, neighborhood and people. Two narrative themes - having my own and civic identity - were mapped onto the apartment and neighborhood categories, respectively. Three additional cross-categorical narrative themes were identified: (re)negotiating relationships and boundaries, moving beyond old identities and future possibilities. Housing was central across themes. Understanding of recovery is enhanced when viewed through participant-controlled visual methods. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intuition in emergency nursing: a phenomenological study.

PubMed

Lyneham, Joy; Parkinson, Camillus; Denholm, Carey

2008-04-01

The evidence of experience of intuitive knowing in the clinical setting has to this point only been informal and anecdotal. Reported experiences thus need to be either validated or refuted so that its place in emergency nursing can be determined. The history, nature and component themes captured within the intuitive practice of emergency nursing are described. This study was informed by the philosophy and method of phenomenology. Participants were 14 experienced emergency nurses. Through their narrative accounts and recall of events their experience of knowing was captured. Through a Van Manen process and a Gadamerian analysis, six themes associated with the ways in which the participants experienced intuition in clinical practice, were identified. This paper reveals the six emerging themes as knowledge, experience, connection, feeling, syncretism and trust.

A content analysis of posthumous sperm procurement protocols with considerations for developing an institutional policy.

PubMed

Bahm, Sarah M; Karkazis, Katrina; Magnus, David

2013-09-01

To identify and analyze existing posthumous sperm procurement (PSP) protocols in order to outline central themes for institutions to consider when developing future policies. Qualitative content analysis. Large academic institutions across the United States. We performed a literature search and contacted 40 institutions to obtain nine full PSP protocols. We then performed a content analysis on these policies to identify major themes and factors to consider when developing a PSP protocol. Presence of a PSP policy. We identified six components of a thorough PSP protocol: Standard of Evidence, Terms of Eligibility, Sperm Designee, Restrictions on Use in Reproduction, Logistics, and Contraindications. We also identified two different approaches to policy structure. In the Limited Role approach, institutions have stricter consent requirements and limit their involvement to the time of procurement. In the Family-Centered approach, substituted judgment is permitted but a mandatory wait period is enforced before sperm use in reproduction. Institutions seeking to implement a PSP protocol will benefit from considering the six major building blocks of a thorough protocol and where they would like to fall on the spectrum from a Limited Role to a Family-Centered approach. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Attitudes towards chiropractic: an analysis of written comments from a survey of north american orthopaedic surgeons

PubMed Central

2011-01-01

Background There is increasing interest by chiropractors in North America regarding integration into mainstream healthcare; however, there is limited information about attitudes towards the profession among conventional healthcare providers, including orthopaedic surgeons. Methods We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopaedic surgeons that inquired about demographic variables and their attitudes towards chiropractic. Our survey included an option for respondants to include written comments, and our present analysis is restricted to these comments. Two reviewers, independantly and in duplicate, coded all written comments using thematic analysis. Results 487 surgeons completed the survey (response rate 49%), and 174 provided written comments. Our analysis revealed 8 themes and 24 sub-themes represented in surgeons' comments. Reported themes were: variability amongst chiropractors (n = 55); concerns with chiropractic treatment (n = 54); areas where chiropractic is perceived as effective (n = 43); unethical behavior (n = 43); patient interaction (n = 36); the scientific basis of chiropractic (n = 26); personal experiences with chiropractic (n = 21); and chiropractic training (n = 18). Common sub-themes endorsed by surgeon's were diversity within the chiropractic profession as a barrier to increased interprofessional collaboration, endorsement for chiropractic treatment of musculoskeletal complaints, criticism for treatment of non-musculoskeletal complaints, and concern over whether chiropractic care was evidence-based. Conclusions Our analysis identified a number of issues that will have to be considered by the chiropractic profession as part of its efforts to further integrate chiropractic into mainstream healthcare. PMID:21970333

Development of a conceptual framework of health-related quality of life in locally recurrent rectal cancer.

PubMed

Harji, D P; Koh, C; Solomon, M; Velikova, G; Sagar, P M; Brown, J

2015-11-01

The surgical management of locally recurrent rectal cancer (LRRC) has become widely accepted to afford cure and improve quality of life in this subset of patients. Thus far, traditional surgical and oncological markers have been used to highlight the success of surgical intervention. The use of patient-reported outcomes, specifically health-related quality of life (HRQoL), is sparse in these patients. This may be in part due to the lack of well-designed, validated instruments. This study identifies HRQoL issues relevant to patients undergoing surgery for LRRC, with the aim of developing a conceptual framework of HRQoL specific to LRRC to enable measurement of patient-reported outcomes in this cohort of patients. Qualitative focus groups were undertaken at two institutions to identify relevant HRQoL themes. The principles of thematic content analysis were used to analysis data. NViVo10 was used to analyse data. Twenty-one patients participated in six consecutive focus groups. Two patterns of themes emerged related to HRQoL and healthcare service delivery and utilization. Identified themes related to HRQoL included symptoms, sexual function, psychological impact, role and social functioning and future perspective. Under healthcare service and delivery and utilization the subdomain of disease management, treatment expectations and healthcare professionals were identified. This is the first qualitative study undertaken exclusively in patients with LRRC to ascertain relevant HRQoL outcomes. The impact of LRRC on patients is wide-ranging and extends beyond traditional HRQoL outcomes. The study operationalizes the identified outcomes into a conceptual framework, which will provide the basis for the development of a LRRC-specific patient-reported outcome measure. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

Assessing competency in practice-based learning: a foundation for milestones in learning portfolio entries.

PubMed

Webb, Travis P; Merkley, Taylor R; Wade, Thomas J; Simpson, Deborah; Yudkowsky, Rachel; Harris, Ilene

2014-01-01

Graduate medical education is undergoing a dramatic shift toward competency-based assessment of learners. Competency assessment requires clear definitions of competency and validated assessment methods. The purpose of this study is to identify criteria used by surgical educators to judge competence in Practice-Based Learning and Improvement (PBL&I) as demonstrated in learning portfolios. A total of 6 surgical learning and instructional portfolio entries served as documents to be assessed by 3 senior surgical educators. These faculty members were asked to rate and then identify criteria used to assess PBL&I competency. Individual interviews and group discussions were conducted, recorded, and transcribed to serve as the study dataset. Analysis was performed using qualitative methodology to identify themes for the purpose of defining competence in PBL&I. The assessment themes derived are presented with narrative examples to describe the progression of competency. The collaborative coding process resulted in identification of 7 themes associated with competency in PBL&I related to surgical learning and instructional portfolio entries: (1) self-awareness regarding effect of actions; (2) identification and thorough description of learning goals; (3) cases used as catalyst for reflection; (4) reconceptualization with appropriate use and critique of cited literature; (5) communication skills/completeness of entry template; (6) description of future behavioral change; and (7) engagement in process--identifies as personally relevant. The identified themes are consistent with and complement other criteria emerging from reflective practice literature and experiential learning theory. This study provides a foundation for further development of a tool for assessing learner portfolios consistent with the Accreditation Council for Graduate Medical Education's Next Accreditation System requirements. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Chronic kidney disease guideline implementation in primary care: a qualitative report from the TRANSLATE CKD study

PubMed Central

Vest, Bonnie M.; York, Trevor R.M.; Sand, Jessica; Fox, Chester H.; Kahn, Linda S.

2016-01-01

Background Primary care physicians (PCPs) are optimally situated to identify and manage early-stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national mixed-methods cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice. Methods As part of mixed-methods process evaluation, semi-structured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the four domains of Normalization Process Theory (NPT). Results Identified themes illuminated the complex work undertaken in primary care practices to manage CKD. Barriers to guideline implementation were identified in each of the four NPT domains, including: 1) lack of knowledge and understanding around CKD (coherence), 2) difficulties engaging providers and patients in CKD management (cognitive participation), 3) limited time and competing demands (collective action), and 4) challenges obtaining and utilizing data to monitor progress (reflexive monitoring). Conclusions Addressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care. PMID:26355134

Qualitative Exploration of the Suitability of Capability Based Instruments to Measure Quality of Life in Family Carers of People with Dementia

PubMed Central

Jones, Carys; Edwards, Rhiannon Tudor; Hounsome, Barry

2014-01-01

Background. In an ageing population, many individuals find themselves becoming a carer for an elderly relative. This qualitative study explores aspects of quality of life affected by caring for a person with dementia, with the aim of identifying whether capability based questionnaires are suitable for measuring carer quality of life. Methods. Semistructured interviews lasting up to an hour were conducted, November 2010–July 2011, with eight family carers of people with dementia. Interviews typically took place at the participants' homes and were recorded and transcribed verbatim. Framework analysis was used to code and analyse data. Domains from three capability based questionnaires (ICECAP-O, Carer Experience Scale, and ASCOT) were used as initial codes. Similar codes were grouped into categories, and broader themes were developed from these categories. Results. Four themes were identified: social network and relationships; interactions with agencies; recognition of role; and time for oneself. Conclusions. By identifying what affects carers' quality of life, an appropriate choice can be made when selecting instruments for future carer research. The themes identified had a high degree of overlap with the capability instruments, suggesting that the capabilities approach would be suitable for future research involving carers of people with dementia. PMID:24967332

Chronic Kidney Disease Guideline Implementation in Primary Care: A Qualitative Report from the TRANSLATE CKD Study.

PubMed

Vest, Bonnie M; York, Trevor R M; Sand, Jessica; Fox, Chester H; Kahn, Linda S

2015-01-01

Primary care physicians (PCPs) are optimally situated to identify and manage early stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national, mixed-methods, cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice. As part of the mixed-methods process evaluation, semistructured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the 4 domains of Normalization Process Theory (NPT). Identified themes illuminated the complex work undertaken to manage CKD in primary care practices. Barriers to guideline implementation were identified in each of the 4 NPT domains, including (1) lack of knowledge and understanding around CKD (coherence), (2) difficulties engaging providers and patients in CKD management (cognitive participation), (3) limited time and competing demands (collective action), and (4) challenges obtaining and using data to monitor progress (reflexive monitoring). Addressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care. © Copyright 2015 by the American Board of Family Medicine.

Rumours about wildlife pest introductions: European rabbits in Spain.

PubMed

Delibes-Mateos, Miguel

2017-03-01

Rumours associated with wildlife are frequent, although they have received little attention in the scientific literature. Studying rumours is important because of their relevance not only in a broad theoretical sense but also in environmental management. The goal of this study is to explore the complexity of the relationships between humans and wildlife through a thematic analysis of rumours associated with allegedly introduced European rabbits (Oryctolagus cuniculus) that cause crop damage in Spain. For this purpose, potential rumours were identified using the Google search engine. Data analysis consisted of reading and re-reading Web-based texts to identify main themes, ideas and topics with the assistance of NVivo 10 software. The analysis identified three main themes: (1) the reviewed websites referred to allegedly introduced rabbits which differed from native rabbits; (2) differences were based on alleged observations of unnatural behaviour, physiology or physical appearance of introduced rabbits; (3) rumours were frequently used in the context of the rabbit management conflict; e.g. farmers accused hunters of releasing harmful rabbits. This study suggests that the analysis of wildlife-release rumours sheds light on the position of parties involved in conflicts associated with the (alleged) introduction of wildlife species. It stresses the importance of rumours in conservation and environmental management, and opens the door to future research.

From source material to news story in New Zealand print media: a prospective study of the stigmatizing processes in depicting mental illness.

PubMed

Nairn, R; Coverdale, J; Claasen, D

2001-10-01

The aim of this study was to analyse how newspaper articles that depict mental illnesses are generated from source materials. From a prospectively collected national sample of print materials involving mental illness, 50 published items that related to the Privacy Commissioner's opinion about disclosure of a psychiatric patient's health information were identified. A copy of the Privacy Commissioner's original Case Note and three news stories about the Case Note distributed by the New Zealand Press Association constituted the database. These materials were subjected to discourse analysis. We identified themes and their transformation from the Case Note through the news stories and examined the impact of these transformations on the stigmatization of mental illness. Four themes were identified: human rights, vulnerability, risk of dangerousness and threat, and mental illness/psychiatric patient. The only potentially positive theme, human rights, was limited both by being fragmented in the source material, and by being utilized, in the published news stories to undermine the legitimacy of the patient's right to privacy. Use of the other themes was consistent with stereotypes about mental illness. Although there were no inaccuracies in the content of the news stories they were substantially more negative than the source material in their depiction of the identified patient. A potentially positive discourse (human rights) was not by itself sufficient to ensure a positive portrayal of mental illness. An understanding of the transformations is important for efforts to effectively combat the stigmatization of those with mental illness.

A Content Analysis of Online Suicide Notes: Attempted Suicide Versus Attempt Resulting in Suicide.

PubMed

Synnott, John; Ioannou, Maria; Coyne, Angela; Hemingway, Siobhan

2017-09-28

Fifty suicide notes of those who died by suicide and 50 suicide notes of those who survived their suicide attempt were analyzed using Smallest Space Analysis. The core of all suicide notes was discovered to be constructed with the use of four variables: saying goodbye to their audience, feelings of loneliness, method used to attempt suicide, and negative self-image. Furthermore, three different suicide note themes of those who died and three suicide note themes from those who survived were also identified. The analysis revealed that suicide note writers who died by their attempt were more likely to combine a dislike of themselves and a concern for loved ones. The implications of the work in terms of suicide prevention are discussed. © 2017 The American Association of Suicidology.

What factors influence ward nurses' recognition of and response to patient deterioration? An integrative review of the literature.

PubMed

Massey, Debbie; Chaboyer, Wendy; Anderson, Vinah

2017-01-01

In this integrative review, we aimed to: first, identify and summarize published studies relating to ward nurses' recognition of and response to patient deterioration; second, to critically evaluate studies that described or appraised the practice of ward nurses in recognizing and responding to patient deterioration; and third, identify gaps in the literature for further research. An integrative review. The Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ovid Medline, Informit and Google Scholar databases were accessed for the years 1990-2014. Data were extracted and summarized in tables and then appraised using the Mixed Method Appraisal Tool. Data were grouped into two domains; recognizing and responding to deterioration and then thematic analysis was used to identify the emerging themes. Seventeen studies were reviewed and appraised. Recognizing patient deterioration was encapsulated in four themes: (1) assessing the patient; (2) knowing the patient; (3) education and (4) environmental factors. Responding to patient deterioration was encapsulated in three themes; (1) non-technical skills; (2) access to support and (3) negative emotional responses. Issues involved in timely recognition of and response to clinical deterioration remain complex, yet patient safety relies on nurses' timely assessments and actions.

Views of Canadian patients on or nearing dialysis and their caregivers: a thematic analysis.

PubMed

Barnieh, Lianne; King-Shier, Kathryn; Hemmelgarn, Brenda; Laupacis, Andreas; Manns, Liam; Manns, Braden

2014-01-01

Quality of life of patients receiving dialysis has been rated as poor. To synthesize the views of Canadian patients on or nearing dialysis, and those who care for them. Secondary analysis of a survey, distributed through dialysis centres, social media and the Kidney Foundation of Canada. Pan-Canadian convenience sample. Patients, their caregivers and health-care providers. Text responses to open-ended questions on topics relevant to end-stage renal disease. Statements related to needs, beliefs or feelings were identified, and were analysed by thematic content analysis. A total of 544 relevant statements from 189 respondents were included for the thematic content analysis. Four descriptive themes were identified through the content analysis: gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care. Respondents primarily identified a need for more information, better communication, increased psychosocial and financial support for patients and their families and a strong desire to maintain their previous lifestyle. Convenience sample; questions were originally asked with a different intent (to identify patient-important research issues). Patients on or nearing dialysis and their caregivers identified four major themes, gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care, several of which could be addressed by the health care system without requiring significant resources. These include the development of patient materials and resources, or sharing of existing resources across Canadian renal programs, along with adopting better communication strategies. Other concerns, such as the need for increased psychosocial and financial support, require consideration by health care funders.

Dr Google and the consumer: a qualitative study exploring the navigational needs and online health information-seeking behaviors of consumers with chronic health conditions.

PubMed

Lee, Kenneth; Hoti, Kreshnik; Hughes, Jeffery David; Emmerton, Lynne

2014-12-02

The abundance of health information available online provides consumers with greater access to information pertinent to the management of health conditions. This is particularly important given an increasing drive for consumer-focused health care models globally, especially in the management of chronic health conditions, and in recognition of challenges faced by lay consumers with finding, understanding, and acting on health information sourced online. There is a paucity of literature exploring the navigational needs of consumers with regards to accessing online health information. Further, existing interventions appear to be didactic in nature, and it is unclear whether such interventions appeal to consumers' needs. Our goal was to explore the navigational needs of consumers with chronic health conditions in finding online health information within the broader context of consumers' online health information-seeking behaviors. Potential barriers to online navigation were also identified. Semistructured interviews were conducted with adult consumers who reported using the Internet for health information and had at least one chronic health condition. Participants were recruited from nine metropolitan community pharmacies within Western Australia, as well as through various media channels. Interviews were audio-recorded, transcribed verbatim, and then imported into QSR NVivo 10. Two established approaches to thematic analysis were adopted. First, a data-driven approach was used to minimize potential bias in analysis and improve construct and criterion validity. A theory-driven approach was subsequently used to confirm themes identified by the former approach and to ensure identified themes were relevant to the objectives. Two levels of analysis were conducted for both data-driven and theory-driven approaches: manifest-level analysis, whereby face-value themes were identified, and latent-level analysis, whereby underlying concepts were identified. We conducted 17 interviews, with data saturation achieved by the 14th interview. While we identified a broad range of online health information-seeking behaviors, most related to information discussed during consumer-health professional consultations such as looking for information about medication side effects. The barriers we identified included intrinsic barriers, such as limited eHealth literacy, and extrinsic barriers, such as the inconsistency of information between different online sources. The navigational needs of our participants were extrinsic in nature and included health professionals directing consumers to appropriate online resources and better filtering of online health information. Our participants' online health information-seeking behaviors, reported barriers, and navigational needs were underpinned by the themes of trust, patient activation, and relevance. This study suggests that existing interventions aimed to assist consumers with navigating online health information may not be what consumers want or perceive they need. eHealth literacy and patient activation appear to be prevalent concepts in the context of consumers' online health information-seeking behaviors. Furthermore, the role for health professionals in guiding consumers to quality online health information is highlighted.

Factors affecting speech pathologists' implementation of stroke management guidelines: a thematic analysis.

PubMed

Miao, Melissa; Power, Emma; O'Halloran, Robyn

2015-01-01

Although clinical practice guidelines can facilitate evidence-based practice and improve the health outcomes of stroke patients, they continue to be underutilised. There is limited research into the reasons for this, especially in speech pathology. This study provides the first in-depth, qualitative examination of the barriers and facilitators that speech pathologists perceive and experience when implementing guidelines. A maximum variation sample of eight speech pathologists participated in a semi-structured interview concerning the implementation of the National Stroke Foundation's Clinical Guidelines for Stroke Management 2010. Interviews were transcribed, thematically analysed and member checked before overall themes were identified. Three main themes and ten subthemes were identified. The first main theme, making implementation explicit, reflected the necessity of accessing and understanding guideline recommendations, and focussing specifically on implementation in context. In the second theme, demand versus ability to change, the size of changes required was compared with available resources and collaboration. The final theme, Speech pathologist motivation to implement guidelines, demonstrated the influence of individual perception of the guidelines and personal commitment to improved practice. Factors affecting implementation are complex, and are not exclusively barriers or facilitators. Some potential implementation strategies are suggested. Further research is recommended. In most Western nations, stroke remains the single greatest cause of disability, including communication and swallowing disabilities. Although adherence to stroke clinical practice guidelines improves stroke patient outcomes, guidelines continue to be underutilised, and the reasons for this are not well understood. This is the first in-depth qualitative study identifying the complex barriers and facilitators to guideline implementation as experienced by speech pathologists in stroke care. Suggested implementation strategies include local monitoring of guideline implementation (e.g. team meetings, audits), increasing collaboration on implementation projects (e.g. managerial involvement, networking), and seeking speech pathologist input into guideline development.

Quality in the pharmaceutical industry – A literature review

PubMed Central

Haleem, Reham M.; Salem, Maissa Y.; Fatahallah, Faten A.; Abdelfattah, Laila E.

2013-01-01

Objectives The aim of this study is to:a.Highlight the most important guidelines and practices of quality in the pharmaceutical industry.b.Organize such guidelines and practices to create a guide to pave the way for other researchers who would like to dig deeper into these guidelines and practices. Design A review was conducted of 102 publications; 56 publications were concerned with the pharmaceutical quality directly while 46 publications were concerned with the general quality practices. The content of those sources was analyzed and the following themes were identified:a.Research theme 1: Guidelines of the pharmaceutical quality.b.Research theme 2: General practices recently applied in the pharmaceutical industry. Main outcome measures The following guidelines were identified and reviewed: WHO guidelines, FDA guidelines, EU guidelines and ICH guidelines in the research theme I. In research theme II; the following topics were identified and reviewed: quality risk management, quality by design, corrective actions and preventive actions, process capability analysis, Six Sigma, process analytical technology, lean manufacturing, total quality management, ISO series and HACCP. Results Upon reviewing the previously highlighted guidelines and the practices that are widely applied in the pharmaceutical industry, it was noticed that there is an abundant number of papers and articles that explain the general guidelines and practices but the literature lack those describing application; case studies of the pharmaceutical factories applying those guidelines and significance of those guidelines and practices. Conclusions It is recommended that the literature would invest more in the area of application and significance of guidelines and practices. New case studies should be done to prove the feasibility of such practices. PMID:26594110

Factors that influence Asian communities' access to mental health care.

PubMed

Wynaden, Dianne; Chapman, Rose; Orb, Angelica; McGowan, Sunita; Zeeman, Zenith; Yeak, SiewHo

2005-06-01

This paper presents the findings of a qualitative study to identify factors that influence Asian communities' access to mental health care and how mental health care is delivered to them. Semistructured interviews were completed with Asian community members/leaders and health-care professionals. Content analysis identified major themes. Participants also completed a demographic data sheet. The research aimed to provide health professionals with an increased understanding of the values and beliefs held by people from Asian communities regarding the cause and treatment of mental illness. Data analysis identified six main themes that influenced Asian communities' access to mental health care and how mental health care is delivered to them. They were: shame and stigma; causes of mental illness; family reputation; hiding up; seeking help; and lack of collaboration. The findings highlighted that people from Asian communities are unwilling to access help from mainstream services because of their beliefs, and that stigma and shame are key factors that influence this reluctance. The findings also highlight that the mental health needs of refugee women are significant, and that they comprise a vulnerable group within Australian society.

An ethnographic study of differentiated practice in an operating room.

PubMed

Graff, C; Roberts, K; Thornton, K

1999-01-01

An ethnographic study was conducted to investigate implementation of the clinical nurse III or team leader (TL) role as part of a newly executed nursing differentiated practice model. The six TLs studied were employed in the operating room (OR). Through participant observation, interviews, and document analysis, the TL role--as well as perceptions of the role by the TLs and OR staff--were studied. Problems related to performance of the role and its evolutionary process were delineated. Data analysis involved identifying categories and subcategories of data and developing a coding system to identify themes. Salient themes were related to the culture of the OR. Because of the OR's highly technical environment, the TLs defined their roles in relation to the organizational and technical needs of their surgical service. Refinement of surgeon "preference cards" and "instrument count sheets" was considered the initial priority for the TLs. Various controllable and uncontrollable factors were identified that affected implementation of the new TL role. Findings suggest that introduction of the role requires insight into setting and an emphasis on staging and orientation of employees to the new role.

The Cockcroft difference: an analysis of the impact of a nursing leadership development programme.

PubMed

Chappell, Kate K; Willis, Leah

2013-03-01

Identifying impact areas of nursing leadership development programmes is needed to determine if there are measureable effects on participants. These impact areas help to identify measures to substantiate the benefits of nursing leadership programmes for organization leaders making decisions about support and implementation of such opportunities for their emerging leaders. Using mixed qualitative/quantitative methods, the impact of a nursing leadership development programme, the Amy V. Cockcroft Fellowship, is examined to determine if there are measureable influences. Themes of four areas of impact: improved conflict resolution/negotiation skills, communication skills, personal development and career action or change were identified through content analysis. These themes provide the basis for creating measureable indicators for nursing organizations to use in determining the value of nursing leadership development programmes such as the Amy V. Cockcroft Fellowship. Based on the findings established in this research article, nurse managers can focus on developing themselves and their peer groups through nursing leadership development programmes to prepare for leading in the present and future healthcare environment. © 2012 Blackwell Publishing Ltd.

Promoting health workers' ownership of infection prevention and control: using Normalization Process Theory as an interpretive framework.

PubMed

Gould, D J; Hale, R; Waters, E; Allen, D

2016-12-01

All health workers should take responsibility for infection prevention and control (IPC). Recent reduction in key reported healthcare-associated infections in the UK is impressive, but the determinants of success are unknown. It is imperative to understand how IPC strategies operate as new challenges arise and threats of antimicrobial resistance increase. The authors undertook a retrospective, independent evaluation of an action plan to enhance IPC and 'ownership' (individual accountability) for IPC introduced throughout a healthcare organization. Twenty purposively selected informants were interviewed. Data were analysed inductively. Normalization Process Theory (NPT) was applied to interpret the findings and explain how the action plan was operating. Six themes emerged through inductive analysis. Theme 1: 'Ability to make sense of ownership' provided evidence of the first element of NPT (coherence). Regardless of occupational group or seniority, informants understood the importance of IPC ownership and described what it entailed. They identified three prerequisites: 'Always being vigilant' (Theme 2), 'Importance of access to information' (Theme 3) and 'Being able to learn together in a no-blame culture' (Theme 4). Data relating to each theme provided evidence of the other elements of NPT that are required to embed change: planning implementation (cognitive participation), undertaking the work necessary to achieve change (collective action), and reflection on what else is needed to promote change as part of continuous quality improvement (reflexive monitoring). Informants identified barriers (e.g. workload) and facilitators (clear lines of communication and expectations for IPC). Eighteen months after implementing the action plan incorporating IPC ownership, there was evidence of continuous service improvement and significant reduction in infection rates. Applying a theory that identifies factors that promote/inhibit routine incorporation ('normalization') of IPC into everyday health care can help explain the success of IPC initiatives and inform implementation. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Physiotherapists' perceptions of workplace competency: a mixed-methods observational study.

PubMed

Sturt, Rodney; Burge, Angela T; Harding, Paula; Sayer, James

2017-06-22

Objectives Workplace-based competency is increasingly considered fundamental to patient safety and quality healthcare. The aim of the present study was to identify and describe physiotherapists' perceptions of workplace competency. Methods The present study was a mixed-methods cross-sectional observational study. Thematic and descriptive analysis of qualitative and survey data were undertaken. Forty-six physiotherapists employed at a metropolitan acute public hospital participated in interviews or focus groups; a subgroup of 31 participants also completed an online survey. Results Five main themes were identified: (1) despite the availability of workplace learning opportunities and supports, less-experienced staff reported limited confidence; (2) assessment and feedback around workplace competency was limited, predominantly informal and unstructured, with less than half of the cohort (42%) agreeing feedback received was useful for improving their workplace skills; (3) practicing within individual scope is an important aspect of workplace competency as a physiotherapist; (4) most (81%) agreed it was important for them to self-determine their learning and development goals, and they relied primarily on informal discussion to achieve these goals; and, (5) physiotherapists felt motivated regarding workplace learning, with 97% interested in developing their workplace skills however, nearly half (45%) did not feel they had sufficient time to do so. Conclusions The perceptions of physiotherapists working in a metropolitan acute public hospital are reflected in five themes. These themes elucidate how workplace competency is supported, maintained and developed among physiotherapists in this setting. These themes also highlight key challenges of workplace learning faced by this cohort of physiotherapists and allude to methods that may assist with improving feedback mechanisms and knowledge acquisition. What is known about this topic? Studies investigating employee perceptions around workplace competency, knowledge, skills and learning are found across a range of industries. Workplace-based competency is increasingly considered fundamental to patient safety and quality health care. There is little known about physiotherapists' perceptions of workplace competency. What does this paper add? This study has identified and described themes around physiotherapists' perceptions of their workplace knowledge and skills. What are the implications for practitioners? The themes identified provide support for the development, implementation and evaluation of a workplace-based competency framework for physiotherapists.

Identifying the latent failures underpinning medication administration errors: an exploratory study.

PubMed

Lawton, Rebecca; Carruthers, Sam; Gardner, Peter; Wright, John; McEachan, Rosie R C

2012-08-01

The primary aim of this article was to identify the latent failures that are perceived to underpin medication errors. The study was conducted within three medical wards in a hospital in the United Kingdom. The study employed a cross-sectional qualitative design. Interviews were conducted with 12 nurses and eight managers. Interviews were transcribed and subject to thematic content analysis. A two-step inter-rater comparison tested the reliability of the themes. Ten latent failures were identified based on the analysis of the interviews. These were ward climate, local working environment, workload, human resources, team communication, routine procedures, bed management, written policies and procedures, supervision and leadership, and training. The discussion focuses on ward climate, the most prevalent theme, which is conceptualized here as interacting with failures in the nine other organizational structures and processes. This study is the first of its kind to identify the latent failures perceived to underpin medication errors in a systematic way. The findings can be used as a platform for researchers to test the impact of organization-level patient safety interventions and to design proactive error management tools and incident reporting systems in hospitals. © Health Research and Educational Trust.

Maternal Styles of Talking about Child Feeding across Sociodemographic Groups

PubMed Central

Pesch, Megan H.; Harrell, Kristina J.; Kaciroti, Niko; Rosenblum, Kate; Lumeng, Julie C.

2011-01-01

This study sought to identify maternal styles of talking about child feeding from a semi-structured interview and to evaluate associated maternal and child characteristics. Mothers of preschool-aged children (n = 133) of diverse race/ethnicity and socioeconomic status (SES) (45 lower SES black, 29 lower SES white, 32 lower SES Hispanic, 15 middle to upper SES white, 12 middle to upper SES Asian) participated in a semi-structured interview about feeding. Interviews were audio-taped and transcribed. Themes were identified, and individual interviews were coded within these themes: authority (high/low), confidence (confident/conflicted/unopinionated), and investment (deep/mild/removed). Demographic characteristics were collected and a subset of children had measured weights and heights. Cluster analysis was used to identify narrative styles. Participant characteristics were compared across clusters using Fisher’s exact test and analysis of variance. Six narrative styles were identified: Easy-Going, Practical No-Nonsense, Disengaged, Effortful No-Nonsense, Indulgent Worry, and Conflicted Control. Cluster membership differed significantly based on maternal demographic group (P < .001) and child weight status (P < .05). More than half (60%) of children of mothers in the Conflicted Control cluster were obese. Maternal styles of talking about feeding are associated with maternal and child characteristics. PMID:22117662

Attitudes of intensive care and emergency physicians in Australia with regard to the organ donation process: A qualitative analysis.

PubMed

Macvean, Emily; Yuen, Eva Yn; Tooley, Gregory; Gardiner, Heather M; Knight, Tess

2018-04-01

Specialized hospital physicians have direct capacity to impact Australia's sub-optimal organ donation rates because of their responsibility to identify and facilitate donation opportunities. Australian physicians' attitudes toward this responsibility are examined. A total of 12 intensive care unit and three emergency department physicians were interviewed using a constructionist grounded theory and situational analysis approach. A major theme emerged, related to physicians' conflicts of interest in maintaining patients'/next-of-kin's best interests and a sense of duty-of-care in this context. Two sub-themes related to this main theme were identified as follows: (1) discussions about organ donation and who is best to carry these out and (2) determining whether organ donation is part of end-of-life care; including the avoidance of non-therapeutic ventilation; and some reluctance to follow clinical triggers in the emergency department. Overall, participants indicated strong support for organ donation but would not consider it part of end-of-life care, representing a major obstacle to the support of potential donation opportunities. Findings have implications for physician education and training. Continued efforts are needed to integrate the potential for organ donation into end-of-life care within intensive care units and emergency departments.

A qualitative analysis of communication between members of a hospital-based multidisciplinary lung cancer team.

PubMed

Rowlands, S; Callen, J

2013-01-01

The aim of the study was to explore how patient information is communicated between health professionals within a multidisciplinary hospital-based lung cancer team and to identify mechanisms to improve these communications. A qualitative method was employed using semi-structured in-depth interviews with a representative sample (n = 22) of members of a multidisciplinary hospital-based lung cancer team including medical, nursing and allied health professionals. Analysis was undertaken using a thematic grounded theory approach to derive key themes to describe communication patterns within the team and how communication could be improved. Two themes with sub-themes were identified: (1) characteristics of communication between team members including the impact of role on direction of communications, and doctors' dominance in communications; and (2) channels of communication including, preference for face-to-face and the suboptimal roles of the Multidisciplinary Team Meeting and the hospital medical record as mediums for communication. Traditional influences of role delineation and the dominance of doctors were found to impact on communication within the multidisciplinary hospital-based lung cancer team. Existing guidelines on implementation of multidisciplinary cancer care fail to address barriers to effective team communication. The paper-based medical record does not support team communications and alternative electronic solutions need to be used. © 2012 Blackwell Publishing Ltd.

The Council of Europe's Citizenship Conception in "Education for Democratic Citizenship": A Critical Discourse Analysis of Two Textbooks

ERIC Educational Resources Information Center

Ververi, Olga

2017-01-01

This paper presents a neocommunitarian conception of citizenship identified in two textbooks of the programme "Education for Democratic Citizenship," organised by the Council of Europe. Critical discourse analysis is applied to the key themes of the textbooks "T-Kit 7: Under construction: Citizenship Youth and Europe" and…

The Transition from a University College to a University: A United Kingdom Study

ERIC Educational Resources Information Center

Hemmings, Brian; Hill, Doug; Sharp, John

2015-01-01

As a result of policy changes, nearly all university colleges in the UK have been redesignated as universities. This transition was studied in one such institution using semi-structured interviews with a representative sample of six academic staff and the transcripts subjected to a thematic analysis. This analysis identified three themes: staying…

Assessing Strategies to Manage Work and Life Balance of Athletic Trainers Working in the National Collegiate Athletic Association Division I Setting

PubMed Central

Mazerolle, Stephanie M.; Pitney, William A.; Casa, Douglas J.; Pagnotta, Kelly D.

2011-01-01

Abstract Context: Certified athletic trainers (ATs) working at the National Collegiate Athletic Association Division I level experience challenges balancing their professional and personal lives. However, an understanding of the strategies ATs use to promote a balance between their professional and personal lives is lacking. Objective: To identify the strategies ATs employed in the Division I setting use to establish a balance between their professional and personal lives. Design: Qualitative investigation using inductive content analysis. Setting: Athletic trainers employed at Division I schools from 5 National Athletic Trainers' Association districts. Patients or Other Participants: A total of 28 (15 women, 13 men) ATs aged 35 ± 9 years volunteered for the study. Data Collection and Analysis: Asynchronous electronic interviews with follow-up phone interviews. Data were analyzed using inductive content analysis. Peer review, member checking, and data-source triangulation were conducted to establish trustworthiness. Results: Three higher-order themes emerged from the analysis. The initial theme, antecedents of work–family conflict, focused on the demands of the profession, flexibility of work schedules, and staffing patterns as contributing to work–life conflict for this group of ATs. The other 2 emergent higher-order themes, professional factors and personal factors, describe the components of a balanced lifestyle. The second-order theme of constructing the professional factors included both organizational policies and individual strategies, whereas the second-order theme of personal factors was separation of work and life and a supportive personal network. Conclusions: Long work hours, lack of control over work schedules, and unbalanced athlete-to-AT ratios can facilitate conflicts. However, as demonstrated by our results, several organizational and personal strategies can be helpful in creating a balanced lifestyle. PMID:21391805

Tobacco users' perceptions of a brief tobacco cessation intervention in community pharmacies.

PubMed

Patwardhan, Pallavi D; Chewning, Betty A

2010-01-01

To explore factors affecting tobacco users' perceived appropriateness of a brief and proactive tobacco cessation counseling program, ask, advise, and refer (AAR), at community pharmacies. Inductive thematic analysis. Southern Wisconsin during fall 2008. 24 tobacco users who had recently received brief and proactive tobacco cessation counseling at a community pharmacy. Semistructured telephone interviews conducted by primary author. Perceptions of a brief and proactive tobacco cessation counseling program conducted at community pharmacies. In conducting the thematic analysis, eight distinct themes were identified. Display of information and resources at pharmacies for use by tobacco users as needed was identified as the most predominant theme and was found to be most helpful by many respondents. Other themes identified in decreasing order of prevalence were: tobacco users' perceptions of the role of pharmacists in health care, tobacco users' belief that smoking could interact with a current medication or health condition, tobacco users' sensitivity toward their tobacco use behavior or being told what to do, nonconfrontational and friendly approach of pharmacists, tobacco users' readiness to quit at the time of AAR counseling, tobacco user initiation of tobacco use discussion, and tobacco users' belief that tobacco use is bad. Overall, this qualitative investigation suggests that several factors might influence tobacco users' perceived appropriateness of AAR counseling at community pharmacies. AAR might be well received by tobacco users and pharmacy patrons as long as it is done in a professional and respectful manner.

Analysis of comments in a petition defending electronic cigarettes.

PubMed

Sumner, Holly Marie; McQueen, Amy; Scott, Michael John; Sumner, Walton

2014-11-01

A 2009 petition opposing a Food and Drug Administration (FDA) ban on electronic cigarettes (e-cigs) garnered international attention from e-cig users (vapers). Petitioners' comments described the perceived benefits of vaping. We conducted a qualitative and quantitative analysis of petitioners' comments. A sample of 200 petitioner names was sought in public records. Reviewers identified 13 major themes in a sample of comments, and themes related to current controversies were added. For each theme, software pattern-matching instructions (regular expressions) were developed and were used to scan comments. Agreement between reviewers and software was calculated; theme prevalence and clustering was ascertained. A total of 13,414 signatures and 8,285 comments from 50 states and 75 nations were collected in 6 months. Temporal patterns and name matches in public records suggest that most petitioners are authentic. Agreement between reviewers and software was moderate to high (κ = 0.4-0.8). Commonly cited themes were "e-cigs helped me quit" (34%), "a ban would be counterproductive" (15%), and "my health improved with e-cigs" (13%). Two clusters of themes emerged: the first combined comments about smoking cessation, health benefits, and smoking relapse that an e-cig ban would cause; the second combined themes that a "ban would be counterproductive," it would infringe on personal liberties, and it was motivated by government or industrial greed. People who cited mental health issues often mentioned avoiding withdrawal as a benefit of e-cigs. Early e-cig adopters were both frustrated and confused by discussion of a ban. They believed that e-cigs safely delivered nicotine and helped them quit smoking. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nursing students' reflections on the learning experience of a unique mental health clinical placement.

PubMed

Patterson, Christopher; Moxham, Lorna; Brighton, Renee; Taylor, Ellie; Sumskis, Susan; Perlman, Dana; Heffernan, Tim; Hadfield, Louise

2016-11-01

There exists a need for innovative thinking to identify new clinical placement opportunities for nursing students. Recovery-based clinical placements for mental health nurse students remain unique and require investigation. To examine the learning experience of Bachelor of Nursing students who undertook an innovative mental health clinical placement known as Recovery Camp. This study incorporated qualitative analysis of written reflections. Using Braun and Clarke's (2006) six phases of thematic analysis the corpus of student reflections were reviewed by three members of the research team independent to each other. Four themes emerged. The theme of Pre-placement Expectations incorporates participant foci on pre-conceptions of Recovery Camp. The theme of Student Learning incorporates the ways in which participants recognised the experience of Recovery Camp influenced learning. Reflections themed under the title Placement Setting include discussion of the Recovery Camp as a clinical placement. The theme of Future Practice incorporates students' reflections on how they plan to practice as nurses as a result the learning experiences of Recovery Camp. An immersive clinical placement such as Recovery Camp can influence students' perceptions of people with mental illness, have a positive impact on student learning and influence students' decisions about future practice. The learning experience of nursing students whom attend unique, recovery-orientated clinical placements can be both positive and educative. Copyright © 2016 Elsevier Ltd. All rights reserved.

THROUGH THE LENS OF RACE: BLACK AND WHITE WOMEN’S PERCEPTIONS OF WOMANHOOD

PubMed Central

Settles, Isis H.; Pratt-Hyatt, Jennifer S.; Buchanan, NiCole T.

2017-01-01

The intersection of race and gender may create unique experiences for Black and White women in terms of work, family, domestic roles, and interpersonal relationships. Dissimilar gender-role norms may foster different perceptions of gender for these two groups of women. In the current study, we examined similarities and differences in Black and White women’s perceptions of their gender using qualitative focus group methodology and grounded theory data analysis. The results identified five themes that were common to Black and White women: Gender-Based Mistreatment, Perceived Advantage, Friendships and Community, Caretaking, and Work and Family Options. One additional theme, Inner Strength, emerged only for Black women. Although many of the broad perceptions of womanhood were similar for Black and White women, analysis of the content within each theme highlighted important differences. We discuss the results in terms of how they may reflect socio-historical factors, gender discrimination, stereotypes, and gender-role norms. PMID:29129954

A pilot analysis of the psychological themes found during the CARING at Columbia--Music Therapy program with refugee adolescents from North Korea.

PubMed

Choi, Carolyn Mi Hwan

2010-01-01

The purpose of this study was to identify the psychological themes found during the modified CARING at Columbia-Music Therapy (CAC-MT) program with refugee adolescents from North Korea. Nine students attending an alternative school participated in this study. Academically, students belong to an equivalent middle school level. Students participated in a music therapy program comprised of 25 sessions. A multiple case analysis was conducted to gather qualitative results. Students were found to be exposed to various psychosocially stressful life situations such as lack of social support system, family separation, academic difficulty, and economic hardship throughout their adaptation process to their new country. There were 5 common psychological themes--avoidance, distrust, loneliness, feelings of loss, and fear--found among the refugee students over the course of the CAC-MT treatment. For future research, studies with a larger sample size and differing types of session structure should be conducted to closely examine the effects of this program on refugee adolescents.

Practice guidelines in the context of primary care, learning and usability in the physicians' decision-making process--a qualitative study.

PubMed

Ingemansson, Maria; Bastholm-Rahmner, Pia; Kiessling, Anna

2014-08-20

Decision-making is central for general practitioners (GP). Practice guidelines are important tools in this process but implementation of them in the complex context of primary care is a challenge. The purpose of this study was to explore how GPs approach, learn from and use practice guidelines in their day-to-day decision-making process in primary care. A qualitative approach using focus-group interviews was chosen in order to provide in-depth information. The participants were 22 GPs with a median of seven years of experience in primary care, representing seven primary healthcare centres in Stockholm, Sweden in 2011. The interviews focused on how the GPs use guidelines in their decision-making, factors that influence their decision how to approach these guidelines, and how they could encourage the learning process in routine practice.Data were analysed by qualitative content analysis. Meaning units were condensed and grouped in categories. After interpreting the content in the categories, themes were created. Three themes were conceptualized. The first theme emphasized to use guidelines by interactive contextualized dialogues. The categories underpinning this theme: 1. Feedback by peer-learning 2. Feedback by collaboration, mutual learning, and equality between specialties, identified important ways to achieve this learning dialogue. Confidence was central in the second theme, learning that establishes confidence to provide high quality care. Three aspects of confidence were identified in the categories of this theme: 1. Confidence by confirmation, 2. Confidence by reliability and 3. Confidence by evaluation of own results. In the third theme, learning by use of relevant evidence in the decision-making process, we identified two categories: 1. Design and lay-out visualizing the evidence 2. Accessibility adapted to the clinical decision-making process as prerequisites for using the practice guidelines. Decision-making in primary care is a dual process that involves use of intuitive and analytic thinking in a balanced way in order to provide high quality care. Key aspects of effective learning in this clinical decision-making process were: contextualized dialogue, which was based on the GPs' own experiences, feedback on own results and easy access to short guidelines perceived as trustworthy.

A qualitative study of younger men's experience of heart attack (myocardial infarction).

PubMed

Merritt, Christopher J; de Zoysa, Nicole; Hutton, Jane M

2017-09-01

The effects of heart attack, or myocardial infarction (MI), across psychosocial domains may be particularly acute in younger adults, for whom serious health events are non-normative. MI morbidity is declining in Western countries, but in England MI numbers have plateaued for the under-45 cohort, where approximately 90% of patients are male. Qualitative research on younger adults' experience of MI is limited, and no study has sampled exclusively under-45s. This study aimed to understand how a sample of men under 45 adjusted to and made sense of MI. Qualitative research design based on semi-structured in-depth interviews. Ten men aged under 45 who had experienced MI in the past 3-6 months were purposively recruited and interviewed. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. Seven superordinate themes were identified. This article focuses in depth on the three most original themes: (1) 'I'm less of a man', which described experiences of losing 'maleness' (strength, independence, ability to provide) post-MI; (2) 'Shortened horizons', which covered participants' sense of foreshortened future and consequent reprioritization; and (3) 'Life loses its colour', describing the loss of pleasure from lifestyle-related changes. Themes broadly overlapped with the qualitative literature on younger adult MI. However, some themes (e.g., loss of 'maleness' post-MI, and ambivalence towards MI risk factors) appeared unique to this study. Themes were also discussed in relation to risk factors for anxiety and depression and how this might inform clinical care for a younger, male population. Statement of contribution What is already known on this subject? Myocardial infarction (MI) morbidity is not declining in England for under-45s. Adjustment to MI is particularly challenging for younger adults, perhaps because it is non-normative. However, little is known about the experience of MI in younger adults. What does this study add? This is the first qualitative study to sample MI patients exclusively under 45, thereby mapping to epidemiological trends. Further support is provided for some themes identified in the existing young adult MI literature. New themes are identified here which can provide insights relevant to clinical care in this population. © 2017 The British Psychological Society.

Transient Disablement in the Physically Active With Musculoskeletal Injuries, Part I: A Descriptive Model

PubMed Central

Vela, Luzita I.; Denegar, Craig

2010-01-01

Abstract Context: Disablement theory has been characterized as the sequence of events that occurs after an injury, but little research has been conducted to establish how disablement is experienced and described by physically active persons. Objective: To describe the disablement process in physically active persons with musculoskeletal injuries. Design: Concurrent, embedded mixed-methods study. For the qualitative portion, interviews were conducted to create descriptive disablement themes. For the quantitative portion, frequencies analysis was used to identify common terminology. Setting: National Collegiate Athletic Association Division I collegiate and club sports, collegiate intramural program, large high school athletics program, and outpatient orthopaedic center. Patients or Other Participants: Thirty-one physically active volunteers (15 males, 16 females; mean age  =  21.2 years; range, 14–53 years) with a current injury (18 lower extremity injuries, 13 upper extremity injuries) participated in individual interviews. Six physically active volunteers (3 males, 3 females; mean age  =  22.2 years; range, 16–28 years) participated in the group interview to assess trustworthiness. Data Collection and Analysis: We analyzed interviews through a constant-comparison method, and data were collected until saturation occurred. Common limitations were transformed into descriptive themes and were confirmed during the group interview. Disablement descriptors were identified with frequencies and fit to the themes. Results: A total of 15 overall descriptive themes emerged within the 4 disablement components, and descriptive terms were identified for each theme. Impairments were marked by 4 complaints: pain, decreased motion, decreased muscle function, and instability. Functional limitations were denoted by problems with skill performance, daily actions, maintaining positions, fitness, and changing directions. Disability consisted of problems with participation in desired activities. Lastly, problems in quality of life encompassed uncertainty and fear, stress and pressure, mood and frustration, overall energy, and altered relationships. A preliminary generic outcomes instrument was generated from the findings. Conclusions: Our results will help clinicians understand how disablement is described by the physically active. The findings also have implications for how disablement outcomes are measured. PMID:21062186

Conceptual model for dietary behaviour change at household level: a 'best-fit' qualitative study using primary data.

PubMed

Daivadanam, Meena; Wahlström, Rolf; Ravindran, T K Sundari; Thankappan, K R; Ramanathan, Mala

2014-06-09

Interventions having a strong theoretical basis are more efficacious, providing a strong argument for incorporating theory into intervention planning. The objective of this study was to develop a conceptual model to facilitate the planning of dietary intervention strategies at the household level in rural Kerala. Three focus group discussions and 17 individual interviews were conducted among men and women, aged between 23 and 75 years. An interview guide facilitated the process to understand: 1) feasibility and acceptability of a proposed dietary behaviour change intervention; 2) beliefs about foods, particularly fruits and vegetables; 3) decision-making in households with reference to food choices and access; and 4) to gain insights into the kind of intervention strategies that may be practical at community and household level. The data were analysed using a modified form of qualitative framework analysis, which combined both deductive and inductive reasoning. A priori themes were identified from relevant behaviour change theories using construct definitions, and used to index the meaning units identified from the primary qualitative data. In addition, new themes emerging from the data were included. The associations between the themes were mapped into four main factors and its components, which contributed to construction of the conceptual model. Thirteen of the a priori themes from three behaviour change theories (Trans-theoretical model, Health Belief model and Theory of Planned Behaviour) were confirmed or slightly modified, while four new themes emerged from the data. The conceptual model had four main factors and its components: impact factors (decisional balance, risk perception, attitude); change processes (action-oriented, cognitive); background factors (personal modifiers, societal norms); and overarching factors (accessibility, perceived needs and preferences), built around a three-stage change spiral (pre-contemplation, intention, action). Decisional balance was the strongest in terms of impacting the process of behaviour change, while household efficacy and perceived household cooperation were identified as 'markers' for stages-of-change at the household level. This type of framework analysis made it possible to develop a conceptual model that could facilitate the design of intervention strategies to aid a household-level dietary behaviour change process.

Conceptual model for dietary behaviour change at household level: a ‘best-fit’ qualitative study using primary data

PubMed Central

2014-01-01

Background Interventions having a strong theoretical basis are more efficacious, providing a strong argument for incorporating theory into intervention planning. The objective of this study was to develop a conceptual model to facilitate the planning of dietary intervention strategies at the household level in rural Kerala. Methods Three focus group discussions and 17 individual interviews were conducted among men and women, aged between 23 and 75 years. An interview guide facilitated the process to understand: 1) feasibility and acceptability of a proposed dietary behaviour change intervention; 2) beliefs about foods, particularly fruits and vegetables; 3) decision-making in households with reference to food choices and access; and 4) to gain insights into the kind of intervention strategies that may be practical at community and household level. The data were analysed using a modified form of qualitative framework analysis, which combined both deductive and inductive reasoning. A priori themes were identified from relevant behaviour change theories using construct definitions, and used to index the meaning units identified from the primary qualitative data. In addition, new themes emerging from the data were included. The associations between the themes were mapped into four main factors and its components, which contributed to construction of the conceptual model. Results Thirteen of the a priori themes from three behaviour change theories (Trans-theoretical model, Health Belief model and Theory of Planned Behaviour) were confirmed or slightly modified, while four new themes emerged from the data. The conceptual model had four main factors and its components: impact factors (decisional balance, risk perception, attitude); change processes (action-oriented, cognitive); background factors (personal modifiers, societal norms); and overarching factors (accessibility, perceived needs and preferences), built around a three-stage change spiral (pre-contemplation, intention, action). Decisional balance was the strongest in terms of impacting the process of behaviour change, while household efficacy and perceived household cooperation were identified as ‘markers’ for stages-of-change at the household level. Conclusions This type of framework analysis made it possible to develop a conceptual model that could facilitate the design of intervention strategies to aid a household-level dietary behaviour change process. PMID:24912496

Assessing Assessment Texts: Where Is Planning?

ERIC Educational Resources Information Center

Fives, Helenrose; Barnes, Nicole; Dacey, Charity; Gillis, Anna

2016-01-01

We conducted a content analysis of 27 assessment textbooks to determine how assessment planning was framed in texts for preservice teachers. We identified eight assessment planning themes: alignment, assessment purpose and types, reliability and validity, writing goals and objectives, planning specific assessments, unpacking, overall assessment…

Positive patient experiences in an Australian integrative oncology centre.

PubMed

Furzer, Bonnie J; Petterson, Anna S; Wright, Kemi E; Wallman, Karen E; Ackland, Timothy R; Joske, David J L

2014-05-14

The purpose of this study was to explore the experiences of cancer patients' utilising complementary and integrative therapies (CIT) within integrative oncology centres across Western Australia. Across four locations 135 patients accessed CIT services whilst undergoing outpatient medical treatment for cancer. Of the 135 patients, 66 (61±12 y; female n=45; male n=21) agreed to complete a personal accounts questionnaire consisting of open-ended questions designed to explore patients' perceptions of CIT. All results were transcribed into nVivo (v9) and using thematic analysis, key themes were identified. Of the 66 participants, 100% indicated they would "recommend complementary therapies to other patients" and 92% stated "CIT would play a significant role in their future lifestyle". A mean score of 8±1 indicated an improvement in participants' perception of wellbeing following a CIT session. Three central themes were identified: empowerment, support and relaxation. Fourteen sub-themes were identified, with all themes clustered into a framework of multifaceted views held by cancer patients in relation to wellbeing, role of significant others and control. Exploration of patients' experiences reveals uniformly positive results. One of the key merits of the environment created within the centres is patients are able to work through their cancer journey with an increased sense of empowerment, without placing them in opposition to conventional medical treatment. In order to effectively target integrative support services it is crucial to explore the experiences of patients in their own words and use those forms of expression to drive service delivery.

Strategies for enhancing medical student resilience: student and faculty member perspectives

PubMed Central

Kamei, Robert; Vidyarthi, Arpana

2018-01-01

Objectives To improve programs aimed to enhance medical student resiliency, we examined both medical student and faculty advisor perspectives on resiliency-building in an Asian medical school. Methods In two separate focus groups, a convenience sample of 8 MD-PhD students and 8 faculty advisors were asked to identify strategies for enhancing resilience. Using thematic analysis, two researchers independently examined discussion transcripts and field notes and determined themes through a consensus process. They then compared the themes to discern similarities and differences between these groups. Results Themes from the student suggestions for increasing resilience included “Perspective changes with time and experience”, “Defining effective advisors,” and “Individual paths to resiliency”. Faculty-identified themes were “Structured activities to change student perspectives,” “Structured teaching of coping strategies”, and “Institution-wide social support”. Students described themselves as individuals building their own resilience path and preferred advisors who were not also evaluators. Faculty, however, suggested systematic, structural ways to increase resilience. Conclusions Students and advisors identified some common, and many distinct strategies for enhancing medical student resilience. Student/advisor discrepancies may exemplify a cultural shift in Singapore’s medical education climate, where students value increased individualism and autonomy in their education. As medical schools create interventions to enhance resilience and combat potential student burnout, they should consider individually-tailored as well as system-wide programs to best meet the needs of their students and faculty. PMID:29334480

Assessing the responsiveness of chronic disease care - is the World Health Organization's concept of health system responsiveness applicable?

PubMed

Röttger, Julia; Blümel, Miriam; Fuchs, Sabine; Busse, Reinhard

2014-07-01

The concept of health system responsiveness is an important dimension of health system performance assessment. Further efforts have been made in recent years to improve the analysis of responsiveness measurements, yet few studies have applied the responsiveness concept to the evaluation of specific health care delivery structures. The objective of this study was to test the World Health Organization's (WHO's) responsiveness concept for an application in the evaluation of chronic disease care. In September and October 2012 we conducted four focus groups of chronically ill people (n = 38) in Germany, in which participants discussed their experiences and expectations regarding health care. The data was analyzed deductively (on the basis of the WHO responsiveness concept) and inductively using directed content analysis. Ten themes related to health system responsiveness and one theme (finances) not directly related to health system responsiveness, but of high importance to the focus group participants, could be identified. Eight of the ten responsiveness themes are consistent with the WHO concept. Additionally, two new themes were identified: trust (consultation and treatment are not led by any motive other than the patients' wellbeing) and coordination (treatment involving different providers is coordinated and different actors communicate with each other). These findings indicate the suitability of the WHO responsiveness concept for the evaluation of chronic disease care. However, some amendments, in particular an extension of the concept to include the two domains trust and coordination, are necessary for a thorough assessment of the responsiveness of chronic disease care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Conflict prevention, conflict mitigation, and manifestations of conflict during emergency department consultations.

PubMed

Chan, Teresa; Bakewell, Francis; Orlich, Donika; Sherbino, Jonathan

2014-03-01

The objective was to determine the causes of and mitigating factors for conflict between emergency physicians and other colleagues during consultations. From March to September 2010, a total of 61 physicians (31 residents and 30 attendings from emergency medicine [EM], internal medicine, and general surgery) were interviewed about how junior learners should be taught about emergency department (ED) consultations. During these interviews, they were asked if and how conflict manifests during the ED consultation process. Two investigators reviewed the transcripts independently to generate themes related to conflict until saturation was reached. Disagreements were resolved by consensus. The trustworthiness of the analysis was ensured by generating an audit trail, which was subsequently audited by an investigator not involved with the initial analysis. This analysis was compared to previously proposed models of trust and conflict from the sociology and business literature. All participants recalled some manifestation of conflict. There were 12 negative conflict-producing themes and 10 protective conflict-mitigating themes. When comparing these themes to a previously developed model of the domains of trust, each theme mapped to domains of the model. Conflict affects the ED consultation process. Areas that lead to conflict are identified that map to previous models of trust and conflict. This work extends the current understanding about intradisciplinary conflict in the clinical realm. These new findings may improve the understanding of the nature of conflicts that occur and form the foundation for interventions that may decrease conflict during ED consultations. © 2014 by the Society for Academic Emergency Medicine.

Personal Network Recovery Enablers and Relapse Risks for Women With Substance Dependence

PubMed Central

Brown, Suzanne; Tracy, Elizabeth M.; Jun, MinKyoung; Park, Hyunyong; Min, Meeyoung O.

2015-01-01

We examined the experiences of women in treatment for substance dependence and their treatment providers about personal networks and recovery. We conducted six focus groups at three women’s intensive substance abuse treatment programs. Four coders used thematic analysis to guide the data coding and an iterative process to identify major themes. Coders identified social network characteristics that enabled and impeded recovery and a reciprocal relationship between internal states, relationship management, and recovery. Although women described adding individuals to their networks, they also described managing existing relationships through distancing from or isolating some members to diminish their negative impact on recovery. Treatment providers identified similar themes but focused more on contextual barriers than the women. The focus of interventions with this population should be on both internal barriers to personal network change such as mistrust and fear, and helping women develop skills for managing enduring network relationships. PMID:25231945

A Community-Engaged Research Approach to Improve Mental Health Among Latina Immigrants: ALMA Photovoice.

PubMed

Perez, Georgina; Della Valle, Pamela; Paraghamian, Sarah; Page, Rachel; Ochoa, Janet; Palomo, Fabiana; Suarez, Emilia; Thrasher, Angela; Tran, Anh N; Corbie-Smith, Giselle

2016-05-01

Recent Latina immigrants are at increased risk of poor mental health due to stressors associated with adapting to life in the United States. Existing social and health care policies often do not adequately address the mental health concerns of new Latino populations. Amigas Latinas Motivando el Alma, a community-partnered research project, seeks to improve immigrant Latinas' mental health outcomes. Using Photovoice methodology, promotoras (lay health advisors) reflected on community factors affecting mental health through photography and guided discussion. Discussions were audio-recorded, transcribed, and coded using content analysis to identify salient themes. Promotoras reviewed codes to develop themes that they presented in community forums to reach local policy makers and to increase community awareness. These forums included an exhibit of the promotoras' photographs and discussion of action steps to address community concerns. Themes included transitioning to life in the United States, parenting, education, and combating racism. Nearly 150 stakeholders attended the community forums and proposed responses to promotoras' photographic themes. Our findings suggest that Photovoice provides an opportunity for Latinas and the larger community to identify issues that they find most important and to explore avenues for action and change by creating sustainable partnerships between the community and forum attendees. © 2015 Society for Public Health Education.

The loneliness experiences of young adults with cerebral palsy who use alternative and augmentative communication.

PubMed

Cooper, Lauren; Balandin, Susan; Trembath, David

2009-01-01

Young adults with cerebral palsy who use augmentative and alternative communication (AAC) systems may be at increased risk of loneliness due to the additional challenges they experience with communication. Six young adults, aged 24-30 years, who used AAC and had cerebral palsy, participated in in-depth interviews to explore their experiences of loneliness as they made the transition into adulthood. A total of five major themes in the data were identified using the constant comparative method of analysis. Three of these themes were discussed by all participants: (a) Support Networks, (b) AAC System Use, and (c) Technology. The authors concluded that these three themes were most important in understanding the experiences of loneliness of the young adults with cerebral palsy who participated in this study.

An empirically based conceptual framework for fostering meaningful patient engagement in research.

PubMed

Hamilton, Clayon B; Hoens, Alison M; Backman, Catherine L; McKinnon, Annette M; McQuitty, Shanon; English, Kelly; Li, Linda C

2018-02-01

Patient engagement in research (PEIR) is promoted to improve the relevance and quality of health research, but has little conceptualization derived from empirical data. To address this issue, we sought to develop an empirically based conceptual framework for meaningful PEIR founded on a patient perspective. We conducted a qualitative secondary analysis of in-depth interviews with 18 patient research partners from a research centre-affiliated patient advisory board. Data analysis involved three phases: identifying the themes, developing a framework and confirming the framework. We coded and organized the data, and abstracted, illustrated, described and explored the emergent themes using thematic analysis. Directed content analysis was conducted to derive concepts from 18 publications related to PEIR to supplement, confirm or refute, and extend the emergent conceptual framework. The framework was reviewed by four patient research partners on our research team. Participants' experiences of working with researchers were generally positive. Eight themes emerged: procedural requirements, convenience, contributions, support, team interaction, research environment, feel valued and benefits. These themes were interconnected and formed a conceptual framework to explain the phenomenon of meaningful PEIR from a patient perspective. This framework, the PEIR Framework, was endorsed by the patient research partners on our team. The PEIR Framework provides guidance on aspects of PEIR to address for meaningful PEIR. It could be particularly useful when patient-researcher partnerships are led by researchers with little experience of engaging patients in research. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Determinants of effective clinical learning: a student and teacher perspective in Saudi Arabia.

PubMed

Alhaqwi, A I; van der Molen, H T; Schmidt, H G; Magzoub, M E

2010-08-01

Graduating clinically competent medical students is probably the principal objective of all medical curricula. Training for clinical competence is rather a complex process and to be effective requires involving all stakeholders, including students, in the processes of planning and implanting the curriculum. This study explores the perceptions of students of the College of Medicine at King Abdul-Aziz Bin Saud University for Health Sciences (KASU-HS), Riyadh, Saudi Arabia of the features of effective clinical rotations by inviting them to answer the question: "Which experiences or activities in your opinion have contributed to the development of your clinical competence? This college was established in 2004 and adopted a problem-based learning curriculum. This question was posed to 24 medical students divided into three focus groups. A fourth focus group interview was conducted with five teachers. Transcriptions of the tape-recorded focus group interviews were qualitatively analyzed using a framework analysis approach. Students identified five main themes of factors perceived to affect their clinical learning: (1) the provision of authentic clinical learning experiences, (2) good organization of the clinical sessions, (3) issues related to clinical cases, (4) good supervision and (5) students' own learning skills. These themes were further subdivided into 18 sub-themes. Teachers identified three principal themes: (1) organizational issues, (2) appropriate supervision and (3) providing authentic experiences. Consideration of these themes in the process of planning and development of medical curricula could contribute to medical students' effective clinical learning and skills competency.

Why are there gaps in our management of those with high cardiovascular risk?

PubMed

Doolan-Noble, Fiona; Tracey, Jocelyn; Mann, Stewart

2012-03-01

Multiple New Zealand and other international studies have identified gaps in the management of those identified at high risk of a future cardiovascular (CV) event. This study sought to explore the views of health professionals about the barriers and facilitators present within the current primary health care system to the optimal management of those at high CV risk. This qualitative study utilised a focus group methodology to examine the barriers and facilitators within primary health care (PHC), and employed a general inductive approach to analyse the text data. The analysis of text data resulted in the emergence of interrelated themes, underpinned by subthemes. The patient, their circumstances and their characteristics and perceptions provided the first key theme and subthemes. The next key theme was primary health care providers, with subthemes of communication and values and beliefs. The general practice was the third theme and included multiple subthemes: implementation planning and pathway development, time and workload and roles and responsibilities. The final main theme was the health system with the subthemes linking to funding and leadership. This study determined the factors that act as barriers and facilitators to the effective management of those at high CV risk within the New Zealand PHC sector. General practice has a pivotal role in preventive health care, but to succeed there needs to be a refocusing of the PHC sector, requiring support from policy makers, District Health Boards and Primary Health Organisations, as well as those working in the sector.

Colostomy Irrigation: Issues Most Important to Wound, Ostomy and Continence Nurses.

PubMed

Tallman, Nancy J; Cobb, Martha D; Grant, Marcia; Wendel, Christopher S; Colwell, Janice; Ercolano, Elizabeth; Krouse, Robert

2015-01-01

The purpose of this study was to describe issues that WOC nurses find most important related to colostomy irrigation (CI). This is an additional analysis of a study focusing on qualitative responses to a survey querying WOC nurses about CI practices. The target population was members of the Wound, Ostomy and Continence Nurses Society. Of the 985 nurses who responded to the survey, 338 (34.3%) answered the optional open-ended question asking for additional comments. A 1-time online survey was conducted. In addition to demographic, educational information, and forced-choice questions about CI, an open-ended question asked for any additional comments about their experience with irrigation and WOC practice. Content analysis was used to identify common themes identified by WOC nurses. Three hundred thirty-eight out of 985 WOC nurses (34.3%) answered the optional open-ended question asking for additional comments; analysis for this study is based on these responses. WOC nurses who responded to the open-ended question had similar characteristics to those who responded to the entire survey but were significantly more experienced (15.1 vs 11.0 years; P < .001). Multiple themes were identified that were related to forced-choice questions in the survey, such as equipment, lack of teaching time, and increased control, while several new themes emerged, including age-related recommendations, economic/ecologic benefits, cultural implications, and misconceptions of CI. Many WOC nurses feel that CI is a valued modality of ostomy care and should be reestablished, although dissenting opinions were expressed. Additional research to increase the evidence base for this procedure is needed. New opportunities to educate WOC nurses and other healthcare professionals and teach eligible patients irrigation techniques are recommended.

Postpartum stressors: a content analysis.

PubMed

Jevitt, Cecilia M; Groer, Maureen W; Crist, Nancy F; Gonzalez, Lois; Wagner, V Doreen

2012-05-01

A qualitative content analysis was conducted on narratives written by 127 mothers at four to six weeks postpartum. This study aimed to identify and compare postpartum stressors to the Tennessee Postpartum Stress Scale (TPSS). The TPSS is a guide to common postpartum stressors and an instrument to assess postpartum stress. Most participants in this study were white (91%), married (72%), and not working (70%). Eighteen stressor categories aggregated into two themes: Stressors Arising within the Maternal-Newborn Dyad and Stressors External to the Maternal-Newborn Dyad. Sixteen of 20 items on the TPSS were identified in the narratives. No stressor categories outside the TPSS were identified.

The Precarity of Older Adults Living Alone With Cognitive Impairment.

PubMed

Portacolone, Elena; Rubinstein, Robert L; Covinsky, Kenneth E; Halpern, Jodi; Johnson, Julene K

2018-01-24

To examine the lived experience of older adults living alone with cognitive impairment to better understand their needs and concerns. Based on our previous work suggesting that older adults living alone often experience a sense of precarity, we were interested in exploring this construct in older adults living alone with a diagnosis of cognitive impairment. The notion of precarity points to the uncertainty deriving from coping with cumulative pressures while trying to preserve a sense of independence. This is a qualitative study of 12 adults aged 65 and older living alone with cognitive impairment. Six participants had a diagnosis of Alzheimer's disease; 6 had a diagnosis of mild cognitive impairment. Participants' lived experiences were elicited through 40 ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Qualitative analysis of transcripts revealed three themes. Theme 1 described the distress stemming from the uncertainty of having cognitive impairment that has an unpredictable course. Theme 2 drew attention to the tendency of participants to feel responsible for managing their cognitive impairment. Theme 3 described the pressures stemming from the lack of appropriate services to support independent living for persons with cognitive impairment. These 3 themes all pointed to facets of precarity. Findings also suggest the dearth of programs to support older adults living alone with cognitive impairment and the need to develop novel programs and interventions. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Patients' Concerns and Perceptions Regarding Biologic Therapies in Ankylosing Spondylitis: Insights from a Large-Scale Survey of Social Media Platforms.

PubMed

Dzubur, Eldin; Khalil, Carine; Almario, Christopher V; Noah, Benjamin; Minhas, Deeba; Ishimori, Mariko; Arnold, Corey; Park, Yujin; Kay, Jonathan; Weisman, Michael H; Spiegel, Brennan M R

2018-05-21

Few studies have examined ankylosing spondylitis (AS) patients' concerns and perceptions of biologic therapies outside of traditional surveys. In this study, we used social media data to examine AS patients' knowledge, attitudes, and beliefs regarding biologic therapies. We collected posts from 601 social media sites made between 1/1/06-4/26/17. Each post mentioned both an AS keyword and a biologic. To explore themes within the collection in an unsupervised manner, a latent Dirichlet allocation topic model was fit to the dataset. Each discovered topic was represented as a discrete distribution over the words in the collection, similar to a word cloud. The topics were manually reviewed to identify themes, which were confirmed with thematic data analysis. We examined 27,416 social media posts and found 112 themes. The majority of themes (60%, 67/112) focused on discussions surrounding AS treatment. Other themes including psychological impact of AS, reporting of medical literature, and AS disease consequences accounted for the remaining 40% (45/112). Within AS treatment discussions, most topics (54%) involved biologics, and most subthemes (78%) centered on side-effects (e.g., fatigue, allergic reactions), biologic attributes (e.g., dosing, frequency), and concerns with biologic use (e.g., increased cancer risk). Additional implicit patient needs (e.g., support) were identified using qualitative analyses. Social media reveals a dynamic range of themes governing AS patients' experience and choice with biologics. The complexity of selecting among biologics and navigating their risk-benefit profiles suggests merit in creating online tailored decision-tools to support patients' decision-making with AS biologic therapies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Uncovering Ways of Thinking, Practicing, and Being through Decoding across Disciplines

ERIC Educational Resources Information Center

Miller-Young, Janice; Boman, Jennifer

2017-01-01

This chapter presents the bottlenecks identified by seven faculty members from diverse disciplines and an inductive content analysis of their Decoding interviews. Representative quotations illustrate themes in the interviews and we consider the implications for both faculty development and pedagogical research.

Development and initial validation of an Aviation Safety Climate Scale.

PubMed

Evans, Bronwyn; Glendon, A Ian; Creed, Peter A

2007-01-01

A need was identified for a consistent set of safety climate factors to provide a basis for aviation industry benchmarking. Six broad safety climate themes were identified from the literature and consultations with industry safety experts. Items representing each of the themes were prepared and administered to 940 Australian commercial pilots. Data from half of the sample (N=468) were used in an exploratory factor analysis that produced a 3-factor model of Management commitment and communication, Safety training and equipment, and Maintenance. A confirmatory factor analysis on the remaining half of the sample showed the 3-factor model to be an adequate fit to the data. The results of this study have produced a scale of safety climate for aviation that is both reliable and valid. This study developed a tool to assess the level of perceived safety climate, specifically of pilots, but may also, with minor modifications, be used to assess other groups' perceptions of safety climate.

Ana and the Internet: a review of pro-anorexia websites.

PubMed

Norris, Mark L; Boydell, Katherine M; Pinhas, Leora; Katzman, Debra K

2006-09-01

The purpose of this article is to describe the content of pro-anorexia websites, both qualitatively and quantitatively. An Internet search protocol was developed to identify pro-anorexia websites. A grounded theory approach was used to generate themes from Internet-based information. Basic descriptive analysis was employed to report on key website characteristics. Twenty pro-anorexia websites met inclusion criteria. Saturation of themes was achieved after review of 12 websites. Key website characteristics included purpose of website (75%), information about webmaster (67%), website disclaimers (58%), and information on "tips and tricks" (67%). Religious metaphors, lifestyle descriptions, and "thinspiration" (inspirational photo galleries and quotes that aim to serve as motivators for weight loss) were frequently present. A total of 10 themes were generated. The most prevalent themes included control, success, and perfection. Health-care providers and caregivers should be aware of pro-anorexia websites and their content, as these websites contain information that promote and support anorexia nervosa. Copyright (c) 2006 by Wiley Periodicals, Inc.

An investigation into drug-related problems identifiable by commercial medication review software.

PubMed

Curtain, Colin; Bindoff, Ivan; Westbury, Juanita; Peterson, Gregory

2013-01-01

Accredited pharmacists conduct home medicines reviews (HMRs) to detect and resolve potential drug-related problems (DRPs). A commercial expert system, Medscope Review Mentor (MRM), has been developed to assist pharmacists in the detection and resolution of potential DRPs. This study compares types of DRPs identified with the commercial system which uses multiple classification ripple down rules (MCRDR) with the findings of pharmacists. HMR data from 570 reviews collected from accredited pharmacists was entered into MRM and the DRPs were identified. A list of themes describing the main concept of each DRP identified by MRM was developed to allow comparison with pharmacists. Theme types, frequencies, similarity and dissimilarity were explored. The expert system was capable of detecting a wide range of potential DRPs: 2854 themes; compared to pharmacists: 1680 themes. The system identified the same problems as pharmacists in many patient cases. Ninety of 119 types of themes identifiable by pharmacists were also identifiable by software. MRM could identify the same problems in the same patients as pharmacists for 389 problems, resulting in a low overlap of similarity with an averaged Jaccard Index of 0.09. MRM found significantly more potential DRPs than pharmacists. MRM identified a wide scope of DRPs approaching the range of DRPs that were identified by pharmacists. Differences may be associated with system consistency and perhaps human oversight or human selective prioritisation. DRPs identified by the system were still considered relevant even though the system identified a larger number of problems.

A Vygotskian Perspective on Parent-Child Talk During iPad Story Sharing

ERIC Educational Resources Information Center

Kucirkova, Natalia; Sheehy, Kieron; Messer, David

2015-01-01

This study explores the themes in the talk of two mothers and daughters as they share a self-created story with an iPad app. Vygotsky's theory of learning is applied to inform a thematic analysis and help interpret the learning potential within the observed parent-child exchanges. A deductive-inductive thematic analysis identified three recurring…

A diffusion of innovations model of physician order entry.

PubMed

Ash, J S; Lyman, J; Carpenter, J; Fournier, L

2001-01-01

To interpret the results of a cross-site study of physician order entry (POE) in hospitals using a diffusion of innovations theory framework. Qualitative study using observation, focus groups, and interviews. Data were analyzed by an interdisciplinary team of researchers using a grounded approach to identify themes. Themes were then interpreted using classical Diffusion of Innovations (DOI) theory as described by Rogers [1]. Four high level themes were identified: organizational issues; clinical and professional issues; technology implementation issues; and issues related to the organization of information and knowledge. Further analysis using the DOI framework indicated that POE is an especially complex information technology innovation when one considers communication, time, and social system issues in addition to attributes of the innovation itself. Implementation strategies for POE should be designed to account for its complex nature. The ideal would be a system that is both customizable and integrated with other parts of the information system, is implemented with maximum involvement of users and high levels of support, and is surrounded by an atmosphere of trust and collaboration.

Barriers and Facilitators of Responding to Problem Gambling: Perspectives from Australian Mental Health Services.

PubMed

Rodda, S N; Manning, V; Dowling, N A; Lee, S J; Lubman, D I

2018-03-01

Despite high rates of comorbidity between problem gambling and mental health disorders, few studies have examined barriers or facilitators to the implementation of screening for problem gambling in mental health services. This exploratory qualitative study identified key themes associated with screening in mental health services. Semi-structured interviews were undertaken with 30 clinicians and managers from 11 mental health services in Victoria, Australia. Major themes and subthemes were identified using qualitative content analysis. Six themes emerged including competing priorities, importance of routine screening, access to appropriate screening tools, resources, patient responsiveness and workforce development. Barriers to screening included a focus on immediate risk as well as gambling being often considered as a longer-term concern. Clinicians perceived problem gambling as a relatively rare condition, but did acknowledge the need for brief screening. Facilitators to screening were changes to system processes, such as identification of an appropriate brief screening instrument, mandating its use as part of routine screening, as well as funded workforce development activities in the identification and management of problem gambling.

What support do health visitor mentors need?

PubMed

Morton, Sarah

2013-08-01

This paper seeks to explore and understand the role of health visitor mentors undertaking a mentoring responsibility for specialist community public health nurses. During the unprecedented round of health visitor training, responsibility for the direct management of this role has been devolved from practice teachers to mentors. A qualitative approach using a purposive sample of eight participants and a semi-structured interview was the chosen method. Simple qualitative analysis was undertaken allowing data to be compared and themes identified. The overarching theme within this study was 'powerlessness'; mentors felt they had no say in adopting this role which was imposed upon them. Sub-themes included 'preparedness' relating to their perceived lack of appropriate training, and 'emotional support', which identified inadequate support from managers, while good levels of support were experienced by most mentors from their colleagues. Finally, 'compromising' related to difficulties associated with managing client care, student education and family responsibilities, achieved through prioritising and working overtime. In conclusion, the paper suggests that mentors need further support that acknowledges the pressure of the dual role, and standards for professional development of mentors need to be developed.

Academic Medicine and Medical Professionalism: A Legacy and a Portal Into An Evolving Field of Educational Scholarship.

PubMed

Hafferty, Frederic W

2017-09-05

In this Invited Commentary, the author examines two curated Academic Medicine volumes showcasing foundational research and key writings on professionalism in medicine and medical education, collectively spanning from 1994 to 2016. The author reviews the beginnings of the medical professionalism movement and examines how the trends and themes reflected in the first volume-specifically the work to define, assess, and institutionalize professionalism-capture key elements in this movement. He then examines how the trends and themes in the second volume align with and build on those from the first, noting two themes that extend across a number of second volume articles: a unit-of-analysis issue and the challenge of context. The author identifies several topics that have yet to be adequately mined and calls attention to two bridge-spanning articles in the second volume that, respectively, take us into the future (around the topic of identify formation) and back to the past (on the hidden curriculum). Finally, the author reflects on "directions home" in medicine's noble search for its moral core and collective identity.

Implementation of a gerontology nurse specialist role in primary health care: Health professional and older adult perspectives.

PubMed

King, Anna I I; Boyd, Michal L; Dagley, Lynelle; Raphael, Deborah L

2018-02-01

To explore an innovative primary healthcare gerontology nurse specialist role from the perspectives of older people and health professionals. Primary care is struggling to meet the needs and demands of complex older people. New models which incorporate holistic assessment and care coordination are necessary. A qualitative descriptive general inductive design was used. Older people at risk of health and functional decline were identified and received a comprehensive gerontology assessment and care coordination. Older adults (75 years+) enrolled within one of three primary healthcare practices in Auckland, New Zealand were eligible. Healthcare professionals directly involved with the primary healthcare gerontology nurse specialist model were invited for study participation. Face-to-face interviews were held with five older people and six health professionals were interviewed by telephone. A semistructured interview guide was used for all interviews. A general inductive approach was undertaken for analysis to systematically identify codes and themes. Data analysis revealed two central themes from the older people perspective: "holistic expertise" and "communication." Two main themes were identified from the health professional perspective: "competency" and "service delivery." Results showed the gerontology nurse specialist role was highly regarded by both older people and the health professionals. The in-home comprehensive geriatric assessment was identified as greatly beneficial. The competence and care coordination of the gerontology nurse specialist reduced fragmentation and were deemed immensely valuable. Care coordination should be recognised as a key component to meeting the complex needs of at-risk older people in the community. The expert knowledge of the gerontology nurse specialist and in-home comprehensive geriatric assessment were crucial aspects of the new model. Equally important was the assimilation of primary and secondary care infrastructure to upskill and deliver mentorship to the gerontology nurse specialist. © 2017 John Wiley & Sons Ltd.

Establishing the Thematic Framework for a Diabetes-Specific Health-Related Quality of Life Item Bank for Use in an English-Speaking Asian Population

PubMed Central

Koh, Odelia; Lee, Jeannette; Tan, Maudrene L. S.; Tai, E-Shyong; Foo, Ce Jin; Chong, Kok Joon; Goh, Su-Yen; Bee, Yong Mong; Thumboo, Julian; Cheung, Yin-Bun; Singh, Avjeet; Wee, Hwee-Lin

2014-01-01

Aims To establish a thematic framework for a Diabetes Mellitus (DM)-specific health-related quality of life (HRQoL) item bank by identifying important HRQoL themes and content gaps in existing DM-specific HRQoL measures and determining whether Patient-Reported Outcomes Measurement Information System (PROMIS) item banks are useful as a starting point. Methodology English-speaking Type 2 DM patients were recruited from an outpatient specialist clinic in Singapore. Thematic analysis was performed through open coding and axial coding. Items from four existing DM-specific measures and PROMIS Version 1.0 and 2.0 item banks were compared with identified themes and sub-themes. Results 42 patients participated (25 men and 17 women; 28 Chinese, 4 Malay, 8 Indians, 2 other ethnicities). Median age was 53.70 years (IQR45.82–56.97) and the median disease duration was 11.13 (SD9.77) years. 10 subthemes (neutral emotions, coping emotions, empowered to help others, support from family, spend more time with family, relationships, financial burden on family, improved relationship, social support and religion/spirituality) were not covered by existing DM-specific measures. PROMIS covered 5 of 6 themes, 15 of 30 subthemes and 19 of 35 codes identified. Emotional distress (frustration, fear and anxiety) was most frequently mentioned (200 times). Conclusions We had developed a thematic framework for assessing DM-specific HRQoL in a multi-ethnic Asian population, identified new items that needed to be written and confirmed that PROMIS was a useful starting point. We hope that better understanding and measurement of HRQoL of Asian DM patients will translate to better quality of care for them. PMID:25531429

Exploring the professional values of Australian physiotherapists.

PubMed

Aguilar, Alejandra; Stupans, Ieva; Scutter, Sheila; King, Sharron

2013-03-01

A profession's values guide daily practice and professional behaviours. They clarify what professionalism means to a profession, by providing insight into the values that members of the profession aim to uphold and profess. There has been limited research into the values of the Australian physiotherapy profession, and as such, the values that guide practice and constitute professionalism are not explicit. This study aimed to make a preliminary identification of the values of the profession, by exploring the shared professional values of 14 Australian physiotherapists. This study was guided by a qualitative approach and constructivist paradigm. Purposive sampling was employed to identify physiotherapists who could contribute rich information to the study. Semi-structured interviews were conducted and analysed using an inductive data analysis method. The emerging professional values formed three main themes. The first theme, 'the patient and the patient-therapist partnership', incorporated values such as having patient trust and working collaboratively with patients. The theme labelled 'physiotherapy knowledge, skills and practice' included the values of having an evidence base and respecting professional boundaries. The last theme, 'altruistic values', was inclusive of values such as honesty, empathy and caring. The values that emerged went beyond philanthropic values, to values that guided every day practice, professional relationships and the responsibilities of being a professional. The results contribute to research orientated towards identifying the values of the profession and in doing so, clarifying what professionalism means to the Australian physiotherapy profession. Differences between the values identified by the American Physical Therapy Association and the study reported in this paper highlight the importance of identifying the values of the profession within the Australian context. In terms of practice implications, physiotherapists may be prompted to reflect on their values and how these values align with those of their patients. Copyright © 2012 John Wiley & Sons, Ltd.

[Being treated as a human being. Experiences of patients in a prenatal service of a philanthropic institution].

PubMed

Bonadio, I C

1998-04-01

This paper reports a qualitative study conducted in an anthropological perspective using the ethnografic research methodology. It had has the objective of knowing and understanding the needs, antenatal care values and beliefs of pregnant women in the context of Prenatal Service of a Philanthropic Institution. The central theme "be treated as a Human Being", identified from the analysis of the cultural themes, revealed that, in the women experience, the most significant element is represented either by the effective interaction or by the establishment on bond of trust between them and nurse.

Measuring the Dynamics of Climate Change Communication in Mass Media and Social Networks with Computer-Assisted Content Analysis

NASA Astrophysics Data System (ADS)

Kirilenko, A.; Stepchenkova, S.

2012-12-01

To date, multiple authors have examined media representations of and public attitudes towards climate change, as well as how these representations and attitudes differ from scientific knowledge on the issue of climate change. Content analysis of newspaper publications, TV news, and, recently, Internet blogs has allowed for identification of major discussion themes within the climate change domain (e.g., newspaper trends, comparison of climate change discourse in different countries, contrasting liberal vs. conservative press). The majority of these studies, however, have processed texts manually, limiting textual population size, restricting the analysis to a relatively small number of themes, and using time-expensive coding procedures. The use of computer-assisted text analysis (CATA) software is important because the difficulties with manual processing become more severe with an increased volume of data. We developed a CATA approach that allows a large body of text materials to be surveyed in a quantifiable, objective, transparent, and time-efficient manner. While staying within the quantitative tradition of content analysis, the approach allows for an interpretation of the public discourse closer to one of more qualitatively oriented methods. The methodology used in this study contains several steps: (1) sample selection; (2) data preparation for computer processing and obtaining a matrix of keyword frequencies; (3) identification of themes in the texts using Exploratory Factor Analysis (EFA); (4) combining identified themes into higher order themes using Confirmatory Factor Analysis (CFA); (5) interpretation of obtained public discourse themes using factor scores; and (6) tracking the development of the main themes of the climate change discourse through time. In the report, we concentrate on two examples of CATA applied to study public perception of climate change. First example is an analysis of temporal change in public discourse on climate change. Applying CATA to a conservatively selected sample of 4043 articles published on climate change in The New York Times from 1995, we found a considerable change in major topics of discussion. One of the most significant tendencies is a gradual decline in the volume of material within the "Science" topic and an expansion of themes classified under the "Politics" topic. The second example is the analysis of public ability to detect climate change, in which we used a database of over 1 million Twitter messages on climate change that we have collected. We compared the intensity of tweeting on climate change with the "common-sense climate index" by Hansen et al (1999) and found that the weather extremes experienced at a certain location is immediately reflected in the number of tweets discussing climate change originating from that location. Although the CATA approach certainly has its limitations, we are convinced that it has a number of advantages over manual processing: it is able to analyze large textual bodies, is more time efficient, has a higher level of detail, enhances the richness of interpretation, and is able to reliably track discourse development through time.

Emergency Department Patient Perspectives on the Risk of Addiction to Prescription Opioids.

PubMed

Conrardy, Michael; Lank, Patrick; Cameron, Kenzie A; McConnell, Ryan; Chevrier, Alison; Sears, Jill; Ahlstrom, Eric; Wolf, Michael S; Courtney, D Mark; McCarthy, Danielle M

2016-01-01

To characterize emergency department (ED) patients' knowledge and beliefs about the addictive potential of opioids. Mixed methods analysis of data from a randomized controlled trial. Urban academic ED (>88,000 visits). One hundred and seventy four discharged ED patients prescribed hydrocodone-acetaminophen for acute pain. The study analyzed data collected from a randomized controlled trial investigating patients' knowledge of opioids. ED patients discharged with hydrocodone-acetaminophen completed an audio-recorded phone interview 4–7 days later. This analysis focuses on responses about addiction. Responses were categorized using content analysis; thematic analysis identified broad themes common across different categories. Participants' mean age was 45.5 years (SD, 14.8), 58.6% female, 50.6% white, and the majority had an orthopedic diagnosis (24.1% back pain, 52.3% other injuries). Responses were categorized first based on whether the patient believed that opioids could be addictive (categorized as: yes, 58.7%; no, 19.5%; depends, 17.2%; or do not know, 4.6%), and second based on whether or not the patient discussed his/her own experience with the medication (categorized as: personalized, 35.6%; or not personalized, 64.4%). Cohen's Kappa was 0.84 for all categories. Three themes emerged in the thematic analysis: theme 1) patients expect to “feel” addicted if they are addicted, theme 2) patients fear addiction, and theme 3) side effects affected patient views of addiction. In this sample, patients had misconceptions about opioid addiction. Some patients did not know opioids could be addictive, others underestimated their personal risk of addiction, and others overtly feared addiction and, therefore, risked inadequate pain management. Despite limited data, we recommend providers discuss opioid addiction with their patients. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government employees and is in the public domain in the US.

Redesigning Children's Services: Mapping Interprofessional Social Capital

ERIC Educational Resources Information Center

Forbes, Joan

2009-01-01

This paper presents an analysis of the policy themes of service integration, social justice and social inclusion which underpin the integrated community schools policy initiative in Scotland. That initiative is identified as an important vehicle for the Scottish Executive Government's aim of integrating children's services with the overarching…

Periodic Early Childhood Hearing Screening: The EHDI Perspective

ERIC Educational Resources Information Center

Hoffman, Jeff; Houston, K. Todd; Munoz, Karen F.; Bradham, Tamala S.

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Concerning periodic early childhood hearing screening, 47 coordinators listed 241 items and themes were identified within each SWOT…

The EHDI and Early Intervention Connection

ERIC Educational Resources Information Center

Nelson, Lauri; Bradham, Tamala S.; Houston, K. Todd

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. For the early intervention focus question, 48 coordinators listed 273 items, and themes were identified within each SWOT category. A…

Interdisciplinary Collaboration in EHDI Programs

ERIC Educational Resources Information Center

Nelson, Lauri; Houston, K. Todd; Hoffman, Jeff; Bradham, Tamala S.

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs were asked to complete a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the interdisciplinary area, 47 coordinators responded with 224 items, and themes were identified within each SWOT…

"Ward v. Wilbanks": Counselor Educators Respond

ERIC Educational Resources Information Center

Burkholder, David; Hall, Stephanie F.; Burkholder, Jessica

2014-01-01

This article investigated 71 counselor educators' perspectives and pedagogical practices related to "Ward v. Wilbanks" (2009) and the American Counseling Association (ACA) response to the case. The authors used qualitative content analysis to identify 6 themes from survey data: (a) views on gatekeeping and student training; (b)…

Acculturative Stress and Adjustment Experiences of Greek International Students

ERIC Educational Resources Information Center

Poulakis, Mixalis; Dike, Craig A.; Massa, Amber C.

2017-01-01

This study investigated eight Greek international college students' experiences of acculturation and acculturative stress at a mid-western university in the United States. Semi-structured interviews were conducted with participants and Consensual Qualitative Research methodology was utilized for data analysis to identify contextual themes and…

Mentoring doctoral students for qualitative research: interviews with experienced nursing faculty in Japan.

PubMed

Kayama, Mami; Gregg, Misuzu F; Asahara, Kiyomi; Yamamoto-Mitani, Noriko; Okuma, Keiko; Ohta, Kikuko; Kinoshita, Yasuhito

2013-05-01

This study aimed to describe the process of mentoring doctoral students for qualitative research in Japanese graduate programs in nursing. Nine experienced faculty-seven nurse researchers and two sociologists-were interviewed. Participants were asked about their process of mentoring students for qualitative nursing dissertations. Data analysis was conducted using a qualitative descriptive method. Participants' age ranged from 48 to 60 years. The first theme in the mentoring process is about the individualized, one-on-one mentorship process. The second theme occurs in a group process. The third theme is coordinating mentors and establishing a network to support the evaluation system. The mentoring processes identified in this study will be useful for future faculty development. The study elucidated much room for improvement in doctoral education programs for qualitative research methods in nursing science. Copyright 2013, SLACK Incorporated.

School violence: an insider view.

PubMed

Johnson, Shelley A; Fisher, Kathleen

2003-01-01

To discover what teachers perceive to be contributing factors to violence in schools. Open-ended questions were asked of a convenience sample of teachers ( = 396) during an in-service education program on school violence. The teachers were in a semi-rural school district in a Mid-Atlantic state. Answers were analyzed using content analysis; all responses were reviewed and important themes were extracted. Identified themes were then placed into suitable categories and studied to determine relationships. Of the surveys analyzed ( = 239), 13 themes were identified. The three categories which then identified probable causes of school violence were (1) lack of knowledge, (2) lack of support, and (3) inadequate safety measures. Nurses can use the results of this study in multiple ways. One is to help parents understand their role in preventing school violence. Because violence in the home and violence in the media seem to foster violent acting-out behavior, nurses can teach parents about these correlations and seek solutions such as the elimination of family violence, and monitoring television viewing and video games. Nursing assessments of school-aged children and their families can include these elements. School nurses in particular can use these study results as an opportunity to develop interventions for students, teachers, and families that stress knowledge building about impulse control, anger management, appropriate parenting, and early intervention for at-risk children.

Exploration of the affordances of mobile devices in integrating theory and clinical practice in an undergraduate nursing programme.

PubMed

Willemse, Juliana J; Bozalek, Vivienne

2015-01-01

Promoting the quality and effectiveness of nursing education is an important factor, given the increased demand for nursing professionals. It is important to establish learning environments that provide personalised guidance and feedback to students about their practical skills and application of their theoretical knowledge. To explore and describe the knowledge and points of view of students and educators about introduction of new technologies into an undergraduate nursing programme. The qualitative design used Tesch's (1990) steps of descriptive data analysis to complete thematic analysis of the data collected in focus group discussions (FGDs) and individual interviews to identify themes. Themes identified from the students’ FGDs and individual interviews included: mobile devices as a communication tool; email, WhatsApp and Facebook as methods of communication; WhatsApp as a method of communication; nurses as role-models in the clinical setting; setting personal boundaries; and impact of mobile devices in clinical practice on professionalism. Themes identified from the FGD, individual interviews and a discussion session held with educators included: peer learning via mobile devices; email, WhatsApp and Facebook as methods of communication; the mobile device as a positive learning method; students need practical guidance; and ethical concerns in clinical facilities about Internet access and use of mobile devices. The research project established an understanding of the knowledge and points of view of students and educators regarding introduction of new technologies into an undergraduate nursing programme with the aim of enhancing integration of theory and clinical practice through use of mobile devices.

[Recovering helpers in the addiction treatment system in Hungary: an interpretative phenomenological analysis].

PubMed

Kassai, Szilvia; Pintér, Judit Nóra; Rácz, József

2015-01-01

The work of recovering helpers who work in the addiction rehabilitation centres was studied. The aim was to investigate the process of addicts becoming recovering helpers, and to study what peer help means to them. According to interpretative phenomenological analysis (IPA) design, subjects were selected, data were collected and analysed. 6 (5 males, 1 female), working as recovering helpers at least one year at addiction rehabilitation centres. Semi-structured life interviews were carried out and analysed according to IPA. Emerging themes from the interviews were identified and summarized, then interpreted as central themes: important periods and turning points of the life story interviews: the experience of psychoactive drugs use, the development of the addiction (which became " Turning Point No 1") then the "rock bottom" experience ("Turning Point No 2"). Then the experience of the helping process was examined: here four major themes were identified: the development of the recovering self and the helping self, the wounded helper and the skilled helper, the experience of the helping process. IPA was found to be a useful method for idiographic exploration of the development and the work of the recovering helpers. The work of the recovering helpers can be described as mentoring of the addict clients. Our experiences might be used for the training programs for recovering helpers as well as to adopt their professional role in addiction services.

International students in speech-language pathology clinical education placements: Perceptions of experience and competency development.

PubMed

Attrill, Stacie; Lincoln, Michelle; McAllister, Sue

2015-06-01

This study aimed to describe perceptions of clinical placement experiences and competency development for international speech-language pathology students and to determine if these perceptions were different for domestic students. Domestic and international students at two Australian universities participated in nine focus group interviews. Thematic analysis led to the identification of two themes shared by international and domestic students and several separate themes. Shared themes identified the important influence of students' relationships with clinical educators, unique opportunities and learning that occurs on placement. International student themes included concerns about their communication skills and the impact of these skills on client progress. They also explored their adjustment to unfamiliar placement settings and relationships, preferring structured placements to assist this adjustment. Domestic student themes explored the critical nature of competency attainment and assessment on placement, valuing placements that enabled them to achieve their goals. The findings of this study suggest that international students experience additional communication, cultural and contextual demands on clinical placement, which may increase their learning requirements. Clinical education practices must be responsive to the learning needs of diverse student populations. Strategies are suggested to assist all students to adjust to the professional and learning expectations of clinical education placements.

Assessing strategies to manage work and life balance of athletic trainers working in the National Collegiate Athletic Association Division I setting.

PubMed

Mazerolle, Stephanie M; Pitney, William A; Casa, Douglas J; Pagnotta, Kelly D

2011-01-01

Certified athletic trainers (ATs) working at the National Collegiate Athletic Association Division I level experience challenges balancing their professional and personal lives. However, an understanding of the strategies ATs use to promote a balance between their professional and personal lives is lacking. To identify the strategies ATs employed in the Division I setting use to establish a balance between their professional and personal lives. Qualitative investigation using inductive content analysis. Athletic trainers employed at Division I schools from 5 National Athletic Trainers' Association districts. A total of 28 (15 women, 13 men) ATs aged 35 ± 9 years volunteered for the study. Asynchronous electronic interviews with follow-up phone interviews. Data were analyzed using inductive content analysis. Peer review, member checking, and data-source triangulation were conducted to establish trustworthiness. Three higher-order themes emerged from the analysis. The initial theme, antecedents of work-family conflict, focused on the demands of the profession, flexibility of work schedules, and staffing patterns as contributing to work-life conflict for this group of ATs. The other 2 emergent higher-order themes, professional factors and personal factors, describe the components of a balanced lifestyle. The second-order theme of constructing the professional factors included both organizational policies and individual strategies, whereas the second-order theme of personal factors was separation of work and life and a supportive personal network. Long work hours, lack of control over work schedules, and unbalanced athlete-to-AT ratios can facilitate conflicts. However, as demonstrated by our results, several organizational and personal strategies can be helpful in creating a balanced lifestyle.

Chameleon Changes: An Exploration of Racial Identity Themes of Multiracial People

ERIC Educational Resources Information Center

Miville, Marie L.; Constantine, Madonna G.; Baysden, Matthew F.; So-Lloyd, Gloria

2005-01-01

The current study explored essential themes of racial identity development among 10 self-identified multiracial adults from a variety of racial backgrounds. Participants were interviewed using a semistructured protocol, and the interviews were recorded, transcribed, and then coded for themes by research team members. Four primary themes were…

Maternal styles of talking about child feeding across sociodemographic groups.

PubMed

Pesch, Megan H; Harrell, Kristina J; Kaciroti, Niko; Rosenblum, Katherine L; Lumeng, Julie C

2011-12-01

This study sought to identify maternal styles of talking about child feeding from a semistructured interview and to evaluate associated maternal and child characteristics. Mothers of preschool-aged children (n=133) of diverse race/ethnicity and socioeconomic status (SES) (45 lower SES black, 29 lower SES white, 32 lower SES Hispanic, 15 middle to upper SES white, and 12 middle to upper SES Asian) participated in a semistructured interview about feeding. Interviews were audiotaped and transcribed. Themes were identified, and individual interviews were coded within these themes: authority (high/low), confidence (confident/conflicted/unopinionated), and investment (deep/mild/removed). Demographic characteristics were collected and a subset of children had measured weights and heights. Cluster analysis was used to identify narrative styles. Participant characteristics were compared across clusters using Fisher's exact test and analysis of variance. Six narrative styles were identified: Easy-Going, Practical No-Nonsense, Disengaged, Effortful No-Nonsense, Indulgent Worry, and Conflicted Control. Cluster membership differed significantly based on maternal demographic group (P<0.001) and child weight status (P<0.05). More than half (60%) of children of mothers in the Conflicted Control cluster were obese. Maternal styles of talking about feeding are associated with maternal and child characteristics. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

'I'm a sick person, not a bad person': patient experiences of treatments for alcohol use disorders.

PubMed

McCallum, Stacey L; Mikocka-Walus, Antonina A; Gaughwin, Matthew D; Andrews, Jane M; Turnbull, Deborah A

2016-08-01

Emerging research indicates that standard treatments for alcohol use disorders may not fully meet the needs of patients with co-occurring severe mental health symptoms. Investigating health quality indicators may provide insight into how current treatment might be improved. To better understand the experiences of patients receiving treatment for alcohol use disorders and compare the experiences of patients with and without co-occurring severe mental health symptoms. Cross-sectional qualitative research design using semi-structured interviews methods and framework analysis approach. Inpatient hospital, outpatient service, inpatient detoxification clinic and a residential/ therapeutic community. Thirty-four patients receiving treatment for an alcohol use disorder. Themes relating to patients' experiences of continuity of care, treatment need and satisfaction with treatment were studied. The qualitative data were divided into two groups: patients with (n = 15) and without (n = 19) severe mental health symptoms. Five themes relating to patient satisfaction with treatment were identified, including: perceived effectiveness of treatment, supportive relationships, specialized but holistic care, patient autonomy and continuity of care. A diverse range of patient treatment needs, staff and service continuity and stigma were also identified as major themes. Five basic themes were identified as more critical to the experiences of patients with severe mental health symptoms. Findings suggest that patients look for supportive relationships with others, to be involved in treatment decisions, effective specialized and holistic approaches to care and a non-judgemental treatment environment. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

The surgical learning and instructional portfolio: what residents at a single institution are learning.

PubMed

Webb, Travis P; Merkley, Taylor R

2011-03-01

The Accreditation Council for Graduate Medical Education (ACGME) Learning Portfolio is recommended as a tool to develop and document reflective, practice-based learning and improvement. There is no consensus regarding the appropriate content of a learning portfolio in medical education. Studying lessons selected for inclusion in their learning portfolios by surgical trainees could help identify useful subject matter for this purpose. Each month, all residents in our surgery residency program submit entries into their individual Surgical Learning and Instructional Portfolio (SLIP). The SLIP entries from July 2008 to 2009 (n = 420) were deidentified and randomized using a random number generator. We conducted a thematic content analysis of 50 random portfolio entries to identify lessons learned. Two independent raters analyzed the "3 lessons learned" portion of the portfolio entries and identified themes and subthemes using the constant comparative method used in grounded theory. The collaborative coding process resulted in theme saturation after the identification of 7 themes and their subthemes. Themes in decreasing order of frequency included complications, disease epidemiology, disease presentation, surgical management of disease, medical management of disease, operative techniques, and pathophysiology. Junior residents chose to focus on a broad array of foundational topics including disease presentation, epidemiology, and overall management of diseases, whereas postgraduate year-4 (PGY-4) and PGY-5 residents most frequently chose to focus on complications as learning points. Lessons learned reflect perceived needs of the trainees based on training year. When given a template to follow, junior and senior residents choose to reflect on different subject matter to meet their learning goals.

The Surgical Learning and Instructional Portfolio: What Residents at a Single Institution Are Learning

PubMed Central

Webb, Travis P; Merkley, Taylor R

2011-01-01

Background The Accreditation Council for Graduate Medical Education (ACGME) Learning Portfolio is recommended as a tool to develop and document reflective, practice-based learning and improvement. There is no consensus regarding the appropriate content of a learning portfolio in medical education. Studying lessons selected for inclusion in their learning portfolios by surgical trainees could help identify useful subject matter for this purpose. Methods Each month, all residents in our surgery residency program submit entries into their individual Surgical Learning and Instructional Portfolio (SLIP). The SLIP entries from July 2008 to 2009 (n = 420) were deidentified and randomized using a random number generator. We conducted a thematic content analysis of 50 random portfolio entries to identify lessons learned. Two independent raters analyzed the “3 lessons learned” portion of the portfolio entries and identified themes and subthemes using the constant comparative method used in grounded theory. Results The collaborative coding process resulted in theme saturation after the identification of 7 themes and their subthemes. Themes in decreasing order of frequency included complications, disease epidemiology, disease presentation, surgical management of disease, medical management of disease, operative techniques, and pathophysiology. Junior residents chose to focus on a broad array of foundational topics including disease presentation, epidemiology, and overall management of diseases, whereas postgraduate year-4 (PGY-4) and PGY-5 residents most frequently chose to focus on complications as learning points. Conclusions Lessons learned reflect perceived needs of the trainees based on training year. When given a template to follow, junior and senior residents choose to reflect on different subject matter to meet their learning goals. PMID:22379531

The impact of stakeholder involvement in hospital policy decision-making: a study of the hospital's business processes.

PubMed

Malfait, Simon; Van Hecke, Ann; Hellings, Johan; De Bodt, Griet; Eeckloo, Kristof

2017-02-01

In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hospital's board of directors on themes of strategic importance. To study the internal hospital's decision processes in order to identify the impact of a stakeholder involvement committee on strategic themes in the hospital decision processes. A retrospective analysis of the decision processes was conducted in three hospitals that implemented a stakeholder committee. The analysis consisted of process and outcome evaluation. Fifteen themes were discussed in the stakeholder committees, whereof 11 resulted in a considerable change. None of these were on a strategic level. The theoretical model was not applied as initially developed, but was altered by each hospital. Consequentially, the decision processes differed between the hospitals. Despite alternation of the model, the stakeholder committee showed a meaningful impact in all hospitals on the operational level. As a result of the differences in decision processes, three factors could be identified as facilitators for success: (1) a close interaction with the board of executives, (2) the inclusion of themes with a more practical and patient-oriented nature, and (3) the elaboration of decisions on lower echelons of the organization. To effectively influence the organization's public accountability, hospitals should involve stakeholders in the decision-making process of the organization. The model of a stakeholder committee was not applied as initially developed and did not affect the strategic decision-making processes in the involved hospitals. Results show only impact at the operational level in the participating hospitals. More research is needed connecting stakeholder involvement with hospital governance.

Issues in Biomedical Research Data Management and Analysis: Needs and Barriers

PubMed Central

Anderson, Nicholas R.; Lee, E. Sally; Brockenbrough, J. Scott; Minie, Mark E.; Fuller, Sherrilynne; Brinkley, James; Tarczy-Hornoch, Peter

2007-01-01

Objectives A. Identify the current state of data management needs of academic biomedical researchers. B. Explore their anticipated data management and analysis needs. C. Identify barriers to addressing those needs. Design A multimodal needs analysis was conducted using a combination of an online survey and in-depth one-on-one semi-structured interviews. Subjects were recruited via an e-mail list representing a wide range of academic biomedical researchers in the Pacific Northwest. Measurements The results from 286 survey respondents were used to provide triangulation of the qualitative analysis of data gathered from 15 semi-structured in-depth interviews. Results Three major themes were identified: 1) there continues to be widespread use of basic general-purpose applications for core data management; 2) there is broad perceived need for additional support in managing and analyzing large datasets; and 3) the barriers to acquiring currently available tools are most commonly related to financial burdens on small labs and unmet expectations of institutional support. Conclusion Themes identified in this study suggest that at least some common data management needs will best be served by improving access to basic level tools such that researchers can solve their own problems. Additionally, institutions and informaticians should focus on three components: 1) facilitate and encourage the use of modern data exchange models and standards, enabling researchers to leverage a common layer of interoperability and analysis; 2) improve the ability of researchers to maintain provenance of data and models as they evolve over time though tools and the leveraging of standards; and 3) develop and support information management service cores that could assist in these previous components while providing researchers with unique data analysis and information design support within a spectrum of informatics capabilities. PMID:17460139

Analysis of the intellectual structure of human space exploration research using a bibliometric approach: Focus on human related factors

NASA Astrophysics Data System (ADS)

Lee, Tai Sik; Lee, Yoon-Sun; Lee, Jaeho; Chang, Byung Chul

2018-02-01

Human space exploration (HSE) is an interdisciplinary field composed of a range of subjects that have developed dramatically over the last few decades. This paper investigates the intellectual structure of HSE research with a focus on human related factors. A bibliometric approach with quantitative analytical techniques is applied to study the development and growth of the research. This study retrieves 1921 papers on HSE related to human factors from the year 1990 to the year 2016 from Web of Science and constructs a critical citation network composed of 336 papers. Edge-betweenness-based clustering is used to classify the citation network into twelve distinct research clusters based on four research themes: "biological risks from space radiation," "health and performance during long-duration spaceflight," "program and in-situ resources for HSE missions," and "habitat and life support systems in the space environment." These research themes are also similar to the classification results of a co-occurrence analysis on keywords for a total of 1921 papers. Papers with high centrality scores are identified as important papers in terms of knowledge flow. Moreover, the intermediary role of papers in exchanging knowledge between HSE sub-areas is identified using brokerage analysis. The key-route main path highlights the theoretical development trajectories. Due to the recent dramatic increase in investment by international governments and the private sector, the theoretical development trajectories of key research themes have been expanding from furthering scientific and technical knowledge to include various social and economic issues, thus encouraging massive public participation. This study contributes to an understanding of research trends and popular issues in the field of HSE by introducing a powerful way of determining major research themes and development trajectories. This study will help researchers seek the underlying knowledge diffusion flow from multifaceted aspects to establish future research directions.

Refugees, asylum-seekers and undocumented migrants and the experience of parenthood: a synthesis of the qualitative literature.

PubMed

Merry, Lisa; Pelaez, Sandra; Edwards, Nancy C

2017-09-19

To synthesize the recent qualitative literature and identify the integrative themes describing the parenthood experiences of refugees, asylum-seekers and undocumented migrants. We searched seven online databases for the period January 2006 to February 2017. We included English and French published peer-reviewed articles and graduate-level dissertations, which qualitatively examined the parenthood experiences of refugees, asylum-seekers and undocumented migrants. We summarized study characteristics and performed a thematic analysis across the studies. One hundred thirty eight studies met inclusion criteria. All but three were conducted in high-income countries, mainly in the US. Migrants studied were mostly undocumented from Latin America and refugees from Sub-Saharan Africa. Almost all studies (93%) included mothers; about half (47%) included fathers; very few (5%) included extended family members. We identified three integrative themes: 1) experiencing hardship and/or loss in the context of precarious migration and past traumas; 2) building resilience and strength by bridging language, norms and expectations; and 3) living transnationally: obligations, challenges and resources. Each theme contributed to shaping the parenthood experience; the transnationalism theme intersected with the themes on hardship and loss and resilience and strength. More research is needed with fathers, extended family members, asylum-seekers and in the LMIC context. A transnational lens needs to be applied to programs, policies and future research for refugee, asylum-seeker and undocumented migrant parents. Addressing transnational concerns (family separation and reunification), acknowledging transnational resources, fostering a transnational family identity and conducting transnational and longitudinal studies are potentially pivotal approaches for this sub-population of parents.

Uncorrected and corrected refractive error experiences of Nepalese adults: a qualitative study.

PubMed

Kandel, Himal; Khadka, Jyoti; Shrestha, Mohan Krishna; Sharma, Sadhana; Neupane Kandel, Sandhya; Dhungana, Purushottam; Pradhan, Kishore; Nepal, Bhagavat P; Thapa, Suman; Pesudovs, Konrad

2018-04-01

The aim of this study was to explore the impact of corrected and uncorrected refractive error (URE) on Nepalese people's quality of life (QoL), and to compare the QoL status between refractive error subgroups. Participants were recruited from Tilganga Institute of Ophthalmology and Dhulikhel Hospital, Nepal. Semi-structured in-depth interviews were conducted with 101 people with refractive error. Thematic analysis was used with matrices produced to compare the occurrence of themes and categories across participants. Themes were identified using an inductive approach. Seven major themes emerged that determined refractive error-specific QoL: activity limitation, inconvenience, health concerns, psycho-social impact, economic impact, general and ocular comfort symptoms, and visual symptoms. Activity limitation, economic impact, and symptoms were the most important themes for the participants with URE, whereas inconvenience associated with wearing glasses was the most important issue in glasses wearers. Similarly, possibilities of having side effects or complications were the major concerns for participants wearing contact lens. In general, refractive surgery addressed socio-emotional impact of wearing glasses or contact lens. However, the surgery participants had concerns such as possibility of having to wear glasses again due to relapse of refractive error. Impact of refractive error on people's QoL is multifaceted. Significance of the identified themes varies by refractive error subgroups. Refractive correction may not always address QoL impact of URE but often add unique QoL issues. This study findings also provide content for developing an item-bank for quantitatively measuring refractive error-specific QoL in developing country setting.

From will to live to will to die: oncologists, nurses, and social workers identification of suicidality in cancer patients.

PubMed

Granek, Leeat; Nakash, Ora; Ariad, Samuel; Chen, Wendy; Birenstock-Cohen, Shira; Shapira, Shahar; Ben-David, Merav

2017-12-01

The purpose of this research was to examine how oncologists, nurses, and social workers identify suicidality in cancer patients. Sixty-one healthcare professionals (23 oncologists, 18 social workers, and 20 nurses) at two academic cancer centers were interviewed using an in-depth interview guide. This was a qualitative study based on grounded theory methodology. Analysis involved line-by-line coding, with categories and themes emerging from participants' narratives. Suicidality in cancer patients exists on a wide spectrum that ranges from an active will to live to an active will to die. Four phases were identified that included: (A) a strong will to live expressed in themes of active treatments, seeking second opinions, overtreatment, and alternative treatments; (B) a decreasing will to live indicated in themes of mental health distress and physical pain and suffering; (C) a readiness to die expressed in themes of mental health distress, previous mental health diagnoses, physical pain, avoiding more suffering, preserving quality of life in old age, nearing end of life, lack of social support, and maintaining a sense of control; and (D) a will to die indicated in themes of euthanasia and active suicidality. Suicidality in cancer patients exists on a continuum. Cancer patients fluctuate on this spectrum depending on circumstances such as degree of suffering, their personalities and life circumstances, and whether they are nearing the end of life. Results of the study emphasize the need to collect more context specific data on suicidality among cancer patients and the importance of early integration of psychosocial and palliative care in the cancer treatment trajectory.

What Happens to the Farm? Australian Farmers' Experiences after a Serious Farm Injury.

PubMed

Beattie, Jessica; McLeod, Candis; Murray, Meg; Pedler, Daryl; Brumby, Susan; Gabbe, Belinda

2018-01-01

To investigate the experiences of farmers on returning to farming following a serious farm-related injury. Patients who had sustained major trauma on a farm in Victoria, Australia, were identified using the Victorian State Trauma Registry (VSTR). In depth, semistructured phone interviews were conducted with 31 participants. Interview data were subjected to thematic analysis to identify important recurring themes. Interviews continued until data saturation was achieved. Interviewees included self-employed full-time farmers, part-time farmers with a supplementary income, and agricultural employees. Analysis of participant responses connected to returning to farming after a serious farm-related injury identified five major interconnected themes: (i) effect on farm work, (ii) farming future, (iii) safety advocacy, (iv) changes to farming practices, and (v) financial ramifications. Farmers who have sustained a serious farm-related injury are an important resource; their experiences and perspectives could assist in the development of educational and transitional support services from recovery back to working at a preinjury level, while ensuring farming production is sustainable during this period. Furthermore, farm safety programs can be enhanced by the engagement of farmers, such as participants in this study as advocates for improved farm safety practices.

Understanding Sexual Abstinence in Urban Adolescent Girls

PubMed Central

Morrison-Beedy, Dianne; Carey, Michael P.; Côté-Arsenault, Denise; Seibold-Simpson, Susan; Robinson, Kerry Anne

2008-01-01

Objectives To gain insight into the context of sexual abstinence and identify potential determinants of abstinence in this population. Design Four focus groups. Participants and Setting Twenty-four, predominantly African American (88%) girls aged 14 to 19 years were recruited from urban health centers and youth development programs in Rochester, New York, between September and December 2006. Data Analysis Content analysis was used to analyze the four verbatim transcripts. Using analytic induction, groups were compared and contrasted at the micro (within-group) and macro (between-group) levels to identify themes. Results Four themes were identified that provided insight into how and why these girls remain abstinent despite being in sexually active social climates. They focused on the following: self-respect (I'm worth it), impact of mothers (Mama says … think before you let it go), influence of boys and other peers (Boys will be boys), and potential negative consequences of sex (Hold on, there's a catch). Conclusions Developing interventions to maintain abstinence, delay onset of sexual activity, and promote protected first and subsequent sexual contact in abstinent girls are key to decreasing future sexual risk. These findings suggest opportunities to develop HIV prevention strategies tailored to the needs of abstinent girls. PMID:18336442

How do individuals with persecutory delusions bring worry to a close? An interpretive phenomenological analysis.

PubMed

Startup, Helen; Pugh, Katherine; Cordwell, Jacinta; Kingdon, David; Freeman, Daniel

2015-07-01

Worry is a significant problem for individuals with paranoia, leading to delusion persistence and greater levels of distress. There are established theories concerning processes that maintain worry but little has been documented regarding what brings worry to a close. The aim was to find out what patients with persecutory delusions report are the factors that bring a worry episode to an end. Eight patients with persecutory delusions who reported high levels of worry participated. An open-ended semi-structured interview technique and IPA qualitative analysis was employed to encourage a broad elaboration of relevant constructs. Analyses revealed one theme that captured participants' detailed descriptions of their experience of worry and five themes that identified factors important for bringing worry episodes to a close: natural drift, distraction, interpersonal support, feeling better, and reality testing. Patients with persecutory delusions report worry being uncontrollable and distressing but are able to identify ways that a period of worry can stop. The present study suggests that building on individuals' distraction techniques, reality testing ability and their social support network could be of benefit. Research is needed to identify the most effective means of bringing paranoid worries to an end.

Exploring the emerging profession of speech-language pathology in Vietnam through pioneering eyes.

PubMed

Atherton, Marie; Davidson, Bronwyn; McAllister, Lindy

2017-04-01

In September 2012, 18 Vietnamese health professionals graduated as Vietnam's first university qualified speech-language pathologists (SLPs). This study details the reflections of these pioneering health professionals at 12 months following their graduation, drawing attention to their scope of practice as SLPs and to the opportunities and challenges to progressing the practice of speech-language pathology (SLP) in Vietnam. Thirteen graduates participated in small group interviews where they described their work and their perceptions of their emerging practice. Thematic analysis of the interview transcripts was employed to identify key concepts and themes within the data. Four overarching themes were identified-scope of practice, establishing identity, confidence to practise and progressing the profession. Overall analysis revealed evolving professional practice characterised by new learning, fluctuations in confidence and an active forging of professional identity. Mentoring and support by international colleagues and advancing professional recognition were identified as critical to the profession's progression and to the development of context-specific and culturally appropriate services. Participants' reflections draw focus to an important role for the international SLP community as it works in partnership with colleagues to enhance awareness of and services for people with communication disabilities in under-served communities such as Vietnam.

Child and Adolescent Perceptions of Oral Health Over the Life Course

PubMed Central

Maida, Carl A.; Marcus, Marvin; Hays, Ron D.; Coulter, Ian D.; Ramos-Gomez, Francisco; Lee, Steve Y.; McClory, Patricia S.; Van, Laura V.; Wang, Yan; Shen, Jie; Cai, Li; Spolsky, Vladimir W.; Crall, James J.; Liu, Honghu

2016-01-01

Purpose To elicit perceptions of oral health in children and adolescents as an initial step in the in the development of oral health item banks for the Patient-Reported Oral Health Outcomes Measurement Information System project. Methods We conducted focus groups with ethnically, socioeconomically, and geographically diverse youth (8-12, 13-17 years) to identify perceptions of oral health status. We performed content analysis, including a thematic and narrative analysis, to identify important themes. Results We identified three unique themes that the youth associated with their oral health status: 1) understanding the value of maintaining good oral health over the life course, with respect to longevity and quality of life in the adult years; 2) positive association between maintaining good oral health and interpersonal relationships at school, and dating, for older youth; and 3) knowledge of the benefits of orthodontic treatment to appearance and positive self-image, while holding a strong view as to the discomfort associated with braces. Conclusions The results provide valuable information about core domains for the oral health item banks to be developed and generated content for new items to be developed and evaluated with cognitive interviews and in a field test. PMID:26038216

Sexual Harassment: A Research Analysis and Agenda for the 1990s.

ERIC Educational Resources Information Center

Fitzgerald, Louise F.; Shullman, Sandra L.

1993-01-01

Reviews two major themes in sexual harassment research (prevalence figures and perceptions/attributions) and two emerging areas (victim responses and organizational factors). Identifies lack of research on training interventions and organizational response patterns as well as a lack of conceptual clarity and specificity in research. (81…

The New Trends in Adaptive Educational Hypermedia Systems

ERIC Educational Resources Information Center

Somyürek, Sibel

2015-01-01

This paper aims to give a general review of existing literature on adaptive educational hypermedia systems and to reveal technological trends and approaches within these studies. Fifty-six studies conducted between 2002 and 2012 were examined, to identify prominent themes and approaches. According to the content analysis, the new technological…

Career Counseling Process: A Qualitative Analysis of Experts' Cases

ERIC Educational Resources Information Center

Whiston, Susan C.; Lindeman, Dawn; Rahardja, Daryn; Reed, Jordan H.

2005-01-01

A consensual qualitative research methodology was used to analyze the career counseling cases of 12 noted vocational psychologists to identify common themes and factors. The findings indicated that the career counseling described by these experts often involved the same counseling or helping skills found in personal counseling or psychotherapy.…

Loss to Follow-Up: Issues and Recommendations

ERIC Educational Resources Information Center

Hoffman, Jeff; Munoz, Karen F.; Bradham, Tamala S.; Nelson, Lauri

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Related to how EHDI programs address loss to follow-up, 47 coordinators responded with 277 items, and themes were identified in each…

Is the Infrastructure of EHDI Programs Working?

ERIC Educational Resources Information Center

Houston, K. Todd; Hoffman, Jeff; Munoz, Karen F.; Bradham, Tamala S.

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the EHDI program infrastructure area, 47 coordinators responded with a total of 292 items, and themes were identified in each…

Transitioning through College with Diabetes: Themes Found in Online Forums

ERIC Educational Resources Information Center

Ravert, Russell D.; Boren, Suzanne A.; Wiebke, Emily

2015-01-01

Objective: Content analysis of Internet-based diabetes forum text was used to examine the experiences encountered by students with diabetes transitioning into and through college. Participants: Forum posts (N = 238) regarding attending college with diabetes were collected and analyzed. Methods: Thematic coding was used to identify prominent…

The Role of Teachers in Peer Conflict: Implications for Teacher Reflections

ERIC Educational Resources Information Center

Blunk, Elizabeth M.; Russell, Elizabeth Morgan; Armga, Carol J.

2017-01-01

The purpose of this qualitative study was to explore early childhood teachers' interventions during peer conflict. Fifteen ethnically diverse teachers in central Texas were asked to reflect on videotaped peer conflict situations. Using thematic analysis, five strategy themes were identified: prevent aggression, consider timing, stop conflict,…

Decision-Making Phenomena Described by Expert Nurses Working in Urban Community Health Settings.

ERIC Educational Resources Information Center

Watkins, Mary P.

1998-01-01

Expert community health nurses (n=28) described crucial clinical situations. Content analysis revealed that decision making was both rational and intuitive. Eight themes were identified: decision-making focus, type, purpose, decision-maker characteristics, sequencing of events, data collection methods, facilitators/barriers, and decision-making…

Changing Times in Adult Literacy Provision: Competition or Not?

ERIC Educational Resources Information Center

Bhela, Baljit

2002-01-01

Analysis of Australian national and state policies and reports on adult literacy identified themes and issues: (1) movement from volunteerism to marketization to globalization; (2) fluctuations and reductions in funding; (3) changes in the role of professional associations due to political and educational agendas; and (4) increased ties to…

An Examination of Paternal Influence on High-Achieving Gifted Males

ERIC Educational Resources Information Center

Hebert, Thomas P.; Pagnani, Alexander R.; Hammond, Daniel R.

2009-01-01

The challenges facing contemporary boys are complex, highlighting the importance of positive paternal influence for young men to achieve success. This study examines the father-son relationships of 10 prominent gifted men of achievement to identify factors influencing talent development. Through biographical analysis, 6 significant themes were…

Men's wilderness experience and spirituality: further explorations

Treesearch

Paul Heintzman

2008-01-01

Most previous research on wilderness experience and spirituality focuses on women only or mixed male and female groups. This qualitative research study investigated the spiritual impact of participation in a men-only wilderness canoe trip. In-depth interviews were conducted after the trip with six participants. Interpretive analysis identified five themes: spiritual...

Fostering Quality Improvement in EHDI Programs

ERIC Educational Resources Information Center

Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd; Guignard, Gayla Hutsell

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each…

Data Management in the EHDI System

ERIC Educational Resources Information Center

Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within EHDI programs. Forty-seven coordinators listed 242 items in the area of data management, and themes were identified in each category. A threats, opportunities,…

Dismissed! Avoidance of Students' Spiritual and LGBT Identities in Public Schools

ERIC Educational Resources Information Center

Schwarz, Jill; Roe, Stuart

2015-01-01

Negotiation of identity development in adolescence has implications that affect overall well-being. Spirituality and sexuality are two salient aspects of identity that are challenging for adolescents, especially those who identify as LGBT. Analysis of intersecting themes across two research inquiries indicated that school counselors and students…

Students' Attitudes towards Individuals with an Intellectual Disability

ERIC Educational Resources Information Center

Patel, Meera; Rose, John

2014-01-01

The aim of the study was to investigate attitudes held by a British student population towards individuals with an intellectual disability. Students participated in focus groups addressing their attitudes, behaviours and perceptions of individuals with an intellectual disability. Thematic analysis was the method used to identify emergent themes.…

Outsourcing within aerospace manufacturing enterprises: A phenomenological study and outsourcing leadership model

NASA Astrophysics Data System (ADS)

Sampson, Enrique, Jr.

Many aerospace workers believe transferring work projects abroad has an erosive effect on the U.S. aerospace industry (Pritchard, 2002). This qualitative phenomenological study examines factors for outsourcing decisions and the perceived effects of outsourcing on U.S. aerospace workers. The research sample consists of aerospace industry leaders and nonleaders from the East Coast, Midwest, and West Coast of the United States. Moustakas' modified van Kaam methods of analysis (1994) and Decision Explorer analysis software were applied to the interview transcripts. Resultant data identified five core themes: communication, best value, opportunities, cost, and offset consideration. The themes provided the framework for a model designed to assist leaders in making effective decisions and communicating the benefits of those decisions when considering outsourcing of work projects.

Coaching mothers of children with autism: a qualitative study for occupational therapy practice.

PubMed

Foster, Lauren; Dunn, Winnie; Lawson, Lisa Mische

2013-05-01

ABSTRACT The purpose of this study was to understand the perceptions of mothers of children with autism spectrum disorder (ASD) who participated in 10 one-hour coaching sessions. Coaching occurred between an occupational therapist and mother and consisted of information sharing, action, and reflection. Researchers asked 10 mothers six open-ended questions with follow-up probes related to their experiences with coaching. Themes were identified, labeled, and categorized. Themes emerged related to relationships, analysis, reflection, mindfulness, and self-efficacy. Findings indicate that parents perceive the therapist-parent relationship, along with analysis and reflection, as core features that facilitate increased mindfulness and self-efficacy. The findings suggest that how an intervention is provided can lead to positive outcomes, including increased mindfulness and self-efficacy.

The Second Closet: A Qualitative Study of HIV Stigma Among Seropositive Gay Men in a Southern U.S. City

PubMed Central

Ross, Michael W.

2014-01-01

Objectives Stigma connected with HIV/AIDS has decreased considerably since the early epidemic yet affects those living with HIV in many ways. Little research, particularly qualitative research, concerning HIV stigma from the perspective of gay men has emerged. The present qualitative study aimed to fill this evidence gap by examining how HIV stigma is perceived and experienced by gay men who have become HIV-infected and how they respond to this stigma. Methods Thematic analysis of 19 gay men's narratives identified six main themes. Results Encountering HIV stigmatization was common and was linked to the physical stigmata identifying respondents as HIV-positive. Overwhelmingly, they found stigmatization to be most intensely felt within gay communities. One profound theme was internalized HIV stigma, referring to respondents' internalized negative feelings about their HIV status. A related theme was the closeted nature of HIV. Lastly, regarding how the men dealt with the HIV diagnosis and experiences of HIV stigma, a theme of adaptation became clear. Conclusions Although exploratory, the results can serve as a beginning framework for understanding and assisting seropositive gay men who experience HIV stigma. The findings are important because it is realistic to expect that in a climate in which HIV has become increasingly invisible and closeted and in which infections are on the rise, gay and bisexual men will be increasingly affected and infected by HIV. PMID:25170366

Accepting the challenge: what academic health sciences library directors do to become effective leaders.

PubMed

Fought, Rick L; Misawa, Mitsunori

2018-04-01

This study sought to better understand effective leadership through the lived experiences of academic health sciences library directors. Phenomenological interviews were conducted with eight academic health sciences library directors to capture the essence of their shared leadership experiences. The research question that guided the study was: How do academic health sciences library directors understand their leadership effectiveness? The interviews were transcribed and coded, and the data were analyzed thematically. Three main themes emerged from data after analysis: assessment of the environment, strategies and decisions, and critical skills. Assessment of the environment includes awareness not only of trends in libraries and technology, but also the trends in health information, higher education, and current events and politics of their institutions and states. The strategies and decisions theme is about the ability to think both in the long-term and short-term when leading the library. Finally, critical skills are those leadership skills that the research participants identified as most important to their leadership effectiveness. The study identified three main themes capturing the essence of the research participants' leadership experiences. The three themes constitute a wide array of leadership skills that are important to learn, understand, and develop to increase leadership effectiveness. Effective leadership is fundamental to obtaining long-term strategic goals and is critical to the long-term future of the libraries.

Breast cancer patients' information seeking during surgical consultations: A qualitative, videotape-based analysis of patients' questions.

PubMed

Robinson, Jeffrey D; Venetis, Maria; Street, Richard L; Kearney, Thomas

2016-12-01

Despite data on breast cancer patients' information needs and their association with patient outcomes, there are currently no data on what U.S. patients actually ask surgeons during primary consultations. Working from transcripts of videotaped, treatment decision making consultations between breast cancer patients and surgeons, we identify all questions (by patients and companions) and then use grounded theory techniques to determine the most recurrent question-asking themes. Sample includes 132 recently diagnosed (M = 8.9 days), late-middle-aged (M = 61.2 years), female patients with predominantly early stage (0-1; 78%), first-time breast cancer (92.4%) consulting with one of nine surgeons in community based offices. Transcripts contained 2,781 questions (1,929 by patients, 852 by companions; Cohen's Kappa = 0.90), which generated 15 patient question asking themes that were represented (i.e., asked about) at least once in >20% of all consultations. Question asking themes are a concrete index of what patients want to know more about prior to treatment. Identified themes specify, modify, and extend prior findings based on self-report data. Findings potentially increase surgeons' levels of patient centered care by improving surgeons' abilities to satisfactorily address patients' information needs, which has the potential to improve both patient outcomes and clinical practice guidelines. J. Surg. Oncol. 2016;114:922-929. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Examining Perceptions of a Smartphone-Based Intervention System for Alcohol Use Disorders

PubMed Central

Bacon, Samantha; King, Diane K.; Dulin, Patrick; Gonzalez, Vivian

2014-01-01

Abstract Background: This study presents results from qualitative interviews conducted with participants in a study on the effectiveness of the Location-Based Monitoring and Intervention System for Alcohol Use Disorders (LBMI-A), a smartphone-based, stand-alone intervention application (app) for adults with alcohol use disorders. Materials and Methods: Participants were provided an LBMI-A-enabled smartphone to use during a 6-week pilot study. The LBMI-A was composed of psychoeducational modules, assessment and feedback of alcohol use patterns, geographic high-risk location monitoring and alerts, and in vivo assessment and intervention for alcohol cravings and help with managing psychological distress. Semistructured interviews were conducted with all participants following 6 weeks of interacting with the LBMI-A app (n=26). Interviews explored user perceptions of the ease and utility of LBMI-A features, module helpfulness, barriers to use, and recommendations for improvements to the program. Researchers applied a systematic qualitative coding process to transcripts that included both a priori themes identified as important by the research team and new themes that emerged during the coding process. Results and Conclusions: Narrative analysis found the emergence of five main themes identified by LBMI-A users as the most helpful functions of the phone: (1) Awareness, (2) Accountability, (3) Skill Transference, (4) Tracking Progress, and (5) Prompts. These themes are explored, and implications of these findings for future smartphone-based interventions are discussed. PMID:25243480

Accepting the challenge: what academic health sciences library directors do to become effective leaders

PubMed Central

Fought, Rick L.; Misawa, Mitsunori

2018-01-01

Objective This study sought to better understand effective leadership through the lived experiences of academic health sciences library directors. Methods Phenomenological interviews were conducted with eight academic health sciences library directors to capture the essence of their shared leadership experiences. The research question that guided the study was: How do academic health sciences library directors understand their leadership effectiveness? The interviews were transcribed and coded, and the data were analyzed thematically. Results Three main themes emerged from data after analysis: assessment of the environment, strategies and decisions, and critical skills. Assessment of the environment includes awareness not only of trends in libraries and technology, but also the trends in health information, higher education, and current events and politics of their institutions and states. The strategies and decisions theme is about the ability to think both in the long-term and short-term when leading the library. Finally, critical skills are those leadership skills that the research participants identified as most important to their leadership effectiveness. Conclusions The study identified three main themes capturing the essence of the research participants’ leadership experiences. The three themes constitute a wide array of leadership skills that are important to learn, understand, and develop to increase leadership effectiveness. Effective leadership is fundamental to obtaining long-term strategic goals and is critical to the long-term future of the libraries. PMID:29632444

An ethnographic study of illness perceptions and practices of Yemeni-Arabs in Michigan.

PubMed

Kulwicki, A

1996-01-01

The purpose of this study was to explore the illness practices of Yemeni-Arab Americans and to generate illness themes based on informant reports. A convenient sample of 30 Yemeni-Arab American women was selected from Dearborn, Michigan. A content analysis of interview data was the basis for data analysis. The Arabic language was used in all the interviews due to enability of the informants to speak English. Thirty-three illness practices were identified by the study informants. Analysis of interview data indicated that informants relied heavily on religious explanations of illness practices. Several cultural themes were deduced from collected data. Among these were belief in an omnipotent deity who is the cause of all that is, confidence in the rational mind of man and empirical knowledge, susceptibility to disease based on gender, reliance and trust in health care providers and desirability of adapting to change.

Systematic text condensation: a strategy for qualitative analysis.

PubMed

Malterud, Kirsti

2012-12-01

To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies. Giorgi's psychological phenomenological analysis is the point of departure and inspiration for systematic text condensation. The basic elements of Giorgi's method and the elaboration of these in systematic text condensation are presented, followed by a detailed description of procedures for analysis according to systematic text condensation. Finally, similarities and differences compared with other frequently applied methods for qualitative analysis are identified, as the foundation of a discussion of strengths and limitations of systematic text condensation. Systematic text condensation is a descriptive and explorative method for thematic cross-case analysis of different types of qualitative data, such as interview studies, observational studies, and analysis of written texts. The method represents a pragmatic approach, although inspired by phenomenological ideas, and various theoretical frameworks can be applied. The procedure consists of the following steps: 1) total impression - from chaos to themes; 2) identifying and sorting meaning units - from themes to codes; 3) condensation - from code to meaning; 4) synthesizing - from condensation to descriptions and concepts. Similarities and differences comparing systematic text condensation with other frequently applied qualitative methods regarding thematic analysis, theoretical methodological framework, analysis procedures, and taxonomy are discussed. Systematic text condensation is a strategy for analysis developed from traditions shared by most of the methods for analysis of qualitative data. The method offers the novice researcher a process of intersubjectivity, reflexivity, and feasibility, while maintaining a responsible level of methodological rigour.

To Drug or Not to Drug: A Qualitative Study of Patients' Decision-Making Processes for Managing Insomnia.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Laba, Tracey-Lea; Saini, Bandana

2018-01-01

Treatment preferences play a key role in dictating sleep health outcomes. However, patients' treatment beliefs, attitudes, and experiences that inform preference conceptualization remain an unknown phenomenon. Therefore, this study aims to explore patient perceptions toward pharmacotherapy and the nonpharmacological management of insomnia. Fifty-one patients with insomnia were recruited from specialist clinics and general community settings. Participants completed a brief questionnaire followed by an in-depth semistructured interview that was digitally recorded, transcribed verbatim, and subjected to Framework Analysis to identify emergent themes. Three key themes were identified: Resolving Insomnia, Self-Imposed Treatment Boundaries, and Treatment Uptake. Patients' illness, treatment, and psychosocial beliefs and experiences are closely linked to treatment choice. Being attuned to these influences during the clinical encounter can facilitate treatment selection that is meaningful for the patient.

Consultant psychiatrists’ experiences of and attitudes towards shared decision making in antipsychotic prescribing, a qualitative study

PubMed Central

2014-01-01

Background Shared decision making represents a clinical consultation model where both clinician and service user are conceptualised as experts; information is shared bilaterally and joint treatment decisions are reached. Little previous research has been conducted to assess experience of this model in psychiatric practice. The current project therefore sought to explore the attitudes and experiences of consultant psychiatrists relating to shared decision making in the prescribing of antipsychotic medications. Methods A qualitative research design allowed the experiences and beliefs of participants in relation to shared decision making to be elicited. Purposive sampling was used to recruit participants from a range of clinical backgrounds and with varying length of clinical experience. A semi-structured interview schedule was utilised and was adapted in subsequent interviews to reflect emergent themes. Data analysis was completed in parallel with interviews in order to guide interview topics and to inform recruitment. A directed analysis method was utilised for interview analysis with themes identified being fitted to a framework identified from the research literature as applicable to the practice of shared decision making. Examples of themes contradictory to, or not adequately explained by, the framework were sought. Results A total of 26 consultant psychiatrists were interviewed. Participants expressed support for the shared decision making model, but also acknowledged that it was necessary to be flexible as the clinical situation dictated. A number of potential barriers to the process were perceived however: The commonest barrier was the clinician’s beliefs regarding the service users’ insight into their mental disorder, presented in some cases as an absolute barrier to shared decision making. In addition factors external to the clinician - service user relationship were identified as impacting on the decision making process, including; environmental factors, financial constraints as well as societal perceptions of mental disorder in general and antipsychotic medication in particular. Conclusions This project has allowed identification of potential barriers to shared decision making in psychiatric practice. Further work is necessary to observe the decision making process in clinical practice and also to identify means in which the identified barriers, in particular ‘lack of insight’, may be more effectively managed. PMID:24886121

Consultant psychiatrists' experiences of and attitudes towards shared decision making in antipsychotic prescribing, a qualitative study.

PubMed

Shepherd, Andrew; Shorthouse, Oliver; Gask, Linda

2014-05-01

Shared decision making represents a clinical consultation model where both clinician and service user are conceptualised as experts; information is shared bilaterally and joint treatment decisions are reached. Little previous research has been conducted to assess experience of this model in psychiatric practice. The current project therefore sought to explore the attitudes and experiences of consultant psychiatrists relating to shared decision making in the prescribing of antipsychotic medications. A qualitative research design allowed the experiences and beliefs of participants in relation to shared decision making to be elicited. Purposive sampling was used to recruit participants from a range of clinical backgrounds and with varying length of clinical experience. A semi-structured interview schedule was utilised and was adapted in subsequent interviews to reflect emergent themes.Data analysis was completed in parallel with interviews in order to guide interview topics and to inform recruitment. A directed analysis method was utilised for interview analysis with themes identified being fitted to a framework identified from the research literature as applicable to the practice of shared decision making. Examples of themes contradictory to, or not adequately explained by, the framework were sought. A total of 26 consultant psychiatrists were interviewed. Participants expressed support for the shared decision making model, but also acknowledged that it was necessary to be flexible as the clinical situation dictated. A number of potential barriers to the process were perceived however: The commonest barrier was the clinician's beliefs regarding the service users' insight into their mental disorder, presented in some cases as an absolute barrier to shared decision making. In addition factors external to the clinician - service user relationship were identified as impacting on the decision making process, including; environmental factors, financial constraints as well as societal perceptions of mental disorder in general and antipsychotic medication in particular. This project has allowed identification of potential barriers to shared decision making in psychiatric practice. Further work is necessary to observe the decision making process in clinical practice and also to identify means in which the identified barriers, in particular 'lack of insight', may be more effectively managed.

Experiences of surgical continence management approaches for cloacal anomalies: a qualitative analysis based on 6 women.

PubMed

Liao, L-M; Baker, E; Boyle, M E; Woodhouse, C R J; Creighton, S M

2014-10-01

The aim of this qualitative study was to gain insight into health care experiences of young women diagnosed with cloacal anomalies, with a special focus on continence management. Qualitative analysis of one-to-one interviews. A tertiary center for congenital anomalies of the urogenital tract in London. Six women aged 16 to 24 with cloacal anomalies. Tape-recorded one-to-one semi-stuctured interviews with a skilled interviewer. The taped interviews were transcribed and analyzed verbatim using interpretative phenomenological analysis according to the research question. Organizing themes across all of the accounts were identified. Two organizing themes concerning our research interests are summarized. The first theme Personal Agency in the Hands of Experts focuses on the interviewees' appreciation of their life-saving surgical care and their involvement in treatment decisions. The second theme Compromises and Trade-Offs focuses on what it was like to live with the more traditional versus the more advanced continence methods. Reliability emerged as a key priority in terms of continence treatment outcome. Gratitude may have interfered with the women's honest communications during treatment decision and evaluation consultations. A more developed approach to communication about the complex interventions proposed, founded on a nuanced understanding of users perspectives, can enhance informed decision making about continence management approaches. Despite these specific gaps, the interviewees were appreciative of their care and optimistic about life. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Understanding the Impact of Residents' Interpersonal Relationships During Emergency Department Referrals and Consultations

PubMed Central

Chan, Teresa; Sabir, Kameron; Sanhan, Sarila; Sherbino, Jonathan

2013-01-01

Background Communicating with colleagues is a key physician competency. Yet few studies have sought to uncover the complex nature of relationships between referring and consulting physicians, which may be affected by the inherent relationships between the participants. Objective Our study examines themes identified from discussions about communications and the role of relationships during the referral-consultation process. Methods From March to September 2010, 30 residents (10 emergency medicine, 10 general surgery, 10 internal medicine) were interviewed using a semistructured focus group protocol. Two investigators independently reviewed the transcripts using inductive methods and grounded theory to generate themes (using codes for ease of analysis) until saturation was reached. Disagreements were resolved by consensus, yielding an inventory of themes and subthemes. Measures for ensuring trustworthiness of the analysis included generating an audit trail and external auditing of the material by investigators not involved with the initial analysis. Results Two main relationship-related themes affected the referral-consultation process: familiarity and trust. Various subthemes were further delineated and studied in the context of pertinent literature. Conclusions Relationships between physicians have a powerful influence on the emergency department referral-consultation dynamic. The emergency department referral-consultation may be significantly altered by the familiarity and perceived trustworthiness of the referring and consulting physicians. Our proposed framework may further inform and improve instructional methods for teaching interpersonal communication. Most importantly, it may help junior learners understand inherent difficulties they may encounter during the referral process between emergency and consulting physicians. PMID:24455004

Promoting and Protecting Against Stigma in Assisted Living and Nursing Homes

PubMed Central

Zimmerman, Sheryl; Dobbs, Debra; Roth, Erin G.; Goldman, Susan; Peeples, Amanda D.; Wallace, Brandy

2016-01-01

Purpose of the Study: To determine the extent to which structures and processes of care in multilevel settings (independent living, assisted living, and nursing homes) result in stigma in assisted living and nursing homes. Design and Methods: Ethnographic in-depth interviews were conducted in 5 multilevel settings with 256 residents, families, and staff members. Qualitative analyses identified the themes that resulted when examining text describing either structures of care or processes of care in relation to 7 codes associated with stigma. Results: Four themes related to structures of care and stigma were identified, including the physical environment, case mix, staff training, and multilevel settings; five themes related to processes of care and stigma, including dining, independence, respect, privacy, and care provision. For each theme, examples were identified illustrating how structures and processes of care can potentially promote or protect against stigma. Implications: In no instance were examples or themes identified that suggested the staff intentionally promoted stigma; on the other hand, there was indication that some structures and processes were intentionally in place to protect against stigma. Perhaps the most important theme is the stigma related to multilevel settings, as it has the potential to reduce individuals’ likelihood to seek and accept necessary care. Results suggest specific recommendations to modify care and reduce stigma. PMID:24928555

Perceptions of professionalism in dentistry - a qualitative study.

PubMed

Zijlstra-Shaw, S; Roberts, T E; Robinson, P G

2013-11-08

Professionalism is an essential competence for dental professionals. Dental educators require both a clear definition and an understanding of the scope of professionalism in order to teach and assess it. The aim of this study was to identify concepts of professionalism in dentistry and the themes within this construct. Semi-structured interviews with participants purposively sampled to ensure representation of relevant viewpoints. Qualitative framework analysis was used to induct themes. Four themes arose from the data: (i) professionalism as a second order competence, (ii) the expression of professionalism as dependent on context, (iii) reflection as a necessary component and (iv) professionalism encompasses both tacit and overt personal aspects. These results were then incorporated into a conceptual model of dental professionalism. Analysis of the interview data reveals that participants conceptualise professionalism as the manner in which one reflects on and reconciles different aspects of professional practice, which demonstrates acceptance of professional responsibility and accountability. It is manifested in the manner in which work is carried out. The definition and model conceptualise the construct of professionalism within dentistry that can be used to derive an educational and assessment system.

The Experience of Psychiatric Care of Adolescents with Anxiety-based School Refusal and of their Parents: A Qualitative Study.

PubMed

Sibeoni, Jordan; Orri, Massimiliano; Podlipski, Marc-Antoine; Labey, Mathilde; Campredon, Sophie; Gerardin, Priscille; Revah-Levy, Anne

2018-01-01

Anxiety-based school refusal in adolescence is a complex, sometimes difficult to treat disorder that can have serious academic and psychiatric consequences. The objective of this qualitative study was to explore how teens with this problem and their parents experience the psychiatric care received. This qualitative multicenter study took place in France, where we conducted semi-structured interviews with adolescents receiving psychiatric care for anxiety-based school refusal and with their parents. Data collection by purposive sampling continued until we reached theoretical sufficiency. Data analysis was thematic. This study included 20 adolescents aged 12 to 18 years and 21 parents. Two themes emerged from the analysis: (1) the goals of psychiatric care with two sub-themes, " self-transformation " and problem solving ; and, (2) the therapeutic levers identified as effective with two sub-themes: time and space and relationships . Our results show a divergence between parents and teens in their representations of care and especially of its goals. Therapeutic and research implications about the terms of return to school within psychiatric care and also the temporality of care are discussed.

Work-related musculoskeletal complaints: some ergonomics challenges upon the start of a new century.

PubMed

Westgaard, R H

2000-12-01

Three themes likely to be important within health-related ergonomics in the coming years are discussed. The first two themes concern methods for risk analysis of low-level biomechanical and psychosocial exposures. The third theme is approaches to successful implementation of ergonomics interventions. Evidence on the assessment of low-level biomechanical and psychosocial exposures by instrumented measurements is discussed. It is concluded that, despite recent advances in our understanding of exposure-effect associations under these exposure conditions, we must at present rely on more subjective methods, employed in a collaboration between expert and worker. This approach to risk analysis identifies in most cases critical exposures in a work situation. The focus should then be on the successful implementation of measures against those exposures, as identification alone does not solve problems. The aim of improved health for the workers further requires that the full complement of risk factors be considered, including work, leisure time and person-based risk factors. Finally, the need to put ergonomics intervention initiatives in an organisational context is emphasised, and examples of approaches used by Norwegian companies are presented.

It's hard to play ball: A qualitative study of knowledge exchange and silo effects in public health.

PubMed

Johnson, Rebecca; Grove, Amy; Clarke, Aileen

2018-01-02

Partnerships in public health form an important component of commissioning and implementing services, in England and internationally. In this research, we examine the views of staff involved in a City-wide health improvement programme which ran from 2009 to 2013 in England. We examine the practicalities of partnership work in community settings, and we describe some of barriers faced when implementing a large, multi-organisation health improvement programme. Qualitative, semi-structured interviews were performed. Purposive sampling was used to identify potential participants in the programme: programme board of directors, programme and project managers and intervention managers. Interviews were conducted one-to-one. We conducted a thematic analysis using the 'one sheet of paper' technique. This involved analysing data deductively, moving from initial to axial coding, developing categories and then identifying emerging themes. Fifteen interviews were completed. Three themes were identified. The first theme reflects how poor communication approaches hindered the ability of partnerships to deliver their aims and objectives in a range of ways and for a range of reasons. Our second theme reflects how a lack of appropriate knowledge exchange hindered decision-making, affected trust and contributed to protectionist approaches to working. This lack of shared, and communicated, understanding of what type of knowledge is most appropriate and in which circumstance made meaningful knowledge exchange challenging for decision-making and partnership-working in the City-wide health improvement programme. Theme three demonstrates how perceptions about silos in partnership-working could be problematic, but silos themselves were at times beneficial to partnerships. This revealed a mismatch between rhetoric and a realistic understanding of what components of the programme were functional and which were more hindrance than help. There were high expectations placed on the concept of what partnership work was, or how it should be done. We found our themes to be interdependent, and reflective of the 'dynamic fluid process' discussed within the knowledge mobilisation literature. We contend that reframing normal and embedded processes of silos and silo-working already in use might ease resistance to some knowledge exchange processes and contribute to better long-term functioning of public health partnerships.

Women's experiences of three early miscarriage management options a qualitative study

PubMed Central

Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo

2006-01-01

Background Miscarriage affects around one in six pregnancies. Much research has taken place identifying the consequences of this for parents but is mainly quantitative. Of the limited qualitative studies, none have explored women's experiences of the methods of miscarriage management received. Aim To assess the social and personal impact of different management methods (expectant, medical and surgical) on women's experience of first trimester miscarriage. Design of study Qualitative interviews using a topic guide with a purposive cohort of four categories of women (each management method plus non-participants) 6 months to 1 year after first trimester miscarriage. Focus groups with both research participants and health workers. Setting Women from three hospitals in the South West of England that participated in the Miscarriage Treatment (MIST) trial. Method Seventy-two interviews were undertaken between September 1999 and June 2000. There were also five focus groups (47 participants) and two feedback sessions (8 participants) with written feedback from 12 women. Interviews lasted 0.5–2.5 hours generating over 2000 A4 pages of transcripts. The transcripts were analysed for common themes, using standard proformas, which were filled in by individual team members and then discussed by the whole research team. Iterative readings in the light of new emerging issues ensured that new themes could be identified throughout the analytical process. All transcripts were then encoded for the identified themes using NUDIST. Results Common themes emerged across all management options although some were specific to just one or two management options. The five major themes arising out of the data analysis were: intervention; experiences of care; finality; the ‘baby’; and pain and bleeding. Conclusions Women's experiences and beliefs vary widely and their preferences need to be considered in their early miscarriage management. The three methods have different benefits and problems from the women's point of view. Competence and caring from professionals are especially important. PMID:16536960

Women's experiences of three early miscarriage management options: a qualitative study.

PubMed

Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo

2006-03-01

Miscarriage affects around one in six pregnancies. Much research has taken place identifying the consequences of this for parents but is mainly quantitative. Of the limited qualitative studies, none have explored women's experiences of the methods of miscarriage management received. To assess the social and personal impact of different management methods (expectant, medical and surgical) on women's experience of first trimester miscarriage. Qualitative interviews using a topic guide with a purposive cohort of four categories of women (each management method plus non-participants) 6 months to 1 year after first trimester miscarriage. Focus groups with both research participants and health workers. Women from three hospitals in the South West of England that participated in the Miscarriage Treatment (MIST) trial. Seventy-two interviews were undertaken between September 1999 and June 2000. There were also five focus groups (47 participants) and two feedback sessions (8 participants) with written feedback from 12 women. Interviews lasted 0.5-2.5 hours generating over 2000 A4 pages of transcripts. The transcripts were analysed for common themes, using standard proformas, which were filled in by individual team members and then discussed by the whole research team. Iterative readings in the light of new emerging issues ensured that new themes could be identified throughout the analytical process. All transcripts were then encoded for the identified themes using NUDIST. Common themes emerged across all management options although some were specific to just one or two management options. The five major themes arising out of the data analysis were: intervention; experiences of care; finality; the 'baby'; and pain and bleeding. Women's experiences and beliefs vary widely and their preferences need to be considered in their early miscarriage management. The three methods have different benefits and problems from the women's point of view. Competence and caring from professionals are especially important.

Transient disablement in the physically active with musculoskeletal injuries, part I: a descriptive model.

PubMed

Vela, Luzita I; Denegar, Craig

2010-01-01

Disablement theory has been characterized as the sequence of events that occurs after an injury, but little research has been conducted to establish how disablement is experienced and described by physically active persons. To describe the disablement process in physically active persons with musculoskeletal injuries. Concurrent, embedded mixed-methods study. For the qualitative portion, interviews were conducted to create descriptive disablement themes. For the quantitative portion, frequencies analysis was used to identify common terminology. National Collegiate Athletic Association Division I collegiate and club sports, collegiate intramural program, large high school athletics program, and outpatient orthopaedic center. Thirty-one physically active volunteers (15 males, 16 females; mean age  =  21.2 years; range, 14-53 years) with a current injury (18 lower extremity injuries, 13 upper extremity injuries) participated in individual interviews. Six physically active volunteers (3 males, 3 females; mean age  =  22.2 years; range, 16-28 years) participated in the group interview to assess trustworthiness. We analyzed interviews through a constant-comparison method, and data were collected until saturation occurred. Common limitations were transformed into descriptive themes and were confirmed during the group interview. Disablement descriptors were identified with frequencies and fit to the themes. A total of 15 overall descriptive themes emerged within the 4 disablement components, and descriptive terms were identified for each theme. Impairments were marked by 4 complaints: pain, decreased motion, decreased muscle function, and instability. Functional limitations were denoted by problems with skill performance, daily actions, maintaining positions, fitness, and changing directions. Disability consisted of problems with participation in desired activities. Lastly, problems in quality of life encompassed uncertainty and fear, stress and pressure, mood and frustration, overall energy, and altered relationships. A preliminary generic outcomes instrument was generated from the findings. Our results will help clinicians understand how disablement is described by the physically active. The findings also have implications for how disablement outcomes are measured.

Key health themes and reporting of numerical cigarette-waterpipe equivalence in online news articles reporting on waterpipe tobacco smoking: a content analysis.

PubMed

Jawad, Mohammed; Bakir, Ali M; Ali, Mohammed; Jawad, Sena; Akl, Elie A

2015-01-01

There is anecdotal evidence that health messages interpreted from waterpipe tobacco smoking (WTS) research are inconsistent, such as comparing the health effects of one WTS session with that of 100 cigarettes. This study aimed to identify key health themes about WTS discussed by online news media, and how numerical cigarette-waterpipe equivalence (CWE) was being interpreted. We identified 1065 online news articles published between March 2011 and September 2012 using the 'Google Alerts' service. We screened for health themes, assessed statements mentioning CWE and reported differences between countries. We used logistic regression to identify factors associated with articles incorrectly reporting a CWE equal to or greater than 100 cigarettes, in the absence of any comparative parameter ('CWE ≥100 cigarettes'). Commonly mentioned health themes were the presence of tobacco (67%) and being as bad as cigarettes (49%), and we report on differences between countries. While 10.8% of all news articles contained at least one positive health theme, 22.9% contained a statement about a CWE. Most of these (18.6% total) were incorrectly a CWE ≥100 cigarettes, a quarter of which were made by healthcare professionals/organisations. Compared with the Middle East, articles from the USA and the UK were the most significant predictors to contain a CWE ≥100 cigarettes statement. Those wishing to write or publish information related to WTS may wish to avoid comparing WTS to cigarettes using numerical values as this is a major source of confusion. Future research is needed to address the impact of the media on the attitudes, initiation and cessation rates of waterpipe smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

What are the characteristics of perinatal events perceived to be traumatic by midwives?

PubMed

Sheen, Kayleigh; Spiby, Helen; Slade, Pauline

2016-09-01

there is potential for midwives to indirectly experience events whilst providing clinical care that fulfil criteria for trauma. This research aimed to investigate the characteristics of events perceived as traumatic by UK midwives. as part of a postal questionnaire survey conducted between December 2011 and April 2012, midwives (n=421) who had witnessed and/or listened to an account of an event and perceived this as traumatic for themselves provided a written description of their experience. A traumatic perinatal event was defined as occurring during labour or shortly after birth where the midwife perceived the mother or her infant to be at risk, and they (the midwife) had experienced fear, helplessness or horror in response. Descriptions of events were analysed using thematic analysis. Witnessed (W; n=299) and listened to (H; n=383) events were analysed separately and collated to identify common and distinct themes across both types of exposure. six themes were identified, each with subthemes. Five themes were identified in both witnessed and listened to accounts and one was salient to witnessed accounts only. Themes indicated that events were characterised as severe, unexpected and complex. They involved aspects relating to the organisational context; typically limited or delayed access to resources or personnel. There were aspects relating to parents, such as having an existing relationship with the parents, and negative perceptions of the conduct of colleagues. Traumatic events had a common theme of generating feelings of responsibility and blame Finally for witnessed events those that were perceived as traumatic sometimes held personal salience, so resonated in some way with the midwife's own life experience midwives are exposed to events as part of their work that they may find traumatic. Understanding the characteristics of the events that may trigger this perception may facilitate prevention of any associated distress and inform the development of supportive interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Role of the Mental Health Worker in a Housing and Accommodation Support Initiative for Indigenous Australians.

PubMed

Sayers, Jan Maree; Cleary, Michelle; Hunt, Glenn E; Burmeister, Oliver K

2017-10-01

To explore the experiences of mental health workers and perceptions of their role and the scope of their work. Qualitative design. Twenty interviews were conducted with mental health workers. Interviews were analyzed using thematic analysis. Three overarching themes were identified. In this paper the overarching theme of "dimensions of my role" is discussed. Subthemes were (a) information and education, (b) person-centered care, and (c) networking and partnerships. Professional development, networking, and partnerships underpin the provision of coordinated services and ultimately person-centered care. Enhancing staff capacity building may also enable sustainability of appropriate quality services. © 2016 Wiley Periodicals, Inc.

Mexican American College Men's (Mis)Understandings About HPV and Cervical Cancer.

PubMed

Schiffner, Tiffany A; Buki, Lydia P; Sabet, Raha F

Latinas have disproportionally high rates of cervical cancer in part due to their reliance on Latino partners to make sexual health decisions, their limited knowledge about human papillomavirus (HPV), and inconsistent Pap smear screening behaviors. In this qualitative study, we examined the sexual health beliefs of Latino college men regarding HPV. Participants included 6 Mexican American college students from a large Midwestern university. We conducted 18 in-depth individual interviews about men's beliefs, attitudes, and knowledge about HPV. Through theme analysis, we identified 4 themes suggesting that participants' limited knowledge of HPV places their female partners at risk. Implications for health promotion programming are discussed.

Teaching in conflict contexts: dimensions of subjective wellbeing in Palestinian teachers living in Israel and the occupied Palestinian territory.

PubMed

Pepe, Alessandro; Addimando, Loredana; Dagdouke, Jamal; Yagi, Shaher; Veronese, Guido

2018-02-21

Subjective wellbeing can be defined in terms of good mental state, including positive and negative evaluations that people make of their affect and lives. The aim of this study was to identify specific domains of wellbeing that are salient to Palestinian teachers living in three different contexts (West Bank, Gaza Strip, and Israel) and to map how components of subjective wellbeing vary between the three cohorts. Data were gathered from interviews of teachers participating in 16 focus groups and from 36 key informants (including psychologists, counsellors, school principals, lawyers). Participants were divided into three groups according to their working locations. Data were analysed by using a mixed-method approach. We used thematic textual analysis, and data were cross-validated with results of statistical significance of lexical specificities (ie, domain-specific terms extracted from specific participants' lexicon) and semantic network analysis. We interviewed 104 teachers. First-order hierarchical categorisation of thematic analysis revealed four dimensions of subjective wellbeing: psychosocial, professional-related, economic issues, and contextual factors. Some second-order subcategories were quality of teaching work, personality aspects, emotional dimensions, political dimensions, and psychological dimensions. Analysis of lexical specificities and results of semantic network analysis revealed that the importance of different components of subjective wellbeing varied across geographical cohorts. Overall, the results of qualitative and quantitative data analysis showed a clear relationship between the teachers' subjective wellbeing and the places they lived. General themes were common in all populations, but the three cohorts differed in terms of the relative salience of each theme. The prominent themes for the Gazan group were quality of teaching, social dimensions, and religion. The key themes for the West Bank group were economic, social dimensions, and recognition. Salient themes for the Arab-Israeli group were professional, emotional, and social dimensions. Despite some differences between the diasporic Palestinian populations in the occupied Palestinian territories and Israel, the categories of wellbeing are supported in all cohorts. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

A phenomenological study of millennial students and traditional pedagogies.

PubMed

Toothaker, Rebecca; Taliaferro, Donna

The Millennial generation comprises the majority of learners in the traditional university setting. Nurse educators identify problems developing teaching strategies in education that undergraduate Millennial nursing students find engaging and meaningful. The purpose of this study was to identify the perception of Millennial students participating in traditional pedagogies and its significant implications for nursing education. This interpretive phenomenological study recorded the lived experiences of Millennial nursing students' experiences in traditional classrooms. One on one interviews with 13 Millennial students were conducted. Data collection and analysis aligned with van Manen's method. There are five themes that emerged from the data: physically present, mentally dislocated; unspoken peer pressure; wanting more from the professors; surface learning; and lack of trust. The essence focuses around the central theme of belonging, while students identified the most significant challenge in a classroom was disengaging professors. Recommendations for faculty to engage nursing students through a method of shared responsibility of educational approach are given. Blended teaching pedagogies that offer traditional and active methods are recommended. Published by Elsevier Inc.

Qualitative analysis of healthcare professionals' viewpoints on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas.

PubMed

Marcus, Brian S; Shank, Gary; Carlson, Jestin N; Venkat, Arvind

2015-03-01

Ethics consultation is a commonly applied mechanism to address clinical ethical dilemmas. However, there is little information on the viewpoints of health care providers towards the relevance of ethics committees and appropriate application of ethics consultation in clinical practice. We sought to use qualitative methodology to evaluate free-text responses to a case-based survey to identify thematically the views of health care professionals towards the role of ethics committees in resolving clinical ethical dilemmas. Using an iterative and reflexive model we identified themes that health care providers support a role for ethics committees and hospitals in resolving clinical ethical dilemmas, that the role should be one of mediation, rather than prescription, but that ultimately legal exposure was dispositive compared to ethical theory. The identified theme of legal fears suggests that the mediation role of ethics committees is viewed by health care professionals primarily as a practical means to avoid more worrisome medico-legal conflict.

A holistic conceptual framework model to describe medication adherence in and guide interventions in diabetes mellitus.

PubMed

Jaam, Myriam; Awaisu, Ahmed; Mohamed Ibrahim, Mohamed Izham; Kheir, Nadir

2018-04-01

Nonadherence to medications in patients with diabetes, which results in poor treatment outcomes and increased healthcare costs, is commonly reported globally. Factors associated with medication adherence have also been widely studied. However, a clear and comprehensive, disease-specific conceptual framework model that captures all possible factors has not been established. This study aimed to develop a conceptual framework that addresses the complex network of barriers to medication adherence in patients with diabetes. Fourteen databases and grey literature sources were systematically searched for systematic reviews reporting barriers to medication adherence in patients with diabetes. A thematic approach was used to categorize all identified barriers from the reviews and to create a matrix representing the complex network and relations of the different barriers. Eighteen systematic reviews were identified and used for the development of the conceptual framework. Overall, six major themes emerged: patient-, medication-, disease-, provider-, system-, and societal-related factors. Each of these themes was further classified into different sub-categories. It was noted that most interactions were identified to be within the patient-related factors, which not only interact with other themes but also within the same theme. Patient's demographics as well as cultural beliefs were the most notable factors in terms of interactions with other categories and themes. The intricate network and interaction of factors identified between different themes and within individual themes indicate the complexity of the problem of adherence. This framework will potentially enhance the understanding of the complex relation between different barriers for medication adherence in diabetes and will facilitate design of more effective interventions. Future interventions for enhancing medication adherence should look at the overall factors and target multiple themes of barriers to improve patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Interdisciplinarity and Undergraduate Psychology Education

ERIC Educational Resources Information Center

Goodwin-Smith, Ian; Pearson, Elissa; Ranzijn, Rob; Campbell, Alan; Lushington, Kurt

2013-01-01

This work identifies the human service sector as an important and growing destination for psychology graduates. It further identifies a number of key themes which flow from that observation and which are important to configuring psychology education in a way which takes account of emerging trends. The major theme identified in the research is the…

"I intend to donate but ...": non-donors' views of blood donation in the UK.

PubMed

McVittie, Chris; Harris, Lisa; Tiliopoulos, Niko

2006-02-01

Although only 6% of the eligible United Kingdom population regularly donate blood, reasons for low donation rates remain poorly understood. In a grounded theory investigation, blood donors (n = 23) and non-donors (n = 27) completed a questionnaire that included 15 open-ended items. Semi-structured interviews were conducted with sub-samples of donors (n = 5) and non-donors (n = 7). Analysis of open-ended responses and interview transcripts identified five themes. Three themes, namely pro-social views, helping behaviour and awareness had similar relevance for donors and non-donors. Two themes, anxiety and practical difficulties, were used by non-donors to account for non-donation despite intentions to donate. Although non-donors' anxieties may be difficult to overcome, perceived practical difficulties provide scope for intervention. The removal of perceived barriers to donation offers one way of increasing donation rates.

Branding a School-Based Campaign Combining Healthy Eating and Eco-friendliness.

PubMed

Folta, Sara C; Koch-Weser, Susan; Tanskey, Lindsay A; Economos, Christina D; Must, Aviva; Whitney, Claire; Wright, Catherine M; Goldberg, Jeanne P

2018-02-01

To develop a branding strategy for a campaign to improve the quality of foods children bring from home to school, using a combined healthy eating and eco-friendly approach and for a control campaign focusing solely on nutrition. Formative research was conducted with third- and fourth-grade students in lower- and middle-income schools in Greater Boston and their parents. Phase I included concept development focus groups. Phase II included concept testing focus groups. A thematic analysis approach was used to identify key themes. In phase I, the combined nutrition and eco-friendly messages resonated; child preference emerged as a key factor affecting food from home. In phase II, key themes included fun with food and an element of mystery. Themes were translated into a concept featuring food face characters. Iterative formative research provided information necessary to create a brand that appealed to a specified target audience. Copyright © 2017. Published by Elsevier Inc.

Integrated multi-cohort transcriptional meta-analysis of neurodegenerative diseases.

PubMed

Li, Matthew D; Burns, Terry C; Morgan, Alexander A; Khatri, Purvesh

2014-09-04

Neurodegenerative diseases share common pathologic features including neuroinflammation, mitochondrial dysfunction and protein aggregation, suggesting common underlying mechanisms of neurodegeneration. We undertook a meta-analysis of public gene expression data for neurodegenerative diseases to identify a common transcriptional signature of neurodegeneration. Using 1,270 post-mortem central nervous system tissue samples from 13 patient cohorts covering four neurodegenerative diseases, we identified 243 differentially expressed genes, which were similarly dysregulated in 15 additional patient cohorts of 205 samples including seven neurodegenerative diseases. This gene signature correlated with histologic disease severity. Metallothioneins featured prominently among differentially expressed genes, and functional pathway analysis identified specific convergent themes of dysregulation. MetaCore network analyses revealed various novel candidate hub genes (e.g. STAU2). Genes associated with M1-polarized macrophages and reactive astrocytes were strongly enriched in the meta-analysis data. Evaluation of genes enriched in neurons revealed 70 down-regulated genes, over half not previously associated with neurodegeneration. Comparison with aging brain data (3 patient cohorts, 221 samples) revealed 53 of these to be unique to neurodegenerative disease, many of which are strong candidates to be important in neuropathogenesis (e.g. NDN, NAP1L2). ENCODE ChIP-seq analysis predicted common upstream transcriptional regulators not associated with normal aging (REST, RBBP5, SIN3A, SP2, YY1, ZNF143, IKZF1). Finally, we removed genes common to neurodegeneration from disease-specific gene signatures, revealing uniquely robust immune response and JAK-STAT signaling in amyotrophic lateral sclerosis. Our results implicate pervasive bioenergetic deficits, M1-type microglial activation and gliosis as unifying themes of neurodegeneration, and identify numerous novel genes associated with neurodegenerative processes.

Provider ambivalence about using forensic medical evaluation to respond to child abuse: A content and discourse analysis.

PubMed

Morris, Marian; Rivaux, Stephanie; Faulkner, Monica

2017-03-01

Forensic medical evaluation rates for child abuse victims in Texas are low relative to national rates. In exploring reasons, researchers collected quantitative and qualitative interview and focus group data from multidisciplinary child abuse response team members across the state. This paper presents results of a secondary analysis of (N=19) health care providers' interview and focus group transcripts, looking specifically at experiences with conducting forensic evaluations - thoughts, struggles, and ethical issues. The analysis was conducted from a critical realist perspective using content and discourse analysis. A theme of ambivalence was identified and explored. Three discursive themes were identified: ambivalence about the legal role, the health care role, and about unintended outcomes of evaluations. Extra-discursive elements related to the physical body, resource distribution, and funding policy were examined for their interaction with discursive patterns. Implications of findings include addressing issues in the current approach to responding to child abuse (e.g., uniting around common definitions of abuse; refining parameters for when FME is helpful; shoring up material resources for the abuse response infrastructure) and considering modification of providers' roles and activities relative to forensic work (e.g., deploying providers for prevention activities versus reactive activities). Copyright © 2017 Elsevier Ltd. All rights reserved.

"Building through the grief": vicarious trauma in a group of inner-city family physicians.

PubMed

Woolhouse, Susan; Brown, Judith Belle; Thind, Amardeep

2012-01-01

Vicarious trauma is an understudied phenomenon among Canadian family physicians. This phenomenological study set out to explore the experiences of a group of inner-city family physicians caring for women using illicit drugs. Ten family physicians working in Toronto and Ottawa, Canada, participated in in-depth interviews. The data were analyzed using an iterative and interpretive process. The first major theme emerging from the data analysis was the emotional impact of the work. Participants shared the challenges, sorrows, and joys they experienced as they struggled to care for their patients. The sub-themes identified were as follows: tragedy and death, difficult behaviors, and isolation from mainstream medical community. The second major theme identified was coping strategies. Participants were open, thoughtful, and eloquent as they reflected on the three primary coping strategies reported: adaptation and evolution of practice style, teamwork, and modification of expectations. Participants, narratives of loss, grief, and compassion were consistent with vicarious trauma and therefore participants risked developing compassion fatigue--a specific form of burnout. These are new and important findings. Further research exploring vicarious trauma as a possible contributor to burnout among family physicians is warranted.

Content and discontent: a qualitative exploration of obstacles to elearning engagement in medical students.

PubMed

Reid, Helen J; Thomson, Clare; McGlade, Kieran J

2016-07-22

Elearning is ubiquitous in healthcare professions education. Its equivalence to 'traditional' educational delivery methods is well established. There is a research imperative to clarify when and how to use elearning most effectively to mitigate the potential of it becoming merely a 'disruptive technology.' Research has begun to broadly identify challenges encountered by elearning users. In this study, we explore in depth the perceived obstacles to elearning engagement amongst medical students. Sensitising concepts of achievement emotions and the cognitive demands of multi-tasking highlight why students' deeply emotional responses to elearning may be so important in their learning. This study used focus groups as a data collection tool. A purposeful sample of 31 participated. Iterative data gathering and analysis phases employed a constant comparative approach to generate themes firmly grounded in participant experience. Key themes that emerged from the data included a sense of injustice, passivity and a feeling of being 'lost at sea'. The actual content of the elearning resource provided important context. The identified themes have strong emotional foundations. These responses, interpreted through the lens of achievement emotions, have not previously been described. Appreciation of their importance is of benefit to educators involved in curriculum development or delivery.

What Are the Issues Confronting Infertile Women? A Qualitative and Quantitative Approach

ERIC Educational Resources Information Center

Hammerli, Katja; Znoj, Hansjorg; Berger, Thomas

2010-01-01

Infertility is a stressful experience, yet little is known about the specific issues confronting infertile women. In the present study, researchers sought to identify themes important to infertile women and examine possible associations with mental health levels. Using qualitative content analysis, researchers analyzed the email messages of 57…

Mutual Support Groups for Long-Term Recipients of TANF

ERIC Educational Resources Information Center

Anderson-Butcher, Dawn; Khairallah, Angela Oliver; Race-Bigelow, Janis

2004-01-01

This study examined the effect of involvement in mutual support groups on long-term recipients of Temporary Assistance for Needy Families (TANF) and other vulnerable individuals. From qualitative interviews with nine group members, the study identified key themes, benefits, and barriers related to involvement in the groups. Content analysis of the…

Exploring Parent Perceptions of the Food Environment in Youth Sport

ERIC Educational Resources Information Center

Thomas, Megan; Nelson, Toben F.; Harwood, Eileen; Neumark-Sztainer, Dianne

2012-01-01

Objective: To examine parent perceptions of the food environment in youth sport. Methods: Eight focus group discussions were held with parents (n = 60) of youth aged 6-13 years participating in basketball programs in Minnesota. Key themes and concepts were identified via transcript-based analysis. Results: Parents reported that youth commonly…

Factors Affecting Christian Parents' School Choice Decision Processes: A Grounded Theory Study

ERIC Educational Resources Information Center

Prichard, Tami G.; Swezey, James A.

2016-01-01

This study identifies factors affecting the decision processes for school choice by Christian parents. Grounded theory design incorporated interview transcripts, field notes, and a reflective journal to analyze themes. Comparative analysis, including open, axial, and selective coding, was used to reduce the coded statements to five code families:…

Professional Development: Are We Meeting the Needs of State EHDI Programs?

ERIC Educational Resources Information Center

Houston, K. Todd; Munoz, Karen F.; Bradham, Tamala S.

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the professional development area, 47 coordinators responded with a total of 223 items, and themes were identified in each SWOT…

Culture Clash or Ties That Bind? What Australian Academics Think of Professional Staff

ERIC Educational Resources Information Center

Gray, Stephen

2015-01-01

This paper uses a framework analysis to explore the opinions a cohort of Australian academic staff hold towards professional staff. Five indicative themes were identified from the extant literature on university professional staff: the professional other; managerialism; an expensive bureaucracy; complementary agendas; and the third space and…

Maintaining or Disrupting Inequality: Diversity Statements in the University

ERIC Educational Resources Information Center

Merkl, Linda

2012-01-01

The purpose of my study was to identify whether university Diversity Statements aid in maintaining or disrupting inequality in the university. Using critical discourse analysis, I analyzed an initial sample of eleven Diversity Statements to develop a list of common themes found within the diversity statements. Using a maximum variation method, I…

A Quantitative Description of FBI Public Relations.

ERIC Educational Resources Information Center

Gibson, Dirk C.

1997-01-01

States that the Federal Bureau of Investigation (FBI) had the most successful media relations program of all government agencies from the 1930s to the 1980s. Uses quantitative analysis to show why those media efforts were successful. Identifies themes that typified the verbal component of FBI publicity and the broad spectrum of mass communication…

Exploring Teacher Leadership in a Rural, Secondary School: Reciprocal Learning Teams as a Catalyst for Emergent Leadership

ERIC Educational Resources Information Center

Cherkowski, Sabre; Schnellert, Leyton

2017-01-01

The purpose of this case study was to examine how teachers experienced professional development as collaborative inquiry, and how their experiences contributed to their development as teacher leaders. Three overarching themes were identified through iterative qualitative analysis of multiple data sources including interviews, observations,…

Identifying the Categories of Spiritual Experience Encountered by Therapists in Their Clinical Work

ERIC Educational Resources Information Center

Ross, Alistair

2016-01-01

Spirituality has replaced religion in popular culture and its presence is being felt in the therapeutic world. Using a questionnaire completed by 104 people utilising six descriptive definitions of spirituality and 36 categories of spiritual experience, three meta-themes of forms of spirituality emerged through a thematic analysis. These are…

Urban African American Adolescent Parents: Their Perceptions of Sex, Love, Intimacy, Pregnancy, and Parenting.

ERIC Educational Resources Information Center

Harris, Jewel L. Jones

1998-01-01

Examines the perception of urban African-American adolescent mothers and fathers regarding sex, love, intimacy, pregnancy, and parenting. Uses structured interviews and focus groups to gather data. Employs inductive data analysis using constant comparison methods to identify themes and patterns within and across gender groups. (Author/GCP)

The Blackberry Image: Self-Identified Perceptions and Motivations Associated with College Student Blackberry Use

ERIC Educational Resources Information Center

Firmin, Michael W.; Firmin, Ruth L.; Orient, Katlyn M.; Edwards, Anna J.; Cunliff, Jennifer M.

2012-01-01

We report the results of a qualitative research study conducted with university students regarding their phenomenological perspectives of BlackBerry use. Three key themes inductively emerged throughout the interview and analysis process regarding self-perceptions college students reported regarding their own BlackBerry use. First, students offered…

Psychological Help-Seeking Attitudes and Barriers to Help-Seeking in Young People in Turkey

ERIC Educational Resources Information Center

Koydemir, Selda; Erel, Ozge; Yumurtaci, Duygu; Sahin, Gozde Nur

2010-01-01

This qualitative research sought to understand the needs of Turkish university students related to adjustment to university, the sources they seek help from, their attitudes about and barriers to psychological help-seeking. Data analysis of interview transcriptions from 15 undergraduates identified several themes. Interpersonal problems,…

Research in disaster settings: a systematic qualitative review of ethical guidelines.

PubMed

Mezinska, Signe; Kakuk, Péter; Mijaljica, Goran; Waligóra, Marcin; O'Mathúna, Dónal P

2016-10-21

Conducting research during or in the aftermath of disasters poses many specific practical and ethical challenges. This is particularly the case with research involving human subjects. The extraordinary circumstances of research conducted in disaster settings require appropriate regulations to ensure the protection of human participants. The goal of this study is to systematically and qualitatively review the existing ethical guidelines for disaster research by using the constant comparative method (CCM). We performed a systematic qualitative review of disaster research ethics guidelines to collect and compare existing regulations. Guidelines were identified by a three-tiered search strategy: 1) searching databases (PubMed and Google Scholar), 2) an Internet search (Google), and 3) a search of the references in the included documents from the first two searches. We used the constant comparative method (CCM) for analysis of included guidelines. Fourteen full text guidelines were included for analysis. The included guidelines covered the period 2000-2014. Qualitative analysis of the included guidelines revealed two core themes: vulnerability and research ethics committee review. Within each of the two core themes, various categories and subcategories were identified. Some concepts and terms identified in analyzed guidelines are used in an inconsistent manner and applied in different contexts. Conceptual clarity is needed in this area as well as empirical evidence to support the statements and requirements included in analyzed guidelines.

The ethics of dietary supplements and natural health products in pharmacy practice: a systematic documentary analysis.

PubMed

Boon, Heather; Hirschkorn, Kristine; Griener, Glenn; Cali, Michelle

2009-02-01

Many natural health products and dietary supplements are purchased in pharmacies and it has been argued that pharmacists are in the best position to provide patients with evidence-based information about them. This study was designed to identify how the pharmacist's role with respect to natural health products and dietary supplements is portrayed in the literature. A systematic search was conducted in a variety of health databases to identify all literature that pertained to both pharmacy and natural health products and dietary supplements. Of the 786 articles identified, 665 were broad-coded and 259 were subjected to in-depth qualitative content analysis for emergent themes. Overwhelmingly, support for the sale of natural health products and dietary supplements in pharmacies is strong. Additionally, a role for pharmacist counselling is underscored. But another recurrent theme is that pharmacists are ill-equipped to counsel patients about these products that are available on their shelves. This situation has led some to question the ethics of pharmacists selling natural health products and dietary supplements and to highlight the existence of an ethical conflict stemming from the profit-motive associated with sales of natural health products and dietary supplements. This analysis raises concerns about the ethics of natural health products and dietary supplements being sold in pharmacies, and about pharmacists being expected to provide counselling about products of which they have little knowledge.

Letters From Peplau.

PubMed

Peden, Ann R

2018-03-01

Dr. Hildegard Peplau, considered to be our first modern Nurse theorist and the Mother of Psychiatric Nursing, was a prolific writer, engaging in correspondence with colleagues and students who sought her professional and theoretical expertise. Through these letters, she influenced psychiatric nursing while maintaining a broad international network of professional colleagues. An analysis of letters, written between 1990 and 1998, provides insights into Peplau's last decade of professional life and a model of how to support the next generation of nurse scholars. Using content analysis, 24 letters received between 1990 and 1998 were read, reread, and coded. Recurring themes were identified. Three themes were identified. These include Peplau, the Person: Living a Life of Professional Balance; Lighting a Spark: Investing in the Next Generation; and Work in the Vineyards of Nursing: Maintaining a Life of Scholarship. The letters depict Peplau's keen intellect, her wide professional network, her leisure time spent with family and friends, and her own work to assure that her theoretical legacy continued. Peplau's insights continue to be relevant as psychiatric mental health nursing leaders engage in activities to support the next generation of scholars and leaders.

Safety perception referents of permanent and temporary employees: safety climate boundaries in the industrial workplace.

PubMed

Luria, Gil; Yagil, Dana

2010-09-01

To explore the significant referents of safety perceptions among permanent and temporary employees in order to identify the boundaries of safety climate in a heterogeneous workforce. Collection of data from semi-structured interviews with employees in manufacturing organizations, using a combination of qualitative and quantitative methods to identify basic safety perceptions. Independent raters used content analysis to examine the data. Analysis of the data revealed differences between safety themes at organization, group and individual levels. Themes relating to the individual were more prevalent among temporary employees, while those relating to the group and the organization prevailed among permanent employees. Permanent employees view organizational and group levels as significant referents of safety perceptions, while temporary employees focus on the individual level. The results challenge the current view of safety climate as a uniform concept for all employees and prescribe boundary conditions for safety climate. It is suggested that organizations should implement "tailor-made" safety-climate practices according to the referents of employee sub-groups. 2009 Elsevier Ltd. All rights reserved.

Perioperative and ICU Healthcare Analytics within a Veterans Integrated System Network: a Qualitative Gap Analysis.

PubMed

Mudumbai, Seshadri; Ayer, Ferenc; Stefanko, Jerry

2017-08-01

Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development. Methods consisted of semi-structured interviews in 2 phases with a diverse set (n = 9) of support personnel and end users from five facilities across a Veterans Integrated Service Network. Phase 1 identified underlying needs and previous experiences with the analytics platform across various roles and operational responsibilities. Phase 2 validated preliminary feedback, lessons learned, and recommendations for improvement. Emerging themes suggested that the existing system met a small pool of national reporting requirements. However, pain points were identified with accessing data in several information system silos and performing multiple manual validation steps of data content. Notable recommendations included enhancing systems integration to create "one-stop shopping" for data, and developing a capability to perform trends analysis. Our gap analysis suggests that analytics platforms designed for surgical and ICU patients should employ approaches similar to those being used for primary care patients.

The Use of Facebook Advertising for Communicating Public Health Messages: A Campaign Against Drinking During Pregnancy in New Zealand

PubMed Central

2017-01-01

Background Social media is gaining recognition as a platform for delivering public health messages. One area attracting attention from public health researchers and professionals is Facebook’s advertising channel. This channel is reported to have a broad reach and generate high user engagement with the disseminated campaign materials. However, to date, no study has examined the communication process via this channel which this study aimed to address. Objective The specific objectives of the study were to (1) examine user engagement for a public health campaign based on the metadata provided by Facebook, (2) analyze comments generated by the campaign materials using text mining, and (3) investigate the relationship between the themes identified in the comments and the message and the sentiments prevalent in the themes that exhibited significant relationships. Methods This study examined a New Zealand public health pilot campaign called “Don’t Know? Don’t Drink,” which warned against drinking alcohol during pregnancy. The campaign conveyed the warning through a video and three banner ads that were delivered as news feeds to women aged 18-30 years. Thematic analysis using text mining performed on the comments (n=819) identified four themes. Logistic regression was used to identify meaning-making themes that exhibited association with the message. Results The users’ engagement was impressive with the video receiving 203,754 views. The combined likes and shares for the promotional materials (video and banner ads) amounted to 6125 and 300, respectively. The logistic regression analysis showed two meaning-making themes, namely, risk of pregnancy (P=.003) and alcohol and culture (P<.001) exhibited association with the message. The sentiment analysis carried out on the two themes revealed there were more negative than positive comments (47% vs 28%). Conclusions The user engagement observed in this study was consistent with previous research. The numbers reported for views, likes, and shares may be seen as unique interactions over the fixed period of the campaign; however, survey research would be required to find out the true evaluative worth of these metadata. A close examination of the comments, employing text mining, revealed that the message was not accepted by a majority of the target segment. Self-identity and conformity theories may help to explain these observed reactions, albeit warrant further investigations. Although the comments were predominantly negative, they provide opportunities to engage back with the women. The one-way communication format followed in this campaign did not support any two-way engagement. Further investigation is warranted to establish whether using a two-way communication format would have improved the acceptability of such public health messages delivered via social media. The findings of this study caution using a one-way communication format to convey public health messages via Facebook’s advertising channel. PMID:28798011

The Use of Facebook Advertising for Communicating Public Health Messages: A Campaign Against Drinking During Pregnancy in New Zealand.

PubMed

Parackal, Mathew; Parackal, Sherly; Eusebius, Shobhit; Mather, Damien

2017-08-10

Social media is gaining recognition as a platform for delivering public health messages. One area attracting attention from public health researchers and professionals is Facebook's advertising channel. This channel is reported to have a broad reach and generate high user engagement with the disseminated campaign materials. However, to date, no study has examined the communication process via this channel which this study aimed to address. The specific objectives of the study were to (1) examine user engagement for a public health campaign based on the metadata provided by Facebook, (2) analyze comments generated by the campaign materials using text mining, and (3) investigate the relationship between the themes identified in the comments and the message and the sentiments prevalent in the themes that exhibited significant relationships. This study examined a New Zealand public health pilot campaign called "Don't Know? Don't Drink," which warned against drinking alcohol during pregnancy. The campaign conveyed the warning through a video and three banner ads that were delivered as news feeds to women aged 18-30 years. Thematic analysis using text mining performed on the comments (n=819) identified four themes. Logistic regression was used to identify meaning-making themes that exhibited association with the message. The users' engagement was impressive with the video receiving 203,754 views. The combined likes and shares for the promotional materials (video and banner ads) amounted to 6125 and 300, respectively. The logistic regression analysis showed two meaning-making themes, namely, risk of pregnancy (P=.003) and alcohol and culture (P<.001) exhibited association with the message. The sentiment analysis carried out on the two themes revealed there were more negative than positive comments (47% vs 28%). The user engagement observed in this study was consistent with previous research. The numbers reported for views, likes, and shares may be seen as unique interactions over the fixed period of the campaign; however, survey research would be required to find out the true evaluative worth of these metadata. A close examination of the comments, employing text mining, revealed that the message was not accepted by a majority of the target segment. Self-identity and conformity theories may help to explain these observed reactions, albeit warrant further investigations. Although the comments were predominantly negative, they provide opportunities to engage back with the women. The one-way communication format followed in this campaign did not support any two-way engagement. Further investigation is warranted to establish whether using a two-way communication format would have improved the acceptability of such public health messages delivered via social media. The findings of this study caution using a one-way communication format to convey public health messages via Facebook's advertising channel. ©Mathew Parackal, Sherly Parackal, Shobhit Eusebius, Damien Mather. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 10.08.2017.

The themes, institutions, and people of medical education research 1988-2010: content analysis of abstracts from six journals.

PubMed

Rotgans, Jerome I

2012-10-01

The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on 10,168 abstracts extracted from the six most influential journals in medical education published since 1988. Twenty-nine major themes were identified, of which student assessment, clinical and communication skills, clinical clerkships, and problem-based learning were the most prominent ones. Some of these themes, such as multiple-choice examinations or computer-assisted instruction seemed to have had their day, whereas other topics, such as the study of clinical clerkships, clinical reasoning, and scholarship in education were on their way up. Medical education research turned out to be a thoroughly international affair to which both US and European research centers contribute. The medical education literature shows an overwhelming emphasis on the preparation of medical students for professional practice. Moreover, the emphasis is very much on the individual student; most research seems to have been conducted with a psychological perspective in mind. It is argued that medical education research would profit from broadening its scope, including sociological, economical, ecological, and system perspectives. These perspectives might bring answers to new questions relevant to the quality of medical education. It is suggested that medical education is in need of moving beyond the conventional effectiveness-driven research approach to a more theory- and discovery-driven approach.

A method comparison of photovoice and content analysis: research examining challenges and supports of family caregivers.

PubMed

Faucher, Mary Ann; Garner, Shelby L

2015-11-01

The purpose of this manuscript is to compare methods and thematic representations of the challenges and supports of family caregivers identified with photovoice methodology contrasted with content analysis, a more traditional qualitative approach. Results from a photovoice study utilizing a participatory action research framework was compared to an analysis of the audio-transcripts from that study utilizing content analysis methodology. Major similarities between the results are identified with some notable differences. Content analysis provides a more in-depth and abstract elucidation of the nature of the challenges and supports of the family caregiver. The comparison provides evidence to support the trustworthiness of photovoice methodology with limitations identified. The enhanced elaboration of theme and categories with content analysis may have some advantages relevant to the utilization of this knowledge by health care professionals. Copyright © 2015 Elsevier Inc. All rights reserved.

Promoting and Protecting Against Stigma in Assisted Living and Nursing Homes.

PubMed

Zimmerman, Sheryl; Dobbs, Debra; Roth, Erin G; Goldman, Susan; Peeples, Amanda D; Wallace, Brandy

2016-06-01

To determine the extent to which structures and processes of care in multilevel settings (independent living, assisted living, and nursing homes) result in stigma in assisted living and nursing homes. Ethnographic in-depth interviews were conducted in 5 multilevel settings with 256 residents, families, and staff members. Qualitative analyses identified the themes that resulted when examining text describing either structures of care or processes of care in relation to 7 codes associated with stigma. Four themes related to structures of care and stigma were identified, including the physical environment, case mix, staff training, and multilevel settings; five themes related to processes of care and stigma, including dining, independence, respect, privacy, and care provision. For each theme, examples were identified illustrating how structures and processes of care can potentially promote or protect against stigma. In no instance were examples or themes identified that suggested the staff intentionally promoted stigma; on the other hand, there was indication that some structures and processes were intentionally in place to protect against stigma. Perhaps the most important theme is the stigma related to multilevel settings, as it has the potential to reduce individuals' likelihood to seek and accept necessary care. Results suggest specific recommendations to modify care and reduce stigma. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evaluating public involvement in research design and grant development: Using a qualitative document analysis method to analyse an award scheme for researchers.

PubMed

Baxter, Susan; Muir, Delia; Brereton, Louise; Allmark, Christine; Barber, Rosemary; Harris, Lydia; Hodges, Brian; Khan, Samaira; Baird, Wendy

2016-01-01

The National Institute for Health Research (NIHR) Research Design Service (RDS) for Yorkshire and Humber has been running a public involvement funding scheme since 2008. This scheme awards researchers a small amount of money to help them get involvement from patients and/or the public. Involvement activities take place at the time when researchers are planning studies, and when they are completing application forms to request funding for a proposed research project. After the public involvement activities researchers are asked to write a report for the RDS describing what they did with the public involvement funding. This study analysed those reports using an approach which included members of a public involvement panel in the data analysis process. The aim of the work was to see what the views and experiences of researchers who received funding were, and what might be learned for the future of the scheme. Twenty five reports were analysed. Four main themes were identified, these described: the added value of public involvement; aspects to consider when planning and designing public involvement; different roles of public contributors; and aspects of valuing public member contributions. The group approach to analysis was successful in enabling involvement of a variety of individuals in the process. The findings of the study provide evidence of the value of public involvement during the development of applications for research funding. The results also indicate that researchers recognise the variety in potential roles for the public in research, and acknowledge how involvement adds value to studies. Background A regional Research Design Service, funded by the National Institute for Health Research, introduced a small grant in 2008, to support public involvement (often known as patient and public involvement [PPI]) activities during the development of applications for research funding. Successful applicants are requested to submit a report detailing how the grant money was used, including a description of the aims and outcomes of the public involvement activities. The purpose of this study was to analyse the content of these reports. We aimed to find out what researcher views and experiences of public involvement activities were, and what lessons might be learned. Methods We used an innovative method of data analysis, drawing on group participatory approaches, qualitative content analysis, and Framework Analysis to sort and label the content of the reports. We developed a framework of categories and sub-categories (or themes and sub-themes) from this process. Results Twenty five documents were analysed. Four main themes were identified in the data: the added value of public involvement; planning and designing involvement; the role of public members; and valuing public member contributions. Within these themes, sub-themes related to the timing of involvement (prior to the research study/intended during the research study), and also specific benefits of public involvement such as: validating ideas; ensuring appropriate outcomes; ensuring the acceptability of data collection methods/tools and advice regarding research processes. Other sub-themes related to: finding and approaching public members; timing of events; training/support; the format of sessions; setting up public involvement panels: use of public contributors in analysis and interpretation of data; and using public members to assist with dissemination and translation into practice. Conclusions The analysis of reports submitted by researchers following involvement events provides evidence of the value of public involvement during the development of applications for research funding, and details a method for involving members of the public in data analysis which could be of value to other researchers The findings of the analysis indicate recognition amongst researchers of the variety in potential roles for public members in research, and also an acknowledgement of how involvement adds value to studies.

"Get drunk. Smoke weed. Have fun.": A Content Analysis of Tweets About Marijuana and Alcohol.

PubMed

Krauss, Melissa J; Grucza, Richard A; Bierut, Laura J; Cavazos-Rehg, Patricia A

2017-05-01

To explore the sentiment and themes of Twitter chatter that mentions both alcohol and marijuana. Cross-sectional analysis of tweets mentioning both alcohol and marijuana during 1 month was performed. The study setting was Twitter. Tweets sent from February 4 to March 5, 2014, were studied. A random sample (n = 5000) of tweets that mentioned alcohol and marijuana were qualitatively coded as normalizing both substances, preferring one substance over the other, or discouraging both substances. Other common themes were identified. More than half (54%) of the tweets normalized marijuana and alcohol (without preferring one substance over the other), and 24% preferred marijuana over alcohol. Only 2% expressed a preference for alcohol over marijuana, 7% discouraged the use of both substances, and the sentiment was unknown for 13% of the tweets. Common themes among tweets that normalized both substances included using the substances with friends (17%) and mentioning substance use in the context of sex or romance (14%). Common themes among tweets that preferred marijuana over alcohol were the beliefs that marijuana is safer than alcohol (46%) and preferences for effects of marijuana over alcohol (40%). Tweets normalizing polysubstance use or encouraging marijuana use over alcohol use are common. Both online and offline prevention efforts are needed to increase awareness of the risks associated with polysubstance use and marijuana use.

Trends and priorities in occupational health research and knowledge transfer in Italy.

PubMed

Rondinone, Bruna Maria; Boccuni, Fabio; Iavicoli, Sergio

2010-06-01

In 2000-2001, the Italian National Institute for Occupational Safety and Prevention (ISPESL) carried out a survey to identify the research priorities in the field of occupational safety and health (OSH). The present study, carried out in 2007-2008, was a follow-up designed to (i) review the themes identified earlier, (ii) detect emerging issues linked to new risks and forms of work, and (iii) look for any shifts in focus. The survey was extended to cover not only research but also the concept of knowledge transfer. In the first round, ISPESL distributed questionnaires to the heads of both university occupational medicine departments and prevention departments in local national health units (known as ASL in Italy) asking respondents to identify OSH priority themes. In the latest survey covering both research and the need for knowledge transfer, the same experts were asked to rank the importance of the earlier-identified topics and list any emerging issues in the OSH field. The two most important themes identified were "work accidents" and "occupational carcinogenesis". In the overall sample and among ASL experts, they received the 1st and 2nd highest mean scores. The university respondents also prioritized them but in reverse order. Some of the new priority topics included: risks associated with nanotechnologies; assessment of psychosocial and organizational risks; migration and work; and cost-benefit analysis of prevention. In light of the findings, efforts are urgently needed to identify research and knowledge transfer priorities related to workers' health and safety on an international scale using a standardized method in order to obtain comparable results, avoid wasteful duplication of resources, and reduce occupational accidents and illness.

The voices of children: stories about hospitalization.

PubMed

Wilson, Margaret E; Megel, Mary E; Enenbach, Laura; Carlson, Kimberly L

2010-01-01

The study explored children's views of hospitalization through their own voices. In this secondary analysis, 93 children aged 5 to 9 years told stories about hospitalization using a set of drawings of children in the hospital. Children were recruited in the hospital and in the community. Themes were identified through qualitative analysis. Children's stories focused on being alone and feeling scared, mad, and sad. These children wanted protection. Children in the stories were not always facing scary events. They were simply not at home and feeling bored, lonely, and sad. They wanted companions. Children displayed awareness of both good and bad outcomes. The hospital was a unique environment that could be fun as well as threatening. Children's views of hospitalization were not invariably negative. The themes of hospitalized and never-hospitalized children were different only in degree of detail.

Evaluation of a novel mentor program to improve surgical care for US hospitals.

PubMed

Berian, Julia R; Thomas, Juliana M; Minami, Christina A; Farrell, Paula R; O'Leary, Kevin J; Williams, Mark V; Prachand, Vivek N; Halverson, Amy L; Bilimoria, Karl Y; Johnson, Julie K

2017-04-01

To evaluate a novel mentor program for 27 US surgeons, charged with improving quality at their respective hospitals, having been paired 1:1 with 27 surgeon mentors through a state-wide quality improvement (QI) initiative. Mixed-methods utilizing quantitative surveys and in-depth semi-structured interviews. The Illinois Surgical Quality Improvement Collaborative (ISQIC) utilized a novel Mentor Program to guide surgeons new to QI. All mentor-mentee pairs received the survey (n = 27). Purposive sampling identified a subset of mentors (n = 8) and mentees (n = 4) for in-depth semi-structured interviews. Surgeons with expertise in QI mentored surgeons new to QI. (i) Quantitative: self-reported satisfaction with the mentor program; (ii) Qualitative: key themes suggesting actions and strategies to facilitate mentorship in QI. Mentees expressed satisfaction with the mentor program (n = 24, 88.9%) and agreed that mentorship is vital to ISQIC (n = 24, 88.9%). Analysis of interview data revealed four key themes: (i) nuances of data management, (ii) culture of quality and safety, (iii) mentor-mentee relationship and (iv) logistics. Strategies from these key themes include: utilize raw data for in-depth QI understanding, facilitate presentations to build QI support, identify opportunities for in-person meetings and establish scheduled conference calls. The mentor's role required sharing experiences and acting as a resource. The mentee's role required actively bringing questions and identifying barriers. Mentorship plays a vital role in advancing surgeon knowledge and engagement with QI in ISQIC. Key themes in mentorship reflect strategies to best facilitate mentorship, which may serve as a guide to other collaboratives. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Patient perspectives about bariatric surgery unveil experiences, education, satisfaction, and recommendations for improvement.

PubMed

Groller, Karen D; Teel, Cynthia; Stegenga, Kristin H; El Chaar, Maher

2018-02-17

Following bariatric surgery, up to 35% of patients struggle with strict regimens and experience weight recidivism within 2 years [1-5]. Accredited weight management centers (WMC) must provide educational programs and support patients in lifestyle changes before and after surgery. Educational programs, however, may not be evidence-based or patient-centered and may vary in curriculum, approach, and educator type [6]. To obtain patient descriptions about the weight loss surgery (WLS) experience, including education, satisfaction, and recommendations for improvement. Participants were recruited from a university hospital-based WMC in Pennsylvania. This qualitative descriptive study used purposive sampling and inductive content analysis. A NEW ME-VERSION 2.0, encompassed themes from semistructured interviews with 11 participants (36% male). Theme 1: Programming and Tools, explained how individuals undergoing WLS found support through educational programming. Theme 2: Updates and Upgrades, identified issues surrounding quality of life and challenges before and after surgery. Theme 3: Lessons Learned and Future Considerations, identified satisfaction levels and recommendations for improving the WLS experience. Participants reported positive experiences, acknowledging educational programs and extensive WMC resources, yet also offered recommendations for improving educational programming. Patient narratives provided evidence about the WLS experience. Achievement of weight goals, adherence to rules, and improved health status contributed to perceptions of WLS success. Participants encouraged educators to identify expected outcomes of educational programming, monitor holistic transformations, foster peer support, and use technology in WMC programming. Results also validated the need for the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program's education requirement (standard 5.1). Future educational research could help develop best practices in WLS patient education and assess associations between education and clinical outcomes. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Breaking Boundaries: Complementary and Alternative Medicine Provider Framing of Preventive Care.

PubMed

Agarwal, Vinita

2017-11-01

This textual examination extends understandings of how complementary and alternative medicine (CAM) providers constitute preventive care in their discourse by identifying the frame of breaking boundaries referencing relational, structural, and philosophical orientations in their practice with their clients. Analysis of semistructured, in-depth interviews with CAM providers ( n = 17) reveals that the frame of breaking boundaries was comprised of three themes: finding one's own strength; I don't prescribe, so I'm exploring; and ground yourself, and have an escape route. The themes describe preventive care by identifying how CAM providers negotiate their relational positionality in connecting with clients, structural positionality within the field of health care, and philosophical positionality within the ontological understandings that guide how health is defined and conceptualized. The study contributes toward enhancing diverse understandings of constituting preventive care in practice and suggests pragmatic implications for addressing biomedical provider communication with their patients seeking CAM care alongside conventional treatments.

Successful Students Who Are Deaf or Hard of Hearing and Culturally and/or Linguistically Diverse in Inclusive Settings.

PubMed

Ayantoye, Catherine Adekemi; Luckner, John L

2016-01-01

The population of students who are deaf or hard of hearing is becoming more culturally and/or linguistically diverse. However, there is a paucity of practitioner literature and research available to professionals and families to guide decision making about daily practices with these students and their families. The study identified factors that contribute to the success of students who are deaf or hard of hearing and from culturally and/or linguistically diverse backgrounds who receive the majority of their education in inclusive settings. Students were recruited from two schools in two school districts in a western state. Students, educators, interpreters, and parents participated in individual in-depth, semi-structured interviews. Observations of the students were also done. Analysis of the data included coding the transcribed interviews and the field notes to identify common themes. Seven themes emerged and are reported. Recommendations for future research are provided.

Identifying Strategies to Decrease Overtime, Absenteeism and Agency Use: Insights from Healthcare Leaders.

PubMed

Jeffs, Lianne; Grinspun, Doris; Closson, Tom; Mainville, Marie-Claude

2015-09-01

Working overtime, absenteeism and agency use can negatively impact working environments, the health of staff and patient outcomes, and increase healthcare costs. The purpose of this study was to explore how healthcare leaders in Ontario hospitals implement and sustain best practices that advance workforce stability within their organization. Qualitative study design using semi-structured interviews and thematic analysis. Participants included 23 healthcare leaders from 16 hospital sites. Two main themes emerged: (1) enacting proactive human resource practices and (2) having strong, caring and strategic leaders that create learning and supportive work environments. A number of sub-themes identified were reported through narratives stratified according to size (small/large) and performance (low/high) of each site. Insights gained from this study may offer healthcare leaders strategies to maximize the nursing workforce and minimize overtime, absenteeism and agency use to ensure safe, efficient and quality healthcare. Copyright © 2015 Longwoods Publishing.

Supporting hemodialysis patients: A phenomenological study

PubMed Central

Shahgholian, Nahid; Yousefi, Hojatollah

2015-01-01

Background: Chronic renal disease and hemodialysis cause numerous psychological, social, cultural, and spiritual challenges for both patients and their families. Overcoming these challenges is possible only through providing holistic support for the patients. Today, despite the support provided by family and professional caregivers for the patients, patients still express dissatisfaction with the support provided and believe it to be inadequate. In fact, patients and family caregivers and healthcare practitioners seem to have different understandings of the notion of support. Thus, the researcher decided to examine the concept of support from the viewpoint of hemodialysis patients. Materials and Methods: This descriptive phenomenological research was conducted on 17 patients with end-stage renal disease (ESRD) who were undergoing hemodialysis. Purposive sampling was performed and continued until data saturation. Data were collected through 30–60 min unstructured interviews and analyzed using Colaizzi's method. Results: From the analysis of data, 4 themes (psychological support, accompaniment, social support, and spiritual support) and 11 sub-themes were obtained. Psychological support consisted of two sub-themes of psychological support by healthcare practitioners and emotional support by family and relatives. Accompaniment included three sub-themes of assistance in transportation, providing and using medicine, and daily activities. Social support was identified with four sub-themes of promotion of the society's understanding of the patients’ condition, improvement of communication with others, the need for employment, and independence. Spiritual support was identified with two sub-themes of the need for faith and trust in God or Imams and the need to resolve spiritual contradictions. Conclusion: The results showed that from the viewpoint of the participants, the concept of support consisted of psychological support, social support, accompanying the patient, and spiritual support. Hence, it can be concluded that this concept should be considered in healthcare planning, in order to improve the health and quality of life of these patients and their adaptation to the disease and its treatment process. PMID:26457103

Patient Use of the Electronic Communication Portal in Management of Type 2 Diabetes.

PubMed

Peremislov, Diana

2017-09-01

High incidence and prevalence of type 2 diabetes require urgent attention to the management of this chronic disease. The purpose of this study was to explore electronic communication (e-communication) between patients with type 2 diabetes and their providers within the patient portal. Qualitative design with conventional content analysis techniques was used. A purposive random sample of 90 electronic medical record charts of patient-portal users with type 2 diabetes was subjected to a retrospective review. The sample mainly consisted of patients between the ages of 50 and 70 years, who were white, non-Hispanic, and English-speaking. The three major themes that emerged in e-communication via patient portal were inform theme, which was the most frequently identified theme; instruct/request theme, which was mainly used in initiation of e-communication; and the question theme. The patient portal was used primarily for requests by patients and instruction by providers, showing relatively short e-message encounters with a high number of partially completed encounters, frequent lack of resolution, and a low level of involvement of diabetes specialists in e-communication. There is a need to revise healthcare system guidelines on initiation and use of e-communication via patient portal and develop standardized templates to promote diabetes education in type 2 diabetes.

Observations and Measurements Design Patterns within INSPIRE

NASA Astrophysics Data System (ADS)

Schleidt, K.; Cox, S.; Grellet, S.; Lowe, D.; Lutz, M.; Portele, C.; Sarretta, A.; Ventouras, S.

2012-04-01

Several INSPIRE spatial data themes have been specified so that their scope, in addition to classical geographic information, includes measured, modelled or simulated data. The FprEN ISO 19156 standard on Observations and Measurements (O&M) was designed for the explicit purpose of creating application schemas for such data, and thus shall be used in INSPIRE as a basis for developing data models for these themes. The following INSPIRE themes have identified O&M as integrally relevant to their thematic domain and are including elements of O&M in their data specifications: • Geology • Oceanographic geographical features • Atmospheric conditions and Meteorological geographical features • Environmental monitoring facilities • Soil In addition to these themes, several other INSPIRE themes have been identified to which observational information, while not at the core of the data specification, is relevant. Some examples of this are the INSPIRE theme "Species distribution", where primary occurrence data could be provided together with the aggregate distribution, as well as "Industrial and production facilities", where the provision of emissions data on such facilities would be useful for various environmental reporting obligations. While the O&M standard provides a generic framework for the provision of measurement data, it is also kept very abstract, and there are many ways of implementing the core structures in specific application schemas. In order to assure the consistent application of the O&M classes and properties across different INSPIRE themes, a cross-thematic working group on the use of O&M in INSPIRE has been convened. This group has analysed the requirements towards O&M within INSPIRE, identified the types of O&M design patterns required in INSPIRE and developed both additional classes identified as necessary within INSPIRE as well as guidelines detailing how this standard is to be used within INSPIRE. Some examples for these additional classes are: • the ObservationCollection class (which was included in O&M v1.0, but has been removed in the final version of FprEN ISO 19156), that serves as a container for semantically grouping multiple observations; • the ObservableProperty class, that provides structures for the definition of complex observed properties including statistical qualifiers and constraints; • the ObservingCapabilities class for providing information about the types of measurements that a facility or instrument can make in a way that reflects the semantics of the actual Observations; • the further specialization of the OM_Process (with identifier, responsible party, etc.) class that is primarily empty within the O&M concept. These additional classes and guidelines can be used by the various INSPIRE themes that integrate or reference the O&M standard, as well as for other specifications that are created outside of the INSPIRE process and extend existing INSPIRE specifications with the use of O&M. The INSPIRE O&M guidelines also contain generic analysis which may be of interest when evaluating how and whether to apply O&M to a particular domain. The results of this work will be presented.

Experiencing patient death in clinical practice: nurses' recollections of their earliest memorable patient death.

PubMed

Anderson, Natalie Elizabeth; Kent, Bridie; Owens, R Glynn

2015-03-01

Death and dying are inevitable life encounters, but a nurse's first experience with patient death may pose considerable cognitive, emotional and clinical challenges. This paper reports the findings of the second phase of a study; the first has been reported elsewhere. This phase explored the earliest memorable patient death experiences of New Zealand registered nurses. A purposeful, self-selected sub-sample of a larger study of New Zealand registered nurses, took part in individual face-to-face semi-structured interviews. Interpretative phenomenological analysis was utilised to seek to understand participants' experiences. Thematic analysis was undertaken to identify emerging themes, with participants' own words used as theme headings, where their phrases provided succinct or powerful descriptors. A diverse participant group of twenty, currently practising, New Zealand registered nurses provided rich and detailed descriptions of their earliest memorable experience with patient death. Participants from a variety of training backgrounds described patient deaths, which occurred in a range of settings - some only a few months prior, others - more than thirty years ago. Seven emergent themes, and features of more positive, or negative experiences were identified: Event Significance; Emotional Challenges; Sharing the Experience; Learning; Feeling Unprepared, Responses to Death and Finding Benefits. For participants in this study, there was considerable evidence that their earliest memorable patient death was a significant event. Furthermore, although most participants' experiences were characterised by emphatic or poignant description, there was most often a balance of challenges and rewards. Copyright © 2014 Elsevier Ltd. All rights reserved.

Commitment to sustainability: A content analysis of website for university organisations

NASA Astrophysics Data System (ADS)

Hasim, M. S.; Hashim, A. E.; Ariff, N. R. M.; Sapeciay, Z.; Abdullah, A. S.

2018-02-01

This research aim on investigating the commitments of organisations towards sustainability. For this research context, ‘commitment’ refers to the extent of information provided by universities in their website which demonstrated initiatives towards achieving the sustainability goal. The objective of this study was to identify sustainability initiatives highlighted within university websites using Australia as a case study. Thirty-nine (39) websites were reviewed and web content analysis was performed to publicly available data including any relevant accessible PDF documents attached to the universities website. Specific websites information was reviewed to detect sustainability themes in the broad university management and operations (i.e., in general policies, corporate mission statements, research activities, positions available and strategies). The commitment of Australian universities was significant and well established with a set of twenty (20) related themes were identified. The findings have some limitations because the established themes only emerged from the websites’ content without human validation which possibly weakens the correlations between website information and organisations actual practice. This possibility is recognised and for this reason, further assessment may be advantageous to provide verification of the findings. Therefore, further studies using other techniques are suggested such as interviews or observations for validation of data and reinforce the entire conclusions. An interesting aspect of this study is the validity of reviewing organisational websites for gauging actual practice and a number of researchers supporting this approached as indicated in methodology section of this paper.

Medical student career choice: a qualitative study of fourth-year medical students at Memorial University, Newfoundland

PubMed Central

Pianosi, Kiersten; Bethune, Cheri; Hurley, Katrina F.

2016-01-01

Background: Specialty career choice is a critical decision for medical students, and research has examined factors influencing particular specialties or assessed it from a demographic perspective. The purpose of this study was to explore and describe influential factors in students' decision-making, irrespective of their particular specialty in a Canadian medical school. Methods: Study participants were recruited from fourth-year medical classes at the Memorial University of Newfoundland in 2003, 2006, 2007 and 2008. Sixteen focus groups (n = 70) were led by a nonfaculty facilitator to uncover factors affecting medical student career choice. The analysis was guided by principles of grounded theory methodology. The focus group transcripts were sequentially coded based on recurring topics and themes that arose in the students' discussions. A set of key themes emerged and representative quotations for each theme were tracked. Results: Twenty themes were identified from the focus group discussions: 7 major, 3 intermediate and 10 minor themes. The major themes were undergraduate experience, exposure, public perception and recruitment, teacher influence, family/outside influences, residency issues and personal philosophy. Intermediate themes included lifestyle, bad-mouthing/negative perceptions and context. Minor themes included critical incidents/experiences, information gaps, uncertainty, nature of the work, extracurricular programs, timing of decision-making, financial issues, prestige, fit with colleagues and gender issues. Interpretation: Exposure to specialties and the timing of this exposure appears to be crucial to career choice, as does the context (who, what, when, where) of any particular rotation. Given the influence of personal philosophy, future research examining students' level of self-assessment and self-reflection in their decision-making processes and level of certainty about their selected specialty would be useful. PMID:27398357

Medical student career choice: a qualitative study of fourth-year medical students at Memorial University, Newfoundland.

PubMed

Pianosi, Kiersten; Bethune, Cheri; Hurley, Katrina F

2016-01-01

Specialty career choice is a critical decision for medical students, and research has examined factors influencing particular specialties or assessed it from a demographic perspective. The purpose of this study was to explore and describe influential factors in students' decision-making, irrespective of their particular specialty in a Canadian medical school. Study participants were recruited from fourth-year medical classes at the Memorial University of Newfoundland in 2003, 2006, 2007 and 2008. Sixteen focus groups (n = 70) were led by a nonfaculty facilitator to uncover factors affecting medical student career choice. The analysis was guided by principles of grounded theory methodology. The focus group transcripts were sequentially coded based on recurring topics and themes that arose in the students' discussions. A set of key themes emerged and representative quotations for each theme were tracked. Twenty themes were identified from the focus group discussions: 7 major, 3 intermediate and 10 minor themes. The major themes were undergraduate experience, exposure, public perception and recruitment, teacher influence, family/outside influences, residency issues and personal philosophy. Intermediate themes included lifestyle, bad-mouthing/negative perceptions and context. Minor themes included critical incidents/experiences, information gaps, uncertainty, nature of the work, extracurricular programs, timing of decision-making, financial issues, prestige, fit with colleagues and gender issues. Exposure to specialties and the timing of this exposure appears to be crucial to career choice, as does the context (who, what, when, where) of any particular rotation. Given the influence of personal philosophy, future research examining students' level of self-assessment and self-reflection in their decision-making processes and level of certainty about their selected specialty would be useful.

A thematic framework of illness narratives produced by stroke patients.

PubMed

Pluta, A; Ulatowska, H; Gawron, N; Sobanska, M; Lojek, E

2015-01-01

The present study aims at elucidating the impact of stroke on psychosocial functioning of stroke survivors. Data were investigated using interpretative thematic analysis of illness stories produced by 29 patients. Eight themes emerged from the data: Medical Information; Interpersonal Changes; Cognitive, Physical and Emotional Functioning; Strategies of Coping; Social Support; and Information Irrelevant to the Question. The most frequent organization of the themes followed the course of medical intervention and rehabilitation. Narrations of individual patients varied in terms of the presence of particular themes, the amount of information on each topic and organization. The results suggest that the analysis of non-guided illness narratives can be effectively used to identify the thematic areas important to individual stroke patients. The thematic content analysis of stroke stories can allow health professionals to better understand the patient's state of knowledge related to illness as well as his or her socio-psychological functioning which may be useful in the course of planning further assessment and rehabilitation of patients with stroke. Implications for Rehabilitation Experience of illness and life changes following stroke should be recognized as central to the provision of targeted rehabilitation. To understand the subjective perspective a content analysis of the content narrative is recommended. Our study highlights seven general thematic categories that may be regarded as key. The categories may be useful for clinicians to help individuals to clarify their main concerns following a stroke.

Global Nursing Issues and Development: Analysis of World Health Organization Documents.

PubMed

Wong, Frances Kam Yuet; Liu, Huaping; Wang, Hui; Anderson, Debra; Seib, Charrlotte; Molasiotis, Alex

2015-11-01

To analyze World Health Organization (WHO) documents to identify global nursing issues and development. Qualitative content analysis. Documents published by the six WHO regions between 2007 and 2012 and with key words related to nurse/midwife or nursing/midwifery were included. Themes, categories, and subcategories were derived. The final coding reached 80% agreement among three independent coders, and the final coding for the discrepant coding was reached by consensus. Thirty-two documents from the regions of Europe (n = 19), the Americas (n = 6), the Western Pacific (n = 4), Africa (n = 1), the Eastern Mediterranean (n = 1), and Southeast Asia (n = 1) were examined. A total of 385 units of analysis dispersed in 31 subcategories under four themes were derived. The four themes derived (number of unit of analysis, %) were Management & Leadership (206, 53.5), Practice (75, 19.5), Education (70, 18.2), and Research (34, 8.8). The key nursing issues of concern at the global level are workforce, the impacts of nursing in health care, professional status, and education of nurses. International alliances can help advance nursing, but the visibility of nursing in the WHO needs to be strengthened. Organizational leadership is important in order to optimize the use of nursing competence in practice and inform policy makers regarding the value of nursing to promote people's health. © 2015 Sigma Theta Tau International.

Maternal concerns about children overeating among low-income children

PubMed Central

Pesch, Megan H.; Rizk, Monika; Appugliese, Danielle P.; Rosenblum, Katherine L.; Miller, Alison; Lumeng, Julie C.

2016-01-01

Addressing overeating is essential to obesity treatment and prevention. The objectives of this study were to investigate maternal concern for child overeating, to identify associated participant characteristics and to determine if concern for child overeating is associated with maternal feeding practices. Low-income mothers (N = 289) of children (mean age 70.8 months) participated in a semi-structured interview. Themes of maternal concern for child overeating were identified and a coding scheme was reliably applied. Maternal feeding practices were measured by questionnaire and videotaped eating interactions. Logistic regressions were used to test the associations of participant characteristics with the presence of each theme, and bivariate analyses were used to test the associations of the presence of each theme with feeding practices. Three themes were identified: 1) mothers worry that their child does overeat, 2) mothers acknowledge that their child may overeat but indicate that it is not problematic because they manage their child’s eating behavior, and 3) mothers acknowledge that their child may overeat but indicate that it is not problematic because of characteristics inherent to the child. Child obesity predicted the themes; mothers of obese and overweight children are more likely to be concerned about overeating. Themes were associated with lower levels of observed pressure to eat. Only Theme 2 was associated with greater restrictive feeding practices. Interventions that provide parents practical, healthy ways to prevent child overeating may be helpful. PMID:27010491

Determining counselling communication strategies associated with successful quits in the National Health Service community pharmacy Stop Smoking programme in East London: a focused ethnography using recorded consultations.

PubMed

Rivas, Carol; Sohanpal, Ratna; MacNeill, Virginia; Steed, Liz; Edwards, Elizabeth; Antao, Laurence; Griffiths, Chris; Eldridge, Sandra; Taylor, Stephanie; Walton, Robert

2017-10-27

To determine communication strategies associated with smoking cessation in the National Health Service community pharmacy Stop Smoking programme. 11 community pharmacies in three inner east London boroughs. 9 stop smoking advisers and 16 pairs of smokers who either quit or did not quit at 4 weeks, matched on gender, ethnicity, age and smoking intensity. 1-3 audio-recorded consultations between an adviser and each pair member over 5-6 weeks were analysed using a mixed-method approach. First a content analysis was based on deductive coding drawn from a theme-oriented discourse analysis approach and the Roter Interaction Analysis System. Core themes were identified through this quantification to explore in detail the qualitative differences and similarities between quitters and non-quitters. Quantitative analysis revealed advisers used a core set of counselling strategies that privileged the 'voice of medicine' and often omitted explicit motivational interviewing. Smokers tended to quit when these core strategies were augmented by supportive talk, clear permission for smokers to seek additional support from the adviser between consultations, encouragement for smokers to use willpower. The thematic analysis highlighted the choices made by advisers as to which strategies to adopt and the impacts on smokers. The first theme 'Negotiating the smoker-adviser relationship' referred to adviser judgements about the likelihood the smoker would quit. The second theme, 'Roles of the adviser and smoker in the quit attempt', focused on advisers' counselling strategies, while the third theme, 'Smoker and adviser misalignment on reasons for smoking, relapsing and quitting', concerned inconsistencies in the implementation of National Centre for Smoking Cessation and Training recommendations. Advisers in community pharmacies should use the advantages of their familiarity with smokers to ensure appropriate delivery of patient-centred counselling strategies and reflect on the impact on their counselling of early judgements of smoker success. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Recommendations for medical training: a Native Hawaiian patient perspective.

PubMed

Kamaka, Martina L; Paloma, Diane S L; Maskarinec, Gregory G

2011-11-01

Culturally competent health care providers are needed to eliminate healthcare disparities. In the State of Hawai'i, Native Hawaiians suffer some of the worst health disparities. Prior to implementing a cultural competency curriculum to address these disparities, the John A. Burns School of Medicine's Department of Native Hawaiian Health Cultural Competency Curriculum Development team asked Native Hawaiian patients about their experiences and recommendations. We conducted four focus groups of Native Hawaiians to obtain recommendations on physician training, to be incorporated into the curriculum. Participants came from both rural and urban areas. Classical qualitative analysis of data identified recurrent themes. Five primary themes, arising in all four groups, were: (1) customer service; (2) respect for the patient; (3) inter-personal skills; (4) thoroughness of care; and (5) costs of medical care. Secondary themes, occurring in three of the four groups, were: (1) cultural competency training; (2) the training of medical office staff; (3) continuity of care; and (4) the role of the patient. Participants specifically requested that medical students receive cultural competency training about the host culture, its history, values, and traditional and alternative healing practices. The emphasis participants placed on the need for cultural competency training of physicians supports the need to address the role of culture in medical education. Although most of the issues raised are not unique to Hawai'i, participants' recommendations to teach students about the host culture and traditional healing practices identify important themes not usually found in medical school curricula.

Recommendations for Medical Training: A Native Hawaiian Patient Perspective

PubMed Central

Paloma, Diane SL; Maskarinec, Gregory G

2011-01-01

Background Culturally competent health care providers are needed to eliminate healthcare disparities. In the State of Hawai‘i, Native Hawaiians suffer some of the worst health disparities. Prior to implementing a cultural competency curriculum to address these disparities, the John A. Burns School of Medicine's Department of Native Hawaiian Health Cultural Competency Curriculum Development team asked Native Hawaiian patients about their experiences and recommendations. Methods We conducted four focus groups of Native Hawaiians to obtain recommendations on physician training, to be incorporated into the curriculum. Participants came from both rural and urban areas. Classical qualitative analysis of data identified recurrent themes. Results Five primary themes, arising in all four groups, were: (1) customer service; (2) respect for the patient; (3) inter-personal skills; (4) thoroughness of care; and (5) costs of medical care. Secondary themes, occurring in three of the four groups, were: (1) cultural competency training; (2) the training of medical office staff; (3) continuity of care; and (4) the role of the patient. Participants specifically requested that medical students receive cultural competency training about the host culture, its history, values, and traditional and alternative healing practices. Discussion The emphasis participants placed on the need for cultural competency training of physicians supports the need to address the role of culture in medical education. Although most of the issues raised are not unique to Hawai‘i, participants' recommendations to teach students about the host culture and traditional healing practices identify important themes not usually found in medical school curricula. PMID:22235153

Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study.

PubMed

Eton, David T; Ramalho de Oliveira, Djenane; Egginton, Jason S; Ridgeway, Jennifer L; Odell, Laura; May, Carl R; Montori, Victor M

2012-01-01

Burden of treatment refers to the workload of health care as well as its impact on patient functioning and well-being. We set out to build a conceptual framework of issues descriptive of burden of treatment from the perspective of the complex patient, as a first step in the development of a new patient-reported measure. We conducted semistructured interviews with patients seeking medication therapy management services at a large, academic medical center. All patients had a complex regimen of self-care (including polypharmacy), and were coping with one or more chronic health conditions. We used framework analysis to identify and code themes and subthemes. A conceptual framework of burden of treatment was outlined from emergent themes and subthemes. Thirty-two patients (20 female, 12 male, age 26-85 years) were interviewed. Three broad themes of burden of treatment emerged including: the work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt. The latter theme encompasses six subthemes including challenges with taking medication, emotional problems with others, role and activity limitations, financial challenges, confusion about medical information, and health care delivery obstacles. We identified several key domains and issues of burden of treatment amenable to future measurement and organized them into a conceptual framework. Further development work on this conceptual framework will inform the derivation of a patient-reported measure of burden of treatment.

Promoting influenza vaccination: insights from a qualitative meta-analysis of 14 years of influenza-related communications research by U.S. Centers for Disease Control and Prevention (CDC).

PubMed

Nowak, Glen J; Sheedy, Kristine; Bursey, Kelli; Smith, Teresa M; Basket, Michelle

2015-06-04

A primary mission of the U.S. Centers for Disease Control and Prevention's (CDC) is promoting immunization against seasonal influenza. As with most education efforts, CDC's influenza-related communications are often informed by formative research. A qualitative meta-analysis of 29 unpublished, primarily qualitative CDC-sponsored studies related to flu and flu vaccination knowledge, attitudes and beliefs (KABs). The studies, undertaken between 2000 and 2013, involved focus groups, in-depth interviews, message testing and surveys. Some involved health care professionals, while others involved members of the public, including sub-populations at risk for severe illness. The themes that emerged suggested progress in terms of KABs related to influenza and influenza vaccination, but also the persistence of many barriers to vaccine acceptance. With respect to the public, recurring themes included limited understanding of influenza and immunization recommendations, indications of greater sub-group recognition of the value of flu vaccination, continued resistance to vaccination among many, and overestimation of the effectiveness of non-vaccine measures. Seven cognitive facilitators of vaccination were identified in the studies along with six cognitive barriers. For health care providers, the analysis suggests greater knowledge and more favorable beliefs, but many misperceptions persist and are similar to those held by the public. KABs often differed by type or category of health care provider. The themes identified in this qualitative analysis illustrate the difficulty in changing KABs related to influenza and influenza vaccine, particularly on the scope and scale needed to greatly improve uptake. Even with an influenza pandemic and more vaccine options available, public and some health care provider perceptions and beliefs are difficult and slow to change. This meta-analysis does, however, provide important insights from previously unpublished information that can help those who are promoting influenza vaccination to health care providers, the general public and specific populations within the general population. Copyright © 2015 Elsevier Ltd. All rights reserved.

Promoting influenza vaccination: Insights from a qualitative meta-analysis of 14 years of influenza-related communications research by U.S. Centers for Disease Control and Prevention (CDC)

PubMed Central

Nowak, Glen J.; Sheedy, Kristine; Bursey, Kelli; Smith, Teresa M.; Basket, Michelle

2018-01-01

Introduction A primary mission of the U.S. Centers for Disease Control and Prevention's (CDC) is promoting immunization against seasonal influenza. As with most education efforts, CDCs influenza-related communications are often informed by formative research. Methods A qualitative meta-analysis of 29 unpublished, primarily qualitative CDC-sponsored studies related to flu and flu vaccination knowledge, attitudes and beliefs (KABs). The studies, undertaken between 2000 and 2013, involved focus groups, in-depth interviews, message testing and surveys. Some involved health care professionals, while others involved members of the public, including sub-populations at risk for severe illness. Findings The themes that emerged suggested progress in terms of KABs related to influenza and influenza vaccination, but also the persistence of many barriers to vaccine acceptance. With respect to the public, recurring themes included limited understanding of influenza and immunization recommendations, indications of greater sub-group recognition of the value of flu vaccination, continued resistance to vaccination among many, and overestimation of the effectiveness of non-vaccine measures. Seven cognitive facilitators of vaccination were identified in the studies along with six cognitive barriers. For health care providers, the analysis suggests greater knowledge and more favorable beliefs, but many misperceptions persist and are similar to those held by the public. KABs often differed by type or category of health care provider. Conclusions The themes identified in this qualitative analysis illustrate the difficulty in changing KABs related to influenza and influenza vaccine, particularly on the scope and scale needed to greatly improve uptake. Even with an influenza pandemic and more vaccine options available, public and some health care provider perceptions and beliefs are difficult and slow to change. This meta-analysis does, however, provide important insights from previously unpublished information that can help those who are promoting influenza vaccination to health care providers, the general public and specific populations within the general population. PMID:25936726

The Parent Perspective: “Being a Good Parent” When Making Critical Decisions in the PICU

PubMed Central

October, Tessie W.; Fisher, Kiondra R.; Feudtner, Chris; Hinds, Pamela S.

2015-01-01

Objective To identify factors important to parents making decisions for their critically ill child. Design Prospective cross-sectional study. Setting Single center, tertiary care PICU. Subjects Parents making critical treatment decisions for their child. Intervention One-on-one interviews that used the Good Parent Tool-2 open-ended question that asks parents to describe factors important for parenting their ill child and how clinicians could help them achieve their definition of “being a good parent” to their child. Parent responses were analyzed thematically. Parents also ranked themes in order of importance to them using the Good Parent Ranking Exercise. Measurement and Main Results Of 53 eligible parents, 43 (81%) participated. We identified nine themes through content analysis of the parent’s narrative statements from the Good Parent Tool. Most commonly (60% of quotes) components of being a good parent described by parents included focusing on their child’s quality of life, advocating for their child with the medical team, and putting their child’s needs above their own. Themes key to parental decision making were similar regardless of parent race and socioeconomic status or child’s clinical status. We identified nine clinician strategies identified by parents as helping them fulfill their parenting role, most commonly, parents wanted to be kept informed (32% of quotes). Using the Good Parent Ranking Exercise, fathers ranked making informed medical decisions as most important, whereas mothers ranked focusing on the child’s health and putting their child’s needs above their own as most important. However, mothers who were not part of a couple ranked making informed medical decisions as most important. Conclusion These findings suggest a range of themes important for parents to “be a good parent” to their child while making critical decisions. Further studies need to explore whether clinician’s knowledge of the parent’s most valued factor can improve family-centered care. PMID:24583502

Teaching and nature: Middle school science teachers' relationship with nature in personal and classroom contexts

NASA Astrophysics Data System (ADS)

Ball, Nadine Butcher

2000-10-01

This qualitative study describes three middle-school science teachers' relationship-with-nature in personal and classroom contexts. Participating teachers had more than 7 years experience and were deemed exemplary practitioners by others. Interview data about personal context focused on photographs the teacher took representing her/his relationship-with-nature in daily life. Interview data for classroom context explored classroom events during three or more researcher observations. Transcripts were analyzed using a multiple-readings approach to data reduction (Gilligan, Brown & Rogers, 1990; Miles & Huberman, 1994, p. 14, 141). Readings generated categorical information focused on portrayals of: nature; self; and relationship-with-nature. Categorical data were synthesized into personal and teaching case portraits for each teacher, and cross case themes identified. Participants indicated the portraits accurately represented who they saw themselves to be. Additional readings identified sub-stories by plot and theme. Narrative data were clustered to highlight elements of practice with implications for the relationship-with-nature lived in the classroom. These individual-scale moments were compared with cultural-scale distinctions between anthropocentric and ecological world views. Cross case themes included dimensions of exemplary middle-school science teaching important to teacher education and development, including an expanded conception of knowing and skillful use of student experience. Categorical analysis revealed each teacher had a unique organizing theme influencing their interpretation of personal and classroom events, and that nature is experienced differently in personal as opposed to teaching contexts. Narrative analysis highlights teachers' stories of classroom pets, dissection, and student dissent, illustrating an interplay between conceptual distinctions and personal dimensions during moments of teacher decision making. Results suggest teachers' competing commitments are resolved by balancing values in unique ways for the context. More productive resolutions involve transformation of the teacher's tensions so that competing goals better coexist. Foci helpful for teacher education and development are identified. Also discussed are complex ways cultural-scale world view is reproduced, or occasionally challenged, in the classroom life of three scientifically literate, skilled, and environmentally concerned teachers. The study concludes education in schools is more likely to reproduce than challenge elements of world view contributing to ecological decline.

A method for developing standardised interactive education for complex clinical guidelines

PubMed Central

2012-01-01

Background Although systematic use of the Perinatal Society of Australia and New Zealand internationally endorsed Clinical Practice Guideline for Perinatal Mortality (PSANZ-CPG) improves health outcomes, implementation is inadequate. Its complexity is a feature known to be associated with non-compliance. Interactive education is effective as a guideline implementation strategy, but lacks an agreed definition. SCORPIO is an educational framework containing interactive and didactic teaching, but has not previously been used to implement guidelines. Our aim was to transform the PSANZ-CPG into an education workshop to develop quality standardised interactive education acceptable to participants for learning skills in collaborative interprofessional care. Methods The workshop was developed using the construct of an educational framework (SCORPIO), the PSANZ-CPG, a transformation process and tutor training. After a pilot workshop with key target and stakeholder groups, modifications were made to this and subsequent workshops based on multisource written observations from interprofessional participants, tutors and an independent educator. This participatory action research process was used to monitor acceptability and educational standards. Standardised interactive education was defined as the attainment of content and teaching standards. Quantitative analysis of positive expressed as a percentage of total feedback was used to derive a total quality score. Results Eight workshops were held with 181 participants and 15 different tutors. Five versions resulted from the action research methodology. Thematic analysis of multisource observations identified eight recurring education themes or quality domains used for standardisation. The two content domains were curriculum and alignment with the guideline and the six teaching domains; overload, timing, didacticism, relevance, reproducibility and participant engagement. Engagement was the most challenging theme to resolve. Tutors identified all themes for revision whilst participants identified a number of teaching but no content themes. From version 1 to 5, a significant increasing trend in total quality score was obtained; participants: 55%, p=0.0001; educator: 42%, p=0.0004; tutor peers: 57%, p=0.0001. Conclusions Complex clinical guidelines can be developed into a workshop acceptable to interprofessional participants. Eight quality domains provide a framework to standardise interactive teaching for complex clinical guidelines. Tutor peer review is important for content validity. This methodology may be useful for other guideline implementation. PMID:23131137

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

PubMed

Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

PubMed Central

Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making. PMID:26295159

'I am not a tragedy. I am full of hope': communication impairment narratives in newspapers.

PubMed

O Malley-Keighran, Mary-Pat; Coleman, Mary

2014-01-01

Individual attitudes and more general attitudes in society can negatively influence the functioning of people with communication disorders according to the World Health Organisation's (WHO) International Classification of Functioning, Disability, and Health (ICF) (2002). Personal narratives have been recommended as the best means to convey and understand a person's life experience and have been investigated extensively. Investigations of personal narratives of communication impairment in mass media continue to be relatively rare in the literature. Published narratives can enrich understandings of clients' experiences by elucidating available representations of lived experiences of communication impairment. To answer the following research questions: What types of personal narratives of communication impairments are currently being disseminated in Irish newspapers? How are experiences of communication impairments represented in these narratives? The study was qualitative, deploying inductive analysis and drawing on Frank's (1995) typology of illness narratives to analyse narratives that were published in two Irish national newspapers over a 12-month period. The results illustrate the under-representation of communication impairments in Irish newspapers as ten out of 51 narratives in the corpus pertained to conditions that may have associated communication impairments. None of the narratives related the lived experience of a person with communication impairment in depth. A combination of quest and chaos narrative types was identified in six out of the ten narratives. Three out of the ten narratives featured a combination of chaos and restitution narrative types. One narrative was identified as being entirely a quest narrative. Three narratives contained elements of restitution. Inductive analysis revealed six main themes in the data (two for each narrative type) with one sub-theme identified for each main theme. The six main themes are: positive stances, re-evaluation of life, despair, fear, hope and support of others. The under-representation of the lived experience of people with communication impairments in Irish national newspapers may be seen as contributing to a general lack of understanding and awareness of communication impairments. This under-representation, coupled with a lack of awareness, may potentially affect the ability of people with communication impairments to re-engage with and reintegrate into their communities. © 2013 Royal College of Speech and Language Therapists.

A method for developing standardised interactive education for complex clinical guidelines.

PubMed

Vaughan, Janet I; Jeffery, Heather E; Raynes-Greenow, Camille; Gordon, Adrienne; Hirst, Jane; Hill, David A; Arbuckle, Susan

2012-11-06

Although systematic use of the Perinatal Society of Australia and New Zealand internationally endorsed Clinical Practice Guideline for Perinatal Mortality (PSANZ-CPG) improves health outcomes, implementation is inadequate. Its complexity is a feature known to be associated with non-compliance. Interactive education is effective as a guideline implementation strategy, but lacks an agreed definition. SCORPIO is an educational framework containing interactive and didactic teaching, but has not previously been used to implement guidelines. Our aim was to transform the PSANZ-CPG into an education workshop to develop quality standardised interactive education acceptable to participants for learning skills in collaborative interprofessional care. The workshop was developed using the construct of an educational framework (SCORPIO), the PSANZ-CPG, a transformation process and tutor training. After a pilot workshop with key target and stakeholder groups, modifications were made to this and subsequent workshops based on multisource written observations from interprofessional participants, tutors and an independent educator. This participatory action research process was used to monitor acceptability and educational standards. Standardised interactive education was defined as the attainment of content and teaching standards. Quantitative analysis of positive expressed as a percentage of total feedback was used to derive a total quality score. Eight workshops were held with 181 participants and 15 different tutors. Five versions resulted from the action research methodology. Thematic analysis of multisource observations identified eight recurring education themes or quality domains used for standardisation. The two content domains were curriculum and alignment with the guideline and the six teaching domains; overload, timing, didacticism, relevance, reproducibility and participant engagement. Engagement was the most challenging theme to resolve. Tutors identified all themes for revision whilst participants identified a number of teaching but no content themes. From version 1 to 5, a significant increasing trend in total quality score was obtained; participants: 55%, p=0.0001; educator: 42%, p=0.0004; tutor peers: 57%, p=0.0001. Complex clinical guidelines can be developed into a workshop acceptable to interprofessional participants. Eight quality domains provide a framework to standardise interactive teaching for complex clinical guidelines. Tutor peer review is important for content validity. This methodology may be useful for other guideline implementation.

Emergence of psychotic content in psychotherapy: An exploratory qualitative analysis of content, process, and therapist variables in a single case study.

PubMed

Leonhardt, Bethany L; Kukla, Marina; Belanger, Elizabeth; Chaudoin-Patzoldt, Kelly A; Buck, Kelly D; Minor, Kyle S; Vohs, Jenifer L; Hamm, Jay A; Lysaker, Paul H

2018-03-01

Emerging integrative metacognitive therapies for schizophrenia seek to promote subjective aspects of recovery. Beyond symptom remission, they are concerned with shared meaning-making and intersubjective processes. It is unclear, however, how such therapies should understand and respond to psychotic content that threatens meaning-making in therapeutic contexts. Accordingly, we sought to understand what factors precede and potentially trigger psychotic content within psychotherapy and what aids in resolution and return to meaning-making. Forty-eight transcripts from a single psychotherapy case were analyzed with thematic analysis. Passages of delusional or disorganized content were identified and themes present prior to the emergence and resolution of such material were identified and coded. Themes that preceded the emergence of psychotic content varied across early, middle, and late phases of therapy. Material related to the patient's experience of inadequacy and potential vulnerability, therapist setting boundaries within the therapeutic relationship and making challenges appeared to trigger psychotic content, especially early in treatment. Psychotic content may emerge in session following identifiable antecedents which change over phases of therapy. Attending to psychotic content by assuming a non-hierarchical stance and not dismissing psychotic content may aid in maintaining intersubjectivity and support patient's movements toward recovery in integrative metacognitive therapies.

Identifying Noncognitive Skills That Contribute to Dental Students' Success: Dental Faculty Perspectives.

PubMed

Virtue, Shannon Myers; Pendergast, Laura; Tellez, Marisol; Waldron, Elizabeth; Ismail, Amid

2017-03-01

The aims of this study were to identify noncognitive factors that dental faculty members perceived to contribute to dental students' success and to assess dental faculty members' ratings of the relative importance of these factors to academic performance, clinical performance, and overall success. Out of 184 eligible faculty members at one U.S. dental school, 43 respondents (23.3%) completed a survey in 2015-16. The survey asked respondents to rank the importance of seven noncognitive factors to academic performance, clinical performance, and overall success. Descriptive analysis was conducted to determine the ratings on importance of each noncognitive factor. Two additional open-ended questions asked faculty members to 1) think of dental students who performed very well and list the noncognitive factors they believed contributed to those students' success and 2) identify the two most important of those factors that contributed to success. Qualitative analysis was conducted to identify themes in the open-ended responses. The respondents rated professionalism and preparedness highest in importance for overall success. Preparedness was rated highest in importance for academic performance, and communication was highest in importance for clinical performance. Six themes were identified in the open-ended responses: communication/interpersonal skills, approach to learning, personal characteristics, professionalism, diverse experiences, and technical abilities. On both open-ended items, the most frequently cited noncognitive skill was communication/interpersonal skills followed by approach to learning. In this study, dental faculty members perceived communication, preparedness, and professionalism as important skills contributing to dental students' success.

Assessment method for epithermal gold deposits in Northeast Washington State using weights-of-evidence GIS modeling

USGS Publications Warehouse

Boleneus, D.E.; Raines, G.L.; Causey, J.D.; Bookstrom, A.A.; Frost, T.P.; Hyndman, P.C.

2001-01-01

The weights-of-evidence analysis, a quantitative mineral resource mapping tool, is used to delineate favorable areas for epithermal gold deposits and to predict future exploration activity of the mineral industry for similar deposits in a four-county area (222 x 277 km), including the Okanogan and Colville National Forests of northeastern Washington. Modeling is applied in six steps: (1) building a spatial digital database, (2) extracting predictive evidence for a particular deposit, based on an exploration model, (3) calculating relative weights for each predictive map, (4) combining the geologic evidence maps to predict the location of undiscovered mineral resources and (5) measuring the intensity of recent exploration activity by use of mining claims on federal lands, and (6) combining mineral resource and exploration activity into an assessment model of future mining activity. The analysis is accomplished on a personal computer using ArcView GIS platform with Spatial Analyst and Weights-of-Evidence software. In accord with the descriptive model for epithermal gold deposits, digital geologic evidential themes assembled include lithologic map units, thrust faults, normal faults, and igneous dikes. Similarly, geochemical evidential themes include placer gold deposits and gold and silver analyses from stream sediment (silt) samples from National Forest lands. Fifty mines, prospects, or occurrences of epithermal gold deposits, the training set, define the appropriate a really-associated terrane. The areal (or spatial) correlation of each evidential theme with the training set yield predictor theme maps for lithology, placer sites and normal faults. The weights-of-evidence analysis disqualified the thrust fault, dike, and gold and silver silt analyses evidential themes because they lacked spatial correlation with the training set. The decision to accept or reject evidential themes as predictors is assisted by considering probabilistic data consisting of weights and contrast values calculated for themes according to areal correlation with the training sites. Predictor themes having acceptable weights and contrast values are combined into a preliminary model to predict the locations of undiscovered epithermal gold deposits. This model facilitates ranking of tracts as non-permissive, permissive or favorable categories based on exclusionary, passive, and active criteria through evaluation of probabilistic data provided by interaction of predictor themes. The method is very similar to the visual inspection method of drawing conclusions from anomalies on a manually overlain system of maps. This method serves as a model for future mineral assessment procedures because of its objective nature. To develop a model to predict future exploration activity, the locations of lode mining claims were summarized for 1980, 1985, 1990, and 1996. Land parcels containing historic claims were identified either as those with mining claims present in 1980 or valid claims present in 1985. Current claim parcels were identified as those containing valid lode claims in either 1990 or 1996. A consistent parcel contains both historic and current claims. The epithermal gold and mining claim activity models were combined into an assessment (or mineral resource-activity) model to assist in land use decisions by providing a prediction of mineral exploration activity on federal land in the next decade. Ranks in the assessment model are: (1) no activity, (2) low activity, (3) low to moderate activity, (4) moderate activity and (5) high activity.

Health benefits of serious involvement in leisure activities among older Korean adults

PubMed Central

Kim, Junhyoung; Yamada, Naoko; Heo, Jinmoo; Han, Areum

2014-01-01

The existing literature suggests that serious engagement in leisure activities leads to happiness, life satisfaction, and successful aging among older adults. This qualitative study was used to examine the benefits of serious involvement in leisure activities among older Korean adults who were members of a sports club. Using an analytic data analysis, we identified three main themes associated with the benefits of serious engagement in leisure activities: 1) the experience of psychological benefits, 2) the creation of social support, and 3) the enhancement of physical health. These themes indicate that, through serious involvement in certain physical activities, participants gain various health benefits, which may contribute to successful aging. PMID:25059979

Health benefits of serious involvement in leisure activities among older Korean adults.

PubMed

Kim, Junhyoung; Yamada, Naoko; Heo, Jinmoo; Han, Areum

2014-01-01

The existing literature suggests that serious engagement in leisure activities leads to happiness, life satisfaction, and successful aging among older adults. This qualitative study was used to examine the benefits of serious involvement in leisure activities among older Korean adults who were members of a sports club. Using an analytic data analysis, we identified three main themes associated with the benefits of serious engagement in leisure activities: 1) the experience of psychological benefits, 2) the creation of social support, and 3) the enhancement of physical health. These themes indicate that, through serious involvement in certain physical activities, participants gain various health benefits, which may contribute to successful aging.

Visualizando el desarrollo de la nanomedicina en México.

PubMed

Robles-Belmont, Eduardo; Gortari-Rabiela, Rebeca de; Galarza-Barrios, Pilar; Siqueiros-García, Jesús Mario; Ruiz-León, Alejandro Arnulfo

2017-01-01

In this article we present a set of different visualizations of Mexico's nanomedicine scientific production data. Visualizations were developed using different methodologies for data analysis and visualization such as social network analysis, geography of science maps, and complex network communities analysis. Results are a multi-dimensional overview of the evolution of nanomedicine in Mexico. Moreover, visualizations allowed to identify trends and patterns of collaboration at the national and international level. Trends are also found in the knowledge structure of themes and disciplines. Finally, we identified the scientific communities in Mexico that are responsible for the new knowledge production in this emergent field of science. Copyright: © 2017 SecretarÍa de Salud

Rock and Roll! Using Classic Rock as a Guide to Fantasy-Theme Analysis

ERIC Educational Resources Information Center

Waite, Lisa

2008-01-01

This article presents an activity which makes use of Don McLean's song "American Pie," to engage students in fantasy-theme analysis. This discussion ultimately demonstrates how reality is constructed to satisfy the views shared by groups and individuals. Fantasy-theme analysis argues that audiences frequently shape their own connotation of an…

A Sex-Based Examination of Violence and Aggression Perceptions among Adolescents: An Interactive Qualitative Analysis

ERIC Educational Resources Information Center

Wyatt, Tammy Jordan

2010-01-01

In this study I examine the critical factors and themes that are identified as salient influencers of overt and relational aggression among youth. Sex differences and similarities associated with such adolescent perceptions are assessed. Forty-eight ethnically diverse youth between the ages of 14 and 16 years participated in sex-specific focus…

Not on the Same Page: Undergraduates' Information Retrieval in Electronic and Print Books

ERIC Educational Resources Information Center

Berg, Selinda Adelle; Hoffmann, Kristin; Dawson, Diane

2010-01-01

Academic libraries are increasingly collecting e-books, but little research has investigated how students use e-books compared to print texts. This study used a prompted think-aloud method to gain an understanding of the information retrieval behavior of students in both formats. Qualitative analysis identified themes that will inform instruction…

"Part of Me Feels Like There Must Be Something Missing": A Phenomenological Exploration of Practising Psychotherapy as a Clinical Psychologist

ERIC Educational Resources Information Center

McMahon, Aisling

2018-01-01

The experience of practising psychotherapy as a clinical psychologist was explored through a small number of in-depth interviews. Using Interpretative Phenomenological Analysis, three main themes were identified: "Feeling there's something missing", "Being able to get in there emotionally" and "Needing somewhere to go for…

Lebanese Youth Narratives: A Bleak Post-War Landscape

ERIC Educational Resources Information Center

Khalaf, Roseanne Saad

2014-01-01

To identify the themes that define the lives of a generation living in a conflict-ridden post-war society, I explore the changing views of Lebanese students through an analysis of the personal narrative texts that they created during my creative writing workshops over a 16-year period (1997-2012). Increasingly, young Lebanese feel trapped in a…

Candid Reflections on the Departure of Black Women Faculty from Academe in the United States

ERIC Educational Resources Information Center

Chambers, Crystal Renee

2012-01-01

Critical content analysis is used to identify content within blogs, exposing views within academe that reinforce and normalize racist, sexist, and interactively racist and sexist perspectives. The two themes explored here are unfairness and subjectivities within personnel processes and the qualifications of Black women faculty, as raised through a…

Educational Experiences and Needs of Higher Education Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Cai, Ru Ying; Richdale, Amanda L.

2016-01-01

Little research directly examines the needs of post-secondary students with ASD. The experiences and support needs of 23 students with ASD enrolled in two universities and four colleges, and 15 family members were explored in 15 semi-structured focus groups. Thematic analysis identified five themes: core ASD features, co-morbid conditions,…

Moving beyond the Apple Orchard: The Institutional Analysis of the Construction of Washtenaw Community College

ERIC Educational Resources Information Center

Kissel, Julie M.

2017-01-01

The purpose of the study was to understand the institutional forces that constructed and shaped the function, nature of funding, and governance of Washtenaw Community College (WCC). This qualitative, historical case study built on organizational theory used archival research to identify themes and the institutional building blocks for the junior…

The Use of Phototherapy in Group Treatment for Persons Who Are Chemically Dependent

ERIC Educational Resources Information Center

Glover-Graf, Noreen M.; Miller, Eva

2006-01-01

This study used photography as a therapeutic tool and a present-focused approach in a 12-week group intervention to treat adults with chemical dependence enrolled in an outpatient treatment program. A qualitative analysis identified themes related to the topics of trust, honesty, self-worth, power, and abuse. Self-esteem, abuse, and trauma-related…

Incredible Years Parent and Teacher Programmes: Emerging Themes and Issues

ERIC Educational Resources Information Center

Wetherall, Michelle

2014-01-01

This paper examines the Incredible Years Parent and Teacher Programmes that have originated from the work of Webster-Stratton. It provides a brief background on the programmes and a critical analysis of the issues as identified in current literature. The issues can be grouped into four main categories, the first being government decision-making…

Intact Marriages in which One Partner Dis-Identifies with Experiences of Same-Sex Attraction.

ERIC Educational Resources Information Center

Yarhouse, Mark A.; Pawlowski, Lisa M.; Tan, Erica S. N.

2003-01-01

This study is of heterosexually married couples in which one partner reports having experienced same-sex attraction and both partners report satisfaction with their marriage despite facing such constraints. Analysis suggested a number of themes related to how spouses learned about their partners' experiences of same-sex attraction, motivations for…

Separating Wheat from Chaff: How Secondary School Principals' Core Values and Beliefs Influence Decision-Making Related to Mandates

ERIC Educational Resources Information Center

Larsen, Donald E.; Hunter, Joseph E.

2014-01-01

Research conducted by Larsen and Hunter (2013, February) identified a clear pattern in secondary school principals' decision-making related to mandated change: more than half of participants' decisions were based on core values and beliefs, requiring value judgments. Analysis of themes revealed that more than half of administrative decisions…

Assessing School Council Contribution to the Enabling Conditions for Instructional Capacity Building: "An Urban District in Kentucky"

ERIC Educational Resources Information Center

Talley, Wade Kenneth; Keedy, John L.

2006-01-01

This study identified the enabling conditions related to building instructional capacity created by the councils in three high-performance schools in an urban district. The authors collected the data through observation, interview, and document mining. School-level data were sorted inductively into themes through constant comparative analysis.…

Editorial: What do we mean by "landscape"?

Treesearch

Paul H. Gobster; Wei-Ning Xiang

2012-01-01

As a prelude to revising the Aims and Scope of Landscape and Urban Planning (LAND), our last editorial discussed the journal’s "intellectual landscape" as revealed by an analysis of conceptual and proximal relationships between articles published in LAND and 50 other research journals. The six conceptual themes we identified--ecology, planning and management...

Embodiments of Human Identity: Detecting and Interpreting Hidden Narratives in Twentieth-Century Design History.

ERIC Educational Resources Information Center

Williamson, Jack

1995-01-01

Argues that the practice and influence of design history can benefit from new forms of visual and chronological analysis. Identifies and discusses a unique phenomenon, the "historical visual narrative." Examines special instances of this phenomenon in twentieth-century design and visual culture, which are tied to the theme of the…

The Experience of Psychiatric Care of Adolescents with Anxiety-based School Refusal and of their Parents: A Qualitative Study

PubMed Central

Sibeoni, Jordan; Orri, Massimiliano; Podlipski, Marc-Antoine; Labey, Mathilde; Campredon, Sophie; Gerardin, Priscille; Revah-Levy, Anne

2018-01-01

Objective Anxiety-based school refusal in adolescence is a complex, sometimes difficult to treat disorder that can have serious academic and psychiatric consequences. The objective of this qualitative study was to explore how teens with this problem and their parents experience the psychiatric care received. Methods This qualitative multicenter study took place in France, where we conducted semi-structured interviews with adolescents receiving psychiatric care for anxiety-based school refusal and with their parents. Data collection by purposive sampling continued until we reached theoretical sufficiency. Data analysis was thematic. Results This study included 20 adolescents aged 12 to 18 years and 21 parents. Two themes emerged from the analysis: (1) the goals of psychiatric care with two sub-themes, “self-transformation” and problem solving; and, (2) the therapeutic levers identified as effective with two sub-themes: time and space and relationships. Conclusion Our results show a divergence between parents and teens in their representations of care and especially of its goals. Therapeutic and research implications about the terms of return to school within psychiatric care and also the temporality of care are discussed. PMID:29375632

Making difficult decisions: Immigrants' experiences of employment preparation and participation.

PubMed

Huot, Suzanne; Chen, Xiaojie; King, Christiana; Painter-Zykmund, Ellen; Watt, Kaitlin

2016-06-13

Immigrants engage in complex integration processes that are mediated through daily occupations. A central element of socio-economic integration relates to labor market preparation and participation, including job searching, learning cultural values in the workplace, pursuing credential recognition and engaging in volunteering roles and paid employment. To examine how immigrants experienced occupations relating to preparing for, seeking, and gainingemployment. A secondary analysis using whole text analysis and line-by-line coding of twenty verbatim transcripts from interviews held with ten recently arrived immigrants to London, Ontario, Canada. Sessions consisted of a narrative interview, creation of an occupational map and a semi-structured follow-up interview. The participants' employment related occupations were characterized by the overarching theme of 'making difficult decisions'. This main theme was connected to four related sub-themes: 1) mechanisms of exclusion, 2) learning the host country's culture, 3) the influence of one's outlook on the decisions made, and 4) accessing support. This study identifies factors influencing immigrants' experiences of labor market preparation and participation. 'Making difficult decisions' was faced by all participants throughout the process of becoming part of the Canadian workforce and, ultimately, society at large.

In response to need: an analysis of social work roles over time.

PubMed

Kerson, Toba Schwaber; McCoyd, Judith L M

2013-10-01

In this qualitative research synthesis, interviews with 22 early health-related social workers were reexamined to identify themes that emerged when these social workers discussed the roles and goals of their work. Those interviews, with colleagues of Ida M. Cannon and those leaders in the next generation of social workers who had practiced during the first half of the 20th century, were conducted in 1976. For this study, the themes that emerged from the original interview data as social workers' responses to perceived needs were then compared with data consisting of 80 cases, drawn from four more recent casebooks (1982, 1989, 1996, 2010), that followed a framework of practice in context. The comparison demonstrated that themes remain consistent over time and include responses to needs created by wars, due to new and underserved populations, created by public health crises, created by technological advances, experienced by organizations, and resulting from economic and policy issues, as well as needs of clients. Analysis also suggests that caution is in order to avoid being co-opted by organizations and others in power at the cost of the profession's social justice mission and ethical imperatives.

Representations of workers with hearing loss in Canadian newspapers: a thematic analysis.

PubMed

Koerber, Raphaelle; Jennings, Mary Beth; Shaw, Lynn; Cheesman, Margaret

2017-04-01

Participation in the labour force with a hearing impairment presents a number of challenges. This study describes how Canadian newspapers represent workers with hearing loss. Taking a critical framing theory approach, thematic analysis was performed through coding relevant articles, abstracting and hierarchically categorising themes. Seven English-language Canadian newspapers were searched for publications between 1995 and 2016. Twenty-six articles met our criteria: discussing paid workers with hearing loss who used English rather than sign language on the job and making reference to workers' competence. We identified a global theme, Focussing on a good worklife or focussing on a limited worklife, composed of three organising themes (1) Prominent individuals struggle, take action, and continue despite hearing loss, (2) Workers with hearing loss in the community create their best day themselves, and (3) Workers with hearing loss, as a generalised whole, are portrayed as either competent or limited. The dominant framing portrays individual workers as ingenious, determined, and successful. Negative framings were predominantly generalisations to these workers as a group. To generate more positive framings, professionals can build relationships with consumer groups and, when contacted by the media, direct journalists to interview workers with hearing loss.

Analysis of humpback whale sounds in shallow waters of the Southeastern Arabian Sea: An indication of breeding habitat.

PubMed

Mahanty, Madan M; Latha, G; Thirunavukkarasu, A

2015-06-01

The primary objective of this work was to present the acoustical identification of humpback whales, detected by using an autonomous ambient noise measurement system, deployed in the shallow waters of the Southeastern Arabian Sea (SEAS) during the period January to May 2011. Seven types of sounds were detected. These were characteristically upsweeps and downsweeps along with harmonics. Sounds produced repeatedly in a specific pattern were referred to as phrases (PQRS and ABC). Repeated phrases in a particular pattern were referred to as themes, and from the spectrographic analysis, two themes (I and II) were identified. The variation in the acoustic characteristics such as fundamental frequency, range, duration of the sound unit, and the structure of the phrases and themes are discussed. Sound units were recorded from mid-January to mid-March, with a peak in February, when the mean SST is approx. 28 degree C, and no presence was recorded after mid-March. The temporal and thematic structures strongly determine the functions of the humpback whale song form. Given the use of song in the SEAS, this area is possibly used as an active breeding habitat by humpback whales during the winter season.

Communication between oncologists and lymphoma survivors during follow-up consultations: A qualitative analysis

PubMed Central

Franco, Kara; Shuk, Elyse; Philip, Errol; Blanch-Hartigan, Danielle; Parker, Patricia A.; Matasar, Matthew; Horwitz, Steven; Kissane, David; Banerjee, Smita C.; Bylund, Carma L.

2017-01-01

Cancer survivors often experience both short- and long-term challenges as a result of their cancer treatment. Many patients report feeling “lost in transition” following cancer treatment. The oncologist plays a key role in helping the patient to transition to survivorship. The purpose of this paper is to provide a descriptive understanding of the clinical care delivered during follow-up visits for lymphoma patients transitioning from active therapy into survivorship. We used thematic text analysis to identify themes in transcripts of audio recordings of 21 physicians and their patients in follow-up visits within 3 years of completing lymphoma treatment. Conversations between oncologists and patients during follow-up visits addressed a variety of themes, including specific health concerns, follow-up care, health promotion, prior treatment and test results, overall health status, emotional communication and affective tone, post-treatment rehabilitation, discussions occurring in the patient’s physical examination, and social issues. However, the frequency with which these themes were discussed varied. In addition, there did not appear to be a consistent framework for these visits. The varied nature of the follow-up visits analyzed in this study suggests the need for increased structure in survivorship-care consultations. PMID:28358241

In Pursuit of Theoretical Ground in Behavior Change Support Systems: Analysis of Peer-to-Peer Communication in a Health-Related Online Community.

PubMed

Myneni, Sahiti; Cobb, Nathan; Cohen, Trevor

2016-02-02

Research studies involving health-related online communities have focused on examining network structure to understand mechanisms underlying behavior change. Content analysis of the messages exchanged in these communities has been limited to the "social support" perspective. However, existing behavior change theories suggest that message content plays a prominent role reflecting several sociocognitive factors that affect an individual's efforts to make a lifestyle change. An understanding of these factors is imperative to identify and harness the mechanisms of behavior change in the Health 2.0 era. The objective of this work is two-fold: (1) to harness digital communication data to capture essential meaning of communication and factors affecting a desired behavior change, and (2) to understand the applicability of existing behavior change theories to characterize peer-to-peer communication in online platforms. In this paper, we describe grounded theory-based qualitative analysis of digital communication in QuitNet, an online community promoting smoking cessation. A database of 16,492 de-identified public messages from 1456 users from March 1-April 30, 2007, was used in our study. We analyzed 795 messages using grounded theory techniques to ensure thematic saturation. This analysis enabled identification of key concepts contained in the messages exchanged by QuitNet members, allowing us to understand the sociobehavioral intricacies underlying an individual's efforts to cease smoking in a group setting. We further ascertained the relevance of the identified themes to theoretical constructs in existing behavior change theories (eg, Health Belief Model) and theoretically linked techniques of behavior change taxonomy. We identified 43 different concepts, which were then grouped under 12 themes based on analysis of 795 messages. Examples of concepts include "sleepiness," "pledge," "patch," "spouse," and "slip." Examples of themes include "traditions," "social support," "obstacles," "relapse," and "cravings." Results indicate that themes consisting of member-generated strategies such as "virtual bonfires" and "pledges" were related to the highest number of theoretical constructs from the existing behavior change theories. In addition, results indicate that the member-generated communication content supports sociocognitive constructs from more than one behavior change model, unlike the majority of the existing theory-driven interventions. With the onset of mobile phones and ubiquitous Internet connectivity, online social network data reflect the intricacies of human health behavior as experienced by health consumers in real time. This study offers methodological insights for qualitative investigations that examine the various kinds of behavioral constructs prevalent in the messages exchanged among users of online communities. Theoretically, this study establishes the manifestation of existing behavior change theories in QuitNet-like online health communities. Pragmatically, it sets the stage for real-time, data-driven sociobehavioral interventions promoting healthy lifestyle modifications by allowing us to understand the emergent user needs to sustain a desired behavior change.

Teaching and Assessing ED Handoffs: A Qualitative Study Exploring Resident, Attending, and Nurse Perceptions.

PubMed

Flanigan, Moira; Heilman, James A; Johnson, Tom; Yarris, Lalena M

2015-11-01

The Accreditation Council for Graduate Medical Education requires that residency programs ensure resident competency in performing safe, effective handoffs. Understanding resident, attending, and nurse perceptions of the key elements of a safe and effective emergency department (ED) handoff is a crucial step to developing feasible, acceptable educational interventions to teach and assess this fundamental competency. The aim of our study was to identify the essential themes of ED-based handoffs and to explore the key cultural and interprofessional themes that may be barriers to developing and implementing successful ED-based educational handoff interventions. Using a grounded theory approach and constructivist/interpretivist research paradigm, we analyzed data from three primary and one confirmatory focus groups (FGs) at an urban, academic ED. FG protocols were developed using open-ended questions that sought to understand what participants felt were the crucial elements of ED handoffs. ED residents, attendings, a physician assistant, and nurses participated in the FGs. FGs were observed, hand-transcribed, audio-recorded and subsequently transcribed. We analyzed data using an iterative process of theme and subtheme identification. Saturation was reached during the third FG, and the fourth confirmatory group reinforced the identified themes. Two team members analyzed the transcripts separately and identified the same major themes. ED providers identified that crucial elements of ED handoff include the following: 1) Culture (provider buy-in, openness to change, shared expectations of sign-out goals); 2) Time (brevity, interruptions, waiting); 3) Environment (physical location, ED factors); 4) Process (standardization, information order, tools). Key participants in the ED handoff process perceive that the crucial elements of intershift handoffs involve the themes of culture, time, environment, and process. Attention to these themes may improve the feasibility and acceptance of educational interventions that aim to teach and assess handoff competency.

Study protocol for a framework analysis using video review to identify latent safety threats: trauma resuscitation using in situ simulation team training (TRUST)

PubMed Central

Petrosoniak, Andrew; Pinkney, Sonia; Hicks, Christopher; White, Kari; Almeida, Ana Paula Siquiera Silva; Campbell, Douglas; McGowan, Melissa; Gray, Alice; Trbovich, Patricia

2016-01-01

Introduction Errors in trauma resuscitation are common and have been attributed to breakdowns in the coordination of system elements (eg, tools/technology, physical environment and layout, individual skills/knowledge, team interaction). These breakdowns are triggered by unique circumstances and may go unrecognised by trauma team members or hospital administrators; they can be described as latent safety threats (LSTs). Retrospective approaches to identifying LSTs (ie, after they occur) are likely to be incomplete and prone to bias. To date, prospective studies have not used video review as the primary mechanism to identify any and all LSTs in trauma resuscitation. Methods and analysis A series of 12 unannounced in situ simulations (ISS) will be conducted to prospectively identify LSTs at a level 1 Canadian trauma centre (over 800 dedicated trauma team activations annually). 4 scenarios have already been designed as part of this protocol based on 5 recurring themes found in the hospital's mortality and morbidity process. The actual trauma team will be activated to participate in the study. Each simulation will be audio/video recorded from 4 different camera angles and transcribed to conduct a framework analysis. Video reviewers will code the videos deductively based on a priori themes of LSTs identified from the literature, and/or inductively based on the events occurring in the simulation. LSTs will be prioritised to target interventions in future work. Ethics and dissemination Institutional research ethics approval has been acquired (SMH REB #15-046). Results will be published in peer-reviewed journals and presented at relevant conferences. Findings will also be presented to key institutional stakeholders to inform mitigation strategies for improved patient safety. PMID:27821600

Being a surgeon--the myth and the reality: a meta-synthesis of surgeons' perspectives about factors affecting their practice and well-being.

PubMed

Orri, Massimiliano; Farges, Olivier; Clavien, Pierre-Alain; Barkun, Jeffrey; Revah-Lévy, Anne

2014-11-01

Synthesize the findings from individual qualitative studies about surgeons' account of their practice. Social and contextual factors of practice influence doctors' well-being and therapeutic relationships. Little is known about surgery, but it is generally assumed that surgeons are not affected by them. We searched international publications (2000-2012) to identify relevant qualitative research exploring how surgeons talk about their practice. Meta-ethnography (a systematic analysis of qualitative literature that compensates for the potential lack of generalizability of the primary studies and provides new insight by their conjoint interpretation) was used to identify key themes and synthesize them. We identified 51 articles (>1000 surgeons) from different specialties and countries. Two main themes emerged. (i) The patient-surgeon relationship, described surgeons' characterizations of their relationships with patients. We identified factors influencing surgical decision making, communication, and personal involvement in the process of care; these were surgeon-related, patient-related, and contextual. (ii) Group relations and culture described perceived issues related to surgical culture (image and education, teamwork, rules, and guidelines); it highlighted the influence of a social dimension on surgical practice. In both themes, we uncovered an emotional dimension of surgeons' practice. Surgeons' emphasis on technical aspects, individuality, and performance seems to impede a modern patient-centered approach to care and to act as a barrier to well-being. Our findings suggest that taking into account the relational and emotional dimensions of surgical practice (both with patients and within the institution) might improve surgical innovation, surgeons' well-being, and the attractiveness of this specialty.

How is stroke thrombolysis portrayed in UK national and London local newspapers? A review and critical discourse analysis.

PubMed

Cluckie, Gillian; Rudd, Anthony G; McKevitt, Christopher

2012-05-01

thrombolysis for stroke has been licensed in the UK since 2007 and needs to be administered within 4.5 h. Given this time critical factor, the media may have an important role in public awareness. this review aimed to find out how stroke thrombolysis was reported in UK national and London local newspapers and how treatment risks and benefits were communicated. Newspapers published between 1 January 2007 and 31 March 2010 were searched for articles on thrombolysis. Fifty-six articles were included and dispositive analysis, a qualitative analysis method, was used to identify themes. four main themes were identified: inaccurate description of thrombolysis, stroke clinicians' involvement, presentation of risks and benefits and patient stories. Inaccuracies included the presentation of thrombolysis as a treatment for transient ischaemic attack. Clinicians were quoted to suggest that thrombolysis produced complete recovery but were not reported to discuss risks or broader stroke management. The articles reported little or no risks of treatment. Patients' stories were used to reinforce that thrombolysis produces full recovery. this review found that newspaper media provides the public with inaccurate perspectives on thrombolysis. Clinicians may wish to check press articles prior to publishing and to consider the impact of reporting thrombolysis as a treatment which produces complete recovery.

Occupational Therapy Students' Perceptions of Spirituality in Training.

PubMed

Mthembu, Thuli Godfrey; Ahmed, Firdous; Nkuna, Thembi; Yaca, Khalipha

2015-12-01

Spirituality is recognized as an essential and integral component of a holistic approach in occupational therapy practice. However, little is known about occupational therapy students' perceptions regarding spirituality in learning context. This study used qualitative exploratory, descriptive design to explore the occupational therapy students' perceptions about spirituality in training. Using purposive sampling, four semi-structured interviews were conducted with two students, a lecturer and an occupational therapist. In addition, two focus groups were conducted with students in order to collect data. Data collected were audio-taped; transcribed and thematic analysis was used to identify themes. The analysis resulted in emergence of four themes: "Unique to every individual," "Spirituality in occupational therapy," "To be or not to be taught," and "The Real world." Participants perceived spirituality as an individually experienced. The study contributes to the body of knowledge base of occupational therapy education regarding spirituality. However, there is a need for guidelines to integrate spirituality in occupational therapy training.

Children's understandings’ of obesity, a thematic analysis

PubMed Central

Fielden, Amy L.; Sillence, Elizabeth; Little, Linda

2011-01-01

Childhood obesity is a major concern in today's society. Research suggests the inclusion of the views and understandings of a target group facilitates strategies that have better efficacy. The objective of this study was to explore the concepts and themes that make up children's understandings of the causes and consequences of obesity. Participants were selected from Reception (4–5 years old) and Year 6 (10–11 years old), and attended a school in an area of Sunderland, in North East England. Participants were separated according to age and gender, resulting in four focus groups, run across two sessions. A thematic analysis (Braun & Clarke, 2006) identified overarching themes evident across all groups, suggesting the key concepts that contribute to children's understandings of obesity are “Knowledge through Education,” “Role Models,” “Fat is Bad,” and “Mixed Messages.” The implications of these findings and considerations of the methodology are discussed in full. PMID:21897830

Redefining the bureaucratic encounter between service providers and service users: evidence from the Norwegian HUSK projects.

PubMed

Carnochan, Sarah; Austin, Michael J

2015-01-01

The HUSK projects, involving collaboration between service users, providers, educators, and researchers, coincided with the reorganization of national government services (NAV). The NAV reorganization brought together employment services, social insurance, and municipal social service benefits, and called for a service model where users would be empowered to influence the provision of services. In this analysis of the HUSK cases the authors focus on the relationship between the service user and the service provider, identifying themes in two broad domains: concepts of the individual that included the service user and the service provider and concepts of the relationship that included power, role, activity, interaction, and communication. Within each theme, the analysis highlights the transition from a traditional or historical state to a new or desired state and draws upon some of the classic literature that frames the encounters between service users and providers.

A Thematic Analysis of Edwin L. Godkin's Editorials in the "Nation," 1865-1899.

ERIC Educational Resources Information Center

Lee, Richard W.

This thematic analysis of Edward L. Godkin's editorials appearing in the "Nation" seeks to reveal the major themes on which he wrote and then, by quantitative analysis, to provide some order to the themes and to study the interaction of the themes. Five hundred and twelve editorials, written over a period of 35 years and representing…

Exploring grassroots feedback about cancer challenges in South Africa: a discussion of themes derived from content thematic analysis of 316 photo-narratives

PubMed Central

Edwards, Lynn Barbara; Greeff, Linda Estelle

2017-01-01

Introduction Cancer is an important health problem in Africa with projections that incidence could double by 2030. While sparse, the literature on cancer control in African low- and middle-income countries suggests poor cancer planning, overburdened services and poor outcomes. South Africa has established oncology health care services but also has low cancer awareness, poor cancer surveillance and widespread service challenges. Methods Data for this study was derived from 316 photovoice interviews with cancer patients, families of cancer patients and oncology workers across South Africa. The objectives of the study were to collect first-hand feedback about cancer challenges and to develop recommendations for the improvement of cancer control strategies. Results 9 themes of cancer challenges were distinguished via thematic content analysis of the photo-narratives. The identified themes of cancer challenges were physical and treatment challenges, emotional, poor services, transport, finances, information, powerlessness, stigma, and schooling challenges. Conclusion The findings of this study offer the patient and family perspective of cancer challenges as a valid contribution to our body of cancer knowledge. The 9 themes of cancer challenges profile the emotional, physical and social impact of cancer on patients and families, and offer detailed subjective information about problem occurrence in the trajectory of care. Recommendations following from the 9 themes of cancer challenges include training for improved patient-centred care standards, the need for cancer surveillance, innovative and locally appropriate cancer awareness campaigns, private and government health care partnerships and the development of psychosocial services. The advocating of findings and recommendations to influence cancer control strategies in South Africa, is indicated. PMID:29541319

Exploring grassroots feedback about cancer challenges in South Africa: a discussion of themes derived from content thematic analysis of 316 photo-narratives.

PubMed

Edwards, Lynn Barbara; Greeff, Linda Estelle

2017-01-01

Cancer is an important health problem in Africa with projections that incidence could double by 2030. While sparse, the literature on cancer control in African low- and middle-income countries suggests poor cancer planning, overburdened services and poor outcomes. South Africa has established oncology health care services but also has low cancer awareness, poor cancer surveillance and widespread service challenges. Data for this study was derived from 316 photovoice interviews with cancer patients, families of cancer patients and oncology workers across South Africa. The objectives of the study were to collect first-hand feedback about cancer challenges and to develop recommendations for the improvement of cancer control strategies. 9 themes of cancer challenges were distinguished via thematic content analysis of the photo-narratives. The identified themes of cancer challenges were physical and treatment challenges, emotional, poor services, transport, finances, information, powerlessness, stigma, and schooling challenges. The findings of this study offer the patient and family perspective of cancer challenges as a valid contribution to our body of cancer knowledge. The 9 themes of cancer challenges profile the emotional, physical and social impact of cancer on patients and families, and offer detailed subjective information about problem occurrence in the trajectory of care. Recommendations following from the 9 themes of cancer challenges include training for improved patient-centred care standards, the need for cancer surveillance, innovative and locally appropriate cancer awareness campaigns, private and government health care partnerships and the development of psychosocial services. The advocating of findings and recommendations to influence cancer control strategies in South Africa, is indicated.

Maternal concerns about children overeating among low-income children.

PubMed

Pesch, Megan H; Rizk, Monika; Appugliese, Danielle P; Rosenblum, Katherine L; Miller, Alison; Lumeng, Julie C

2016-04-01

Addressing overeating is essential to obesity treatment and prevention. The objectives of this study were to investigate maternal concern for child overeating, to identify associated participant characteristics and to determine if concern for child overeating is associated with maternal feeding practices. Low-income mothers (N=289) of children (mean age 70.8months) participated in a semi-structured interview. Themes of maternal concern for child overeating were identified and a coding scheme was reliably applied. Maternal feeding practices were measured by questionnaire and videotaped eating interactions. Logistic regressions were used to test the associations of participant characteristics with the presence of each theme, and bivariate analyses were used to test the associations of the presence of each theme with feeding practices. Three themes were identified: 1) mothers worry that their child does overeat, 2) mothers acknowledge that their child may overeat but indicate that it is not problematic because they manage their child's eating behavior, and 3) mothers acknowledge that their child may overeat but indicate that it is not problematic because of characteristics inherent to the child. Child obesity predicted the themes; mothers of obese and overweight children are more likely to be concerned about overeating. Themes were associated with lower levels of observed pressure to eat. Only Theme 2 was associated with greater restrictive feeding practices. Interventions that provide parents' practical, healthy ways to prevent child overeating may be helpful. Copyright © 2016. Published by Elsevier Ltd.

Free text adversity statements as part of a contextualised admissions process: a qualitative analysis.

PubMed

Owen, Lysa E; Anderson, Stephanie Ann; Dowell, Johnathan S

2018-04-02

Medical schools globally are encouraged to widen access and participation for students from less privileged backgrounds. Many strategies have been implemented to address this inequality, but much still needs to be done to ensure fair access for all. In the literature, adverse circumstances include financial issues, poor educational experience and lack of professional-status parents. In order to take account of adverse circumstances faced by applicants, The University of Dundee School of Medicine offers applicants the opportunity to report circumstances which may have resulted in disadvantage. Applicants do this by completing a free text statement, known as an 'adversity statement', in addition to the other application information. This study analysed adversity statements submitted by applicants during two admissions cycles. Analysis of content and theme was done to identify the information applicants wished to be taken into consideration, and what range of adverse circumstances individuals reported. This study used a qualitative approach with thematic analysis to categorise the adversity statements. The data was initially analysed to create a coding framework which was then applied to the whole data set. Each coded segment was then analysed for heterogeneity and homogeneity, segments merged into generated themes, or to create sub-themes. The data set comprised a total of 384 adversity statements. These showed a wide range of detail involving family, personal health, education and living circumstances. Some circumstances, such as geographical location, have been identified and explored in previous research, while others, such as long term health conditions, have had less attention in the literature. The degree of impact, the length of statement and degree of detail, demonstrated wide variation between submissions. This study adds to the debate on best practice in contextual admissions and raises awareness of the range of circumstances and impact applicants wish to be considered. The themes which emerged from the data included family, school, personal health, and geographical location issues. Descriptions of the degree of impact that an adverse circumstance had on educational or other attainment was found to vary substantially from statements indicating minor, impact through to circumstances stated as causing major impact.

Expanding the relationship context for couple-based HIV prevention: Elucidating women's perspectives on non-traditional sexual partnerships.

PubMed

Crankshaw, T L; Voce, A; Butler, L M; Darbes, L

2016-10-01

HIV prevention interventions targeting couples are efficacious, cost-effective and a key strategy for preventing HIV transmission. Awareness of the full spectrum of relationship types and underlying complexities, as well as available support mechanisms in a given context, are critical to the design of effective couple-based interventions. This paper is based on a sub-analysis of a qualitative research study investigating HIV disclosure dynamics amongst pregnant women living with HIV in Durban, South Africa. The sub-analysis explored the nature of participants' social and relationship contexts and consequences of these dynamics on women's feelings of trust towards partners and perceptions of partner commitment. Between June and August 2008, we conducted in-depth interviews with 62 pregnant women living with HIV and accessing Prevention of Mother-to-Child Transmission (PMTCT) services in Durban, South Africa. Transcripts were coded for emergent themes and categories using a grounded theoretical approach. The median age of participants was 26 years (interquartile range: 22-29 years). Three major themes with accompanying sub themes were identified: 1) relationship types (sub themes included unmarried status, minimal cohabitation with partners, presence of concurrent relationships), 2) relationship quality/functioning (sub themes included low trust and expectation of partner commitment, relationship turbulence, and lack of communication/ability to negotiate protective behaviours), and 3) factors underlying the relationship functioning (sub themes included dynamics of concurrent relationships coinciding with concurrent pregnancies, gender roles and unequal relationship power, intimate partner violence or threat thereof, and lack of social support). Our research findings indicate a lack of many of the dyadic relationship elements underlying couple-counselling frameworks for successful risk reduction coordination. Understanding sexual behaviour and the accompanying relationship dynamics within different types of partnerships is crucial for the optimal design of couple-based HIV prevention interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Barriers to antiretroviral therapy adherence in developed countries: a qualitative synthesis to develop a conceptual framework for a new patient-reported outcome measure.

PubMed

Engler, Kim; Lènàrt, Andras; Lessard, David; Toupin, Isabelle; Lebouché, Bertrand

2018-05-02

Suboptimal adherence to antiretroviral therapy (ART) remains common. Patient-centered tools are needed to comprehensively assess adherence barriers in HIV clinical practice. Thus, we conducted a research synthesis to produce a conceptual framework for a new patient-reported outcome measure (PRO) for use in routine HIV care in Canada and France. A PRO's conceptual framework graphically represents the concepts to be measured and the potential relationships between them. Towards ensuring the framework's relevance to the target populations' concerns, qualitative studies with HIV-positive adults on barriers to ART adherence in developed countries were synthesized with thematic analysis, attending to the cross-study prevalence and interrelationships of barrier themes. In March 2016, searches within Medline, PsychINFO, and Embase produced 5,284 records. Two reviewers determined the final sample (n = 41). Analysis generated three levels of ART adherence barrier themes. Twenty Level 2 themes and their component subthemes (Level 3) were organized into 6 higher-order themes (Level 1): Cognitive and emotional aspects (100% of studies contributing content -prevalence), Lifestyle factors (95%), Social and material context (95%), Characteristics of ART (90%), Health experience and state (73%), and Healthcare services and system (66%). As to interrelationships, study authors articulated relationships between all higher-order themes (Level 3). Linkages between Level 2 barrier themes showed great variability, from 21% to 95%. Overall, this synthesis contributes an exceptionally detailed conceptual framework and report of ART adherence barriers, applicable to a wide range of PLHIV. It suggests that a key to understanding many barriers is through their interconnections. It also identifies gaps in barrier research. Concerning the new PRO's development, comprehensiveness will need to be weighed against other concerns (e.g., respondent burden) and the provision of barrier-specific guidance for clinically addressing its scores seems essential.

Prescription drug abuse communication: A qualitative analysis of prescriber and pharmacist perceptions and behaviors.

PubMed

Hagemeier, Nicholas E; Tudiver, Fred; Brewster, Scott; Hagy, Elizabeth J; Hagaman, Angela; Pack, Robert P

Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited. This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists. Five focus groups (N = 35) were conducted within the Appalachian Research Network (AppNET), a rural primary care practice-based research network (PBRN) in South Central Appalachia between February and October, 2014. Focus groups were structured around the administration of three previously validated trait-level communication survey instruments, and one instrument developed by the investigators to gauge HCP prescription drug abuse communication engagement and perceived communication importance. Using a grounded theory approach, focus group themes were inductively derived and coded independently by study investigators. Member-checking interviews were conducted to validate derived themes. Respondents' trait-level communication self-perceptions indicated low communication apprehension, high self-perceived communication competence, and average willingness to communicate as compared to instrument specific criteria and norms. Significant variation in HCP communication behavior engagement was noted specific to PDA. Two overarching themes were noted for HCP-patient communication: 1) influencers of HCP communication and prescribing/dispensing behaviors, and 2) communication behaviors. Multiple sub-themes were identified within each theme. Similarities were noted in perceptions and behaviors across both prescribers and pharmacists. Despite the perceived importance of engaging in PDA communication, HCPs reported that prescription drug abuse communication is uncomfortable, variable, multifactorial, and often avoided. The themes that emerged from this analysis support the utility of communication science and health behavior theories to better understand and improve PDA communication behaviors of both prescribers and pharmacists, and thereby improve engagement in PDA prevention and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Prescription Drug Abuse Communication: A Qualitative Analysis of Prescriber and Pharmacist Perceptions and Behaviors

PubMed Central

Hagemeier, Nicholas E.; Tudiver, Fred; Brewster, Scott; Hagy, Elizabeth J.; Hagaman, Angela; Pack, Robert P.

2016-01-01

Background Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited. Objectives This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists. Methods Five focus groups (N=35) were conducted within the Appalachian Research Network (AppNET), a rural primary care practice-based research network (PBRN) in South Central Appalachia between February and October, 2014. Focus groups were structured around the administration of three previously validated trait-level communication survey instruments, and one instrument developed by the investigators to gauge HCP prescription drug abuse communication engagement and perceived communication importance. Using a grounded theory approach, focus group themes were inductively derived and coded independently by study investigators. Member-checking interviews were conducted to validate derived themes. Results Respondents’ trait-level communication self-perceptions indicated low communication apprehension, high self-perceived communication competence, and average willingness to communicate as compared to instrument specific criteria and norms. Significant variation in HCP communication behavior engagement was noted specific to PDA. Two overarching themes were noted for HCP-patient communication: 1) influencers of HCP communication and prescribing/dispensing behaviors, and 2) communication behaviors. Multiple sub-themes were identified within each theme. Similarities were noted in perceptions and behaviors across both prescribers and pharmacists. Conclusions Despite the perceived importance of engaging in PDA communication, HCPs reported that prescription drug abuse communication is uncomfortable, variable, multifactorial, and often avoided. The themes that emerged from this analysis support the utility of communication science and health behavior theories to better understand and improve PDA communication behaviors of both prescribers and pharmacists, and thereby improve engagement in PDA prevention and treatment. PMID:26806859

"Back in the day"… what are surgeon bloggers saying about their careers?

PubMed

Knox, Aaron D C; Reddy, Shalini; Mema, Briseida; DeMoya, Marc; Cilli-Turner, Emily; Harris, Ilene

2014-01-01

The projected shortage of general surgeons is owing to an increased demand for surgical services and a declining pool of practicing general surgeons. Burnout and attrition of residents from surgical residencies contribute to the latter. Attrition may be caused by the choice of a career in surgery without an understanding of the realities; subsequent recognition of the realities may cause residents to reexamine the opportunity costs of a career in the field. Because weblogs (blogs) are often used for reflection, qualitative analysis of the content of blogs authored by general surgeons may provide insight into the positive and negative realities of a surgical career. These insights may be informative to students as they consider a surgical career, may better prepare residents for the reality of what is to come, and identify targets for improving the culture of surgery and mitigating sources of career dissatisfaction. This is a qualitative analysis of entries on blogs authored by practicing general surgeons. A systematic approach was used to identify a sample of blog posts. These posts were analyzed using a constant comparative analysis method associated with constructivist grounded theory. Thirty-five posts drawn from 9 blogs were analyzed. Five main themes were identified in the reviewed blogs. Overall, 104 comments were positive in tone, 74 were neutral, and 147 were negative. There were 96 comments that focused on the rewards of being a surgeon, 88 concerning the practice environment, 57 about the educational environment, 54 about the toll of being a surgeon, and 30 pertaining to nostalgia. The most commonly identified subthemes focused on the training experience (38 comments), a surgical career providing personal fulfillment (35 comments), the impact of the culture of surgery (33 comments), and financial concerns (30 comments). A conceptual framework focused on balance was used to explain how the themes relate to each other. Themes identified are consistent with prior studies about surgeon career satisfaction. The considerable rewards of being a surgeon were outweighed by the challenges encountered in day-to-day practice. Meeting societal needs for more general surgeons would require efforts to minimize the tolls, to the extent possible, while encouraging individuals drawn to the rewarding work of being a surgeon. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Content analysis of public opinion on sexual expression and dementia: Implications for nursing home policy development.

PubMed

Syme, Maggie L; Yelland, Erin; Cornelison, Laci; Poey, Judith L; Krajicek, Ryan; Doll, Gayle

2017-08-01

We examined public opinion of sexual expression and dementia to inform nursing home policy and practice. A content analysis was conducted on public comments (N=1194) posted in response to a New York Times article about a highly publicized legal case involving a husband engaging in sexual acts with his wife who had dementia, living in a nursing home. Researchers utilized constant comparative analysis to code the comments; reliability analysis showed moderately strong agreement at the subcategory level. Data were also coded to indicate whether the commenter thought the couple should or should not have been allowed to be sexual. One primary theme was identified: conditions necessary for someone to be sexual. Six categories were identified within this theme, with the public commentary considering factors such as marital relationships, intimacy needs and several sexual consent-related issues as key conditions necessary to be sexual in a nursing home setting. Overall, the majority of commenters were in support of sexual expression for an individual with dementia in the described situation. This study revealed sexual expression among individuals with dementia is a contentious issue with strong public opinions about how this should be managed in a nursing home setting. These opinions should be considered as policy related to sexual expression in nursing homes is developed. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

The use of social environment in a psychosocial clubhouse to facilitate recovery-oriented practice

PubMed Central

Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2016-01-01

Background Recovery-oriented language has been widely adopted in mental health policy; however, little is known about how recovery practices are implemented within individual services, such as psychosocial clubhouses. Aims To explore how recovery practices are implemented in a psychosocial clubhouse. Method Qualitative case study design informed by self-determination theory was utilised. This included 120 h of participant observation, interviews with 12 clubhouse members and 6 staff members. Field notes and interview transcripts were subject to theoretical thematic analysis. Results Two overarching themes were identified, each comprising three sub-themes. In this paper, the overarching theme of ‘social environment’ is discussed. It was characterised by the sub-themes, ‘community and consistency’, ‘participation and opportunity’ and ‘respect and autonomy’. Conclusions Social environment was used to facilitate recovery-oriented practice within the clubhouse. Whether recovery is experienced by clubhouse members in wider society, may well depend on supports and opportunities outside the clubhouse. Declaration of interests None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703771

A qualitative study of interference with communicative participation across communication disorders in adults.

PubMed

Baylor, Carolyn; Burns, Michael; Eadie, Tanya; Britton, Deanna; Yorkston, Kathryn

2011-11-01

To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Interviews were conducted with 44 adults representing 7 different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering, Parkinson's disease, amyotrophic lateral sclerosis, and laryngectomy. This article represents a secondary analysis of qualitative data collected in cognitive interviews during development of the Communicative Participation Item Bank. The data were analyzed to identify themes in participants' experiences related to communicative participation. Participants described many situations in which they experienced interference in communicative participation. Two themes emerged from the data. The first theme was Interference is both "functional" and "emotional," in which participants defined interference as limitations in accomplishing tasks and emotional consequences. The second theme was "It depends"-sources of interference, in which participants described many variables that contribute to interference in participation. Participants had limited control of some variables such as symptoms and environmental contexts, but personal decisions and priorities also influenced participation. Despite different impairments and activity limitations, participants described similar communicative participation restrictions. These similarities may have theoretical and clinical implications in terms of how we assess, treat, and study the participation restrictions associated with communication disorders.

Mothers' perceptions of family centred care in neonatal intensive care units.

PubMed

Finlayson, Kenneth; Dixon, Annie; Smith, Chris; Dykes, Fiona; Flacking, Renee

2014-10-01

To explore mothers' perceptions of family centred care (FCC) in neonatal intensive care units (NICUs) in England. The qualitative experiences of 12 mothers from three NICUs in the UK were elicited using individual interviews. A thematic network analysis was conducted on the transcribed interviews A central global theme supported by a number of organizing themes were developed reflecting the views of the mothers and their experiences of FCC. A global theme of "Finding My Place" was identified, supported by six organizing themes: Mothering in Limbo; Deference to the Experts; Anxious Surveillance; Muted Relations, Power Struggles and Consistently Inconsistent. Mothers experienced a state of liminality and were acutely sensitive to power struggles, awkward relationships and inconsistencies in care. To try to maintain their equilibrium and protect their baby they formed deferential relationships with health professionals and remained in a state of anxious surveillance. This study illustrates that despite the rhetoric around the practice of FCC in NICUs, there was little in the mother's narratives to support this. It is of the utmost importance to minimize the consequences of the liminal experience, to improve staff-mother interactions and to facilitate mothers' opportunities to be primary caregivers. Copyright © 2014 Elsevier B.V. All rights reserved.

Autonomy support and need satisfaction in prevocational programs on care farms: The self-determination theory perspective.

PubMed

Ellingsen-Dalskau, Lina H; Morken, Margrete; Berget, Bente; Pedersen, Ingeborg

2015-01-01

Mental health problems are leading causes for early and prolonged withdrawal from the workforce. Green work on care farms represents a prevocational training program intended to stimulate return to work for people with mental health problems. Research suggests that care farms may improve mental health, but there is still little knowledge of the subjective perspective of clients in green work programs. To gain a deeper and broader understanding of the individual experiences of people with mental health problems participating in green work on care farms in Norway. A hermeneutic phenomenological research design was applied. Ten semi-structured interviews were conducted. The self-determination theory (SDT) was adapted to gain a deeper understanding of the themes that emerged in the analysis process of the interviews. Five main themes materialize describing participants' experiences within the green work program. The main themes consist of (1) structure and flexibility, (2) understanding and acknowledgement, (3) guidance and positive feedback, (4) nature and animals, and (5) reflections on personal functioning and the future. The main themes identified indicate a high degree of autonomy support and need satisfaction within the care farm context, which according to SDT can facilitate good human functioning, and well-being.

The Acceptability of Acupuncture for Low Back Pain: A Qualitative Study of Patient’s Experiences Nested within a Randomised Controlled Trial

PubMed Central

Hopton, Ann; Thomas, Kate; MacPherson, Hugh

2013-01-01

Introduction The National Institute for Health and Clinical Excellence guidelines recommend acupuncture as a clinically effective treatment for chronic back pain. However, there is insufficient knowledge of what factors contribute to patients’ positive and negative experiences of acupuncture, and how those factors interact in terms of the acceptability of treatment. This study used patient interviews following acupuncture treatment for back pain to identify, understand and describe the elements that contribute or detract from acceptability of treatment. Methods The study used semi-structured interviews. Twelve patients were interviewed using an interview schedule as a sub-study nested within a randomised controlled trial of acupuncture for chronic back pain. The interviews were analysed using thematic analysis. Results and Discussion Three over-arching themes emerged from the analysis. The first entitled facilitators of acceptability contained five subthemes; experience of pain relief, improvements in physical activity, relaxation, psychological benefit, reduced reliance on medication. The second over-arching theme identified barriers to acceptability, which included needle-related discomfort and temporary worsening of symptoms, pressure to continue treatment and financial cost. The third over-arching theme comprised mediators of acceptability, which included pre-treatment mediators such as expectation and previous experience, and treatment-related mediators of time, therapeutic alliance, lifestyle advice and the patient’s active involvement in recovery. These themes inform our understanding of the acceptability of acupuncture to patients with low back pain. Conclusion The acceptability of acupuncture treatment for low back pain is complex and multifaceted. The therapeutic relationship between the practitioner and patient emerged as a strong driver for acceptability, and as a useful vehicle to develop the patients’ self-efficacy in pain management in the longer term. Unpleasant treatment related effects do not necessarily detract from patients’ overall perception of acceptability. PMID:23437246

A systematic review of the factors that influence the quality and effectiveness of telesupervision for health professionals.

PubMed

Martin, Priya; Lizarondo, Lucylynn; Kumar, Saravana

2018-05-01

Introduction Whilst telesupervision (clinical supervision undertaken using communication technology) is being used more frequently, there is limited information on what factors influence its effectiveness and quality. We undertook this systematic review to address this gap. Methods Eligible telesupervision studies were identified following targeted search of electronic databases and the grey literature. Data were synthesised thematically, resulting in development of core themes. Results We identified 286 papers for initial relevancy screening by title and abstract. The full text of 36 papers were then retrieved and assessed for further relevance. A total of 11 papers were included in the final analysis. We identified eight themes that contribute to effective and high-quality telesupervision: supervisee characteristics, supervisor characteristics, supervision characteristics, supervisory relationship, communication strategies, prior face-to-face contact, environmental factors and technological considerations. Conclusion From the available evidence, telesupervision can be a feasible and acceptable form of clinical supervision if set up well. Further studies with robust designs are required to strengthen the existing evidence on what makes telesupervision effective, as well as to examine its cost-effectiveness.

Adolescents’ Perception of the Psychosocial Factors affecting Sustained Engagement in Sports and Physical Activity

PubMed Central

GAVIN, JAMES; MCBREARTY, MADELEINE; MALO, KIT; ABRAVANEL, MICHAEL; MOUDRAKOVSKI, TATIANA

2016-01-01

The purpose of this study was to explore adolescents’ perceptions of psychosocial influences – personal characteristics, environmental factors and behavioural undertakings – influencing their prolonged involvement in sports and physical activity (PA). A qualitative approach was adopted wherein 16 adolescents (8 boys, 8 girls; mean age 15.9 years), who had been physically active for at least the last 8 years, and sixteen adults identified as their ‘parents’ or ‘guardians’ participated in semi-structured interviews. Interviews were transcribed verbatim and coded using the HyperRESEARCH software. Data were analysed using thematic analysis procedures. Four main themes pertaining to psychosocial influences were identified: 1) personal characteristics; 2) school and community resources; 3) parental support; and 4) social interaction. Except for social interaction, for which participants did not identify challenges, themes are discussed according to their motivational aspects and the challenges they represent for adolescents’ PA involvement. The research has implications for health promotion endeavours directed toward parents of children and adolescents. Given the limitations of a qualitative study, readers are invited to apply the conclusions to their own context. PMID:27766129

"… Trial and error …": Speech-language pathologists' perspectives of working with Indigenous Australian adults with acquired communication disorders.

PubMed

Cochrane, Frances Clare; Brown, Louise; Siyambalapitiya, Samantha; Plant, Christopher

2016-10-01

This study explored speech-language pathologists' (SLPs) perspectives about factors that influence clinical management of Aboriginal and Torres Strait Islander adults with acquired communication disorders (e.g. aphasia, motor speech disorders). Using a qualitative phenomenological approach, seven SLPs working in North Queensland, Australia with experience working with this population participated in semi-structured in-depth interviews. Qualitative content analysis was used to identify categories and overarching themes within the data. Four categories, in relation to barriers and facilitators, were identified from participants' responses: (1) The Practice Context; (2) Working Together; (3) Client Factors; and (4) Speech-Language Pathologist Factors. Three overarching themes were also found to influence effective speech pathology services: (1) Aboriginal and Torres Strait Islander Cultural Practices; (2) Information and Communication; and (3) Time. This study identified many complex and inter-related factors which influenced SLPs' effective clinical management of this caseload. The findings suggest that SLPs should employ a flexible, holistic and collaborative approach in order to facilitate effective clinical management with Aboriginal and Torres Strait Islander people with acquired communication disorders.

Parental perspectives on inpatient versus outpatient management of pediatric febrile neutropenia.

PubMed

Diorio, Caroline; Martino, Julia; Boydell, Katherine Mary; Ethier, Marie-Chantal; Mayo, Chris; Wing, Richard; Teuffel, Oliver; Sung, Lillian; Tomlinson, Deborah

2011-01-01

To describe parent preference for treatment of febrile neutropenia and the key drivers of parental decision making, structured face-to-face interviews were used to elicit parent preferences for inpatient versus outpatient management of pediatric febrile neutropenia. Parents were presented with 4 different scenarios and asked to indicate which treatment option they preferred and to describe reasons for this preference during the face-to-face interview. Comments were recorded in writing by research assistants. A consensus approach to thematic analysis was used to identify themes from the written comments of the research assistants. A total of 155 parents participated in the study. Of these, 80 (51.6%) parents identified hospital-based intravenous treatment as the most preferred treatment scenario for febrile neutropenia. The major themes identified included convenience/disruptiveness, physical health, emotional well-being, and modifiers of parental decision making. Most parents preferred hospital-based treatment for febrile neutropenia. An understanding of issues that influence parental decision making may assist health care workers in planning program implementation and further support families in their decision-making process.

The current status of theory evaluation in nursing.

PubMed

Im, Eun-Ok

2015-10-01

To identify the current status of theory evaluation in nursing and provide directions for theory evaluation for future development of theoretical bases of nursing discipline. Theory evaluation is an essential component in development of nursing knowledge, which is a critical element in development of nursing discipline. Despite earlier significant efforts for theory evaluation in nursing, a recent decline in the number of theory evaluation articles was noted and there have been few updates on theory evaluation in nursing. Discussion paper. A total of 58 articles published from 2003-2014 were retrieved through searches using the PUBMED, PsyInfo and CINAHL. The articles were sorted by the area of evaluation and analysed to identify themes reflecting the theory evaluation process. Diverse ways of theory evaluation need to be continuously used in future theory evaluation efforts. Six themes reflecting the theory evaluation process were identified: (a) rarely using existing theory evaluation criteria; (b) evaluating specifics; (c) using various statistical analysis methods; (d) developing instruments; (e) adopting in practice and education; and (f) evaluating mainly middle-range theories and situation-specific theories. © 2015 John Wiley & Sons Ltd.

Adolescents' Perception of the Psychosocial Factors affecting Sustained Engagement in Sports and Physical Activity.

PubMed

Gavin, James; McBrearty, Madeleine; Malo, Kit; Abravanel, Michael; Moudrakovski, Tatiana

2016-01-01

The purpose of this study was to explore adolescents' perceptions of psychosocial influences - personal characteristics, environmental factors and behavioural undertakings - influencing their prolonged involvement in sports and physical activity (PA). A qualitative approach was adopted wherein 16 adolescents (8 boys, 8 girls; mean age 15.9 years), who had been physically active for at least the last 8 years, and sixteen adults identified as their 'parents' or 'guardians' participated in semi-structured interviews. Interviews were transcribed verbatim and coded using the HyperRESEARCH software. Data were analysed using thematic analysis procedures. Four main themes pertaining to psychosocial influences were identified: 1) personal characteristics; 2) school and community resources; 3) parental support; and 4) social interaction. Except for social interaction, for which participants did not identify challenges, themes are discussed according to their motivational aspects and the challenges they represent for adolescents' PA involvement. The research has implications for health promotion endeavours directed toward parents of children and adolescents. Given the limitations of a qualitative study, readers are invited to apply the conclusions to their own context.

Examination of China’s performance and thematic evolution in quantum cryptography research using quantitative and computational techniques

PubMed Central

2018-01-01

This study performed two phases of analysis to shed light on the performance and thematic evolution of China’s quantum cryptography (QC) research. First, large-scale research publication metadata derived from QC research published from 2001–2017 was used to examine the research performance of China relative to that of global peers using established quantitative and qualitative measures. Second, this study identified the thematic evolution of China’s QC research using co-word cluster network analysis, a computational science mapping technique. The results from the first phase indicate that over the past 17 years, China’s performance has evolved dramatically, placing it in a leading position. Among the most significant findings is the exponential rate at which all of China’s performance indicators (i.e., Publication Frequency, citation score, H-index) are growing. China’s H-index (a normalized indicator) has surpassed all other countries’ over the last several years. The second phase of analysis shows how China’s main research focus has shifted among several QC themes, including quantum-key-distribution, photon-optical communication, network protocols, and quantum entanglement with an emphasis on applied research. Several themes were observed across time periods (e.g., photons, quantum-key-distribution, secret-messages, quantum-optics, quantum-signatures); some themes disappeared over time (e.g., computer-networks, attack-strategies, bell-state, polarization-state), while others emerged more recently (e.g., quantum-entanglement, decoy-state, unitary-operation). Findings from the first phase of analysis provide empirical evidence that China has emerged as the global driving force in QC. Considering China is the premier driving force in global QC research, findings from the second phase of analysis provide an understanding of China’s QC research themes, which can provide clarity into how QC technologies might take shape. QC and science and technology policy researchers can also use these findings to trace previous research directions and plan future lines of research. PMID:29385151

Examination of China's performance and thematic evolution in quantum cryptography research using quantitative and computational techniques.

PubMed

Olijnyk, Nicholas V

2018-01-01

This study performed two phases of analysis to shed light on the performance and thematic evolution of China's quantum cryptography (QC) research. First, large-scale research publication metadata derived from QC research published from 2001-2017 was used to examine the research performance of China relative to that of global peers using established quantitative and qualitative measures. Second, this study identified the thematic evolution of China's QC research using co-word cluster network analysis, a computational science mapping technique. The results from the first phase indicate that over the past 17 years, China's performance has evolved dramatically, placing it in a leading position. Among the most significant findings is the exponential rate at which all of China's performance indicators (i.e., Publication Frequency, citation score, H-index) are growing. China's H-index (a normalized indicator) has surpassed all other countries' over the last several years. The second phase of analysis shows how China's main research focus has shifted among several QC themes, including quantum-key-distribution, photon-optical communication, network protocols, and quantum entanglement with an emphasis on applied research. Several themes were observed across time periods (e.g., photons, quantum-key-distribution, secret-messages, quantum-optics, quantum-signatures); some themes disappeared over time (e.g., computer-networks, attack-strategies, bell-state, polarization-state), while others emerged more recently (e.g., quantum-entanglement, decoy-state, unitary-operation). Findings from the first phase of analysis provide empirical evidence that China has emerged as the global driving force in QC. Considering China is the premier driving force in global QC research, findings from the second phase of analysis provide an understanding of China's QC research themes, which can provide clarity into how QC technologies might take shape. QC and science and technology policy researchers can also use these findings to trace previous research directions and plan future lines of research.

Does simulation enhance nurses' ability to assess deteriorating patients?

PubMed

Bliss, Maria; Aitken, Leanne M

2018-01-01

Recognising and responding to patient deterioration has been identified as a key skill in nursing care to ensure that care is escalated for prompt, efficient management of the potentially critically ill patient. Simulation is one teaching strategy that has been established in nurse education as a method for enhancing skills. The objective was to explore the experiences of registered nurses to ascertain whether they perceived that simulation enhanced their skills in recognising the deteriorating patient. An exploratory qualitative design was used. Data were collected from registered nurses using semi-structured interviews following a professional development course where scenario-based simulation had been used to assess the patient. Eight registered nurses were interviewed for this study. Semi-structured interviews were conducted face to face. Verbatim transcripts were analysed using thematic analysis to identify major themes. Four themes were identified: knowledge, improved assessment skills in caring for the acutely ill patient, the learning environment and decision making. The use of simulation as a strategy was perceived by nurses to improve their own ability in identifying deteriorating patients. The participants described how their knowledge was transferred to clinical practice, with the overall perception that this led to improved patient care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Building capacity in Australian interprofessional health education: perspectives from key health and higher education stakeholders.

PubMed

Matthews, Lynda R; Pockett, Rosalie B; Nisbet, Gillian; Thistlethwaite, Jill E; Dunston, Roger; Lee, Alison; White, Jill F

2011-05-01

A substantial literature engaging with the directions and experiences of stakeholders involved in interprofessional health education exists at the international level, yet almost nothing has been published that documents and analyses the Australian experience. Accordingly, this study aimed to scope the experiences of key stakeholders in health and higher education in relation to the development of interprofessional practice capabilities in health graduates in Australia. Twenty-seven semi-structured interviews and two focus groups of key stakeholders involved in the development and delivery of interprofessional health education in Australian higher education were undertaken. Interview data were coded to identify categories that were organised into key themes, according to principles of thematic analysis. Three themes were identified: the need for common ground between health and higher education, constraints and enablers in current practice, and the need for research to establish an evidence base. Five directions for national development were also identified. The study identified a range of interconnected changes that will be required to successfully mainstream interprofessional education within Australia, in particular, the importance of addressing issues of culture change and the need for a nationally coordinated and research informed approach. These findings reiterate those found in the international literature.

Identifying Perceived Neighborhood Stressors Across Diverse Communities in New York City.

PubMed

Shmool, Jessie L C; Yonas, Michael A; Newman, Ogonnaya Dotson; Kubzansky, Laura D; Joseph, Evelyn; Parks, Ana; Callaway, Charles; Chubb, Lauren G; Shepard, Peggy; Clougherty, Jane E

2015-09-01

There is growing interest in the role of psychosocial stress in health disparities. Identifying which social stressors are most important to community residents is critical for accurately incorporating stressor exposures into health research. Using a community-academic partnered approach, we designed a multi-community study across the five boroughs of New York City to characterize resident perceptions of key neighborhood stressors. We conducted 14 community focus groups; two to three in each borough, with one adolescent group and one Spanish-speaking group per borough. We then used systematic content analysis and participant ranking data to describe prominent neighborhood stressors and identify dominant themes. Three inter-related themes regarding the social and structural sources of stressful experiences were most commonly identified across neighborhoods: (1) physical disorder and perceived neglect, (2) harassment by police and perceived safety and (3) gentrification and racial discrimination. Our findings suggest that multiple sources of distress, including social, political, physical and economic factors, should be considered when investigating health effects of community stressor exposures and psychological distress. Community expertise is essential for comprehensively characterizing the range of neighborhood stressors that may be implicated in psychosocial exposure pathways.

The complex relationships involved in global health: a qualitative description

PubMed Central

2013-01-01

Background Growing numbers of medical trainees now participate in global health experiences (GHEs) during their training. To enhance these experiences we sought to explore expectations inherent in the relationships between GHE stakeholder groups. Methods 20 open-ended, semi-structured interviews probed participant perceptions and assumptions embedded in GHEs. A fundamental qualitative descriptive approach was applied, with conventional content analysis and constant comparison methods, to identify and refine emerging themes. Thematic structure was finalized when saturation was achieved. Participants all had experience as global health participants (10 trainees, 10 professionals) from an urban, academic, Canadian medical centre. Results We identified three stakeholder groups: participants (trainees and professionals), host communities, and sponsoring institutions. During interviews, four major themes emerged: (i) cultural challenges, (ii) expectations and perceptions, (iii) relationships and communication, and (iv) discordant objectives. Within each theme, participants recurrently described tensions existing between the three stakeholder groups. Conclusions GHE participants frequently face substantial tensions with host communities and sponsoring agencies. Trainees are particularly vulnerable as they lack experience to navigate these tensions. In the design of GHEs, the needs of each group must be considered to ensure that benefits outweigh potential harms. We propose a conceptual model for developing educational objectives that acknowledge all three GHE stakeholder groups. PMID:24090069

Authentic leadership in healthcare: a scoping review.

PubMed

Malila, Niina; Lunkka, Nina; Suhonen, Marjo

2018-02-05

Purpose The purpose of this paper is to review peer-reviewed original research articles on authentic leadership (AL) in health care to identify potential research gaps and present recommendations for future research. The objectives are to examine and map evidence of the main characteristics, research themes and methodologies in the studies. AL is a leader's non-authoritarian, ethical and transparent behaviour pattern. Design/methodology/approach A scoping review with thematic analysis was conducted. A three-step search strategy was used with database and manual searches. The included studies were composed of English language peer-reviewed original research articles referring to both AL and health care. Findings In total, 29 studies were included. The studies favoured Canadian nurses in acute care hospitals. AL was understood as its original definition. The review identified four research themes: well-being at work, patient care quality, work environment and AL promotion. Quantitative research methodology with the authentic leadership questionnaire and cross-sectional design were prevalent. Research limitations/implications Future research needs more variation in research themes, study populations, settings, organisations, work sectors, geographical origins and theory perspectives. Different research methodologies, such as qualitative and mixed methods research and longitudinal designs, should be used more. Originality/value This is presumably the first literature review to map the research on AL in health care.

Multiple sclerosis and employment: Associations of psychological factors and work instability.

PubMed

Wicks, Charlotte Rose; Ward, Karl; Stroud, Amanda; Tennant, Alan; Ford, Helen L

2016-10-12

People with multiple sclerosis often stop working earlier than expected. Psychological factors may have an impact on job retention. Investigation may inform interventions to help people stay in work. To investigate the associations between psychological factors and work instability in people with multiple sclerosis. A multi-method, 2-phased study. Focus groups were held to identify key themes. Questionnaire packs using validated scales of the key themes were completed at baseline and at 8-month follow-up. Four key psychological themes emerged. Out of 208 study subjects 57.2% reported medium/high risk of job loss, with marginal changes at 8 months. Some psychological variables fluctuated significantly, e.g. depression fell from 24.6% to 14.5%. Work instability and anxiety and depression were strongly correlated (χ2 p < 0.001). Those with probable depression at baseline had 7.1 times increased odds of medium/high work instability, and baseline depression levels also predicted later work instability (Hosmer-Lemeshow test 0.899; Nagelkerke R Square 0.579). Psychological factors fluctuated over the 8-month follow-up period. Some psychological variables, including anxiety and depression, were significantly associated with, and predictive of, work instability. Longitudinal analysis should further identify how these psychological attributes impact on work instability and potential job loss in the longer term.

Managing pain in the workplace: a focus group study of challenges, strategies and what matters most to workers with low back pain.

PubMed

Tveito, Torill Helene; Shaw, William S; Huang, Yueng-Hsiang; Nicholas, Michael; Wagner, Gregory

2010-01-01

Most working adults with low back pain (LBP) continue to work despite pain, but few studies have assessed self-management strategies in this at-work population. The purpose of this study was to identify workplace challenges and self-management strategies reported by workers remaining at work despite recurrent or persistent LBP, to be used as a framework for the development of a workplace group intervention to prevent back disability. Workers with LBP (n = 38) participated in five focus groups, and audio recordings of sessions were analysed to assemble lists of common challenges and coping strategies. A separate analysis provided a general categorisation of major themes. Workplace pain challenges fell within four domains: activity interference, negative self-perceptions, interpersonal challenges and inflexibility of work. Self-management strategies consisted of modifying work activities and routines, reducing pain symptoms, using cognitive strategies and communicating pain effectively. Theme extraction identified six predominant themes: knowing your work setting, talking about pain, being prepared for a bad day, thoughts and emotions, keeping moving and finding leeway. To retain workers with LBP, this qualitative investigation suggests future intervention efforts should focus on worker communication and cognitions related to pain, pacing of work and employer efforts to provide leeway for altered job routines.

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework

PubMed Central

Corazzini, Kirsten; Twersky, Jack; White, Heidi K.; Buhr, Gwendolen T.; McConnell, Eleanor S.; Weiner, Madeline; Colón-Emeric, Cathleen S.

2015-01-01

Purpose of the Study: To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. Design and Methods: The study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership. Results: Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. Implications: Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges. PMID:24451896

Perceptions of northeast Thai breastfeeding mothers regarding facilitators and barriers to six-month exclusive breastfeeding: focus group discussions.

PubMed

Thepha, Thiwawan; Marais, Debbie; Bell, Jacqueline; Muangpin, Somjit

2018-01-01

The 6-month exclusive breastfeeding rate in the Northeast region of Thailand has recently significantly decreased in contrast to all other regions in Thailand. The factors that have influenced this decrease remain unknown. Hence, it is suggested that an investigation into factors that could improve or hinder EBF for 6 months in Northeast Thailand may be required to inform the development of relevant interventions to improve this situation. This study aimed to identify perceived facilitators and barriers to providing exclusive breastfeeding for 6 months in Northeast Thailand among breastfeeding mothers. Six focus group discussions were conducted with a total of 30 mothers aged 20 to 40 years who had children aged between 4 and 6 months and were currently breastfeeding or had breastfeeding experience. Participants were recruited through self-selection sampling from Khonkaen hospital (urban), Numphong hospital (peri-urban) and private hospitals (urban) in Khonkaen, Thailand. Thematic analysis was employed to analyse the data. Five main themes, with 10 sub-themes, were identified as either facilitators (+) or barriers (-), or in some cases, as both (+/-). Breastfeeding knowledge, perceptions, maternal circumstances, support, and traditional food were the main identified themes. Mother's breastfeeding knowledge, intention to breastfeed, and social media were perceived as facilitators. Perceptions, employment, and formula milk promotion were perceived as barriers. Family, healthcare, and traditional food were perceived as both facilitators and barriers. The perception that social media was a way to access breastfeeding knowledge and support mothers in Northeast Thailand emerged as a new facilitating factor that had not previously been identified in Thai literature relating to facilitators and barriers to exclusive breastfeeding. Intention to breastfeed, family support, healthcare support and traditional food were mentioned by all groups, whereas mothers from urban areas specifically mentioned mother's breastfeeding knowledge, social media and employment sub-themes. Only mothers from the peri-urban area mentioned formula milk promotion and only mothers who had delivered in public hospitals mentioned the perceptions sub-theme. Knowledge about these facilitators and barriers may inform the design and development of specific and relevant interventions to improve the 6-month exclusive breastfeeding rate in the Northeast region of Thailand and be useful in other contexts. Social media emerged as a newly perceived facilitator in the Thai context and may be a useful inclusion in a 6-month exclusive breastfeeding intervention model.

Gardening for the mental well-being of homeless women.

PubMed

Grabbe, Linda; Ball, Janell; Goldstein, Allison

2013-12-01

To explore the perceptions of homeless women regarding their experience in a shelter-based garden project to promote mental wellness. Participants planted and tended the vegetable garden and prepared and ate the fruits of their labor. A qualitative descriptive design with a conventional content analysis of narrative data. Data were gathered in semistructured interviews. Participants were homeless daytime shelter guests who had participated in at least eight gardening sessions over 4 weeks. The project was started in the fall of 2010 and the interviews were conducted over 2 months in the summer of 2011. Two polarized themes were identified in the narratives, clustering around negative and positive thoughts. The "dark" theme centered on marginalization and the oppressiveness of shelter life. The "light" theme centered on stress relief, feeling socially included, and personal change. The gardening experience interrupted the participants' negative ruminations, offering stress relief and elements of social inclusion and self-actualization. Gardening is an inexpensive and positive intervention for a population with a high incidence of mental illness and distress.

Latino Immigrants, Acculturation, and Health: Promising New Directions in Research.

PubMed

Abraído-Lanza, Ana F; Echeverría, Sandra E; Flórez, Karen R

2016-01-01

This article provides an analysis of novel topics emerging in recent years in research on Latino immigrants, acculturation, and health. In the past ten years, the number of studies assessing new ways to conceptualize and understand how acculturation-related processes may influence health has grown. These new frameworks draw from integrative approaches testing new ground to acknowledge the fundamental role of context and policy. We classify the emerging body of evidence according to themes that we identify as promising directions--intrapersonal, interpersonal, social environmental, community, political, and global contexts, cross-cutting themes in life course and developmental approaches, and segmented assimilation--and discuss the challenges and opportunities each theme presents. This body of work, which considers acculturation in context, points to the emergence of a new wave of research that holds great promise in driving forward the study of Latino immigrants, acculturation, and health. We provide suggestions to further advance the ideologic and methodologic rigor of this new wave.

Comparison of Abuse Experiences of Rural and Urban African American Women During Perinatal Period

PubMed Central

Bhandari, Shreya; Bullock, Linda F. C.; Richardson, Jeanita W.; Kimeto, Pamela; Campbell, Jacquelyn C.; Sharps, Phyllis W.

2015-01-01

A subsample of 12 African American women (6 urban and 6 rural) were selected from a larger longitudinal, randomized control trial, Domestic Violence Enhanced Home Visitation (DOVE-R01 900903 National Institute of Nursing Research [NINR]/National Institutes of Health [NIH]). All African American women were chosen to control for any racial- and/or race-related cultural differences that may exist among women across geographical areas. The experiences of abuse during the perinatal period are drawn from in-depth interviews conducted at five points in time during pregnancy and the post-partum period. The analysis describes three major themes that highlight the similarities and differences among rural and urban women. The main themes found were (1) types of abuse, (2) location of abuse, and (3) response to abuse. In addition, two sub-themes (a) defiance and compliance and (b) role of children were also identified. Implications for universal screening for women of reproductive age, safer gun laws, and the need for further research are discussed. PMID:25315478

Long-Term Learning in a Short-Term Study Abroad Program: "Are We Really Truly Helping the Community?".

PubMed

Caldwell, Penelope; Purtzer, Mary Anne

2015-01-01

To discover long-term learning outcomes in a short-term study abroad program. Students worked directly with community members to identify health issues, implement educational workshops addressing those issues, and evaluate health outcomes. This is a qualitative, descriptive study. Thematic analysis was conducted using a written questionnaire completed one or more years postimmersion. The sample was 41 nursing students who participated in a 10-day immersion experience in remote Honduras. Four themes emerged revealing evidence of long-term learning. Three of these themes, Embracing Other, Gaining Cultural Competencies, and Experiencing an Ethnocentric Shift, are supported in the literature. The fourth theme, Negotiating Ethical Dilemmas, offers a new finding. Although educators have questioned ethical consequences of study abroad programs, there is a paucity of literature indicating that students are the ones doing the questioning. Implications for educators and community members alike include facilitating dialog about collective worldviews related to global health ethics when designing study abroad programs. © 2014 Wiley Periodicals, Inc.

Childhood esotropia: child and parent concerns.

PubMed

Liebermann, Laura; Leske, David A; Castañeda, Yolanda S; Hatt, Sarah R; Wernimont, Suzanne M; Cheng, Christina S; Birch, Eileen E; Holmes, Jonathan M

2016-08-01

To identify specific health-related quality of life (HRQOL) concerns affecting children with esotropia as expressed by children or one of their parents (proxy) and concerns affecting the parents themselves. Sixty children with esotropia (0-17 years of age) and 1 parent for each child were prospectively enrolled. Individual semistructured interviews were conducted with children aged 5-17 years (n = 40) and 1 parent each for child ages 0-17 years. Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified from both child and parent interviews and coded. From these specific codes, broad themes were identified. Frequency of each theme was calculated, along with the frequency of specific codes within each theme. Regarding the child's experience 6 broad themes were identified: visual function (mentioned by 32 of 40 children (80%) and by 50 of 60 parents (proxy assessment of child, 83%), treatment (78% and 85%), emotions (65% and 67%), social (58% and 68%), physical (58% and 32%), and worry (45% and 7%). Regarding the parents' own experience, 5 broad themes were identified: treatment (59 of 60 parents, 98%), worry (97%), emotions (82%), compensation for condition (80%), and affects family (23%). A wide range of concerns were identified from interviews of children with esotropia and their parents. Concerns reflect the impact of esotropia in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the effects of esotropia on children's and parents' quality of life. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Quality of life and functional vision concerns of children with cataracts and their parents.

PubMed

Castañeda, Y S; Cheng-Patel, C S; Leske, D A; Wernimont, S M; Hatt, S R; Liebermann, L; Birch, E E; Holmes, J M

2016-09-01

PurposeTo identify specific health-related quality of life (HRQOL) and functional vision concerns affecting children with cataracts and common associated conditions as expressed by children or one of their parents (proxy), and HRQOL concerns affecting the parents themselves.MethodsIndividual semi-structured interviews were conducted with parents of children with cataracts (N=31) and with the children themselves (ages 5-17 years; N=16). Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified and coded, and broad themes were identified. The frequency of each theme was calculated, with the frequency of specific concerns within each theme.ResultsRegarding the child's experience, 6 themes were identified: Visual Function (mentioned by 16 of 16 children (100%) and by 26 of 31 parents (84%), Social (94 and 65%), Treatment (81 and 90%), Worry (75 and 10%), Emotions (63 and 68%), and Physical Discomfort (63 and 26%). Worry showed the largest discrepancy between child and their parent; although 75% children reported Worry, only 6% of parents reported that their child experienced Worry (P=0.0009). Regarding the parents' own experience, 5 themes were identified: Worry (100%), Compensation for Condition (100%), Treatment (94%), Emotions (90%), and Affects Family (52%).ConclusionsA wide range of concerns were identified from interviews of children with cataracts and their parents. Concerns reflect the impact of cataracts in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the quality of life and functional vision effects of cataracts.

Quality of life and functional vision concerns of children with cataracts and their parents

PubMed Central

Castañeda, Y S; Cheng-Patel, C S; Leske, D A; Wernimont, S M; Hatt, S R; Liebermann, L; Birch, E E; Holmes, J M

2016-01-01

Purpose To identify specific health-related quality of life (HRQOL) and functional vision concerns affecting children with cataracts and common associated conditions as expressed by children or one of their parents (proxy), and HRQOL concerns affecting the parents themselves. Methods Individual semi-structured interviews were conducted with parents of children with cataracts (N=31) and with the children themselves (ages 5–17 years; N=16). Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified and coded, and broad themes were identified. The frequency of each theme was calculated, with the frequency of specific concerns within each theme. Results Regarding the child's experience, 6 themes were identified: Visual Function (mentioned by 16 of 16 children (100%) and by 26 of 31 parents (84%), Social (94 and 65%), Treatment (81 and 90%), Worry (75 and 10%), Emotions (63 and 68%), and Physical Discomfort (63 and 26%). Worry showed the largest discrepancy between child and their parent; although 75% children reported Worry, only 6% of parents reported that their child experienced Worry (P=0.0009). Regarding the parents' own experience, 5 themes were identified: Worry (100%), Compensation for Condition (100%), Treatment (94%), Emotions (90%), and Affects Family (52%). Conclusions A wide range of concerns were identified from interviews of children with cataracts and their parents. Concerns reflect the impact of cataracts in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the quality of life and functional vision effects of cataracts. PMID:27391939

Getting by, getting back, and getting on: Matching mental health services to consumers' recovery goals.

PubMed

Yarborough, Bobbi Jo H; Yarborough, Micah T; Janoff, Shannon L; Green, Carla A

2016-06-01

The goal of this study was to better understand mental health recovery from the point of view of mental health consumers to identify opportunities for practice improvements that closely align services with consumer goals and consumer-preferred outcomes. As part of an exploratory study of recovery, semistructured interviews were conducted with 177 integrated health plan members diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, or affective psychosis. Transcripts of in-depth interviews were coded using Atlas.ti, and definitions of recovery were further subcoded. A qualitative analysis using a modified grounded theory approach and constant comparative method identified common themes and less common but potentially important recovery-related experiences and perspectives. Three primary and 2 cross-cutting themes emerged. "Getting by" meant coping and meeting basic needs. "Getting back" meant learning to live with mental illness. "Getting on" meant living a life where mental illness was no longer prominent. Regaining control and recouping losses were cross-cutting themes. Mental health recovery is complex and dynamic; individuals' recovery goals can be expected to change over time. Person-centered care must accommodate changing consumer priorities, services must be flexible and responsive, and outcomes need to match consumers' objectives. Clinicians can assist in (a) identifying recovery goals, (b) monitoring progress toward and recognizing movement away from goals, (c) tailoring support to different phases/stages, and (d) supporting transitions between phases/stages. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Perspectives of the community-based dementia care workforce: "occupational communion" a key finding from the Work 4 Dementia Project.

PubMed

Elliott, Kate-Ellen J; Stirling, Christine M; Martin, Angela J; Robinson, Andrew L; Scott, Jennifer L

2013-05-01

Community care workers' experience of delivering support to people with dementia is less researched than that of residential workers. The purpose of the study is to explore community-based dementia care workers' perspectives about their roles and the contextual variables that impact upon their work experiences. A qualitative design was employed. Twenty-five community dementia care workers (average age 53 years, majority female and employed casually) participated in standardized semi-structured interviews about their job roles, training, employer agenda, organizational support, and intention to stay. A deductive approach to Interpretive Phenomenological Analysis was adopted to identify key themes. Three themes highlighted workers' experiences. Occupational communion described strong attachment to clients and a desire for greater connection with colleagues. Job demands described the challenges of work, which varied with intensity. Job resources ranged from positive (strong organizational commitment) to negative (poor pay and conditions). Occupational communion was identified as a concept that exists at the interface between social and organization psychology that was perceived to be essential for adaptive coping. Identifying themes informed a conceptual model for designing intervention components aimed at improving workers' skills, capabilities, and employer supportive functions. Occupational communion may be particularly relevant for women's caring careers and future research is needed to explore the relevance of this concept for men. To determine reliable change associated with interventions that target occupational communion, further investigation is required in relation to measurement approaches.

Exploring the Sexuality of African American Older Women

PubMed Central

Laganá, Luciana; White, Theresa; Bruzzone, Daniel E.; Bruzzone, Cristine E.

2014-01-01

Aims To identify sexually-related themes of the sexuality of older African American women. Study Design Mixed method. Place and Duration of Study Department of Psychology, California State University Northridge, between July 2009 and June 2011. Methodology We included 13 African American older women (57 to 82 years of age), 11 of whom self-identified as heterosexual, one as bisexual, and one as lesbian. We used a semi-structured interview protocol through which we explored some aspects of the respondents’ sexuality (assessed at a superficial level, to be as tactful as possible). Moreover, we collected information on demographics and self-rated physical health. Two co-authors served as coders, and used content analysis to identify the most salient sexuality themes. Results Emerging themes were (in order from most to least endorsed): having sexual desire (often unfulfilled); engaging in less sexual activity in older age; experiencing changes in one’s sexual life as a function of absence of a spouse; and exercising control over how one’s sexual life is conducted. Motivated by the paucity of our sexuality data, we have also provided suggestions to scholars interested in conducting more in-depth further research on this topic with older African American women. Conclusion Our findings indicate that the common notion that older women are asexual is a myth, while lack of a suitable sexual partner is a problem reported by many African American older women who would otherwise enjoy sexual interaction. PMID:25632380

Abortion and contemporary hip-hop: a thematic analysis of lyrics from 1990-2015.

PubMed

Premkumar, Ashish; Brown, Katherine; Mengesha, Biftu; Jackson, Andrea V

2017-07-01

To evaluate the representation of abortion in contemporary hip-hop music, gaining insight into the myriad of attitudes of abortion in the black community. We used Genius, an online storehouse for lyrical content, to identify songs by querying the database for search terms related to family planning, including slang terms. We then cross-referenced identified songs using an online list of songs about abortion. We analyzed eligible songs using grounded theory in order to identify key themes. Of 6577 songs available, a total of 101 songs performed by 122 individual artists met inclusion criteria. The majority of artists were Black men; five artists were Black women. Key themes were: use of abortion as braggadocio; equating abortion with sin, genocide, or murder; male pressure for women to seek abortion; and the specific association of Planned Parenthood services with abortion. The moral and ethical themes surrounding abortion in hip-hop lyrics reveal a unique perspective within a marginalized community. The overall negative context of abortion in hip-hop lyrics needs to be reconciled with the gendered, economic, historical, political, racial and ethnic background of hip-hop and rap music in America. This study is the first to evaluate lyrical content from contemporary popular music in relation to abortion and family planning. Examining the intersection of reproductive rights and popular culture can provide a unique insight into the limited knowledge of the perspectives of abortion in the black community. Copyright © 2017 Elsevier Inc. All rights reserved.

A critical analysis of the literature on the Internet and consumer health information.

PubMed

Powell, J A; Lowe, P; Griffiths, F E; Thorogood, M

2005-01-01

A critical review of the published literature investigating the Internet and consumer health information was undertaken in order to inform further research and policy. A qualitative, narrative method was used, consisting of a three-stage process of identification and collation, thematic coding, and critical analysis. This analysis identified five main themes in the research in this area: (1) the quality of online health information for consumers; (2) consumer use of the Internet for health information; (3) the effect of e-health on the practitioner-patient relationship; (4) virtual communities and online social support and (5) the electronic delivery of information-based interventions. Analysis of these themes revealed more about the concerns of health professionals than about the effect of the Internet on users. Much of the existing work has concentrated on quantifying characteristics of the Internet: for example, measuring the quality of online information, or describing the numbers of users in different health-care settings. There is a lack of qualitative research that explores how citizens are actually using the Internet for health care.

Parental Perspectives of Communication at the End of Life at a Pediatric Oncology Institution.

PubMed

Snaman, Jennifer M; Torres, Carlos; Duffy, Brian; Levine, Deena R; Gibson, Deborah V; Baker, Justin N

2016-03-01

The interaction of health care providers and hospital staff with patients and families at the end of life affects the parental grief experience. Both verbal and nonverbal communication are key components of this interaction. The study objective was to explore the communication between hospital staff members and patients and families at the time of patients' health decline near the end of life. Twelve bereaved parents participated in a focus group. Semantic content analysis was used to analyze the transcript. Parents' responses to the prompt about typical ways the medical team communicated yielded 109 codes, which were grouped into 12 themes. The most common themes were "patient inclusion" and "explanation of medical plan," both used in 17% of responses. Responses to the prompt about positive and negative aspects of communication generated 208 codes, yielding 15 different themes. The most common theme about positive communication was the "strong relationship between family and staff." The theme "variations in care with a negative impact" was used most frequently in describing negative communication. This study helps to identify techniques that should be used by clinicians as they work with children with cancer and their families, particularly including patients in treatment decisions, ongoing relationship building, communicating with caring and empathy, using an interdisciplinary team for additional support, and pairing bad news with a plan of action.

Using link analysis to explore the impact of the physical environment on pharmacist tasks.

PubMed

Lester, Corey A; Chui, Michelle A

2016-01-01

National community pharmacy organizations have been redesigning pharmacies to better facilitate direct patient care. However, evidence suggests that changing the physical layout of a pharmacy prior to understanding how the environment impacts pharmacists' work may not achieve the desired benefits. This study describes an objective method to understanding how the physical layout of the pharmacy may affect how pharmacists perform tasks. Link analysis is a systems engineering method used to describe the influence of the physical environment on task completion. This study used a secondary data set of field notes collected from 9 h of direct observation in one mass-merchandise community pharmacy in the U.S. State, Wisconsin. A node is an individual location in the environment. A link is the movement between two nodes. Tasks were inventoried and task themes identified. The mean, minimum, and maximum number of links needed to complete each task were then determined and used to construct a link table. A link diagram is a graphical display showing the links in conjunction with the physical layout of the pharmacy. A total of 92 unique tasks were identified resulting in 221 links. Tasks were sorted into five themes: patient care activities, insurance issues, verifying prescriptions, filling prescriptions, and other. Insurance issues required the greatest number of links with a mean of 4.75. Verifying prescriptions and performing patient care were the most commonly performed tasks with 36 and 30 unique task occurrences, respectively. Link analysis provides an objective method for identifying how a pharmacist interacts with the physical environment to complete tasks. This method provides designers with useful information to target interventions to improve the effectiveness of pharmacist work. Analysis beyond link analysis should be considered for large scale system redesign. Copyright © 2015 Elsevier Inc. All rights reserved.

Refusals and Rejections: Designing Messages to Serve Multiple Goals.

ERIC Educational Resources Information Center

Saeki, Mimako; O'Keefe, Barbara J.

1994-01-01

Tests a rational model of the elaboration of themes found in rejection messages, using Japanese and American participants. Finds partial support for the initial rational model but notes two key revisions: identifies two new themes in rejection messages and suggests substantial differences in the way Americans and Japanese elaborate themes to serve…

'The secret shame': a content analysis of online news reporting of a celebrity admitting smoking while pregnant.

PubMed

Carroll, Beverley; Freeman, Becky

2015-04-01

Around one in 10 Australian women report that they smoke while pregnant, and this may be a significant underestimation. In 2013, Australian celebrity Chrissie Swan announced publicly that she had been smoking during her pregnancy, generating substantial media coverage. This study sought to identify the main themes in the reporting of the 'Swan pregnant and admitting smoking' story by online news media. Between 6 February 2013 and 18 February 2013 inclusively, a content analysis was conducted of Australian online news items using the keywords: 'Chrissie Swan smoking', and 'Chrissie Swan pregnant and smoking'. News items were coded for nine themes. A total of 124 items were identified. The most frequent themes were: 'celebrity story' (90.32%) and 'societal judgement of pregnant smokers' (69.35%). Less than one-half (45.97%) of the news items included 'quitting is hard' content and only 29.03% of the news items included 'smoking and health' content. Specific quit-referral content was found in only 13.71% of the news items. There was a missed opportunity to promote positive, non-judgemental smoking and pregnancy messages and health information that support pregnant women to quit smoking. SO WHAT?: Health promotion strategies are needed to build capacity in advocacy to promote positive health messages and counter societal judgement of pregnant smokers. Formative research into the use of celebrities and other influential women to promote positive empowering messages should be carried out and incorporated in future health promotion campaigns to improve pregnant women's ability to quit smoking.

Social Listening: A Content Analysis of E-Cigarette Discussions on Twitter.

PubMed

Cole-Lewis, Heather; Pugatch, Jillian; Sanders, Amy; Varghese, Arun; Posada, Susana; Yun, Christopher; Schwarz, Mary; Augustson, Erik

2015-10-27

Electronic cigarette (e-cigarette) use has increased in the United States, leading to active debate in the public health sphere regarding e-cigarette use and regulation. To better understand trends in e-cigarette attitudes and behaviors, public health and communication professionals can turn to the dialogue taking place on popular social media platforms such as Twitter. The objective of this study was to conduct a content analysis to identify key conversation trends and patterns over time using historical Twitter data. A 5-category content analysis was conducted on a random sample of tweets chosen from all publicly available tweets sent between May 1, 2013, and April 30, 2014, that matched strategic keywords related to e-cigarettes. Relevant tweets were isolated from the random sample of approximately 10,000 tweets and classified according to sentiment, user description, genre, and theme. Descriptive analyses including univariate and bivariate associations, as well as correlation analyses were performed on all categories in order to identify patterns and trends. The analysis revealed an increase in e-cigarette-related tweets from May 2013 through April 2014, with tweets generally being positive; 71% of the sample tweets were classified as having a positive sentiment. The top two user categories were everyday people (65%) and individuals who are part of the e-cigarette community movement (16%). These two user groups were responsible for a majority of informational (79%) and news tweets (75%), compared to reputable news sources and foundations or organizations, which combined provided 5% of informational tweets and 12% of news tweets. Personal opinion (28%), marketing (21%), and first person e-cigarette use or intent (20%) were the three most common genres of tweets, which tended to have a positive sentiment. Marketing was the most common theme (26%), and policy and government was the second most common theme (20%), with 86% of these tweets coming from everyday people and the e-cigarette community movement combined, compared to 5% of policy and government tweets coming from government, reputable news sources, and foundations or organizations combined. Everyday people and the e-cigarette community are dominant forces across several genres and themes, warranting continued monitoring to understand trends and their implications regarding public opinion, e-cigarette use, and smoking cessation. Analyzing social media trends is a meaningful way to inform public health practitioners of current sentiments regarding e-cigarettes, and this study contributes a replicable methodology.

Conflicting Views of Realistic Professionalism: Preservice Educators' Concerns Arising from Analysis of Themes in Their Reflective Writings

ERIC Educational Resources Information Center

Boyer, Wanda A. R.

2004-01-01

Current demands for professionalism from society are great, and future educators are concerned that they do not have the stamina and resources to fulfill their personal roles. This research examines 453 reflective writings of 151 preservice teachers, child and youth care providers, and counselors who, despite being asked to identify how their…

Divorce Is a Part of My Life . . . Resilience, Survival, and Vulnerability: Young Adults' Perception of the Implications of Parental Divorce

ERIC Educational Resources Information Center

Eldar-Avidan, Dorit; Haj-Yahia, Muhammad M.; Greenbaum, Charles W.

2009-01-01

A qualitative study among 22 young adults (20-25 years old) whose parents divorced during their childhood was conducted in Israel, using semi-structured, in-depth, open-ended interviews. Qualitative data analysis led to identification of three profiles, aiming at a grounded theoretical conceptualization. Three core themes were identified: the…

Women and Feminism in Technical Communication: A Qualitative Content Analysis of Journal Articles Published in 1989 through 1997.

ERIC Educational Resources Information Center

Thompson, Isabelle

1999-01-01

Identifies 40 articles about women and feminism published in five technical communication journals in a period of nine years. Notes major themes, all concerning inclusion. Concludes that although research about women and feminism has been accepted as part of the scholarly purview of technical communication, the ways in which this research has…

Hispanic Male’s Perspectives of Health Behaviors Related to Weight Management

PubMed Central

Garcia, David O.; Valdez, Luis A.; Hooker, Steven P.

2015-01-01

Hispanic males have the highest prevalence of overweight and obesity among men in the United States; yet are significantly underrepresented in weight loss research. The purpose of the current study was to examine Hispanic male’s perspectives of health behaviors related to weight management to refine the methodologies to deliver a gender-sensitive and culturally sensitive weight loss intervention. From October 2014 to April 2015, semistructured interviews were conducted with 14 overweight Hispanic men of ages 18 to 64 years. The interviews lasted approximately 60 minutes. Participants also completed a brief questionnaire and body weight/height were measured. Grounded in a deductive process, a preliminary codebook was developed based on the topics included in the interview guides. A thematic analysis facilitated the identification of inductive themes and the finalization of the codebook used for transcript analysis. Four overarching themes were identified: (a) general health beliefs of how diet and physical activity behaviors affect health outcomes, (b) barriers to healthy eating and physical activity, (c) motivators for change, and (d) viable recruitment and intervention approaches. Future research should examine feasible and appropriate recruitment and intervention strategies identified by Hispanic males to improve weight management in this vulnerable group. PMID:26634854

When East meets West: intensive care unit experiences among first-generation Chinese American parents.

PubMed

Lee, Shih-Yu; Weiss, Sandra J

2009-01-01

To explore the experiences of first-generation Chinese American parents while their infants are cared for in intensive care units (ICUs). Because the study focus was on understanding the experiences of parents, a phenomenological approach was used, with open-ended questions that encouraged participants to describe events they perceived to be important. The data analysis procedure suggested by van Manen was used for the qualitative data analysis. A convenience sample of 25 first-generation Chinese American families, with infants hospitalized in the intensive care units of three teaching hospitals in the San Francisco area. Seven themes were identified: perceived incompetence, self-blame, blame from others, filial piety, lack of support in the US, communication issues, and cultural differences. Both fathers and mothers experienced stress related to all identified themes. Findings suggest the need for more resources to educate and support families as well as culturally competent care within pediatric ICUs. Further study is critical to understand how the Chinese American's personal and family characteristics may influence stress perceptions when coping with their children's hospitalization. This study can help healthcare providers to understand Chinese American parents' perceptions while their infants are hospitalized in the ICU, which can enhance cultural competence care services.

Senior Medical Student Mock Interview Program in Pediatrics.

PubMed

Multerer, Sara; Carothers, Becky; Patel, Pradip D; Ziegler, Craig; Rowland, Michael; Davis, Deborah Winders

2016-02-01

Residency interviews play an integral part in medical residency placement. We aimed to develop and evaluate a mock interview program for fourth-year medical students interested in a pediatric specialty. A mock interview program for fourth-year medical students interested in pediatrics was developed and implemented. Preinterview quantitative data and postinterview qualitative data were collected. Fifty-nine students completed the program across three consecutive academic years. Preinterview surveys were completed regarding comfort and confidence levels specific to aspects of the interview process. Descriptive analyses were used. In addition, a focus group was held with nine of the participating students to obtain qualitative data via a paper blog process. Themes in student responses were identified through constant comparative analysis. Before the mock interview, students were most uncomfortable with introductory and closing remarks and their confidence levels varied by topic. A thematic analysis of focus group data identified five themes (preparation, stress reduction, interview process familiarity, confidence of skills, and receiving feedback) for which the mock interviews were most helpful. Implementation of a mock interview program was feasible and acceptable for senior medical students and may improve comfort and confidence levels in the residency interview process. Further longitudinal research is needed.

Frontiers in Ecosystem Science: Energizing the Research Agenda

NASA Astrophysics Data System (ADS)

Weathers, K. C.; Groffman, P. M.; VanDolah, E.

2014-12-01

Ecosystem science has a long history as a core component of the discipline of Ecology, and although topics of research have fluctuated over the years, it retains a clear identity and continues to be a vital field. As science is becoming more interdisciplinary, particularly the science of global environmental change, ecosystem scientists are addressing new and important questions at the interface of multiple disciplines. Over the last two years, we organized a series of workshops and discussion groups at multiple scientific-society meetings, including AGU to identify frontiers in ecosystem research. The workshops featured short "soapbox" presentations where speakers highlighted key questions in ecosystem science. The presentations were recorded (video and audio) and subjected to qualitative text analysis for identification of frontier themes, attendees completed surveys, and a dozen additional "key informants" were interviewed about their views about frontiers of the discipline. Our effort produced 253 survey participants; the two largest groups of participants were full professors (24%) and graduate students (24%); no other specific group was > 10%. Formal text analysis of the soapbox presentations produced three major themes; "frontiers," "capacity building," and "barriers to implementation" with four or five sub-themes within each major theme. Key "frontiers" included; 1) better understanding of the drivers of ecosystem change, 2) better understanding of ecosystem process and function, 3) human dimensions of ecosystem science, and 4) problem-solving/applied research. Under "capacity building," key topics included: holistic approaches, cross-disciplinary collaboration, public support for research, data, training, and technology investment. Under "barriers" key topics included: limitations in theoretical thinking, insufficient funding/support, fragmentation across discipline, data access and data synthesis. In-depth interviews with 13 experts validated findings from analysis of soapbox presentations and surveys and also resulted in a conceptual model for understanding disciplinary frontiers.

The Evolution of World Health Organization's Initiatives for the Strengthening of Nursing and Midwifery.

PubMed

Ventura, Carla Aparecida Arena; Mendes, Isabel Amélia Costa; Fumincelli, Laís; Trevizan, Maria Auxiliadora

2015-09-01

To describe the evolution in the resolutions approved by World Health Organization (WHO)'s World Health Assembly (WHA) to strengthen nursing and midwifery. Qualitative and descriptive study, undertaken through a search of resolutions presented by WHA, on the WHO website, regarding the theme "strengthening of nursing and midwifery." The resolutions on the theme "nursing and midwifery" were included, whose titles were available and whose full texts were accessed, excluding those on general health themes. The key words used were resolutions, strengthening, and nursing and midwifery. Among the 20 resolutions found, 12 were selected, adopted between 1948 and 2013, in accordance with the study inclusion criteria. The data were interpreted using thematic qualitative analysis, identifying and grouping the data in categories related to the study theme. Based on the content analysis of the 12 resolutions studied, three thematic categories were defined: "nursing and midwifery in primary health"; "role of nursing and midwifery in health for all"; and "nurses and midwives' professional training." Based on the categories, the evolution in the strengthening of nursing and midwifery was demonstrated through the initiatives and resolutions approved by WHA, highlighting the importance of nurses and midwives as multiprofessional health team members and their fundamental role in the improvements of the health system. Therefore, in accordance with the needs of each country, the member states can implement strategies presented by the WHA resolutions to strengthen nursing and midwifery services. This study has relevance for the development of health policies considering the relevant contributions of nurses and midwives to healthcare systems and services, based on the analysis of WHO resolutions involving these professions. © 2015 Sigma Theta Tau International.

A thematic analysis for how patients, prescribers, experts, and patient advocates view the prescription choice process.

PubMed

Schommer, Jon C; Worley, Marcia M; Kjos, Andrea L; Pakhomov, Serguei V S; Schondelmeyer, Stephen W

2009-06-01

Typically, patients are unaware of the cost consequences regarding prescribing decisions during their clinical encounter and rarely talk with their physicians about costs of prescription drugs. Prescription medications that are deemed by patients to be too costly when the costs become known after purchase are discontinued or used at suboptimal doses compared to prescription medications that are deemed to be worth the cost. To learn more about the prescription choice process from several viewpoints, the purpose of this study was to uncover and describe how patients, prescribers, experts, and patient advocates view the prescription choice process. Data were collected via 9 focus group interviews held between April 24 and July 31, 2007 (3 with patients, 3 with prescribers, 2 with experts, and 1 with patient advocates). The interviews were audiotaped and transcribed. The resulting text was analyzed in a descriptive and interpretive manner. Theme extraction was based on convergence and external divergence; that is, identified themes were internally consistent but distinct from one and another. To ensure quality and credibility of analysis, multiple analysts and multiple methods were used to provide a quality check on selective perception and blind interpretive bias that could occur through a single person doing all of the analysis or through employment of a single method. The findings revealed 5 overall themes related to the prescription choice process: (1) information, (2) relationship, (3) patient variation, (4) practitioner variation, and (5) role expectations. The results showed that patients, prescribers, experts, and patient advocates viewed the themes within differing contexts. It appears that the prescription choice process entails an interplay among information, relationship, patient variation, practitioner variation, and role expectations, with each viewed within different contexts by individuals engaged in such decision making.

Questioning diagnoses in clinical practice: a thematic analysis of clinical psychologists' accounts of working beyond diagnosis in the United Kingdom.

PubMed

Randall-James, James; Coles, Steven

2018-02-08

The British Psychological Society proposes that clinical psychologists are well placed to move beyond psychiatric diagnoses and develop alternative practices. This study sought to explore what the application of these guiding principles looks like in clinical practice, the challenges faced and possible routes forward. A purpose-designed survey was completed by 305 respondents and a thematic analysis completed. Thematic analysis was used to identify five superordinate themes relating to individuals, relational, others, structures and society, comprising of a total of 21 group themes. The presented group themes highlight an array of approaches to practicing beyond diagnosis and factors that help and hinder such action; from scaffolding change, becoming leaders, relating to the multi-disciplinary team, restructuring services and the processes of change. A key concept was "playing the diagnostic game". "Playing the diagnostic game" enables psychologists to manage an array of tensions and anxieties: conflicts between belief and practice, relationships with colleagues, and dilemmas of position and power. It also potentially limits a concerted questioning of diagnosis and consideration of alternatives. An alternative conceptual framework for non-diagnostic practice is needed to aid the collective efforts of clinical psychologists developing their practice beyond diagnosis, some of which have been highlighted in this study. Until then, ways of mitigating the perceived threats to questioning diagnosis need further exploration, theorising and backing.

Re-designing Orem's Self-care Theory for Patients with Chronic Hepatitis.

PubMed

Hasanpour-Dehkordi, Ali; Mohammadi, Nooredin; Nikbakht-Nasrabadi, Alireza

2016-01-01

Hepatitis is an inflammatory disease which has many adverse effects on patients' life because of its chronic nature. Since Orem's theory of self-care is a grounded theory, the concepts and applications of this theory in patients with chronic hepatitis who have special needs may lead to some challenges. The purpose of this study was to explore self-care in patients with chronic hepatitis. A directed content analysis was used in this qualitative study. Participants were recruited from a metropolitan area. Data were collected through semi-structured interviews. The verbatim transcripts of the participants' interviews were analyzed according to directed content analysis. In this study, four themes, suggested by Orem, were drawn from the data according to directed content analysis. The codes generated from the data were classified into concepts and then the concepts were assigned into these four themes. These themes were needs in the matrix of time and place, self-care agency, need for change in self-care and consequences of hepatitis. The use of Orem's self-care theory cannot meet the need for self-care in hepatitis patients because these patients have vital sexual, respect and belonging, physical, economical, and psychological-behavioral needs, and lack adequate knowledge about self-care. Consequently, the specific self-care model developed in this study helps health professionals identify self-care activities in patients with chronic hepatitis.

Stories of chronic kidney disease: listening for the unsayable.

PubMed

Makaroff, Kara L Schick; Sheilds, Laurene; Molzahn, Anita

2013-12-01

To explore individuals' stories of chronic kidney disease, particularly those aspects of experience that are difficult to discuss using language (i.e. unsayable). Chronic kidney disease is continuous, but it is also life-threatening and sometimes people ask difficult questions about life and death that can be challenging and for some, impossible to discuss. These 'unsayables' are the focus of this article. The unsayable may reside both within and beyond language. Careful analysis of narratives of illness for sayable and unsayable aspects of the experience can help illuminate new areas of concern for people with chronic kidney disease. Narrative inquiry, located in a social constructionist framework, guided this study. Secondary data analysis was conducted with 46 in-depth interviews (collected between 2008-2011) with 14 people living with chronic kidney disease. Through narrative thematic analysis, we identify that the unsayable includes the following five themes: living with death, embodied experiences that were difficult to language, that which was unthinkable, unknowable mystery and that which was untold/unheard. Whereas the first four themes attend to that which is unsayable for people living with chronic kidney disease, the last theme acknowledges that which is unsayable to people living with chronic kidney disease. Not all experiences of illness can be explicitly articulated in language. Listening for both the sayable and unsayable aspects of life with chronic and life-threatening illness is an important nursing role. © 2013 John Wiley & Sons Ltd.

A Qualitative Analysis of Stress and Relaxation Themes Contributing to Burnout in First-Year Psychiatry and Medicine Residents.

PubMed

Benson, Nicole M; Chaukos, Deanna; Vestal, Heather; Chad-Friedman, Emma F; Denninger, John W; Borba, Christina P C

2018-05-14

Qualitative research on trainee well-being can add nuance to the understanding of propagators of burnout, and the role for interventions aimed at supporting well-being. This qualitative study was conducted to identify (i) situations and environments that cause stress for trainees, (ii) stress-reducing activities that trainees utilize, and (iii) whether trainees who report distress (high burnout and depression scores) describe different stressors and relaxation factors than those who do not. The study was conducted with a convenience sample of first-year medicine and psychiatry residents at a large urban teaching hospital. Participants were asked to complete electronic stress and relaxation diaries daily for 1 week. Diary entries were coded for recurrent themes. Participants were screened for burnout and depression. Codes were compared by subgroup based on baseline burnout and depression status to elucidate if specific themes emerged in these subgroups. Study sample included 51 interns. Sixteen (16/50, 32%) screened positive for burnout and three (3/50, 14%) had a positive depression screen. The most common stressors related to aspects of the learning environment, compounded by feeling under-equipped, overwhelmed, or out of time. The majority of relaxation activities involved social connection, food, other comforts, and occurred outside of the hospital environment. This study reveals that interns (regardless of burnout or depression screen) identify stressors that derive primarily from organizational, interpersonal, and cultural experiences of the learning environment; whereas relaxation themes are diversely represented across realms (home, leisure, social, health), though emphasize activities that occur outside of the work place.

Developing a pilot curriculum to foster humanism among graduate medical trainees.

PubMed

Dotters-Katz, Sarah K; Chuang, Alice; Weil, Amy; Howell, Jennifer O

2018-01-01

Humanism is a central tenant of professionalism, a required competency for all residency programs. Yet, few residencies have formal curriculum for teaching this critical aspect of medicine. Instead, professionalism and humanism are often taught informally through role-modeling. With increased burnout, faculty professionalism may suffer and may compromise resident role-modeling. The objective of this study was to design a pilot curriculum to foster humanism in among residents and assess its ability to do so. Two-phase exploratory sequential mixed methods study. Phase 1: a qualitative analysis of residents' narratives regarding challenges to humanistic behavior, and identified themes of compassion, fatigue, communication challenges, and work-life balance. Themes used as needs assessment to build curriculum. Phase 2: three sessions with themes taken from faculty development course. Participants and controls completed baseline and 60-day follow-up questionnaires assessing burnout, compassion, satisfaction, and ability to practice psychological medicine. Phase one included Obstetrics/Gynecology and internal medicine residents. Phase two included residents from the above programs, who attended at least 2/3 interactive sessions designed to address the themes identified above. Twelve participants began and ten completed curriculum (83%). The curriculum met course objectives and was well-received (4.8/5). Burnout decreased (-3.1 vs. 2.5, P = 0.048). A trend toward improved compassion (4.4 vs.-0.6, P = 0.096) for participants compared to controls was noted. A pilot humanism curriculum for residents was well-received. Participants showed decreased burnout and trended to improved compassion scores. Development and evaluation of an expanded curriculum would further explore feasibility and effectiveness of the intervention.

Living With Dementia: A Meta-synthesis of Qualitative Research on the Lived Experience

PubMed Central

Górska, Sylwia; Forsyth, Kirsty; Maciver, Donald

2018-01-01

Abstract Purpose of the Study To identify and examine the published qualitative research evidence relative to the experience of living with dementia. Design and Methods Metasynthesis was used as the methodological framework to guide data collection and analysis. Results Three themes were identified. The first theme considered the main condition-related changes experienced by people with dementia (PWD) and showed how these are interlinked and impact upon various areas of people’s lives. The second theme indicated that amidst these changes, PWD strive to maintain continuity in their lives by employing various resources and coping strategies. The third theme underlined the role of contextual factors. The reviewed evidence indicates that, the emerging experience of PWD and their potential to adjust to the continuous changes is influenced by access to and quality of both personal and contextual resources which remain in a constant, transactional relationship to each other. Implications The findings were interpreted and discussed in the context of relevant theoretical frameworks and research evidence. It was considered that current evidence and findings presented in this review can be further explored and expanded upon in a more systematic way through research conducted within the theoretical framework of dynamic systems theory. Further research would be also beneficial to explore the subjective experience of dementia from a participatory perspective. Exploring the application of these theoretical standpoints would contribute to the current state of knowledge and offer both PWD and carers fresh perspective on the nature of change and potential for adaptability in dementia. PMID:28069886

Using family and staff experiences of a botulinum toxin-A service to improve service quality.

PubMed

Burton, K L O; Bau, K; Lewis, J; Aroyan, K R; Botha, B; Botman, A G M; Stewart, K; Waugh, M-C A; Paget, S P

2017-11-01

The decision for families to proceed with botulinum toxin-A (BoNT-A) injections for managing childhood conditions involving hypertonia can be complex. Family-centred care is a service model that facilitates supporting families in this decision-making process. Understanding families' experiences of services is critical to developing family-centred care. The aim of this project was therefore to increase understanding of the experiences of families of children attending a BoNT-A service in order to improve the service and its family-centred approach to care. Sixteen staff of a BoNT-A service participated in a patient journey mapping exercise. Nine families of the service participated in in-depth interviews. Interviews were audio-recorded and transcribed verbatim. Data from the staff session and interviews were analysed independently using grounded, hermeneutic thematic analysis. Staff sessions revealed 5 core themes that related to impacting on the family experience. Family interviews revealed 4 core themes, with 7 subthemes and 1 latent theme. Areas of importance identified by families relating to BoNT-A treatment included acknowledgement of individual needs, care coordination, empowerment of families and patients, consistency in service delivery, and the distressing nature of appointment and decision-making. Comparison of the data from the staff patient journey mapping and family interviews suggested that staff have a good but incomplete understanding of the factors important to families, highlighting the need for consumer engagement in establishing family-centred care. The themes identified can guide the provision of family-centred BoNT-A injection clinics. © 2017 John Wiley & Sons Ltd.

Pediatric acute gastroenteritis: understanding caregivers' experiences and information needs.

PubMed

Albrecht, Lauren; Hartling, Lisa; Scott, Shannon D

2017-05-01

Pediatric acute gastroenteritis (AGE) is a common condition with high health care utilization, persistent practice variation, and substantial family burden. An initial approach to resolve these issues is to understand the patient/caregiver experience of this illness. The objective of this study was to describe caregivers' experiences of pediatric AGE and identify their information needs, preferences, and priorities. A qualitative, descriptive study was conducted. Caregivers of a child with AGE were recruited for this study in the pediatric emergency department (ED) at a tertiary hospital in a major urban centre. Individual interviews were conducted (n=15), and a thematic analysis of interview transcripts was completed using a hybrid inductive/deductive approach. Five major themes were identified and described: 1) caregiver management strategies; 2) reasons for going to the ED; 3) treatment and management of AGE in the ED; 4) caregivers' information needs; and 5) additional factors influencing caregivers' experiences and decision-making. A number of subthemes within each major theme were identified and described. This qualitative descriptive study has identified caregiver information needs, preferences, and priorities regarding pediatric AGE. This study also identified inconsistencies in the treatment and management of pediatric AGE at home and in the ED that influence health care utilization and patient outcomes related to pediatric AGE.

Gynecologic Care of the Female-to-Male Transgender Man

PubMed Central

Dutton, Lauren; Koenig, Karel; Kristopher, Fennie

2016-01-01

Transgender men are a vulnerable population whose health care needs have been difficult to identify because of limited research and an inability to identify the population. Limited evidence suggests that transgender men are at increased risk of having polycystic ovarian syndrome, contracting HIV, experiencing violence, and committing suicide. This qualitative study, conducted through face-to-face interviews of a convenient sample, was a three-part interview containing a demographic and health questionnaire, the Norbeck Social Support Questionnaire, as well as the Health Care Relationship Trust Scale. Audio recordings and written notes were reviewed and common themes were identified via content analysis. Six self-identified transgender men between the ages of 19 and 45 years were enrolled in the study. Participants were at varying degrees of social and medical transition. Four major themes were identified: 1) receiving gynecologic care was perceived to be important; 2) breasts caused the most gender identity conflict; 3) transgender men struggle with revealing their gender identity to health care providers; and 4) the male/female boxes on health intake forms, as well as pronoun usage by medical staff, were barriers to receiving health care. This gynecologic health care needs assessment of transgender men begins to characterize the barriers transgender men face when seeking health care. PMID:18586186

Why Do Women Not Use Preconception Care? A Systematic Review On Barriers And Facilitators.

PubMed

Poels, Marjolein; Koster, Maria P H; Boeije, Hennie R; Franx, Arie; van Stel, Henk F

2016-10-01

Preconception care (PCC) has the potential to optimize pregnancy outcomes. However, awareness of PCC among the target population is generally limited, and the use of PCC remains low. The objective of this study was to review the literature on women's perceptions regarding barriers and facilitators for the use of PCC. A systematic search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO for published studies until February 2015. Original qualitative and quantitative peer-reviewed studies from Western countries in English, holding women's perceptions regarding barriers and facilitators for the use of PCC. Data extraction and analysis were performed using NVivo version 10 software. A coding frame was derived from the findings and applied by 2 authors. Thematic analysis was used to identify key topics and themes. Twenty-one good-quality articles were included, of which 10 qualitative and 11 quantitative studies. Seven main themes were identified: preconditions, emotions and beliefs, perceived need, knowledge and experience, social structure, accessibility, and provider characteristics. "Not (fully) planning pregnancy", "perceived absence of risks", "lack of awareness", and "pregnancy experiences" were the most frequently identified barriers and "believing in the benefits" and "availability of PCC" the most frequently identified facilitators for PCC use. Women perceive more barriers than facilitators related to PCC uptake, which explains why the use of PCC remains low. Our results provide a starting point to refocus interventions and strategies, aiming on enlarging the awareness, perceived importance, and accessibility of PCC to improve its uptake.

Ethical conflicts with hospitals: the perspective of nurses and physicians.

PubMed

Gaudine, Alice; LeFort, Sandra M; Lamb, Marianne; Thorne, Linda

2011-11-01

Nurses and physicians may experience ethical conflict when there is a difference between their own values, their professional values or the values of their organization. The distribution of limited health care resources can be a major source of ethical conflict. Relatively few studies have examined nurses' and physicians' ethical conflict with organizations. This study examined the research question 'What are the organizational ethical conflicts that hospital nurses and physicians experience in their practice?' We interviewed 34 registered nurses, 10 nurse managers, and 31 physicians as part of a larger study, and asked them to describe their ethical conflicts with organizations. Through content analysis, we identified themes of nurses' and physicians' ethical conflict with organizations and compared the themes for nurses with those for physicians.

[Mercosur's regional health agenda: architecture and themes].

PubMed

Queiroz, Luisa Guimaraes; Giovanella, Ligia

2011-08-01

This article describes the shaping of institutional health spaces in the Mercosur, with analysis of themes and results and considerations on the construction of the regional agenda and on the effects of regional economic integration processes on health policies and systems. We discuss the organization, operation, focus topics, and results achieved in specific health forums (Meeting of Ministers of Health and Sub-Working Group 11), seeking to analyze the architecture and issues addressed by the regional agenda and drawing parallels with the European experience. The aim of this reflection is to identify how the work done by Mercosur structures contributes to building a regional agenda, with the expectation that the integration can contribute to reducing inequalities in access to health care in the region.

Culture Writ Electronic: Themes in Television Advertising.

ERIC Educational Resources Information Center

Cheney, Michael R.

A content analysis was made of the advertisements broadcast during a half-hour of prime-time television, in an effort to discern the overt (obvious) and covert (underlying) themes present in television advertising. The analysis revealed an overt theme of a world view of individual determination, initiative, self-confidence and self-reliance, and…

A Fantasy Theme Analysis of Nixon's "Checkers" Speech.

ERIC Educational Resources Information Center

Wells, William T.

1996-01-01

Applies fantasy theme analysis to Richard Nixon's "Checkers" speech. States that three major themes emerge: Nixon as Moral Model, Nixon as the American Dream, and Nixon as Patriot. Points out that each issue responds to allegations of dishonesty that were leveled against him at the time. Argues that Nixon's speech was accepted and…

The Astronomy of Africa's Health Systems Literature During the MDG Era: Where Are the Systems Clusters?

PubMed

Phillips, James F; Sheff, Mallory; Boyer, Christopher B

2015-09-01

Growing international concern about the need for improved health systems in Africa has catalyzed an expansion of the health systems literature. This review applies a bibliometric procedure to analyze the acceleration of scientific writing on this theme. We focus on research published during the Millennium Development Goal (MDG) era between 1990 and 2014, reporting findings from a systematic review of a database comprised of 17,655 articles about health systems themes from sub-Saharan African countries or subregions. Using bibliometric tools for co-word textual analysis, we analyzed the incidence and associations of keywords and phrases to generate and visualize topical foci on health systems as clusters of themes, much in the manner that astronomers represent groupings of stars as galaxies of celestial entities. The association of keywords defines their relative position, with the size of images weighted by the relative frequency of terms. Sets of associated keywords are arrayed as stars that cluster as "galaxies" of concepts in the knowledge universe represented by health systems research from sub-Saharan Africa. Results show that health systems research is dominated by literature on diseases and categorical systems research topics, rather than on systems science that cuts across diseases or specific systemic themes. Systems research is highly developed in South Africa but relatively uncommon elsewhere in the region. "Black holes" are identified by searching for terms in our keyword library related to terms in widely cited reviews of health systems. Results identify several themes that are unexpectedly uncommon in the country-specific health systems literature. This includes research on the processes of achieving systems change, the health impact of systems strengthening, processes that explain the systems determinants of health outcomes, or systematic study of organizational dysfunction and ways to improve system performance. Research quantifying the relationship of governance indicators to health systems strengthening is nearly absent from the literature. Long-term experimental studies and statistically rigorous research on cross-cutting themes of health systems strengthening are rare. Studies of organizational malaise or corruption are virtually absent. Trend analysis shows the emergence of organizational research on specific priority diseases, such as on HIV/AIDS, malaria, and tuberculosis, but portrays a lack of focus on integrated systems research on the general burden of disease. If health systems in Africa are to be strengthened, then organizational change research must be a more concerted focus in the future than has been the case in the past. © Phillips et al.

The Astronomy of Africa’s Health Systems Literature During the MDG Era: Where Are the Systems Clusters?

PubMed Central

Sheff, Mallory; Boyer, Christopher B

2015-01-01

Growing international concern about the need for improved health systems in Africa has catalyzed an expansion of the health systems literature. This review applies a bibliometric procedure to analyze the acceleration of scientific writing on this theme. We focus on research published during the Millennium Development Goal (MDG) era between 1990 and 2014, reporting findings from a systematic review of a database comprised of 17,655 articles about health systems themes from sub-Saharan African countries or subregions. Using bibliometric tools for co-word textual analysis, we analyzed the incidence and associations of keywords and phrases to generate and visualize topical foci on health systems as clusters of themes, much in the manner that astronomers represent groupings of stars as galaxies of celestial entities. The association of keywords defines their relative position, with the size of images weighted by the relative frequency of terms. Sets of associated keywords are arrayed as stars that cluster as “galaxies” of concepts in the knowledge universe represented by health systems research from sub-Saharan Africa. Results show that health systems research is dominated by literature on diseases and categorical systems research topics, rather than on systems science that cuts across diseases or specific systemic themes. Systems research is highly developed in South Africa but relatively uncommon elsewhere in the region. “Black holes” are identified by searching for terms in our keyword library related to terms in widely cited reviews of health systems. Results identify several themes that are unexpectedly uncommon in the country-specific health systems literature. This includes research on the processes of achieving systems change, the health impact of systems strengthening, processes that explain the systems determinants of health outcomes, or systematic study of organizational dysfunction and ways to improve system performance. Research quantifying the relationship of governance indicators to health systems strengthening is nearly absent from the literature. Long-term experimental studies and statistically rigorous research on cross-cutting themes of health systems strengthening are rare. Studies of organizational malaise or corruption are virtually absent. Trend analysis shows the emergence of organizational research on specific priority diseases, such as on HIV/AIDS, malaria, and tuberculosis, but portrays a lack of focus on integrated systems research on the general burden of disease. If health systems in Africa are to be strengthened, then organizational change research must be a more concerted focus in the future than has been the case in the past. PMID:26374806

HIV-Prevention Opportunities With GPS-Based Social and Sexual Networking Applications for Men Who Have Sex With Men.

PubMed

Jenkins Hall, Wendasha; Sun, Christina J; Tanner, Amanda E; Mann, Lilli; Stowers, Jason; Rhodes, Scott D

2017-02-01

The goal of this study was to gain insight on the sexual health needs of men who have sex with men (MSM) who use GPS-based social and sexual networking mobile applications (apps) and the future utility of app-based interventions. A health educator promoted HIV-testing resources in four popular apps used by MSM. Content analysis was used to identify salient themes that emerged from the conversations. Four major themes were identified: (1) soliciting sexual encounters, (2) relationship building, (3) HIV and STI-testing inquiries, and (4) seeking other sexual health information. The results suggest the intervention's social media-based strategy, respect for community culture, and unobtrusive approach was advantageous in establishing credibility and rapport with app users. These results highlight a need for convenient and discreet methods to access accurate sexual health information and suggest that apps provide an alternative, non-traditional venue for sexual health education in addition to HIV testing promotion.

OAST Space Theme Workshop. Volume 3: Working group summary. 2: Data handling, communications (E-2). A. Statement. B. Technology needs (form 1). C. Priority assessment (form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

Technologies required to support the stated OAST thrust to increase information return by X1000, while reducing costs by a factor of 10 are identified. The most significant driver is the need for an overall end-to-end data system management technology. Maximum use of LSI component technology and trade-offs between hardware and software are manifest in most all considerations of technology needs. By far, the greatest need for data handling technology was identified for the space Exploration and Global Services themes. Major advances are needed in NASA's ability to provide cost effective mass reduction of space data, and automated assessment of earth looking imagery, with a concomitant reduction in cost per useful bit. A combined approach embodying end-to-end system analysis, with onboard data set selection, onboard data processing, highly parallel image processing (both ground and space), low cost, high capacity memories, and low cost user data distribution systems would be necessary.

The expression of depression among Javanese patients with major depressive disorder: a concept mapping study.

PubMed

Brintnell, E Sharon; Sommer, Ryan W; Kuncoro, Bambang; Setiawan, G Pandu; Bailey, Patricia

2013-08-01

In this study, we explored the presentation of clinical depression in Java, Indonesia. Interviews were conducted with 20 Javanese patients (male and female) with major depressive disorder from both lower and higher socioeconomic levels. The recruited participants came from provincial and private mental health hospitals in the cities of Solo, Yogykarta (Jogja), Jakarta, and Malang on the island of Java, Indonesia. Concept mapping methodology using multidimensional scaling and hierarchical cluster analysis was used to identify underlying themes in the expression of depressive phenomena in this Indonesian population. The results identified themes that grouped into six clusters: interpersonal relationships, hopelessness, physical/somatic, poverty of thought, discourage, and defeat. Findings give support to the view that culture influences the expression of Indonesian depressive phenomenology, which nevertheless has some common roots with Western clinical pictures of the disorder. Cultural influences may mask symptoms of the disorder to clinicians. Diagnostic and assessment tools must be carefully selected to ensure they address culturally specific expressions of depression.

Beyond Einstein

NASA Astrophysics Data System (ADS)

Hertz, P.

2003-03-01

The Structure and Evolution of the Universe (SEU) theme within NASA's Office of Space Science seeks to explore and understand the dynamic transformations of energy in the Universe - the entire web of biological and physical interactions that determine the evolution of our cosmic habitat. This search for understanding will enrich the human spirit and inspire a new generation of explorers, scientists, and engineers. To that end, NASA's strategic planning process has generated a new Roadmap to enable those goals. Called "Beyond Einstein", this Roadmap identifies three science objectives for the SEU theme: (1) Find out what powered the Big Bang; (2) Observe how black holes manipulate space, time, and matter; and (3) Identify the mysterious dark energy pullingthe Universe apart. These objectives can be realized through a combination of large observatories (Constellation-X, LISA), moderate sized, PI-led missions (the Einstein Probes), and a contuinuing program of technology development, research and analysis, and education/public outreach. In this presentation, NASA's proposed Beyond Einstein Program will be described. The full Roadmap is available at http://universe.nasa.gov/.

Understanding mothers' perceptions of what is important about themselves and parenting.

PubMed

Riesch, S K; Coleman, R; Glowacki, J S; Konings, K

1997-01-01

The purpose of this article is to report what mothers of young adolescents perceive as important about themselves and parenting. Their perceptions were identified from brief written statements from a sample of 538 mothers of young adolescents. The women's statements were analyzed using content analysis techniques. Six themes emerged. Mothers described the challenges of putting their ideals about parenting into practice, including incorporating or discarding the influence of their own upbringing and the seeking of knowledge and skills to improve their parenting. Mothers described their values and goals. Feelings of self-doubt were made apparent through self-critical comments. Expressions of frustration were evident as were the serious life stressors managed by the sample. Repeated comments identified mothers' emphases on the importance of open family communication. Mothers had developed styles of parenting based on decision-making methods and understanding the child's perspective. We suggest community health nurses use the themes as guidelines for anticipatory guidance with families during adolescence.

Intimate partner violence in Kenya: expanding healthcare roles.

PubMed

Maina, Geoffrey; Majeke, Sisana

To identify health professionals' perceptions of their role working in the emergency department (ED) in managing and preventing intimate partner violence in Kenya. A qualitative research study was conducted involving in-depth interviews with one doctor, six nurses and four clinical officers who had worked in an ED for at least one year. Interviews were recorded on a digital voice recorder. Transcription and subsequent analysis of the interviews were done using NVivo 7 software for qualitative data. Emerging ideas were collated into themes and sub-themes. Participants found themselves assuming diverse roles within and without the health setting, for example that of clinician, liaison officer, counsellor and health and community educators. These roles represented the wide scope of involvement of healthcare professionals in relation to intimate partner violence and were perceived as enhancing effectiveness in addressing domestic violence towards women. Healthcare providers identified several roles that they assume to assist abused women. These roles were considered over and above the usual clinical roles that they are expected to perform.

Teaching in the Field: What Teacher Professional Life Histories Tell About How They Learn to Teach in the Outdoor Learning Environment

NASA Astrophysics Data System (ADS)

Feille, Kelly K.

2017-06-01

This research investigates the professional life histories of upper elementary science teachers who were identified as effective both within the classroom and in the outdoor learning environment (OLE). The narratives of five teachers, collected through semistructured and open-ended interviews, provided the data for the study. Professional life histories were constructed for each teacher participant and an analysis of the teacher narratives identified the themes of teacher development across the voices of the participants. Narrative reasoning was used to unify those themes into a hypothetical professional life history as reported in this manuscript. Implications of this research can be realized for stakeholders in the preparation of pre-service teachers as well as the development of in-service teachers. Future research regarding the early induction years of new teachers, impacts of inclusion of the OLE in pre-service teacher instruction, and teacher experiences regarding professional development relating to efforts to include the OLE in formal education should be investigated.