Sample records for individual structured interviews

  1. Vocational Decision-Making Interview. Administration Manual.

    ERIC Educational Resources Information Center

    Czerlinsky, Thomas; McCray, Paul M.

    This guide is intended to assist rehabilitation counselors, school guidance personnel, and others involved in administering and interpreting the results of the Vocational Decision-Making Interview (VDMI). (The VDMI is a structured interview instrument that was developed to facilitate the assessment of an individual's vocational decision-making…

  2. Exploration of Quality-of-Life Goals in Individuals with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Kullmann, Lajos; Toth, Katalin

    2012-01-01

    The aim of the study is to investigate the applicability of structured interviews for exploration of quality-of-life goals using an established instrument. Structured interviews were performed using WHOQOL-BREF and Disabilities Module as guideline with 35 clients admitted for first rehabilitation intervention after spinal cord injury. Although…

  3. Impression Management in the Psychiatric Interview: Quality, Style, and Individual Differences

    ERIC Educational Resources Information Center

    Sherman, Mark; And Others

    1975-01-01

    The ability of 24 Veterans Administration Day Treatment Center psychiatric outpatients to vary intentionally their degree of apparent psychopathology during structured interviews was studied. Patients defined as sick presenters behaved in a significantly more pathological manner during an interview preceded by "fake sick" instructions than they…

  4. Rater Perceptions of Bias Using the Multiple Mini-Interview Format: A Qualitative Study

    ERIC Educational Resources Information Center

    Alweis, Richard L.; Fitzpatrick, Caroline; Donato, Anthony A.

    2015-01-01

    Introduction: The Multiple Mini-Interview (MMI) format appears to mitigate individual rater biases. However, the format itself may introduce structural systematic bias, favoring extroverted personality types. This study aimed to gain a better understanding of these biases from the perspective of the interviewer. Methods: A sample of MMI…

  5. Resilience Among Naval Recruits: A Quantitative and Qualitative Analysis of Interventions at Recruit Training Command and Implications on Fleet Readiness

    DTIC Science & Technology

    2016-03-01

    associated with higher levels of resilience (Connor & Davidson, 2003). The CD-RISC offers a validated quantitative scale to researchers , allowing for the...a total of 35 recruits and 12 RDCs were interviewed. Four focus groups and 30 personal interviews were conducted. The interviews included recruits...two to four individuals. The interviews and focus groups were semi-structured. A set of questions were identified prior to the interviews as a

  6. Occupational therapists' job satisfaction in a changing hospital organisation--a time-geography-based study.

    PubMed

    Bendixen, Hans Jørgen; Ellegård, Kajsa

    2014-01-01

    To investigate occupational therapists' job satisfaction under a changing regime by using a time-geographic approach focusing on the therapists' everyday working lives. Nine occupational therapists at the Copenhagen University Hospital, Gentofte, Denmark. A mixed-method design was employed. Occupational therapists kept time-geographic diaries, and the results from them were grounded for individual, semi-structured in-depth interviews. Individual reflections on everyday working life were recorded. Transcribed statements from the interviews were analysed to determine factors influencing job satisfaction. The nine therapists kept diaries for one day a month for a total of 70 preselected days over a period of nine months; six participated in individual interviews. Four factors constraining OT job satisfaction were revealed. Economic concerns, new professional paradigms and methods in combination with a new organisational structure for the occupational therapy service caused uncertainty. In addition, decreasing possibilities for supervision by colleagues influenced job satisfaction. Opportunities for experiencing autonomy in everyday working life were described as facilitators for job satisfaction. The time-geographic and interview methods were useful in focusing on the job satisfaction of occupational therapists, who provided individual interpretations of the balance between autonomy and three types of constraints in everyday working life. The constraints related to organisation, power relations and - not least - how the organisational project of the department fitted in with OTs' individual projects. Matching of organisational and individual projects is of crucial importance, not only for OTs but for most workplaces where individuals are employed to serve patients in the healthcare sector.

  7. Organizational Context of Structured On-the-Job Training.

    ERIC Educational Resources Information Center

    Versloot, A. M.; DeJong, J. A.

    A study examined structured on-the-job training (SOJT) within the organizational context of 8 Dutch firms exploring more than 500 individuals each. Between 7 and 19 individuals (trainees, trainers, supervisors, managers, and/or human resource development officers) were interviewed at each firm. The effectiveness of SOJT was found to be greatly…

  8. Prospective Teachers' Perceptions on Different Aspects of Portfolio

    ERIC Educational Resources Information Center

    Ok, Ahmet; Erdogan, Mehmet

    2010-01-01

    This qualitative-case study examined how portfolio and portfolio assessment were perceived by prospective teachers. The participants were 23 prospective teachers from seven different teaching areas from a Turkish university. A semi-structured individual interview was conducted. The interview schedule included 15 open-ended questions. The main…

  9. 78 FR 942 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-07

    ..., health IT usage, and work processes. A total of 14 observation periods will take place across the six... 1. (4) Semi-structured individual interviews and surveys with clinic staff to further understand... the Technology Assessment Model (TAM) survey. The interview will address up to five key topic areas...

  10. What's Not Being Said? Recollections of Nondisclosure in Clinical Supervision While in Training

    ERIC Educational Resources Information Center

    Sweeney, Jennifer; Creaner, Mary

    2014-01-01

    The aim of this qualitative study was to retrospectively examine nondisclosure in individual supervision while in training. Interviews were conducted with supervisees two years post-qualification. Specific nondisclosures were examined and reasons for these nondisclosures were explored. Six in-depth semi-structured interviews were conducted and…

  11. Bananas, pesticides and health in southwestern Ecuador: A scalar narrative approach to targeting public health responses.

    PubMed

    Brisbois, Benjamin

    2016-02-01

    Public health responses to agricultural pesticide exposure are often informed by ethnographic or other qualitative studies of pesticide risk perception. In addition to highlighting the importance of structural determinants of exposure, such studies can identify the specific scales at which pesticide-exposed individuals locate responsibility for their health issues, with implications for study and intervention design. In this study, an ethnographic approach was employed to map scalar features within explanatory narratives of pesticides and health in Ecuador's banana-producing El Oro province. Unstructured observation, 14 key informant interviews and 15 in-depth semi-structured interviews were carried out during 8 months of fieldwork in 2011-2013. Analysis of interview data was informed by human geographic literature on the social construction of scale. Individual-focused narratives of some participants highlighted characteristics such as carelessness and ignorance, leading to suggestions for educational interventions. More structural explanations invoked farm-scale processes, such as uncontrolled aerial fumigations on plantations owned by elites. Organization into cooperatives helped to protect small-scale farmers from 'deadly' banana markets, which in turn were linked to the Ecuadorian nation-state and actors in the banana-consuming world. These scalar elements interacted in complex ways that appear linked to social class, as more well-off individuals frequently attributed the health problems of other (poorer) people to individual behaviours, while providing more structural explanations of their own difficulties. Such individualizing narratives may help to stabilize inequitable social structures. Research implications of this study include the possibility of using scale-focused qualitative research to generate theory and candidate levels for multi-level models. Equity implications include a need for public health researchers planning interventions to engage with scale-linked inequities, such as disparities within nation-states. Finally, the prominence of the global North in explanatory narratives is a useful reminder that 'structural factors' prominently include inequities related to the legacies of colonialism. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day.

    PubMed

    Haislup, Brett D; Kraeutler, Matthew J; Baweja, Rishi; McCarty, Eric C; Mulcahey, Mary K

    2017-12-01

    Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Cross-sectional study. A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year, with each applicant participating in an average of 2 to 4 individual interviews per interview day and interviews commonly lasting between 5 and 15 minutes.

  13. Structured scaffolding for reflection and problem solving in diabetes self-management: qualitative study of mobile diabetes detective.

    PubMed

    Mamykina, Lena; Heitkemper, Elizabeth M; Smaldone, Arlene M; Kukafka, Rita; Cole-Lewis, Heather; Davidson, Patricia G; Mynatt, Elizabeth D; Tobin, Jonathan N; Cassells, Andrea; Goodman, Carrie; Hripcsak, George

    2016-01-01

    To investigate subjective experiences and patterns of engagement with a novel electronic tool for facilitating reflection and problem solving for individuals with type 2 diabetes, Mobile Diabetes Detective (MoDD). In this qualitative study, researchers conducted semi-structured interviews with individuals from economically disadvantaged communities and ethnic minorities who are participating in a randomized controlled trial of MoDD. The transcripts of the interviews were analyzed using inductive thematic analysis; usage logs were analyzed to determine how actively the study participants used MoDD. Fifteen participants in the MoDD randomized controlled trial were recruited for the qualitative interviews. Usage log analysis showed that, on average, during the 4 weeks of the study, the study participants logged into MoDD twice per week, reported 120 blood glucose readings, and set two behavioral goals. The qualitative interviews suggested that individuals used MoDD to follow the steps of the problem-solving process, from identifying problematic blood glucose patterns, to exploring behavioral triggers contributing to these patterns, to selecting alternative behaviors, to implementing these behaviors while monitoring for improvements in glycemic control. This qualitative study suggested that informatics interventions for reflection and problem solving can provide structured scaffolding for facilitating these processes by guiding users through the different steps of the problem-solving process and by providing them with context-sensitive evidence and practice-based knowledge related to diabetes self-management on each of those steps. This qualitative study suggested that MoDD was perceived as a useful tool in engaging individuals in self-monitoring, reflection, and problem solving. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Assessing cannabis use in adolescents and young adults: what do urine screen and parental report tell you?

    PubMed

    Gignac, Martin; Wilens, Timothy E; Biederman, Joseph; Kwon, A; Mick, E; Swezey, A

    2005-10-01

    Our analysis compares three approaches to detect the most common drug abused in early adulthood, cannabis: (1) report on direct structured interview; (2) indirect parental report; and (3) urine toxicology screen. We examined data on 207 subjects (36% also met criteria for alcohol abuse; 9% for alcohol dependence) derived from two prospective and ongoing family studies of boys and girls with or without attention-deficit/hyperactivity disorder (ADHD). Assessments relied on the Schedule for Affective Disorders and Schizophrenia (K-SADS-E; under 18 years of age) and on the Structured Clinical Interview for DSM-IV (SCID-IV; over 18 years of age). Urine samples were analyzed with Auccusign DOA5 (on-site screening assay). Ninety-seven percent (97%) of individuals, who reported no use of cannabis within the past month, had a negative urine screening and 79% of individuals, who endorsed cannabis abuse/dependence, had a positive urine screening. The sensitivity of the direct structured interview report was 91%, the specificity 87%, the positive predicting value 67%, and the negative predictive value 97%. Indirect parental reports were found to be less informative on cannabis use than direct report. Direct report of cannabis use, abuse, or dependence during the structured interview is both sensitive and specific when compared to urine toxicology screens and indirect parental reports.

  15. Creating a Positive School Culture in Newly Opened Schools

    ERIC Educational Resources Information Center

    Holmes, Michael Todd

    2009-01-01

    The purpose of this study was to determine the most effective practices by school administrators when creating school culture in newly opened schools. Using semi-structured interviews, four principals who opened a new school were interviewed individually and in a focus group. The constant comparative method was used to analyze the data. Two themes…

  16. 77 FR 65888 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ..., health IT usage, and work processes. A total of 14 observation periods will take place across the six...) Semi-structured individual interviews and surveys with clinic staff to further understand their use of... Technology Assessment Model (TAM) survey. The interview will address up to five key topic areas: Demographics...

  17. Structured Interviews on Children's Conceptions of Computers. Technical Report No. 19.

    ERIC Educational Resources Information Center

    Mawby, Ronald; And Others

    The terms and concepts children used to explain their beliefs about computers before and after classroom exposure to microcomputers were studied to identify misconceptions about computers that could interfere with computer-based learning. Children in each of two classrooms at the Bank Street School for Children were interviewed individually on…

  18. A Taxometric Study of the Adult Attachment Interview

    ERIC Educational Resources Information Center

    Roisman, Glenn I.; Fraley, R. Chris; Belsky, Jay

    2007-01-01

    This study is the first to examine the latent structure of individual differences reflected in the Adult Attachment Interview (AAI; C. George, N. Kaplan, & M. Main, 1985), a commonly used and well-validated measure designed to assess an adult's current state of mind regarding childhood experiences with caregivers. P. E. Meehl's (1995)…

  19. Identity and Spirituality: A Psychosocial Exploration of the Sense of Spiritual Self

    ERIC Educational Resources Information Center

    Kiesling, Chris; Sorell, Gwendolyn T.; Montgomery, Marilyn J.; Colwell, Ronald K.

    2006-01-01

    The authors examined the structure and content of adults' sense of spiritual identity by analyzing semistructured interviews with 13 spiritually devout men and 15 devout women, ages 22 to 72. "Individuals' responses to the Role-Related Identity Interview" (G. T. Sorell, M. J. Montgomery, & N. A. Busch-Rossnagel, 1997b) were…

  20. What Do We Do Today, Daddy? (Father's Perception of His Role and Responsibilities).

    ERIC Educational Resources Information Center

    Woolner, Rosestelle B.

    This paper presents brief summaries of two exploratory studies conducted to determine the non-custodial father's perception of his role and responsibilities following divorce. In Study I, eight middle class males who visited their children at least twice a month were interviewed individually. The interview consisted of a structured questionnaire…

  1. An exploration of cognitive appraisals following spinal cord injury.

    PubMed

    Kaiser, Sally; Kennedy, Paul

    2011-12-01

    This study explored the cognitive appraisals that people make following spinal cord injury (SCI) about their situation and their ability to cope with it. Appraisals are thought to be important in determining individual responses to different events and have been shown to predict psychological well-being following injury. A cross-sectional interview study was used. Ten individuals who had recently started rehabilitation at the National Spinal Injuries Centre following an SCI were interviewed. Eight men and two women with a variety of injury level and completeness participated. Interviews were semi-structured and aimed to elicit participants' appraisals of their experiences and their ability to cope. Interviews were analysed qualitatively using interpretative phenomenological analysis. Four super-ordinate themes emerged from the interviews. These were making sense of a traumatic experience, impact of the SCI, coping and altered view of self and life. The interviews revealed that appraisals following SCI are complex and relate not only to the individual but also to their context, life stage, roles and relationships. The study adds to the theoretical understanding of the appraisal process following SCI. Ideas for further research are generated and clinical implications for improving patient experiences and developing appraisal-focused interventions are considered.

  2. Assessment of personality disorders in anorexia nervosa and bulimia nervosa. A comparison of self-report and structured interview methods.

    PubMed

    Kennedy, S H; Katz, R; Rockert, W; Mendlowitz, S; Ralevski, E; Clewes, J

    1995-06-01

    Interest in assessing Personality Disorders (PDs) in association with anorexia nervosa (AN) and bulimia nervosa (BN) has been accompanied by the development of several structured interview and self-report measures. In an attempt to see how the self-report Millon Clinical Multiaxial Inventory (MCMI-II) compared with the Structured Clinical Interview for DSM-III-R (SCID-II) in the assessment of PDs, we gave both instruments to 43 inpatients with a diagnosis of AN or BN. Correlation coefficient values for both categorical and dimensional comparisons were generally less than .4. Although comparable rates of positive PDs occurred for each of the three clusters (A: 30.2% vs. 34.9%, B: 25.6% vs. 18.6%, and C: 62.8% vs. 81.4% for SCID-II vs. MCMI-II), agreement for individual diagnosis and individual subjects was poor. In conclusion, the MCMI-II did not prove to be a reliable instrument for assessing axis II PDs in patients with AN and BN when compared with the SCID-II.

  3. Individuals' Long Term Use of Cognitive Behavioural Skills to Manage their Depression: A Qualitative Study.

    PubMed

    French, Lydia R M; Thomas, Laura; Campbell, John; Kuyken, Willem; Lewis, Glyn; Williams, Chris; Wiles, Nicola J; Turner, Katrina M

    2017-01-01

    Cognitive Behavioural Therapy (CBT) aims to teach people skills to help them self-manage their depression. Trial evidence shows that CBT is an effective treatment for depression and individuals may experience benefits long-term. However, there is little research about individuals' continued use of CBT skills once treatment has finished. To explore whether individuals who had attended at least 12 sessions of CBT continued to use and value the CBT skills they had learnt during therapy. Semi-structured interviews were held with participants from the CoBalT trial who had received CBT, approximately 4 years earlier. Interviews were audio-recorded, transcribed and analysed thematically. 20 participants were interviewed. Analysis of the interviews suggested that individuals who viewed CBT as a learning process, at the time of treatment, recalled and used specific skills to manage their depression once treatment had finished. In contrast, individuals who viewed CBT only as an opportunity to talk about their problems did not appear to utilize any of the CBT skills they had been taught and reported struggling to manage their depression once treatment had ended. Our findings suggest individuals may value and use CBT skills if they engage with CBT as a learning opportunity at the time of treatment. Our findings underline the importance of the educational model in CBT and the need to emphasize this to individuals receiving treatment.

  4. Enhancing motivational interviewing training in a family medicine clerkship.

    PubMed

    Kaltman, Stacey; WinklerPrins, Vincent; Serrano, Adriana; Talisman, Nicholas

    2015-01-01

    Despite the prevalence of unhealthy behaviors among patients in the healthcare system, traditional medical training involves little or no exposure to effective behavior change techniques such as Motivational Interviewing. An online learning community for enhanced training in Motivational Interviewing was developed for 3rd-year medical students. The website included educational materials about Motivational Interviewing as well as problematic health behaviors, a repository of exemplar videos and student videos with feedback, and a discussion board. Student participants were given the opportunity to record an encounter with a patient and to receive feedback on their use of Motivational Interviewing from a faculty member. Student volunteers in the Family Medicine Clerkship at Georgetown University School of Medicine were randomized to enhanced training, which included the online learning community, or training as usual. All student volunteers completed a questionnaire assessing self-efficacy initially and at the end of the clerkship. Students also participated in an Observed Structured Clinical Exam, which was subsequently coded by a blinded rater for behavioral counts of Motivational Interviewing techniques, key steps in Motivational Interviewing, and overall Motivational Interviewing style. Students in the enhanced training arm were rated as having significantly higher scores in Motivational Interviewing style in the Observed Structured Clinical Exam than training as usual students. A significant increase in self-efficacy from pre- to posttest in the overall sample was observed but between-group differences were not significant. Student feedback was particularly positive regarding video recorded practice sessions with patients and individualized feedback. The results of this study as well as student feedback suggest that future work should include patient practice sessions and individualized feedback in developing Motivational Interviewing curricula.

  5. The key factors affecting students' individual interest in school science lessons

    NASA Astrophysics Data System (ADS)

    Cheung, Derek

    2018-01-01

    Individual interest in school science lessons can be defined as a relatively stable and enduring personal emotion comprising affective and behavioural reactions to events in the regular science lessons at school. Little research has compared the importance of different factors affecting students' individual interest in school science lessons. The present study aimed to address this gap, using a mixed methods design. Qualitative interview data were collected from 60 Hong Kong junior secondary school students, who were asked to describe the nature of their interest in science lessons and the factors to which they attribute this. Teacher interviews, parent interviews, and classroom observations were conducted to triangulate student interview data. Five factors affecting students' individual interest in school science lessons were identified: situational influences in science lessons, individual interest in science, science self-concept, grade level, and gender. Quantitative data were then collected from 591 students using a questionnaire. Structural equation modelling was applied to test a hypothesised model, which provided an acceptable fit to the student data. The strongest factor affecting students' individual interest in school science lessons was science self-concept, followed by individual interest in science and situational influences in science lessons. Grade level and gender were found to be nonsignificant factors. These findings suggest that teachers should pay special attention to the association between academic self-concept and interest if they want to motivate students to learn science at school.

  6. Trainee Teachers' Experience of Reflection

    ERIC Educational Resources Information Center

    McKenzie, Liz

    2015-01-01

    This article reports an investigation of trainee teachers' experience of reflection whilst undertaking a teaching qualification for the post-compulsory sector. The study used a sequential, mixed-methods design, employing a structured questionnaire and a semi-structured interview; 127 individuals completed the questionnaire about their experience…

  7. Social Network Decay as Potential Recovery from Homelessness: A Mixed Methods Study in Housing First Programming

    PubMed Central

    Golembiewski, Elizabeth; Watson, Dennis P.; Robison, Lisa; Coberg, John W.

    2017-01-01

    The positive relationship between social support and mental health has been well documented, but individuals experiencing chronic homelessness face serious disruptions to their social networks. Housing First (HF) programming has been shown to improve health and stability of formerly chronically homeless individuals. However, researchers are only just starting to understand the impact HF has on residents’ individual social integration. The purpose of the current study was to describe and understand changes in social networks of residents living in a HF program. Researchers employed a longitudinal, convergent parallel mixed method design, collecting quantitative social network data through structured interviews (n = 13) and qualitative data through semi-structured interviews (n = 20). Quantitative results demonstrated a reduction in network size over the course of one year. However, increases in both network density and frequency of contact with network members increased. Qualitative interviews demonstrated a strengthening in the quality of relationships with family and housing providers and a shedding of burdensome and abusive relationships. These results suggest network decay is a possible indicator of participants’ recovery process as they discontinued negative relationships and strengthened positive ones. PMID:28890807

  8. Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study.

    PubMed

    Andersén, Åsa; Ståhl, Christian; Anderzén, Ingrid; Kristiansson, Per; Larsson, Kjerstin

    2017-10-10

    The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individual's ability to work. The aim of this study was to investigate clients' experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.

  9. Meaning of Homeownership for Individuals with Developmental Disabilities: A Qualitative Study

    ERIC Educational Resources Information Center

    Hagner, David; Snow, Judith; Klein, Jay

    2006-01-01

    In-person semi-structured interviews were conducted with 7 homeowners selected by 6 state homeownership programs as representing good examples of homeownership by individuals with developmental disabilities. Recurring themes were found in the choice of a home, advantages and disadvantages of homeownership, handling problems, community…

  10. Sipping Coffee with a Serial Killer: On Conducting Life History Interviews with a Criminal Genius

    ERIC Educational Resources Information Center

    Oleson, J. C.

    2004-01-01

    As part of my Ph.D. research on criminal genius, I conducted 44 semi-structured interviews. One of the 44 subjects, in particular, stood out. This noteworthy individual claimed that he had killed 15 people. His story was particularly interesting because--unlike most social research involving serial killers--he claimed that he had never been…

  11. Individual experiences following a 6-month exercise intervention: A qualitative study

    PubMed Central

    Kerkelä, Ellen Staveborg; Jonsson, Linus; Lindwall, Magnus; Strand, Jennifer

    2015-01-01

    Purpose Dropout is a common problem in various exercise interventions. The individual's experience is believed to greatly impact dropout, yet little is known about the individual experiences of taking part in exercise interventions. The aim of this study was to examine individuals’ experiences following a self-determination theory–based exercise intervention in order to gain understanding of how standardized interventions can be adjusted to fit individuals’ specific needs, capacities, and circumstances. Methods A qualitative approach with semi-structured interviews was conducted with eight informants (three male and five female) aged between 26 and 47 years, whom all had participated in a 6-month exercise intervention with individual coaching based on self-determination theory and motivational interviewing. The interviews were analyzed thematically with an inductive approach. Results Aspects that influenced the informants’ motivation and participation in the exercise intervention were linked to three themes: the frames of the intervention, measurable changes, and the individual's context. The themes present information about the process and to what extent the informants felt that the intervention was adapted to fit their lives and needs. Conclusions This study emphasizes the importance of individualizing exercise interventions to support individuals’ diverse capacities and psychological needs. PMID:26282865

  12. Using GIS and perceived distance to understand the unequal geographies of healthcare in lower-income urban neighbourhoods.

    PubMed

    Hawthorne, Timothy L; Kwan, Mei-Po

    2012-01-01

    Geographers play important roles in public health research, particularly in understanding healthcare accessibility, utilisation, and individual healthcare experiences. Most accessibility studies have benefited from the increased sophistication of geographic information systems (GIS). Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilised individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed methods including GIS analysis and individual data from semi-structured in-depth interviews, we offer satisfaction-adjusted distance as a new way of conceptualising accessibility in GIS. Based on fieldwork in a predominantly lower-income community in Columbus, Ohio (USA), we find many residents felt neighbourhood healthcare facilities offered low-quality care, which suggested an added perceived distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure accounts for the perceived distance some residents feel as they search for high-quality healthcare in lower-income urban neighbourhoods. In moving beyond conventional GIS and re-conceptualising accessibility in this way, we offer a more realistic portrayal of the issues lower-income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualising healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare in urban neighbourhoods.

  13. The Inclusion House: Where Pastors Learn to Minister to Individuals with Disabilities

    ERIC Educational Resources Information Center

    Finn, Jane; Utting, Allison

    2017-01-01

    The Inclusion House is a unique dorm in Holland, Michigan, where nondisabled students, studying to be leaders in the faith community as future pastors, live side-by-side same-aged individuals with intellectual disabilities. After one year, a qualitative study using semi-structured interviews was conducted with the nondisabled roommates. Findings…

  14. Teachers' Perceptions of Individual Performance-Related Pay in Practice: A Picture of a Counterproductive Pay System

    ERIC Educational Resources Information Center

    Lundstrom, Ulf

    2012-01-01

    This article describes and discusses Swedish upper-secondary teachers' perceptions of the effects of individual performance-related pay (PRP) in the context of educational restructuring and governance. The empirical data were generated through semi-structured interviews of 23 teachers. Power's distinction between programmatic and technological…

  15. Unprotected sex of homeless youth: results from a multilevel dyadic analysis of individual, social network, and relationship factors.

    PubMed

    Kennedy, David P; Tucker, Joan S; Green, Harold D; Golinelli, Daniela; Ewing, Brett

    2012-10-01

    Homeless youth have elevated risk of HIV through sexual behavior. This project investigates the multiple levels of influence on unprotected sex among homeless youth, including social network, individual, and partner level influences. Findings are based on analyses of an exploratory, semi-structured interview (n = 40) and a structured personal network interview (n = 240) with randomly selected homeless youth in Los Angeles. Previous social network studies of risky sex by homeless youth have collected limited social network data from non-random samples and have not distinguished sex partner influences from other network influences. The present analyses have identified significant associations with unprotected sex at multiple levels, including individual, partner, and, to a lesser extent, the social network. Analyses also distinguished between youth who did or did not want to use condoms when they had unprotected sex. Implications for social network based HIV risk interventions with homeless youth are discussed.

  16. Unprotected Sex of Homeless Youth: Results from a Multilevel Analysis of Individual, Social Network, and Relationship Factors

    PubMed Central

    Kennedy, David P.; Tucker, Joan S.; Green, Harold D.; Golinelli, Daniela; Ewing, Brett

    2012-01-01

    Homeless youth have elevated risk of HIV through sexual behavior. This project investigates the multiple levels of influence on unprotected sex among homeless youth, including social network, individual, and partner level influences. Findings are based on analyses of an exploratory, semi-structured interview (n=40) and a structured personal network interview (n=240) with randomly selected homeless youth in Los Angeles. Previous social network studies of risky sex by homeless youth have collected limited social network data from non-random samples and have not distinguished sex partner influences from other network influences. The present analyses have identified significant associations with unprotected sex at multiple levels, including individual, partner, and, to a lesser extent, the social network. Analyses also distinguished between youth who wished they used condoms after having unprotected sex and youth who did not regret having unprotected sex. Implications for social network based HIV risk interventions with homeless youth are discussed. PMID:22610421

  17. African American Transgender Women's Individual, Family, and Organizational Relationships: Implications for Nurses.

    PubMed

    Cornelius, Judith B; Whitaker-Brown, Charlene D

    2017-06-01

    Guided by the relational cultural theory, we conducted a qualitative study to examine the relationship experiences of African American transgender women living in North Carolina. A convenience sample of 15 transgender women participated in the study. Semi-structured interviews, guided by an investigator-developed interview guide, were used to explore the personal experiences of transgender women on individual, family, and organizational levels. The findings provide a scheme for understanding the process through which transgender women's relationships hinder or enhance their ability to connect with individuals, family, and organizations. Nurses can use these findings to better understand the connectedness that occurs or does not occur in transgender women's relationships and provide culturally competent care to empower them to become resilient.

  18. Exploring Individual and Structural Factors Associated with Employment Among Young Transgender Women of Color Using a No-Cost Transgender Legal Resource Center.

    PubMed

    Hill, Brandon J; Rosentel, Kris; Bak, Trevor; Silverman, Michael; Crosby, Richard; Salazar, Laura; Kipke, Michele

    2017-01-01

    The purpose of this study was to explore individual and structural factors associated with employment among young transgender women (TW) of color. Sixty-five trans women of color were recruited from the Transgender Legal Defense and Education Fund to complete a 30-min interviewer-assisted survey assessing sociodemographics, housing, workplace discrimination, job-seeking self-efficacy, self-esteem, perceived public passability, and transactional sex work. Logistic regression models revealed that stable housing (structural factor) and job-seeking self-efficacy (individual factor) were significantly associated with currently being employed. Our findings underscore the need for multilevel approaches to assist TW of color gain employment.

  19. Transition to Adult-Oriented Health Care: Perspectives of Youth and Adults with Complex Physical Disabilities

    ERIC Educational Resources Information Center

    Young, Nancy L.; Barden, Wendy S.; Mills, Wendy A.; Burke, Tricia A.; Law, Mary; Boydell, Katherine

    2009-01-01

    Introduction: The transition to adulthood is extremely difficult for individuals with disabilities. We sought to explore the specific issue of transition to adult-oriented health care in a Canadian context. Methods: We conducted semi-structured individual interviews with 15 youth and 15 adults with cerebral palsy, spina bifida, and acquired brain…

  20. An Investigative Assessment of the Need for Individual Learning Support for a Y9 Pupil with Learning Difficulties and ADHD.

    ERIC Educational Resources Information Center

    Pester, James

    2002-01-01

    A year nine pupil with attention deficit hyperactivity disorder in a residential school was not accessing the curriculum due to distractibility and aggressive behavior. Analysis of data gathered through individual interviews, analysis of daily staff reports, and structured behavioral observation, indicate the student functions more successfully…

  1. The Perceived Effect of Time on HIV/AIDS Identity Incorporation

    ERIC Educational Resources Information Center

    Baumgartner, Lisa M.

    2012-01-01

    Individuals experience disease in a variety of contexts. In this study, I examined how the temporal context (e.g., historical time, social time, chronological age and the passage of time) affected the incorporation of the HIV/AIDS identity into the self. I used semi structured interviews to collect data from 36 individuals living with HIV/AIDS.…

  2. Theory X and Theory Y in the Organizational Structure.

    ERIC Educational Resources Information Center

    Barry, Thomas J.

    This document defines contrasting assumptions about the labor force--theory X and theory Y--and shows how they apply to the pyramid organizational structure, examines the assumptions of the two theories, and finally, based on a survey and individual interviews, proposes a merger of theories X and Y to produce theory Z. Organizational structures…

  3. Opening the Black Box: Cognitive Strategies in Family Practice

    PubMed Central

    Christensen, Robert E.; Fetters, Michael D.; Green, Lee A.

    2005-01-01

    PURPOSE We wanted to describe the cognitive strategies used by family physicians when structuring the decision-making tasks of an outpatient visit. METHODS This qualitative study used cognitive task analysis, a structured interview method in which a trained interviewer works individually with expert decision makers to capture their stages and elements of information processing. RESULTS Eighteen family physicians of varying levels of experience participated. Three dominant themes emerged: time pressure, a high degree of variation in task structuring, and varying degrees of task automatization. Based on these data and previous research from the cognitive sciences, we developed a model of novice and expert approaches to decision making in primary care. The model illustrates differences in responses to unexpected opportunity in practice, particularly the expert’s use of attentional surplus (reserve capacity to handle problems) vs the novice’s choice between taking more time or displacing another task. CONCLUSIONS Family physicians have specific, highly individualized cognitive task-structuring approaches and show the decision behavior features typical of expert decision makers in other fields. This finding places constraints on and suggests useful approaches for improving practice. PMID:15798041

  4. Stakeholders' contributions to tailored implementation programs: an observational study of group interview methods.

    PubMed

    Huntink, Elke; van Lieshout, Jan; Aakhus, Eivind; Baker, Richard; Flottorp, Signe; Godycki-Cwirko, Maciek; Jäger, Cornelia; Kowalczyk, Anna; Szecsenyi, Joachim; Wensing, Michel

    2014-12-06

    Tailored strategies to implement evidence-based practice can be generated in several ways. In this study, we explored the usefulness of group interviews for generating these strategies, focused on improving healthcare for patients with chronic diseases. Participants included at least four categories of stakeholders (researchers, quality officers, health professionals, and external stakeholders) in five countries. Interviews comprised brainstorming followed by a structured interview and focused on different chronic conditions in each country. We compared the numbers and types of strategies between stakeholder categories and between interview phases. We also determined which strategies were actually used in tailored intervention programs. In total, 127 individuals participated in 25 group interviews across five countries. Brainstorming generated 8 to 120 strategies per group; structured interviews added 0 to 55 strategies. Healthcare professionals and researchers provided the largest numbers of strategies. The type of strategies for improving healthcare practice did not differ systematically between stakeholder groups in four of the five countries. In three out of five countries, all components of the chosen intervention programs were mentioned by the group of researchers. Group interviews with different stakeholder categories produced many strategies for tailored implementation of evidence-based practice, of which the content was largely similar across stakeholder categories.

  5. Life satisfaction in adults with pediatric-onset spinal cord injuries.

    PubMed

    Anderson, Caroline J; Krajci, Katherine A; Vogel, Lawrence C

    2002-01-01

    To determine the level of life satisfaction of adults with pediatric-onset spinal cord injuries (SCI) and the factors associated with life satisfaction. A structured interview including standardized measures. Participants were individuals who sustained SCI at age 18 years or younger, were 24 years of age or olderat interview, did not have significant brain injury, and were living in the United States or Canada. A structured interview, the Functional Independence Measure (FIM), the Craig Handicap Assessment and Reporting Technique (CHART), the Short-Form 12 (SF-12), and the Satisfaction with Life Scale (SWLS). Two hundred sixteen individuals were interviewed. Mean age at injury was 1 4 years, mean age at interview was 29 years, and mean duration of injury was 14 years. The mean SWLS score was 23.6, and the median score was 25. There was not a significant difference between men and women, but those with tetraplegia were significantly less satisfied than were those with paraplegia. A regression model identified age at injury, community mobility (CHART), marital status, use of street drugs, perceived mental health (SF-12), and medical complications as predictors of life satisfaction. Other factors strongly associated with SWLS were employment, income, independent living, FIM total plus physical and sociocognitive domain scores, perceived physical health (SF-12), and CHART total plus the subscales of physical independence, cognitive independence, and occupation. Life satisfaction in adults with pediatric-onset SCI is associated with demographic, injury-related, and functional limitation factors, as well as with health status and community integration outcomes.

  6. Are Suicide Attempters Wired Differently?: A Comparison With Nonsuicidal Depressed Individuals Using Plan Analysis.

    PubMed

    Brüdern, Juliane; Berger, Thomas; Michel, Konrad; Maillart, Anja Gysin; Held, Isabelle Schmutz; Caspar, Franz

    2015-07-01

    Limited research exists on internal risk processes in suicide attempters and factors that distinguish them from nonsuicidal depressive individuals. In this qualitative study, we investigated Plans, motives, and underlying self-regulatory processes of the two groups and conducted a comparative analysis. We analyzed narrative interviews of 17 suicide attempters and intake interviews of 17 nonsuicidal depressive patients using Plan Analysis. Then, we developed a prototypical Plan structure for both groups. Suicidal behavior serves various Plans found only in suicide attempters. Plans of this group are especially related to social perfectionism and withdrawal to protect their self-esteem. Depressive patients use several interpersonal control and coping strategies, which might help prevent suicidal behavior. The prototypical Plan structure of suicide attempters may be a valuable tool for clinicians to detect critical Plans and motives in their interaction with patients, which are related to suicide risk.

  7. Facing the dilemma of patient-centred psoriasis care: a qualitative study identifying patient needs in dermatological outpatient clinics.

    PubMed

    Khoury, L R; Skov, L; Møller, T

    2017-08-01

    Caregivers must be aware of patients' current needs by providing care responsive to patients' values and preferences and by identifying what approach improves and encourages patients to participate in their treatment and disease management. Patients with psoriasis healthcare needs perhaps change as medical knowledge improves, new drugs emerge and the healthcare system improves its efficiency as a result of constant structural development. To explore the unmet needs and health perceptions of people with psoriasis, regarding interaction with clinicians and the structure inherent to consultations in a hospital outpatient dermatological clinic. A qualitative investigation with data generated from semi-structured interviews. Transcriptions were subsequently analysed using the template analysis method. Sixteen patients with psoriasis were interviewed. Challenges and dilemmas of patient-centred psoriasis care were identified. Patients have a strong need to be met as individuals as the burden of living with psoriasis goes beyond the skin. Patients strive for efficient treatment and ultimately dream of being cured of psoriasis. They prefer individualized health education in order to adjust their knowledge and self-management skills. These central issues are as yet rarely addressed in clinical consultations. Consultations with a standardized structure do not match the individual challenges and healthcare needs of patients with psoriasis. In order to achieve a more patient-centred approach, health professionals should implement minor structural changes to dermatological services to meet patients' current needs and invite dialogue about the patients' emotional well-being and concerns that go beyond biomedical factors, as well as offer individualized health education. © 2016 British Association of Dermatologists.

  8. Co-production and Pilot of a Structured Interview Using Talking Mats® to Survey the Television Viewing Habits and Preferences of Adults and Young People with Learning Disabilities

    ERIC Educational Resources Information Center

    Bunning, Karen; Alder, Ruth; Proudman, Lydia; Wyborn, Harriet

    2017-01-01

    Background: Capturing the views of people with learning disabilities is not straightforward. Talking Mats® has been used successfully to solicit the views of such individuals. The aim was to co-produce an interview schedule using Talking Mats® on the subject of television-viewing habits and preferences of adults and young people with learning…

  9. Observed Connection and Individuation: Relation to Symptoms in Families of Adolescents with Bulimia Nervosa

    PubMed Central

    Thomas, Sarah A.; Hoste, Renee Rienecke; Le Grange, Daniel

    2012-01-01

    Objective To examine the relation between observed familial connection and individuation and adolescent bulimia nervosa (BN) symptoms. Method As part of a treatment study for adolescent BN, adolescents (n = 54) and their parents participated in a videotaped semi-structured interview. Participants were rated on observed connection and individuation from these interviews using the Scale of Intergenerational Relationship Quality and two measures of connection. Results There was a significant negative relation between individuation from parents and adolescent BN symptoms. Connection both to and from mothers and adolescents was negatively associated with BN symptoms. Increased eating concern was significantly associated with a greater likelihood of expressing a desire for more connection with the family. Discussion Investigating and understanding family factors present at the time of adolescent BN may assist in providing treatment specific to the needs of the family to best aid the adolescent’s recovery process. PMID:22593023

  10. Observed connection and individuation: relation to symptoms in families of adolescents with bulimia nervosa.

    PubMed

    Thomas, Sarah A; Hoste, Renee Rienecke; Le Grange, Daniel

    2012-11-01

    To examine the relation between observed familial connection and individuation and adolescent bulimia nervosa (BN) symptoms. As part of a treatment study for adolescent BN, adolescents (n = 54) and their parents participated in a videotaped semi-structured interview. Participants were rated on observed connection and individuation from these interviews using the Scale of Intergenerational Relationship Quality and two measures of connection. There was a significant negative relation between individuation from parents and adolescent BN symptoms. Connection both to and from mothers and adolescents was negatively associated with BN symptoms. Increased eating concern was significantly associated with a greater likelihood of expressing a desire for more connection with the family. Investigating and understanding family factors present at the time of adolescent BN may assist in providing treatment specific to the needs of the family to best aid the adolescent's recovery process. Copyright © 2012 Wiley Periodicals, Inc.

  11. Exploring Individual and Structural Factors Associated with Employment Among Young Transgender Women of Color Using a No-Cost Transgender Legal Resource Center

    PubMed Central

    Hill, Brandon J.; Rosentel, Kris; Bak, Trevor; Silverman, Michael; Crosby, Richard; Salazar, Laura; Kipke, Michele

    2017-01-01

    Abstract Purpose: The purpose of this study was to explore individual and structural factors associated with employment among young transgender women (TW) of color. Methods: Sixty-five trans women of color were recruited from the Transgender Legal Defense and Education Fund to complete a 30-min interviewer-assisted survey assessing sociodemographics, housing, workplace discrimination, job-seeking self-efficacy, self-esteem, perceived public passability, and transactional sex work. Results: Logistic regression models revealed that stable housing (structural factor) and job-seeking self-efficacy (individual factor) were significantly associated with currently being employed. Conclusion: Our findings underscore the need for multilevel approaches to assist TW of color gain employment. PMID:28795154

  12. Qualitative interviewing with vulnerable populations: individuals' experiences of participating in suicide and self-harm based research.

    PubMed

    Biddle, Lucy; Cooper, Jayne; Owen-Smith, Amanda; Klineberg, Emily; Bennewith, Olive; Hawton, Keith; Kapur, Nav; Donovan, Jenny; Gunnell, David

    2013-03-05

    Concern exists that involving vulnerable individuals as participants in research into suicide and self-harm may cause distress and increase suicidal feelings. Actual understanding of participants' experiences is however limited, especially in relation to in-depth qualitative research. Data were collected from four separate studies focused on self-harm or suicide. These included people with varying levels of past distress, including some who had made nearly lethal suicide attempts. Each involved semi-structured qualitative interviewing. Participants (n=63) were asked to complete a visual analogue scale measuring current emotional state before and after their interview and then comment on how they had experienced the interview, reflecting on any score change. Most participants experienced a change in well-being. Between 50% and 70% across studies reported improvement, many describing the cathartic value of talking. A much smaller group in each study (18-27%) reported lowering of mood as they were reminded of difficult times or forced to focus on current issues. However, most anticipated that their distress would be transient and it was outweighed by a desire to contribute to research. An increase in distress did not therefore necessarily indicate a negative experience. There was no follow-up so the long-term effects of participation are unknown. Scores and post interview reflections were collected from participants by the researcher who had conducted the interview, which may have inhibited reporting of negative effects. These findings suggest individuals are more likely to derive benefit from participation than experience harm. Overprotective gate-keeping could prevent some individuals from gaining these benefits. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.

    PubMed

    Randell, Kimberly A; Evans, Sarah E; O'Malley, Donna; Dowd, M Denise

    2015-03-01

    The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system. The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach. The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues. The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system. Copyright © 2015 by the American Academy of Pediatrics.

  14. Coping strategies may not be reflected by simulated performance-based measures of functional ability

    PubMed Central

    Riazi, Abbas; Boon, Mei Ying; Dain, Stephen J.; Bridge, Catherine

    2012-01-01

    Purpose To determine whether the Melbourne Low Vision Index (MLVI) can be used to characterise the ability to carry out Activities of Daily Living (ADL) in a group of older people with age-related macular degeneration (AMD) which was reflective of actual day-to-day function according to in-depth interviews which encompassed questions about personal and environmental coping strategies. Method Thirty-one individuals (23 females, 8 males, aged 79.1 ± 5.6 years) with AMD (16 dry, 15 wet) and no other ocular diseases underwent tests of clinical visual function, the MLVI and a semi-structured interview intended to highlight functionality in the home environment. Results Participants’ clinical visual measures were correlated with MLVI score such that poorer visual function was associated with poorer functional ability for daily living activities (p < 0.05). Moreover, part (a) of the MLVI, which is assessed by observation of task performance, has a significant correlation with the severity of AMD (p < 0.05). Semi-structured interviews revealed a mismatch between MLVI part (a) and self-reported functionality in their own home environment. Conclusion Low functionality score (total) with MLVI is associated with severity of AMD and poor clinical visual function. The disparity between observed measures of functional vision (MLVI part (a)) and self-reported measures in the MLVI and in the semi-structured interviews may be explained in part by individual participant coping and adaptation strategies. The MLVI is therefore reflective of function in unfamiliar environments where people with low vision may not have recourse to compensatory strategies.

  15. “What's the right thing to do?” Correctional healthcare providers' knowledge, attitudes and experiences caring for transgender inmates

    PubMed Central

    Clark, Kirsty A.; White Hughto, Jaclyn M.; Pachankis, John E.

    2017-01-01

    Rational Incarcerated transgender individuals may need to access physical and mental health services to meet their general and gender-affirming (e.g., hormones, surgery) medical needs while incarcerated. Objective This study sought to examine correctional healthcare providers’ knowledge of, attitudes toward, and experiences providing care to transgender inmates. Method In 2016, 20 correctional healthcare providers (e.g., physicians, social workers, psychologists, mental health counselors) from New England participated in in-depth, semi-structured interviews examining their experiences caring for transgender inmates. The interview guide drew on healthcare-related interviews with recently incarcerated transgender women and key informant interviews with correctional healthcare providers and administrators. Data were analyzed using a modified grounded theory framework and thematic analysis. Results Findings revealed that transgender inmates do not consistently receive adequate or gender-affirming care while incarcerated. Factors at the structural level (i.e., lack of training, restrictive healthcare policies, limited budget, and an unsupportive prison culture); interpersonal level (i.e., custody staff bias); and individual level (i.e., lack of transgender cultural and clinical competence) impede correctional healthcare providers’ ability to provide gender-affirming care to transgender patients. These factors result in negative health consequences for incarcerated transgender patients. Conclusions Results call for transgender-specific healthcare policy changes and the implementation of transgender competency trainings for both correctional healthcare providers and custody staff (e.g., officers, lieutenants, wardens). PMID:29028559

  16. Continuing professional development and the charity paradigm: interrelated individual, collective and organisational issues about continuing professional development.

    PubMed

    Munro, Kathleen M

    2008-11-01

    This paper aims to highlight some issues and tensions that currently challenge the profession, individual nurses and their employers when considering the need for continuing professional development. The Nursing and Midwifery Council states the professional requirements for continuing professional development. However the nature and type required seems to be determined by the individual on the one hand and the organisation on the other, rather than an integral part of professional activity within the context of work. This can lead to a mismatch between personal and organisational goals. Views emerged from participants in a previous case study that focused on learning through work, about support available to nurses for professional development. The perceptions of nurses and their managers about learning through work were explored, using semi structured interviews, picture mapping and structured interviews. The 'Charity Paradigm' is presented as an outcome of major issues within an organisation. It underpins negative perceptions of individuals about employer support of continuing professional development. It is suggested that there is a need for collaborative collective approaches to structured development in order to meet both individual and organisational needs. This is also advocated in order to achieve life long learning and transformational learning within an organisation. The tension between individual personal ambitions and employer demands can adversely affect the professional development of the practitioner and the organisation that employs them. The personal perspectives of nurses and managers about learning within their organisation are therefore important to acknowledge in terms of positive and negative influences. It is also necessary to recognise the contribution of the employer as well as the identifiable charitable contribution of individual practitioners and the input from external contributors to the organisation.

  17. Understanding students' explanations of biological phenomena: Conceptual frameworks or p-prims?

    NASA Astrophysics Data System (ADS)

    Southerland, Sherry A.; Abrams, Eleanor; Cummins, Catherine L.; Anzelmo, Julie

    2001-07-01

    This study explores two differing perspectives of the nature of students' biological knowledge structures, conceptual frameworks, and p-prims. Students from four grade levels and from three regions of the United States were asked to explain a variety of biological phenomena. Students' responses to the interview probes were analyzed to describe 1) patterns in the nature of students' explanations across grade levels and interview probes, and 2) the consistency of students' explanations across individual interview probes and across the range of probes. The results were interpreted from both perspectives of knowledge structures. While definitive assertions supporting either perspective could not be made, each hypothesis was explored. Although the more prevalent description of student conceptions within a broader conceptual framework could not be discounted, the p-prim of need as a rationale for change was also found to offer a useful description of knowledge frameworks for this content area. The difficulties endemic to the use of biology for the study of basic knowledge structures are also discussed.

  18. In-Service Training as a Factor in the Formation of the Teacher's Individual Theory of Education

    ERIC Educational Resources Information Center

    Sakkoulis, Dimitris P.; Asimaki, Anna; Vergidis, Dimitris K.

    2018-01-01

    The purpose of this paper is the investigation of the prevailing forms of in-service training, the detection of the dominant pedagogical discourse they promote as well as their contribution to the shaping of the teacher's individual theory of education (I.T.E.). The research was conducted using semi-structured interviews with a sample of 11…

  19. Individual-Level Predictors of Nonparticipation and Dropout in a Life-Skills HIV Prevention Program for Adolescents in Foster Care

    ERIC Educational Resources Information Center

    Thompson, Ronald G., Jr.; Auslander, Wendy F.; Alonzo, Dana

    2012-01-01

    The purpose of this study is to identify individual-level characteristics of foster care adolescents who are more likely to not participate in, and drop out of, a life-skills HIV prevention program delivered over 8 months. Structured interviews were conducted with 320 foster care adolescents (15-18 years). Logistic regression and survival analyses…

  20. Healthcare professionals experience with motivational interviewing in their encounter with obese pregnant women.

    PubMed

    Lindhardt, Christina Louise; Rubak, Sune; Mogensen, Ole; Hansen, Helle Ploug; Goldstein, Henri; Lamont, Ronald F; Joergensen, Jan Stener

    2015-07-01

    to explore and describe how healthcare professionals in the Southern Region of Denmark experienced motivational interviewing as a communication method when working with pregnant women with obesity. a qualitative, descriptive study based on face-to-face interviews with 11 obstetric healthcare professionals working in a perinatal setting. a thematic descriptive method was applied to semi-structured interviews. The healthcare professional's experiences were recorded verbatim during individual semi-structured qualitative interviews, transcribed, and analysed using a descriptive analysis methodology. motivational interviewing was found to be a useful method when communicating with obese pregnant women. The method made the healthcare professionals more aware of their own communication style both when encountering pregnant women and in their interaction with colleagues. However, most of the healthcare professionals emphasised that time was crucial and they had to be dedicated to the motivational interviewing method. The healthcare professionals further stated that it enabled them to become more professional in their daily work and made some of them feel less 'burned out', 'powerless' and 'stressed' as they felt they had a communication method in handling difficult workloads. healthcare professionals experienced motivational interviewing to be a useful method when working perinatally. The motivational interviewing method permitted heightened awareness of the healthcare professionals communication method with the patients and increased their ability to handle a difficult workload. Overall, lack of time restricted the use of the motivational interviewing method on a daily basis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. An empirical typology of hospital nurses' individual learning paths.

    PubMed

    Poell, Rob F; Van der Krogt, Ferd J

    2014-03-01

    A relatively new theoretical concept is proposed in this paper, namely, the individual learning path. Learning paths are created by individual employees and comprise a set of learning-relevant activities that are both coherent as a whole and meaningful to them. To explore the empirical basis of this theoretical concept. A qualitative study involving semi-structured interviews. Two academic medical centers (university hospitals) and two general hospitals in the Netherlands. A total of 89 nurses were involved in the study. Semi-structured interviews were analyzed qualitatively; cluster analysis was then performed on quantified data from the interviews. Four types of learning path emerged, namely, the formal-external, self-directed, social-emotional, and information-oriented learning paths. The relatively new theoretical concept of an individual learning path can be observed in practice and a number of different learning-path types can be distinguished. Nurses were found to create their own learning paths, that is, select a theme that is relevant primarily to themselves, conduct a variety of learning activities around this theme, participate in social contexts that might help them, and mobilize learning facilities provided by their organization. These activities go way beyond the notion of employees as self-directed learners merely in a didactic sense (establishing learning goals, choosing the right learning activities for these goals, evaluating to what extent their goals have been met as a result). The findings can be interpreted as evidence of employees acting strategically when it comes to their professional development. Providers of continuing professional education/development need to take this into account. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Disempowerment and Psychological Distress in the Lives of Young People in Eastern Cape, South Africa

    ERIC Educational Resources Information Center

    Nduna, Mzikazi; Jewkes, Rachel

    2012-01-01

    A qualitative study was conducted in Butterworth, in the rural Eastern Cape Province of South Africa, to explore sources of distress for young people. Semi-structured, individual in-depth interviews were conducted with 16 men and 24 women aged 16-22 years. The findings revealed interconnections between structural factors such as death, poverty,…

  3. Gender Variance and Sexual Orientation Among Male Spirit Mediums in Myanmar.

    PubMed

    Coleman, Eli; Allen, Mariette Pathy; Ford, Jessie V

    2018-05-01

    This article describes the gender identity, gender expression, and sexual orientation of male spirit mediums in Myanmar. Our analysis is based on ethnographic work, field observation, and 10 semi-structured interviews. These observations were conducted from 2010 to 2015, mostly in Mandalay, with some fieldwork in Yangon and Bagan. The focus of this investigation was specifically on achout (gender variant individuals) who were spirit mediums (nat kadaw). Semi-structured interviews explored the ways that participants understood their gender identity, gender expression, and sexuality in relation to their work as spirit mediums and broader social life. Myanmar remains quite a homophobic and transphobic culture but is undergoing rapid economic and social change. Therefore, it provides an interesting context to study how safe spaces are produced for sexual/gender minorities amidst broader social change. We find that, through the animistic belief structure, there is a growing space for gender nonconforming people, gender variant, and same-sex-oriented individuals (achout) to neutralize their stigmatized status and attain a level of respect and economic advantage. Their ability to become nat kadaw (mediums of spirits) mitigates or trumps their stigmatized status.

  4. How GPs implement clinical guidelines in everyday clinical practice--a qualitative interview study.

    PubMed

    Le, Jette V; Hansen, Helle P; Riisgaard, Helle; Lykkegaard, Jesper; Nexøe, Jørgen; Bro, Flemming; Søndergaard, Jens

    2015-12-01

    Clinical guidelines are considered to be essential for improving quality and safety of health care. However, interventions to promote implementation of guidelines have demonstrated only partial effectiveness and the reasons for this apparent failure are not yet fully understood. To investigate how GPs implement clinical guidelines in everyday clinical practice and how implementation approaches differ between practices. Individual semi-structured open-ended interviews with seven GPs who were purposefully sampled with regard to gender, age and practice form. Interviews were recorded, transcribed verbatim and then analysed using systematic text condensation. Analysis of the interviews revealed three different approaches to the implementation of guidelines in clinical practice. In some practices the GPs prioritized time and resources on collective implementation activities and organized their everyday practice to support these activities. In other practices GPs discussed guidelines collectively but left the application up to the individual GP whilst others again saw no need for discussion or collective activities depending entirely on the individual GP's decision on whether and how to manage implementation. Approaches to implementation of clinical guidelines vary substantially between practices. Supporting activities should take this into account. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Identification of resources and skills developed by partners of patients with advanced colon cancer: a qualitative study.

    PubMed

    Meunier-Beillard, N; Ponthier, N; Lepage, C; Gagnaire, A; Gheringuelli, F; Bengrine, L; Boudrant, A; Rambach, L; Quipourt, V; Devilliers, H; Lejeune, Catherine

    2018-06-05

    Family caregivers play an important role in caring for patients with advanced cancer. To become competent, individuals must draw on and mobilise an adequate combination of resources. Our goal was to identify the skills developed by caregivers of patients with advanced cancer and the associated resources mobilised. We chose to do it with partners of patients with colon cancer. The study used a cross-sectional qualitative design based on 20 individual interviews and a focus group. Partners were recruited from patients treated in three hospitals of France. Semi-structured interviews were conducted until data saturation was achieved. Each interview was transcribed verbatim, and thematic analyses were performed to extract significant themes and subthemes. Results from the individual and focus group interviews showed that the skills implemented by the partners (in domains of social relationships and health, domestic, organisational, emotional and well-being dimensions) were singular constructs, dependant on if resources (personal, external and schemes) may have been missing and insufficient. In addition, partners may have had these resources but not mobilised them. The identification of the skills and associated resources could allow healthcare professionals better identifying and understanding of the difficulties met by partners in taking care of patients. This could enable them to offer appropriate support to help the caregivers in their accompaniment.

  6. Cancer caregivers' perceptions of an exercise and nutrition program.

    PubMed

    Anton, Philip M; Partridge, Julie A; Morrissy, Margaret J

    2013-03-01

    Little research has addressed exercise and nutrition-based interventions for cancer caregivers. This study explored cancer caregivers' perceptions of participating in a structured exercise and nutrition program alongside cancer survivors for whom they provided care. In-depth, semi-structured interviews were conducted by one interviewer with 12 cancer caregivers about their experiences participating in a structured, 12-week exercise and nutrition program designed for cancer survivors and caregivers to complete concurrently. Interviews were conducted until data saturation was reached. Inductive content analysis from individual interviews indicated three separate, but interrelated, themes: (1) the program was a positive mechanism through which caregivers shared and supported the cancer journey concurrently with survivors, (2) the program led to perceived physical and psychological benefits for both caregivers and survivors, and (3) participants perceived that participation in the program led to feeling increased social support in their caregiving duties. Findings from this study suggest that participating in an exercise- and nutrition-based intervention is viewed positively by caregivers and that the outcomes are seen as beneficial to both caregivers and survivors. Interventions that address the health needs of both members of the caregiver-survivor dyad should continue to be encouraged by allied health professionals.

  7. Learning Experiences of University Biology Faculty: A Qualitative Pilot Study

    ERIC Educational Resources Information Center

    Kusch, Jennifer

    2016-01-01

    The study described in this article incorporates qualitative research through in-depth, individual, structured interviews with 12 biology faculty from two Midwestern universities to explore perceptions about how they have learned to teach and how they work to improve their skills.

  8. 'A different world' individuals' experience of an integrated family intervention for psychosis and its contribution to recovery.

    PubMed

    Allen, Jo; Burbach, Frank; Reibstein, Janet

    2013-06-01

    The aim of this study is to explore the meaning and significance of family interventions (FI) for the individual who experiences psychosis, and its significance for recovery. A qualitative in-depth interview design was used to explore individuals' experience of FI and its meaning to them. Seven individuals recovering from psychosis attending integrated FI sessions were interviewed using a semi-structured interview schedule developed with service user input. Interviews were recorded, transcribed verbatim, and explored using Interpretative Phenomenological Analysis. Three central themes highlighted the participants' experience: (1) They welcomed the shared experience with their families and felt contained and valued by the therapists; (2) They felt the sessions contributed to changed patterns of relating within the family and the creation of new meaning through the validation of multiple perspectives; and (3) They described how the family sessions supported a new positioning in the world, a sense of their own empowerment and personal responsibility, greater self-acceptance, an increased ability to manage emotions, and hope for the future. Conditions in the family sessions provided an environment for changes in patterns of relating, personal meaning, and emotions to take place. Recovery, for these individuals, appeared to be about repositioning themselves in the world. The shared experience of sessions and the recognition of multiple perspectives within a containing environment may be related to recovery via the development of new perspectives and a more robust sense of self. This has clinical implications for the focus of FI sessions. © 2012 The British Psychological Society.

  9. The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center (SIST-M): development, reliability, and cross-sectional validation of a brief structured clinical dementia rating interview.

    PubMed

    Okereke, Olivia I; Copeland, Maura; Hyman, Bradley T; Wanggaard, Taylor; Albert, Marilyn S; Blacker, Deborah

    2011-03-01

    The Clinical Dementia Rating (CDR) and CDR Sum-of-Boxes can be used to grade mild but clinically important cognitive symptoms of Alzheimer disease. However, sensitive clinical interview formats are lengthy. To develop a brief instrument for obtaining CDR scores and to assess its reliability and cross-sectional validity. Using legacy data from expanded interviews conducted among 347 community-dwelling older adults in a longitudinal study, we identified 60 questions (from a possible 131) about cognitive functioning in daily life using clinical judgment, inter-item correlations, and principal components analysis. Items were selected in 1 cohort (n=147), and a computer algorithm for generating CDR scores was developed in this same cohort and re-run in a replication cohort (n=200) to evaluate how well the 60 items retained information from the original 131 items. Short interviews based on the 60 items were then administered to 50 consecutively recruited older individuals, with no symptoms or mild cognitive symptoms, at an Alzheimer's Disease Research Center. Clinical Dementia Rating scores based on short interviews were compared with those from independent long interviews. In the replication cohort, agreement between short and long CDR interviews ranged from κ=0.65 to 0.79, with κ=0.76 for Memory, κ=0.77 for global CDR, and intraclass correlation coefficient for CDR Sum-of-Boxes=0.89. In the cross-sectional validation, short interview scores were slightly lower than those from long interviews, but good agreement was observed for global CDR and Memory (κ≥0.70) as well as for CDR Sum-of-Boxes (intraclass correlation coefficient=0.73). The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center is a brief, reliable, and sensitive instrument for obtaining CDR scores in persons with symptoms along the spectrum of mild cognitive change.

  10. Developing critical consciousness or justifying the system? A qualitative analysis of attributions for poverty and wealth among low-income racial/ethnic minority and immigrant women

    PubMed Central

    Godfrey, Erin B.; Wolf, Sharon

    2015-01-01

    Objectives Economic inequality is a growing concern in the United States and globally. The current study uses qualitative techniques to (1) explore the attributions low-income racial/ethnic minority and immigrant women make for poverty and wealth in the U.S., and (2) clarify important links between attributions, critical consciousness development and system justification theory. Methods In-depth interview transcripts from 19 low-income immigrant Dominican and Mexican and native African-American mothers in a large Northeastern city were analyzed using open coding techniques. Interview topics included perceptions of current economic inequality and mobility and experiences of daily economic hardships. Results Almost all respondents attributed economic inequality to individual factors (character flaws, lack of hard work). Structural explanations for poverty and wealth were expressed by less than half the sample and almost always paired with individual explanations. Moreover, individual attributions included system-justifying beliefs such as the belief in meritocracy and equality of opportunity and structural attributions represented varying levels of critical consciousness. Conclusions Our analysis sheds new light on how and why individuals simultaneously hold individual and structural attributions and highlights key links between system justification and critical consciousness. It shows that critical consciousness and system justification do not represent opposite stances along a single underlying continuum, but are distinct belief systems and motivations. It also suggests that the motive to justify the system is a key psychological process impeding the development of critical consciousness. Implications for scholarship and intervention are discussed. PMID:25915116

  11. Developing critical consciousness or justifying the system? A qualitative analysis of attributions for poverty and wealth among low-income racial/ethnic minority and immigrant women.

    PubMed

    Godfrey, Erin B; Wolf, Sharon

    2016-01-01

    Economic inequality is a growing concern in the United States and globally. The current study uses qualitative techniques to (a) explore the attributions low-income racial/ethnic minority and immigrant women make for poverty and wealth in the U.S., and (b) clarify important links between attributions, critical consciousness development, and system justification theory. In-depth interview transcripts from 19 low-income immigrant Dominican and Mexican and native African American mothers in a large Northeastern city were analyzed using open coding techniques. Interview topics included perceptions of current economic inequality and mobility and experiences of daily economic hardships. Almost all respondents attributed economic inequality to individual factors (character flaws, lack of hard work). Structural explanations for poverty and wealth were expressed by fewer than half the sample and almost always paired with individual explanations. Moreover, individual attributions included system-justifying beliefs such as the belief in meritocracy and equality of opportunity and structural attributions represented varying levels of critical consciousness. Our analysis sheds new light on how and why individuals simultaneously hold individual and structural attributions and highlights key links between system justification and critical consciousness. It shows that critical consciousness and system justification do not represent opposite stances along a single underlying continuum, but are distinct belief systems and motivations. It also suggests that the motive to justify the system is a key psychological process impeding the development of critical consciousness. Implications for scholarship and intervention are discussed. (c) 2016 APA, all rights reserved).

  12. Structured interview versus self-report test vantages for the assessment of personality pathology in cocaine dependence.

    PubMed

    Marlowe, D B; Husband, S D; Bonieskie, L M; Kirby, K C; Platt, J J

    1997-01-01

    The study compared structured interview (SCID-II) and self-report test (MCMI-II) vantages for the detection and characterization of personality pathology among 144 urban, poor, cocaine-addicted individuals seeking outpatient treatment. Diagnostic agreement was inadequate for most disorders, and the instruments at best shared only modest common variance. Positive predictive power was poor for all MCMI-II scales, though negative predictive power was good to excellent. This lends support for the use of the MCMI-II as a screening measure to rule out Axis II disorders; however, confirmation of positive diagnoses will require follow-up interview assessment. Future development of self-report personality inventories for substance abusers should focus on controlling for the acute dysphoric effects of drug use and related dysfunction, expanding attention to Cluster B content domains, and incorporating more objective criteria for assessing paranoia and "odd/eccentric" traits.

  13. Insights into Chronic Functional Movement Disorders: The Value of Qualitative Psychiatric Interviews.

    PubMed

    Epstein, Steven A; Maurer, Carine W; LaFaver, Kathrin; Ameli, Rezvan; Sinclair, Stephen; Hallett, Mark

    Patients with functional movement disorders (FMDs) are commonly seen by neurologists and psychosomatic medicine psychiatrists. Research literature provides scant information about the subjective experiences of individuals with this often chronic problem. To enhance our understanding of psychologic aspects of FMDs by conducting qualitative interviews of research subjects. In total, 36 patients with FMDs were recruited from the Human Motor Control clinic at the National Institutes of Health. Each subject participated in a qualitative psychiatric interview and a structured diagnostic psychiatric interview. Of our 36 subjects, 28 had current or lifetime psychiatric disorders in addition to conversion disorder and 22 had current disorders. Qualitative interviews provided rich information on patients' understanding of their illnesses and impaired cognitive processing of emotions. Our study supports the addition of open-ended qualitative interviews to delineate emotional dynamics and conceptual frameworks among such patients. Exploratory interviews generate enhanced understanding of such complex patients, above and beyond that gained by assessing DSM diagnostic comorbidities. Copyright © 2016 The Academy of Psychosomatic Medicine. All rights reserved.

  14. Recruiting for values in healthcare: a preliminary review of the evidence.

    PubMed

    Patterson, Fiona; Prescott-Clements, Linda; Zibarras, Lara; Edwards, Helena; Kerrin, Maire; Cousans, Fran

    2016-10-01

    Displaying compassion, benevolence and respect, and preserving the dignity of patients are important for any healthcare professional to ensure the provision of high quality care and patient outcomes. This paper presents a structured search and thematic review of the research evidence relating to values-based recruitment within healthcare. Several different databases, journals and government reports were searched to retrieve studies relating to values-based recruitment published between 1998 and 2013, both in healthcare settings and other occupational contexts. There is limited published research related to values-based recruitment directly, so the available theoretical context of values is explored alongside an analysis of the impact of value congruence. The implications for the design of selection methods to measure values is explored beyond the scope of the initial literature search. Research suggests some selection methods may be appropriate for values-based recruitment, such as situational judgment tests (SJTs), structured interviews and multiple-mini interviews (MMIs). Personality tests were also identified as having the potential to compliment other methods (e.g. structured interviews), as part of a values-based recruitment agenda. Methods including personal statements, references and unstructured/'traditional' interviews were identified as inappropriate for values-based recruitment. Practical implications are discussed in the context of values-based recruitment in the healthcare context. Theoretical implications of our findings imply that prosocial implicit trait policies, which could be measured by selection tools such as SJTs and MMIs, may be linked to individuals' values via the behaviours individuals consider to be effective in given situations. Further research is required to state this conclusively however, and methods for values-based recruitment represent an exciting and relatively unchartered territory for further research.

  15. HIV testing among MSM in Bogotá, Colombia: The role of structural and individual characteristics

    PubMed Central

    Reisen, Carol A.; Zea, Maria Cecilia; Bianchi, Fernanda T.; Poppen, Paul J.; del Río González, Ana Maria; Romero, Rodrigo A. Aguayo; Pérez, Carolin

    2014-01-01

    This study used mixed methods to examine characteristics related to HIV testing among men who have sex with men (MSM) in Bogotá, Colombia. A sample of 890 MSM responded to a computerized quantitative survey. Follow-up qualitative data included 20 in-depth interviews with MSM and 12 key informant interviews. Hierarchical logistic set regression indicated that sequential sets of variables reflecting demographic characteristics, insurance coverage, risk appraisal, and social context each added to the explanation of HIV testing. Follow-up logistic regression showed that individuals who were older, had higher income, paid for their own insurance, had had a sexually transmitted infection, knew more people living with HIV, and had greater social support were more likely to have been tested for HIV at least once. Qualitative findings provided details of personal and structural barriers to testing, as well as interrelationships among these factors. Recommendations to increase HIV testing among Colombian MSM are offered. PMID:25068180

  16. An Institutional Ethnography of Nurses' Support of Breastfeeding on the Night Shift.

    PubMed

    Grassley, Jane S; Clark, Manda; Schleis, Joyce

    2015-01-01

    To describe nurses' support of breastfeeding on the night shift and to identify the interpersonal interactions and institutional structures that affect this support. Institutional ethnography. The mother/baby unit of a tertiary care hospital with 4200 births per year. Registered nurses (N = 16) who provided care on the night shift to mother/infant dyads in the immediate postpartum period. Data were collected using focus groups, individual and group interviews, and mother/baby unit observations. The focus groups were held before the night shift and had five participants. The nine individual and group interviews were conducted between 0100 and 0230 on the mother/baby unit. Three unit observations were conducted. Interviews were recorded, professionally transcribed, and analyzed using a content analysis method. Data analysis yielded three themes that described these nurses' support of breastfeeding on the night shift: competing priorities, incongruent expectations, and influential institutional structures. The need of visitors to see their new family members competed with the needs of mothers to rest and breastfeed their newborns. Helping breastfeeding dyads who experienced difficulties competed with providing care to other patients. Parents' expectations regarding newborn behavior were incongruent with the reality of newborn feeding and sleeping patterns. Institutional structures that affected the provision of breastfeeding support by nurses included hospital breastfeeding practices, staffing, and policies. Nurses' support of breastfeeding on the night shift encompasses a complex interplay of interpersonal interactions with new families and visitors regarding priorities and expectations and negotiating institutional structures such as feeding policies and staffing. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  17. [Knowledge of family members on the rights of individuals affected by mental illness].

    PubMed

    Moreno, Vania; Barbosa, Guilherme Correa

    2015-03-01

    The objective of this investigation was to understand what family members know about the rights of individuals affected by mental illness. To this end, a qualitative exploratory study was conducted. A semi-structured interview was used for data collection. Eighteen family members were interviewed at a psychosocial care center (CAPS) and a civil society organization (CSO) located in a municipality in the state of São Paulo, Brazil, between March and September 2013. Data were analyzed using thematic content analysis and the following categories were constructed: mental health services and the rights of individuals affected by mental illness. We were able to infer that in addition to drug-based therapy, mental health services must provide therapeutic activities. Family members of those affected by mental illness were unaware of the Brazilian Psychiatric Reform Law and mentioned the following rights: welfare benefits, free public transport, basic food basket and medications.

  18. Narratives of mothers of children with autism spectrum disorders: focus on eating behavior.

    PubMed

    Lázaro, Cristiane P; Pondé, Milena P

    2017-01-01

    To investigate the eating behavior of individuals with autism through their mothers' narratives. The study of narratives was used to report on the narrators' experiences. Data on the eating habits of individuals with autism were collected using semi-structured interviews held individually with the mothers. The interviews were recorded, transcribed and codified using the NVivo software program. Eighteen mothers of boys/young men with autism participated in the study. Analysis yielded three major categories: eating patterns, the family's attitudes to the child's eating habits, and food-related behavior. Results show that autism-related factors may affect the child's food choices. Environmental factors, particularly the parents' behavior, may also play a decisive role, both in reinforcing the child's food choices and in encouraging a healthier and more diversified diet. Professionals should instruct parents regarding their decisive role in reinforcing or discouraging inappropriate mealtime behavior in children with autism.

  19. Learning in the tutorial group: a balance between individual freedom and institutional control.

    PubMed

    McAllister, Anita; Aanstoot, Janna; Hammarström, Inger Lundeborg; Samuelsson, Christina; Johannesson, Eva; Sandström, Karin; Berglind, Ulrika

    2014-01-01

    The study investigates factors in problem-based learning tutorial groups which promote or inhibit learning. The informants were tutors and students from speech-language pathology and physiotherapy programmes. Semi-structured focus-group interviews and individual interviews were used. Results revealed three themes: Responsibility. Time and Support. Under responsibility, the delicate balance between individual and institutional responsibility and control was shown. Time included short and long-term perspectives on learning. Under support, supporting documents, activities and personnel resources were mentioned. In summary, an increased control by the program and tutors decreases student's motivation to assume responsibility for learning. Support in tutorial groups needs to adapt to student progression and to be well aligned to tutorial work to have the intended effect. A lifelong learning perspective may help students develop a meta-awareness regarding learning that could make tutorial work more meaningful.

  20. Individual-level outcomes from a national clinical leadership development programme.

    PubMed

    Patton, Declan; Fealy, Gerard; McNamara, Martin; Casey, Mary; Connor, Tom O; Doyle, Louise; Quinlan, Christina

    2013-08-01

    A national clinical leadership development programme was instituted for Irish nurses and midwives in 2010. Incorporating a development framework and leadership pathway and a range of bespoke interventions for leadership development, including workshops, action-learning sets, mentoring and coaching, the programme was introduced at seven pilot sites in the second half of 2011. The programme pilot was evaluated with reference to structure, process and outcomes elements, including individual-level programme outcomes. Evaluation data were generated through focus groups and group interviews, individual interviews and written submissions. The data provided evidence of nurses' and midwives' clinical leadership development through self and observer-reported behaviours and dispositions including accounts of how the programme participants developed and displayed particular clinical leadership competencies. A key strength of the new programme was that it involved interventions that focussed on specific leadership competencies to be developed within the practice context.

  1. Improving a Case-Control Study of Multiple Sclerosis Using Formative Research

    PubMed Central

    Williamson, Dhelia M.; Wagner, Laurie; Henry, Judy P.

    2015-01-01

    Formative research (i.e. focus groups and key informant interviews) was conducted to understand risk perceptions and identify barriers to participation in a case-control study of environmental exposures and genetic susceptibility as risk factors for multiple sclerosis (MS). Individuals with MS were recruited to participate in a focus group discussion and individual interviews. Participants were asked to review and comment on study materials and process including participation, interview, genetic testing, confidentiality, and questionnaire. A structured discussion guide was used with all participants to ensure uniformity and coverage of all predetermined topics. Participants reported an increased likelihood of participation if they were informed about the study by their neurologist and not a government agency. All participants expressed willingness to provide a blood sample for genotyping but disagreed about the setting for the blood draw (at home or in a lab). Participants were concerned that they would not receive their individual genotyping results. The study protocol and materials were revised based on comments from the focus group participants. Formative research is an under-utilized resource for researchers conducting epidemiologic studies. Even with limited resources, piloting study materials with individuals similar to the proposed study population can provide opportunities to make modifications to effectively meet the needs of participants and promote participation and retention. PMID:25741529

  2. User experience of lower-limb orthosis.

    PubMed

    Yang, Bing-Shiang; Chen, Yen-Wan; Tong, Ji-Rou

    2017-06-09

    If an assistive device is not acceptable to the user, it will not achieve efficacy and would be resource-wasting. This study employed in-depth interviews to understand what users' individual activities of daily living, problems of using orthoses, and considerations for selecting orthoses are. We conducted qualitative interviews with 35 lower-limb orthosis users, and semi-structured interviews were applied in this study. We analyzed the interview data from transcripts, through coding and concepts, to theories based on grounded theory. The results showed that problems of using orthoses are mostly related to activities of daily living of the user and user's expectation. Therefore, in order to enhance its efficacy and use intention, the design and prescribing process of orthoses need to address the problems in the light of activities of daily living and user education.

  3. Perspectives of Community Co-Researchers About Group Dynamics and Equitable Partnership Within a Community-Academic Research Team.

    PubMed

    Vaughn, Lisa M; Jacquez, Farrah; Zhen-Duan, Jenny

    2018-04-01

    Equitable partnership processes and group dynamics, including individual, relational, and structural factors, have been identified as key ingredients to successful community-based participatory research partnerships. The purpose of this qualitative study was to investigate the key aspects of group dynamics and partnership from the perspectives of community members serving as co-researchers. Semistructured, in-depth interviews were conducted with 15 Latino immigrant co-researchers from an intervention project with Latinos Unidos por la Salud (LU-Salud), a community research team composed of Latino immigrant community members and academic investigators working in a health research partnership. A deductive framework approach guided the interview process and qualitative data analysis. The LU-Salud co-researchers described relationships, personal growth, beliefs/identity motivation (individual dynamics), coexistence (relational dynamics), diversity, and power/resource sharing (structural dynamics) as key foundational aspects of the community-academic partnership. Building on existing CBPR and team science frameworks, these findings demonstrate that group dynamics and partnership processes are fundamental drivers of individual-level motivation and meaning making, which ultimately sustain efforts of community partners to engage with the research team and also contribute to the achievement of intended research outcomes.

  4. Heroin users' views and experiences of physical activity, sport and exercise.

    PubMed

    Neale, Joanne; Nettleton, Sarah; Pickering, Lucy

    2012-03-01

    Although there is limited research on heroin users' participation in physical activity, sport and exercise, public health literature asserts that being physically active is good for individuals. Critics, however, caution that the benefits of sport and exercise are overstated and sport may itself reinforce or create inequalities. In-depth interviews were conducted with 40 current or ex-heroin users, of whom 37 were re-interviewed three months later. Data from all 77 interviews were analysed to explore individuals' self-reported participation in physical activity, sport and exercise; their desire to participate; and any barriers to participation experienced. Participants were very interested in sport and exercise and engaged in a wide variety of active pastimes. Although they did little structured sport or exercise during periods of heavy heroin use, they still often walked or cycled. Enjoyment was a key feature of being physically active in treatment and in early recovery. Additionally, individuals reported diverse health and social gains and felt that sport and exercise helped them to reduce their heroin use. These benefits notwithstanding, there were personal, social and structural barriers to being active and so individuals were generally keen to take advantage of any sport or exercise opportunities offered to them by services. By focusing on the meanings that heroin users themselves attribute to being active, our analyses reveal that members of this population derive great pleasure from all manner of physical pastimes. A small but growing literature on embodied sporting practices helps us to interpret this. We conclude that there is an important role for physical activity, sport and exercise within policy and practice responses to heroin use, but with a need to be creative and flexible regarding the kinds of activities promoted. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Calling in sick: impacts of fever on intra-urban human mobility.

    PubMed

    Perkins, T Alex; Paz-Soldan, Valerie A; Stoddard, Steven T; Morrison, Amy C; Forshey, Brett M; Long, Kanya C; Halsey, Eric S; Kochel, Tadeusz J; Elder, John P; Kitron, Uriel; Scott, Thomas W; Vazquez-Prokopec, Gonzalo M

    2016-07-13

    Pathogens inflict a wide variety of disease manifestations on their hosts, yet the impacts of disease on the behaviour of infected hosts are rarely studied empirically and are seldom accounted for in mathematical models of transmission dynamics. We explored the potential impacts of one of the most common disease manifestations, fever, on a key determinant of pathogen transmission, host mobility, in residents of the Amazonian city of Iquitos, Peru. We did so by comparing two groups of febrile individuals (dengue-positive and dengue-negative) with an afebrile control group. A retrospective, semi-structured interview allowed us to quantify multiple aspects of mobility during the two-week period preceding each interview. We fitted nested models of each aspect of mobility to data from interviews and compared models using likelihood ratio tests to determine whether there were statistically distinguishable differences in mobility attributable to fever or its aetiology. Compared with afebrile individuals, febrile study participants spent more time at home, visited fewer locations, and, in some cases, visited locations closer to home and spent less time at certain types of locations. These multifaceted impacts are consistent with the possibility that disease-mediated changes in host mobility generate dynamic and complex changes in host contact network structure. © 2016 The Author(s).

  6. ‘Not Until I'm Absolutely Half-Dead and Have To:’ Accounting for Non-Use of Antiretroviral Therapy in Semi-Structured Interviews with People Living with HIV in Australia

    PubMed Central

    Mao, Limin; Persson, Asha; Holt, Martin; Slavin, Sean; Kidd, Michael R.; Post, Jeffrey J.; Wright, Edwina; de Wit, John

    2015-01-01

    Abstract Current debates regarding the use of antiretroviral therapy (ART) to promote both individual- and population-level health benefits underscore the importance of understanding why a subpopulation of people with diagnosed HIV and access to treatment choose not to use it. Semi-structured interviews were conducted between 2012 and 2014 with 27 people living with HIV in Australia who were not using ART at the time of interview. Analytic triangulation permitted an appreciation of not only the varied personal reasons for non-use of treatment, but also underlying views on HIV treatment, and the ideal conditions imagined necessary for treatment initiation. Policy goals to increase the number of people with HIV using ART must recognize the diverse explanations for non-use of ART, which include concerns about the various impacts of committing to lifelong pharmaceutical treatment use. Our research identified distinctive subgroups among people who are not using antiretroviral therapy, with a range of individual and social needs that may affect treatment decisions. These findings challenge assumptions about treatment non-use in resource-rich settings, revealing persistent consumer fears about the potent and unknown effects of HIV medications that deserve greater recognition in policy debate on treatment uptake. PMID:25806574

  7. Barriers and facilitators to mobile phone use for people with aphasia.

    PubMed

    Greig, Carole-Ann; Harper, Renée; Hirst, Tanya; Howe, Tami; Davidson, Bronwyn

    2008-01-01

    Mobile phone use increases social participation. People with the communication disorder of aphasia are disadvantaged in the use of information and communication technology such as mobile phones and are reported to be more socially isolated than their peers. The World Health Organization's International Classification of Functioning, Disability and Health provides a framework to address the impact of environmental factors on individual participation. The aim of this preliminary study was to identify the barriers and facilitators to mobile phone use for people with aphasia. A qualitative descriptive study involving two phases was conducted: (1) semi-structured interviews with 6 individuals with aphasia who owned or expressed a desire to own a mobile phone; (2) structured observations of key scenarios identified in the interviews of 3 participants who were sampled from the interview study. Results identified 18 barriers and 9 facilitators to mobile phone use. Key barriers and facilitators were identified in the areas of design and features, written support and training, and communicative partners. Mobile phone use can be problematic for people with aphasia. Intervention needs to address the barriers and utilise the facilitators to mobile phone use for this population. Further research is required to inform policy and intervention programs to ensure that people with aphasia have access to this technology.

  8. Calling in sick: impacts of fever on intra-urban human mobility

    PubMed Central

    Perkins, T. Alex; Paz-Soldan, Valerie A.; Stoddard, Steven T.; Morrison, Amy C.; Forshey, Brett M.; Long, Kanya C.; Halsey, Eric S.; Kochel, Tadeusz J.; Elder, John P.; Kitron, Uriel; Scott, Thomas W.; Vazquez-Prokopec, Gonzalo M.

    2016-01-01

    Pathogens inflict a wide variety of disease manifestations on their hosts, yet the impacts of disease on the behaviour of infected hosts are rarely studied empirically and are seldom accounted for in mathematical models of transmission dynamics. We explored the potential impacts of one of the most common disease manifestations, fever, on a key determinant of pathogen transmission, host mobility, in residents of the Amazonian city of Iquitos, Peru. We did so by comparing two groups of febrile individuals (dengue-positive and dengue-negative) with an afebrile control group. A retrospective, semi-structured interview allowed us to quantify multiple aspects of mobility during the two-week period preceding each interview. We fitted nested models of each aspect of mobility to data from interviews and compared models using likelihood ratio tests to determine whether there were statistically distinguishable differences in mobility attributable to fever or its aetiology. Compared with afebrile individuals, febrile study participants spent more time at home, visited fewer locations, and, in some cases, visited locations closer to home and spent less time at certain types of locations. These multifaceted impacts are consistent with the possibility that disease-mediated changes in host mobility generate dynamic and complex changes in host contact network structure. PMID:27412286

  9. Genres, Contexts, and Literacy Practices: Literacy Brokering among Sudanese Refugee Families

    ERIC Educational Resources Information Center

    Perry, Kristen H.

    2009-01-01

    This ethnographic study examined literacy brokering among Sudanese refugee families in Michigan. Literacy brokering occurs as individuals seek informal help with unfamiliar texts and literacy practices. Data collection involved participant observation, semi-structured interviews, and collection of artifacts over 18 months. Researcher analysis of…

  10. Mathematical Identity for a Sustainable Future: An Interpretative Phenomenological Analysis

    ERIC Educational Resources Information Center

    Pipere, Anita; Micule, Ilona

    2014-01-01

    Individual in-depth, semi-structured interviews with three mathematics teachers were conducted to investigate the dynamics of their life-long relationships with mathematics, synthesised as mathematical identity from different identity positions in the context of dialogical self. The qualitative data were scrutinised employing interpretive…

  11. Adolescent and Parent Assessments of Diabetes Mellitus Management at School

    ERIC Educational Resources Information Center

    Hayes-Bohn, Rachel; Neumark-Sztainer, Dianne; Mellin, Alison; Patterson, Joan

    2004-01-01

    This study explored opinions, concerns, and recommendations regarding care of Type 1 diabetes in schools. Thirty adolescent females and their parents participated in semi- structured, individual interviews that were audiotaped, transcribed, coded, and qualitatively analyzed. Responses emerged in three categories: (1) knowledge/training of school…

  12. Counseling Psychology Doctoral Students' Training Experiences in Primary Care Psychology

    ERIC Educational Resources Information Center

    Cox, Jared

    2011-01-01

    This qualitative study focused on counseling psychology doctoral students' perspectives regarding their practicum training experience in primary care psychology. The four participants included three females and one male. Semi-structured individual and focus group interviews were used to explore participants' experiences. The participants described…

  13. Brokenhearts: Dissolution of Romantic Relationships.

    ERIC Educational Resources Information Center

    Meeker, F. B.; La Fong, Carl

    Results of an investigation examining the dissolution of romantic relationships are analyzed. Men and women (N=105) who had ended romantic relationships were surveyed in structured individual interviews. Commonalities and differences in respondents' perceptions of the experience were examined. Specific tests were made of a corollary to Waller's…

  14. Rehabilitation for patients with rheumatic diseases: Patient experiences of a structured goal planning and tailored follow-up programme

    PubMed Central

    Dager, Turid Nygaard; Kjeken, Ingvild; Berdal, Gunnhild; Sand-Svartrud, Anne-Lene; Bø, Ingvild; Dingsør, Anne; Eppeland, Siv Grødal; Hagfors, Jon; Hamnes, Bente; Nielsen, Merete; Slungaard, Bente; Wigers, Sigrid Hørven; Hauge, Mona-Iren

    2017-01-01

    Objective: To explore the significance of the content of rehabilitation in terms of achieving a personal outcome, and to understand the significance of tailored follow-up interventions for individual efforts to prolong health behaviour change after rehabilitation. Design: Semi-structured interviews with patients who had received an extended rehabilitation programme. All interviews were transcribed verbatim. A thematic analysis was applied. Subjects: A purposeful sample of 18 patients with rheumatic diseases who had attended specialized multidisciplinary rehabilitation with an extended programme consisting of a self-help booklet, structured goal-setting talks and tailored follow-up calls based on motivational interviewing. Results: Four overarching and interrelated themes were identified. Experienced Person-centred interventions represented a basis for the patients’ motivation and personal outcomes. Confident self-management describes a new confident approach to exercise and illness management after rehabilitation with person-centred interventions. For many, this included reaching a different mindset, a change of illness perception. Continuity of the personal outcomes describes the importance of follow-up telephone calls to maintain the focus on goals and continued efforts. Building on established relationships and practising person-centred communication were essential. Conclusion: Tailoring of communication and rehabilitation interventions may be a premise for enhancing health behaviour, including a beneficial illness perception. Structured goal setting and follow-up telephone calls using motivational interviewing enhance motivation and may contribute to prolonged goal attainment. PMID:29163943

  15. Social care and support needs of community-dwelling people with dementia and concurrent visual impairment.

    PubMed

    Nyman, Samuel Robert; Innes, Anthea; Heward, Michelle

    2017-09-01

    This study explored the social care and support needs of people with dementia and visual impairment, and the barriers and facilitators for meeting these needs. Twenty-six semi-structured interviews were conducted: 21 joint and 5 individual interviews with the person with dementia and visual impairment (n=4) or their family/paid carer (n=1). Interviews were analysed thematically. Three themes are presented. (1) Social care needs: having dementia can reduce an individual's ability to cope with their visual impairment, and lead to increased dependency and reduced daily stimulation. (2) Barriers to using technology to meet social care needs: difficulties were reported with learning to use unfamiliar technology and the cost of visual impairment aids, and for some, the presence of dementia made visual impairment aids unusable and vice versa. (3) Familiarity as a facilitator for meeting social care needs: living at home or taking furnishings and ornaments into a new home facilitated independence, and continuity of paid carers/volunteers facilitated the caring relationship between the individual and staff/volunteer. Care workers will better serve older people if they are aware of the social care and support needs that arise from having both dementia and visual impairment.

  16. Exploring Perception of Vibrations from Rail: An Interview Study.

    PubMed

    Maclachlan, Laura; Waye, Kerstin Persson; Pedersen, Eja

    2017-10-26

    Rail transport is an environmentally responsible approach and traffic is expected to increase in the coming decades. Little is known about the implications for quality of life of populations living close to railways. This study explores the way in which vibrations from rail are perceived and described by these populations. The study took place in the Västra Götaland and Värmland regions of Sweden. A qualitative study approach was undertaken using semi-structured interviews within a framework of predetermined questions in participants' homes. A 26.3% response rate was achieved and 17 participants were interviewed. The experience of vibrations was described in tangible terms through different senses. Important emerging themes included habituation to and acceptance of vibrations, worry about property damage, worry about family members and general safety. Participants did not reflect on health effects, however, chronic exposure to vibrations through multimodal senses in individual living environments may reduce the possibility for restoration in the home. Lack of empowerment to reduce exposure to vibrations was important. This may alter individual coping strategies, as taking actions to avoid the stressor is not possible. The adoption of other strategies, such as avoidance, may negatively affect an individual's ability to cope with the stressor and their health.

  17. Interprofessional primary care team meetings: a qualitative approach comparing observations with personal opinions.

    PubMed

    van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia; Daniëls, Ramon; Lenzen, Stephanie Anna; van der Weijden, Trudy; Beurskens, Anna

    2017-02-01

    The number of people with multiple chronic conditions requiring primary care services increases. Professionals from different disciplines collaborate and coordinate care to deal with the complex health care needs. There is lack of information on current practices regarding interprofessional team (IPT) meetings. This study aimed to improve our understanding of the process of interprofessional collaboration in primary care team meetings in the Netherlands by observing the current practice and exploring personal opinions. Qualitative study involving observations of team meetings and interviews with participants. Eight different IPT meetings (n = 8) in different primary care practices were observed by means of video recordings. Experiences were explored by conducting individual semi-structured interviews (n = 60) with participants (i.e. health care professionals from different disciplines) of the observed team meetings. The data were analysed by means of content analysis. Most participants expressed favourable opinions about their team meetings. However, observations showed that team meetings were more or less hectic, and lacked a clear structure and team coordinator or leader. There appears to be a discrepancy between findings from observations and interviews. From the interviews, four main themes were extracted: (1) Team structure and composition, (2) Patient-centredness, (3) Interaction and (4) Attitude and motivation. IPT meetings could benefit from improvements in structure, patient-centredness and leadership by the chairpersons. Given the discrepancy between observations and interviews, it would appear useful to improve team members' awareness of aspects that could be improved before training them in dealing with specific challenges. © The Author 2016. Published by Oxford University Press.

  18. Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.

    PubMed

    Levis, Brooke; Benedetti, Andrea; Riehm, Kira E; Saadat, Nazanin; Levis, Alexander W; Azar, Marleine; Rice, Danielle B; Chiovitti, Matthew J; Sanchez, Tatiana A; Cuijpers, Pim; Gilbody, Simon; Ioannidis, John P A; Kloda, Lorie A; McMillan, Dean; Patten, Scott B; Shrier, Ian; Steele, Russell J; Ziegelstein, Roy C; Akena, Dickens H; Arroll, Bruce; Ayalon, Liat; Baradaran, Hamid R; Baron, Murray; Beraldi, Anna; Bombardier, Charles H; Butterworth, Peter; Carter, Gregory; Chagas, Marcos H; Chan, Juliana C N; Cholera, Rushina; Chowdhary, Neerja; Clover, Kerrie; Conwell, Yeates; de Man-van Ginkel, Janneke M; Delgadillo, Jaime; Fann, Jesse R; Fischer, Felix H; Fischler, Benjamin; Fung, Daniel; Gelaye, Bizu; Goodyear-Smith, Felicity; Greeno, Catherine G; Hall, Brian J; Hambridge, John; Harrison, Patricia A; Hegerl, Ulrich; Hides, Leanne; Hobfoll, Stevan E; Hudson, Marie; Hyphantis, Thomas; Inagaki, Masatoshi; Ismail, Khalida; Jetté, Nathalie; Khamseh, Mohammad E; Kiely, Kim M; Lamers, Femke; Liu, Shen-Ing; Lotrakul, Manote; Loureiro, Sonia R; Löwe, Bernd; Marsh, Laura; McGuire, Anthony; Mohd Sidik, Sherina; Munhoz, Tiago N; Muramatsu, Kumiko; Osório, Flávia L; Patel, Vikram; Pence, Brian W; Persoons, Philippe; Picardi, Angelo; Rooney, Alasdair G; Santos, Iná S; Shaaban, Juwita; Sidebottom, Abbey; Simning, Adam; Stafford, Lesley; Sung, Sharon; Tan, Pei Lin Lynnette; Turner, Alyna; van der Feltz-Cornelis, Christina M; van Weert, Henk C; Vöhringer, Paul A; White, Jennifer; Whooley, Mary A; Winkley, Kirsty; Yamada, Mitsuhiko; Zhang, Yuying; Thombs, Brett D

    2018-06-01

    Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics. Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit. A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15-3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98-10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7-15) (OR = 0.96; 95% CI = 0.56-1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26-0.97). The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

  19. Perceptions of Adult Males Who Participated in Counseling for Trauma: A Generic Qualitative Study

    ERIC Educational Resources Information Center

    Pullen, Annette M.

    2017-01-01

    This generic qualitative inquiry explored the perceptions of adult males regarding their counseling for trauma experiences. Through that exploration, literature was enhanced considering the information processing theory. Individual interviews of 10 men were conducted using semi-structured, open-ended questions. Braun and Clarke's thematic analysis…

  20. Binge Eating in Humans.

    ERIC Educational Resources Information Center

    Edelman, Barbara

    The psychosomatic theory of obesity assumes that binging, eating in response to emotional distress, is characteristic of obese individuals, yet experimental attempts to demonstrate binging have yielded weak support for this assumption. The incidence of binging was investigated by means of structured interviews on food habits with 41 male and 39…

  1. Unlocking the Potential of Public Libraries in Supporting Distance Learning

    ERIC Educational Resources Information Center

    Nabushawo, Harriet Mutambo; Aguti, Jessica Norah; Winterbottom, Mark

    2016-01-01

    This paper examines the place of public libraries in supporting distance learners in Makerere University, exploring the factors which affect utilisation of their services. The study adopted a survey design with 300 B.Ed. students, collecting data through focus group discussions, structured questionnaires and individual interviews.

  2. Negotiating Reassurance: Parents' Narratives on Follow-Up after Cochlear Implantation

    ERIC Educational Resources Information Center

    Bruin, Marieke; Ohna, Stein Erik

    2015-01-01

    This study presents an analysis of parental experiences on follow-up after cochlear implantation. Data were constructed in semi-structured, individual interviews with the parents of 14 children who use cochlear implants. Drawing on narrative analysis, the study explores parental responses to insecurity concerning children's learning and…

  3. Motivators of Educational Success: Perceptions of Grade 12 Aboriginal Students

    ERIC Educational Resources Information Center

    Preston, Jane P.; Claypool, Tim R.

    2013-01-01

    The purpose of this paper is to identify motivators that support educational success, as perceived by Aboriginal high school students enrolled in two urban Saskatchewan schools. Twelve semi-structured individual interviews revealed that students were motivated by a hospitable school culture, relevant learning opportunities, and positive personal…

  4. 75 FR 6641 - Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-10

    ...; subjective measures such as personality traits and values; and performance in a structured interview. All... individuals as judge advocates. A survey will allow the JAG Corps to assess whether certain traits and/or... surveys are the most accurate and cost-effective means for determining personality and value indicators of...

  5. Cyberbullying: A Study of School Administrators' Perceptions and Responses to Online Aggression

    ERIC Educational Resources Information Center

    Hasenstab, Jean Jegglin

    2012-01-01

    This qualitative, phenomenological study examined the perspectives and responses of twelve school administrators who have responded to cyberbullying with a disciplinary action. The majority of the data collected for this study was gathered through individual semi-structured interviews. Supporting documentation such as entries in a reflective…

  6. Psychological Sense of Community: An Australian Aboriginal Experience

    ERIC Educational Resources Information Center

    Bishop, Brian; Colquhoun, Simon; Johnson, Gemma

    2006-01-01

    Sense of community (SOC) is central to an individual's psychological wellbeing (Sarason, 1974). Eleven participants, mainly from the North West of Western Australia, took part in semistructured interviews investigating Australian Aboriginal notions of community and SOC. Five key themes emerged from the data. These included: kinship structure,…

  7. Empower, Inspire, Achieve: (Dis)Empowerment and the Paralympic Games

    ERIC Educational Resources Information Center

    Purdue, David E. J.; Howe, P. David

    2012-01-01

    This paper undertakes a critical examination of the International Paralympic Committee's desire to use the Paralympic Games as a vehicle to empower individuals with a disability. We achieve this by applying Pierre Bourdieu's sociological concepts of habitus and capital to semi-structured interviews conducted with Paralympic stakeholders.…

  8. Modeling Pupils' Understanding and Explanations Concerning Changes in Matter

    ERIC Educational Resources Information Center

    Hatzinikita, Vassilia; Koulaidis, Vasilios; Hatzinikitas, Agapitos

    2005-01-01

    The explanations of thirty primary pupils for changes in matter were recorded through individual, semi-structured interviews. The analysis of data pointed to the construction of a system for classifying pupils' explanations of changes in matter. A parallel analysis of data focused on the identification and interpretation of associations between…

  9. Real-Life Contextual Manifestations of Wisdom

    ERIC Educational Resources Information Center

    Yang, Shih-Ying

    2008-01-01

    Wisdom pertains to managing human affairs, and it arises in highly contextualized situations. The present study aims to investigate manifestations of wisdom in real-life contexts through semi-structured interviews with 66 individuals nominated as wise persons. All nominees were ethnic Chinese from Taiwan, an East Asian country which has…

  10. Exploring the Micropolitics of Principal Staffing Advocacy

    ERIC Educational Resources Information Center

    Lochmiller, Chad R.

    2018-01-01

    Purpose: The purpose of this paper is to examine the micropolitical strategies principals use to influence school staffing within an urban school district. Design/methodology/approach: The author used a qualitative case study approach drawing upon 47 semi-structured participant interviews with 25 individual research participants, 80 hours of…

  11. Low-Income, Single-Parent Francophone Mothers and the Educational Achievement of Their Children

    ERIC Educational Resources Information Center

    Caissie, Julie; Gaudet, Jeanne d'Arc; Godin, Jeanne

    2017-01-01

    This phenomenological study focused on single-parent, low-income francophone mothers' relationships with the educational and cultural achievement of their children attending French-speaking schools in Anglo-dominant settings in New Brunswick (Canada). We conducted individual (N = 8) semi-structured interviews to solicit information about the…

  12. Analyzing Number Composition and Decomposition Activities in Kindergarten from a Numeracy Perspective

    ERIC Educational Resources Information Center

    Tsamir, Pessia; Tirosh, Dina; Levenson, Esther; Tabach, Michal; Barkai, Ruthi

    2015-01-01

    This study explores two number composition and decomposition activities from a numeracy perspective. Both activities have the same mathematical structure but each employs different tools and contexts. Twenty kindergarten children engaged individually with these activities. Verbal utterances as well as actions of the child and interviewer were…

  13. Emerging Considerations for Professional Development Institutes for Science Teachers

    ERIC Educational Resources Information Center

    Freeman, John G.; Marx, Ronald W.; Cimellaro, Luigia

    2004-01-01

    This paper describes two professional development institutes in project-based science. We collected data from these institutes in the form of structured questionnaires, individual written reflections by the teachers, and focus-group interviews. An analysis of the data revealed three factors that had been underrepresented in previous research:…

  14. The admissions process of a bachelor of science in nursing program: initial reliability and validity of the personal interview.

    PubMed

    Carpio, B; Brown, B

    1993-01-01

    The undergraduate nursing degree program (B.Sc.N.) at McMaster University School of Nursing uses small groups, and is learner-centered and problem-based. A study was conducted during the 1991 admissions cycle to determine the initial reliability and validity of the semi-structured personal interview which constitutes the final component of candidate selection for this program. During the interview, three-member teams assess applicant suitability to the program based on six dimensions: applicant motivation, awareness of the program, problem-solving abilities, ability to relate to others, self-appraisal skills, and career goals. Each interviewer assigns the applicant a global rating using a seven-point scale. For the purposes of this study four interviewer teams were randomly selected from the pool of 31 teams to interview four simulated (preprogrammed) applicants. Using two-factor repeated-measures ANOVA to analyze interview ratings, inter-rater and inter-team intraclass correlation coefficients (ICC) were calculated. Inter-team reliability ranged from .64 to .97 for the individual dimensions, and .66 to .89 on global ratings. Inter-rater ICC for the six dimensions ranged from .81 to .99, and .96 to .99 for the global ratings. The item-to-total correlation coefficients between individual dimensions and global ratings ranged from .8 to 1.0. Pearson correlations between items ranged from .77 to 1.0. The ICC were then calculated for the interview scores of 108 actual applicants to the program. Inter-rater reliability based on global ratings was .79 for the single (1 rater) observation, and .91 for the multiple (3 rater) observation. These findings support the continued use of the interview as a reliable instrument with face validity. Studies of predictive validity will be undertaken.

  15. Perceptions of admission committee members: some aspects on individual admission to dental education at Karolinska Institutet.

    PubMed

    Röding, Karin

    2005-08-01

    The aim of the study was to generate an overall impression of the admission committee's (AC) perspective on individualised admission procedures, derived from some perceived experience of the individual committee members using semi-structured interviews. Qualitative research was used and data were collected by use of interviews. The results show that the committee members are highly committed to the task and try to identify desirable, non-cognitive attributes in the applicants, such as motivation, empathy, drive, and tenacity: 'emotional intelligence'. The committee members were of the opinion that it was possible to identify these attributes in an applicant. The AC further believes that the admissions procedure influences academic achievements because students regard themselves as specially selected and therefore aspire to higher achievements.

  16. Facilitating collaboration between pharmacists and physicians using an iterative interview process

    PubMed Central

    Chui, Michelle A.; Stone, Jamie A.; Odukoya, Olufumilola K.; Maxwell, Leigh

    2014-01-01

    Objective To elicit and describe mutually agreed upon common problems and subsequent solutions resulting from a facilitated face-to-face meeting between pharmacists and physicians. Design Descriptive, exploratory, non-experimental study. Setting Wisconsin from October to December 2011. Participants Physicians and community pharmacists Intervention Face-to-face semi-structured interviews with pharmacists and physicians from the same community, informed by previous individual interviews. Main outcome measure Methods to enhance collaboration and barriers to implementing collaboration between pharmacists and physicians Results Physicians and pharmacists generated ideas in which collaboration could improve patient care, including controlled substance monitoring, medication adherence, collaborative practice agreements for point of service issues, and a mechanism for urgent communication. Methods on how to collaborate on these issues were also discussed. Conclusions Bringing physicians and pharmacists together for a face-to-face interaction that was informed by information gained in previous individual interviews successfully stimulated conversation on ways in which each profession could help the other provide optimal patient care. This interaction appeared to dispel assumptions and build trust. Results of this project may provide pharmacists with the confidence to reach out to their physician colleagues. PMID:24362573

  17. Staff Views of Acceptability and Appropriateness of a Computer-Delivered Brief Intervention for Moderate Drug and Alcohol Use.

    PubMed

    Mitchell, Shannon Gwin; Monico, Laura B; Gryczynski, Jan; O'Grady, Kevin E; Schwartz, Robert P

    2015-01-01

    The use of computers for identifying and intervening with stigmatized behaviors, such as drug use, offers promise for underserved, rural areas; however, the acceptability and appropriateness of using computerized brief intervention (CBIs) must be taken into consideration. In the present study, 12 staff members representing a range of clinic roles in two rural, federally qualified health centers completed semi-structured interviews in a qualitative investigation of CBI vs. counselor-delivered individual brief intervention (IBI). Thematic content analysis was conducted using a constant comparative method, examining the range of responses within each interview as well as data across interview respondents. Overall, staff found the idea of providing CBIs both acceptable and appropriate for their patient population. Acceptability by clinic staff centered on the ready availability of the CBI. Staff also believed that patients might be more forthcoming in response to a computer program than a personal interview. However, some staff voiced reservations concerning the appropriateness of CBIs for subsets of patients, including older patients, illiterate individuals, or those unfamiliar with computers. Findings support the potential suitability and potential benefits of providing CBIs to patients in rural health centers.

  18. Bridging the gap between interviewer and interviewee: developing an interview guide for individual interviews by means of a focus group.

    PubMed

    Pedersen, Birgith; Delmar, Charlotte; Falkmer, Ursula; Grønkjaer, Mette

    2016-09-01

    In developing an interview guide, pre-existing knowledge about the research topic is essential. In a recent study, we were interested in exploring the experiences of weight changes among women treated for breast cancer using individual interviews. However, to develop an interview guide for the individual interviews that covered relevant thematic and dynamic dimensions, we found existing literature insufficient. Thus, we turned our attention to the benefit of the focus group method. This study aims to discuss how a focus group prior to individual interviews may contribute in developing the thematic dimension and translating the dynamic dimension of an interview guide into everyday language. We conducted one focus group interview of five women treated for breast cancer with experiences in weight changes. Data were analysed using content and conversation analysis and discussed with relevant literature on interview guide development. The study is approved by the Danish Data Protection Agency (2008-58-0028) and follows the ethical guidelines for qualitative research. Data generation and analysis resulted in themes for the thematic dimension, as well as three dynamic areas to consider in the individual interviews to bridge the gap between the interviewer and the interviewee. The dynamic areas are as follows: The use of words, images and metaphors - a shield and self-protection, Multiple meanings to explore and Staying close to the everyday language. The analysis made us more familiar with the content and meaning of weight changes among breast cancer survivors. Furthermore, it provided images and metaphors, multiple meanings and a sense of the women's everyday language that calls for an open interview frame to be used in subsequent individual interviews. © 2015 Nordic College of Caring Science.

  19. Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.

    PubMed

    Whittle, Henry J; Palar, Kartika; Napoles, Tessa; Hufstedler, Lee Lemus; Ching, Irene; Hecht, Frederick M; Frongillo, Edward A; Weiser, Sheri D

    2015-01-01

    Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM). Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were coded and analyzed according to content analysis methods using an inductive-deductive approach. Food insecurity was reported to be a strong contributor to risky sexual practices among MSM and female participants. Individuals described engaging in transactional sex for food or money to buy food, often during times of destitution. Participants also explained how food insecurity could lead to condomless sex despite knowledge of and desire to use safe sexual practices, largely because the need to obtain food in the short term was prioritized over the desire to use barrier protection. Our data extend previous research by demonstrating that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among MSM. These findings underscore the importance of public health and social intervention efforts focused on structural inequalities.

  20. Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting

    PubMed Central

    Whittle, Henry J; Palar, Kartika; Napoles, Tessa; Hufstedler, Lee Lemus; Ching, Irene; Hecht, Frederick M; Frongillo, Edward A; Weiser, Sheri D

    2015-01-01

    Background Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM). Methods Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were coded and analyzed according to content analysis methods using an inductive-deductive approach. Results Food insecurity was reported to be a strong contributor to risky sexual practices among MSM and female participants. Individuals described engaging in transactional sex for food or money to buy food, often during times of destitution. Participants also explained how food insecurity could lead to condomless sex despite knowledge of and desire to use safe sexual practices, largely because the need to obtain food in the short term was prioritized over the desire to use barrier protection. Conclusions Our data extend previous research by demonstrating that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among MSM. These findings underscore the importance of public health and social intervention efforts focused on structural inequalities. PMID:26546789

  1. Concordance of DSM-IV Axis I and II diagnoses by personal and informant's interview.

    PubMed

    Schneider, Barbara; Maurer, Konrad; Sargk, Dieter; Heiskel, Harald; Weber, Bernhard; Frölich, Lutz; Georgi, Klaus; Fritze, Jürgen; Seidler, Andreas

    2004-06-30

    The validity and reliability of using psychological autopsies to diagnose a psychiatric disorder is a critical issue. Therefore, interrater and test-retest reliability of the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders and the usefulness of these instruments for the psychological autopsy method were investigated. Diagnoses by informant's interview were compared with diagnoses generated by a personal interview of 35 persons. Interrater reliability and test-retest reliability were assessed in 33 and 29 persons, respectively. Chi-square analysis, kappa and intraclass correlation coefficients, and Kendall's tau were used to determine agreement of diagnoses. Kappa coefficients were above 0.84 for substance-related disorders, mood disorders, and anxiety and adjustment disorders, and above 0.65 for Axis II disorders for interrater and test-retest reliability. Agreement by personal and relative's interview generated kappa coefficients above 0.79 for most Axis I and above 0.65 for most personality disorder diagnoses; Kendall's tau for dimensional individual personality disorder scores ranged from 0.22 to 0.72. Despite of a small number of psychiatric disorders in the selected population, the present results provide support for the validity of most diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders. This instrument can be recommended as a tool for the psychological autopsy procedure in post-mortem research. Copyright 2004 Elsevier Ireland Ltd.

  2. The use of programme planning and social marketing models by a state public health agency: a case study.

    PubMed

    Kohr, J M; Strack, R W; Newton-Ward, M; Cooke, C H

    2008-03-01

    To investigate the use of planning models and social marketing planning principles within a state's central public health agency as a means for informing improved planning practices. Qualitative semi-structured interviews were conducted with 30 key programme planners in selected division branches, and a quantitative survey was distributed to 63 individuals responsible for programme planning in 12 programme-related branches. Employees who have an appreciation of and support for structured programme planning and social marketing may be considered the 'low hanging fruit' or 'early adopters'. On the other hand, employees that do not support or understand either of the two concepts have other barriers to using social marketing when planning programmes. A framework describing the observed factors involved in programme planning on an individual, interpersonal and organizational level is presented. Understanding the individual and structural barriers and facilitators of structured programme planning and social marketing is critical to increase the planning capacity within public health agencies.

  3. Experiences and expectations of women with urogenital prolapse: a quantitative and qualitative exploration.

    PubMed

    Srikrishna, S; Robinson, D; Cardozo, L; Cartwright, R

    2008-10-01

    To explore the expectations and goals of women undergoing surgery for urogenital prolapse using both a quantitative quality of life approach exploring symptom bother and a qualitative interview-based approach exploring patient goals and expectations. Prospective observational study. Tertiary referral centre for urogynaecology. Forty-three women with symptomatic pelvic organ prolapse were recruited from the waiting list for pelvic floor reconstructive surgery. All women were assessed with a structured clinical interview on an individual basis. The data obtained were transcribed verbatim and then analysed thematically based on the grounded theory. Individual codes and subcodes were identified to develop a coding framework. The prolapse quality-of-life (pQoL) questionnaire was used to determine the impact of pelvic organ prolapse on the woman's daily life. We arbitrarily classified 'bother' as minimal, mild, moderate and marked if scores ranged from 0 to 25, 25-50, 50-75 and 75-100, respectively. The degree of prolapse was objectively quantified using the pelvic organ prolapse quantification (POP-Q) system. Quantitative data were analysed using SPSS. Ethical approval was obtained from the Kings College Hospital Ethics Committee. Quantitative data from POP-Q, subjective data from pQoL, qualitative data based on the structured clinical interview. Forty-three women were recruited over the first 1 year of the study. Their mean age was 56 years (range 36-78) and mean parity was 2 (range 0-6). The mean ordinal stage of the prolapse was 2 (range stages 1-4). Quantitative analysis of the pQoL data suggested that the main domains affected were prolapse impact on life (mean score 74.71) and personal relationships (mean score 46.66). Qualitative analysis based on the clinical interview suggested that these women were most affected by the actual physical symptoms of prolapse (bulge, pain and bowel problems) as well by the impact prolapse has on their sexual function. While disease-specific QoL questionnaires allow broad comparisons to be made assessing patient bother, they may lack the sensitivity to assess individual symptoms. A qualitative approach may individualize patient care and ultimately improve patient satisfaction and overall outcome when treating women complaining of urogenital prolapse.

  4. Changes in physical activity during the retirement transition: a theory-based, qualitative interview study.

    PubMed

    McDonald, Suzanne; O'Brien, Nicola; White, Martin; Sniehotta, Falko F

    2015-02-21

    There are considerable inter-individual differences in the direction and degree of change in physical activity (PA) levels during the retirement transition. There is currently a limited theoretical understanding of how these differences can be explained. This study aimed to explore and compare perceptions about how theory-based factors influence PA change during the transition from employment to retirement among individuals approaching retirement and recently retired. Theory-based, one-to-one, semi-structured interviews were conducted with a purposive sample of 28 adults (15 retired) within 24 months of retirement. Participants were sampled to reflect a diverse range of socio-economic and occupational backgrounds. The interview was based on the 12 domains within the Theory Domain Framework and designed to elicit anticipated or experienced retirement-related changes in PA behaviour and perceived determinants. Interview transcripts were analysed using Framework analysis to explore intra- and inter-individual perceptions of how PA changes after retirement and the factors which may influence this change. The majority of participants perceived retirement to be related to an increase in PA levels. Four themes emerged from the data regarding factors perceived to influence changes in PA behaviour after retirement: (1) resources for PA; (2) structure of daily life in retirement; (3) opportunities for PA; and (4) transitional PA phases after retirement. Retirement is associated with a number of inter-related changes and opportunities which can have a positive or negative impact on PA behaviour. The influence of these factors does not appear to be static and may change over time. A number of different transitional phases may be experienced after leaving work and each phase may have a differential impact on PA behaviour. The findings of this qualitative study contribute to the theoretical understanding of PA change during the retirement transition. Each post-retirement PA trajectory is highly individual and personalised intervention approaches to increase PA during the retirement transition may be most successful. Future research should focus on the maintenance of PA change during the retirement transition and should develop and evaluate interventions to promote and maintain PA during retirement.

  5. Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

    PubMed

    Molinari, Victor A; Brown, Lisa M; Frahm, Kathryn A; Schinka, John A; Casey, Roger

    2013-05-01

    To understand the needs and challenges encountered by older homeless veterans. We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.

  6. Expert agreed standards for the selection and development of cancer support group leaders: an online reactive Delphi study.

    PubMed

    Pomery, Amanda; Schofield, Penelope; Xhilaga, Miranda; Gough, Karla

    2018-01-01

    The aim of this study was to develop pragmatic, consensus-based minimum standards for the role of a cancer support group leader. Secondly, to produce a structured interview designed to assess the knowledge, skills and attributes of the individuals who seek to undertake the role. An expert panel of 73 academics, health professionals, cancer agency workers and cancer support group leaders were invited to participate in a reactive online Delphi study involving three online questionnaire rounds. Participants determined and ranked requisite knowledge, skills and attributes (KSA) for cancer support group leaders, differentiated ideal from required KSA to establish minimum standards, and agreed on a method of rating KSA to determine suitability and readiness. Forty-five experts (62%) participated in round 1, 36 (49%) in round 2 and 23 (31%) in round 3. In round 1, experts confirmed 59 KSA identified via a systemic review and identified a further 55 KSA. In round 2, using agreement ≥75%, 52 KSA emerged as minimum standards for support group leaders. In round 3, consensus was reached on almost every aspect of the content and structure of a structured interview. Panel member comments guided refinement of wording, re-ordering of questions and improvement of probing questions. Alongside a novel structured interview, the first consensus-based minimum standards have been developed for cancer support group leaders, incorporating expert consensus and pragmatic considerations. Pilot and field testing will be used to appraise aspects of clinical utility and establish a rational scoring model for the structured interview.

  7. Structural risk and limits on agency among exotic dancers: HIV risk practices in the exotic dance club.

    PubMed

    Footer, Katherine H A; Lim, Sahnah; Brantley, Meredith R; Sherman, Susan G

    2018-03-01

    This paper provides longitudinal examination of women's health and sexual risk trajectories in US exotic dance clubs, which represent an important commercial setting for the economic mainstreaming of sexual services and an important target for public health programmes. Between July 2014 and May 2015, two semi-structured interviews (at baseline and at three months) were conducted with 24 female exotic dancers who had recently started working in in Baltimore City, USA. Results from a constant comparative analysis point to the interrelationship between the structures of the club setting, including the social context, and women's agentic practices concerning their sexual health. Study findings highlight the centrality of the interrelationship between individual- and structural-level experiences in influencing dancers' risk behavior. Findings point to the need for interventions to empower women both individually and collectively so as to provide the foundation for longer-term structural change.

  8. Albanian Parents and the Greek Educational Context: Who Is Willing to Fight for the Home Language?

    ERIC Educational Resources Information Center

    Gkaintartzi, Anastasia; Chatzidaki, Aspasia; Tsokalidou, Roula

    2014-01-01

    This article examines views of Albanian immigrant parents regarding home-language maintenance in Greece. It aims to reveal language ideologies in relation to broader ideologies about schooling and education. Following a qualitative interpretative approach, we conducted semi-structured individual and group interviews with 19 parents of bilingual…

  9. Children's Models of the Ozone Layer and Ozone Depletion.

    ERIC Educational Resources Information Center

    Christidou, Vasilia; Koulaidis, Vasilis

    1996-01-01

    The views of 40 primary students on ozone and its depletion were recorded through individual, semi-structured interviews. The data analysis resulted in the formation of a limited number of models concerning the distribution and role of ozone in the atmosphere, the depletion process, and the consequences of ozone depletion. Identifies five target…

  10. Teaching Life Sciences to Blind and Visually Impaired Learners

    ERIC Educational Resources Information Center

    Fraser, William John; Maguvhe, Mbulaheni Obert

    2008-01-01

    This study reports on the teaching of life sciences (biology) to blind and visually impaired learners in South Africa at 11 special schools with specific reference to the development of science process skills in outcomes-based classrooms. Individual structured interviews were conducted with nine science educators teaching at the different special…

  11. Blogging and Tweens: Communication Portal to Reading Selection and Engagement

    ERIC Educational Resources Information Center

    Sharber, Shelli K.

    2012-01-01

    The ethnographic study utilized the research techniques of observations, content analysis, and semi-structured interviews with tween participants (i.e., 9- through 13-year-old youth) during an 8-week literary blog project. Twenty-six participants created individual blog pages within a member-only classroom blog site that allowed for online…

  12. Perceived Mental Illness Stigma among Youth in Psychiatric Outpatient Treatment

    ERIC Educational Resources Information Center

    Elkington, Katherine S.; Hackler, Dusty; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.

    2012-01-01

    This research explores the experiences of mental illness stigma in 24 youth (58.3% male, 13-24 years, 75% Latino) in psychiatric outpatient treatment. Using Link and Phelan's (2001) model of stigmatization, we conducted thematic analysis of the interview texts, examining experiences of stigma at individual and structural levels, in addition to the…

  13. Seeing Strengths in a Rural School: Educators' Conceptions of Individual and Environmental Resilience Factors

    ERIC Educational Resources Information Center

    McMahon, Brenda

    2015-01-01

    This qualitative study of educators' understandings of resilience contributes to ongoing rural school research that examines educators' beliefs about, and attitudes toward, rural students whom are at-risk and factors that impact rural school success. Semi-structured interviews were conducted with teachers and administrators in one rural Florida…

  14. Teaching: An Option for Mid-Life Retirees.

    ERIC Educational Resources Information Center

    Bell, David

    This document identifies patterns of characteristics of those who have leisure as an option at mid-life. A comparison was made between individuals electing to enter teaching and those electing to pursue leisure at this life stage. Results of structured interviews, statistical results, and an analysis of a life satisfaction scale is given. In…

  15. Educational Leadership and Culture in China: Dichotomies between Chinese and Anglo-American Leadership Traditions?

    ERIC Educational Resources Information Center

    Law, Wing-Wah

    2012-01-01

    This article explores the extent to which Chinese school leaders espouse dichotomous or integrated Chinese and Anglo-American leadership and management preferences. Data are drawn from questionnaires completed by school leaders and from semi-structured interviews with individual school leaders from different parts of China. The exploratory study…

  16. Latinas in Higher Education: An Interpretive Study of Experiential Influences That Impact Their Life Choices

    ERIC Educational Resources Information Center

    Torres-Capeles, Belkis

    2012-01-01

    This basic interpretive qualitative study used individual semi-structured interviews to explore and understand the experiences of seven self-identified Latina participants, who reside in Northeast Ohio and belong to a volunteer organization promoting professional Latinas. The study used Latina Critical Race theory and feminist perspectives to…

  17. Academic Innovation and Autonomy: An Exploration of Entrepreneurship Education within American Community Colleges and the Academic Capitalist Context

    ERIC Educational Resources Information Center

    Mars, Matthew M.; Ginter, Mary Beth

    2012-01-01

    Employing interviews with individuals from 16 community colleges across the country, as well as an independent consultant engaged in activities of the National Association for Community College Entrepreneurship (NACCE), this study considers the organizational structures and academic practices associated with community college entrepreneurship…

  18. Effectiveness of Inquiry-Based Learning in an Undergraduate Exercise Physiology Course

    ERIC Educational Resources Information Center

    Nybo, Lars; May, Michael

    2015-01-01

    The present study was conducted to investigate the effects of changing a laboratory physiology course for undergraduate students from a traditional step-by-step guided structure to an inquiry-based approach. With this aim in mind, quantitative and qualitative evaluations of learning outcomes (individual subject-specific tests and group interviews)…

  19. Promising Homework Practices: Teachers' Perspectives on Making Homework Work for Newcomer Immigrant Students

    ERIC Educational Resources Information Center

    Bang, Hee Jin

    2012-01-01

    This study examines the homework practices of eight teachers working in a high school designed to serve newcomer immigrant students. Individual structured interviews were conducted in which teachers working in an innovative setting explained their purposes of assigning homework, their beliefs about factors affecting their students' homework…

  20. Parents' Perspectives on Coping with Duchenne Muscular Dystrophy and Concomitant Specific Learning Disabilities

    ERIC Educational Resources Information Center

    Webb, Carol L.

    2005-01-01

    This study addresses parental perspectives and coping strategies related to Duchenne muscular dystrophy and specific learning disabilities. Data were collected through individual semi-structured in-depth interviews with fifteen sets of parents. Participants were selected based on variables such as age of children, number of children with both…

  1. Mathematics Teachers and ICT: Factors Affecting Pre-Service Use in School Placements

    ERIC Educational Resources Information Center

    Bozkurt, Gulay

    2016-01-01

    This study examines the factors influencing student teachers' use of information and communication technology (ICT) to teach mathematics. Data collection involved questionnaire surveys and individual follow-up semi-structured interviews of student teachers concerning the factors that they felt had hindered or promoted their development in the use…

  2. A School Council's Experience with School Improvement: A Saskatchewan Case Study

    ERIC Educational Resources Information Center

    Preston, Jane P.

    2012-01-01

    Based on a qualitative case study conducted within one Saskatchewan (Canada) rural community, the purpose of this article is to describe the challenges a school council faced when supporting a school improvement plan. The primary data for the study were 35 semi-structured individual interviews conducted with school council members, teachers, and…

  3. The Subjective Well-Being of First-Year Tertiary Students during an Induction Programme

    ERIC Educational Resources Information Center

    Chigeza, Shingairai; de Kock, Johannes H.; Roos, Vera; Wissing, Marie P.

    2017-01-01

    This article describes the perceptions of first-year students' subjective appraisal of their well-being before, during and after participation in an induction programme at a higher education institution (HEI). Twenty-two first-year students participated in focus group discussions (FGDs) and semi-structured individual interviews. Thematic and…

  4. Physical Activity Promotion in General Practices of Barcelona: A Case Study

    ERIC Educational Resources Information Center

    Puig Ribera, Anna; McKenna, Jim; Riddoch, Chris

    2006-01-01

    This case study aimed to generate explanations for the lack of integration of physical activity (PA) promotion in general practices of Barcelona, the capital of Catalonia. This explanatory study adopted a qualitative approach, based on three techniques; focus groups (n = 3), semi-structured (n = 25) and short individual interviews (n = 5). These…

  5. "I Tolerate Technology--I Don't Embrace It": Instructor Surprise and Sensemaking in a Technology-Rich Learning Environment

    ERIC Educational Resources Information Center

    Fairchild, Jennifer L.; Meiners, Eric B.; Violette, Jayne L.

    2016-01-01

    Assuming a dialectical approach to technology and pedagogy, this study explores sensemaking processes for instructors teaching in a technologically enhanced college classroom environment. Through a series of semi-structured individual and group interviews, seven instructors provided narrative accounts of the problems encountered with progressive…

  6. Ecologic Reformulation of Pediatric Social Illness.

    ERIC Educational Resources Information Center

    Newberger, Eli H.; Marx, Thomas J.

    Members of a group of hospitalized children under 4 years of age (48 under care for child abuse, 97 for accidents, 41 for failure to thrive, and 23 for ingestions) were matched individually on age, social class, and race with controls suffering from comparable acute medical conditions. A structured maternal and paternal interview yielded 63…

  7. Perceptions of Hong Kong Physical Education Teachers on the Inclusion of Students with Disabilities

    ERIC Educational Resources Information Center

    Qi, Jing; Wang, Lijuan; Ha, Amy

    2017-01-01

    Based on Lev Vygotsky's social constructivism theory, this study examined the perceptions of Hong Kong physical education (PE) teachers regarding the inclusion of students with disabilities in general PE programmes. Eight secondary PE teachers (female = 5, male = 3) were recruited for individual semi-structured interviews. Data gathered from the…

  8. Music Teacher Educators' Visions of Music Teacher Preparation in Finland, Norway and Sweden

    ERIC Educational Resources Information Center

    Thorgersen, Cecilia Ferm; Johansen, Geir; Juntunen, Marja-Leena

    2016-01-01

    In this study we investigated the visions of 12 music teacher educators who teach pedagogical courses called instrumental pedagogy and classroom music pedagogy in three music academies in Finland, Norway and Sweden. The data were collected through individual, semi-structured qualitative interviews. Drawing on Hammerness' concept of "teachers'…

  9. Case Study of a Gifted and Talented Catholic Dominican Nun

    ERIC Educational Resources Information Center

    Lavin, Angela

    2017-01-01

    The case of a gifted and talented Catholic Dominican nun is described and analysed in the context of Renzulli's Three-Ring Conception of Giftedness and Gagne's Differentiated Model of Giftedness and Talent. Using qualitative methods, semi-structured interviews of relevant individuals were conducted and analysed. Based on the conclusions of this…

  10. Making a Difference: Women Headteachers' Contribution to Schools As Learning Institutions.

    ERIC Educational Resources Information Center

    Hall, Valerie

    This paper presents findings of a study that examined how six women headteachers in Great Britain worked as school leaders. Data were obtained through observation, joint inquiry, structured conversations, and life-history interviews. The study drew on Wallace and Hall's (1994) power-culture metaphor, which stated that individuals make different…

  11. Vicarious Racism: A Qualitative Analysis of Experiences with Secondhand Racism in Graduate Education

    ERIC Educational Resources Information Center

    Truong, Kimberly A.; Museus, Samuel D.; McGuire, Keon M.

    2016-01-01

    In this article, the authors examine the role of vicarious racism in the experiences of doctoral students of color. The researchers conducted semi-structured individual interviews with 26 doctoral students who self-reported experiencing racism and racial trauma during their doctoral studies. The analysis generated four themes that detail the…

  12. The Role of Mobile Phones in Family Communication

    ERIC Educational Resources Information Center

    Devitt, Kerry; Roker, Debi

    2009-01-01

    Whilst there is a wealth of research into family communication and family relationships, there is little information about whether (and if so how) mobile phones have impacted on these processes. The authors' study involved individual semi-structured interviews with 60 families, including parents/carers and young people aged 11-17, to investigate…

  13. The Perceived Effect of HIV/AIDS on Other Identities

    ERIC Educational Resources Information Center

    Baumgartner, Lisa M; Niemi, Eric

    2013-01-01

    The onset of a chronic disease influences other roles or identities. For example, an HIV or AIDS diagnosis can affect a person's work identity (Bedell, 1997). In this article, we explored how living with HIV/AIDS shapes other identities. Thirty-six individuals living with HIV/AIDS (PLWHAs) participated in semi-structured interviews. Participants'…

  14. Perceptions and Practices of Principals: Supporting Positive Educational Experiences for Aboriginal Learners

    ERIC Educational Resources Information Center

    Preston, Jane P.; Claypool, Tim R.; Rowluck, William; Green, Brenda

    2017-01-01

    The purpose of this paper is to describe the leadership perceptions and practices of principals who promote positive school experiences for Aboriginal students. This qualitative multi-case study encapsulates 14 semi-structured individual interviews conducted with nine principals from the Canadian provinces of Saskatchewan and Prince Edward Island.…

  15. Learning from Student Retrospective Reports: Implications for the College Developmental Classroom

    ERIC Educational Resources Information Center

    Perin, Dolores; Grant, Geremy; Raufman, Julia; Kalamkarian, Hoori Santikian

    2017-01-01

    Retrospective reports gathered from developmental education students as part of a learning assessment revealed the use of several strategies for writing a summary based on a text. Participants were selected for the study based on the richness and variety of their verbal descriptions of task performance in structured, individualized interviews.…

  16. Comorbidity in Emetophobia (Specific Phobia of Vomiting).

    PubMed

    Sykes, Mark; Boschen, Mark J; Conlon, Elizabeth G

    2016-07-01

    Emetophobia (fear of vomiting) is an anxiety disorder in which individuals report clinical levels of fear that they may vomit or be exposed to the vomit of others. The prevalence of comorbidity of emetophobia with other conditions has previously only been investigated using self-report instruments. Sixty-four adults with emetophobia participated in an online structured clinical diagnostic interview assessing the presence of emetophobia and other conditions. Higher comorbidity for depression, generalized anxiety disorder, panic disorder, social anxiety disorder and obsessive-compulsive disorder were found in participants compared with general population norms. Emetophobia is commonly comorbid with other anxiety and depressive disorders. Comorbidity rates, when assessed using a structured clinical interview, were lower than previously reported using self-report alone. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Emetophobia (specific phobia of vomiting) is a clinical fear of vomiting. Individuals with emetophobia show high comorbidity with other anxiety and mood disorders. The most common comorbid conditions were generalized anxiety disorder, panic disorder, hypochondriasis and obsessive-compulsive disorder. Clinicians should ensure that they assess for the presence of comorbid conditions when treating emetophobia. Copyright © 2015 John Wiley & Sons, Ltd.

  17. Sustaining inquiry-based teaching methods in the middle school science classroom

    NASA Astrophysics Data System (ADS)

    Murphy, Amy Fowler

    This dissertation used a combination of case study and phenomenological research methods to investigate how individual teachers of middle school science in the Alabama Math, Science, and Technology Initiative (AMSTI) program sustain their use of inquiry-based methods of teaching and learning. While the overall context for the cases was the AMSTI program, each of the four teacher participants in this study had a unique, individual context as well. The researcher collected data through a series of interviews, multiple-day observations, and curricular materials. The interview data was analyzed to develop a textural, structural, and composite description of the phenomenon. The Reformed Teaching Observation Protocol (RTOP) was used along with the Assesing Inquiry Potential (AIP) questionnaire to determine the level of inquiry-based instruction occuring in the participants classrooms. Analysis of the RTOP data and AIP data indicated all of the participants utilized inquiry-based methods in their classrooms during their observed lessons. The AIP data also indicated the level of inquiry in the AMSTI curricular materials utilized by the participants during the observations was structured inquiry. The findings from the interview data suggested the ability of the participants to sustain their use of structured inquiry was influenced by their experiences with, beliefs about, and understandings of inquiry. This study contributed to the literature by supporting existing studies regarding the influence of teachers' experiences, beliefs, and understandings of inquiry on their classroom practices. The inquiry approach stressed in current reforms in science education targets content knowledge, skills, and processes needed in a future scientifically literate citizenry.

  18. The meaning of work and working life after cancer: an interview study.

    PubMed

    Rasmussen, Dorte M; Elverdam, Beth

    2008-12-01

    Cancer survivors have diverse and complex patterns of return to work, but little attention has been given to individual experiences of returning to work. To analyse the meaning of work and working life for cancer survivors over time. Participant observation was carried out at a cancer rehabilitation centre. A total of 23 participants were interviewed twice. Cancer survivors try to get back to work after treatment and try to re-establish their former structure of everyday-life that is seen as a normal and healthy existence. Work contributes to creating the individual as a social being, partaking in social relations with others. Work plays a role in establishing the individual's identity. It is difficult for many to resume work. When they are unable to work, they establish new activities in everyday-life that give meaning to a life. In order to understand the cultural meaning of work in capitalist society, we incorporate the theoretical perspective of Max Weber. Those who after cancer treatment are unable to work lose a part of their identity; they lose the personal challenge and satisfaction related to work. They are no longer part of the companionship related to work. Having had cancer means a disruption of the structure of everyday-life that is taken for granted. (c) 2008 John Wiley & Sons, Ltd.

  19. Social and Structural Challenges to Drug Cessation Among Couples in Northern Mexico: Implications for Drug Treatment in Underserved Communities

    PubMed Central

    Bazzi, Angela Robertson; Syvertsen, Jennifer L.; Rolón, María Luisa; Martinez, Gustavo; Rangel, Gudelia; Vera, Alicia; Amaro, Hortensia; Ulibarri, Monica D.; Hernandez, Daniel O.; Strathdee, Steffanie A.

    2015-01-01

    Background Available drug treatment modalities may inadequately address social and structural contexts surrounding recovery efforts. Methods This mixed methods analysis drew on (1) surveys with female sex workers and their intimate male partners and (2) semi-structured interviews with a subsample of 41 couples (n = 82 individuals, 123 total interviews) in Northern Mexico. Descriptive and content analyses examined drug cessation and treatment experiences. Results Perceived need for drug treatment was high, yet only 35% had ever accessed services. Financial and institutional barriers (childcare needs, sex-segregated facilities) prevented partners from enrolling in residential programs together or simultaneously, leading to self-treatment attempts. Outpatient methadone was experienced more positively, yet financial constraints limited access and treatment duration. Relapse was common, particularly when one partner enrolled alone while the other continued using drugs. Conclusions Affordable, accessible, evidence-based drug treatment and recovery services that acknowledge social and structural contexts surrounding recovery are urgently needed for drug-involved couples. PMID:26470596

  20. The personal value of being a palliative care Community Volunteer Worker in Uganda: a qualitative study.

    PubMed

    Jack, Barbara A; Kirton, Jennifer A; Birakurataki, Jerith; Merriman, Anne

    2012-07-01

    Volunteers in palliative care play a key role, particularly in the hospice setting. The expansion of palliative care into developing countries has been accompanied by the emergence of volunteer workers, who are providing a main source of support and care for patients, many of whom never see a health professional. The aim of this study was to evaluate the motivation for becoming a volunteer and the personal impact of being a palliative care Community Volunteer Worker in Uganda. A qualitative methodology using semi-structured individual and group digitally recorded interviews was adopted for the study. Data were analysed for emerging themes using thematic analysis. Forty-three interviews were undertaken, 32 with Community Volunteer Workers and 11 with the Hospice clinical teams, using semi-structured digitally recorded individual, group and focus group interviews at the Hospice Africa sites in Uganda. The results identified the cultural wish to help people as a key motivator in becoming a volunteer. Additionally, the volunteers reported having a sense of pride in their volunteering role, and this role had a positive impact on their perceived status in their local community. This model of volunteering is clearly having an impact on the volunteers, both personally and also in terms of how they are treated in their communities. Further research to explore the long-term personal benefits of being a palliative care volunteer is recommended.

  1. Exploring patient experiences of participating in a group exercise class for the management of nonspecific shoulder pain.

    PubMed

    Barrett, Eva; Hayes, Amy; Kelleher, Mags; Conroy, Carmela; Robinson, Katie; O'Sullivan, Kieran; McCreesh, Karen

    2018-06-01

    Recent evidence has demonstrated that group-based physiotherapy interventions for musculoskeletal pain can have similar clinical outcomes compared to one-to-one treatment. This study qualitatively explored the experiences of individuals who participated in a physiotherapist-led group exercise class for people with nonspecific shoulder pain (NSSP). Semi-structured interviews were carried out with 23 people with NSSP, who had recently participated in a 6-week structured exercise class. All recorded verbal data were transcribed verbatim. Transcripts of interview data were verified by participants and analyzed using thematic analysis. The exercise class was positively evaluated by all participants. Four themes emerged from the data: (1) the participant's experiences of support, motivation, and learning from peers; (2) the preference for an exercise class compared to individual physiotherapy; (3) the physiotherapist as an educator and facilitator; and (4) beliefs about pain and exercise. Among those interviewed, the exercise class was described as providing an environment conducive to the development of relationships, friendships, humor and fun, gaining mastery of their exercises, and encouraging the transition toward self-management of their pain. For those who had previous experience of one-to-one physiotherapy, the exercise class was evaluated as the preferred mode of physiotherapy delivery. The findings of this study support a move away from traditional one-on-one physiotherapy sessions to the potentially more cost-effective group setting.

  2. Social challenges and supports from the perspective of individuals with Asperger syndrome and other autism spectrum disabilities.

    PubMed

    Müller, Eve; Schuler, Adriana; Yates, Gregory B

    2008-03-01

    The study describes the perspectives of individuals with Asperger syndrome and other autism spectrum disabilities (ASDs) regarding social challenges and supports. Eighteen adults with ASDs were individually interviewed. They were asked to describe their experiences navigating their social worlds, and recommend effective social supports and strategies for improving social connectedness. Qualitative analyses of the interview transcripts revealed a number of common experiences including a profound sense of isolation, difficulty initiating social interactions, challenges relating to communication, longing for greater intimacy, desire to contribute to one's community, and effort to develop greater social/self-awareness. Commonly recommended social supports included external supports (e.g. activities based on shared interests, highly structured or scripted social activities, and small groups or dyads); communication supports (e.g. alternative modes of communication, explicit communication, and instruction in interpreting and using social cues); and self-initiated strategies for handling social anxiety (e.g. creative/improvisational outlets, physical activity, spiritual practice/organized religion, and time spent alone).

  3. Eating disorder symptomatology among ballet dancers.

    PubMed

    Ringham, Rebecca; Klump, Kelly; Kaye, Walter; Stone, David; Libman, Steven; Stowe, Susan; Marcus, Marsha

    2006-09-01

    The current study sought to compare eating disorder symptomatology among ballet dancers and individuals with restricting anorexia nervosa (RAN), bulimia nervosa (BN), and no eating pathology. Twenty-nine female ballet dancers completed assessments and were compared with an archival dataset of 26 women with RAN, 47 women with BN, and 44 women with no eating pathology. Eating disorder diagnoses and behaviors were assessed with a semi-structured clinical interview, the Eating Disorder Inventory (EDI), and a weight history interview. Eighty-three percent of dancers met lifetime criteria for AN (6.9%), BN (10.3%), AN+BN (10.3%), or EDNOS (55.0%). Moreover, dancers looked more similar to eating-disordered individuals than to control individuals on measures of eating pathology. Despite previous emphasis on the pathology AN, the current findings suggest that dancers frequently engage in binge eating and purging behaviors. Moreover, it appears that their pathology is as severe as that of non-dancing women with eating disorders. Copyright (c) 2006 by Wiley Periodicals, Inc.

  4. Everyday listeners' impressions of speech produced by individuals with adductor spasmodic dysphonia.

    PubMed

    Nagle, Kathleen F; Eadie, Tanya L; Yorkston, Kathryn M

    2015-01-01

    Individuals with adductor spasmodic dysphonia (ADSD) have reported that unfamiliar communication partners appear to judge them as sneaky, nervous or not intelligent, apparently based on the quality of their speech; however, there is minimal research into the actual everyday perspective of listening to ADSD speech. The purpose of this study was to investigate the impressions of listeners hearing ADSD speech for the first time using a mixed-methods design. Everyday listeners were interviewed following sessions in which they made ratings of ADSD speech. A semi-structured interview approach was used and data were analyzed using thematic content analysis. Three major themes emerged: (1) everyday listeners make judgments about speakers with ADSD; (2) ADSD speech does not sound normal to everyday listeners; and (3) rating overall severity is difficult for everyday listeners. Participants described ADSD speech similarly to existing literature; however, some listeners inaccurately extrapolated speaker attributes based solely on speech samples. Listeners may draw erroneous conclusions about individuals with ADSD and these biases may affect the communicative success of these individuals. Results have implications for counseling individuals with ADSD, as well as the need for education and awareness about ADSD. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Communication after mild traumatic brain injury--a spouse's perspective.

    PubMed

    Crewe-Brown, Samantha Jayne; Stipinovich, Alexandra Maria; Zsilavecz, Ursula

    2011-10-01

    Individuals with mild traumatic brain injury (MTBI) often perform within normal limits on linguistic and cognitive assessments. However, they may present with debilitating communicative difficulties in daily life. A multifaceted approach to MTBI with a focus on everyday communication in natural settings is required. Significant others who interact with the individual with MTBI in a variety of settings may be sensitive to communicative difficulties experienced by the individual with MTBI. This article examines communication after MTBI from the perspective of the spouse. A case study design was implemented. The spouses of two individuals with MTBI served as the participants for this study. Semi-structured interviews were held, during which each participant was requested to describe the communication of their spouse with MTBI. The content obtained from the interviews was subjected to a discourse analysis. The results show that both participants perceived changes in the communication of their spouse following the MTBI. The results further show that MTBI affected communication of the two individuals in different ways. The value of a 'significant other' in providing information regarding communication in natural settings is highlighted. The implications of these findings for the assessment and management of the communication difficulties associated with MTBI are discussed.

  6. 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

  7. The Biographical Personality Interview (BPI)--a new approach to the assessment of premorbid personality in psychiatric research. Part I: Development of the instrument.

    PubMed

    von Zerssen, D; Pössl, J; Hecht, H; Black, C; Garczynski, E; Barthelmes, H

    1998-01-01

    The Biographical Personality Interview (BPI) is a research instrument for the retrospective assessment of premorbid personality traits of psychiatric patients. Its construction is based on results of a series of investigations in which biographical data from psychiatric case notes were analysed with respect to premorbid personality traits. In order to avoid methodological shortcomings of the utilisation of clinical records, an interview technique was developed. It is applied by two independent, specially trained investigators who are kept "blind" regarding any clinical data of the subject under study. One of them has to conduct the interview of a clinically remitted patient and to provide an interview protocol, the other one has to rate personality traits from that protocol along a large series of purely descriptive items. Sum scores for six personality structures ("types") are calculated and the case is then assigned to the intra-individually dominating personality type according to the highest of these scores.

  8. Motivational interviewing for HIV risk reduction among gay men in commercial and public sex settings.

    PubMed

    Harding, R; Dockrell, M J; Dockrell, J; Corrigan, N

    2001-08-01

    The present paper addresses the feasibility of combining motivational interviewing and cognitive interventions to HIV risk reduction in commercial venues and public sex environments (PSEs). The logic for these two approaches is considered and an intervention combining key elements of the two is presented. The intervention uses a questionnaire format to encourage individuals to compare their desired versus actual behaviour (i.e. chosen personal risk reduction strategy versus 'slip-ups'/unwanted risk taking), and to recognize their risk-related cognitions. High-risk individuals are identified, and health-focused conversations developed from the brief schedule. The structure and key design issues in the development of a feasible, acceptable and evidence-based tool are reviewed. The limitations of more complex, focused interventions in the context of commercial and PSE settings are discussed.

  9. Adult attachment interview, thematic analysis, and communicative style in families with substance use disorder.

    PubMed

    Anolli, Luigi; Balconi, Michela

    2002-02-01

    The paper examined the Adult Attachment Interview with special reference to thematic and semantic analysis in line with the discourse study (van Dijk, 1997). The hypothesis was that correspondence between the communicative organization of speech and the mental representations of the attachment experiences would be substantial. Eight Adult Attachment Interview transcripts of fathers with a heroin addicted young son were analyzed at two levels, (a) thematic analysis to individuate the topics of their talk applying the structural and semantic study of discourse and (b) enunciative analysis of speech to define their linguistic patterns utilizing a set of linguistic micro- and macro-units. Results showed nine main topics in the Adult Attachment Interview, each of which was characterized by a distinctive linguistic profile. In this perspective this device seems to be effective not only for discriminating attachment styles between subjects but also to identify differences within subjects belonging to the same attachment pattern.

  10. A study of rural preschool practitioners' views on young children's mathematical thinking

    NASA Astrophysics Data System (ADS)

    Hunting, Robert P.; Mousley, Judith A.; Perry, Bob

    2012-03-01

    The project Mathematical Thinking of Preschool Children in Rural and Regional Australia: Research and Practice aimed to investigate views of preschool practitioners about young children's mathematical thinking and development. Structured individual interviews were conducted with 64 preschool practitioners from rural areas of three Australian states. The questions focused on five broad themes: children's mathematics learning, support for mathematics teaching, technology and computers, attitudes and feelings, and assessment and record keeping. We review results from the interview data for each of these themes, discuss their importance, and outline recommendations related to teacher education as well as resource development and research.

  11. Improving the organization of palliative care: identification of barriers and facilitators in five European countries.

    PubMed

    van Riet Paap, Jasper; Vernooij-Dassen, Myrra; Brouwer, Frederike; Meiland, Franka; Iliffe, Steve; Davies, Nathan; Leppert, Wojciech; Jaspers, Birgit; Mariani, Elena; Sommerbakk, Ragni; Vissers, Kris; Engels, Yvonne

    2014-10-16

    Interventions to improve palliative care encounter challenges beyond the usual implementation problems because of palliative care's complex and changing character. In this study, we explored barriers and facilitators faced by health-care professionals in five European countries (England, Germany, Italy, Norway and the Netherlands) with regard to improving the organization of their palliative care service. Semi-structured individual and focus group interviews were conducted with purposefully selected health-care professionals. The constant comparative method was used to analyse the data. Professionals working in hospitals, hospices, nursing homes and primary care facilities who provide palliative care to adult patients were interviewed (n =40) or participated in ten focus group interviews (n =59). Barriers and facilitators were inductively grouped into 16 categories and arranged into five themes: innovation, individual professional level, group dynamics, organizational context and local political-economic context. Although the barriers and facilitators identified differed in scope, context, strength and provenance, they were shared by professionals from different European countries. This study identified barriers and facilitators to organizational change in palliative care. Some of these barriers and facilitators were experienced by professionals in almost all countries and are therefore prerequisites to change. Understanding the barriers to and facilitators of change will help tailor organizational improvements to the needs of individuals and organizations.

  12. How Older Persons Perceive the Loss of Independence: The Need of a Holistic Approach to Frailty.

    PubMed

    Escourrou, E; Cesari, M; Chicoulaa, B; Fougère, B; Vellas, B; Andrieu, S; Oustric, S

    2017-01-01

    Since 2004, the definition of the frailty syndrome has shifted from purely physical criteria to a more comprehensive consideration of the individual, including their psychosocial criteria. In this study, qualitative research methods were used as a complementary approach in order to enrich the existing quantitative results in this area. To understand the views of older persons on the risk of loss of independence. The study population comprised people over 75 years of age who were living at home in the south-west of France and were considered to be at risk of losing their independence. Data were collected using individual semi-structured in-depth interviews, accompanied by observations. Inductive analysis was carried out according to grounded theory methods. Fifteen individual interviews were conducted to achieve theoretical data saturation. Analysis of the content of the interviews revealed seven risk factors for the loss of independence: poor mental health, poor physical health, social isolation, no longer leaving the home, an unsuitable environment, unsuitable living conditions, and few resources. These results complement the purely physical approach to screening for the frailty syndrome and lead us to reconsider our screening approach to include a more holistic view of the older person and their circumstances.

  13. The psychosocial impact of wheelchair tennis on participants from developing countries.

    PubMed

    Richardson, Emma V; Papathomas, Anthony; Smith, Brett; Goosey-Tolfrey, Victoria L

    2017-01-01

    Individuals with physical disabilities in developing countries can experience many instances of psychosocial hardship. Although scholars have suggested that participation in sport can positively impact psychosocial health, few studies have explored this phenomenon within the disabled population of developing nations. Sixteen wheelchair tennis players were recruited across six developing countries and interviewed in regards to their experiences. Data were collected using semi-structured interviews, transcribed verbatim and subject to thematic analysis. Wheelchair tennis players perceived their participation in sport enhanced their psychosocial well-being. Three broad themes emerged from analysis of the interviews; (1) developed transferrable skills, (2) perceived personal growth and (3) benefits of an athletic identity. Sports participation, in this case wheelchair tennis, may be a viable means to promote psychosocial well-being in disabled populations within developing nations. Moreover, sport holds the potential to challenge negative perceptions of disability at an individual and societal level within these cultures. Implication for Rehabilitation Individuals with physical disabilities in developing countries may experience psychosocial hardship and cultural stigma. Wheelchair sport may be a viable means to enhance psychosocial well-being in this population. Skills learnt "on court" are transferrable to everyday life potentially improving independence and quality of life. Identifying as an athlete can challenge negative cultural perceptions of disability.

  14. Empirical testing of criteria for dissociative schizophrenia.

    PubMed

    Laferrière-Simard, Marie-Christine; Lecomte, Tania; Ahoundova, Lola

    2014-01-01

    This study examined the validity of dissociative schizophrenia diagnostic criteria. In the first phase, 50 participants with a psychotic disorder were administered the Dissociative Experiences Scale and the Childhood Trauma Questionnaire to identify those with dissociative characteristics. In the second phase, we selected those who had a score of 15 or above on the Dissociative Experiences Scale. Fifteen of these participants were evaluated thoroughly with the Structured Clinical Interview for DSM-IV Axis I, Structured Clinical Interview for DSM-IV Axis II, and Structured Clinical Interview for DSM-IV Dissociative Disorders to determine whether they met the criteria for dissociative schizophrenia and to generate a clinical description. Our results indicated that 24% of the individuals we tested met these criteria. We propose making mandatory 1 of the 3 dissociative symptoms of the criteria to eliminate people with only nonspecific symptoms (e.g., extensive comorbidity). According to this modified criterion, 14% of our sample would receive a diagnosis of dissociative schizophrenia. However, a more comprehensive look at the clinical picture begs the question of whether dissociative schizophrenia is truly present in every person meeting the criteria. We discuss the relevance of creating a new schizophrenia subtype and offer recommendations for clinicians.

  15. Couple relationships in families with dependent children after a diagnosis of maternal breast cancer in the United Kingdom: Perspectives from mothers and fathers.

    PubMed

    Corney, Roslyn; Puthussery, Shuby; Swinglehurst, Jane

    2016-01-01

    This article examines the facilitators and the barriers to couple relationships in families in the UK with dependent children after a diagnosis of maternal breast cancer. Qualitative data were collected through in-depth semi-structured interviews with 23 participants, including 10 couples and three women whose partners did not take part. Recorded interviews were analyzed using a thematic approach identifying themes and patterns in the interview transcripts and categorizing them using a framework. Key individual and contextual factors perceived as barriers or facilitators to couple relationships included: being a "young" family with young children, frustration and resentment from male partners, women's reactions to the illness, individual communication styles, differing needs for "personal space," body image concerns, and social support. Findings indicated the need for strengthening "family focus" in services with adequate support for male partners. Health and family services should consider variability in the experiences of couples with dependent children and be sensitive to the needs of partners alongside the women.

  16. 41 CFR 301-75.201 - May we allow the interviewee to use individual Government contractor-issued charge cards for pre...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... interviewee to use individual Government contractor-issued charge cards for pre-employment interview travel... System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL... individual Government contractor-issued charge cards for pre-employment interview travel? No. ...

  17. Strength in the Face of Adversity: Resilience Strategies of Transgender Individuals

    ERIC Educational Resources Information Center

    Singh, Anneliese A.; Hays, Danica G.; Watson, Laurel S.

    2011-01-01

    This phenomenological inquiry explored the lived experiences of resilience of 21 transgender individuals. Through individual semistructured interviews (3 interviews each with 5 participants) and 1 focus group interview (16 participants), the authors identified 5 common resiliency themes (evolving a self-generated definition of self, embracing…

  18. Interviewing to develop Patient-Reported Outcome (PRO) measures for clinical research: eliciting patients’ experience

    PubMed Central

    2014-01-01

    Patient-reported outcome (PRO) measures must provide evidence that their development followed a rigorous process for ensuring their content validity. To this end, the collection of data is performed through qualitative interviews that allow for the elicitation of in-depth spontaneous reports of the patients’ experiences with their condition and/or its treatment. This paper provides a review of qualitative research applied to PRO measure development. A clear definition of what is a qualitative research interview is given as well as information about the form and content of qualitative interviews required for developing PRO measures. Particular attention is paid to the description of interviewing approaches (e.g., semi-structured and in-depth interviews, individual vs. focus group interviews). Information about how to get prepared for a qualitative interview is provided with the description of how to develop discussion guides for exploratory or cognitive interviews. Interviewing patients to obtain knowledge regarding their illness experience requires interpersonal and communication skills to facilitate patients’ expression. Those skills are described in details, as well as the skills needed to facilitate focus groups and to interview children, adolescents and the elderly. Special attention is also given to quality assurance and interview training. The paper ends on ethical considerations since interviewing for the development of PROs is performed in a context of illness and vulnerability. Therefore, it is all the more important that, in addition to soliciting informed consent, respectful interactions be ensured throughout the interview process. PMID:24499454

  19. 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.

  20. Correspondence between Psychometric and Clinical High Risk for Psychosis in an Undergraduate Population

    PubMed Central

    Cicero, David C.; Martin, Elizabeth A.; Becker, Theresa M.; Docherty, Anna; Kerns, John G.

    2014-01-01

    Despite the common use of either psychometric or clinical methods for identifying individuals at risk for psychosis, previous research has not examined the correspondence and extent of convergence of these two approaches. Undergraduates (n = 160), selected from a larger pool, completed three self-report schizotypy scales, the Magical Ideation Scale, the Perceptual Aberration Scale, and the Revised Social Anhedonia Scale, and were administered the Structured Interview for Prodromal Syndromes (SIPS). First, high correlations were observed for self-report and interview-rated psychotic like experiences (rs between .48 and .61, p < .001). Second, 77 percent of individuals identified as having a risk for psychosis with the self-report measures reported at least one clinically meaningful psychotic-like experience on the SIPS. Third, receiver operating characteristic curve analyses showed that the self-report scales can be used to identify which participants report clinically meaningful positive symptoms. These results suggest that mostly white undergraduate participants identified as at risk with the psychometric schizotypy approach report clinically meaningful psychotic-like experiences in an interview format and that the schizotypy scales are moderately to strongly correlated with interview-rated psychotic-like experiences. The results of the current research provide a baseline for comparing research between these two approaches. PMID:24708081

  1. [The National Board of Health's information pamphlet to pregnant women causes insecurity].

    PubMed

    Jensen, Puk; Brodersen, John

    2010-06-07

    Since 2004, all pregnant women in Denmark have been offered prenatal screening. The aim of this study was to investigate how the Danish National Board of Health's information pamphlet adressed to pregnant women was perceived by young female readers. Five women aged 23-26 years were interviewed. At the time of the interview, none of the women were pregnant or had previously been pregnant. The five individual interviews were carried out using a semi-structured interview guide. They were recorded, transcribed and analysed using Steinar Kvale's theory of meaning condensation. After reading the pamphlet, the informants became worried, anxious or frightened about the risk of giving birth to a seriously ill or handicapped child. They all wanted a risk estimation in order to be reassured that they were going to have a healthy child. The existence of a screening programme was perceived as an indication of risk. In its present form, the information pamphlet of the Danish National Board of Health suggests a yes rather than a no regarding participation in prenatal screening. This is reprehensible, partly because the aim of the pamphlet was to strengthen the self-determination of pregnant women, and partly because the benefits of participation in the screening programme do not clearly outweigh the corresponding drawbacks for the individual pregnant woman.

  2. Dimensions, discourses and differences: trainees conceptualising health care leadership and followership.

    PubMed

    Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer

    2015-12-01

    As doctors in all specialties are expected to undertake leadership within health care organisations, leadership development has become an inherent part of medical education. Whereas the leadership literature within medical education remains mostly focused on individual, hierarchical leadership, contemporary theory posits leadership as a group process, which should be distributed across all levels of health care organisation. This gap between theory and practice indicates that there is a need to understand what leadership and followership mean to medical trainees working in today's interprofessional health care workplace. Epistemologically grounded in social constructionism, this research involved 19 individual and 11 group interviews with 65 UK medical trainees across all stages of training and a range of specialties. Semi-structured interviewing techniques were employed to capture medical trainees' conceptualisations of leadership and followership. Interviews were audiotaped, transcribed verbatim and analysed using thematic framework analysis to identify leadership and followership dimensions which were subsequently mapped onto leadership discourses found in the literature. Although diversity existed in terms of medical trainees' understandings of leadership and followership, unsophisticated conceptualisations focusing on individual behaviours, hierarchy and personality were commonplace in trainees' understandings. This indicated the dominance of an individualist discourse. Patterns in understandings across all stages of training and specialties, and whether definitions were solicited or unsolicited, illustrated that context heavily influenced trainees' conceptualisations of leadership and followership. Our findings suggest that UK trainees typically hold traditional understandings of leadership and followership, which are clearly influenced by the organisational structures in which they work. Although education may change these understandings to some extent, changes in leadership practices to reflect contemporary theory are unlikely to be sustained if leadership experiences in the workplace continue to be based on individualist models. © 2015 John Wiley & Sons Ltd.

  3. Bystanders to Bullying: Fourth-to Seventh-Grade Students' Perspectives on Their Reactions

    ERIC Educational Resources Information Center

    Forsberg, Camilla; Thornberg, Robert; Samuelsson, Marcus

    2014-01-01

    The aim with the present study was to investigate bystander actions in bullying situations as well as reasons behind these actions as they are articulated by Swedish students from fourth to seventh grade. Forty-three semi-structured individual interviews were conducted with students. Qualitative analysis of data was performed by methods from…

  4. EFL Teaching and Learning at a Vietnamese University: What Do Teachers Say?

    ERIC Educational Resources Information Center

    Nguyen, Hong Thi; Fehring, Heather; Warren, Wendy

    2015-01-01

    This paper reports part of a study that documents the factors affecting the efficacy of teaching and learning English as a Foreign Language (EFL) in Vietnamese higher education from the teachers' perspectives. Individual face-to-face semi-structured interviews were conducted with twelve EFL teachers at Ho Chi Minh City University of Technology…

  5. Ideas of and Attitudes towards Projects and Changing Practices: Voices of Four Teachers

    ERIC Educational Resources Information Center

    Shome, Saurav; Natarajan, Chitra

    2013-01-01

    The paper reports a study of the project practices of four Indian middle school teachers, elicited through semi-structured interviews of individual teachers. The teachers also responded to a proposal to modify four aspects of existing project practices, viz. subject integration, assessment, group work, and management of resources. The aspects were…

  6. The Utility of the Structured Interview of Reported Symptoms in a Sample of Individuals with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Weiss, Rebecca A.; Rosenfeld, Barry; Farkas, Melanie R.

    2011-01-01

    The challenges of accurate forensic assessment are aggravated when evaluatees have intellectual disabilities. Few studies have addressed the efficacy of forensic assessment in samples diagnosed with an intellectual disability, and those that have typically focus on measures of cognitive effort rather than on feigned psychiatric symptoms. This…

  7. Stroking the Net Whale: A Constructivist Grounded Theory of Self-Regulated Learning in Virtual Social Spaces

    ERIC Educational Resources Information Center

    Kasperiuniene, Judita; Zydziunaite, Vilma; Eriksson, Malin

    2017-01-01

    This qualitative study explored the self-regulated learning (SRL) of teachers and their students in virtual social spaces. The processes of SRL were analyzed from 24 semi-structured individual interviews with professors, instructors and their students from five Lithuanian universities. A core category stroking the net whale showed the process of…

  8. Teaching, an Alternative to Leisure: Ozark Case Studies of Mid-Life Retirees.

    ERIC Educational Resources Information Center

    Bell, David; Reed, Stan

    This document identifies characteristics and patterns of characteristics of those who have leisure as a mid-life option. A comparison was made between individuals electing to pursue leisure and those electing to enter teaching at this life stage. Results of structured interviews, statistical results, and an analysis of a life satisfaction scale…

  9. Stressful Life Events and Behavior Change: A Qualitative Examination of African American Women's Participation in a Weight Loss Program

    ERIC Educational Resources Information Center

    Cox, Tiffany L.; Zunker, Christie; Wingo, Brooks C.; Jefferson, Wendy K.; Ard, Jamy D.

    2011-01-01

    We qualitatively assessed how life stressors affected African American women's participation in a weight reduction program. A sample of 9 women, who completed a behavioral lifestyle intervention, participated in individual, structured, in-depth interviews. Life stressors, ranging from personal illness to changes in employment status, had varied…

  10. The Role of Developmental Relationships in the Transition to Entrepreneurship: A Qualitative Study and Agenda for Future Research

    ERIC Educational Resources Information Center

    Terjesen, Siri; Sullivan, Sherry E.

    2011-01-01

    Purpose: The purpose of this study is to examine the under-researched subject of the role of mentoring relationships within and outside of organizational boundaries as individuals make the career transition from being a corporate employee to becoming an entrepreneur. Design/methodology/approach: Using structured interviews, the authors collected…

  11. Personal Understanding of Assessment and the Link to Assessment Practice: The Perspectives of Higher Education Staff

    ERIC Educational Resources Information Center

    Reimann, Nicola; Sadler, Ian

    2017-01-01

    The study investigates how higher education staff understand assessment, and the relationship between these understandings and their assessment practices. Nine individuals attended a workshop that guided them through the creation of a concept map about assessment, which was subsequently discussed in one-to-one semi-structured interviews. We found…

  12. Exposing Whiteness in Higher Education: White Male College Students Minimizing Racism, Claiming Victimization, and Recreating White Supremacy

    ERIC Educational Resources Information Center

    Cabrera, Nolan León

    2014-01-01

    This research critically examines racial views and experiences of 12 white men in a single higher education institution via semi-structured interviews. Participants tended to utilize individualized definitions of racism and experience high levels of racial segregation in both their pre-college and college environments. This corresponded to…

  13. In Their Own Voices: Adolescent African American Males' Experiences of the Achievement Gap

    ERIC Educational Resources Information Center

    Moon, Natasha S.; Singh, Anneliese A.

    2015-01-01

    The authors use a phenomenological research tradition grounded in CRT tenets to describe the daily lived experiences that 12 male African American youth had in relation to the achievement gap. Researchers collected individual semi-structured interviews and focus group data related to the study phenomenon. There were five themes identified in…

  14. Argentinean Students' and Teachers' Conceptions of Day and Night: An Analysis in Relation to Astronomical Reference Systems

    ERIC Educational Resources Information Center

    Galperin, D.; Raviolo, A.

    2015-01-01

    This work analysed the evolution of day/night cycle conceptions held by students of different ages and teachers in the Patagonian region of Argentina. The research was based on drawings, written explanations and semi-structured individual interviews. The results showed that both teachers and students had significant comprehension problems. These…

  15. Factors Influencing Pre-Service Teachers' Perception of Teaching Games for Understanding: A Constructivist Perspective

    ERIC Educational Resources Information Center

    Wang, Lijuan; Ha, Amy S.

    2012-01-01

    This study aims to examine the factors influencing pre-service Physical Education (PE) teachers' perception of a specific constructivist approach--Teaching Games for Understanding (TGfU) in Hong Kong. By adopting a qualitative approach, 20 pre-service PE teachers were recruited for individual semi-structured interviews. Deductive data analysis was…

  16. What Barriers and Facilitators Do School Nurses Experience When Implementing an Obesity Intervention?

    ERIC Educational Resources Information Center

    Schroeder, Krista; Smaldone, Arlene

    2017-01-01

    A recent evaluation of a school nurse-led obesity intervention demonstrated a 5% implementation rate. The purpose of this study was to explore school nurses' perceived barriers to and facilitators of the intervention in order to understand reasons for the low implementation rate. Methods included semi-structured individual interviews with school…

  17. The Communication Experiences of Adult Deaf People within their Family during Childhood in Cyprus

    ERIC Educational Resources Information Center

    Hadjikakou, Kika; Nikolaraizi, Magda

    2008-01-01

    This study investigates the personal communication memories and experiences of adult deaf people during their childhoods in their homes. In order to obtain relevant information in depth semi-structured interviews were conducted with twenty four Cypriot deaf individuals between the ages of 19 to 54 years with different family and school…

  18. Responding to Racism and Racial Trauma in Doctoral Study: An Inventory for Coping and Mediating Relationships

    ERIC Educational Resources Information Center

    Truong, Kimberly A.; Museus, Samuel D.

    2012-01-01

    In this study, Kimberly A. Truong and Samuel D. Museus focus on understanding strategies doctoral students of color use to respond to racism. The authors conducted semi-structured individual interviews with twenty-six participants who self-reported experiencing racism and racial trauma during doctoral studies. Analysis of the data resulted in…

  19. New Insights into the Compulsion to Use Tobacco from an Adolescent Case-Series

    ERIC Educational Resources Information Center

    DiFranza, Joseph R.; Ursprung, W. W. Sanouri; Carson, Alisha

    2010-01-01

    Nicotine addiction is the most common preventable cause of premature death presenting during adolescence. No prior study has described the onset of this condition based on case histories. We used trained personnel to conduct individual semi-structured interviews to obtain case histories from 50 adolescent and young adult current and former…

  20. Asian Students' Perceptions of Group Work and Group Assignments in a New Zealand Tertiary Institution

    ERIC Educational Resources Information Center

    Li, Mingsheng; Campbell, Jacqui

    2008-01-01

    This study, conducted in 2005 in a New Zealand tertiary institution, examines Asian students' perceptions of the much-promulgated cooperative learning concepts in the form of group work and group assignments. Twenty-two Asian students participated in one-hour individual face-to-face semi-structured interviews. The study found that Asian students…

  1. The "Why" of Who We Are: Exploring the "Culture of Practice" of Ministry of Education, Special Education Occupational Therapists and Physiotherapists

    ERIC Educational Resources Information Center

    Simmons Carlsson, Carolyn; Hocking, Clare; Wright-St Clair, Valerie

    2007-01-01

    This qualitative study sought to describe the shared "culture of practice" of a group of Ministry of Education, Special Education occupational therapists and physiotherapists. Data from individual semi-structured interviews, enriched by insider observations, were thematically analysed within a cultural constructs framework. An ethos of…

  2. Writing Goes Back to School: Exploring the "Institutional Practice of Mystery" in a Graduate Education Program

    ERIC Educational Resources Information Center

    Stooke, Rosamund K.; Hibbert, Kathryn

    2017-01-01

    Drawing on a qualitative case study of writing practices and pedagogies in one Canadian graduate Education program, this article discusses roles and responsibilities of course instructors for teaching and supporting academic writing at the master's level. Data were collected through individual, semi-structured, in-depth interviews with 14 graduate…

  3. Exploring Children's Thinking with and about Numbers from a Resources-Based Approach

    ERIC Educational Resources Information Center

    Scheuer, Nora; Santamaria, Flavia Irene; Echenique, Mónica Haydée

    2017-01-01

    The aim of this study is to achieve a deeper understanding of the repertoire of cognitive resources children can display in the process of learning numbers. Forty-two children attending Age 4 Kindergarten Class or Year-One in Argentina were individually interviewed, based on a semi-structured script requiring them to represent definite and…

  4. The Educational, Social and Emotional Experiences of Students with Dyslexia: The Perspective of Postsecondary Education Students

    ERIC Educational Resources Information Center

    Doikou-Avlidou, Maro

    2015-01-01

    The present study aimed at exploring the educational, social and emotional experiences of individuals with dyslexia both during school and tertiary education. For this purpose, semi-structured interviews were conducted with ten Greek students with dyslexia who were enrolled in higher education institutions. The data analysis was carried out with…

  5. Educators' Roles in Developing Adolescent HIV/AIDS Knowledge and Attitudes within School Culture

    ERIC Educational Resources Information Center

    Chabilall, Jyothi

    2012-01-01

    This paper reports on part of a study with the aim of exploring how Muslim learners' knowledge and attitudes of HIV/AIDS were influenced by family and school culture. Findings from data collected during individual semi-structured interviews with the principals, Life Orientation educators, and school guidance counsellors are discussed. Reviewed…

  6. Comparative Reliability of Structured Versus Unstructured Interviews in the Admission Process of a Residency Program

    PubMed Central

    Blouin, Danielle; Day, Andrew G.; Pavlov, Andrey

    2011-01-01

    Background Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. Methods In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Results Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. Conclusions A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains established as essential to succeed in this residency program. PMID:23205201

  7. Comparative reliability of structured versus unstructured interviews in the admission process of a residency program.

    PubMed

    Blouin, Danielle; Day, Andrew G; Pavlov, Andrey

    2011-12-01

    Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains established as essential to succeed in this residency program.

  8. "Well, it's nobody's responsibility but my own." A qualitative study to explore views about the determinants of health and prevention of knee pain in older adults.

    PubMed

    Jinks, Clare; Ong, Bie Nio; O'Neill, Tracey

    2010-03-22

    Dahlgren and Whitehead's 'rainbow' outlines key determinants of health and has been widely adopted within public health policy and research. Public understanding regarding the determinants of health is, however, relatively unknown, particularly in relation to common chronic joint problems like knee pain. We aimed to explore individual attitudes to the prevention of knee pain, and assess how people make sense of their lives by using the rainbow model to explore social determinants of health. Twenty-eight semi-structured interviews were undertaken with older adults living in the community. The format of the interview enabled individuals to first tell their story, then the rainbow picture was used to further prompt discussion. Interviews were digitally recorded and transcripts were fully transcribed. Qualitative computer software package NVivo 2 was used to manage the data. Thematic analysis was undertaken. Individual responsibility for health was a dominant theme although the role of health and statutory services was also recognised. Barriers to uptake of prevention activities included cultural perceptions, attitudes towards work and perceived costs of prevention activities. Participants used the rainbow for locating their personal life within a wider social, economic and policy context. People view individual responsibility as key to maintaining health and draw upon the past, present and future expectations when considering social determinants of their health. The rainbow picture does have relevance at the individual level and can help to formulate more dynamic and contextualised approaches to the prevention of health conditions in community living adults.

  9. The impact of organisational and individual factors on team communication in surgery: a qualitative study.

    PubMed

    Gillespie, Brigid M; Chaboyer, Wendy; Longbottom, Paula; Wallis, Marianne

    2010-06-01

    Effective teamwork and communication is a crucial determinant of patient safety in the operating room. Communication failures are often underpinned by the inherent differences in professional practices across disciplines, and the ways in which they collaborate. Despite the overwhelming international support to improve team communication, progress has been slow. The aim of this paper is to extend understanding of the organisational and individual factors that influence teamwork in surgery. This qualitative study used a grounded theory approach to generate a theoretical model to explain the relations between organisational and individual factors that influence interdisciplinary communication in surgery. A purposive sample of 16 participants including surgeons, anaesthetists, and nurses who worked in an operating room of a large metropolitan hospital in south east Queensland, Australia, were selected. Participants were interviewed during 2008 using semi-structured individual and group interviews. All interviews were recorded and transcribed. Using a combination of inductive and deductive approaches, thematic analyses uncovered individual experiences in association with teamwork in surgery. Analysis generated three themes that identified and described causal patterns of interdisciplinary teamwork practices; interdisciplinary diversity in teams contributes to complex interpersonal relations, the pervasive influence of the organisation on team cohesion, and, education is the panacea to improving team communications. The development of shared mental models has the potential to improve teamwork in surgery, and thus enhance patient safety. This insight presents a critical first step towards the development teambuilding interventions in the operating room that would specifically address communication practices in surgery. (c) 2009 Elsevier Ltd. All rights reserved.

  10. Conducting preference assessments for youth with disorders of consciousness during rehabilitation.

    PubMed

    Amari, Adrianna; Suskauer, Stacy J; Paasch, Valerie; Grodin, Lauren K; Slomine, Beth S

    2017-08-01

    Care and rehabilitation for individuals with disorders of consciousness (DOC) can be challenging; the use of observational data collection, individualized treatment programs, and incorporation of preferred, personally meaningful and salient items may be helpful in addressing such challenges during assessment and intervention. In this article, we extend the predominantly adult literature on use of salient items to promote differential responding by describing our methodology to identify preferred items across sensory domains for application during inpatient rehabilitation with children with DOC. Details on the indirect and direct preference assessment procedures rooted in applied behavior analysis that we have tailored for this population are provided. We describe steps of the procedures, including structured caregiver interview, staff survey, item inclusion, in vivo single-item stimulus preference assessment, and treatment. Clinical case examples further illustrate implementation of our methodology, observed response topographies, individually identified preferred items, and their application for 3 children in a minimally conscious state. In addition, we introduce a new structured caregiver interview, the Preference Assessment for Youth with Disorders of Consciousness (PAYDOC), modeled on the Reinforcer Assessment for Individuals with Severe Disabilities (RAISD; Fisher, Piazza, Bowman, & Amari, 1996) and modified to be appropriate for future use as a clinical tool to enhance assessment of preferences with this pediatric brain injury population. This methodology can be used to identify highly idiosyncratic stimuli that can be incorporated in multiple ways throughout rehabilitation to optimize care for youth with DOC. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. Life Impact and Treatment Preferences of Individuals with Asthma and Chronic Obstructive Pulmonary Disease: Results from Qualitative Interviews and Focus Groups.

    PubMed

    Svedsater, Henrik; Roberts, June; Patel, Chloe; Macey, Jake; Hilton, Emma; Bradshaw, Lisa

    2017-06-01

    The impact of asthma and chronic obstructive pulmonary disease (COPD) on individuals' lives may be substantial, yet clinical practice often focuses only on symptoms. We aimed to better understand the perspective of asthma or COPD patients and to identify condition-related burden, life impact, priorities, unmet needs, and treatment goals. Individuals aged at least 18 years with asthma or COPD were identified by a recruitment panel via clinical referrals, support groups, consumer networks, and a patient database. Interviews were carried out individually (by telephone) or in focus groups (with no more than five participants per group). A semi-structured interview guide was used with prespecified topics, informed by a literature review, that were considered impactful in asthma or COPD (symptoms and daily-life impact, satisfaction with current treatment, important aspects of treatment, adherence, and ideal treatment). Overall, 72 people participated in focus groups/individual interviews (asthma n = 18/n = 21; COPD n = 15/n = 18). "Shortness of breath" was the most frequently reported symptom; however, participants discussed the life impact of their condition more than symptoms alone. Reported physical impacts included the inability to sleep and socialize, while emotional impacts included "embarrassment, stigma, and/or self-consciousness", "fear and/or panic", and "sadness, anxiety, and/or depression". Coping mechanisms for normal activities included continuing at reduced pace and avoidance. Treatment preferences centered on resolving impacts; improved sleep, "speed of action", and "length of relief" were the most frequently reported ideal treatment factors. Patients with asthma or COPD experience substantial quality of life limitations and tend to focus on these in their expressions of concern, rather than symptoms per se. Life impacts of these conditions may have implications beyond those commonly appreciated in routine practice; these considerations will be applied to a future discrete choice experiment survey. GSK funded study (H0-15-15502/204821).

  12. Acceptability, Language, and Structure of Text Message-Based Behavioral Interventions for High-Risk Adolescent Females: A Qualitative Study

    PubMed Central

    Ranney, Megan L.; Choo, Esther K.; Cunningham, Rebecca M.; Spirito, Anthony; Thorsen, Margaret; Mello, Michael J.; Morrow, Kathleen

    2014-01-01

    Purpose To elucidate key elements surrounding acceptability/feasibility, language, and structure of a text message-based preventive intervention for high-risk adolescent females. Methods We recruited high-risk 13- to 17-year-old females screening positive for past-year peer violence and depressive symptoms, during emergency department visits for any chief complaint. Participants completed semistructured interviews exploring preferences around text message preventive interventions. Interviews were conducted by trained interviewers, audio-recorded, and transcribed verbatim. A coding structure was iteratively developed using thematic and content analysis. Each transcript was double coded. NVivo 10 was used to facilitate analysis. Results Saturation was reached after 20 interviews (mean age 15.4; 55% white; 40% Hispanic; 85% with cell phone access). (1) Acceptability/feasibility themes: A text-message intervention was felt to support and enhance existing coping strategies. Participants had a few concerns about privacy and cost. Peer endorsement may increase uptake. (2) Language themes: Messages should be simple and positive. Tone should be conversational but not slang filled. (3) Structural themes: Messages may be automated but must be individually tailored on a daily basis. Both predetermined (automatic) and as-needed messages are requested. Dose and timing of content should be varied according to participants’ needs. Multimedia may be helpful but is not necessary. Conclusions High-risk adolescent females seeking emergency department care are enthusiastic about a text message-based preventive intervention. Incorporating thematic results on language and structure can inform development of future text messaging interventions for adolescent girls. Concerns about cost and privacy may be able to be addressed through the process of recruitment and introduction to the intervention. PMID:24559973

  13. Innovation in values based public health nursing student selection: A qualitative evaluation of candidate and selection panel member perspectives.

    PubMed

    McGraw, Caroline; Abbott, Stephen; Brook, Judy

    2018-02-19

    Values based recruitment emerges from the premise that a high degree of value congruence, or the extent to which an individual's values are similar to those of the health organization in which they work, leads to organizational effectiveness. The aim of this evaluation was to explore how candidates and selection panel members experienced and perceived innovative methods of values based public health nursing student selection. The evaluation was framed by a qualitative exploratory design involving semi-structured interviews and a group exercise. Data were thematically analyzed. Eight semi-structured interviews were conducted with selection panel members. Twenty-two successful candidates took part in a group exercise. The use of photo elicitation interviews and situational judgment questions in the context of selection to a university-run public health nursing educational program was explored. While candidates were ambivalent about the use of photo elicitation interviews, with some misunderstanding the task, selection panel members saw the benefits for improving candidate expression and reducing gaming and deception. Situational interview questions were endorsed by candidates and selection panel members due to their fidelity to real-life problems and the ability of panel members to discern value congruence from candidates' responses. Both techniques offered innovative solutions to candidate selection for entry to the public health nursing education program. © 2018 Wiley Periodicals, Inc.

  14. Systematic methodological review: developing a framework for a qualitative semi-structured interview guide.

    PubMed

    Kallio, Hanna; Pietilä, Anna-Maija; Johnson, Martin; Kangasniemi, Mari

    2016-12-01

    To produce a framework for the development of a qualitative semi-structured interview guide. Rigorous data collection procedures fundamentally influence the results of studies. The semi-structured interview is a common data collection method, but methodological research on the development of a semi-structured interview guide is sparse. Systematic methodological review. We searched PubMed, CINAHL, Scopus and Web of Science for methodological papers on semi-structured interview guides from October 2004-September 2014. Having examined 2,703 titles and abstracts and 21 full texts, we finally selected 10 papers. We analysed the data using the qualitative content analysis method. Our analysis resulted in new synthesized knowledge on the development of a semi-structured interview guide, including five phases: (1) identifying the prerequisites for using semi-structured interviews; (2) retrieving and using previous knowledge; (3) formulating the preliminary semi-structured interview guide; (4) pilot testing the guide; and (5) presenting the complete semi-structured interview guide. Rigorous development of a qualitative semi-structured interview guide contributes to the objectivity and trustworthiness of studies and makes the results more plausible. Researchers should consider using this five-step process to develop a semi-structured interview guide and justify the decisions made during it. © 2016 John Wiley & Sons Ltd.

  15. The ‘empty choice’: A sociological examination of choosing medical research participation in resource-limited Sub-Saharan Africa

    PubMed Central

    Kingori, Patricia

    2015-01-01

    This article explores the views of frontline research staff in different Sub-Saharan African contexts on the notion of choice in biomedical research. It argues that the current emphasis on individual choice, in the conduct of biomedical research, ignores significant structural and contextual factors in resource-limited settings. These factors severely constrain individual options and often make biomedical research enrolment the most amenable route to healthcare for the world’s poorest. From the position of frontline research staff, local contextual factors and structural issues narrowly frame the parameters within which many prospective participants are asked to choose, to such an extent that individuals are effectively presented with an ‘empty choice’. The article draws on ethnographic and interview data and insights gained through graphic elucidation techniques. It demonstrates that for frontline research staff, macro-level structural factors and their bearing on everyday realities shape what choice in biomedical research participation means in practice. PMID:27182072

  16. Individual interviews and focus groups in patients with rheumatoid arthritis: a comparison of two qualitative methods.

    PubMed

    Coenen, Michaela; Stamm, Tanja A; Stucki, Gerold; Cieza, Alarcos

    2012-03-01

    To compare two different approaches to performing focus groups and individual interviews, an open approach, and an approach based on the International Classification of Functioning, Disability and Health (ICF). Patients with rheumatoid arthritis attended focus groups (n = 49) and individual interviews (n = 21). Time, number of concepts, ICF categories identified, and sample size for reaching saturation of data were compared. Descriptive statistics, Chi-square tests, and independent t tests were performed. With an overall time of 183 h, focus groups were more time consuming than individual interviews (t = 9.782; P < 0.001). In the open approach, 188 categories in the focus groups and 102 categories in the interviews were identified compared to the 231 and 110 respective categories identified in the ICF-based approach. Saturation of data was reached after performing five focus groups and nine individual interviews in the open approach and five focus groups and 12 individual interviews in the ICF-based approach. The method chosen should depend on the objective of the study, issues related to the health condition, and the study's participants. We recommend performing focus groups if the objective of the study is to comprehensively explore the patient perspective.

  17. Therapeutic horseback riding for ACT patients with schizophrenia.

    PubMed

    Corring, Deborah; Lundberg, Erica; Rudnick, Abraham

    2013-02-01

    One form of psychiatric leisure rehabilitation which has only recently been explored for individuals with schizophrenia is Therapeutic Horseback Riding (THBR). This study is the first to examine THBR for Assertive Community Treatment (ACT) patients with schizophrenia. A sample of 6 ACT patients with schizophrenia or schizoaffective disorder who reside in the community and 6 mental health care staff participated in 10 weeks of weekly horseback riding sessions with an experienced THBR instructor. Participating patients, staff and the THBR instructor were qualitatively interviewed at the start, during and at the end of the THBR program and these semi-structured interviews were analyzed for recurrent themes. We found that THBR benefitted this group of patients. In spite of our study's limitations, such as its exploratory nature and the small sample size, it demonstrates that THBR has promise and should be further developed and studied for individuals with schizophrenia.

  18. "The solution needs to be complex." Obese adults' attitudes about the effectiveness of individual and population based interventions for obesity

    PubMed Central

    2010-01-01

    Background Previous studies of public perceptions of obesity interventions have been quantitative and based on general population surveys. This study aims to explore the opinions and attitudes of obese individuals towards population and individual interventions for obesity in Australia. Methods Qualitative methods using in-depth semi-structured telephone interviews with a community sample of obese adults (Body Mass Index ≥30). Theoretical, purposive and strategic recruitment techniques were used to ensure a broad sample of obese individuals with different types of experiences with their obesity. Participants were asked about their attitudes towards three population based interventions (regulation, media campaigns, and public health initiatives) and three individual interventions (tailored fitness programs, commercial dieting, and gastric banding surgery), and the effectiveness of these interventions. Results One hundred and forty two individuals (19-75 years) were interviewed. Participants strongly supported non-commercial interventions that were focused on encouraging individuals to make healthy lifestyle changes (regulation, physical activity programs, and public health initiatives). There was less support for interventions perceived to be invasive or high risk (gastric band surgery), stigmatising (media campaigns), or commercially motivated and promoting weight loss techniques (commercial diets and gastric banding surgery). Conclusion Obese adults support non-commercial, non-stigmatising interventions which are designed to improve lifestyles, rather than promote weight loss. PMID:20633250

  19. Enhancing person-centred communication in NICU: a comparative thematic analysis.

    PubMed

    Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

    2015-11-01

    Aims of this article were (a) to explore how parents of premature infants experience guided family-centred care (GFCC), and (b) to compare how parents receiving GFCC versus standard care (SC) describe nurse-parent communication in the neonatal intensive care unit. Family-centred care (FCC) is acknowledged as fundamental to supporting parents of premature infants, and communication is central to this practice. Accordingly, nurses need good communication skills. GFCC is an intervention developed to improve nurse-parent communication in the neonatal intensive care unit. This intervention helps nurses to realize person-centred communication as an approach to optimize contemporary practice. Our qualitative study had a descriptive and comparative design using semi-structured interviews to explore the parent's experience of GFCC. We conducted 10 dyad interviews with parents (n = 20) and two individual interviews with mothers of premature infants (n = 2). Parents in the intervention group versus SC group were 13 versus 9. Thematic analysis was applied. GFCC was generally experienced as supportive. Three interrelated themes were identified that illustrated how the intervention helped parents cope as persons, parents and couples: (a) discovering and expressing emotions, (b) reaching a deeper level of communication, and (c) obtaining mutual understanding. In contrast, SC communication was more superficial and less structured. Factors such as inaccessibility of nurses, inability to ask for assistance and parent popularity impaired successful communication. Our study suggested that compared to SC, GFCC provided structured delivery of supportive communication between nurses and parents of premature infants. The intervention promoted the discovery of the parents' individual preferences and concerns, which enabled more focused communication, and set the stage for better nurse-parent and parent-parent understanding. We recommend GFCC as a method to improve communication in the neonatal intensive care unit. © 2013 British Association of Critical Care Nurses.

  20. Living with primary ciliary dyskinesia: a prospective qualitative study of knowledge sharing, symptom concealment, embarrassment, mistrust, and stigma

    PubMed Central

    Whalley, Simon; McManus, IC

    2006-01-01

    Background Primary ciliary dyskinesia (PCD) is a chronic respiratory disease for which there is little psycho-social research and no qualitative studies of individuals living with the condition. A questionnaire-based survey in 2003 found evidence of stigmatisation in some individuals with PCD. Although the questionnaire had face and construct validity, stigmatisation was not cross-validated against interviews. The present study had the twin aims of carrying out a qualitative study of the adult patients living with PCD, and using a structured design to validate the questionnaire measure of stigma. Methods Interviews were carried out with six pairs of individuals with PCD, matched for sex, situs, and age, one with a high stigma score in 2003 and the other with a low stigma score. Depth-qualitative interviews were conducted by one author to explore themes surrounding the psycho-social impact of PCD using a grounded theory analysis. The interviewer was blind to the stigma scores of participants, and after the qualitative analysis was completed, the interviewer made an assessment of which member of each pair seemed the more stigmatised, after which the code was broken. Results Interviews revealed a number of themes, including other people's knowledge of PCD, the sharing of knowledge about PCD, the concealment of symptoms of PCD, embarrassment at symptoms, changes of behaviour in response to PCD, mistrust of medical care, in particular in relation to problems in diagnosis, a mistrust of general practitioners who were seen as poorly informed, and the importance of expert care at tertiary referral centres. Although stigmatisation as such was rarely mentioned directly by respondents, when the interviewer's judgement on level of stigmatisation was correlated with stigma scores from 2003, it was found that the more stigmatised member had been correctly identified in all six pairs (p = .016). Conclusion Our results suggest that some people with PCD feel isolated through mistrust in medicine, and lack of knowledge surrounding PCD. Many responses to PCD can be explained in terms of stigmatisation, and in particular felt stigma. The correlation between questionnaire used several years previously, and the interviewer's judgements of stigmatisation suggest that the stigma questionnaire had both predictive validity and long-term stability. As in other chronic conditions, stigmatisation occurs only in some individuals with PCD, and the present study explores the basis of stigmatisation, and validate the questionnaire as a measure of difference in stigma. PMID:17040569

  1. Reshaping an enduring sense of self: the process of recovery from a first episode of schizophrenia.

    PubMed

    Romano, Donna M; McCay, Elizabeth; Goering, Paula; Boydell, Katherine; Zipursky, Robert

    2010-08-01

    Although advances in the treatment of schizophrenia have been made, little is known about the process of recovery from first episode of schizophrenia (FES). To date, the study of recovery in the field of mental health has focused on long-term mental illness. This qualitative study addresses ways in which individuals with FES describe their process of recovery and how identified individuals (e.g. family members) describe their perceptions of and roles in the participant's process of recovery. Charmaz's constructivist grounded theory methodology was used to interview 10 young adults twice who self-identified as recovering from FES. In addition, 10 individuals were identified who had influenced their recovery and were interviewed once, for a total of 30 interviews. Data collection sources included in-depth semi-structured interviews. Data analysis methods were consistent with Charmaz's methodology and included coding, and constant comparison of data. The results provide a substantive theory of the process of recovery from FES that is comprised of the following phases: 'Who they were prior to the illness', 'Lives interrupted: Encountering the illness', 'Engaging in services and supports', 'Re-engaging in life', 'Envisioning the future'; and the core category, 'Re-shaping an enduring sense of self', that occurred throughout all phases. A prominent feature of this model is that participants' enduring sense of self were reshaped rather than reconstructed throughout their recovery. This model of recovery from FES is unique, and as such, provides implications for clinical care, research and policy development for these young adults and their families.

  2. Getting it "right": how collaborative relationships between people with disabilities and professionals can lead to the acquisition of needed assistive technology.

    PubMed

    Johnston, Patricia; Currie, Leanne M; Drynan, Donna; Stainton, Tim; Jongbloed, Lyn

    2014-09-01

    The purpose of this study was to examine the impact of a consumer-led equipment and device program [Equipment and Assistive Technology Initiative (EATI) in British Columbia, Canada] from the perspective of program participants. The importance of collaborative assessments for obtaining the right assistive technology (AT) for meeting an individual's needs is discussed in light of the program's participant-centered "Participation Model", or philosophy by which the program is structured. A cross-sectional survey with participants and semi-structured interviews were conducted with participants (≥ 18 years) who held a range of disabilities. The survey asked participants to rank their AT and to identify the method by which they obtained the technology [by self, prescribed by a health professional or collaborative (self and professional)]. Interviews addressed participants' opinions about obtaining and using AT. In total, 357 people responded to the survey (17% response rate) and 16 people participated in the interviews. The highest ranking AT was assigned to devices assessed via a collaborative method (self = 31%, practitioner = 26%, collaborative = 43%; χ(2) (16,180) = 39.604, p < 0.001). Shared decision-making between health professionals and people with disabilities within the assessment process for assistive technology leads to what participants perceive as the right AT. Collaborative decision-making can lead to the selection of assistive technology that is considered needed and right for the individual. Person-centered philosophy associated with assistive technology assessment is contributing to attaining "the right" AT.

  3. Productivity, vitality and utility in a group of healthy professionally active individuals with nocturia.

    PubMed

    Kobelt, G; Borgström, F; Mattiasson, A

    2003-02-01

    To assess the effect of nocturia on productivity, vitality and utility in a selected group of professionally active individuals with nocturia, compared with matched controls, and investigate the effect of symptom severity, to test the hypothesis that lack of sleep caused by frequent sleep interruptions could reduce an individuals' daytime energy and activity levels. Subjects (203) were recruited in Sweden through advertisements, and their suitability for the study assessed in a structured interview. Controls (80) matched for age and gender were randomly selected from a market research panel and given the same interview. Both groups completed a productivity questionnaire, a generic quality-of-life questionnaire with a specific domain for vitality and a utility instrument. The study group with nocturia had a significantly lower level of vitality and utility, and greater impairment of work and activity, than the control group. Women were more affected than men. Symptom severity correlated with all three measures. In an otherwise healthy and professionally active group of individuals, waking at night to void significantly diminishes their overall well-being, vitality and productivity, leading to a significant level of indirect and intangible costs.

  4. How a Stressed Local Public System Copes With People in Psychiatric Crisis

    PubMed Central

    Wells, Rebecca; La, Elizabeth Holdsworth; Morrissey, Joseph; Hall, Marissa; Lich, Kristen Hassmiller; Blouin, Rachel

    2012-01-01

    In order to bolster the public mental health safety net, we must first understand how these systems function on a day-to-day basis. This study explored how individual attributes and organizational interdependencies within one predominantly urban US county affected responses to individuals’ needs during psychiatric crises. We interviewed clinicians and managers within the crisis response network about people at immediate risk of psychiatric hospitalization, what had happened to them during their crises, and factors affecting services provided (N = 94 individuals and 9 agencies). Social network diagrams depicted patterns of referrals between agencies. Iterative coding of interview transcripts was used to contextualize the social network findings. Often, agencies saw crises through to resolution. However, providers also limited the types of people they served, leaving many people in crisis in limbo. This study illustrates how attributes of individuals with mental illness, service providers and their interactions, and state and federal policies intersect to shape the trajectories of individuals during psychiatric crises. Understanding both the structures of current local systems and their contexts may support continued evolution toward a more humane and robust safety net for some of our society’s most vulnerable members. PMID:23065371

  5. [Personality structure and subjective illness concepts of neurotically depressed patients. Qualitative comparison of 11 individual cases analyses of initial psychotherapy interviews].

    PubMed

    Frommer, J; Jüttemann-Lembke, A; Stratkötter, A; Tress, W

    1995-07-01

    Verbatim transcripts of 11 psychotherapeutic interviews with patients suffering from depressive neurosis were examined, focusing on subjective theories of illness, biography, and descriptions of the patient's own personality. The results of our qualitative content analysis allow reconstruction of some characteristic features of these patients, like over identification with social roles and norms (1), feeling of being dependent and injured by another person (2), problems of self-esteem (3), shyness (4), unfulfilled wishes to be loved and accepted (5). These findings are discussed in the context of psychopathological and psychoanalytic concepts of depression.

  6. Structured Interviews: Developing Interviewing Skills in Human Resource Management Courses

    ERIC Educational Resources Information Center

    Doll, Jessica L.

    2018-01-01

    Structured interviews are widely used in the employment process; however, students often have little experience asking and responding to structured interview questions. In a format similar to "speed dating," this exercise actively engages students in the interview process. Students pair off to gain experience as an interviewer by asking…

  7. Relationships between In-Service Teacher Achievement Motivation and Use of Educational Technology: Case Study with Latvian and Estonian Teachers

    ERIC Educational Resources Information Center

    Karaseva, Agnese; Pruulmann-Vengerfeldt, Pille; Siibak, Andra

    2018-01-01

    This study explored the relationship of in-service teacher achievement goal orientation and practices of educational technology use. Semi-structured individual interviews with secondary school teachers in Latvia (N = 16) and Estonia (N = 10) revealed that the use of information and communication technology (ICT) in pedagogical work and the ways in…

  8. Physical Education Teacher Educators' Views Regarding the Purpose(s) of School Physical Education

    ERIC Educational Resources Information Center

    McEvoy, Eileen; Heikinaro-Johansson, Pilvikki; MacPhail, Ann

    2017-01-01

    The aim of this paper was to gain an understanding of the views of a group of physical education teacher educators on the purpose(s) of school physical education and whether, how and why these views have changed over time. Semi-structured individual interviews were carried out with thirteen physical education teacher educators; a fourteenth…

  9. "Students Getting Pregnant Are Not Gonna Go Nowhere": Manifestations of Stigma in Adolescent Mothers' Educational Environment

    ERIC Educational Resources Information Center

    Bermea, Autumn M.; Toews, Michelle L.; Wood, Leila G.

    2018-01-01

    The purpose of this study was to examine adolescent mothers' perceptions of how individuals within the schools viewed them and how those views shaped their educational experiences. The sample consisted of 83 primarily Hispanic adolescent mothers who participated in one of 19 semi-structured focus group interviews during the 2014-2015 school year.…

  10. The Relationship between Patron-Dependence, Communication and Development: A Look into Social Integration and Socio-Economic Control.

    ERIC Educational Resources Information Center

    Quesada, Gustavo M.

    Personal interviews were conducted in July, 1967, with 315 farm operators in rural Brazil where the local extension service had been in operation for more than four years. Patron-dependence (PD) was described as the subscription to a value system, according to the individual's position in the status structure, which produces dependency at…

  11. Muslim Women in Graduate Studies: Some Insights into the Accessibility of Higher Education for Minority Women Students

    ERIC Educational Resources Information Center

    Oplatka, Izhar; Lapidot, Orit

    2012-01-01

    Based on semi-structured interviews with 11 Muslim women graduate students in Israel, the current study provides insight into the determinants enabling this group of women in the Arab sector to apply for a second degree and succeed. Among these determinants are the family, the high school, the individual's personal drive for learning, the…

  12. Negotiating Professional Identities in Higher Education in Kenya: Dilemmas and Priorities of Faculty

    ERIC Educational Resources Information Center

    Arasa, Josephine Nyaboke; Calvert, Mike

    2013-01-01

    This research builds on work carried out in England looking at how faculty negotiate their personal and professional identities. It focuses on a sample of full-time faculty in a private secular university in Kenya. Weekly time logs with follow-up individual semi-structured interviews were used as a basis for an examination on how faculty spend…

  13. The Reliability and Validity of the Panic Disorder Self-Report: A New Diagnostic Screening Measure of Panic Disorder

    ERIC Educational Resources Information Center

    Newman, Michelle G.; Holmes, Marilyn; Zuellig, Andrea R.; Kachin, Kevin E.; Behar, Evelyn

    2006-01-01

    This study examined the Panic Disorder Self-Report (PDSR), a new self-report diagnostic measure of panic disorder based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994). PDSR diagnoses were compared with structured interview diagnoses of individuals with generalized anxiety…

  14. Taking Control of Their Lives? A Comparison of the Experiences of Unemployed Young Adults (18-25) in England and the New Germany.

    ERIC Educational Resources Information Center

    Behrens, Martina; Evans, Karen

    2002-01-01

    A survey and group interviews with unemployed young people aged 18-25 in Derby (England), Hannover (western Germany), and Leipzig (eastern Germany) examined the relative importance to their life and work transitions of individual agency and structural factors. Two national job training "schemes" for unemployed youth are compared: the…

  15. Implementation of targeted medication adherence interventions within a community chain pharmacy practice: The Pennsylvania Project.

    PubMed

    Bacci, Jennifer L; McGrath, Stephanie Harriman; Pringle, Janice L; Maguire, Michelle A; McGivney, Melissa Somma

    2014-01-01

    To identify facilitators and barriers to implementing targeted medication adherence interventions in community chain pharmacies, and describe adaptations of the targeted intervention and organizational structure within each individual pharmacy practice. Qualitative study. Central and western Pennsylvania from February to April 2012. Rite Aid pharmacists staffed at the 118 Pennsylvania Project intervention sites. Qualitative analysis of pharmacists' perceptions of facilitators and barriers experienced, targeted intervention and organizational structure adaptations implemented, and training and preparation prior to implementation. A total of 15 key informant interviews were conducted from February to April 2012. Ten pharmacists from "early adopter" practices and five pharmacists from "traditionalist" practices were interviewed. Five themes emerged regarding the implementation of targeted interventions, including all pharmacists' need to understand the relationship of patient care programs to their corporation's vision; providing individualized, continual support and mentoring to pharmacists; anticipating barriers before implementation of patient care programs; encouraging active patient engagement; and establishing best practices regarding implementation of patient care services. This qualitative analysis revealed that there are a series of key steps that can be taken before the execution of targeted interventions that may promote successful implementation of medication therapy management in community chain pharmacies.

  16. The embodiment of emotion: language use during the feeling of social emotions predicts cortical somatosensory activity.

    PubMed

    Saxbe, Darby E; Yang, Xiao-Fei; Borofsky, Larissa A; Immordino-Yang, Mary Helen

    2013-10-01

    Complex social emotions involve both abstract cognitions and bodily sensations, and individuals may differ on their relative reliance on these. We hypothesized that individuals' descriptions of their feelings during a semi-structured emotion induction interview would reveal two distinct psychological styles-a more abstract, cognitive style and a more body-based, affective style-and that these would be associated with somatosensory neural activity. We examined 28 participants' open-ended verbal responses to admiration- and compassion-provoking narratives in an interview and BOLD activity to the same narratives during subsequent functional magnetic resonance imaging scanning. Consistent with hypotheses, individuals' affective and cognitive word use were stable across emotion conditions, negatively correlated and unrelated to reported emotion strength in the scanner. Greater use of affective relative to cognitive words predicted more activation in SI, SII, middle anterior cingulate cortex and insula during emotion trials. The results suggest that individuals' verbal descriptions of their feelings reflect differential recruitment of neural regions supporting physical body awareness. Although somatosensation has long been recognized as an important component of emotion processing, these results offer 'proof of concept' that individual differences in open-ended speech reflect different processing styles at the neurobiological level. This study also demonstrates SI involvement during social emotional experience.

  17. Amobarbital treatment of multiple personality. Use of structured video tape interviews as a basis for intensive psychotherapy.

    PubMed

    Hall, R C; LeCann, A F; Schoolar, J C

    1978-09-01

    The case of a 30-year-old woman with five distinct personalities is presented. The patient was treated, using a system of structured video taped sodium amobarbital interviews, in which areas to be explored were developed in psychotherapy. Tapes were played for the patient after each session. The taped material was used as the basis for psychotherapeutic investigation. The patient evidenced many of the features previously reported in cases of multiple personality, specifically: being the product of an unwanted pregnancy in a repressively rigid family; emotional distancing by one parent; strong sibling rivalry with an adopted sib; family history of mental illness; a traumatic first sexual experience (rape); a marriage to a maladjusted individual in an attempt to escape the parental home; a high internalized standard of performance and an inability to display anger or negative feelings toward the parents. In the course of treatment, the patient's personalties fused and she was able to accept each component as part of herself. No further fragmentation has occurred during the year following discharge. The therapy technique minimized dependency, and the possiblity of addiction to amobarbital interviews permitted more active patient therapy involvement, and set clear-cut goals and expectations for improvement before further amobarbital interviews could be conducted.

  18. A Longitudinal Study of Predictors of Housing Stability, Housing Quality, and Mental Health Functioning Among Single Homeless Individuals Staying in Emergency Shelters.

    PubMed

    Aubry, Tim; Duhoux, Arnaud; Klodawsky, Fran; Ecker, John; Hay, Elizabeth

    2016-09-01

    The current study examined risk and resilience factors at multiple levels that affect homeless individuals' ability to exit homelessness and achieve housing stability. It also examined the relationship between housing status, housing quality and mental health functioning. The methodology is a longitudinal study of single homeless individuals staying in emergency shelters in a medium-sized Canadian city who were followed for a 2 year period. Data were collected from participants at a baseline interview when they were homeless and at a 2-year follow-up. There were 329 participants interviewed at baseline and 197 (59.9%) participants interviewed at follow-up. Results from a structural equation modelling analysis found that having interpersonal and community resources were predictive of achieving housing stability. Specifically, having a larger social support network, access to subsidized housing, and greater income was related to achieving housing stability. On the other hand, having a substance use problem was a risk factor associated with a failure to achieving housing stability. Being female, feeling personally empowered, having housing that is perceived of being of higher quality were directly predictive of mental health functioning at follow-up. Findings are discussed in the context of previous research and their policy implications. © Society for Community Research and Action 2016.

  19. Dementia and well-being: A conceptual framework based on Tom Kitwood's model of needs.

    PubMed

    Kaufmann, Elke G; Engel, Sabine A

    2016-07-01

    The topic of well-being is becoming increasingly significant as a key outcome measure in dementia care. Previous work on personhood of individuals with dementia suggests that their subjective well-being can be described in terms of comfort, inclusion, identity, occupation and attachment The study aimed to examine Tom Kitwood's model of psychological needs and well-being in dementia based on the self-report of individuals with moderate or severe dementia and to differentiate and elaborate this model in the light of the empirical qualitative data. Nineteen inhabitants of a special long-term care unit were interviewed using a semi-structured interview. Data were analysed using content analysis. Thirty components within Kitwood's model have been identified. A conceptual framework of subjective well-being in dementia was developed based on a theoretical background. The study was able to find indications that Kitwood's model has empirical relevance. Nevertheless, it requires to be extended by the domain agency. Furthermore, the study suggests that individuals with dementia are important informants of their subjective well-being. © The Author(s) 2014.

  20. Validation of a community-based survey assessing non-obstetric surgical conditions in Burera District, Rwanda.

    PubMed

    Linden, Allison F; Maine, Rebecca; Hedt-Gauthier, Bethany L; Kamanzi, Emmanual; Mody, Gita; Ntakiyiruta, Georges; Kansayisa, Grace; Ntaganda, Edmond; Niyonkuru, Francine; Mubiligi, Joel; Mpunga, Tharcisse; Meara, John G; Riviello, Robert

    2015-04-27

    Community-based surveillance methods to monitor epidemiological progress in surgery have not yet been employed for surgical capacity building. The aim of this study was to create and assess the validity of a questionnaire that collected data for untreated surgically correctable diseases throughout Burera District, northern Rwanda, to accurately plan for surgical services. A structured interview to assess for the presence or absence of ten index surgically treatable conditions (breast mass, cleft lip/palate, club foot, hernia or hydrocele [adult and paediatric]), hydrocephalus, hypospadias, injuries or wounds, neck mass, undescended testes, and vaginal fistula) was created. The interview was built based on previously validated questionnaires, forward and back translated into the local language and underwent focus group augmentation and pilot testing. In March and May, 2012, data collectors conducted the structured interviews with a household representative in 30 villages throughout Burera District, selected using a two-stage cluster sampling design. Rwandan physicians revisited the surveyed households to perform physical examinations on all household members, used as the gold standard to validate the structured interview. Ethical approval was obtained from Boston Children's Hospital (Boston, MA, USA) and the Rwandan National Ethics Committee (Kigali, Rwanda). Informed consent was obtained from all households. 2990 individuals were surveyed, a 97% response rate. 2094 (70%) individuals were available for physical examination. The calculated overall sensitivity of the structured interview tool was 44·5% (95% CI 38·9-50·2) and the specificity was 97·7% (96·9-98·3%; appendix). The positive predictive value was 70% (95% CI 60·5-73·5), whereas the negative predictive value was 91·3% (90·0-92·5). The conditions with the highest sensitivity and specificity, respectively, were hydrocephalus (100% and 100%), clubfoot (100% and 99·8%), injuries or wounds (54·7% and 98·9%), and hypospadias (50% and 100%). Injuries or wounds and hernias or hydroceles were the conditions most frequently identified on examination that were not reported during the interview (appendix). To the best of our knowledge, this study provides the first attempt to validate a community-based surgical surveillance tool. The finding of low sensitivity limits the use of the tool, which will require further revision, and calls into question previously published unvalidated community surgical survey data. To improve validation of community-based surveys, community education efforts on common surgically treatable conditions are needed in conjunction with increased access to surgical care. Accurate community-based surveys are crucial to integrated health system planning that includes surgical care as a core component. The Harvard Sheldon Traveling Fellowship. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Identification of Anxiety Sensitivity Classes and Clinical Cut-Scores in a Sample of Adult Smokers: Results from a Factor Mixture Model

    PubMed Central

    Allan, Nicholas P.; Raines, Amanda M.; Capron, Daniel W.; Norr, Aaron M.; Zvolensky, Michael J.; Schmidt, Norman B.

    2014-01-01

    Anxiety sensitivity (AS), a multidimensional construct, has been implicated in the development and maintenance of anxiety and related disorders. Recent evidence suggests that AS is a dimensional-categorical construct within individuals. Factor mixture modeling was conducted in a sample of 579 adult smokers (M age = 36.87 years, SD = 13.47) to examine the underlying structure. Participants completed the Anxiety Sensitivity Index-3 and were also given a Structured Clinical Interview for DSM-IV-TR. Three classes of individuals emerged, a high AS (5.2% of the sample), a moderate AS (19.0%), and a normative AS class (75.8%). A cut-score of 23 to identify high AS individuals, and a cut-score of 17 to identify moderate-to-high AS individuals were supported in this study. In addition, the odds of having a concurrent anxiety disorder (controlling for other Axis I disorders) were the highest in the high AS class and the lowest in the normative AS class. PMID:25128664

  2. Barriers and facilitators of help-seeking among unemployed persons with mental health problems: a qualitative study.

    PubMed

    Staiger, Tobias; Waldmann, Tamara; Rüsch, Nicolas; Krumm, Silvia

    2017-01-17

    Unemployed people with mental health problems often do not use mental health services and therefore do not benefit from available therapies. As unemployed individuals outside the healthcare system are a hard-to-reach group, barriers to and facilitators of mental health service use are poorly understood. The purpose of this study was to identify barriers to and facilitators of help-seeking and service use based on experiences of unemployed people with mental health problems. Fifteen qualitative semi-structured individual interviews were conducted with unemployed persons who reported mental health problems. Interview topics included individual experience with help-seeking and mental health service use with a focus on barriers and facilitators. Transcripts were analysed using qualitative content analysis and major themes were identified. Participants reported being treated as "different" within their social environment as well as by health care professionals because of their mental health problems, which resulted in a lack of self-esteem and avoidance of help-seeking. Interviewees associated negative attributes with help-seeking such as helplessness and weakness. They equated psychiatric medication with illegal drugs and worried about the risk of addiction. However, social support and a desire for change on the other hand increased the motivation to search for help. Employment agency staff were mostly perceived as supportive by individuals seeking mental health services. Unemployed individuals with mental health problems faced barriers and facilitators when seeking help on three different levels: (1) mental health literacy; (2) stigma and discrimination; and (3) structures and conditions of health care. Awareness and attitudes of health care professionals concerning mental health issues should be improved. Stigmatisation of people with mental illnesses should be reduced in health care settings. Training for employment agency staff concerning mental health problems and services is recommended.

  3. Key Hospital Anxiety and Depression Scale (HADS) items associated with DSM-IV depressive and anxiety disorder 12-months post traumatic brain injury.

    PubMed

    McKenzie, Dean P; Downing, Marina G; Ponsford, Jennie L

    2018-08-15

    Anxiety and depression are common problems following traumatic brain injury (TBI), warranting routine screening. Self-report rating scales including the Hospital Anxiety and Depression Scale (HADS) are associated with depression and anxiety diagnoses in individuals with TBI. The relationship between individual HADS symptoms and structured clinical interview methods (SCID) requires further investigation, particularly in regard to identifying a small number of key items that can potentially be recognised by clinicians and carers of individuals with TBI. 138 individuals sustaining a complicated-mild to severe TBI completed the HADS, and the Structured Clinical Interview for DSM-IV, Research Version (SCID) at 12-months post-injury. The associations between individual HADS items, separately and in combination, as well as overall depression and anxiety subscale scores, and SCID-diagnosed depressive and anxiety disorders were analysed. CART (Classification and Regression Tree) analysis found HADS depression item 2 "I still enjoy the things I used to enjoy" and a combination of two anxiety items, 3 "I get a sort of frightened feeling as if something awful is about to happen" and 5 "worrying thoughts go through my mind", performed similarly to total depression and anxiety subscales in terms of their association with depressive and anxiety disorders respectively, at 12-months post-injury. Patients were predominantly injured in motor vehicle accidents and received comprehensive care within a no-fault accident compensation system and so may not be representative of the wider TBI population. Although validation is required, a small number of self-report items are highly associated with 12-month post-injury diagnoses. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Perceptions of the Nature and 'Goodness' of Argument among College Students, Science Teachers, and Scientists

    NASA Astrophysics Data System (ADS)

    Abi-El-Mona, Issam; Abd-El-Khalick, Fouad

    2011-03-01

    This study aimed to elucidate college freshmen science students, secondary science teachers, and scientists' perceptions of 'scientific' argument; to compare participants' perceptions with Stephen Toulmin's analytical framework of argument; and to characterize the criteria that participants deployed when assessing the 'quality' or 'goodness' of arguments. Thirty students, teachers, and scientists-with 10 members in each group-participated in two semi-structured individual interviews. During the first interview, participants generated an argument in response to a socioscientific issue. In the second interview, each participant 'evaluated' three arguments generated by a member from each participant group without being privy to the arguer's group membership. Interview transcripts were qualitatively analyzed. The findings point to both similarities and differences between participants' conceptions of argument and those based on Toulmin's analytical framework. Participants used an array of common and idiosyncratic criteria to judge the quality or goodness of argument. Finally, contrary to expectations, participants independently agreed that the 'best' arguments were those generated by participant science teachers.

  5. Neighbourhood cohesion and mental wellbeing among older adults: a mixed methods approach.

    PubMed

    Elliott, Jane; Gale, Catharine R; Parsons, Samantha; Kuh, Diana

    2014-04-01

    There is now a body of evidence that demonstrates strong links between neighbourhood characteristics and mental health and wellbeing. There is an increasing interest in how this relationship varies for individuals of different ages. Understanding the link between neighbourhood and wellbeing for older adults is of particular significance, given the changing age structure of the population and the desire among policy makers and practitioners to promote healthy and active ageing. This paper provides further evidence on the nature and strength of the link between individual perceptions of neighbourhood belonging and mental wellbeing among those over age fifty using both qualitative and quantitative data from three British cohort studies. Between 2008 and 2011 quantitative data were collected from 10,312 cohort members, and 230 of them took part in qualitative biographical interviews. Quantitative analysis confirms that there is a moderate association between neighbourhood cohesion and wellbeing measured at the individual level in each of the three cohorts. This association persists after controlling for a range of covariates including personality. The association between neighbourhood cohesion and wellbeing is stronger for individuals in the older two cohorts than in the younger cohort. Using qualitative biographical interviews with 116 men and 114 women we illustrate how individuals talk about their sense of neighbourhood belonging. The importance of social participation as a mechanism for promoting neighbourhood belonging, and the use of age and life stage as characteristics to describe and define neighbours, is clear. In addition, the qualitative interviews point to the difficulties of using a short battery of questions to capture the varied and multi-dimensional nature of neighbourhood relations. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Public perceptions of Florida red tide risks.

    PubMed

    Kuhar, Sara E; Nierenberg, Kate; Kirkpatrick, Barbara; Tobin, Graham A

    2009-07-01

    This research integrates theoretical frameworks of risk perception, social amplification of risk, and the role of place-specific contexts in order to explore the various perceptions surrounding Florida red tides. Florida red tides are naturally occurring events that are increasing in frequency, duration, and severity. This has implications for public health, the local economy, and ecosystem health. While many of the negative impacts of Florida red tides are not easily controlled, some of the secondary impacts may be mitigated through individuals' responses. However, public perception and consequent reactions to Florida red tides have not been investigated. This research uses questionnaire surveys, and semi-structured interviews, to explore the various perceptions of the risk surrounding red tides. Surveys and interviews were conducted along two Florida west coast beaches. The results indicate that the underlying foundations of the social amplification of the risk framework are applicable to understanding how individuals form perceptions of risk relative to red tide events. There are key differences between the spatial locations of individuals and corresponding perceptions, indicating that place-specific contexts are essential to understanding how individuals receive and interpret risk information. The results also suggest that individuals may be lacking efficient and up-to-date information about Florida red tides and their impacts because of inconsistent public outreach. Overall, social and spatial factors appear to be influential as to whether individuals amplify or attenuate the risks associated with Florida red tides.

  7. 'It's more about the heroin': injection drug users' response to an overdose warning campaign in a Canadian setting.

    PubMed

    Kerr, Thomas; Small, Will; Hyshka, Elaine; Maher, Lisa; Shannon, Kate

    2013-07-01

    To assess heroin injectors' perceptions of and responses to a warning issued by public health officials regarding high-potency heroin and increases in fatal overdoses. Semi-structured qualitative interviews. Vancouver, Canada. Eighteen active heroin injectors. Semi-structured interview guide focussing on heroin injectors' perceptions of and responses to the overdose warning, including reasons for failing to adhere to risk reduction recommendations. Although nearly all participants were aware of the warning, their recollections of the message and the timing of its release were obscured by on-going social interactions within the drug scene focussed on heroin quality. Many injection drug users reported seeking the high potency heroin and nearly all reported no change in overdose risk behaviours. Responses to the warning were shaped by various social, economic and structural forces that interacted with individual behaviour and undermined efforts to promote behavioural change, including sales tactics employed by dealers, poverty, the high cost and shifting quality of available heroin, and risks associated with income-generating activities. Individual-level factors, including emotional suffering, withdrawal, entrenched injecting routines, perceived invincibility and the desire for intense intoxication also undermined risk reduction messages. Among heroin injectors in British Columbia, a 2011 overdose warning campaign appeared to be of limited effectiveness and also produced unintended negative consequences that exacerbated overdose risk. © 2013 Society for the Study of Addiction.

  8. Sensor technology more than a support.

    PubMed

    Olsson, Anna; Persson, Ann-Christine; Bartfai, Aniko; Boman, Inga-Lill

    2018-03-01

    This interview study is a part of a project that evaluated sensor technology as a support in everyday activities for patients with memory impairment. To explore patients with memory impairment and their partners' experiences of using sensor technology in their homes. Five patients with memory impairment after stroke and three partners were interviewed. Individual semi-structured interviews were analyzed with qualitative content analysis. Installing sensor technology with individually prerecorded voice reminders as memory support in the home had a broad impact on patients' and their families' lives. These effects were both positive and negative. The sensor technology not only supported activities but also influenced the patients by changing behavior, providing a sense of security, independence and increased self-confidence. For the partners, the sensor technology eased daily life, but also gave increased responsibility for maintenance. Technical problems led to frustration and stress for the patients. The results indicate that sensor technology has potential to increase opportunities for persons with memory impairment to perform and participate in activities and to unburden their partners. The results may promote an understanding of how sensor technology can be used to support persons with memory impairment in their homes.

  9. Women's experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study.

    PubMed

    Hermansen, Anna; Peolsson, Anneli; Kammerlind, Ann-Sofi; Hjelm, Katarina

    2016-04-01

    To explore and describe women's experiences of daily life after anterior cervical decompression and fusion surgery. Qualitative explorative design. Fourteen women aged 39-62 years (median 52 years) were included 1.5-3 years after anterior cervical decompression and fusion for cervical disc disease. Individual semi-structured interviews were analysed by qualitative content analysis with an inductive approach. The women described their experiences of daily life in 5 different ways: being recovered to various extents; impact of remaining symptoms on thoughts and feelings; making daily life work; receiving support from social and occupational networks; and physical and behavioural changes due to interventions and encounters with healthcare professionals. This interview study provides insight into women's daily life after anterior cervical decompression and fusion. Whilst the subjects improved after surgery, they also experienced remaining symptoms and limitations in daily life. A variety of mostly active coping strategies were used to manage daily life. Social support from family, friends, occupational networks and healthcare professionals positively influenced daily life. These findings provide knowledge about aspects of daily life that should be considered in individualized postoperative care and rehabilitation in an attempt to provide better outcomes in women after anterior cervical decompression and fusion.

  10. Barriers in access to home care services among ethnic minority and Dutch elderly--a qualitative study.

    PubMed

    Suurmond, Jeanine; Rosenmöller, Doenja L; El Mesbahi, Hakima; Lamkaddem, Majda; Essink-Bot, Marie-Louise

    2016-02-01

    Ethnic minority elderly have a high prevalence of functional limitations and chronic conditions compared to Dutch elderly. However, their use of home care services is low compared to Dutch elderly. Explore the barriers to access to home care services for Turkish, Moroccan Surinamese and ethnic Dutch elderly. Qualitative semi-structured group interviews and individual interviews. The Netherlands. Seven group interviews (n=50) followed by individual interviews (n=5) were conducted, in the preferred language of the participants. Results were ordered and reported according to a framework of access to health care services. This framework describes five dimensions of accessibility to generate access to health care services, from the perspective of the users: ability to perceive health needs, ability to seek health care, ability to reach, ability to pay and ability to engage. This study shows that while barriers are common among all groups, several specific barriers in access to home care services exist for ethnic minority elderly. Language and communication barriers as well as limited networks and a preference for informal care seem to mutually enforce each other, resulting in many barriers during the navigation process to home care. In order to provide equal access to home care for all who need it, the language and communication barriers should be tackled by home care services and home care nurses. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Use of retailer fidelity card schemes in the assessment of food additive intake: Sunset Yellow a case study.

    PubMed

    Sardi, M; Haldemann, Y; Nordmann, H; Bottex, B; Safford, B; Smith, B; Tennant, D; Howlett, J; Jasti, P R

    2010-11-01

    The feasibility of using a retailer fidelity card scheme to estimate food additive intake was investigated using the Swiss retailer MIGROS's Cumulus Card and the example of the food colour Sunset Yellow (E 110). Information held within the card scheme was used to identify a sample of households purchasing foods containing Sunset Yellow over a 15 day period. A sample of 1204 households was selected for interview, of which 830 households were retained in the study following interview. Interviews were conducted to establish household structure, patterns of consumption by different individuals within the household, and the proportion of foods containing Sunset Yellow habitually purchased at the retailer and/or consumed outside the home. Information provided by the retailer on levels of Sunset Yellow in the foods was combined with the information obtained at interview to calculate the per-capita intake of Sunset Yellow by members of participating households. More than 99% of consumers (n = 1902) of foods containing Sunset Yellow were estimated to consume less than 1 mg Sunset Yellow kg(-1) body weight day(-1). The method proved to be a simple and resource-efficient approach to estimate food additive intake on the basis of actual consumer behaviour and thus reports results more closely related to the actual consumption of foods by individuals.

  12. International perspectives on sharing clinical data with patients.

    PubMed

    Prey, Jennifer E; Polubriaginof, Fernanda; Kuperman, Gilad J; Tiase, Victoria; Collins, Sarah A; Vawdrey, David K

    2016-02-01

    Engaging patients in their care has become a topic of increasing importance, and enabling patients to have access to their clinical data is a key aspect of such engagement. We investigated, on an international scale, the current state of approaches for providing patients with access to their own clinical information. Individuals from 28 countries were invited to participate in a cross-sectional semi-structured interview. Interview questions focused on social and cultural influences that affected patient engagement activities, government support for current and planned initiatives, data ownership models, and technical issues. Interviews were conducted with individuals from 16 countries representing six continents. Respondents reported substantive initiatives for providing information to patients in the majority of countries interviewed. These initiatives were diverse in nature and stage of implementation. Enabling patient access to data is occurring on an international scale. There is considerable variability in the level of maturity, the degree of government involvement, the technical infrastructure, and the plans for future development across the world. As informaticians, we are still in the early stages of deploying patient engagement technologies and have yet to identify optimal strategies in this arena. Efforts to improve patient access to data are active on a global-scale. There are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Prevention of and dealing with poor performance: an interview study about how professional associations aim to support healthcare professionals.

    PubMed

    Weenink, Jan-Willem; Kool, Rudolf B; Hesselink, Gijs; Bartels, Ronald H; Westert, Gert P

    2017-10-01

    To explore how professional associations of nine healthcare professions aim to support professionals to prevent and deal with poor performance. Qualitative interview study. The Netherlands. Representatives of professional associations for dentists, general practitioners, medical specialists, midwives, nurses, pharmacists, physiotherapists, psychologists and psychotherapists. During nine face-to-face semi-structured interviews we asked how associations aim to support professionals in prevention of and dealing with poor performance. Following the first interview, we monitored new initiatives in support over a 2.5-year period, after which we conducted a second interview. Interviews were analysed using thematic analysis. Available policy and support regarding poor performance. Three themes emerged from our data (i.e. elaborating on professional performance, performance insight and dealing with poor performance) for which we identified a total of 10 categories of support. Support concerned professional codes, guidelines and codes of conduct, quality registers, individual performance assessment, peer consultation, practice evaluation, helpdesk and expert counselling, a protocol for dealing with poor performance, a place for support and to report poor performance, and internal disciplinary procedures. This study provides an overview of support given to nine healthcare professions by their associations regarding poor performance, and identifies gaps that associations could follow up on, such as clarifying what to do when confronted with a poorly performing colleague, supporting professionals that poorly perform, and developing methods for individual performance assessment to gain performance insight. A next step would be to evaluate the use and effect of different types of support. © 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

  14. More than a break: the impact of a social-pedagogical intervention during young persons' long-term hospital admission--a qualitative study.

    PubMed

    Villadsen, Katrine Weiersoe; Blix, Charlotte; Boisen, Kirsten A

    2015-02-01

    Critical illness and long-term or repeated hospitalization can affect normal adolescent development. As a result, adolescents may feel isolated and "misplaced" on both pediatric and adult departments. The mission of the Center of Adolescent Medicine is to improve conditions for adolescent patients. To achieve this, the social educator offers an individualized social-pedagogical intervention for young people during long-term or repeated hospitalization. The aim of this study was to identify the impact of the social-pedagogical intervention using a qualitative approach. A trained anthropologist interviewed seven adolescents who had individual sessions with a social educator during their hospital stay. The interviews were recorded and transcribed verbatim, and the transcripts were coded and thematized continuously. Through qualitative analysis, the following themes emerged: Recreation; Structure, participation, and motivation; and Friends and social network. The social-pedagogical approach is a combination of interpersonal relationships and individually tailored recreational activities. Even small entertaining activities changed the focus from patient identity and contributed to the feeling of being "normal." All young patients reported that the increased opportunities for decision-making and influence on the daily structure supported the feeling of being recognized and respected as an individual person as well as increased their motivation to go through their treatment. The interviewees emphasized the importance of experiencing something that was worth telling their friends about to help them stay in touch. Although the young patients emphasized the recreational aspects, the time spent with the social educator facilitated training in social competencies as well as conversations about emotional and sensitive topics.

  15. The structural influence of family and parenting on young people's sexual and reproductive health in rural northern Tanzania

    PubMed Central

    Wamoyi, Joyce; Wight, Daniel; Remes, Pieter

    2015-01-01

    This paper explores the structural role of the family and parenting in young people's sexual and reproductive health. The study involved eight weeks of participant observation, 26 in-depth interviews, and 11 group discussions with young people aged 14–24 years, and 20 in-depth interviews and 6 group discussions with parents/carers of children in this age group. At an individual level, parenting and family structure were found to affect young people's sexual behaviour by influencing children's self-confidence and interactional competence, limiting discussion of sexual health and shaping economic provision for children, which in turn affected parental authority and daughters' engagement in risky sexual behaviour. Sexual norms are reproduced both through parents' explicit prohibitions and their own behaviours. Girls are socialised to accept men's superiority, which shapes their negotiation of sexual relationships. Interventions to improve young people's sexual and reproductive health should recognise the structural effects of parenting, both in terms of direct influences on children and the dynamics by which structural barriers such as gendered power relations and cultural norms around sexuality are transmitted across generations. PMID:25597368

  16. Individual Difference Variables and the Occurrence and Effectiveness of Faking Behavior in Interviews

    PubMed Central

    Buehl, Anne-Kathrin; Melchers, Klaus G.

    2017-01-01

    There is widespread fear that applicants can fake during selection interviews and that this impairs the quality of selection decisions. Several theories assume that faking occurrence is influenced by personality and attitudes, which together influence applicants’ motivation to show faking behavior. However, for faking behavior to be effective, interviewees also need certain skills and abilities. To investigate the impact of several relevant individual difference variables on faking behavior and interview success, we conducted two studies. In Study 1, we surveyed 222 individuals to assess different personality variables, attitude toward faking, cognitive ability, self-reported faking behavior, and success in previous interviews, and in Study 2, we assessed cognitive ability, social skills, faking behavior, and interview performance in an interview simulation with 108 participants. Taken together, personality, as well as attitude toward faking, influenced who showed faking behavior in an interview, but there was no evidence for the assumed moderating effect of cognitive ability or social skills on interview success. PMID:28539895

  17. Improving Healthcare Transition Planning and Health-Related Independence for Youth with ASD and their Families

    DTIC Science & Technology

    2015-10-01

    volunteers) recruited Objective 5: Develop and test focus group & individual interview guide; train staff on protocol and procedure • Caregiver and young...and individual items will then be evaluated and revised based on finds from cognitive interviewing and full-scale pretesting . 15. SUBJECT TERMS...first modality assessed caregiver perspectives on health-related transitioning using focus groups . The second modality included individual interviews

  18. Are We Monitoring the Quality of Cataract Surgery Services? A Qualitative Situation Analysis of Attitudes and Practices in a Large City in South Africa

    PubMed Central

    Haastrup, Oluwatosin O. O.; Buchan, John C.; Cassels-Brown, Andy; Cook, Colin

    2015-01-01

    Purpose: To evaluate the current quality “assurance” and “improvement” mechanisms, the knowledge, attitudes and practices of cataract surgeons in a large South African city. Methodology: A total of 17 in-depth semi-structured interviews were conducted with ophthalmologists in June 2012 at 2 tertiary institutions in the Republic of South Africa. Recruitment of the purposive sample was supplemented by snowball sampling. The study participants were 5 general ophthalmologists and 2 pediatric ophthalmologists; 4 senior and 4 junior registrars and a medical officer. Participants were interviewed by a trained qualitative interviewer. The interview lasted between 20 and 60 min. The interviews were recorded, transcribed verbatim and analyzed for thematic content. Results: Mechanisms for quality assurance were trainee logbooks and subjective senior staff observation. Clinicians were encouraged, but not obliged to self-audit. Quality improvement is incentivized by personal integrity and ambition. Poorly performing departments are inconspicuous, especially nationally, and ophthalmologists rely on the impression to gauge the quality of service provided by colleagues. Currently, word of mouth is the method for determining the better cataract surgical centers. Conclusion: The quality assurance mechanisms were dependent on insight and integrity of the individual surgeons. No structures were described that would ensure the detection of surgeons with higher than expected complication rates. Currently, audits are not enforced, and surgical outcomes are not well monitored due to concerns that this may lead to lack of openness among ophthalmologists. PMID:25949081

  19. Are we monitoring the quality of cataract surgery services? A qualitative situation analysis of attitudes and practices in a large city in South Africa.

    PubMed

    Haastrup, Oluwatosin O O; Buchan, John C; Cassels-Brown, Andy; Cook, Colin

    2015-01-01

    To evaluate the current quality "assurance" and "improvement" mechanisms, the knowledge, attitudes and practices of cataract surgeons in a large South African city. A total of 17 in-depth semi-structured interviews were conducted with ophthalmologists in June 2012 at 2 tertiary institutions in the Republic of South Africa. Recruitment of the purposive sample was supplemented by snowball sampling. The study participants were 5 general ophthalmologists and 2 pediatric ophthalmologists; 4 senior and 4 junior registrars and a medical officer. Participants were interviewed by a trained qualitative interviewer. The interview lasted between 20 and 60 min. The interviews were recorded, transcribed verbatim and analyzed for thematic content. Mechanisms for quality assurance were trainee logbooks and subjective senior staff observation. Clinicians were encouraged, but not obliged to self-audit. Quality improvement is incentivized by personal integrity and ambition. Poorly performing departments are inconspicuous, especially nationally, and ophthalmologists rely on the impression to gauge the quality of service provided by colleagues. Currently, word of mouth is the method for determining the better cataract surgical centers. The quality assurance mechanisms were dependent on insight and integrity of the individual surgeons. No structures were described that would ensure the detection of surgeons with higher than expected complication rates. Currently, audits are not enforced, and surgical outcomes are not well monitored due to concerns that this may lead to lack of openness among ophthalmologists.

  20. Proxy decision making and dementia: Using Construal Level Theory to analyse the thoughts of decision makers.

    PubMed

    Convey, Helen; Holt, Janet; Summers, Barbara

    2018-07-01

    This study explored the feasibility of using Construal Level Theory to analyse proxy decision maker thinking about a hypothetical ethical dilemma, relating to a person who has dementia. Proxy decision makers make decisions on behalf of individuals who are living with dementia when dementia affects that individual's decision making ability. Ethical dilemmas arise because there is a need to balance the individual's past and contemporary values and views. Understanding of how proxy decision makers respond is incomplete. Construal Level Theory contends that individuals imagine reactions and make predications about the future by crossing psychological distance. This involves abstract thinking, giving meaning to decisions. There is no empirical evidence of Construal Level Theory being used to analyse proxy decision maker thinking. Exploring the feasibility of using Construal Level Theory to understand dementia carer thinking regarding proxy decisions may provide insights which inform the support given. Descriptive qualitative research with semi-structured interviews. Seven participants were interviewed using a hypothetical dementia care scenario in February 2016. Interview transcripts were analysed for themes. Construal Level Theory was applied to analyse participant responses within themes using the Linguistic Category Model. Participants travelled across psychological distance, using abstract thinking to clarify goals and provide a basis for decisions. When thinking concretely participants established boundaries regarding the ethical dilemma. Construal Level Theory gives insight into proxy decision maker thinking and the levels of abstraction used. Understanding what dementia carers think about when making proxy decisions may help nurses to understand their perspectives and to provide appropriate support. © 2018 John Wiley & Sons Ltd.

  1. Autism in Adults: Symptom Patterns and Early Childhood Predictors. Use of the DISCO in a Community Sample Followed from Childhood

    ERIC Educational Resources Information Center

    Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher

    2007-01-01

    Background: Few studies have looked at the very long-term outcome of individuals with autism who were diagnosed in childhood. Methods: A longitudinal, prospective, community-based follow-up study of adults who had received the diagnosis of autism (classic and atypical) in childhood (n = 105) was conducted. A structured interview (the Diagnostic…

  2. Pathways of Thriving and Resilience: Growth Responses to Adversity and Trauma in Two Cambodian Communities: A Comparative Study between Lowell, Massachusetts and Phnom Penh, Cambodia.

    ERIC Educational Resources Information Center

    West, Cheryl D.

    This qualitative study investigated individual, contextual, and cultural factors that promote trauma-related resilience and positive growth among Cambodian survivors of the Pol Pot regime who reside in Phnom Penh, Cambodia and Lowell, Massachusetts. A thriving paradigm framed semi-structured interviews that were conducted with 21 Cambodians in…

  3. Negotiating a Sense of Identity in a Foreign Land: Navigating Public School Structures and Practices that Often Conflict with Haitian Culture and Values

    ERIC Educational Resources Information Center

    Cone, Neporcha; Buxton, Cory; Lee, Okhee; Mahotiere, Margarette

    2014-01-01

    As part of a larger investigation into the educational experiences of Haitians in South Florida, this study explores factors that influence the identity development and academic success of Haitian students. Individual and focus group interviews with Haitian students, parents, and teachers provide the context for studying how pressures from both…

  4. Institutional Motivations and Barriers to the Construction of Green Buildings on Campus: A Case Study of the University of Waterloo, Ontario

    ERIC Educational Resources Information Center

    Richardson, Gregory R. A.; Lynes, Jennifer K.

    2007-01-01

    Purpose: To explore the barriers and motivations to the construction of green buildings at the University of Waterloo (UW) by documenting and analysing the UW building process. Design/methodology/approach: The authors conducted 13 semi-structured in-depth interviews with key UW individuals as well as analyzing numerous internal reports in order to…

  5. Working with Clients Who Engage in Self-Harming Behaviour: Experiences of a Group of Counsellors

    ERIC Educational Resources Information Center

    Fox, Claudine

    2011-01-01

    This study aimed to explore the experiences of a group of counsellors regarding working with clients who engage in self-harming behaviour, in order to gain an understanding of what it is like to work with this client group. A series of six individual, semi-structured qualitative interviews were carried out, which were then transcribed and analysed…

  6. Interplay of Formal and Material Role-Taking in the Understanding of Suicide Among Adolescents and Young Adults:II. Naive Suicide Theories in the Structural Approach.

    ERIC Educational Resources Information Center

    Dobert, Rainer; Nunner-Winkler, Gertrud

    1985-01-01

    Constructs a tentative stage model of the development of the understanding of suicide motives, based on interview data from 14- to 22-year-old male and female subjects of different SES backgrounds. Development is characterized by these trends: extension of time perspective; differentiation and individualization of actor schemata and motive…

  7. High-School Students' Conceptual Difficulties and Attempts at Conceptual Change: The Case of Basic Quantum Chemical Concepts

    ERIC Educational Resources Information Center

    Tsaparlis, Georgios; Papaphotis, Georgios

    2009-01-01

    This study tested for deep understanding and critical thinking about basic quantum chemical concepts taught at 12th grade (age 17-18). Our aim was to achieve conceptual change in students. A quantitative study was conducted first (n = 125), and following this 23 selected students took part in semi-structured interviews either individually or in…

  8. "The Blue Table Means You Don't Have a Clue": The Persistence of Fixed-Ability Thinking and Practices in Primary Mathematics in English Schools

    ERIC Educational Resources Information Center

    Marks, Rachel

    2013-01-01

    The use of structured ability grouping is increasing in English primary schools and is regularly seen in primary mathematics classrooms. Ability is a normalised discourse with beliefs that some individuals are "born to do maths" permeating society and infiltrating school practices. In this article, observation and interview data…

  9. The Transition to Preschool: A Problem or an Opportunity for Children? A Sociological Perspective in the Context of a "Split System"

    ERIC Educational Resources Information Center

    Amerijckx, Gaëlle; Humblet, Perrine C.

    2015-01-01

    This article discusses the central issue of the transition to preschool. Individual semi-structured interviews with school professionals and parents in the Brussels region revealed that this issue is crucial for the well-being of young children, from both an educational and a social perspective. We discovered that the education system works under…

  10. "It'll Never Be the White Kids, It'll Always Be Us": Black High School Students' Evolving Critical Analysis of Racial Discrimination and Inequity in Schools

    ERIC Educational Resources Information Center

    Hope, Elan C.; Skoog, Alexandra B.; Jagers, Robert J.

    2015-01-01

    We examine how Black high school students, participants in a Youth Participatory Action Research (YPAR) program, understand issues of racial discrimination and inequality in their schools. Through semi-structured individual interviews conducted early in the program, eight students (six boys and two girls) recount experiences of racial…

  11. Teaching a Pedagogy of Peace: A Study of Peace Educators in United States Schools in the Aftermath of September 11

    ERIC Educational Resources Information Center

    Joseph, Pamela Bolotin; Duss, Leslie Smith

    2009-01-01

    This qualitative study, based on in-depth semi-structured interviews, depicts practices of seven peace educators in public elementary and secondary classrooms in the United States during the time of the terrorist attacks on 11 September 2001 through the US engagement in war in Afghanistan and Iraq. Focusing on individual perceptions of practice…

  12. Virtual reality job interview training and 6-month employment outcomes for individuals with schizophrenia seeking employment.

    PubMed

    Smith, Matthew J; Fleming, Michael F; Wright, Michael A; Roberts, Andrea G; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D

    2015-08-01

    Individuals with schizophrenia have low employment rates and the job interview presents a critical barrier for them to obtain employment. Virtual reality training has demonstrated efficacy at improving interview skills and employment outcomes among multiple clinical populations. However, the effects of this training on individuals with schizophrenia are unknown. This study evaluated the efficacy of virtual reality job interview training (VR-JIT) at improving job interview skills and employment outcomes among individuals with schizophrenia in a small randomized controlled trial (n=21 VR-JIT trainees, n=11 waitlist controls). Trainees completed up to 10h of virtual interviews using VR-JIT, while controls received services as usual. Primary outcome measures included two pre-test and two post-test video-recorded role-play interviews scored by blinded raters with expertise in human resources and self-reported interviewing self-confidence. Six-month follow-up data on employment outcomes were collected. Trainees reported that the intervention was easy-to-use, helpful, and prepared them for future interviews. Trainees demonstrated increased role-play scores between pre-test and post-test while controls did not (p=0.001). After accounting for neurocognition and months since prior employment, trainees had greater odds of receiving a job offer by 6month follow-up compared to controls (OR: 8.73, p=0.04) and more training was associated with fewer weeks until receiving a job offer (r=-0.63, p<0.001). Results suggest that VR-JIT is acceptable to trainees and may be efficacious for improving job interview skills in individuals with schizophrenia. Moreover, trainees had greater odds of receiving a job offer by 6-month follow-up. Future studies could evaluate the effectiveness of VR-JIT within community-based services. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Rigidity in routines and the development of resistance to change in individuals with Prader-Willi syndrome.

    PubMed

    Haig, E L; Woodcock, K A

    2017-05-01

    Individuals with Prader-Willi syndrome (PWS) commonly show debilitating resistance to change, which has been linked to cognitive deficits in task switching. Anecdotal reports suggest that exposure to flexibility in routines during development may be beneficial for limiting subsequent resistance to change in people with PWS, which is consistent with a beneficial role of such exposure on the development of task switching, highlighted in typical children. Here, we aim to investigate the development of resistance to change in individuals with PWS and hypothesise that exposure to increased rigidity in routines will be associated with increased subsequent resistance to change. An author-compiled informant report interview and two previously validated questionnaires were administered to the caregivers of 10 individuals with PWS (5-23 years). The interview examined rigidity in routines and resistance to change across life stages defined by easily distinguishable events (before school, during primary school, during secondary school, after school, currently), using open-ended and structured yes/no and 5-point Likert questions. Open-ended data were coded using an author-compiled system. Responses from two additional informants and data from the questionnaires were used to assess inter-informant reliability and concurrent validity of the structured questions. The validity of the interview was supported by acceptable inter-rater reliability of the open-ended coding system and inter-informant reliability, internal consistency and concurrent validity of structured questions. Descriptive analyses of ratings of behaviour change showed a pattern of increasing resistance to change over the life course for the four oldest individuals, who had all been exposed to substantial rigidity in routines before and during primary school. Furthermore, only one individual - currently in primary school - was exposed to very little rigidity in routines before and during primary school, and he had showed a decrease in resistance to change after entering primary school. Open-ended data showed that more individuals currently evidencing little resistance to change had been exposed to parent or self-imposed flexibility in routines, than those currently evidencing substantial resistance to change. However, correlational analyses on rigidity and resistance to change ratings highlighted the possibility that rigidity during primary school is most relevant for developing resistance to change. Finally, open-ended data emphasised an important beneficial role of rigidity in routines for limiting the current challenging behaviour of individuals with high resistance to change. Because task switching appears to evidence a period of high developmental sensitivity during early primary school years, we propose that this period may represent a critical time when increasing flexibility in the routines of children with PWS could limit the development of resistance to change. However, a careful balance would need to be struck, given the apparent benefit of rigid routines on current behaviour. Further work in this area is much needed. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  14. Telephone health services in the field of rare diseases: a qualitative interview study examining the needs of patients, relatives, and health care professionals in Germany.

    PubMed

    Babac, Ana; Frank, Martin; Pauer, Frédéric; Litzkendorf, Svenja; Rosenfeldt, Daniel; Lührs, Verena; Biehl, Lisa; Hartz, Tobias; Storf, Holger; Schauer, Franziska; Wagner, Thomas O F; Graf von der Schulenburg, J-Matthias

    2018-02-09

    Rare diseases are, by definition, very serious and chronic diseases with a high negative impact on quality of life. Approximately 350 million people worldwide live with rare diseases. The resulting high disease burden triggers health information search, but helpful, high-quality, and up-to-date information is often hard to find. Therefore, the improvement of health information provision has been integrated in many national plans for rare diseases, discussing the telephone as one access option. In this context, this study examines the need for a telephone service offering information for people affected by rare diseases, their relatives, and physicians. In total, 107 individuals participated in a qualitative interview study conducted in Germany. Sixty-eight individuals suffering from a rare disease or related to somebody with rare diseases and 39 health care professionals took part. Individual interviews were conducted using a standardized semi-structured questionnaire. Interviews were analysed using the qualitative content analysis, triangulating patients, relatives, and health care professionals. The fulfilment of qualitative data processing standards has been controlled for. Out of 68 patients and relatives and 39 physicians, 52 and 18, respectively, advocated for the establishment of a rare diseases telephone service. Interviewees expected a helpline to include expert staffing, personal contact, good availability, low technical barriers, medical and psychosocial topics of counselling, guidance in reducing information chaos, and referrals. Health care professionals highlighted the importance of medical topics of counselling-in particular, differential diagnostics-and referrals. Therefore, the need for a national rare diseases helpline was confirmed in this study. Due to limited financial resources, existing offers should be adapted in a stepwise procedure in accordance with the identified attributes.

  15. HPTN 062: A Pilot Randomized Controlled Trial Exploring the Effect of a Motivational-Interviewing Intervention on Sexual Behavior among Individuals with Acute HIV Infection in Lilongwe, Malawi.

    PubMed

    Pettifor, Audrey; Corneli, Amy; Kamanga, Gift; McKenna, Kevin; Rosenberg, Nora E; Yu, Xuesong; Ou, San-San; Massa, Cecilia; Wiyo, Patricia; Lynn, Diana; Tharaldson, Jenae; Golin, Carol; Hoffman, Irving

    2015-01-01

    We pilot tested a Motivational Interviewing (MI) -based counseling intervention for individuals with Acute HIV Infection (AHI) to reduce risky sexual behavior in Lilongwe, Malawi. Twenty-eight individuals diagnosed with AHI were randomized to receive either brief education alone, or the brief education plus the MI-based intervention, called Uphungu Wanga. Participants in Uphungu Wanga received four sessions delivered on the day of diagnosis, three days later and at weeks 1 and 2 with a booster session at week 8; participants were followed for 24 weeks from diagnosis. An interviewer administered quantitative questionnaire was conducted at baseline and at weeks 2, 4, 8, 12, 16, 20 and 24. Semi-structured qualitative interviews (SSI) were conducted at weeks 2, 8, 12, and 24. The majority of participants in both arms reported rapid and sustained behavior change following diagnosis with AHI. Very few participants reported having sex without a condom after diagnosis. Participants reported a trend towards fewer sex partners and abstaining from sex during study follow-up. Participants in the MI-based arm provided concrete examples of risk reduction strategies in the SSIs while those in the brief education arm primarily described reducing risk behavior, suggesting that the MI-based group may have acquired more risk reduction skills. Individuals in both study arms reduced risky sexual behaviors after diagnosis with AHI. We found few major differences between study arms during the 6-month follow up period in self-reported sexual behaviors therefore a MI-based intervention may not be needed to trigger behavior change following AHI. However, comparing the MI-based intervention to repeated brief education sessions made it difficult to assess the potential benefit of an MI-based intervention in a setting where standard counseling often consists of one post-test session. Nevertheless, provision of counseling immediately following diagnosis with HIV to support behavior change should remain a priority. ClinicalTrials.gov NCT01197027.

  16. Barriers and facilitators to physical activity amongst overweight and obese women in an Afro-Caribbean population: A qualitative study.

    PubMed

    Alvarado, Miriam; Murphy, Madhuvanti M; Guell, Cornelia

    2015-07-28

    The proportion of obese women is nearly twice the proportion of obese men in Barbados, and physical inactivity may be a partial determinant. Using qualitative interviews and 'semi-structured' participant observation, the aim of this study was to identify modifiable barriers to physical activity and to explore the factors that facilitate physical activity amongst overweight and obese women in this low-resourced setting. Seventeen women aged 25 to 35 years with a BMI ≥25, purposefully sampled from a population-based cross-sectional study conducted in Barbados, were recruited in 2014 to participate in in-depth semi-structured interviews. Twelve of these women participated in one or more additional participant observation sessions in which the researcher joined and observed a routine activity chosen by the participant. More than 50 hours of participant observation data collection were accumulated and documented in field notes. Thematic content analysis was performed on transcribed interviews and field notes using the software Dedoose. Social, structural and individual barriers to physical activity were identified. Social factors related to gender norms and expectations. Women tended to be active with their female friends rather than partners or male peers, and reported peer support but also alienation. Being active also competed with family responsibilities and expectations. Structural barriers included few opportunities for active commuting, limited indoor space for exercise in the home, and low perceived access to convenient and affordable exercise classes. Several successful strategies associated with sustained activity were observed, including walking and highly social, low-cost exercise groups. Individual barriers related to healthy living strategies included perceptions about chronic disease and viewing physical activity as a possible strategy for desired weight loss but less effective than dieting. It is important to understand why women face barriers to physical activity, particularly in low-resourced settings, and to investigate how this could be addressed. This study highlights the role that gender norms and health beliefs play in shaping experiences of physical activity. In addition, structural barriers reflect a mix of resource-scarce and resource-rich factors which are likely to be seen in a wide variety of developing contexts.

  17. Care Seeking Patterns Among Women Who Have Experienced Gender-Based Violence in Afghanistan.

    PubMed

    Stokes, Sonya; Seritan, Andreea L; Miller, Elizabeth

    2016-06-01

    This study explored patterns of abuse and care seeking among women victims of gender-based violence (GBV) in Afghanistan. Individual, semi-structured interviews were conducted with 22 Afghan women (M age = 19 years) living in a shelter for victims of GBV. Interviews were analyzed thematically. Participants reported experiencing multiple forms of abuse. The majority received medical treatment for abuse-related health concerns. However, less than half reported abuse to health care providers or were asked by health care providers about the context of their injuries. Strategies to improve health care responses to GBV are needed to ensure safety and support for Afghan women. © The Author(s) 2015.

  18. [Intervening factors in attention flow of professionals injured by biological material].

    PubMed

    Ribeiro, Luana Cássia Miranda; Souza, Adenícia Custódia Silva E; Tipple, Anaclara Ferreira Veiga; Melo, Dulcelene Sousa; Peixoto, Myrian Karla Ayres Veronez; Munari, Denize Bouttelet

    2014-06-01

    To describe the barriers and facilitator factors to follow the attention flow of professionals injured by biological material in the worker perspective. Qualitative descriptive study with data collected through individual interviews with 18 injured workers, assisted in reference public units in the city of Goiânia. The content analysis was carried out with assistance of the ATLAS.ti 6.2 software, under the work organization and subjective perspectives. From the interviews regarding the barriers and facilitator factors emerged the categories: organizational structure, Support from close people, and Knowledge influence. The organized services have enabled more qualified consultations and the workers follow-up, which caused a satisfaction feeling in relation to the working environment.

  19. Explain the 'unexplainable': A qualitative enquiry of the representations of the caregivers of brain-injured people.

    PubMed

    Huet, Magali; Dany, Lionel; Apostolidis, Thémistoklis

    2016-04-01

    The aim of our research is to highlight the role of social representations of the traumatic brain-injured person in the adjustments made by caregivers in building and maintaining quality of care. Twenty-three semi-structured interviews were conducted with nursing assistants and medico-psychological assistants, working in a long-term care facility. The interviews were the subject of a thematic content analysis. The analysis shows the role of representations of the traumatic brain-injured person in the way caregivers explain behaviours and situations and in the orientation of their professional practices. In explaining the inexplicable, caregivers establish a more human relationship through individualized care.

  20. Responding to rural social care needs: older people empowering themselves, others and their community.

    PubMed

    Walsh, Kieran; O'Shea, Eamon

    2008-12-01

    Older adult active retirement groups encompass health promotion, social and community psychological potential. However, little is known about the internal dynamics of these groups or their contribution to individual well-being and the community. This paper examines the Third Age Foundation as an example of one such group operating in a rural area in Ireland and explores the various relationships at work internally and externally. Methodology included: structured and semi-structured interviews, focus groups and a postal survey. A substantial contribution to members' well-being and community competence and cohesion was found. Findings are discussed in reference to the importance of individual and community empowerment, sustainability, social entrepreneurship/leadership and the potential of such models to support community-based living in older age.

  1. Online support for individuals with spinal cord injuries: An ethnographic investigation

    PubMed Central

    O'Riley, Alisa A.; Rose, Jon; Dalal, Brinda

    2014-01-01

    Background Although social support is an important protective factor for individuals with spinal cord injuries (SCIs), individuals often encounter significant barriers to obtaining support after experiencing a SCI. It has been suggested that the Internet may serve to help individuals with disabilities overcome common barriers in obtaining support, yet research examining the efficacy of Internet-based support for individuals with SCI has been mixed. Objective To develop a more nuanced understanding of how individuals with SCI can or might use the Internet for support. Design Using an ethnographic approach, we conducted semi-structured interviews with nine individuals with SCI to explore perceived needs and barriers to information-seeking and online support. Setting Participants were recruited from Veterans Administration medical center outpatient and inpatient units providing specialty care to individuals with SCIs and from a community SCI Center of Excellence. Results Individuals with SCI gain emotional, problem-focused, and reciprocal support from online sources. Conclusions Online resources can provide important opportunities for social support for individuals with SCI. PMID:24090378

  2. The Promise of Pre-Exposure Prophylaxis for Black Men Who Have Sex with Men: An Ecological Approach to Attitudes, Beliefs, and Barriers.

    PubMed

    Philbin, Morgan M; Parker, Caroline M; Parker, Richard G; Wilson, Patrick A; Garcia, Jonathan; Hirsch, Jennifer S

    2016-06-01

    Research has demonstrated the clinical effectiveness of pre-exposure prophylaxis (PrEP) for HIV prevention, but little is known about how factors at the individual-, interpersonal-, community-, and structural levels impact PrEP use for black men who have sex with men (BMSM). We advance existing work by examining how all levels of the ecological framework must be addressed for PrEP to be successfully implemented as an effective HIV prevention approach. We interviewed 31 BMSM three times each and 17 community stakeholders once each; interviews were taped, transcribed, and analyzed using the constant comparative method. Factors that influence how BMSM experienced PrEP emerged across all levels of the ecological framework: At the individual level, respondents were wary of giving medication to healthy people and of the potential side-effects. At the interpersonal level, BMSM believed that PrEP use would discourage condom use and that PrEP should only be one option for HIV prevention, not the main option. At the community level, men described not trusting the pharmaceutical industry and described PrEP as an option for others, not for themselves. At the structural level, BMSM talked about HIV and sexuality-related stigmas and how they must overcome those before PrEP engagement. BMSM are a key population in the US National HIV/AIDS Strategy, yet few individuals believe that PrEP would be personally helpful. Our research indicates the urgent need to raise awareness and address structural stigma and policies that could be substantial barriers to the scale-up and implementation of PrEP-related services.

  3. The Promise of Pre-Exposure Prophylaxis for Black Men Who Have Sex with Men: An Ecological Approach to Attitudes, Beliefs, and Barriers

    PubMed Central

    Parker, Caroline M.; Parker, Richard G.; Wilson, Patrick A.; Garcia, Jonathan; Hirsch, Jennifer S.

    2016-01-01

    Abstract Research has demonstrated the clinical effectiveness of pre-exposure prophylaxis (PrEP) for HIV prevention, but little is known about how factors at the individual-, interpersonal-, community-, and structural levels impact PrEP use for black men who have sex with men (BMSM). We advance existing work by examining how all levels of the ecological framework must be addressed for PrEP to be successfully implemented as an effective HIV prevention approach. We interviewed 31 BMSM three times each and 17 community stakeholders once each; interviews were taped, transcribed, and analyzed using the constant comparative method. Factors that influence how BMSM experienced PrEP emerged across all levels of the ecological framework: At the individual level, respondents were wary of giving medication to healthy people and of the potential side-effects. At the interpersonal level, BMSM believed that PrEP use would discourage condom use and that PrEP should only be one option for HIV prevention, not the main option. At the community level, men described not trusting the pharmaceutical industry and described PrEP as an option for others, not for themselves. At the structural level, BMSM talked about HIV and sexuality-related stigmas and how they must overcome those before PrEP engagement. BMSM are a key population in the US National HIV/AIDS Strategy, yet few individuals believe that PrEP would be personally helpful. Our research indicates the urgent need to raise awareness and address structural stigma and policies that could be substantial barriers to the scale-up and implementation of PrEP-related services. PMID:27220036

  4. Primary care contact prior to suicide in individuals with mental illness

    PubMed Central

    Pearson, Anna; Saini, Pooja; Da Cruz, Damian; Miles, Caroline; While, David; Swinson, Nicola; Williams, Alyson; Shaw, Jenny; Appleby, Louis; Kapur, Navneet

    2009-01-01

    Background Previous studies have reported differing rates of consultation with GPs prior to suicide. Patients with a psychiatric history have higher rates of consultation and consult closer to the time of their death. Aim To investigate the frequency and nature of general practice consultations in the year before suicide for patients in current, or recent, contact with secondary mental health services. Design of study Retrospective case-note study and semi-structured interviews. Setting General practices in the northwest of England. Method General practice data were obtained by a retrospective review of medical records (n = 247) and semi-structured interviews with GPs (n = 159). Results GP records were reviewed in 247 of the 286 cases (86%). Overall, 91% of individuals (n = 224) consulted their GP on at least one occasion in the year before death. The median number of consultations was 7 (interquartile range = 3–10). Interviews were carried out with GPs with regard to 159 patients. GPs reported concerns about their patient's safety in 43 (27%) cases, but only 16% of them thought that the suicide could have been prevented. Agreement between GPs and mental health teams regarding risk of suicide was poor. Both sets of clinicians rated moderate to high levels of risk in only 3% of cases for whom information was available (n = 139) (overall κ = 0.024). Conclusion Consultation prior to suicide is common but suicide prevention in primary care is challenging. Possible strategies might include examining the potential benefits of risk assessment and collaborative working between primary and secondary care. PMID:19861027

  5. Sustaining enrollment in health insurance for vulnerable populations: lessons from Massachusetts.

    PubMed

    Capoccia, Victor; Croze, Colette; Cohen, Martin; O'Brien, John P

    2013-04-01

    Since 2008 Massachusetts has had universal health insurance with an individual mandate. As a result, only about 3% of the population is uninsured. However, patients who use behavioral health services are uninsured at much higher rates. This 2011 study sought to understand reasons for the discrepancy and identify approaches to reduce disenrollment and sustain coverage. The qualitative study was based on structured interviews and focus groups. Structured interviews were conducted with 15 policy makers, consumer advocates, and chief executive officers of provider organizations, and three focus groups were held with 33 patient volunteers. The interviews and focus groups identified several disenrollment opportunities, all of which contribute to "churn" (the process by which disenrolled persons who remain eligible are reenrolled in the same or a different plan): missing and incomplete documentation, acute and chronic conditions and long-term disabilities that interfere with a patient's ability to respond to program communications, and lack of awareness among beneficiaries of the consequences of changes that trigger termination and the need to transfer to another program. Although safeguards are built into the system to avoid some disenrollments, the policies and procedures that drive the system are built on a default assumption of ineligibility or disenrollment until the individual establishes eligibility and completes requirements. Practices that can sustain enrollment include real-time Web-based prepopulated enrollment and redetermination processes, redetermination flexibility for designated chronic illnesses, and standardized performance metrics for churn and associated costs. Changes in the information system infrastructure and in outreach, enrollment, disenrollment, and reenrollment procedures can improve continuity and retention of health insurance coverage.

  6. Psychiatric diagnoses in a group of astronaut applicants

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.; Faulk, Dean M.; Holland, Al W.

    1991-01-01

    Between 1959 and 1987, the psychiatric evaluation of astronaut candidates evolved from a 30-h intensive examination evaluating applicants for psychopathology, and studying their performance under stress, to a 2-h clinical interview whose structure and contents were determined by the individual examiner. Evaluations done during these years applied both psychiatric (or, 'select-out') criteria and psychological (or, 'select-in') criteria. In an attempt to more rigorously define the psychiatric, 'select-out' component, a standardized, semistructured clinical interview was developed to identify the presence or history of psychiatric disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed. ('DSM-III'). A total of 117 astronaut applicants underwent this clinical interview as part of a comprehensive medical evaluation during a recent astronaut selection. Of the 117 applicants, 9 (7.7 percent) met DSM-III criteria for a variety of Axis I and Axis II diagnoses, including V-code diagnoses.

  7. Factors that influence disclosure of hearing loss in the workplace.

    PubMed

    Southall, Kenneth; Jennings, Mary Beth; Gagné, Jean-Pierre

    2011-10-01

    The objective of the study was to identify factors that lead individuals to conceal or disclose their hearing loss in the workplace. A qualitative research paradigm called qualitative description was selected to address this issue. Twelve people who had an adult onset hearing loss, and were gainfully employed, participated in audio-recorded semi-structured interviews designed to probe issues related to disclosure of hearing loss. A photo elicitation interview technique was employed during the interviews. Content analyses were used to extract pertinent information from verbatim transcripts. Five recurring themes emerged as important considerations in relation to this topic: (1) perceived importance of the situation; (2) perceived sense of control; (3) community affiliation; (4) burden of communication; and (5) coexisting issues related to hearing loss. The findings are discussed in relation to other concealable stigmatizing traits, stigma-theory, and social-cognitive theory. The clinical implications of these findings are discussed, with particular emphasis placed on worker self-efficacy.

  8. Work reality perceived by individuals with impairments: a biopsychosocial experience.

    PubMed

    Coelho, Cecília Martins; Sampaio, Rosana Ferreira; Luz, Madel Therezinha; Mancini, Marisa Cotta

    2013-01-01

    Individuals with different impairments are working in the formal and/or informal market despite physical and attitudinal barriers. To date, few studies have addressed this situation from the perspective of the individuals. Apprehend factors that restrict work performance in the perspective of workers with impairments and identify the strategies employed and the difficulties faced. Individuals with impairment who exercised paid activities. Thirty semi-structured interviews and eleven observations of individuals in work activities. Limitations stemming from participants' disability and health status had an influence over their execution of tasks, but did not compromise work performance. Environmental factors that impacted as facilitators or barriers were: lack of preparation of colleagues, employers, education and rehabilitation systems; attitudes and coexistence; accessibility, implementation of land use policies, urban structures and transportation; products and technology; and distributive policies. Personal factors (upbringing, self-esteem, good mood, outgoingness, communicability, willpower, age and how the disability was acquired) also influenced participation at work. Important strategies included recognizing and sharing capabilities and needs, which minimized or eliminated difficulties at work. Workers with impairments developed effective strategies for dealing with adverse situations, which remained in the individual realm. Working with impairments is a complex experience that demands overcoming old paradigms.

  9. The myth of the normal, average human brain--the ICBM experience: (1) subject screening and eligibility.

    PubMed

    Mazziotta, John C; Woods, Roger; Iacoboni, Marco; Sicotte, Nancy; Yaden, Kami; Tran, Mary; Bean, Courtney; Kaplan, Jonas; Toga, Arthur W

    2009-02-01

    In the course of developing an atlas and reference system for the normal human brain throughout the human age span from structural and functional brain imaging data, the International Consortium for Brain Mapping (ICBM) developed a set of "normal" criteria for subject inclusion and the associated exclusion criteria. The approach was to minimize inclusion of subjects with any medical disorders that could affect brain structure or function. In the past two years, a group of 1685 potential subjects responded to solicitation advertisements at one of the consortium sites (UCLA). Subjects were screened by a detailed telephone interview and then had an in-person history and physical examination. Of those who responded to the advertisement and considered themselves to be normal, only 31.6% (532 subjects) passed the telephone screening process. Of the 348 individuals who submitted to in-person history and physical examinations, only 51.7% passed these screening procedures. Thus, only 10.7% of those individuals who responded to the original advertisement qualified for imaging. The most frequent cause for exclusion in the second phase of subject screening was high blood pressure followed by abnormal signs on neurological examination. It is concluded that the majority of individuals who consider themselves normal by self-report are found not to be so by detailed historical interviews about underlying medical conditions and by thorough medical and neurological examinations. Recommendations are made with regard to the inclusion of subjects in brain imaging studies and the criteria used to select them.

  10. The stories we tell: qualitative research interviews, talking technologies and the 'normalisation' of life with HIV.

    PubMed

    Mazanderani, Fadhila; Paparini, Sara

    2015-04-01

    Since the earliest days of the HIV/AIDS epidemic, talking about the virus has been a key way affected communities have challenged the fear and discrimination directed against them and pressed for urgent medical and political attention. Today, HIV/AIDS is one of the most prolifically and intimately documented of all health conditions, with entrenched infrastructures, practices and technologies--what Vinh-Kim Nguyen has dubbed 'confessional technologies'--aimed at encouraging those affected to share their experiences. Among these technologies, we argue, is the semi-structured interview: the principal methodology used in qualitative social science research focused on patient experiences. Taking the performative nature of the research interview as a talking technology seriously has epistemological implications not merely for how we interpret interview data, but also for how we understand the role of research interviews in the enactment of 'life with HIV'. This paper focuses on one crucial aspect of this enactment: the contemporary 'normalisation' of HIV as 'just another' chronic condition--a process taking place at the level of individual subjectivities, social identities, clinical practices and global health policy, and of which social science research is a vital part. Through an analysis of 76 interviews conducted in London (2009-10), we examine tensions in the experiential narratives of individuals living with HIV in which life with the virus is framed as 'normal', yet where this 'normality' is beset with contradictions and ambiguities. Rather than viewing these as a reflection of resistances to or failures of the enactment of HIV as 'normal', we argue that, insofar as these contradictions are generated by the research interview as a distinct 'talking technology', they emerge as crucial to the normative (re)production of what counts as 'living with HIV' (in the UK) and are an inherent part of the broader performative 'normalisation' of the virus. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Expert and self-assessment of lifetime symptoms and diagnosis of major depressive disorder in large-scale genetic studies in the general population: comparison of a clinical interview and a self-administered checklist.

    PubMed

    Martin, Jessica; Streit, Fabian; Treutlein, Jens; Lang, Maren; Frank, Josef; Forstner, Andreas J; Degenhardt, Franziska; Witt, Stephanie H; Schulze, Thomas G; Cichon, Sven; Nöthen, Markus M; Rietschel, Marcella; Strohmaier, Jana

    2017-10-01

    Major depression disorder (MDD) is a complex neuropsychiatric disorder and an increasing number of genetic risk variants are being identified. Investigation of their influence in the general population requires accurate and efficient assessment of depressive symptoms. Here, clinical interviews conducted by clinicians are the gold standard. We investigated whether valid and reliable clinical phenotypes can be obtained efficiently using self-administered instruments. Lifetime depressive symptoms and lifetime MDD diagnosis were assessed in 464 population-based individuals using a clinical interview and a structured, self-administered checklist. Analyses were carried out of the following: (i) intraclass correlations (ICC) between checklist and interview; (ii) sensitivity/specificity of the checklist; and (iii) the association of interview and checklist with a positive family history of MDD (FH-MDD+). The correspondence of the self-administered checklist with the clinical interview was good for most depressive symptoms (ICC=0.60-0.80) and moderate for MDD diagnosis (ICC=0.45). With the consecutive inclusion of MDD diagnostic criteria, sensitivity decreased from 0.67 to 0.46, whereas specificity remained high (0.95). For checklist and interview, strong associations were found between FH-MDD+ and most depressive symptoms and MDD diagnosis (all odds ratio≥1.83). The self-administered checklist showed high reliability for both the assessment of lifetime depressive symptoms and screening for individuals with no lifetime diagnosis of MDD. However, attention is warranted when the aim is to identify MDD cases. The positive association between depressive symptomatology and FH-MDD+ indicates the usefulness of both instruments to assess patients in genetic studies. Our data suggest that the more time-efficient and cost-efficient self-administered instruments also allow for the assessment of depressive symptoms accurate enough to investigate the influence of MDD genetic risk variants in the general population.

  12. Expert and self-assessment of lifetime symptoms and diagnosis of major depressive disorder in large-scale genetic studies in the general population: comparison of a clinical interview and a self-administered checklist

    PubMed Central

    Martin, Jessica; Streit, Fabian; Treutlein, Jens; Lang, Maren; Frank, Josef; Forstner, Andreas J.; Degenhardt, Franziska; Witt, Stephanie H.; Schulze, Thomas G.; Cichon, Sven; Nöthen, Markus M.; Rietschel, Marcella

    2017-01-01

    Major depression disorder (MDD) is a complex neuropsychiatric disorder and an increasing number of genetic risk variants are being identified. Investigation of their influence in the general population requires accurate and efficient assessment of depressive symptoms. Here, clinical interviews conducted by clinicians are the gold standard. We investigated whether valid and reliable clinical phenotypes can be obtained efficiently using self-administered instruments. Lifetime depressive symptoms and lifetime MDD diagnosis were assessed in 464 population-based individuals using a clinical interview and a structured, self-administered checklist. Analyses were carried out of the following: (i) intraclass correlations (ICC) between checklist and interview; (ii) sensitivity/specificity of the checklist; and (iii) the association of interview and checklist with a positive family history of MDD (FH-MDD+). The correspondence of the self-administered checklist with the clinical interview was good for most depressive symptoms (ICC=0.60–0.80) and moderate for MDD diagnosis (ICC=0.45). With the consecutive inclusion of MDD diagnostic criteria, sensitivity decreased from 0.67 to 0.46, whereas specificity remained high (0.95). For checklist and interview, strong associations were found between FH-MDD+ and most depressive symptoms and MDD diagnosis (all odds ratio≥1.83). The self-administered checklist showed high reliability for both the assessment of lifetime depressive symptoms and screening for individuals with no lifetime diagnosis of MDD. However, attention is warranted when the aim is to identify MDD cases. The positive association between depressive symptomatology and FH-MDD+ indicates the usefulness of both instruments to assess patients in genetic studies. Our data suggest that the more time-efficient and cost-efficient self-administered instruments also allow for the assessment of depressive symptoms accurate enough to investigate the influence of MDD genetic risk variants in the general population. PMID:28731911

  13. New Interview and Observation Measures of the Broader Autism Phenotype: Description of Strategy and Reliability Findings for the Interview Measures.

    PubMed

    Parr, Jeremy R; De Jonge, Maretha V; Wallace, Simon; Pickles, Andrew; Rutter, Michael L; Le Couteur, Ann S; van Engeland, Herman; Wittemeyer, Kerstin; McConachie, Helen; Roge, Bernadette; Mantoulan, Carine; Pedersen, Lennart; Isager, Torben; Poustka, Fritz; Bolte, Sven; Bolton, Patrick; Weisblatt, Emma; Green, Jonathan; Papanikolaou, Katerina; Baird, Gillian; Bailey, Anthony J

    2015-10-01

    Clinical genetic studies confirm the broader autism phenotype (BAP) in some relatives of individuals with autism, but there are few standardized assessment measures. We developed three BAP measures (informant interview, self-report interview, and impression of interviewee observational scale) and describe the development strategy and findings from the interviews. International Molecular Genetic Study of Autism Consortium data were collected from families containing at least two individuals with autism. Comparison of the informant and self-report interviews was restricted to samples in which the interviews were undertaken by different researchers from that site (251 UK informants, 119 from the Netherlands). Researchers produced vignettes that were rated blind by others. Retest reliability was assessed in 45 participants. Agreement between live scoring and vignette ratings was very high. Retest stability for the interviews was high. Factor analysis indicated a first factor comprising social-communication items and rigidity (but not other repetitive domain items), and a second factor comprised mainly of reading and spelling impairments. Whole scale Cronbach's alphas were high for both interviews. The correlation between interviews for factor 1 was moderate (adult items 0.50; childhood items 0.43); Kappa values for between-interview agreement on individual items were mainly low. The correlations between individual items and total score were moderate. The inclusion of several factor 2 items lowered the overall Cronbach's alpha for the total set. Both interview measures showed good reliability and substantial stability over time, but the findings were better for factor 1 than factor 2. We recommend factor 1 scores be used for characterising the BAP. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

  14. [Cranial-cerebral trauma after a traffic accident: perceptions of patients, family, physicians and professionals].

    PubMed

    Lefebvre, Hélène; Pelchat, Diane; Swaine, Bonnie; Gélinas, Isabelle; Levert, Marie Josée

    2004-09-01

    This is a study of medical care when road accident incidents result in traumatic brain injury (TBI). We investigated the personal perceptions of those involved in acute care episodes and subsequent rehabilitation. We conducted simultaneous semi-structured interviews with individuals who had sustained a TBI (8) and their families (8). We then conducted semi-structured individual interviews with the professionals (22) and physicians (9) who attended them. Results reveal the difficulties encountered by the different people involved, from the standpoint of the rehabilitation of both the person who with the TBI and their families, the relationships among the various actors, and the continuity of care. The results disclose the importance of including the family and the TBI casualty in the care process by endorsing their participation and by setting up suitable structures that prioritize a meaningful partnership among the individuals, families, physicians, professionals and health care organizations and in which each person can play a role as an agent in the care of the person with the TBI. An important element, which came out again in our results, is that the shortage of information provided to the families can jeopardize establishing a relationship of trust among the actors. Furthermore, many of the family members were upset that the health intervention was entirely focussed on the TBI casualty: none of the professionals were concerned with what the families were going through, either during the acute care or rehabilitation. Another major problem is lack of communication, not just amongst the professionals, but also between institutions which seem to function in isolation. Lack of resources, the limited availability of those that are offered, and social policies are also detrimental to the reintegration of the TBI individual into the community. Finally, many of the professionals reported that they had not been trained to assist families in this situation.

  15. Reliability and Validity of Autism Diagnostic Interview-Revised, Japanese Version

    ERIC Educational Resources Information Center

    Tsuchiya, Kenji J.; Matsumoto, Kaori; Yagi, Atsuko; Inada, Naoko; Kuroda, Miho; Inokuchi, Eiko; Koyama, Tomonori; Kamio, Yoko; Tsujii, Masatsugu; Sakai, Saeko; Mohri, Ikuko; Taniike, Masako; Iwanaga, Ryoichiro; Ogasahara, Kei; Miyachi, Taishi; Nakajima, Shunji; Tani, Iori; Ohnishi, Masafumi; Inoue, Masahiko; Nomura, Kazuyo; Hagiwara, Taku; Uchiyama, Tokio; Ichikawa, Hironobu; Kobayashi, Shuji; Miyamoto, Ken; Nakamura, Kazuhiko; Suzuki, Katsuaki; Mori, Norio; Takei, Nori

    2013-01-01

    To examine the inter-rater reliability of Autism Diagnostic Interview-Revised, Japanese Version (ADI-R-JV), the authors recruited 51 individuals aged 3-19 years, interviewed by two independent raters. Subsequently, to assess the discriminant and diagnostic validity of ADI-R-JV, the authors investigated 317 individuals aged 2-19 years, who were…

  16. Exploration of Individual Study Paths of Successful First-Year Students: An Interview Study

    ERIC Educational Resources Information Center

    Lindblom-Ylänne, Sari; Haarala-Muhonen, Anne; Postareff, Liisa; Hailikari, Telle

    2017-01-01

    The aim of the present study was to explore the individual profiles of successful, rapidly progressing first-year university students. The participants numbered 38 humanities and law students, who volunteered to be interviewed. The interview data were analysed using abductive content analysis. Two student profiles were distinguished:…

  17. First Year Co-Teaching: Disclosed through Focus Group and Individual Interviews

    ERIC Educational Resources Information Center

    Isherwood, Robert; Barger-Anderson, Richael; Merhaut, Joseph; Badgett, Rebecca; Katsafanas, Jodi

    2011-01-01

    Focus group interviews and individual interviews were conducted with 47 faculty members and administrators in a rural school district in Western Pennsylvania to determine strategies for consideration when attempting to establish and implement a co-teaching program. Participants were part of a school district in its second year of adopting a…

  18. The views and habits of the individuals with mental illness about physical activity and nutrition.

    PubMed

    Çelik Ince, Sevecen; Partlak Günüşen, Neslihan

    2018-05-07

    The aim of this study is to determine the views and habits of the individuals with mental illness on physical activities and nutrition behaviors. This study was carried out descriptive qualitative method. The sample of the study consisted of 15 individuals with mental illness. The data were collected with Socio-Demographic Information Form and Semi-Structured Interview Form and analyzed by content analysis. Four main themes emerged as the result of the analysis of the data. These themes are the barriers, facilitators, habits, and the needs. Mental health nurses should be aware of the barriers of individuals with mental illness. It is recommended that mental health nurses make interventions to encourage patients to have physical activity and healthy eating. © 2018 Wiley Periodicals, Inc.

  19. Individual quality of life of people with severe mental disorders.

    PubMed

    Pitkänen, A; Hätönen, H; Kuosmanen, L; Välimäki, M

    2009-02-01

    People with mental disorders have been found to suffer from impaired quality of life (QoL). Therefore, the assessment of QoL has become important in psychiatric research. This explorative study was carried out in acute psychiatric wards. Thirty-five patients diagnosed with schizophrenia and related psychosis were interviewed. QoL was rated by the Schedule for Evaluation of Individual Quality of Life which is a respondent-generated QoL measure using semi-structured interview technique. Patients named five areas of life important to them and then rated their current status and placed relative weight on each QoL area. The data were analysed with qualitative content analysis and descriptive statistics. The most frequently named areas for QoL were health, family, leisure activities, work/study and social relationships, which represented 72% of all QoL areas named. Patients' average satisfaction with these QoL areas ranged 49.0-69.1 (scale 0-100). The mean global QoL score was 61.5 (standard deviation 17.4; range 24.6-89.6; scale 0-100). Awareness of patients' perceptions of their QoL areas can enhance our understanding of an individual patient's QoL and reveal unsatisfactory areas where QoL could be improved with individually tailored needs-based interventions.

  20. 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.

  1. "Anything above marijuana takes priority": Obstetric providers' attitudes and counseling strategies regarding perinatal marijuana use.

    PubMed

    Holland, Cynthia L; Nkumsah, Michelle Abena; Morrison, Penelope; Tarr, Jill A; Rubio, Doris; Rodriguez, Keri L; Kraemer, Kevin L; Day, Nancy; Arnold, Robert M; Chang, Judy C

    2016-09-01

    To describe obstetric provider attitudes, beliefs, approaches, concerns, and needs about addressing perinatal marijuana use with their pregnant patients. We conducted individual semi-structured interviews with obstetric providers and asked them to describe their thoughts and experiences about addressing perinatal marijuana use. Interviews were transcribed verbatim, coded and reviewed to identify themes. Fifty-one providers participated in semi-structured interviews. Providers admitted they were not familiar with identified risks of marijuana use during pregnancy, they perceived marijuana was not as dangerous as other illicit drugs, and they believed patients did not view marijuana as a drug. Most provider counseling strategies focused on marijuana's status as an illegal drug and the risk of child protective services being contacted if patients tested positive at time of delivery. When counseling about perinatal marijuana use, obstetric providers focus more on legal issues than on health risks. They describe needing more information regarding medical consequences of marijuana use during pregnancy. Provider training should include information about potential consequences of perinatal marijuana use and address ways to improve obstetric providers' counseling. Future studies should assess changes in providers' attitudes as more states consider the legalization of marijuana. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Best Practices in Establishing and Sustaining Consortia in Pharmacy Education

    PubMed Central

    Hincapie, Ana; Baugh, Gina; Rice, Luke; Sy, Erin; Penm, Jonathan; Albano, Christian

    2017-01-01

    Objective. To describe best practices, necessary resources, and success or lessons learned from established consortia in pharmacy education. Methods. Using semi-structured interviews and qualitative analysis, interviews with members of established consortia in pharmacy education were conducted until saturation was reached. Themes were analyzed and meaningful descriptions of consortia characteristics were developed using systematic text condensation. Results. Thirteen interviews were conducted. The primary purpose for forming a consortium was identified as threefold: share ideas/best practices; facilitate collaboration; and perform shared problem-solving. For experiential education consortia, two additional purposes were found: share capacity for practice sites, and promote standardization across programs. When investigating best practices for established consortia, three main themes were identified. These included strategies for: (1) relationship building within consortia, (2) successful outcomes of consortia, and (3) sustainability. Successful outcomes included scholarship and, sometimes, program standardization. Sustainability was linked to structure/support and momentum. Respect was considered the foundation for collaborative relationships to flourish in these consortia. Conclusions. Pharmacy education consortia form through a process that involves relationship building to produce outcomes that promote sustainability, which benefits both pharmacy schools and individual faculty members. Consortium formation is a viable, productive, and often necessary institutional goal for pharmacy schools. PMID:28381887

  3. Development of a Patient-Reported Outcome Instrument to Evaluate Symptoms of Advanced NSCLC: Qualitative Research and Content Validity of the Non-Small Cell Lung Cancer Symptom Assessment Questionnaire (NSCLC-SAQ)

    PubMed Central

    Atkinson, Thomas M.; DeBusk, Kendra P.A.; Liepa, Astra M.; Scanlon, Michael; Coons, Stephen Joel

    2016-01-01

    PURPOSE To describe the process and results of the preliminary qualitative development of a new symptom-based PRO measure intended to assess treatment benefit in advanced non-small cell lung cancer (NSCLC) clinical trials. METHODS Individual qualitative interviews were conducted with adult NSCLC (Stage I–IV) patients in the US. Experienced interviewers conducted concept elicitation (CE) and cognitive interviews using semi-structured interview guides. The CE interview guide was used to elicit spontaneous reports of symptom experiences along with probing to further explore and confirm concepts. Interview transcripts were coded and analyzed by professional qualitative coders using Atlas.ti software, and were summarized by like-content using an iterative coding framework. Data from the CE interviews were considered alongside existing literature and clinical expert opinion during an item-generation process, leading to development of a preliminary version of the NSCLC Symptom Assessment Questionnaire (NSCLC-SAQ). Three waves of cognitive interviews were conducted to evaluate concept relevance, item interpretability, and structure of the draft items to facilitate further instrument refinement. FINDINGS Fifty-one patients (mean age 64.9 [SD=11.2]; 51.0% female) participated in the CE interviews. A total of 1,897 expressions of NSCLC-related symptoms were identified and coded in interview transcripts, representing approximately 42 distinct symptom concepts. A 9-item initial draft instrument was developed for testing in three waves of cognitive interviews with additional NSCLC patients (n=20), during which both paper and electronic versions of the instrument were evaluated and refined. Participant responses and feedback during cognitive interviews led to the removal of 2 items and substantial modifications to others. IMPLICATIONS The NSCLC-SAQ is a 7-item PRO measure intended for use in advanced NSCLC clinical trials to support medical product labelling. The NSCLC-SAQ uses a 7-day recall period and verbal rating scales. It was developed in accordance with the FDA’s PRO Guidance and scientific best practices, and the resulting qualitative interview data provide evidence of content validity. The NSCLC-SAQ has been prepared in both paper and electronic administration formats and a tablet computer-based version is currently undergoing quantitative testing to confirm its measurement properties and support FDA qualification. PMID:27041408

  4. An interview study of young adults born to mothers with mild intellectual disability.

    PubMed

    Lindblad, Ida; Billstedt, Eva; Gillberg, Christopher; Fernell, Elisabeth

    2013-12-01

    A group of 10 young adults from a population-based series in Sweden, of originally 42 individuals, born to mothers with mild intellectual disability (ID), were interviewed with regard to their experiences during childhood, adolescence, and their current situation. The interview revealed that 6 of the 10 individuals had been removed from their biological parents during childhood, 6 reported clear child abuse and/or neglect, and 6 individuals had mild ID. The majority of the individuals reported difficulties in their relations with family and in school. The small number of participants (n = 10) who could be personally interviewed reflected the major problems that were encountered in the process of making contact with this group of young individuals. In conclusion, this study adds to other reports that children of mothers with ID constitute an extremely vulnerable group. Therefore, these families need full and continuous attention from the supportive systems in society.

  5. Participants’ perceptions of a knowledge-brokering strategy to facilitate evidence-informed policy-making in Fiji

    PubMed Central

    2013-01-01

    Background Evidence-informed policy-making (EIPM) is optimal when evidence-producers (researchers) and policy developers work collaboratively to ensure the production and use of the best available evidence. This paper examined participants’ perceptions of knowledge-brokering strategies used in the TROPIC (Translational Research in Obesity Prevention in Communities) project to facilitate the use of obesity-related evidence in policy development in Fiji. Method Knowledge-brokers delivered a 12-18 month programme comprising workshops targeting EIPM skills and practical support for developing evidence-informed policy briefs to reduce obesity. The programme was tailored to each of the six participating organizations. Knowledge-brokering strategies included negotiating topics that were aligned to the goals of individual organizations, monitoring and evaluating time-management skills, accommodating other organizational and individual priorities, delivering practical sessions on use of appropriate research tools and supporting individual writing of policy briefs. Two qualitative methods were used to examine individuals’ perceptions of skills obtained, opportunities afforded by the TROPIC project, facilitators and inhibiters to planned policy brief development and suggestions for improved programme delivery. Forty-nine participants completed an electronic word table and then participated in a semi-structured interview. An independent interviewer conducted structured interviews with a high-ranking officer in each organization to examine their perceptions of TROPIC engagement strategies. Data were analyzed descriptively and thematically, with the first author and another experienced qualitative researcher analyzing data sets separately, and then combining analyses. Results Many participants believed that they had increased their skills in acquiring, assessing, adapting and applying evidence, writing policy briefs and presenting evidence-based arguments to higher levels. Many participants preferred one-to-one meetings to group activities to ensure early resolution of developing issues and to refine policy briefs. Perceived barriers to EIPM were lack of knowledge about data sources, inadequate time to develop evidence-informed briefs, and insufficient resources for accessing and managing evidence. Conclusion An innovative knowledge-brokering approach utilizing skill development and mentorship facilitated individual EIPM skills and policy brief development. The TROPIC model could stimulate evidence-based policy action relating to obesity prevention and other policy areas in other Pacific countries and elsewhere. PMID:23919672

  6. Negotiating identity and self-image: perceptions of falls in ambulatory individuals with spinal cord injury - a qualitative study.

    PubMed

    Jørgensen, Vivien; Roaldsen, Kirsti Skavberg

    2017-04-01

    Explore and describe experiences and perceptions of falls, risk of falling, and fall-related consequences in individuals with incomplete spinal cord injury (SCI) who are still walking. A qualitative interview study applying interpretive content analysis with an inductive approach. Specialized rehabilitation hospital. A purposeful sample of 15 individuals (10 men), 23 to 78 years old, 2-34 years post injury with chronic incomplete traumatic SCI, and walking ⩾75% of time for mobility needs. Individual, semi-structured face-to-face interviews were recorded, condensed, and coded to find themes and subthemes. One overarching theme was revealed: "Falling challenges identity and self-image as normal" which comprised two main themes "Walking with incomplete SCI involves minimizing fall risk and fall-related concerns without compromising identity as normal" and "Walking with incomplete SCI implies willingness to increase fall risk in order to maintain identity as normal". Informants were aware of their increased fall risk and took precautions, but willingly exposed themselves to risky situations when important to self-identity. All informants expressed some conditional fall-related concerns, and a few experienced concerns limiting activity and participation. Ambulatory individuals with incomplete SCI considered falls to be a part of life. However, falls interfered with the informants' identities and self-images as normal, healthy, and well-functioning. A few expressed dysfunctional concerns about falling, and interventions should target these.

  7. Public Perceptions of Florida Red Tide Risks

    PubMed Central

    Kuhar, Sara E.; Nierenberg, Kate; Kirkpatrick, Barbara; Tobin, Graham A.

    2009-01-01

    This research integrates theoretical frameworks of risk perception, social amplification of risk, and the role of place-specific contexts in order to explore the various perceptions surrounding Florida red tides. Florida red tides are naturally occurring events that are increasing in frequency, duration, and severity. This has implications for public health, the local economy, and ecosystem health. While many of the negative impacts of Florida red tides are not easily controlled, some of the secondary impacts may be mitigated through individuals’ responses. However, public perception and consequent reactions to Florida red tides have not been investigated. This research uses questionnaire surveys, and semi-structured interviews, to explore the various perceptions of the risk surrounding red tides. Surveys and interviews were conducted along two Florida west coast beaches. The results indicate that the underlying foundations of the social amplification of the risk framework are applicable to understanding how individuals form perceptions of risk relative to red tide events. There are key differences between the spatial locations of individuals and corresponding perceptions, indicating that place-specific contexts are essential to understanding how individuals receive and interpret risk information. The results also suggest that individuals may be lacking efficient and up-to-date information about Florida red tides and their impacts because of inconsistent public outreach. Overall, social and spatial factors appear to be influential as to whether individuals amplify or attenuate the risks associated with Florida red tides. PMID:19392675

  8. Strategies for coping with individual PTSD symptoms: Experiences of African American victims of intimate partner violence.

    PubMed

    Sullivan, Tami P; Weiss, Nicole H; Price, Carolina; Pugh, Nicole; Hansen, Nathan B

    2018-05-01

    Understanding how populations at particular risk for posttraumatic stress disorder (PTSD) and its deleterious outcomes cope with individual PTSD symptoms is critical to developing interventions that promote resilience, support recovery, and ultimately empower traumatized populations. Therefore, the purpose of this study was to identify specific strategies women use to cope with individual PTSD symptoms among a population at particular risk for experiencing trauma and its negative sequelae-African American victims of intimate partner violence (IPV) who use substances. This 30-day study included 107 African American women who reported experiencing current IPV and using a substance. During their follow-up interviews, women participated in a structured interview to retrospectively report on the strategies they typically used to cope with various PTSD symptoms during the 30-day period. Results of content analysis revealed that women used 19 different strategies to cope with symptoms (e.g., social support, substance use, electronic media, religious or spiritual coping), which varied as a function of the PTSD symptom experienced. Aggregating symptoms to the cluster level obscured the variability in strategies used to cope with individual symptoms. Findings are discussed in the context of the larger literature on coping and PTSD, specifically regarding (a) coping strategies that may be adaptive or maladaptive and (b) directions for future research that attend to experiences of individual PTSD symptoms. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. The globalization of behavioral science evidence about battered women: a theory of production and diffusion.

    PubMed

    Gatowski, S I; Dobbin, S A; Richardson, J T; Ginsburg, G P

    1997-01-01

    A theoretical framework is proposed for understanding how the innovative use of behavioral science evidence is both produced and diffused among members of the global legal community. Using case law analyses and interviews with key individuals involved in selected cases, we examine how battered woman syndrome (BWS) is produced and diffused between and among Australia, Canada, England, and the United States. The following diffusion mechanisms are proposed: (1) The availability and accessibility of credible dissemination sources; (2) characteristics of the overall practice environment operating in each legal culture; (3) the attitudes and knowledge of attorneys and judges about the use of scientific evidence; (4) political and social support for the use of the evidence in the legal culture; and (5) the level of structural equivalence, communication, and "neighbor effects" between and among legal cultures. Each mechanism is discussed and supplemented with information from interviews with individuals involved in key cases involving BWS evidence.

  10. [A phenomenological study of suicide attempts in elders].

    PubMed

    Im, Mi Young; Kim, Yun Jeong

    2011-02-01

    The purpose of this study was to examine the meaning and essence of suicide for elderly people who had previously attempted suicide as an older person. Giorgi's descriptive phenomenology was used for analysis. The researchers carried out in-depth interviews, recordings and memos individually with four elders. The elders were individuals who had attempted suicide sometime in the past 5 yr. They were interviewed from 5 to 10 times using open-ended questions and a semi-structural format. Demographic data were also collected. The meaning of suicide before a suicide attempt in older people had four core components: conflict with family, powerlessness and despair in their life with a drop in self-esteem, using internal and external resources to resolve their troubles and awareness of imminent crisis. These results of this study will increase understanding of suicide in older people by defining their subjective experience of suicide attempts and applying grounded data in the development of programs that provide concrete intervention strategies to prevent suicide in elderly people.

  11. Exploration of the administrative aspects of the delivery of home health care services: a qualitative study.

    PubMed

    Shahsavari, Hooman; Nasrabadi, Alireza Nikbakht; Almasian, Mohammad; Heydari, Heshmatolah; Hazini, Abdolrahim

    2018-01-01

    Because of the variety of services and resources offered in the delivery of home health care, its management is a challenging and difficult task. The purpose of this study was to explore the administrative aspects of the delivery of home health care services. This qualitative study was conducted based on the traditional content analysis approach in 2015 in Iran. The participants were selected using the purposeful sampling method and data were collected through in-depth semi-structured personal interviews and from discussions in a focus group. The collected data were analyzed using the Lundman and Graneheim method. 23 individuals participated in individual interviews, and the collected data were categorized into the two main themes of policymaking and infrastructures, each of which consisted of some subcategories. Health policymakers could utilize the results of this study as baseline information in making decisions about the delivery of home health care services, taking into account the contextual dimensions of home care services, leading to improvements in home health care services.

  12. Consultancy research as a barrier to strengthening social science research capacity in Uganda.

    PubMed

    Wight, Daniel; Ahikire, Josephine; Kwesiga, Joy C

    2014-09-01

    There is a shortage of senior African social scientists available to lead or manage research in Africa, undermining the continent's ability to interpret and solve its socio-economic and public health problems. This is despite decades of investment to strengthen research capacity. This study investigated the role of individually commissioned consultancy research in this lack of capacity. In 2006 structured interviews (N = 95) and two group discussions (N = 16 total) were conducted with a fairly representative sample of Ugandan academic social scientists from four universities. Twenty-four senior members of 22 Ugandan and international commissioning organizations were interviewed. Eight key actors were interviewed in greater depth. Much of Ugandan social science research appears to take the form of small, individually contracted consultancy projects. Researchers perceived this to constrain their professional development and, more broadly, social science research capacity across Uganda. Conversely, most research commissioners seemed broadly satisfied with the research expertise available and felt no responsibility to contribute to strengthening research capacity. Most consultancy research does not involve institutional overheads and there seems little awareness of, or interest in, such overheads. Although inequalities in the global knowledge economy are probably perpetuated primarily by macro-level factors, in line with Dependency Theory, meso-level factors are also important. The current research market and institutional structures in Uganda appear to create career paths that seriously impede the development of high quality social science research capacity, undermining donor investments and professional effort to strengthen this capacity. These problems are probably generic to much of sub-Saharan Africa. However, both commissioning and research organizations seem ready, in principle, to establish national guidelines for institutional research consultancies. These could develop both institutional and individual research capacity, improve output and accountability, and facilitate academic research funding and indigenous research agendas. Copyright © 2014. Published by Elsevier Ltd.

  13. A study of education and KSAOs on career entry for product engineers: What employers really want

    NASA Astrophysics Data System (ADS)

    Thornburgh, James

    The purpose of the study was to investigate the ways that employers of product engineers evaluate potential employees' job readiness, and which theories related to the education-work transaction are supported by practice. This study used a mixed methods approach and consisted of a state-wide survey (N=106) and local interviews (N=8). The results of the research indicate that attributes of both the Theory of Individual Differences and Credentialing Theory are present in the hiring practices of product engineers. Consistent with the Theory of Individual Differences, employers indicate they look for evidence of various job-related Knowledge, Skills, Abilities, and Other attributes (KSAOs) and they indicate they are willing to hire applicants who have less than a bachelor's degree. Consistent with Credentialing Theory, employers advertise a formal education minimum which represents only one way that individuals may learn to be an engineer. This study also confirmed prior research that most employers use primarily non-evidence based predictors to evaluate applicants. The primary initial screening predictors were experience, GPA, and major, while the primary finalist selection predictors were unstructured interviews, and applications, followed by structured interviews, job knowledge tests, and work sample test. Contrary to previous findings, this study did not find any major differences between what HR professionals, engineering managers, or other manager look for in terms of qualifications or what predictors they use when evaluating applicants for product engineer positions.

  14. Effects of Gender Reassignment on Quality of Life and Mental Health in People with Gender Dysphoria.

    PubMed

    Özata Yıldızhan, Berna; Yüksel, Şahika; Avayu, Mirella; Noyan, Handan; Yıldızhan, Eren

    2018-01-01

    Our purpose was to compare the life style, family and social relationships (social adaptation) and the quality of life in people with gender dysphoria with and without history of sex reassignment surgery. Twenty  individuals (SR group) who were earlier followed   in Istanbul University Psychiatry Department Psychoneurosis and Psychotherapy Unit with gender dysphoria diagnosis in  order  to  have confirmative reports for the sex reassignment (SR) surgery were interviewed at least one year after the surgery. For comparison, 50 individuals with gender dysphoria (NSR group) who had recently applied to the same unit were interviewed. Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I), Family Assessment Device (FAD), Multidimensional Scale for Perceived Social Support (MSPSS), World Health Organization Quality of Life Scale (WHOQOL-BREF) were administered. In the SR group, concerns about gender related discrimination and victimization were lower, but concerns related to the disclosure of transgender identity were higher compared to the NSR group. The SR group scored lower on FAD Affective Involvement, Problem Solving, Affective Responsiveness subscales, but scored higher on MSPSS family subscale and psychological domain of WHOQOL-BREF. The sex reassignment surgeries (SRS) required for legal change in gender status of individuals with gender dysphoria are helpful in relieving the conflicts. SRS causes improvements in the quality of life, family support, interpersonal relationships and reduces the concerns about the gender related discrimination and victimization.

  15. From "Forest Fires" and "Hunting" to Disturbing "Habitats" and "Food Chains": Do Young Children Come Up with Any Ecological Interpretations of Human Interventions within a Forest?

    ERIC Educational Resources Information Center

    Ergazaki, Marida; Andriotou, Eirini

    2010-01-01

    This study aims at highlighting young children's reasoning about human interventions within a forest ecosystem. Our focus is particularly set on whether preschoolers are able to come up with any basic ecological interpretations of human actions upon forest plants or animals and how. Conducting individual, semi-structured interviews with 70…

  16. Discovering Factors that Influence the Decision to Pursue a Chemistry-Related Career: A Comparative Analysis of the Experiences of Non Scientist Adults and Chemistry Teachers in Greece

    ERIC Educational Resources Information Center

    Salta, Katerina; Gekos, Michael; Petsimeri, Irene; Koulougliotis, Dionysios

    2012-01-01

    This study aims at identifying factors that influence students' choice not to pursue a chemistry-related career by analyzing the experiences of secondary education chemistry teachers in Greece and of Greek adults who have not pursued studies related to science. Data collection was done with the method of individual structured interviews. The…

  17. Comparing the Personality Disorder Interview for DSM-IV (PDI-IV) and SCID-II borderline personality disorder scales: an item-response theory analysis.

    PubMed

    Huprich, Steven K; Paggeot, Amy V; Samuel, Douglas B

    2015-01-01

    One-hundred sixty-nine psychiatric outpatients and 171 undergraduate students were assessed with the Personality Disorder Interview-IV (PDI-IV; Widiger, Mangine, Corbitt, Ellis, & Thomas, 1995) and the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1997) for borderline personality disorder (BPD). Eighty individuals met PDI-IV BPD criteria, whereas 34 met SCID-II BPD criteria. Dimensional ratings of both measures were highly intercorrelated (rs = .78, .75), and item-level interrater reliability fell in the good to excellent range. An item-response theory analysis was performed to investigate whether properties of the items from each interview could help understand these differences. The limited agreement seemed to be explained by differences in the response options across the two interviews. We found that suicidal behavior was among the most discriminating criteria on both instruments, whereas dissociation and difficulty controlling anger had the 2 lowest alpha parameter values. Finally, those meeting BPD criteria on both interviews had higher levels of anxiety, depression, and more impairments in object relations than those meeting criteria on just the PDI-IV. These findings suggest that the choice of measure has a notable effect on the obtained diagnostic prevalence and the level of BPD severity that is detected.

  18. Provoked vestibulodynia-women's experience of participating in a multidisciplinary vulvodynia program.

    PubMed

    Sadownik, Leslie A; Seal, Brooke N; Brotto, Lori A

    2012-04-01

    Provoked Vestibulodynia (PVD) is the most common cause of pain with intercourse that affects reproductively aged women. The treatment outcome literature suggests that existing treatments, when administered individually, may have only limited benefits for improving pain, and that multidisciplinary approaches may be more effective for reducing pain and pain-associated distress. A program that offers education, group cognitive behavioral therapy, pelvic floor physiotherapy, and medical appointments was developed and implemented at our hospital site. To explore the experiences of women who participated in the Multidisciplinary Vulvodynia Program (MVP) in order to identify the perceived benefits of this program. Qualitative retrospective study. A semi-structured interview format was used to interview graduates of the MVP. Nineteen women, mean age 30.8 (20-54 years), participated in a one-on-one in-depth interview with a trained interviewer. The key question asked was "What has been the impact of the mvp on your life?" interviews were audio-recorded, transcribed, and qualitatively analyzed for major themes. Content analysis of interview transcripts. Five main themes emerged and included: increased knowledge, gained tools/skills, perceived improved mood/psychological well-being, a sense of validation and support, and an enhanced sense of empowerment. Overall, a multidisciplinary vulvodynia program was perceived as being beneficial for women with PVD. © 2012 International Society for Sexual Medicine.

  19. "I didn't have anything to decide, I wanted to help my kids" - An interview-based study of consent procedures for sampling human biological material for genetic research in rural Pakistan.

    PubMed

    Kongsholm, Nana Cecilie Halmsted; Lassen, Jesper; Sandøe, Peter

    2018-05-03

    Individual, comprehensive, and written informed consent is broadly considered an ethical obligation in research involving the sampling of human material. In developing countries, however, local conditions, such as widespread illiteracy, low levels of education, and hierarchical social structures complicate compliance with these standards. As a result, researchers may modify the consent process to secure participation. To evaluate the ethical status of such modified consent strategies it is necessary to assess the extent to which local practices accord with the values underlying informed consent. Over a two-week period in April 2014 we conducted semi-structured interviews with researchers from a genetic research institute in rural Pakistan and families who had given blood samples for their research. Interviews with researchers focused on the institute's requirements for consent, and the researchers' strategies for and experiences with obtaining consent in the field. Interviews with donors focused on their motivation for donating samples, their experience of consent and donation, and what factors were central in their decisions to give consent. Researchers often reported modifications to consent procedures suited to the local context, standardly employing oral and elder consent, and tailoring information to the social education level of donor families. Central themes in donors' accounts of their decision to consent were the hope of getting something out of their participation and their remarkably high levels of trust in the researchers. Several donor accounts indicated a degree of confusion about participation and diagnosis, resulting in misconceived expectations of therapeutic benefits. We argue that while building and maintaining trusting relationships in research is important - not least in developing countries - strategies that serve this endeavor should be supplemented with efforts to ensure proper provision and understanding of relevant information, specifically about the nature of research and measures for individual consent and opt-out.

  20. Can We Get Faculty Interviewers on the Same Page? An Examination of a Structured Interview Course for Surgeons.

    PubMed

    Gardner, Aimee K; D'Onofrio, Brenna C; Dunkin, Brian J

    Guidance on how to train faculty to conduct structured interviews and implement them into current screening processes is lacking. The goal of this study is to describe a structured interview training program designed specifically for surgeons and examine its effectiveness. Faculty involved in advanced surgical fellowship interviews completed a 20-item knowledge assessment and video-based applicant interview ratings before taking a half-day course on conducting structured interviews. The course consisted of evidence-based strategies and methods for conducting structured interviews, asking questions, and rating applicants in a highly interactive format. After the course, faculty again completed the knowledge assessment and provided ratings for 3 video-based applicant interviews. All faculty members (N = 5) responsible for selecting fellows in minimally invasive and bariatric surgery completed the training. Faculty had an average of 15.8 ± 9.12 years in practice. Average performance on the precourse knowledge assessment was 35% ± 6.12% and the group was unable to achieve acceptable agreement for applicant interview scores for any of the competencies assessed. After the course, faculty demonstrated significant improvements (p < 0.01) on the knowledge assessment, more than doubling their scores on the pretest with average scores of 80% ± 9.35%. Faculty also improved their interrater agreement of applicant competency, with 80% of the applicant interview ratings within 2 points of each other. Implementation of a half-day course designed to teach principles and skills around structured interviewing and assessment demonstrated significant improvements in both interviewing knowledge and interrater agreement. These findings support the time and resources required to develop and implement a structured interview training program for surgeons for the postgraduate admissions process. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Exploring challenges in the patient's discharge process from the internal medicine service: A qualitative study of patients' and providers' perceptions.

    PubMed

    Pinelli, Vincent; Stuckey, Heather L; Gonzalo, Jed D

    2017-09-01

    In hospital-based medicine units, patients have a wide range of complex medical conditions, requiring timely and accurate communication between multiple interprofessional providers at the time of discharge. Limited work has investigated the challenges in interprofessional collaboration and communication during the patient discharge process. In this study, authors qualitatively assessed the experiences of internal medicine providers and patients about roles, challenges, and potential solutions in the discharge process, with a phenomenological focus on the process of collaboration. Authors conducted interviews with 87 providers and patients-41 providers in eight focus-groups, 39 providers in individual interviews, and seven individual patient interviews. Provider roles included physicians, nurses, therapists, pharmacists, care coordinators, and social workers. Interviews were audio-recorded and transcribed verbatim, followed by iterative review of transcripts using qualitative coding and content analysis. Participants identified several barriers related to interprofessional collaboration during the discharge process, including systems insufficiencies (e.g., medication reconciliation process, staffing challenges); lack of understanding others' roles (e.g., unclear which provider should be completing the discharge summary); information-communication breakdowns (e.g., inaccurate information communicated to the primary medical team); patient issues (e.g., patient preferences misaligned with recommendations); and poor collaboration processes (e.g., lack of structured interprofessional rounds). These results provide context for targeting improvement in interprofessional collaboration in medicine units during patient discharges. Implementing changes in care delivery processes may increase potential for accurate and timely coordination, thereby improving the quality of care transitions.

  2. What do GUM physicians think should be taught in a modern undergraduate GUM module? A qualitative inquiry.

    PubMed

    Fernando, I

    2015-10-01

    Traditional undergraduate Genitourinary Medicine (GUM) teaching in the UK concentrated on the management of individual sexually transmitted infections. There is significant variation, however, in the GUM teaching provided by different medical schools today. I undertook a qualitative interview study to gather views of GUM and other sexual health clinicians regarding what should be taught within a modern undergraduate GUM module. Nine GUM clinicians and two Sexual and Reproductive Health (SRH) clinicians participated in the study; all were directly involved in undergraduate teaching. Semi-structured interviews were conducted with study participants by a single interviewer, focusing on three key topics: their individual opinions regarding important learning outcomes (LOs) for a modern model GUM curriculum, their preferred teaching methods and the total recommended teaching time required. Interviews were audio-recorded with consent and professionally transcribed. Data were analysed by the content analysis method. Interviewees frequently stressed skill and attitudinal LOs, even above knowledge. Recommended important skills included sexual history taking, HIV risk assessment and testing, and male and female genital examination. Recommended attitudinal LOs were developing an open and non-judgemental approach to sexual health issues and understanding sexual well-being to be an important component of general health. Respondents were keen for a mixture of teaching methods, but generally agreed that clinic attendance and experiential learning were beneficial. They preferred that GUM teaching should be delivered in the latter years of the undergraduate curriculum. © The Author(s) 2015.

  3. 75 FR 69677 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... interviews will participate in this interview. Questions vary by respondent type. 6. Post-implementation semi... semi-structured interviews will participate in this interview. Questions do not vary by respondent type... each nursing home. 4. Pre-implementation semi-structured interview--The purpose of this interview is to...

  4. An Interview Study of Young Adults Born to Mothers with Mild Intellectual Disability

    ERIC Educational Resources Information Center

    Lindblad, Ida; Billstedt, Eva; Gillberg, Christopher; Fernell, Elisabeth

    2013-01-01

    A group of 10 young adults from a population-based series in Sweden, of originally 42 individuals, born to mothers with mild intellectual disability (ID), were interviewed with regard to their experiences during childhood, adolescence, and their current situation. The interview revealed that 6 of the 10 individuals had been removed from their…

  5. Meaningfulness in work - experiences among employed individuals with persistent mental illness.

    PubMed

    Leufstadius, Christel; Eklund, Mona; Erlandsson, Lena-Karin

    2009-01-01

    The aim of the present study was to investigate how people with persistent mental illness, with various types of work and employment conditions, experience and describe the meaningfulness of work. The study had a qualitative approach and twelve informants living in the community were purposefully selected and interviewed according to overarching themes. The interviews were analysed using qualitative content analysis, and all of the authors were involved in the analysis process. The findings resulted in four main themes: 1) work per se has certain characteristics, 2) participation in different contexts gives a feeling of normality, acceptance, belonging and fulfilment of norms and values, 3) work affords structure, energy and a balanced daily life, and 4) work increases well-being and strengthens one's identity. A tentative model is described concerning perceived meaningfulness in work among individuals with persistent mental illness, in which the first three aspects of meaning are a prerequisite for meaning in terms of increased well-being and strengthened identity. Furthermore, it seems important that work has to bring the just right challenge to the individual in order for him or her to perceive the identified aspects of meaningfulness.

  6. Sleep loss as a trigger of mood episodes in bipolar disorder: individual differences based on diagnostic subtype and gender.

    PubMed

    Lewis, Katie Swaden; Gordon-Smith, Katherine; Forty, Liz; Di Florio, Arianna; Craddock, Nick; Jones, Lisa; Jones, Ian

    2017-09-01

    Background Sleep loss may trigger mood episodes in people with bipolar disorder but individual differences could influence vulnerability to this trigger. Aims To determine whether bipolar subtype (bipolar disorder type I (BP-I) or II (BD-II)) and gender were associated with vulnerability to the sleep loss trigger. Method During a semi-structured interview, 3140 individuals (68% women) with bipolar disorder (66% BD-I) reported whether sleep loss had triggered episodes of high or low mood. DSM-IV diagnosis of bipolar subtype was derived from case notes and interview data. Results Sleep loss triggering episodes of high mood was associated with female gender (odds ratio (OR) = 1.43, 95% CI 1.17-1.75, P < 0.001) and BD-I subtype (OR = 2.81, 95% CI 2.26-3.50, P < 0.001). Analyses on sleep loss triggering low mood were not significant following adjustment for confounders. Conclusions Gender and bipolar subtype may increase vulnerability to high mood following sleep deprivation. This should be considered in situations where patients encounter sleep disruption, such as shift work and international travel. © The Royal College of Psychiatrists 2017.

  7. Obese persons' physical activity experiences and motivations across weight changes: a qualitative exploratory study.

    PubMed

    Bombak, Andrea E

    2015-11-14

    Obese individuals are encouraged to participate in physical activity. However, few qualitative studies have explored obese individuals' motivations for and experiences with physical activity. The physical activity experiences of self-identified obese or formerly obese persons (n = 15) were explored through in-depth, semi-structured, audio-taped, repeated interviews and ethnography over one year. Participant observation occurred at multiple sites identified by participants as meaningful to them as obese persons. Data from interview transcripts and fieldnotes were analyzed via thematic content analysis. Underlying goals for engaging in physical activity were diverse. Emergent motivation themes included: protection, pressure, and pleasure. Participants were protective of maintaining functional capacity, establishing fit identities, and achieving weight loss. Participants also discussed feelings of excessive pressure to continue progressing toward weight and fitness goals. Enjoyment in physical activity was often a by-product for all participants and could become a sought-after endpoint. Finding an environment in which participants felt safe, accepted, and encouraged to be active was extremely important for continual engagement. Obese individuals enjoyed physical activity and were concerned about maintaining functional fitness. Stigmatization and untenable goals and monitoring could disrupt physical activity.

  8. Sleep loss as a trigger of mood episodes in bipolar disorder: individual differences based on diagnostic subtype and gender

    PubMed Central

    Lewis, Katie Swaden; Gordon-Smith, Katherine; Forty, Liz; Di Florio, Arianna; Craddock, Nick; Jones, Lisa; Jones, Ian

    2017-01-01

    Background Sleep loss may trigger mood episodes in people with bipolar disorder but individual differences could influence vulnerability to this trigger. Aims To determine whether bipolar subtype (bipolar disorder type I (BP-I) or II (BD-II)) and gender were associated with vulnerability to the sleep loss trigger. Method During a semi-structured interview, 3140 individuals (68% women) with bipolar disorder (66% BD-I) reported whether sleep loss had triggered episodes of high or low mood. DSM-IV diagnosis of bipolar subtype was derived from case notes and interview data. Results Sleep loss triggering episodes of high mood was associated with female gender (odds ratio (OR) = 1.43, 95% CI 1.17–1.75, P < 0.001) and BD-I subtype (OR = 2.81, 95% CI 2.26–3.50, P < 0.001). Analyses on sleep loss triggering low mood were not significant following adjustment for confounders. Conclusions Gender and bipolar subtype may increase vulnerability to high mood following sleep deprivation. This should be considered in situations where patients encounter sleep disruption, such as shift work and international travel. PMID:28684405

  9. Individual Supervision to Enhance Reflexivity and the Practice of Patient-Centered Care: Experience at the Undergraduate Level.

    PubMed

    Berney, Alexandre; Bourquin, Céline

    2017-12-22

    This article reports on what is at work during individual supervision of medical students in the context of teaching breaking bad news (BBN). Surprisingly, there is a relative lack of research and report on the topic of supervision, even though it is regularly used in medical training. Building on our research and teaching experience on BBN at the undergraduate level, as well as interviews of supervisors, the following key elements have been identified: learning objectives (e.g., raising student awareness of structural elements of the interview, emotion (patients and students) handling), pedagogical approach (being centered on student's needs and supportive to promote already existing competences), essentials (e.g., discussing skills and examples from the clinical practice), and enhancing reflexivity while discussing specific issues (e.g., confusion between the needs of the patient and those of the student). Individual supervision has been identified as crucial and most satisfactory by students to provide guidance and to foster a reflexive stance enabling them to critically apprehend their communication style. Ultimately, the challenge is to teach medical students to not only connect with the patient but also with themselves.

  10. Relevance of philosophy of life and optimism for psychological distress among individuals in a stage where death is approaching.

    PubMed

    Winterling, Jeanette; Wasteson, Elisabet; Sidenvall, Birgitta; Sidenvall, Erik; Glimelius, Bengt; Sjödén, Per-Olow; Nordin, Karin

    2006-04-01

    The purpose was to investigate the relevance of philosophy of life as well as optimism for the psychological distress among Swedish individuals in a stage where death is approaching. Sixty-nine persons were included; of these were 42 patients newly diagnosed with advanced gastrointestinal cancer and 26 were partners to these patients. The participants' philosophy of life was studied through a semi-structured interview. The interview statements were subjected to content analysis. Optimism was measured by the Life Orientation Test and psychological distress by the Hospitality and Depression Scale. The results showed that optimistic respondents had less psychological distress. Two aspects of philosophy of life had relevance for such distress. These were wondering about why the cancer had occurred and having a feeling of being able to live a good life having or living near a person with advanced cancer. In conclusion, the above-mentioned aspects of philosophy of life as well as optimism have relevance for psychological distress among these individuals, which stress the importance that health-care staff address both patients' and their partners' concerns about their philosophy of life.

  11. Using systems thinking and the Intervention Level Framework to analyse public health planning for complex problems: Otitis media in Aboriginal and Torres Strait Islander children

    PubMed Central

    Durham, Jo; Vaughan, Lisa; Willis, Cameron D.

    2018-01-01

    Background Middle ear disease (otitis media) is endemic among Aboriginal and Torres Strait Islander children in Australia and represents an important cause of hearing loss. The disease is the result of a mix of biological, environmental and host risk factors that interact in complex, non-linear ways along a dynamic continuum. As such, it is generally recognised that a holistic, systems approach is required to reverse the high rates of otitis media in Aboriginal and Torres Strait Islander children. The objective of this paper is to examine the alignment between efforts designed to address otitis media in Aboriginal and Torres Strait Islander children in Queensland, Australia and core concepts of systems thinking. This paper’s overall purpose is to identify which combination of activities, and at which level, hold the potential to facilitate systems changes to better support ear health among Aboriginal and Torres Strait Islander children. Methods We began with a review of documents identified in consultation with stakeholders and an online search. In addition, key informants were invited to participate in an online survey and a face-to-face or phone interview. Qualitative interviews using a semi-structured interview guide were used to explore survey responses in more depth. We also undertook interviews at the community level to elicit a diverse range of views. Ideas, statements or activities reported in the documents and interviews as being performed under the Intervention Level Framework were identified using qualitative thematic and content analysis. A quantitative descriptive analysis was also undertaken, whereby data was extracted into an Excel spreadsheet and coded under the relevant strategic directions and performance indicators of the Framework. Subsequently, we coded activities against the five-level intervention framework developed by Malhi and colleagues, that is: 1) paradigm; 2) goals; 3) system structure; 4) feedback and delays; and 5) structural elements. Results Overall, twenty documents were reviewed. We examined surveys and interviews with six key informants. Twenty-four individual and 3 group interviews were conducted across central and community level informants. One hundred and four items were coded from the 20 documents and 156 items from interview data. For both data sets, the majority of activities were coded at the structural elements level. The results suggested three key areas where further work is needed to drive sustained improvements: 1) build the governance structures needed for paradigm shift to achieve a multi-sectoral approach; 2) develop shared system level goals; 3) develop system-wide feedback processes. Conclusions Sustained progress in improving ear health within Aboriginal and Torres Strait Islander children requires a holistic, system-wide approach. To advance such work, governance structures for multi-sectoral collaboration including the development of joint goals and monitoring and feedback are required. Intervening at these higher leverage points could have a profound effect on persistent public health issues. PMID:29561891

  12. Using systems thinking and the Intervention Level Framework to analyse public health planning for complex problems: Otitis media in Aboriginal and Torres Strait Islander children.

    PubMed

    Durham, Jo; Schubert, Lisa; Vaughan, Lisa; Willis, Cameron D

    2018-01-01

    Middle ear disease (otitis media) is endemic among Aboriginal and Torres Strait Islander children in Australia and represents an important cause of hearing loss. The disease is the result of a mix of biological, environmental and host risk factors that interact in complex, non-linear ways along a dynamic continuum. As such, it is generally recognised that a holistic, systems approach is required to reverse the high rates of otitis media in Aboriginal and Torres Strait Islander children. The objective of this paper is to examine the alignment between efforts designed to address otitis media in Aboriginal and Torres Strait Islander children in Queensland, Australia and core concepts of systems thinking. This paper's overall purpose is to identify which combination of activities, and at which level, hold the potential to facilitate systems changes to better support ear health among Aboriginal and Torres Strait Islander children. We began with a review of documents identified in consultation with stakeholders and an online search. In addition, key informants were invited to participate in an online survey and a face-to-face or phone interview. Qualitative interviews using a semi-structured interview guide were used to explore survey responses in more depth. We also undertook interviews at the community level to elicit a diverse range of views. Ideas, statements or activities reported in the documents and interviews as being performed under the Intervention Level Framework were identified using qualitative thematic and content analysis. A quantitative descriptive analysis was also undertaken, whereby data was extracted into an Excel spreadsheet and coded under the relevant strategic directions and performance indicators of the Framework. Subsequently, we coded activities against the five-level intervention framework developed by Malhi and colleagues, that is: 1) paradigm; 2) goals; 3) system structure; 4) feedback and delays; and 5) structural elements. Overall, twenty documents were reviewed. We examined surveys and interviews with six key informants. Twenty-four individual and 3 group interviews were conducted across central and community level informants. One hundred and four items were coded from the 20 documents and 156 items from interview data. For both data sets, the majority of activities were coded at the structural elements level. The results suggested three key areas where further work is needed to drive sustained improvements: 1) build the governance structures needed for paradigm shift to achieve a multi-sectoral approach; 2) develop shared system level goals; 3) develop system-wide feedback processes. Sustained progress in improving ear health within Aboriginal and Torres Strait Islander children requires a holistic, system-wide approach. To advance such work, governance structures for multi-sectoral collaboration including the development of joint goals and monitoring and feedback are required. Intervening at these higher leverage points could have a profound effect on persistent public health issues.

  13. It's not just a knee, but a whole life: A qualitative descriptive study on patients' experiences of living with knee osteoarthritis and their expectations for knee arthroplasty.

    PubMed

    Nyvang, Josefina; Hedström, Margareta; Gleissman, Sissel Andreassen

    2016-01-01

    Knee arthroplasties are an increasingly common treatment for osteoarthritis (OA) and the main indication is pain. Previous research states, however, that 15-20% of the operated patients are dissatisfied and 20-30% have persistent pain after surgery. This study is aimed at describing patients' experiences of living with knee OA when scheduled for surgery and further their expectations for future life after surgery. We interviewed 12 patients with knee OA scheduled for arthroplasty, using semi-structured qualitative interviews. The interviews were recorded and transcribed verbatim and analyzed using qualitative thematic analysis. Three categories were formulated with an overriding theme: "It's not just a knee, but a whole life." The three categories were "Change from their earlier lives," "Coping with knee problems," and "Ultimate decision to undergo surgery." The main finding was that knee OA affects the whole body and self, ultimately affecting the patients' lives on many levels. Further findings were that knee OA was considered to be the central focus in the participants' lives, which limited their level of activity, their ability to function as desired, their quality of life, and their mental well-being. Although surgery was considered to be the only solution, the expectations regarding the outcome differed. The participants were forced to change how they previously had lived their lives resulting in a feeling of loss. Thus, the experienced loss and expectations for future life must be put into the context of the individual's own personality and be taken into account when treating individuals with knee OA. The experience of living with knee OA largely varies between individuals. This mandates that patients' assessment should be considered on individual basis with regard to each patient.

  14. Informed consent in medical decision-making in commercial gestational surrogacy: a mixed methods study in New Delhi, India.

    PubMed

    Tanderup, Malene; Reddy, Sunita; Patel, Tulsi; Nielsen, Birgitte Bruun

    2015-05-01

    To investigate ethical issues in informed consent for decisions regarding embryo transfer and fetal reduction in commercial gestational surrogacy. Mixed methods study employing observations, an interview-guide and semi-structured interviews. Fertility clinics and agencies in Delhi, India, between December 2011 and December 2012. Doctors providing conceptive technologies to commissioning couples and carrying out surrogacy procedures; surrogate mothers; agents functioning as links for surrogacy. Interviews using semi-structured interview guides were carried out among 20 doctors in 18 fertility clinics, five agents from four agencies and 14 surrogate mothers. Surrogate mothers were interviewed both individually and in the presence of doctors and agents. Data on socio-economic context and experiences among and between various actors in the surrogacy process were coded to identify categories of ethical concern. Numerical and grounded theory-oriented analyses were used. Informed consent, number of embryos transferred, fetal reduction, conflict of interest among the involved parties. None of the 14 surrogate mothers were able to explain the risks involved in embryo transfer and fetal reduction. The majority of the doctors took unilateral decisions about embryo transfer and fetal reduction. The commissioning parents were usually only indirectly involved. In the qualitative analysis, difficulties in explaining procedures, autonomy, self-payment of fertility treatment and conflicts of interest were the main themes. Clinical procedural decisions were primarily made by the doctors. Surrogate mothers were not adequately informed. There is a need for regulation on decision-making procedures to safeguard the interests of surrogate mothers. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Identification of anxiety sensitivity classes and clinical cut-scores in a sample of adult smokers: results from a factor mixture model.

    PubMed

    Allan, Nicholas P; Raines, Amanda M; Capron, Daniel W; Norr, Aaron M; Zvolensky, Michael J; Schmidt, Norman B

    2014-10-01

    Anxiety sensitivity (AS), a multidimensional construct, has been implicated in the development and maintenance of anxiety and related disorders. Recent evidence suggests that AS is a dimensional-categorical construct within individuals. Factor mixture modeling was conducted in a sample of 579 adult smokers (M age=36.87 years, SD=13.47) to examine the underlying structure. Participants completed the Anxiety Sensitivity Index-3 and were also given a Structured Clinical Interview for DSM-IV-TR. Three classes of individuals emerged, a high AS (5.2% of the sample), a moderate AS (19.0%), and a normative AS class (75.8%). A cut-score of 23 to identify high AS individuals, and a cut-score of 17 to identify moderate-to-high AS individuals were supported in this study. In addition, the odds of having a concurrent anxiety disorder (controlling for other Axis I disorders) were the highest in the high AS class and the lowest in the normative AS class. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly—A Qualitative Study

    PubMed Central

    Schoenmakers, Daphne; Lamkaddem, Majda; Suurmond, Jeanine

    2017-01-01

    Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems. PMID:29019961

  17. Strategies for diagnosing leg oedema in primary care: a qualitative study of GPs' approaches.

    PubMed

    Diederich, Judith; Hartel, Simone; Baum, Erika; Bösner, Stefan

    2014-12-01

    The symptom leg oedema represents a broad range of possible underlying aetiologies. The background of leg oedema is multifactorial and usually the GP is the first contact point for patients presenting with this symptom. GPs rely on patient history and physical examination as their main diagnostic tools. To identify GPs' diagnostic approaches and heuristics in patients presenting with leg oedema. Interviews with 15 GPs (20-30 min) using a semi-structured interview-guideline were conducted. GPs described their individual diagnostic strategies concerning all patients presenting with leg oedema they had prospectively identified during the previous four weeks. Interviews were taped and transcribed verbatim. Qualitative analysis was conducted by two independent raters. GPs applied a variety of diagnostic approaches, which can be grouped in active and passive strategies. Active strategies comprised the use of decision rules and guidelines, Bayesian arguing, problem dichotomisation and discrepancy heuristics. Passive approaches included test of time, therapy as diagnosis, and taking patient assumptions into account. When dealing with leg oedema, GPs use prior information of individual patients in a specific way. There is a broad variety of diagnostic approaches that can be grouped in 'active' and 'passive' behaviour. Approaches mostly match with established diagnostic strategies in primary care.

  18. A qualitative study of patients' experiences of participating in SPACE for COPD: a Self-management Programme of Activity, Coping and Education.

    PubMed

    Apps, Lindsay D; Harrison, Samantha L; Mitchell, Katy E; Williams, Johanna E A; Hudson, Nicky; Singh, Sally J

    2017-10-01

    The aim of this study was to understand experiences of participation in a supported self-management programme for chronic obstructive pulmonary disease (COPD). There is a wealth of clinical trials examining the outcomes of self-management interventions for individuals with COPD, but current understanding regarding patients' perspectives of such complex interventions is limited. Further insight may help to tailor self-management interventions and maximise patient engagement. Semi-structured interviews were conducted with individuals participating in a self-management programme, SPACE for COPD. Interviews took place at 6 weeks and 6 months following the programme. Data were analysed at each time point using inductive thematic analysis, and subsequently re-examined together. 40 interviews were undertaken and four themes emerged from the analysis: perceptions of the programme; lifestyle changes; social support; and disrupting factors and barriers to maintaining routines. SPACE for COPD was acceptable to participants in this study. The importance of education and social support was emphasised at both time points studied, but there were challenges such as comorbidities, ill health of family members and limited maintenance of exercise behaviours over the longer term. Further consideration of the role of carers and partners may help to improve adherence to self-management programmes once healthcare professional support has stopped.

  19. The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly-A Qualitative Study.

    PubMed

    Schoenmakers, Daphne; Lamkaddem, Majda; Suurmond, Jeanine

    2017-10-11

    Abstract : Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusion s : Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems.

  20. The hospital doctor of today - still continuously on duty.

    PubMed

    Hertzberg, Tuva Kolstad; Skirbekk, Helge; Tyssen, Reidar; Aasland, Olaf Gjerløw; Rø, Karin Isaksson

    2016-10-01

    Norwegian hospital doctors emphasise the value of working hard and efficiently and of a high degree of attendance in the workplace. This helps establish social norms that guide behaviour within the professional culture. It is important to examine what consequences these values may entail when the doctor also needs to cater to his or her own needs. We conducted eight focus-group interviews and three individual interviews among a total of 48 senior consultants and specialty registrars working in the areas of surgery, psychiatry and internal medicine. Total N = 48; 56  % women. The interviews were analysed with the aid of systematic text condensation. When Norwegian hospital doctors wish to appear as good doctors, they see that this entails consequences for the interrelationships with colleagues, the management and the work-life balance. Conflicts of interest arose between senior consultants and specialty registrars. Management initiatives to deal with absence, adaptation of the job to the life stage of each individual doctor and increased management involvement among doctors were among the measures proposed. Better mutual knowledge between doctors and management with regard to each other’s values and responsibilities could constitute key premises for structural changes, for example in terms of better planning of leaves of absence and opportunities for adaptation of work schedules to the life stage of the persons concerned.

  1. GPs' views and perspectives on patient non-adherence to treatment in primary care prior to suicide.

    PubMed

    Saini, Pooja; Chantler, Khatidja; Kapur, Navneet

    2018-04-01

    Individuals who do not adhere to their treatment regimens may be at greater risk of suicide but these issues are relatively unexplored in primary care services. To explore GPs' views and perspectives on the reasons why patients who were in contact with mental health services in the year prior to suicide was non-adherent to treatment prior to their death. In total, 198 semi-structured face-to-face interviews with GPs of people who had died by suicide. Interviews were transcribed verbatim and analyzed using a thematic approach. The following themes were conceptualized from GP interviews: (i) "Lack of insight or denial?" relates to what GPs perceived as their patients lack of insight into their psychiatric illness; (ii) "Lack of treatment choices" discusses GPs' understanding of patient treatment choices; (iii) "Services for comorbidity and dual diagnosis" refers to treatment availability for suicidal patients with two or more mental health diagnoses. For suicide prevention, it is crucial for health professionals to assess patients and manage the possible causes of non-adherence. Policies for increasing treatment adherence, improving services for dual diagnosis, or providing alternative treatments to meet individual patient needs may help to achieve the best health outcomes and could potentially prevent suicide.

  2. Life situation and identity among single older home-living people: A phenomenological–hermeneutic study

    PubMed Central

    Söderhamn, Ulrika; Söderhamn, Olle

    2012-01-01

    Being able to continue living in their own home as long as possible is the general preference for many older people, and this is also in line with the public policy in the Nordic countries. The aim of this study was to elucidate the meaning of self-care and health for perception of life situation and identity among single-living older individuals in rural areas in southern Norway. Eleven older persons with a mean age of 78 years were interviewed and encouraged to narrate their self-care and health experiences. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological–hermeneutic method inspired by the philosophy of Ricoeur. The findings are presented as a naïve reading, an inductive structural analysis characterized by two main themes; i.e., “being able to do” and “being able to be”, and a comprehensive interpretation. The life situation of the interviewed single-living older individuals in rural areas in southern Norway was interpreted as inevitable, appropriate and meaningful. Their identity was constituted by their freedom and self-chosen actions in their personal contexts. The overall impression was that independence and the ability to control and govern their own life in accordance with needs and preferences were ultimate goals for the study participants. PMID:22848230

  3. Exploring Perception of Vibrations from Rail: An Interview Study

    PubMed Central

    Maclachlan, Laura; Pedersen, Eja

    2017-01-01

    Rail transport is an environmentally responsible approach and traffic is expected to increase in the coming decades. Little is known about the implications for quality of life of populations living close to railways. This study explores the way in which vibrations from rail are perceived and described by these populations. The study took place in the Västra Götaland and Värmland regions of Sweden. A qualitative study approach was undertaken using semi-structured interviews within a framework of predetermined questions in participants’ homes. A 26.3% response rate was achieved and 17 participants were interviewed. The experience of vibrations was described in tangible terms through different senses. Important emerging themes included habituation to and acceptance of vibrations, worry about property damage, worry about family members and general safety. Participants did not reflect on health effects, however, chronic exposure to vibrations through multimodal senses in individual living environments may reduce the possibility for restoration in the home. Lack of empowerment to reduce exposure to vibrations was important. This may alter individual coping strategies, as taking actions to avoid the stressor is not possible. The adoption of other strategies, such as avoidance, may negatively affect an individual’s ability to cope with the stressor and their health. PMID:29072612

  4. What haematopoietic stem cell transplant patients think about health and oral care: A qualitative study in a Brazilian health service.

    PubMed

    Mendes, S R; Silva, M E S; Firmo, J O A; de Abreu, M H N G

    2018-04-25

    Differences in the perceptions of treatment between healthcare team and patients should be identified, aiming to provide a more humanised health care. We sought to understand and evaluate the concepts regarding oral health and dental care among haematopoietic stem cell transplant patients. Individual semi-structured interviews were conducted with patients, from both sexes, in the post-haematopoietic stem cell transplant stage, who underwent dental treatment. All interviews were recorded and transcribed, respecting the spelling and syntax used by the interviewees. A thematic content analysis was performed, and three themes were assessed: what is oral health, why was pre-transplant dental treatment performed, and what was the relevance of dental treatment for the haematopoietic stem cell transplant. Oral health was understood as the act of dental care through oral hygiene. The reason for performing prior dental treatment involves strict guidelines for transplants, and when questioned as to the importance of the dental treatment for transplants, the interviewed subjects' statements focused on the prevention of infections during the low-immunity stage. The individuals saw dental treatment as a step towards a successful transplant; their main concerns were not to re-establish their oral health, but rather to end the dental treatment as quickly as possible. © 2018 John Wiley & Sons Ltd.

  5. The Role of Structure Versus Individual Agency in Churches’ Responses to HIV/AIDS: A Case Study of Baltimore City Churches

    PubMed Central

    Cunningham, Shayna D.; Kerrigan, Deanna L.; McNeely, Clea A.; Ellen, Jonathan M.

    2016-01-01

    This paper examines the activities of churches in Baltimore, Maryland, concerning the issues of sexuality, whether they potentially stigmatize persons with or at risk for HIV/AIDS, and to what extent individual agency versus institutional forces influence churches in this regard. In-depth interviews were conducted with 20 leaders from 16 churches and analyzed using a grounded theory methodology. Although many churches were involved in HIV/AIDS-related activities, the content of such initiatives was sometimes limited due to organizational constraints. Church leaders varied, however, in the extent to which they responded in accordance with or resisted these constraints, highlighting the importance of individual agency influencing churches’ responses to HIV/AIDS. PMID:19714469

  6. [Active aging from the perspective of aged individuals who are functionally independent].

    PubMed

    Ferreira, Olivia Galvão Lucena; Maciel, Silvana Carneiro; Silva, Antonia Oliveira; dos Santos, Walberto Silva; Moreira, Maria Adelaide Silva P

    2010-12-01

    The objective of this study was to identify the social representations of the elderly regarding active aging. Semi-structured interviews were performed with 100 functionally independent aged individuals from João Pessoa, Paraiba, Brazil. The data was organized and analyzed using Alceste software. Results showed that the aged individuals' statements about active aging are permeated with positive contents. However, when aging is not associated with the word active, it is still represented as losses and disabilities. Despite the existence of losses during the process, active aging should be encouraged among the elderly, as it means living a quality, plentiful life. Maintaining the elderly functionally independent is the first step to achieving active aging and thus improving their quality of life.

  7. Patients' consent preferences for research uses of information in electronic medical records: interview and survey data.

    PubMed

    Willison, Donald J; Keshavjee, Karim; Nair, Kalpana; Goldsmith, Charlie; Holbrook, Anne M

    2003-02-15

    To assess patients' preferred method of consent for the use of information from electronic medical records for research. Interviews and a structured survey of patients in practices with electronic medical records. Family practices in southern Ontario, Canada. 123 patients: 17 were interviewed and 106 completed a survey. Patients' opinions and concerns on use of information from their medical records for research and their preferences for method of consent. Most interviewees were willing to allow the use of their information for research purposes, although the majority preferred that consent was sought first. The seeking of consent was considered an important element of respect for the individual. Most interviewees made little distinction between identifiable and anonymised data. Research sponsored by private insurance firms generated the greatest concern, and research sponsored by foundation the least. Sponsorship by drug companies evoked negative responses during interview and positive responses in the survey. Patients are willing to allow information from their medical records to be used for research, but most prefer to be asked for consent either verbally or in writing.

  8. Assessing Adolescents’ Attachment Hierarchies: Differences Across Developmental Periods and Associations With Individual Adaptation

    PubMed Central

    Rosenthal, Natalie L.; Kobak, Roger

    2012-01-01

    Adolescents’ attachment hierarchies were assessed in a sample of 212 high school and 198 college students. The Important People Interview (IPI) differentiated attachment bonds from other supportive or affiliative relationships and indicated that adolescents show a hierarchical ordering of preferences for multiple attachment figures. Differences in the composition and structure of adolescents’ attachment hierarchies were found between the early high school (9th and 10th grades), later high school (11th and 12th grades), and college samples. In the college sample, romantic partners were placed in higher positions in adolescents’ hierarchies, fathers were placed in lower positions, and the structure of adolescents’ hierarchies were less differentiated than in the high school samples. Individual differences in the composition of adolescents’ hierarchies were associated with adjustment outcomes. Friends’ placement in higher positions and fathers’ exclusion from or placement in quaternary positions was associated with increased behavior problems. Findings demonstrate that the IPI provides a measure of adolescents’ attachment hierarchies that is sensitive to developmental stage and individual differences. PMID:22545000

  9. What should men living with severe haemophilia need to know? The perspectives of Canadian haemophilia health care providers.

    PubMed

    Lane, S; Arnold, E; Webert, K E; Chan, A; Walker, I; Heddle, N M

    2013-07-01

    Haemophilia is a complex disease to manage. Home-based management of haemophilia has placed greater responsibility for disease management on individuals with haemophilia, heightening the individual's need for knowledge, particularly among individuals with severe haemophilia. The aim of this study was to identify and understand the knowledge needs and gaps of Canadian men with severe haemophilia from the perspectives of health care providers. A qualitative approach was undertaken. Data were collected using semi-structured focus groups and interviews with health care providers from Haemophilia Treatment Centres (HTCs) across Canada; data were analysed using thematic analysis. Three focus groups and two interviews were conducted; 13 individuals participated in this study. Health care providers identified the following areas of knowledge required by men with severe haemophilia: disease pathology, causes and consequences of bleeds, bleed prevention, recognition, treatment, how and when to access support, activity selection and risk reduction, benefits of exercise, genetic inheritance patterns, impact on career selection, travel and ageing. Knowledge gaps and challenges to knowledge provision were highlighted. In addition, providers emphasized the influences of timing, rapport and context on readiness to receive and assimilate information and recommended tailoring education to the individual and creating a developmental curriculum and knowledge assessment tool. Provision and uptake of disease knowledge is essential to patient self-management. To effectively receive, retain and assimilate information, individuals with severe haemophilia require the right information, from the right source, at the right time. Education should be tailored to the needs of the individual, provided throughout the lifespan. © 2013 John Wiley & Sons Ltd.

  10. Evaluation of an interview process for admission into a school of pharmacy.

    PubMed

    Kelsch, Michael P; Friesner, Daniel L

    2012-03-12

    To evaluate the doctor of pharmacy (PharmD) admissions interview process at North Dakota State University (NDSU). Faculty pairs interviewed candidates using a standardized grading rubric to evaluate qualitative parameters or attributes such as ethics, relevant life and work experience, emotional maturity, commitment to patient care, leadership, and understanding of the pharmacy profession. Total interview scores, individual attribute domain scores, and the consistency and reliability of the interviewers were assessed. The total mean interview score for the candidate pool was 17.4 of 25 points. Mean scores for individual domains ranged from 2.3 to 3.0 on a Likert-scale of 0-4. Nine of the 11 faculty pairs showed no mean differences from their interview partner in total interview scores given. Evaluations by 8 of the 11 faculty pairs produced high interrater reliability. The current interview process is generally consistent and reliable; however, future improvements such as additional interviewer training and adoption of a multiple mini-interview format could be made.

  11. Evaluation of an Interview Process for Admission Into a School of Pharmacy

    PubMed Central

    Friesner, Daniel L.

    2012-01-01

    Objective. To evaluate the doctor of pharmacy (PharmD) admissions interview process at North Dakota State University (NDSU). Methods. Faculty pairs interviewed candidates using a standardized grading rubric to evaluate qualitative parameters or attributes such as ethics, relevant life and work experience, emotional maturity, commitment to patient care, leadership, and understanding of the pharmacy profession. Total interview scores, individual attribute domain scores, and the consistency and reliability of the interviewers were assessed. Results. The total mean interview score for the candidate pool was 17.4 of 25 points. Mean scores for individual domains ranged from 2.3 to 3.0 on a Likert-scale of 0-4. Nine of the 11 faculty pairs showed no mean differences from their interview partner in total interview scores given. Evaluations by 8 of the 11 faculty pairs produced high interrater reliability. Conclusions. The current interview process is generally consistent and reliable; however, future improvements such as additional interviewer training and adoption of a multiple mini-interview format could be made. PMID:22438594

  12. [Social representations of illness among people with chronic kidney disease].

    PubMed

    Campos, Caroline Gonçalves Pustiglione; Mantovani, Maria de Fátima; Nascimento, Maria Elisa Brum do; Cassi, Cristiam Carla

    2015-06-01

    To describe the social representations of illness among people with chronic kidney disease undergoing haemodialysis. Descriptive, qualitative research, anchored on the social representations theory. This study was conducted in the municipality of Ponta Grossa, Paraná State, Brazil, with 23 adults with chronic kidney disease. Data were collection between February and November 2012 by means of a semi-structured interview, and analyzed using Content Analysis. The interviews led to the categories "the meaning of kidney disease": awareness of finitude, and "survival": the visible with chronic kidney disease. The representation of illness unveiled a difference and interruption in life projects, and haemodialysis meant loss of freedom, imprisonment and stigma. Family ties and the individuals´ social role are determining representations for healthcare.

  13. Accreditation in a public hospital: perceptions of a multidisciplinary team.

    PubMed

    Camillo, Nadia Raquel Suzini; Oliveira, João Lucas Campos de; Bellucci Junior, José Aparecido; Cervilheri, Andressa Hirata; Haddad, Maria do Carmo Fernandez Lourenço; Matsuda, Laura Misue

    2016-06-01

    to analyze the perceptions of the multidisciplinary team on Accreditation in a public hospital. descriptive, exploratory, qualitative research, performed in May 2014, using recorded individual interviews. In total, 28 employees of a public hospital, Accredited with Excellence, answered the guiding question: "Tell me about the Accreditation system used in this hospital". The interviews were transcribed and subjected to content analysis. of the speeches, three categories emerged: Advantages offered by the Accreditation; Accredited public hospital resembling a private hospital; Pride/satisfaction for acting in an accredited public hospital. participants perceived Accreditation as a favorable system for a quality management in the public service because it promotes the development of professional skills and improves cost management, organizational structure, management of assistance and perception of job pride/satisfaction.

  14. The Structured Interview and Interviewer Training in the Admissions Process

    PubMed Central

    Cox, Wendy C.; White-Harris, Carla; Blalock, Susan J.

    2007-01-01

    Objectives To determine the extent to which the structured interview is used in the PharmD admissions process in US colleges and schools of pharmacy, and the prevalence and content of interviewer training. Methods A survey instrument consisting of 7 questions regarding interviews and interviewer training was sent to 92 colleges and schools of pharmacy in the United States that were accredited or seeking accreditation. Results Sixty survey instruments (65% response rate) were returned. The majority of the schools that responded (80%) used interviews as part of the PharmD admissions process. Of the schools that used an interview as part of the admissions process, 86% provided some type of interviewer training and 13% used a set of predefined questions in admissions interviews. Conclusions Most colleges and schools of pharmacy use some components of the structured interview in the PharmD admissions process; however, training for interviewers varies widely among colleges and schools of pharmacy. PMID:17998980

  15. Acceptance of a structured diagnostic interview in children, parents, and interviewers.

    PubMed

    Neuschwander, Murielle; In-Albon, Tina; Meyer, Andrea H; Schneider, Silvia

    2017-09-01

    The objective of this study was to investigate the satisfaction and acceptance of a structured diagnostic interview in clinical practice and in a research setting. Using the Structured Diagnostic Interview for Mental Disorders in Children and Adolescents (Kinder-DIPS), 28 certified interviewers conducted 202 interviews (115 with parents, 87 with children). After each interview, children, parents, and interviewers completed a questionnaire assessing the overall satisfaction (0 = not at all satisfied to 100 = totally satisfied) and acceptance (0 = completely disagree to 3 = completely agree) with the interview. Satisfaction ratings were highly positive, all means >82. The mean of the overall acceptance for children was 2.43 (standard deviation [SD] = 0.41), 2.54 (SD = 0.33) of the parents, 2.30 (SD = 0.43) of the children's interviewers, and 2.46 (SD = 0.32) of the parents' interviewers. Using separate univariate regression models, significant predictors for higher satisfaction and acceptance with the interview are higher children's Global Assessment of Functioning, fewer number of children's diagnoses, shorter duration of the interview, a research setting, female sex of the interviewer, and older age of the interviewer. Results indicate that structured diagnostic interviews are highly accepted by children, parents, and interviewers. Importantly, this is true for different treatment settings. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Kleptomania and Co-morbid addictive disorders.

    PubMed

    Kim, Hyoun S; Christianini, Aparecida Rangon; Bertoni, Daniela; de Oliveira, Maria do Carmo Medeiros; Hodgins, David C; Tavares, Hermano

    2017-04-01

    We examined the association between kleptomania and addictive disorders, including behavioral addictions. Fifty-three individuals with a diagnosis of kleptomania completed measures of kleptomania severity, semi-structured clinical interviews to assess co-morbid diagnosis of addictive disorders, and the Shorter PROMIS Questionnaire (SPQ) assessing an array of addictive behaviors. 20.75% of the sample met criteria for an addictive disorder; four for a substance use disorder and four for a behavioral addiction. Kleptomania severity was significantly associated with compulsive work and shopping measured by the SPQ. The results suggest the need to assess a wide array of addictive behaviors in individuals with kleptomania. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  17. HIV Prevention, Stigma, and Care in Ho Chi Minh City and Da Lat Vietnam.

    PubMed

    DeMarco, Rosanna F; Cao, Cindy

    2015-01-01

    A four-week interdisciplinary student/faculty research project in Vietnam served as a focused experience in understanding Vietnamese healthcare structures, functions, outcomes. Testing the validity and feasibility of a successful US HIV intervention program called Women's Voices Women's Lives© using group and individual interviews. Healthcare inequities and poverty were found to paralyze individual, family, and community mobilization in HIV testing while stigma is a key barrier to both testing and care seeking. Vietnam has become a place where living with HIV infection challenges communities in a distinct socio-cultural context while incidence and prevalence rates continue to rise.

  18. Understanding the working alliance with clients diagnosed with anorexia nervosa.

    PubMed

    Oyer, Laura; O'Halloran, Mary Sean; Christoe-Frazier, Liesel

    2016-01-01

    The therapeutic working alliance is a vital ingredient of psychotherapy, specifically for clients diagnosed with anorexia nervosa, as progress is often slow and treatment difficult. This qualitative phenomenological study investigated the experiences of eight clients with anorexia nervosa and seven therapists who work with this population, regarding which therapist factors aided in and challenged the working alliance formation in individual psychotherapy. Data was gathered through semi-structured interviews. Some helpful therapist factors included collaboration, appropriate self-disclosure, providing a warm and safe environment, and willingness to be contacted outside of a session. Unhelpful factors included lack of attunement and objectivity and failure to individualize treatment.

  19. Item-Level Psychometrics of the Glasgow Outcome Scale: Extended Structured Interviews.

    PubMed

    Hong, Ickpyo; Li, Chih-Ying; Velozo, Craig A

    2016-04-01

    The Glasgow Outcome Scale-Extended (GOSE) structured interview captures critical components of activities and participation, including home, shopping, work, leisure, and family/friend relationships. Eighty-nine community dwelling adults with mild-moderate traumatic brain injury (TBI) were recruited (average = 2.7 year post injury). Nine items of the 19 items were used for the psychometrics analysis purpose. Factor analysis and item-level psychometrics were investigated using the Rasch partial-credit model. Although the principal components analysis of residuals suggests that a single measurement factor dominates the measure, the instrument did not meet the factor analysis criteria. Five items met the rating scale criteria. Eight items fit the Rasch model. The instrument demonstrated low person reliability (0.63), low person strata (2.07), and a slight ceiling effect. The GOSE demonstrated limitations in precisely measuring activities/participation for individuals after TBI. Future studies should examine the impact of the low precision of the GOSE on effect size. © The Author(s) 2016.

  20. Family experiences of living with an eating disorder: a narrative analysis.

    PubMed

    Papathomas, Anthony; Smith, Brett; Lavallee, David

    2015-03-01

    Families are considered important in the management and treatment of eating disorders. Yet, rarely has research focused on family experiences of living with an eating disorder. Addressing this gap, this study explores the experiences of an elite 21-year-old triathlete with an eating disorder in conjunction with the experiences of her parents. Family members attended interviews individually on three separate occasions over the course of a year. In line with the narrative approach adopted, whereby stories are considered the primary means to construct experience, interviews encouraged storytelling through an open-ended, participant-led structure. Narrative analysis involved repeated readings of the transcripts, sensitising towards issues of narrative content (key themes) and structure (overarching plot). Family difficulties arose when personal experiences strayed from culturally dominant narrative forms and when family members held contrasting narrative preferences. Suggestions are forwarded as to how an appreciation of eating disorder illness narratives might inform treatment and support. © The Author(s) 2015.

  1. Possible Barriers to Enrollment in Substance Abuse Treatment among a Diverse Sample of Asian Americans and Pacific Islanders: Opinions of Treatment Clients

    PubMed Central

    Masson, Carmen L.; Shopshire, Michael S.; Sen, Soma; Hoffman, Kim; Hengl, Nicholas; Bartolome, John; McCarty, Dennis; Sorensen, James L.; Iguchi, Martin

    2012-01-01

    This mixed methods study examined motivations and barriers to substance abuse treatment entry and treatment continuation among Asian American and Pacific Islander (AAPI) substance users. AAPI substance users (N = 61) were recruited from substance abuse treatment programs in California and Hawaii. Semi-structured interviews and interviewer-administered surveys assessed barriers and facilitators to entering substance abuse treatment. Barriers included peer pressure, family influences, and face loss concerns. Facilitators included peer support, involvement in the criminal justice system, a perceived need for treatment, and culturally competent substance abuse treatment services. Family and peer influences may act as both facilitators and impediments. AAPI substance using populations face many of the same individual-level and structural and systems barriers to entry to treatment as other substance using populations. However, similar to other racial/ethnic minority groups, it is important to address cultural differences and develop culturally competent substance abuse treatments for the AAPI population. PMID:22985677

  2. The Demand for Antiretroviral Drugs in the Illicit Marketplace: Implications for HIV disease management among vulnerable populations

    PubMed Central

    Tsuyuki, Kiyomi; Surratt, Hilary L.; Levi-Minzi, Maria A.; O’Grady, Catherine L.; Kurtz, Steven P.

    2014-01-01

    The diversion of antiretroviral medications (ARVs) has implications for the integrity and success of HIV care, however little is known about the ARV illicit market. This paper aimed to identify the motivations for buying illicit ARVs and to describe market dynamics. Semi-structured interviews (n=44) were conducted with substance-involved individuals living with HIV with a history of purchasing ARVs on the street. Grounded theory was used to code and analyze interviews. Motivations for buying ARVs on the illicit market were: to repurchase ARVs after having diverted them for money or drugs; having limited access or low quality health care; to replace lost or ruined ARVs; and to buy a back-up stock of ARVs. This study identified various structural barriers to HIV treatment and ARV adherence that incentivized ARV diversion. Findings highlight the need to improve patient-provider relationships, ensure continuity of care, and integrate services to engage and retain high-needs populations. PMID:25092512

  3. The Demand for Antiretroviral Drugs in the Illicit Marketplace: Implications for HIV Disease Management Among Vulnerable Populations.

    PubMed

    Tsuyuki, Kiyomi; Surratt, Hilary L; Levi-Minzi, Maria A; O'Grady, Catherine L; Kurtz, Steven P

    2015-05-01

    The diversion of antiretroviral medications (ARVs) has implications for the integrity and success of HIV care, however little is known about the ARV illicit market. This paper aimed to identify the motivations for buying illicit ARVs and to describe market dynamics. Semi-structured interviews (n = 44) were conducted with substance-involved individuals living with HIV who have a history of purchasing ARVs on the street. Grounded theory was used to code and analyze interviews. Motivations for buying ARVs on the illicit market were: to repurchase ARVs after having diverted them for money or drugs; having limited access or low quality health care; to replace lost or ruined ARVs; and to buy a back-up stock of ARVs. This study identified various structural barriers to HIV treatment and ARV adherence that incentivized ARV diversion. Findings highlight the need to improve patient-provider relationships, ensure continuity of care, and integrate services to engage and retain high-needs populations.

  4. Possible barriers to enrollment in substance abuse treatment among a diverse sample of Asian Americans and Pacific Islanders: opinions of treatment clients.

    PubMed

    Masson, Carmen L; Shopshire, Michael S; Sen, Soma; Hoffman, Kim A; Hengl, Nicholas S; Bartolome, John; McCarty, Dennis; Sorensen, James L; Iguchi, Martin Y

    2013-03-01

    This mixed methods study examined motivations and barriers to substance abuse treatment entry and treatment continuation among Asian American and Pacific Islander (AAPI) substance users. AAPI substance users (N = 61) were recruited from substance abuse treatment programs in California and Hawaii. Semi-structured interviews and interviewer-administered surveys assessed barriers and facilitators to entering substance abuse treatment. Barriers included peer pressure, family influences, and face loss concerns. Facilitators included peer support, involvement in the criminal justice system, a perceived need for treatment, and culturally competent substance abuse treatment services. Family and peer influences may act as both facilitators and impediments. AAPI substance using populations face many of the same individual-level and structural and systems barriers to entry to treatment as other substance using populations. However, similar to other racial/ethnic minority groups, it is important to address cultural differences and develop culturally competent substance abuse treatments for the AAPI population. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. "Sounds a Bit Crazy, But It Was Almost More Personal:" A Qualitative Study of Patient and Clinician Experiences of Physical Therapist-Prescribed Exercise For Knee Osteoarthritis Via Skype.

    PubMed

    Hinman, R S; Nelligan, R K; Bennell, K L; Delany, C

    2017-12-01

    To explore the experience of patients and physical therapists with Skype for exercise management of knee osteoarthritis (OA). This was a qualitative study. The Donabedian model for quality assessment in health care (structure, process, and outcomes) informed semistructured individual interview questions. The study involved 12 purposively sampled patients with knee OA who received physical therapist-prescribed exercise over Skype, and all therapists (n = 8) who delivered the intervention in a clinical trial were interviewed about their experiences. Interviews were audio recorded and transcribed. Two investigators undertook coding and analysis using a thematic approach. Six themes arose from both patients and therapists. The themes were Structure: technology (easy to use, variable quality, set-up assistance helpful) and patient convenience (time efficient, flexible, increased access); Process: empowerment to self-manage (facilitated by home environment and therapists focusing on effective treatment) and positive therapeutic relationships (personal undivided attention from therapists, supportive friendly interactions); and Outcomes: satisfaction with care (satisfying, enjoyable, patients would recommend, therapists felt Skype more useful as adjunct to usual practice) and patient benefits (reduced pain, improved function, improved confidence and self-efficacy). A seventh theme arose from therapists regarding process: adjusting routine treatment (need to modify habits, discomfort without hands-on, supported by research environment). Patients and physical therapists described mostly positive experiences using Skype as a service delivery model for physical therapist-supervised exercise management of moderate knee OA. Such a model is feasible and acceptable and has the potential to increase access to supervised exercise management for people with knee OA, either individually or in combination with traditional in-clinic visits. © 2017, American College of Rheumatology.

  6. ["General Practice is a great job anyway" - a qualitative study with vocational trainees].

    PubMed

    Steinhäuser, Jost; Paulus, Jan; Roos, Marco; Peters-Klimm, Frank; Ledig, Thomas; Szecsenyi, Joachim; Joos, Stefanie

    2011-01-01

    Due to the increasing lack of physicians, an ageing and thus multi-morbid society and a misdistribution of physicians in Germany primary care provided by general practitioners is at risk. Therefore, approaches to recruit more physicians for general practice are being sought. The aim of the present study was to explore individual motivations for choosing a career in general practice, vocational trainees' perspectives on the current situation of vocational training and to identify possible approaches to improve the situation with suggestions from vocational trainees in Germany. A qualitative study was conducted by interviewing 13 trainees. The interviews that were based on a predefined interview guideline were recorded and transcribed. The analysis was performed according to Mayring supported by the software Atlas.ti. In general, the reasons given for choosing general practice include the holistic view towards patients, the opportunity to see the direct impact of therapies and self-employment. Furthermore, general practice was perceived as a job with a positive work-life balance. Barriers to vocational training are the lack of structure of individual rotations and the low salaries during the rotation in practice. Furthermore, the basic conditions for working as a self-employed general practitioner in Germany were described as being a disincentive. A general suggestion for improvement was to promote professional recognition of general practice at universities. A qualification of vocational trainers was requested. Specific suggestions were: better payment, better-structured rotations and a specific preparation for the self-employed general practitioner. The results of this study reveal that a single measure is insufficient for recruiting more young doctors for general practice. In fact, a package of measures is necessary to improve aspects of the vocational training but also general conditions for the profession. Copyright © 2010. Published by Elsevier GmbH.

  7. Distributed health literacy among people living with type 2 diabetes in Portugal: Defining levels of awareness and support.

    PubMed

    Abreu, Liliana; Nunes, João Arriscado; Taylor, Peter; Silva, Susana

    2018-01-01

    This study embraces a patient-centred and narrative-oriented notion of health literacy, exploring how social networks and personal experiences constitute distributed health literacy (DHL) by mapping out health literacy mediators of each individual and how they enable self-management skills and knowledge of health conditions. Semi-structured interviews with 26 patients with type 2 diabetes were conducted in a Primary Care Center of Porto (Portugal) from October 2014 to December 2015. Data were collected based on McGill Illness Narrative Interview (MINI). Following the grounded theory, interviews were analysed as case-based and process-tracing-oriented. Three awareness narratives emerged: (i) a narrative of minimisation revealing minimal impact of diabetes in patients' lives and daily routines, resignation towards "inevitable" consequences of the diagnosis and dependence of a large network of health literacy mediators; (ii) a narrative of empathy, where patients tended to mention readjustments in their lives by following medical recommendations regarding medication without criticism and with few health literacy mediators; (iii) a narrative of disruption, with patients highlighting the huge impact of diabetes on their lives and their individual responsibility and autonomy with respect to the management of diabetes and the search for alternatives to medication, relying on a very restrictive network of mediators. Exploring meanings given to diagnosis, identifying health mediators and analysing the structure of social networks can contribute to understand the distributed nature of health literacy. Assessing DHL can assist health professionals and those providing care in the community in promoting health literacy and providing models for a more patient-centred health system. © 2017 John Wiley & Sons Ltd.

  8. Internet-based interventions for cancer-related distress: exploring the experiences of those whose needs are not met.

    PubMed

    Gorlick, Amanda; Bantum, Erin O'Carroll; Owen, Jason E

    2014-04-01

    Low levels of engagement in Internet-based interventions are common. Understanding users' experiences with these interventions is a key to improving efficacy. Although qualitative methods are well-suited for this purpose, few qualitative studies have been conducted in this area. In the present study, we assessed experiences with an Internet-based intervention among cancer survivors who made minimal use of the intervention. Semi-structured interviews were conducted with 25 cancer survivors who were minimally engaged (i.e., spent around 1 h total on website) with the online intervention, health-space.net. The intervention was a 12-week, facilitated support group with social and informational components. Interviews were analyzed using an interpretive descriptive design. Three broad categories, consisting of 18 specific themes, were identified from the interviews, which included connecting with similar others, individual expectations, and problems with the site (Κ = 0.88). The 'similar others' category reflected the significance of interacting with relatable survivors (i.e., same cancer type), the 'individual expectations' category reflected the significance of participants' expectations about using online interventions (i.e., personally relevant information), and the 'problems with the site' category reflected the significance of study procedures (i.e., website structure). The data indicate that minimally engaged participants have high variability regarding their needs and preferences for Internet-based interventions. Using qualitative methodologies to identify and incorporate these needs into the next generation of interventions has the potential to increase engagement and outcomes. The current study provides a foundation for future research to characterize survivors' needs and offer suggestions for better meeting these needs. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Social capital in a lower socioeconomic palliative care population: a qualitative investigation of individual, community and civic networks and relations.

    PubMed

    Lewis, Joanne M; DiGiacomo, Michelle; Currow, David C; Davidson, Patricia M

    2014-01-01

    Lower socioeconomic populations live and die in contexts that render them vulnerable to poorer health and wellbeing. Contexts of care at the end of life are overwhelmingly determined by the capacity and nature of formal and informal networks and relations to support care. To date, studies exploring the nature of networks and relations of support in lower socioeconomic populations at the end of life are absent. This qualitative study sought to identify the nature of individual, community and civic networks and relations that defined the contexts of care for this group. Semi-structured qualitative interviews were conducted with 16 patients and 6 informal carers who identified that they had social and economic needs and were from a lower socioeconomic area. A social capital questionnaire identifying individual, community and civic networks and relations formed the interview guide. Interviews were audio-taped, transcribed and analysed using framework analysis. Participants identified that individual and community networks and relations of support were mainly inadequate to meet care needs. Specifically, data revealed: (1) individual (informal caregivers) networks and relations were small and fragile due to the nature of conflict and crisis; (2) community trust and engagement was limited and shifted by illness and caregiving; (3) and formal care services were inconsistent and provided limited practical support. Some transitions in community relations for support were noted. Levels of civic and government engagement and support were overall positive and enabled access to welfare resources. Networks and relations of support are essential for ensuring quality end of life care is achieved. Lower socioeconomic groups are at a distinct disadvantage where these networks and relations are limited, as they lack the resources necessary to augment these gaps. Understanding of the nature of assets and limitations, in networks and relations of support, is necessary to inform interventions to improve end of life care for lower socioeconomic populations.

  10. Social capital in a lower socioeconomic palliative care population: a qualitative investigation of individual, community and civic networks and relations

    PubMed Central

    2014-01-01

    Background Lower socioeconomic populations live and die in contexts that render them vulnerable to poorer health and wellbeing. Contexts of care at the end of life are overwhelmingly determined by the capacity and nature of formal and informal networks and relations to support care. To date, studies exploring the nature of networks and relations of support in lower socioeconomic populations at the end of life are absent. This qualitative study sought to identify the nature of individual, community and civic networks and relations that defined the contexts of care for this group. Methods Semi-structured qualitative interviews were conducted with 16 patients and 6 informal carers who identified that they had social and economic needs and were from a lower socioeconomic area. A social capital questionnaire identifying individual, community and civic networks and relations formed the interview guide. Interviews were audio-taped, transcribed and analysed using framework analysis. Results Participants identified that individual and community networks and relations of support were mainly inadequate to meet care needs. Specifically, data revealed: (1) individual (informal caregivers) networks and relations were small and fragile due to the nature of conflict and crisis; (2) community trust and engagement was limited and shifted by illness and caregiving; (3) and formal care services were inconsistent and provided limited practical support. Some transitions in community relations for support were noted. Levels of civic and government engagement and support were overall positive and enabled access to welfare resources. Conclusion Networks and relations of support are essential for ensuring quality end of life care is achieved. Lower socioeconomic groups are at a distinct disadvantage where these networks and relations are limited, as they lack the resources necessary to augment these gaps. Understanding of the nature of assets and limitations, in networks and relations of support, is necessary to inform interventions to improve end of life care for lower socioeconomic populations. PMID:24959101

  11. Malaria risk factors and care-seeking behaviour within the private sector among high-risk populations in Vietnam: a qualitative study.

    PubMed

    Chen, Ingrid; Thanh, Huong Ngo Thi; Lover, Andrew; Thao, Phung Thi; Luu, Tang Viet; Thang, Hoang Nghia; Thang, Ngo Duc; Neukom, Josselyn; Bennett, Adam

    2017-10-16

    Vietnam has successfully reduced malaria incidence by more than 90% over the past 10 years, and is now preparing for malaria elimination. However, the remaining malaria burden resides in individuals that are hardest to reach, in highly remote areas, where many malaria cases are treated through the informal private sector and are not reported to public health systems. This qualitative study aimed to contextualize and characterize the role of private providers, care-seeking behaviour of individuals at high risk of malaria, as well as risk factors that should be addressed through malaria elimination programmes in Vietnam. Semi-structured qualitative interviews were conducted with 11 key informants in Hanoi, 30 providers, 9 potential patients, and 11 individuals at risk of malaria in Binh Phuoc and Kon Tum provinces. Audio recorded interviews were transcribed and uploaded to Atlas TI™, themes were identified, from which programmatic implications and recommendations were synthesized. Qualitative interviews revealed that efforts for malaria elimination in Vietnam should concentrate on reaching highest-risk populations in remote areas as well their care providers, in particular private pharmacies, private clinics, and grocery stores. Among these private providers, diagnosis is currently based on symptoms, leaving unconfirmed cases that are not reported to public health surveillance systems. Among at-risk individuals, knowledge of malaria was limited, and individuals reported not taking full courses of treatment, a practice that threatens selection for drug resistance. Access to insecticide-treated hammock nets, a potentially important preventive measure for settings with outdoor biting Anopheles vectors, was also limited. Malaria elimination efforts in Vietnam can be accelerated by targeting improved treatment, diagnosis, and reporting practices to private pharmacies, private clinics, and grocery stores. Programmes should also seek to increase awareness and understanding of malaria among at-risk populations, in particular the importance of using preventive measures and adhering to complete courses of anti-malarial medicines.

  12. An international qualitative study of functioning in autism spectrum disorder using the World Health Organization international classification of functioning, disability and health framework

    PubMed Central

    Mahdi, Soheil; Viljoen, Marisa; Yee, Tamara; Selb, Melissa; Singhal, Nidhi; Almodayfer, Omar; Granlund, Mats; de Vries, Petrus J.; Zwaigenbaum, Lonnie

    2017-01-01

    This is the third in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The present study aimed to describe functioning in ASD (as operationalized by the ICF) derived from the perspectives of diagnosed individuals, family members, and professionals. A qualitative study using focus groups and semi‐structured interviews were conducted with 19 stakeholder groups (N = 90) from Canada, India, Saudi Arabia, South Africa, and Sweden. Meaningful concepts from the focus groups and individual interviews were linked to ICF categories using a deductive qualitative approach with standardized linking procedures. The deductive qualitative content analysis yielded meaningful functioning concepts that were linked to 110 ICF categories across all four ICF components. Broad variation of environmental factors and activities and participation categories were identified in this study, while body functions consisted mainly of mental functions. Body structures were sparsely mentioned by the participants. Positive aspects of ASD included honesty, attention to detail, and memory. The experiences provided by international stakeholders support the need to understand individuals with ASD in a broader perspective, extending beyond diagnostic criteria into many areas of functioning and environmental domains. This study is part of a larger systematic effort that will provide the basis to define ICF Core Sets for ASD, from which assessment tools can be generated for use in clinical practice, research, and health care policy making. Autism Res 2018, 11: 463–475. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary The study findings support the need to understand the living experiences of individuals with Autism Spectrum Disorder (ASD) from a broader perspective, taking into account many areas of an individual's functioning and environment. The ICF can serve as foundation for exploring these living experiences more extensively by offering tools that enable wide variety of individual difficulties and strengths to be captured along with important environmental influences. As such, these tools can facilitate interventions that meet the needs and goals of the individual. PMID:29226604

  13. Selectively willing and conditionally able: HIV vaccine trial participation among women at "high risk" of HIV infection.

    PubMed

    Voytek, Chelsea D; Jones, Kevin T; Metzger, David S

    2011-08-18

    Efficacy studies of investigational HIV vaccines require enrollment of individuals at 'high risk' for HIV. This paper examines participation in HIV vaccine trials among women at 'high risk' for HIV acquisition. In-depth interviews were conducted with 17 African-American women who use crack cocaine and/or exchange sex for money/drugs to elicit attitudes toward medical research and motivators and deterrents to HIV vaccine trial participation. Interviews were digitally recorded and transcribed; data were coded and compiled into themes. Most women expressed favorable attitudes toward medical research in general. Motivators for trial participation included compensation; personal benefits including information, social services, and the possibility that the trial vaccine could prevent HIV; and altruism. Deterrents included: dislike of needles; distrust; concern about future consequences of participating. In addition, contingencies, care-giving responsibilities, and convenience issues constituted barriers which could impede participation. Respondents described varied, complex perspectives, and individual cases illustrate how these themes played out as women contemplated trial participation. Understanding factors which influence vaccine research participation among women at 'high risk' can aid sites to tailor recruitment procedures to local contexts. Concerns about future reactions can be addressed through sustained community education. Convenience barriers can be ameliorated by providing rides to study visits when necessary, and/or conducting study visits in accessible neighborhood locations. Women in this sample thought carefully about enrolling in HIV vaccine trials given the structural constraints within which they lived. Further research is needed regarding structural factors which influence personal agency and individuals' thinking about research participation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. The Myth of the Normal, Average Human Brain—The ICBM Experience: (1) Subject Screening and Eligibility

    PubMed Central

    Mazziotta, John C.; Woods, Roger; Iacoboni, Marco; Sicotte, Nancy; Yaden, Kami; Tran, Mary; Bean, Courtney; Kaplan, Jonas; Toga, Arthur W.

    2009-01-01

    In the course of developing an atlas and reference system for the normal human brain throughout the human age span from structural and functional brain imaging data, the International Consortium for Brain Mapping (ICBM) developed a set of “normal” criteria for subject inclusion and the associated exclusion criteria. The approach was to minimize inclusion of subjects with any medical disorders that could affect brain structure or function. In the past two years, a group of 1,685 potential subjects responded to solicitation advertisements at one of the consortium sites (UCLA). Subjects were screened by a detailed telephone interview and then had an in-person history and physical examination. Of those who responded to the advertisement and considered themselves to be normal, only 31.6% (532 subjects) passed the telephone screening process. Of the 348 individuals who submitted to in-person history and physical examinations, only 51.7% passed these screening procedures. Thus, only 10.7% of those individuals who responded to the original advertisement qualified for imaging. The most frequent cause for exclusion in the second phase of subject screening was high blood pressure followed by abnormal signs on neurological examination. It is concluded that the majority of individuals who consider themselves normal by self-report are found not to be so by detailed historical interviews about underlying medical conditions and by thorough medical and neurological examinations. Recommendations are made with regard to the inclusion of subjects in brain imaging studies and the criteria used to select them. PMID:18775497

  15. Exploring risk, prevention and educational approaches for the non-diabetic offspring of patients with type 2 diabetes--a qualitative study.

    PubMed

    Gordon, Charlotte; Walker, Mark; Carrick-Sen, Debbie

    2013-12-01

    To understand the knowledge and perceptions of type 2 diabetes and to explore preferable educational strategies in the non-diabetic offspring of patients with the disease. Type 2 diabetes is an increasingly prevalent disease with significant long-term consequences. Offspring of patients with type 2 diabetes have an increased risk of developing the disease compared with the general population. Previous studies have shown that offspring have a poor perception of their own risk. A qualitative study was carried out using semi-structured one-to-one interviews. Analysis was completed using a structured framework approach. Research was carried out during January-March 2011 in the north east of UK. Six offspring of patients diagnosed with the disease were interviewed. Participants balanced positive and negative aspects of their lifestyle behaviours to estimate their own risk. They had adequate knowledge of healthy lifestyle behaviours, but were uncertain about the long-term effects and seriousness of the disease and the role of inheritance. Behavioural changes at an individual level would only be motivated by an event, which would impact on their own health. Participants believed that 'fear'-based strategies to health promotion would be most effective to encourage behaviour change. Knowledge of individual risk and why diabetes was serious was limited and variable. The health behaviours of this at-risk group were complex. Nurses engaged in the care of at-risk individuals must take this complexity into account when developing and implementing multi-faceted strategies to improve awareness. © 2013 John Wiley & Sons Ltd.

  16. Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi.

    PubMed

    Arnold, Trisha; Brinkley-Rubinstein, Lauren; Chan, Philip A; Perez-Brumer, Amaya; Bologna, Estefany S; Beauchamps, Laura; Johnson, Kendra; Mena, Leandro; Nunn, Amy

    2017-01-01

    Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep South. Therefore, this study explored the structural, social, behavioral, and clinical factors that affect PrEP use and retention in care among YMSM in Jackson, Mississippi. Thirty MSM who were prescribed PrEP at an outpatient primary care clinic were interviewed and included 23 men who had been retained in PrEP care and seven who had not been retained. The mean age of participants was 26.6 years. Most (23) participants were African American. Major factors affecting PrEP use and retention in PrEP care included 1) structural factors such as cost and access to financial assistance for medications and clinical services; 2) social factors such as stigma and relationship status; 3) behavioral factors including sexual risk behaviors; and 4) clinical factors such as perceived and actual side effects. Many participants also discussed the positive spillover effects of PrEP use and reported that PrEP had a positive impact on their health. Four of the seven individuals who had not been retained re-enrolled in PrEP care after completing their interviews, suggesting that case management and ongoing outreach can enhance retention in PrEP care. Interventions to enhance retention in PrEP care among MSM in the Deep South will be most effective if they address the complex structural, social, clinical, and behavioral factors that influence PrEP uptake and retention in PrEP care.

  17. Hierarchical structure and importance of patients' reasons for treatment choices in knee and hip osteoarthritis: a concept mapping study.

    PubMed

    Selten, Ellen M H; Geenen, Rinie; van der Laan, Willemijn H; van der Meulen-Dilling, Roelien G; Schers, Henk J; Nijhof, Marc W; van den Ende, Cornelia H M; Vriezekolk, Johanna E

    2017-02-01

    To improve patients' use of conservative treatment options of hip and knee OA, in-depth understanding of reasons underlying patients' treatment choices is required. The current study adopted a concept mapping method to thematically structure and prioritize reasons for treatment choice in knee and hip OA from a patients' perspective. Multiple reasons for treatment choices were previously identified using in-depth interviews. In consensus meetings, experts derived 51 representative reasons from the interviews. Thirty-six patients individually sorted the 51 reasons in two card-sorting tasks: one based on content similarity, and one based on importance of reasons. The individual sortings of the first card-sorting task provided input for a hierarchical cluster analysis (squared Euclidian distances, Ward's method). The importance of the reasons and clusters were examined using descriptive statistics. The hierarchical structure of reasons for treatment choices showed a core distinction between two categories of clusters: barriers [subdivided into context (e.g. the healthcare system) and disadvantages] and outcome (subdivided into treatment and personal life). At the lowest level, 15 clusters were identified of which the clusters Physical functioning, Risks and Prosthesis were considered most important when making a treatment decision for hip or knee OA. Patients' treatment choices in knee and hip OA are guided by contextual barriers, disadvantages of the treatment, outcomes of the treatment and consequences for personal life. The structured overview of reasons can be used to support shared decision-making. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Negotiating identity and self-image: perceptions of falls in ambulatory individuals with spinal cord injury – a qualitative study

    PubMed Central

    Jørgensen, Vivien; Roaldsen, Kirsti Skavberg

    2016-01-01

    Objective: Explore and describe experiences and perceptions of falls, risk of falling, and fall-related consequences in individuals with incomplete spinal cord injury (SCI) who are still walking. Design: A qualitative interview study applying interpretive content analysis with an inductive approach. Setting: Specialized rehabilitation hospital. Subjects: A purposeful sample of 15 individuals (10 men), 23 to 78 years old, 2-34 years post injury with chronic incomplete traumatic SCI, and walking ⩾75% of time for mobility needs. Methods: Individual, semi-structured face-to-face interviews were recorded, condensed, and coded to find themes and subthemes. Results: One overarching theme was revealed: “Falling challenges identity and self-image as normal” which comprised two main themes “Walking with incomplete SCI involves minimizing fall risk and fall-related concerns without compromising identity as normal” and “Walking with incomplete SCI implies willingness to increase fall risk in order to maintain identity as normal”. Informants were aware of their increased fall risk and took precautions, but willingly exposed themselves to risky situations when important to self-identity. All informants expressed some conditional fall-related concerns, and a few experienced concerns limiting activity and participation. Conclusion: Ambulatory individuals with incomplete SCI considered falls to be a part of life. However, falls interfered with the informants’ identities and self-images as normal, healthy, and well-functioning. A few expressed dysfunctional concerns about falling, and interventions should target these. PMID:27170274

  19. The importance of building trust and tailoring interactions when meeting older adults' health literacy needs.

    PubMed

    Brooks, Charlotte; Ballinger, Claire; Nutbeam, Don; Adams, Jo

    2017-11-01

    Health literacy is the ability to access, understand and use health information. This study qualitatively explored the views and experiences of older adults with varying health literacy levels who had attended a falls clinic on their overall experience of the falls clinic, access to the service and provider-patient interaction. Individual semi-structured interviews were conducted with nine older adults using a falls clinic in England. Health literacy was assessed using the REALM and NVS-UK. Interviews were audio-recorded, transcribed verbatim and interrogated using interpretative phenomenological analysis (IPA). Two superordinate themes emerged from the analysis: The importance of trust and relationship building to achieve effective communication with older adults; and the importance of tailoring education and healthcare to older adults' individual health literacy needs and preferences. The findings corroborate previous research emphasising the importance of face-to-face communication in responding to older adults' individual health literacy needs. Building trust in the relationship and tailoring communication to older adults' individual attributes and preferred learning styles is essential. Healthcare practitioners and managers should consider how service organisation and communication methods can enhance positive and effective relationships with patients. Improved training could support healthcare providers in meeting patients' personal communication needs. Implications for Rehabilitation Rehabilitation professionals should be aware of their patients' individual health literacy needs and communication/learning preferences. It is important to build relationships and trust with older adults attending rehabilitation services. Further training for rehabilitation professionals could support them in meeting patients' personal communication needs.

  20. Structural validity and reliability of the Positive and Negative Affect Schedule (PANAS): evidence from a large Brazilian community sample.

    PubMed

    Carvalho, Hudson W de; Andreoli, Sérgio B; Lara, Diogo R; Patrick, Christopher J; Quintana, Maria Inês; Bressan, Rodrigo A; Melo, Marcelo F de; Mari, Jair de J; Jorge, Miguel R

    2013-01-01

    Positive and negative affect are the two psychobiological-dispositional dimensions reflecting proneness to positive and negative activation that influence the extent to which individuals experience life events as joyful or as distressful. The Positive and Negative Affect Schedule (PANAS) is a structured questionnaire that provides independent indexes of positive and negative affect. This study aimed to validate a Brazilian interview-version of the PANAS by means of factor and internal consistency analysis. A representative community sample of 3,728 individuals residing in the cities of São Paulo and Rio de Janeiro, Brazil, voluntarily completed the PANAS. Exploratory structural equation model analysis was based on maximum likelihood estimation and reliability was calculated via Cronbach's alpha coefficient. Our results provide support for the hypothesis that the PANAS reliably measures two distinct dimensions of positive and negative affect. The structure and reliability of the Brazilian version of the PANAS are consistent with those of its original version. Taken together, these results attest the validity of the Brazilian adaptation of the instrument.

  1. Barriers to the implementation of the SAFE strategy to combat hyperendemic trachoma in Australia.

    PubMed

    Wright, Heathcote R; Keeffe, Jill E; Taylor, Hugh R

    2010-12-01

    Australia is the only developed country in the world that still has endemic levels of blinding trachoma. The SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) strategy is an effective public health intervention that has been successfully used to eliminate blinding trachoma in some of the poorest countries of the world. Yet the SAFE strategy has not been systematically implemented in Australia. We undertook semi-structured interviews to identify some of barriers to the implementation of the SAFE strategy within remote indigenous communities of Australia. Health care professionals who were responsible for delivering trachoma control programs throughout the Northern Territory were asked to participate in a semi-structured interview. Quantitative analysis was performed using an existing strategic management framework. Fourteen individuals were interviewed. Responses were grouped into 19 categories; 12 from the existing strategic management framework and 7 additional categories that were created for ideas unique to the trachoma control program in Australia. A number of key themes emerged from the interview and are presented in a literary style. From these key themes critical success factors for the implementation of a sustainable trachoma control program were identified. With the election of the Rudd government there has been a renewed interest in "closing the gap" between the health of indigenous and non-indigenous Australians. A federal government funding package of $58 million over four years has just been announced to tackle trachoma. It is hoped that the findings of this research can assist in making sure that money achieves its goal.

  2. A one-size-fits-all HIV prevention and education approach?: Analyzing and interpreting divergent HIV risk perceptions between African American and East African immigrant women in Washington, DC

    PubMed Central

    De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia

    2015-01-01

    Background To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born Black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women’s perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the US. Methods Forty in-depth, semi-structured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semi-structured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. Results Adopting Boerma and Weir’s Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. While African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival. Conclusions Study findings suggest that addressing HIV prevention and education among Black women in DC will require distinct and targeted strategies that are culturally and community-centered in order to resonate with these different audiences. PMID:26766523

  3. Screening for DSM-5 Other Specified Feeding or Eating Disorder in a Weight-Loss Treatment–Seeking Obese Sample

    PubMed Central

    Gorman, Mark J.; Sogg, Stephanie; Lamont, Evan M.; Eddy, Kamryn T.; Becker, Anne E.; Thomas, Jennifer J.

    2014-01-01

    Objective: To evaluate the effectiveness of specific self-report questionnaires in detecting DSM-5 eating disorders identified via structured clinical interview in a weight-loss treatment–seeking obese sample, to improve eating disorder recognition in general clinical settings. Method: Individuals were recruited over a 3-month period (November 2, 2011, to January 10, 2012) when initially presenting to a hospital-based weight-management center in the northeastern United States, which offers evaluation and treatment for outpatients who are overweight or obese. Participants (N = 100) completed the Structured Clinical Interview for DSM-IV eating disorder module, a DSM-5 feeding and eating disorders interview, and a battery of self-report questionnaires. Results: Self-reports and interviews agreed substantially in the identification of bulimia nervosa (DSM-IV and DSM-5: tau-b = 0.71, P < .001) and binge-eating disorder (DSM-IV and DSM-5: tau-b = 0.60, P < .001), modestly for subthreshold binge-eating disorder (tau-b = 0.44, P < .001), and poorly for other subthreshold conditions (night-eating syndrome: tau-b = –0.04, P = .72, r = 0.06 [DSM-5]). Discussion: Current self-report assessments are likely to identify full syndrome DSM-5 eating disorders in treatment-seeking obese samples, but unlikely to detect DSM-5 other specified feeding or eating disorders. We propose specific content changes that might enhance clinical utility as suggestions for future evaluation. PMID:25667810

  4. Oral health education for schoolchildren: a qualitative study of dental care professionals' view of knowledge and learning.

    PubMed

    Hedman, E; Ringberg, K; Gabre, P

    2009-08-01

    The aim of the study was to describe and interpret dental professionals' view of knowledge, learning, health promotion and their expectations of and attitudes to the response from schoolchildren. A qualitative study design was used with discourse method. Nine dental hygienists and dental nurses, who have practised oral health education among schoolchildren, described their work in tape-recorded, semi-structured interviews. The discourse method stresses the variation and distinctions in the statements, and to understand the content of the text, its contextual dependence must be taken into account. The preventive discourse could be found in all interviews, but it was concentrated on disease prevention and less on maintaining health. The biomedical view of knowledge dominated. Children's and parent's own responsibility for healthy habits was stressed, but no reflection of ethical considerations associated with influencing people's life-style was found. The text revealed discrepancy between the informants, and even within the same individual, showing ambivalence towards oral health education. Some individuals suggested lessons guided by communication with the children, while others wanted to maintain methods based on information about oral diseases to a greater extent. Different perspectives were found. The expression 'oral health promotion' was frequently used and supported by all the interviewed informants, but the statements did not reveal the informant's definition of the concept. Several educators focused on signs of diseases and less on the individual's view of their own health. In the future, oral health education programme needs to focus on quality of life, behavioural variables and indicators of empowerment rather than just disease outcomes.

  5. A prospective examination of service use by abused and neglected children followed up into adulthood.

    PubMed

    Yanos, Philip T; Czaja, Sally J; Widom, Cathy Spatz

    2010-08-01

    This study sought to determine whether abused and neglected children are more likely than those without childhood maltreatment to use health and social services as adults and whether psychiatric status mediates or moderates the relationship. A prospective cohort design was used. Individuals with documented cases of physical and sexual abuse and neglect (ages 0-10) and nonvictimized children matched on age, sex, and race-ethnicity were interviewed in adulthood (mean age 41 years). Past-year service use (general medical, mental health, substance abuse, and social) was assessed during 2003-2004 interviews (maltreated group, N=458; control group, N=349). Psychiatric status (posttraumatic stress disorder [PTSD], drug abuse, and major depressive disorder) was assessed during 1989-1995 (mean age 29) by structured interview. Individuals with histories of childhood abuse and neglect were significantly more likely than their control group counterparts to use mental health services (odds ratio [OR]=1.60, 95% confidence interval [CI]=1.04-2.45) and social services (OR=2.95, CI=2.19-3.97) in adulthood. Psychiatric status in young adulthood (PTSD and major depressive disorder) partially mediated the relationship between childhood maltreatment and use of mental health services, whereas major depression and drug abuse moderated the relationship between maltreatment and use of any services and general medical services. In adulthood, individuals with documented histories of childhood abuse and neglect are more likely than persons without such histories to use some types of services, and psychiatric status mediates and moderates these relationships. Findings have implications for the provision of services to persons with childhood abuse and neglect.

  6. Silent Bias: Challenges, Obstacles, and Strategies for Leadership Development in Academic Medicine-Lessons From Oral Histories of Women Professors at the University of Kansas.

    PubMed

    Pingleton, Susan K; Jones, Emily V M; Rosolowski, Tacey A; Zimmerman, Mary K

    2016-08-01

    Despite dramatic increases in female learners and junior faculty, a significant gap remains in female leadership in academic medicine. To assess challenges and obstacles encountered, strategies for academic success, and lessons learned for leadership development, the authors conducted an in-depth study of women full professors. The authors used a qualitative oral history approach, interviewing 87% of the cohort of female full professors at one Midwestern medical school in 2013 using a pretested, open-ended, semistructured interview guide. Interviews were videotaped and the audio recordings transcribed. Content was sorted into categories and key themes identified within each category. Participants described significant challenges: being treated with "silent bias," "being ignored," and being seen as an "other." Coping strategies included downplaying, keeping a distance, employing humor, and using symbols (e.g., white coat) to carefully present themselves. Explanations for success included intelligence, meritocracy, being even-tempered, and carefully constructing femininity. The participants recommended individual skills and actions to prepare for leadership development. Virtually all women could describe an individual mentor (sponsor), usually male, who provided essential assistance for their career success. At the same time, they stressed the importance of institutional support for diversity, especially with child care. Attaining "full professor" status is the pinnacle of academic success. Women who successfully navigated this academic ladder describe significant external and internal challenges that require multiple strategies to overcome. Leadership development entails a combination of individual support through mentors and sponsors, self-education and reflection, and organizational structural support to promote diversity.

  7. Novel Method for Recruiting Representative At-Risk Individuals into Cancer Prevention Trials: Online Health Risk Assessment in Employee Wellness Programs.

    PubMed

    Hui, Siu-Kuen Azor; Miller, Suzanne M; Hazuda, Leah; Engelman, Kimberly; Ellerbeck, Edward F

    2016-09-01

    Participation in cancer prevention trials (CPT) is lower than 3 % among high-risk healthy individuals, and racial/ethnic minorities are the most under-represented. Novel recruitment strategies are therefore needed. Online health risk assessment (HRA) serves as a gateway component of nearly all employee wellness programs (EWPs) and may be a missed opportunity. This study aimed to explore employees' interest, willingness, motivators, and barriers of releasing their HRA responses to an external secure research database for recruitment purpose. We used qualitative research methods (focus group and individual interviews) to examine employees' interest and willingness in releasing their online HRA responses to an external, secure database to register as potential CPT participants. Fifteen structured interviews (40 % of study participants were of racial/ethnic minority) were conducted, and responses reached saturation after four interviews. All employees showed interest and willingness to release their online HRA responses to register as a potential CPT participant. Content analyses revealed that 91 % of participants were motivated to do so, and the major motivators were to (1) obtain help in finding personally relevant prevention trials, (2) help people they know who are affected by cancer, and/or (3) increase knowledge about CPT. A subset of participants (45 %) expressed barriers of releasing their HRA responses due to concerns about credibility and security of the external database. Online HRA may be a feasible but underutilized recruitment method for cancer prevention trials. EWP-sponsored HRA shows promise for the development of a large, centralized registry of racially/ethnically representative CPT potential participants.

  8. Novel method for recruiting representative at-risk individuals into cancer prevention trials: on-line health risk assessment in employee wellness programs

    PubMed Central

    Hui, Siu-kuen Azor; Miller, Suzanne M.; Hazuda, Leah; Engelman, Kimberly; Ellerbeck, Edward F.

    2015-01-01

    Participation in cancer prevention trials (CPT) is lower than 3% among high-risk healthy individuals, and racial/ethnic minorities are the most under-represented. Novel recruitment strategies are therefore needed. On-line health risk assessment (HRA) serves as a gateway component of nearly all employee wellness programs (EWP) and may be a missed opportunity. This study aimed to explore employees’ interest, willingness, motivators, and barriers of releasing their HRA responses to an external secure research database for recruitment purpose. We used qualitative research methods (focus group and individual interviews) to examine employees’ interest and willingness in releasing their on-line HRA responses to an external, secure database to register as potential CPT participants. Fifteen structured interviews (40% of study participants were of racial/ethnic minority) were conducted and responses reached saturation after four interviews. All employees showed interest and willingness to release their on-line HRA responses to register as a potential CPT participant. Content analyses revealed that 91% of participants were motivated to do so, and the major motivators were to: 1) obtain help in finding personally relevant prevention trials, 2) help people they know who are affected by cancer, and/or 3) increase knowledge about CPT. A subset of participants (45%) expressed barriers of releasing their HRA responses due to concerns about credibility and security of the external database. On-line HRA may be a feasible but underutilized recruitment method for cancer prevention trials. EWP-sponsored HRA shows promise for the development of a large, centralized registry of racially/ethnically representative CPT potential participants. PMID:26507744

  9. The structure of genetic and environmental risk factors for fears and phobias

    PubMed Central

    Loken, E. K.; Hettema, J.M.; Aggen, S.H.; Kendler, K. S.

    2014-01-01

    Background Although prior genetic studies of interview-assessed fears and phobias have shown that genetic factors predispose individuals to fears and phobias, they have been restricted to the DSM-III to DSM-IV aggregated subtypes of phobias rather than to individual fearful and phobic stimuli. Method We examined the lifetime history of fears and/or phobias in response to 21 individual phobic stimuli in 4067 personally interviewed twins from same-sex pairs from the Virginia Adult Twin Study of Psychiatric and Substance Abuse Disorders (VATSPSUD). We performed multivariate statistical analyses using Mx and Mplus. Results The best-fitting model for the 21 phobic stimuli included four genetic factors (agora-social-acrophobia, animal phobia, blood-injection-illness phobia and claustrophobia) and three environmental factors (agora-social-hospital phobia, animal phobia, and situational phobia). Conclusions This study provides the first view of the architecture of genetic and environmental risk factors for phobic disorders and their subtypes. The genetic factors of the phobias support the DSM-IV and DSM-5 constructs of animal and blood-injection-injury phobias but do not support the separation of agoraphobia from social phobia. The results also do not show a coherent genetic factor for the DSM-IV and DSM-5 situational phobia. Finally, the patterns of co-morbidity across individual fears and phobias produced by genetic and environmental influences differ appreciably. PMID:24384457

  10. How to tell a happy from an unhappy schizotype: personality factors and mental health outcomes in individuals with psychotic experiences.

    PubMed

    Alminhana, Letícia O; Farias, Miguel; Claridge, Gordon; Cloninger, Claude R; Moreira-Almeida, Alexander

    2017-01-01

    It is unclear why some individuals reporting psychotic experiences have balanced lives while others go on to develop mental health problems. The objective of this study was to test if the personality traits of harm avoidance, self-directedness, and self-transcendence can be used as criteria to differentiate healthy from unhealthy schizotypal individuals. We interviewed 115 participants who reported a high frequency of psychotic experiences. The instruments used were the Temperament and Character Inventory (140), Structured Clinical Interview for DSM-IV, and the Oxford-Liverpool Inventory of Feelings and Experiences. Harm avoidance predicted cognitive disorganization (β = 0.319; t = 2.94), while novelty seeking predicted bipolar disorder (β = 0.136, Exp [β] = 1.146) and impulsive non-conformity (β = 0.322; t = 3.55). Self-directedness predicted an overall decrease in schizotypy, most of all in cognitive disorganization (β = -0.356; t = -2.95) and in impulsive non-conformity (β = -0.313; t = -2.83). Finally, self-transcendence predicted unusual experiences (β = 0.256; t = 2.32). Personality features are important criteria to distinguish between pathology and mental health in individuals presenting high levels of anomalous experiences (AEs). While self-directedness is a protective factor, both harm avoidance and novelty seeking were predictors of negative mental health outcomes. We suggest that the impact of AEs on mental health is moderated by personality factors.

  11. A qualitative study exploring patients' experiences of standard care or cardiac rehabilitation post minor stroke and transient ischaemic attack.

    PubMed

    Hillsdon, Kaye M; Kersten, Paula; Kirk, Hayden J S

    2013-09-01

    To explore individuals' experiences of receiving either standard care or comprehensive cardiac rehabilitation post minor stroke or transient ischaemic attack. A qualitative study using semi-structured interviews, alongside a randomized controlled trial, exploring the effectiveness of comprehensive cardiac rehabilitation compared with standard care. Interviews were transcribed verbatim and subjected to thematic analysis. Individuals' homes. People who have experienced a minor stroke or transient ischaemic attack and who were partaking in a secondary prevention randomized controlled trial (6-7 months post the event, 17 males, five females; mean age 67 years). Not relevant. Not relevant. Four themes were identified: information delivery, comparing oneself with others, psychological impact, attitudes and actions regarding risk factor reduction. Participants indicated a need for improved information delivery, specific to their own risk factors and lifestyle changes. Many experienced psychological impact as a result of their minor stroke. Participants were found to make two types of social comparison; the comparison of self to another affected by stroke, and the comparison of self to cardiac patients. Comprehensive cardiac rehabilitation was reported to have positive effects on people's motivation to exercise. Following a minor stroke, many individuals do not recall information given or risk factors specific to them. Downward comparison with individuals who have had a cardiovascular event led to some underplaying the significance of their minor stroke.

  12. Knowing you: the interpersonal perceptions of staff towards aggressive individuals with mild to moderate intellectual disabilities in situations of conflict.

    PubMed

    Jahoda, A; Wanless, L K

    2005-07-01

    Staff attributions concerning challenging behaviour have been found to play a role in determining their responses. The emphasis in the literature has been on staff beliefs about the challenging behaviour itself. However, staff are also likely to be responding to the person engaging in the behaviour. The aim of this study was to explore workers' perceptions of individuals who are frequently aggressive. Thirty-six staff members working with individuals presenting problems of frequent aggression participated in this study. They were interviewed about an incident of aggression involving the person they worked with. The semi-structured interview, based on a Rational Emotive Therapy format, aimed to tap into the emotions aroused in the staff members and interpersonal appraisals that they made at the time of the incident. The responses were content analyzed. The strength of the staff member's emotional reactions were noteworthy. Furthermore, approximately half of the staff members believed that the clients' aggression was directed at them personally. In turn, the majority of staff members described their clients in negative terms, and said that their first impulse had been to confront the clients. The findings suggest that interpersonal perceptions may have a role in determining staff responses to individuals who behave aggressively. The clinical and theoretical implications of the findings were discussed, alongside directions for future research.

  13. The structure of genetic and environmental risk factors for fears and phobias.

    PubMed

    Loken, E K; Hettema, J M; Aggen, S H; Kendler, K S

    2014-08-01

    Although prior genetic studies of interview-assessed fears and phobias have shown that genetic factors predispose individuals to fears and phobias, they have been restricted to the DSM-III to DSM-IV aggregated subtypes of phobias rather than to individual fearful and phobic stimuli. We examined the lifetime history of fears and/or phobias in response to 21 individual phobic stimuli in 4067 personally interviewed twins from same-sex pairs from the Virginia Adult Twin Study of Psychiatric and Substance Abuse Disorders (VATSPSUD). We performed multivariate statistical analyses using Mx and Mplus. The best-fitting model for the 21 phobic stimuli included four genetic factors (agora-social-acrophobia, animal phobia, blood-injection-illness phobia and claustrophobia) and three environmental factors (agora-social-hospital phobia, animal phobia, and situational phobia). This study provides the first view of the architecture of genetic and environmental risk factors for phobic disorders and their subtypes. The genetic factors of the phobias support the DSM-IV and DSM-5 constructs of animal and blood-injection-injury phobias but do not support the separation of agoraphobia from social phobia. The results also do not show a coherent genetic factor for the DSM-IV and DSM-5 situational phobia. Finally, the patterns of co-morbidity across individual fears and phobias produced by genetic and environmental influences differ appreciably.

  14. The interplay between interpersonal dynamics, treatment barriers, and larger social forces: an exploratory study of drug-using couples in Hartford, CT

    PubMed Central

    Simmons, Janie

    2006-01-01

    Background The drug treatment field tends to place emphasis on the individual rather than the individual in social context. While there are a growing number of studies indicating that drug-using intimate partners are likely to play an important role in determining treatment options, little attention has been given to the experience and complex treatment needs of illicit drug-using (heroin, cocaine, crack) couples. Methods This exploratory study used in-depth interviews and ethnographic engagement to better understand the relationship between interpersonal dynamics and the treatment experience of ten relatively stable drug-using couples in Hartford, CT. Semi-structured and open-ended qualitative interviews were conducted with each couple and separately with each partner. Whenever possible, the day-to-day realities and contexts of risk were also observed via participant and non-participant observation of these couples in the community. A grounded theory approach was used to inductively code and analyze nearly 40 transcripts of 60–90 minute interviews as well as fieldnotes. Results This study builds on a concept of complex interpersonal dynamics among drug users. Interpersonal dynamics of care and collusion were identified: couples cared for each other and colluded to acquire and use drugs. Care and collusion operate at the micro level of the risk environment. Treatment barriers and inadequacies were identified as part of the risk environment at the meso or intermediate level of analysis, and larger social forces such as gender dynamics, poverty and the "War on Drugs" were identified at the macro level. Interpersonal dynamics posed problems for couples when one or both partners were interested in accessing treatment. Structural barriers presented additional obstacles with the denial of admittance of both partners to treatment programs which had a sole focus on the individual and avoided treating couples. Conclusion Detoxification and treatment facilities need to recognize the complex interplay between interpersonal dynamics which shape the treatment experience of couples, and which are also shaped by larger structural dynamics, including barriers in the treatment system. Improvements to the treatment system in general will go a long way in improving treatment for couples. Couples-specific programming also needs to be developed. PMID:16722545

  15. The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease.

    PubMed

    Schumacher, Tracy L; Burrows, Tracy L; Thompson, Deborah I; Callister, Robin; Spratt, Neil J; Collins, Clare E

    2016-09-30

    Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD) events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years) who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18-70 years, 47% male, five with CVD diagnosis). Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived "need" to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family "ringleader" to influence involvement and capitalising on personal accountability to other family members.

  16. Interactive models of depression vulnerability: the role of childhood trauma, dysfunctional attitudes, and coping.

    PubMed

    Morris, Matthew C; Kouros, Chrystyna D; Fox, Kathryn R; Rao, Uma; Garber, Judy

    2014-06-01

    This prospective study investigated whether within-individual relations between depression vulnerability factors (childhood trauma, dysfunctional attitudes, maladaptive coping) and depressive symptom trajectories varied as a function of the number of prior major depressive episodes (MDEs) experienced in their lifetime. Participants were 68 young adults who varied with regard to their history of depression; 32 were remitted depressed and 36 were never depressed. Depressive symptoms and disorders were assessed using semi-structured psychiatric interviews conducted twice over a 6-month period; interviews yielded weekly ratings of depressive symptoms during the follow-up interval. Childhood trauma, dysfunctional attitudes and coping were assessed with self-report measures. Data analyses were conducted using time-lagged multilevel models. Individuals with more previous MDEs who reported greater childhood trauma exposure, more dysfunctional attitudes, or greater use of maladaptive coping strategies experienced more rapid increases in depressive symptoms during the follow-up period. A significant interaction of coping, number of previous MDEs, and time was found indicating that among individuals with less adaptive coping (i.e., lower primary or lower secondary control coping scores), depressive symptoms rating (DSR) increased significantly in relation to number of prior depressive episodes; no change in DSR was observed for never-depressed individuals. Among individuals with higher primary control coping scores, significant increases in DSR scores were observed for individuals with ≥3 prior MDEs only. Findings highlight the need for treatment and prevention programmes that target stress reactivity and coping strategies early in the course of depression. © 2013 The British Psychological Society.

  17. Interactive models of depression vulnerability: The role of childhood trauma, dysfunctional attitudes, and coping

    PubMed Central

    Morris, Matthew C.; Kouros, Chrystyna D.; Fox, Kathryn R.; Rao, Uma; Garber, Judy

    2013-01-01

    Objectives This prospective study investigated whether within-individual relations between depression vulnerability factors (childhood trauma, dysfunctional attitudes, maladaptive coping) and depressive symptom trajectories varied as a function of the number of prior major depressive episodes experienced in their lifetime. Design Participants were 68 young adults who varied with regard to their history of depression; 32 were remitted depressed and 36 were never depressed Methods Depressive symptoms and disorders were assessed using semi-structured psychiatric interviews conducted twice over a 6-month period; interviews yielded weekly ratings of depressive symptoms during the follow-up interval. Childhood trauma, dysfunctional attitudes and coping were assessed with self-report measures. Data analyses were conducted using time-lagged multilevel models. Results Individuals with more previous major depressive episodes (MDEs) who reported greater childhood trauma exposure, more dysfunctional attitudes, or greater use of maladaptive coping strategies experienced more rapid increases in depressive symptoms during the follow-up period. A significant interaction of coping, number of previous MDEs, and time was found indicating that among individuals with less adaptive coping (i.e., lower primary or lower secondary control coping scores), depressive symptoms (DSR) increased significantly in relation to number of prior depressive episodes; no change in DSR was observed for never-depressed individuals. Among individuals with higher primary control coping scores, significant increases in DSR scores were observed for individuals with ≥ 3 prior MDEs only. Conclusions Findings highlight the need for treatment and prevention programs that target stress reactivity and coping strategies early in the course of depression. PMID:24372468

  18. The readiness and motivation interview for families (RMI-Family) managing pediatric obesity: study protocol.

    PubMed

    Ball, Geoff D C; Spence, Nicholas D; Browne, Nadia E; O'Connor, Kathleen; Srikameswaran, Suja; Zelichowska, Joanna; Ho, Josephine; Gokiert, Rebecca; Mâsse, Louise C; Carson, Valerie; Morrison, Katherine M; Kuk, Jennifer L; Holt, Nicholas L; Kebbe, Maryam; Gehring, Nicole D; Cesar, Melody; Virtanen, Heidi; Geller, Josie

    2017-04-11

    Experts recommend that clinicians assess motivational factors before initiating care for pediatric obesity. Currently, there are no well-established clinical tools available for assessing motivation in youth with obesity or their families. This represents an important gap in knowledge since motivation-related information may shed light on which patients might fail to complete treatment programs. Our study was designed to evaluate the measurement properties and utility of the Readiness and Motivational Interview for Families (RMI-Family), a structured interview that utilizes a motivational interviewing approach to (i) assess motivational factors in youth and their parents, and (ii) examine the degree to which motivation and motivation-related concordance between youth and parents are related to making changes to lifestyle habits for managing obesity in youth. From 2016 to 2020, this prospective study will include youth with obesity (body mass index [BMI] ≥97th percentile; 13-17 years old; n = 250) and their parents (n = 250). The study will be conducted at two primary-level, multidisciplinary obesity management clinics based at children's hospitals in Alberta, Canada. Participants will be recruited and enrolled after referral to these clinics, but prior to initiating clinical care. Each youth and their parent will complete the RMI-Family (~1.5 h) at baseline, and 6- and 12-months post-baseline. Individual (i.e., youth or parent) and family-level (i.e., across youth and parent) responses to interview questions will be scored, as will aspects of interview administration (e.g., fidelity to motivational interviewing tenets). The RMI-Family will also be examined for test-retest reliability. Youth data collected at each time point will include demography, anthropometry, lifestyle habits, psychosocial functioning, and health services utilization. Cross-sectional and longitudinal associations between individual and family-level interview scores on the RMI-Family and these clinical measures will be examined. As a measurement tool drawing on family-centered care and motivational interviewing, the RMI-Family was designed to increase understanding of the role of motivational factors in pediatric obesity management, allowing healthcare providers and policymakers to manage pediatric obesity more effectively and efficiently. Findings will help to create an innovative, tailored model of health care delivery that uses resources judiciously and is designed to best meet families' needs.

  19. Understanding the Experiences of Rural Community-Dwelling Older Adults in Using a New DVD-Delivered Otago Exercise Program: A Qualitative Study.

    PubMed

    Agha, Arun; Liu-Ambrose, Teresa Y L; Backman, Catherine L; Leese, Jennifer; Li, Linda C

    2015-08-13

    The home-based Otago Exercise Program (OEP) has been shown to reduce the occurrence of falls in community-dwelling seniors. A new OEP DVD was recently developed for people living in rural communities to be used with minimal coaching by a physical therapist. This study aimed to understand older adults' experiences using the DVD-delivered OEP and explore barriers and facilitators to implementing the DVD-delivered OEP from the participants' perspectives. Rural community-dwelling older adults (75 years and older) who participated in a six-month DVD-delivered OEP study were invited to participate in this qualitative study. Two small group interviews were initially conducted to explore the breadth of participants' experiences with the program. These were followed by semi-structured individual interviews to gain an in-depth understanding of these experiences. An inductive constant comparison analysis of the transcripts was performed. To ensure methodological rigor, field notes, journaling, and an audit trail were maintained, supplemented by peer-review. Of 32 eligible participants, five participated in group interviews and 16 in individual interviews. Three themes emerged. Theme 1, The OEP DVD-useful training tool but in need of more pep, represented participants' experiences that the DVD provided important guidance at program onset, but was too slow and low-energy for longer-term use. Theme 2, Gaining control over one's exercise regimen, but sometimes life gets in the way of staying active, described participants' appreciation of the program's flexibility, but personal health concerns and everyday lives posed challenges to adhering to the program. Theme 3, Social creatures-wanting greater human connection during exercise, described how some participants desired further social interactions for enhancing motivation and receiving guidance. Individuals should be encouraged to refer to the OEP user manual or DVD as needed and engage friends and family in exercises. The importance of exercise even when living with health problems should be raised at program onset, and participants should be supported in working through challenging issues. Health professionals should work with individuals to integrate the program with their everyday activities.

  20. Understanding diabetes self-management behaviors among Hispanics in New York City.

    PubMed

    Aponte, Judith; Campos-Dominguez, Giselle; Jaramillo, Diana

    2015-01-01

    Diabetes mellitus is a public health concern disproportionately affecting Hispanics. Because Hispanics are greatly affected by a high prevalence of diabetes, a qualitative study was conducted, which explored how Hispanics understand, perceive, and experience behavioral change and how they maintain such change while managing their diabetes. Twenty Caribbean (Dominican and Puerto Rican) Hispanic adults with diabetes, who were either English- or Spanish-speaking, participated in the study. Twenty individual interviews were conducted, audiotaped, and transcribed and translated. Structured questions were used in the interviews which covered the meaning of certain terms (e.g., healthy eating, exercise), motivators and barriers to changing behaviors related to diabetes management, and a question to explore ways nurses can assist them in changing behaviors. Content analysis was used to analyze the text of the interviews. Three themes (diabetes management, behavior change, and nurse's role) emerged from the data, including apparent gaps in the participants' perception of adapting their cultural foods into healthier dietary habits.

  1. Factors influencing audiologists' perception of moral climate in the workplace.

    PubMed

    Simpson, Andrea; Phillips, Kendall; Wong, Danny; Clarke, Sandy; Thornton, Michelle

    2018-05-01

    The purpose of this study was to assess audiologists' perceptions of ethics and moral climate in the workplace. The Ethics Environmental Questionnaire (EEQ) was sent out to all audiologists registered with the professional body Audiology Australia. Participants were also invited to undertake a semi-structured interview. A total of 301 audiologists completed the questionnaire. Eight of these participants also agreed to complete the interview. The overall mean on the EEQ was approximately equivalent to that of a positive ethical environment, with the exception of those working in adult rehabilitation settings who scored significantly poorer. Scores were significantly associated with state and age. Qualitative analysis from the interviews found that sales pressure from employers was the dominant cause for concern amongst the group. For those working in adult rehabilitation, moral distress is most likely to occur as the result of conflicting goals between the organisation and the audiologist. There is a need to regulate the practice at an organisational as well as individual level to ensure the focus remains on ethical practice.

  2. Potential Motivators and Barriers for Encouraging Health Screening for Cardiovascular Disease Among Latino Men in Rural Communities in the Northwestern United States.

    PubMed

    Lee, Moon J; Sobralske, Mary C; Fackenthall, Chelane

    2016-04-01

    Cardiovascular disease (CVD) is the leading cause of death across all races and ethnicities. In particular, Latino men suffer disproportionately from conditions that lead to CVD such as hypertension, high cholesterol, and diabetes. There are easy and inexpensive ways to screen for certain cardiovascular conditions, yet Latino men are not benefiting from these. It is important to identify motivators and barriers to screening among this population. The purpose of this qualitative, descriptive study was to determine what motivates Latino men to participate in health screening for diabetes, high blood pressure, and high cholesterol. Self-identified Latino men (n = 17) were interviewed following a community health screening targeting Latinos. Individual semi-structured interviews were conducted in either Spanish or English after giving written consent. Trained interpreters were used for Spanish interviews. Emerging themes include motivating factors and barriers to participate in screening. Data findings direct future studies and provide culturally meaningful and relevant strategies to reduce health disparities.

  3. It can work: Open employment for people with experience of mental illness.

    PubMed

    Peterson, Debbie; Gordon, Sarah; Neale, Jenny

    2017-01-01

    Previous research has tended to focus on the barriers to employment for people with mental illness and the extra support they may need. This research contributes to the knowledge base pertaining to this population by looking at successful employment relationships in New Zealand. To describe factors enabling and/or sustaining the open employment of people with experience of mental illness. Fifteen pairs of employers and employees were interviewed individually but consecutively (using a semi-structured interview schedule) about their perceptions of the critical factors that enabled and sustained the employee's employment. Employee participants were recruited by advertisement, with employers approached through their employees. Transcripts were analysed using a thematic analysis. Themes raised in the interviews included the meaning of work, disclosure of mental illness, the benefits of working, special arrangements or accommodations, the work environment and key things employers and employees do to sustain successful employment. Four critical success factors were identified relating to disclosure, the employment relationship, freedom from discrimination and workplace flexibility.

  4. [Suffering at work among medical students: qualitative study using semi-structured interviews].

    PubMed

    Le Provost, A-S; Loddé, B; Pietri, J; De Parscau, L; Pougnet, L; Dewitte, J-D; Pougnet, R

    2018-01-01

    Suffering at work among health professionals is a hot topic. Medical students, doctors of tomorrow, are far from being spared. Prevalence of anxiety and mood disorders range from 20.3 to 69 % for the former and from 12 to 30 % for the latter. The purpose of this article is to determine these factors by qualitative research, according to medical students' points of view. It is a qualitative study using semistructured interviews. The analysis is done according to the Grounded Theory. 12 medical students are interviewed. They expressed difficulties at work and positive factors. Three major themes are identified in selective coding: occupational factors, " study " factors and individual factors. All themes are both a source of well-being and ill-being according to the situations specified in the results. Studying medicine includes positive and negative aspects. Abandonment issues, lack of recognition and insufficient coaching emerge from our study. Screening of suffering at work should be systematic for medical students.

  5. Patient Health Questionnaire-9 versus Edinburgh Postnatal Depression Scale in screening for major depressive episodes: a cross-sectional population-based study.

    PubMed

    Santos, Iná S; Tavares, Beatriz Franck; Munhoz, Tiago N; Manzolli, Patricia; de Ávila, Gisele Bartz; Jannke, Eduardo; Matijasevich, Alicia

    2017-01-21

    Major depressive episodes (MDE) are frequent at the population level and are generally associated with severe symptoms that impair performance of activities of daily living of individuals suffering from this condition. The aim of this study was to compare the accuracy of two tests that separately showed suitable properties in screening for MDE: the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS). In a previous study, the sensitivity and specificity of the PHQ-9 and the EPDS in screening for MDE were compared with a structured diagnostic interview conducted by psychiatrics and psychologists using the Mini International Neuropsychiatric Interview as the gold standard. In a sample of adults living in the community in Pelotas, Brazil, the PHQ-9 and EPDS were applied at the same interview and the gold standard on a median of 17 days later. The interviews were carried out at the participant's home. 447 Individuals (191 men and 256 women) were assessed. The PHQ-9 and the EPDS results were concordant in 87.5% of the respondents, with a moderate agreement beyond what was expected by chance alone (kappa = 0.61). The areas below the ROC curves were not statistically different (82.1% for PHQ-9 and 83.5% for EPDS) (p = 0.291), thus indicating that the two tests had similar moderate accuracy. PHQ-9 and EPDS may be applied with equal confidence in screening for MDE in the community.

  6. Quality care provision for older people: an interview study with patients and primary healthcare professionals.

    PubMed

    van de Pol, Marjolein Helena Johanna; Fluit, Cornelia Rita Maria Gertruda; Lagro, Joep; Niessen, Danielle; Rikkert, Marcellinus Gerardus Maria Olde; Lagro-Janssen, Antoinette Leonarda Maria

    2015-08-01

    In recent years, primary health care for the ageing population has become increasingly complex. This study sought to explore the views and needs of healthcare professionals and older patients relating to primary care in order to identify focal areas for improving primary health care for older people. This research was structured as a mixed interview study with focus groups and individual interviews. Participants were made up of primary healthcare professionals and older patients. Patients were recruited from five elderly care homes in a small city in the southern part of the Netherlands. All interviews were transcribed verbatim and analysed by two individual researchers applying constant comparative analysis. Data collection proceeded until saturation was reached. Participants in the study agreed about the need for primary care for older patients, and showed sympathy with one another's perspectives. They did note, however, a number of obstacles hindering good healthcare provision. The major themes that arose were: 'autonomy and independence', 'organisational barriers', and 'professional expertise'. Participants generally noted that it is important to clarify differences in perspectives about good care between patients and healthcare professionals. Effective primary care intervention for older patients requires mutual understanding of the expectations and goals of all parties involved. There are a number of important requirements, especially accessible patient information in the form of care plans; specialist training for nurses and GPs on complex care and multimorbidity; and training on discussing autonomy, goal setting, and shared care. Further improvement in health care for older people and its evaluation research should focus on these requirements. © British Journal of General Practice 2015.

  7. Patient experiences of colonoscopy, barium enema and CT colonography: a qualitative study.

    PubMed

    Von Wagner, C; Knight, K; Halligan, S; Atkin, W; Lilford, R; Morton, D; Wardle, J

    2009-01-01

    Previous studies of patient experience with bowel screening tests, in particular CT colonography (CTC), have superimposed global rating scales and not explored individual experience in detail. To redress this, we performed qualitative interviews in order to characterize patient expectations and experiences in depth. Following ethical permission, 16 patients undergoing CTC, 18 undergoing colonoscopy and 15 undergoing barium enema agreed to a semi-structured interview by a health psychologist. Interviews were recorded, responses transcribed and themes extracted with the aim of assimilating individual experiences to facilitate subsequent development and interpretation of quantitative surveys of overall satisfaction with each diagnostic test. Transcript analysis identified three principal themes: physical sensations, social interactions and information provision. Physical sensations differed for each test but were surprisingly well tolerated overall. Social interactions with staff were perceived as very important in colouring the whole experience, particularly in controlling the feelings of embarrassment, which was critical for all procedures. Information provision was also an important determinant of experience. Verbal feedback was most common during colonoscopy and invariably reassuring. However, patients undergoing CTC received little visual or verbal feedback and were often confused regarding the test outcome. Barium enema had no specific advantage over other tests. Qualitative interviews provided important perspectives on patient experience. Our data demonstrated that models describing the quality of medical encounters are applicable to single diagnostic episodes. Staff interactions and information provision were particularly important. We found advantages specific to both CTC and colonoscopy but none for barium enema. CTC could benefit greatly from improved information provision following examination.

  8. Patient health questionnaire-9 versus Edinburgh postnatal depression scale in screening for major depressive episodes: a cross-sectional population-based study.

    PubMed

    Santos, Iná S; Tavares, Beatriz Franck; Munhoz, Tiago N; Manzolli, Patricia; de Ávila, Gisele Bartz; Jannke, Eduardo; Matijasevich, Alicia

    2016-09-27

    Major depressive episodes (MDE) are frequent at the population level and are generally associated with severe symptoms that impair performance of activities of daily living of individuals suffering from this condition. The aim of this study was to compare the accuracy of two tests that separately showed suitable properties in screening for MDE: the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh postnatal depression scale (EPDS). In a previous study, the sensitivity and specificity of the PHQ-9 and the EPDS in screening for MDE were compared with a structured diagnostic interview conducted by psychiatrics and psychologists using the Mini International Neuropsychiatric Interview as the gold standard. In a sample of adults living in the community in Pelotas, Brazil, the PHQ-9 and EPDS were applied at the same interview and the gold standard on a median of 17 days later. The interviews were carried out at the participant's home. 447 individuals (191 men and 256 women) were assessed. The PHQ-9 and the EPDS results were concordant in 87.5 % of the respondents, with a moderate agreement beyond what was expected by chance alone (kappa = 0.61). The areas below the ROC curves were not statistically different (82.1 % for PHQ-9 and 83.5 % for EPDS) (p = 0.291), thus indicating that the two tests had similar moderate accuracy. PHQ-9 and EPDS may be applied with equal confidence in screening for MDE in the community.

  9. The Eating Disorder Assessment for DSM-5 (EDA-5): Development and Validation of a Structured Interview for Feeding and Eating Disorders

    PubMed Central

    Sysko, Robyn; Glasofer, Deborah R.; Hildebrandt, Tom; Klimek, Patrycja; Mitchell, James E.; Berg, Kelly C.; Peterson, Carol B.; Wonderlich, Stephen A.; Walsh, B. Timothy

    2016-01-01

    Objective Existing measures for DSM-IV eating disorder diagnoses have notable limitations, and there are important differences between DSM-IV and DSM-5 feeding and eating disorders. This study developed and validated a new semi-structured interview, the Eating Disorders Assessment for DSM-5 (EDA-5). Method Two studies evaluated the utility of the EDA-5. Study 1 compared the diagnostic validity of the EDA-5 to the Eating Disorder Examination (EDE) and evaluated the test-retest reliability of the new measure. Study 2 compared the diagnostic validity of an EDA-5 electronic application (“app”) to clinician interview and self-report assessments. Results In Study 1, the kappa for EDE and EDA-5 eating disorder diagnoses was 0.74 across all diagnoses (n= 64), with a range of κ=0.65 for Other Specified Feeding or Eating Disorder (OSFED)/Unspecified Feeding or Eating Disorder (USFED) to κ=0.90 for Binge Eating Disorder (BED). The EDA-5 test-retest kappa coefficient was 0.87 across diagnoses. For Study 2, clinical interview versus “app” conditions revealed a kappa of 0.83 for all eating disorder diagnoses (n=71). Across individual diagnostic categories, kappas ranged from 0.56 for OSFED/USFED to 0.94 for BN. Discussion High rates of agreement were found between diagnoses by EDA-5 and the EDE, and EDA-5 and clinical interviews. As this study supports the validity of the EDA-5 to generate DSM-5 eating disorders and the reliability of these diagnoses, the EDA-5 may be an option for the assessment of Anorexia Nervosa, Bulimia Nervosa, and BED. Additional research is needed to evaluate the utility of the EDA-5 in assessing DSM-5 feeding disorders. PMID:25639562

  10. Feeling Blue or Turquoise? Emotional Differentiation in Major Depressive Disorder

    PubMed Central

    Demiralp, Emre; Thompson, Renee J.; Mata, Jutta; Jaeggi, Susanne M.; Buschkuehl, Martin; Barrett, Lisa Feldman; Ellsworth, Phoebe C.; Demiralp, Metin; Hernandez-Garcia, Luis; Deldin, Patricia J.; Gotlib, Ian H.; Jonides, John

    2014-01-01

    Some individuals have very specific and differentiated emotional experiences, such as anger, shame, excitement, and happiness, whereas others have more general affective experiences of pleasure or discomfort that are not as highly differentiated. Considering that individuals with major depressive disorder (MDD) have cognitive deficits for negative information, we predicted that people with MDD would have less differentiated negative emotional experiences than would healthy people. To test this hypothesis, we assessed participants' emotional experiences using a 7-day experience-sampling protocol. Depression was assessed using structured clinical interviews and the Beck Depression Inventory-II. As predicted, individuals with MDD had less differentiated emotional experiences than did healthy participants, but only for negative emotions. These differences were above and beyond the effects of emotional intensity and variability. PMID:23070307

  11. WHAT INFLUENCES INDIVIDUALS TO ENGAGE IN ADVANCE CARE PLANNING?

    PubMed Central

    Dellasega, Cheryl; Whitehead, Megan; Green, Michael J.

    2013-01-01

    Background Advance care planning (ACP) is an under-utilized process that involves thinking about what kind of life-prolonging medical care one would want should the need arise, identifying a spokesperson, and then communicating these wishes. Objective To better understand what influences individuals to engage in ACP. Design Three focus groups using semi-structured interactive interviews were conducted with 23 older individuals from three diverse populations in central Pennsylvania. Results Four categories of influences for engaging in ACP were identified: 1) Concern for Self; 2) Concern for Others; 3) Expectations About the Impact of Advance Care Planning; and 4) Anecdotes, Stories, & Experiences. Conclusions The motivations for undertaking ACP that we have identified offer healthcare providers insight into effective strategies for facilitating the process of ACP with their patients. PMID:20103783

  12. Enterprising health: creating the conditions for entrepreneurial behaviour as a strategy for effective and sustainable change in health services.

    PubMed

    Exton, Rosemary

    2010-01-01

    This paper seeks to investigate conditions under which entrepreneurs emerge as agents of effective and sustainable change in UK National Health Service Trusts. The research synthesises literature on changing regulatory structures ("post-bureaucracy") and entrepreneurial behaviour to understand how individual identity construction is informed both by context and by individual attributes. Thematic analysis of interview data involving managers from 11 NHS Trusts, including detailed analysis of six transcripts, focuses on regulatory processes, the emergence of entrepreneurial behaviour and outcome variations in workplace innovation and improvement. This study identifies co-existing modes of regulation, which interact with individual behaviour, generating strategies differentiated as entrepreneurial or conformist. Four ideal types are identified: organisational entrepreneurship, resisted or dissonant entrepreneurship, conformity, and symbolic entrepreneurship. Analysis reinforces those literature findings, which suggest that the interaction of regulatory structures and the identity work of individuals influence the emergence of entrepreneurial behaviour and the effectiveness of change. The ability to achieve effective and sustainable outcomes varies considerably even between NHS Trusts faced with comparable challenges in implementing nationally prescribed targets. This variance is explained in terms of the organisation's ability to generate the structures, processes, individual competence and motivation which enable employees at all levels to act entrepreneurially with the ability and legitimacy to achieve strategic goals by working creatively in the spaces between formal organisational structures. The study identifies specific conditions, which stimulate the emergence of entrepreneurs as agents of effective and sustainable change in the NHS, identifying factors that policymakers should consider when implementing change.

  13. What do They Know? Guidelines and Knowledge Translation for Foreign Health Sector Workers Following Natural Disasters.

    PubMed

    Dunin-Bell, Ola

    2018-04-01

    Introduction The incidence of natural disasters is increasing worldwide, with countries the least well-equipped to mitigate or manage them suffering the greatest losses. Following natural disasters, ill-prepared foreign responders may become a burden to the affected population, or cause harm to those needing help. Problem The study was performed to determine if international guidelines for foreign workers in the health sector exist, and evidence of their implementation. A structured literature search was used to identify guidelines for foreign health workers (FHWs) responding to natural disasters. Analysis of semi-structured interviews of health sector responders to the 2015 Nepal earthquake was then performed, looking at preparation and field activities. No guidelines were identified to address the appropriate qualifications of, and preparations for, international individuals participating in disaster response in the health sector. Interviews indicated individuals choosing to work with experienced organizations received training prior to disaster deployment and described activities in the field consistent with general humanitarian principles. Participants in an ad hoc team (AHT) did not. In spite of need, there is a lack of published guidelines for potential international health sector responders to natural disasters. Learning about disaster response may occur only after joining a team. Dunin-Bell O . What do they know? Guidelines and knowledge translation for foreign health sector workers following natural disasters. Prehosp Disaster Med. 2018;33(2):139-146.

  14. How I Learned to Design and Conduct Semi-Structured Interviews: An Ongoing and Continuous Journey

    ERIC Educational Resources Information Center

    Rabionet, Silvia E.

    2011-01-01

    Qualitative interviewing is a flexible and powerful tool to capture the voices and the ways people make meaning of their experience Learning to conduct semi-structure interviews requires the following six stages: (a) selecting the type of interview; (b) establishing ethical guidelines, (c) crafting the interview protocol; (d) conducting and…

  15. Barriers in Access to the Treatment for People with Gambling Disorders. Are They Different from Those Experienced by People with Alcohol and/or Drug Dependence?

    PubMed

    Dąbrowska, Katarzyna; Moskalewicz, Jacek; Wieczorek, Łukasz

    2017-06-01

    A prevalence of gambling disorders is diversified depending on the region of the world. Almost three quarters of pathological gamblers had never sought a professional treatment as well as an assistance in self-help groups. Reasons why they do not initiate a treatment are complex. The aim of the article is to compare barriers to the treatment for people with gambling disorders found in presented study and barriers to alcohol and drug treatment identified in the available literature. The semi structured interviews were applied and conducted with people with gambling disorders, social workers, therapists employed in the addiction treatment facilities, General Practitioners and psychiatrists. Selection of the respondents was based on purposive sampling. In total, 90 interviews were completed. Respondents identified individual barriers as well as structural ones. Individual barriers include internal resistance and a fear of the treatment. In turn structural barriers apply to the organization of the therapy, infrastructure, personnel, and the therapeutic program. A comparison of barriers experienced by people with gambling disorders and substance use disorders showed that they are largely similar, but people with gambling disorders also experience specific barriers. Empirical studies focused specifically on treatment needs of people experiencing gambling disorders may improve an offer of help for them. More adequate treatment options could contribute to the increasing in the number of people who start the treatment. It can result in improving their quality of life and may have positive impact on public health.

  16. Effects of a training in the Disability Assessment Structured Interview on the interviews of Dutch insurance physicians.

    PubMed

    Spanjer, Jerry; van de Mei, Sijrike; Cornelius, Bert; Brouwer, Sandra; van der Klink, Jac

    2016-08-01

    The Disability Assessment Structured Interview (DASI) is a semi-structured interview for assessing functional limitations of claimants in a work disability evaluation. The aim of this study is to evaluate the effect of a 3-day DASI training course on the quality of assessment interviews of insurance physicians (IPs). In a pretest-posttest study, 55 IPs employed at the Dutch National Institute for Employee Benefits Schemes completed a 3-day DASI training. Before (T0), directly after the training (T1) and after 3 months follow-up (T2), these IPs filled out questionnaires that measured knowledge, skills, attitude and self-efficacy. Furthermore, in 10 disability assessment cases interview duration, IP's satisfaction, amount of acquired information and confidence of judgement were measured. Finally, the amount of information reported was measured in three randomly selected disability assessment reports of each IP. IP's knowledge, skills and self-efficacy improved significantly after the training. The attitude of the IPs changed towards a more open attitude and structuring of the interview. Satisfaction about the interview, amount of acquired information and confidence of their judgement all increased. The DASI training improved the quality of assessment interviews of IPs. A semi-structured interview, like the DASI, can help physicians to pay more attention to activity limitations and participation in addition to medical information. Implications for Rehabilitation Experienced IPs are able to change their disability assessment interview routine after training. In determining work ability, IPs should pay more attention to claimant's activity limitations and participation in addition to medical information. A semi-structured interview as the DASI can help IPs to pay more attention to claimant's functioning. A 3-day DASI training for IPs can increase their confidence in their judgement and provides significantly more information in their assessment reports.

  17. HIV provider and patient perspectives on the Development of a Health Department "Data to Care" Program: a qualitative study.

    PubMed

    Dombrowski, Julia C; Carey, James W; Pitts, Nicole; Craw, Jason; Freeman, Arin; Golden, Matthew R; Bertolli, Jeanne

    2016-06-10

    U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing "Data to Care" programs to assists persons living with HIV (PLWH) with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009-2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care program in Seattle-King County was designed to incorporate an HIV-positive peer component and to ensure coordination with HIV care providers in the process of relinking patients to care. Health departments can build support for Data to Care efforts by gathering input of key stakeholders, such as HIV medical and social service providers, and coordinating with clinic-based efforts to re-engage patients in care.

  18. Getting on the same page: The effect of normative feedback interventions on structured interview ratings.

    PubMed

    Hartwell, Christopher J; Campion, Michael A

    2016-06-01

    This study explores normative feedback as a way to reduce rating errors and increase the reliability and validity of structured interview ratings. Based in control theory and social comparison theory, we propose a model of normative feedback interventions (NFIs) in the context of structured interviews and test our model using data from over 20,000 interviews conducted by more than 100 interviewers over a period of more than 4 years. Results indicate that lenient and severe interviewers reduced discrepancies between their ratings and the overall normative mean rating after receipt of normative feedback, though changes were greater for lenient interviewers. When various waves of feedback were presented in later NFIs, the combined normative mean rating over multiple time periods was more predictive of subsequent rating changes than the normative mean rating from the most recent time period. Mean within-interviewer rating variance, along with interrater agreement and interrater reliability, increased after the initial NFI, but results from later NFIs were more complex and revealed that feedback interventions may lose effectiveness over time. A second study using simulated data indicated that leniency and severity errors did not impact rating validity, but did affect which applicants were hired. We conclude that giving normative feedback to interviewers will aid in minimizing interviewer rating differences and enhance the reliability of structured interview ratings. We suggest that interviewer feedback might be considered as a potential new component of interview structure, though future research is needed before a definitive conclusion can be drawn. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. People and Teams Matter in Organizational Change: Professionals’ and Managers’ Experiences of Changing Governance and Incentives in Primary Care

    PubMed Central

    Allan, Helen T; Brearley, Sally; Byng, Richard; Christian, Sara; Clayton, Julie; Mackintosh, Maureen; Price, Linnie; Smith, Pam; Ross, Fiona

    2014-01-01

    ObjectivesTo explore the experiences of governance and incentives during organizational change for managers and clinical staff. Study SettingThree primary care settings in England in 2006–2008. Study DesignData collection involved three group interviews with 32 service users, individual interviews with 32 managers, and 56 frontline professionals in three sites. The Realistic Evaluation framework was used in analysis to examine the effects of new policies and their implementation. Principal FindingsIntegrating new interprofessional teams to work effectively is a slow process, especially if structures in place do not acknowledge the painful feelings involved in change and do not support staff during periods of uncertainty. ConclusionsEliciting multiple perspectives, often dependent on individual occupational positioning or place in new team configurations, illuminates the need to incorporate the emotional as well as technocratic and system factors when implementing change. Some suggestions are made for facilitating change in health care systems. These are discussed in the context of similar health care reform initiatives in the United States. PMID:23829292

  20. Self-determination and motivation for bariatric surgery: a qualitative study.

    PubMed

    Park, Juyeon

    2016-10-01

    This study examined how obese individuals acquire their motivation to undergo weight loss surgery and characterized the motivations within the framework of the self-determination theory (SDT). Participants expecting to have bariatric surgery were recruited and participated in semi-structured interviews. Interview accounts characterized different types of motivation for individuals seeking surgical weight loss treatments on the SDT continuum of relative autonomy. This study demonstrated that the more one's motivation was internally regulated, related to one's personal life and supported for competency, the more personal and hopeful were the anecdotes participants mentioned in accounts, thus the more positive the surgical outcomes were anticipated. Study limitations and future research were discussed as was the need for a systematic scheme to categorize types of motivation within the SDT, a longitudinal approach to measure actual weight loss outcomes based on the patient's pre-surgical motivation, and a further investigation with a larger sample size and balanced gender ratio. Practical implications of the study findings were also discussed as a novel strategy to internalize bariatric patients' motivation, further helping to improve their long-term quality of life post-surgery.

  1. Body dysmorphic disorder and eating disorders in elite professional female ballet dancers.

    PubMed

    Nascimento, Antonio Leandro; Luna, Juliano Victor; Fontenelle, Leonardo F

    2012-08-01

    Our objective is to report the prevalence and the clinical features associated with body dysmorphic disorder (BDD) and eating disorders (ED) in a group of elite Brazilian professional female ballet dancers. Thirty-five elite Brazilian professional female ballet dancers were invited to participate in the study and 19 agreed to be assessed. Individuals were evaluated with a series of instruments, including the Mini International Neuropsychiatric Interview supplemented by the somatoform and eating disorders modules of the Structured Clinical Interview for DSM-IV disorders, the Bulimic Investigatory Test, and the Beck Depression Inventory. Three dancers (15.78%) had a lifetime diagnosis of anorexia nervosa (restrictive subtype) and 2 others (10.52%) presented a current diagnosis of BDD. No individuals had current or lifetime bulimia nervosa. Results could not be ascribed to comorbid major depression or increased severity of depression. The lifetime prevalence of BDD and ED among elite professional female ballet dancers was higher than the general population. High standards of beauty, public body exposure, and repeated exposure to mirrors in the rehearsal rooms may contribute to the development of body image disorders in this sample.

  2. "Wear Some Thick Socks If You Walk in My Shoes": Agency, Resilience, and Well-Being in Communities of North American Sex Workers.

    PubMed

    Burnes, Theodore R; Rojas, Elizabeth M; Delgado, Irena; Watkins, Tianna E

    2018-07-01

    Using a participatory action research (PAR) paradigm, this study investigated how 35 individuals involved in the sex work industry exemplified aspects of agency and intentional well-being under harsh work environments. Using PAR and qualitative research, sex workers were asked to identify research questions and help to design a study investigating the relationship between well-being and sex worker agency. Participants in the study each completed one semi-structured individual interview to share their experiences in the sex work industry. Data from these interviews were analyzed using constructivist phenomenology; standards of trustworthiness were accounted for using multiple tools. Four themes emerged from the data that described how the participants understood their own resilience and areas of needed attention with respect to their mental health: (1) validating sex work and eliminating whorephobic oppression; (2) safety and mobility within practice environments; (3) sexual boundary setting; and (4) social support for sex workers. Implications of the findings on theory, research, practice, and advocacy are discussed.

  3. Inclusion Through Work and Productivity for Persons with Intellectual and Developmental Disabilities.

    PubMed

    Lysaght, Rosemary; Petner-Arrey, Jami; Howell-Moneta, Angela; Cobigo, Virginie

    2017-09-01

    Employment provides an important avenue to social inclusion for most adults. A range of productivity options exist for persons with intellectual and developmental disabilities (IDD) who wish to work, each offering unique challenges relative to inclusion. This qualitative study examined the productivity experiences of people with intellectual and developmental disabilities in Ontario, Canada. A purposive sample of 74 individuals with productivity experiences spanning the spectrum of no employment to community-based jobs was selected from a pool of volunteers recruited through a mailed survey. Semi-structured interviews were conducted with individuals and family members. Interview transcripts were subjected to a team-based analysis using grounded theory methods. Varying needs and interests exist in regard to work. Participants revealed a multitude of factors contributing to inclusion and exclusion through productivity. Productivity, whether paid or unpaid, can be an avenue to social inclusion. The experience of inclusion, particularly of belonging, depends on a successfully negotiated congruence between worker attributes and the social features and demands of the work environment. © 2016 John Wiley & Sons Ltd.

  4. Exploratory and Confirmatory Factor Analyses of the Structured Interview for Disorders of Extreme Stress

    ERIC Educational Resources Information Center

    Scoboria, Alan; Ford, Julian; Lin, Hsiu-ju; Frisman, Linda

    2008-01-01

    Two studies were conducted to provide the first empirical examination of the factor structure of a revised version of the clinically derived Structured Interview for Disorders of Extreme Stress, a structured interview designed to assess associated features of posttraumatic stress disorder (PTSD) thought to be related to early onset, interpersonal,…

  5. Situating mental health work in place: Qualitative findings from interviews with Veterans in Southeastern Louisiana and Northern California.

    PubMed

    Abraham, Traci H; Koenig, Christopher J; Zamora, Kara; Hill, Coleen; Uddo, Madeline; Kelly, Adam P; Hamilton, Michelle F; Curran, Geoffrey M; Pyne, Jeffrey M; Seal, Karen H

    2017-09-01

    Most chronic illness management occurs outside clinics and hospitals, in the everyday lives of individuals. We use data from semi-structured interviews with 37 veterans from Southeastern Louisiana and Northern California to illustrate how "health work" for mental health concerns are shaped by place. Using health work as an orienting concept for analysis, we discerned variation between the two study sites in how Veterans used interacting with the natural environment, cultivating time alone, and religious practice to manage their mental health and well-being. Through these findings, we advocate for a situated notion of health work that is mindful of how health-related behaviors are shaped by place and the attributes that constitute place. Published by Elsevier Ltd.

  6. Experiences of Sex Education and Sexual Awareness in Young Adults with Autism Spectrum Disorder.

    PubMed

    Hannah, Laura A; Stagg, Steven D

    2016-12-01

    The research investigated feelings towards sex education and sexual awareness in young adults with autism spectrum disorder (ASD). Data were generated from the sexual knowledge, experiences, feelings and needs questionnaire (McCabe et al. 1999), the sexual awareness questionnaire (Snell et al. 1991) and semi-structured interviews. Twenty typically developing and 20 ASD individuals participated. Feelings toward sex education did not differ between the groups, but the groups differed significantly on measures of sexual awareness. Negative experiences of sex education and issues of vulnerability, social anxiety, and confused sexuality were prominent features of the qualitative interviews. This report suggest that mainstream sex and relationship education is not sufficient for people with ASD, specific methods and curricular are necessary to match their needs.

  7. Fluctuating asymmetry, sociosexuality, and intrasexual competitive tactics.

    PubMed

    Simpson, J A; Gangestad, S W; Christensen, P N; Leck, K

    1999-01-01

    Heterosexual men and women were told they were competing with another same-sex individual for a date with an attractive opposite-sex interviewer. After answering 6 questions, participants were asked to tell the competitor why the interviewer should choose them over the competitor. Participants' videotaped behavior was coded for different behavioral tactics. Men who were more symmetrical and who had a more unrestricted sociosexual orientation were more likely to use direct competition tactics than were less symmetrical and restricted men. Restricted men accentuated their positive personal qualities, presenting themselves as "nice guys." Structural equation modeling revealed that fluctuating asymmetry (FA) was directly associated with the use of direct competition tactics. However, the link between FA and presenting oneself as a nice guy was mediated through sociosexuality. No effects were found for women.

  8. Reliability of a structured interview for admission to an emergency medicine residency program.

    PubMed

    Blouin, Danielle

    2010-10-01

    Interviews are most important in resident selection. Structured interviews are more reliable than unstructured ones. We sought to measure the interrater reliability of a newly designed structured interview during the selection process to an Emergency Medicine residency program. The critical incident technique was used to extract the desired dimensions of performance. The interview tool consisted of 7 clinical scenarios and 1 global rating. Three trained interviewers marked each candidate on all scenarios without discussing candidates' responses. Interitem consistency and estimates of variance were computed. Twenty-eight candidates were interviewed. The generalizability coefficient was 0.67. Removing the central tendency ratings increased the coefficient to 0.74. Coefficients of interitem consistency ranged from 0.64 to 0.74. The structured interview tool provided good although suboptimal interrater reliability. Increasing the number of scenarios improves reliability as does applying differential weights to the rating scale anchors. The latter would also facilitate the identification of those candidates with extreme ratings.

  9. Role stressors and coping strategies among nurse managers.

    PubMed

    Udod, Sonia; Cummings, Greta G; Care, W Dean; Jenkins, Megan

    2017-02-06

    Purpose The purpose of this paper is to share preliminary evidence about nurse managers' (NMs) role stressors and coping strategies in acute health-care facilities in Western Canada. Design/methodology/approach A qualitative exploratory inquiry provides deeper insight into NMs' perceptions of their role stressors, coping strategies and factors and practices in the organizational context that facilitate and hinder their work. A purposeful sample of 17 NMs participated in this study. Data were collected through individual interviews and a focus group interview. Braun and Clarke's (2006) six phase approach to thematic analysis guided data analysis. Findings Evidence demonstrates that individual factors, organizational practices and structures affect NMs stress creating an evolving role with unrealistic expectations, responding to continuous organizational change, a fragmented ability to effectively process decisions because of work overload, shifting organizational priorities and being at risk for stress-related ill health. Practical implications These findings have implications for organizational support, intervention programs that enhance leadership approaches, address individual factors and work processes and redesigning the role in consideration of the role stress and work complexity affecting NMs health. Originality/value It is anticipated that health-care leaders would find these results concerning and inspire them to take action to support NMs to do meaningful work as a way to retain existing managers and attract front line nurses to positions of leadership.

  10. The advantage of being oneself: The role of applicant self-verification in organizational hiring decisions.

    PubMed

    Moore, Celia; Lee, Sun Young; Kim, Kawon; Cable, Daniel M

    2017-11-01

    In this paper, we explore whether individuals who strive to self-verify flourish or flounder on the job market. Using placement data from 2 very different field samples, we found that individuals rated by the organization as being in the top 10% of candidates were significantly more likely to receive a job offer if they have a stronger drive to self-verify. A third study, using a quasi-experimental design, explored the mechanism behind this effect and tested whether individuals who are high and low on this disposition communicate differently in a structured mock job interview. Text analysis (LIWC) of interview transcripts revealed systematic differences in candidates' language use as a function of their self-verification drives. These differences led an expert rater to perceive candidates with a strong drive to self-verify as less inauthentic and less misrepresentative than their low self-verifying peers, making her more likely to recommend these candidates for a job. Taken together, our results suggest that authentic self-presentation is an unidentified route to success on the job market, amplifying the chances that high-quality candidates can convert organizations' positive evaluations into tangible job offers. We discuss implications for job applicants, organizations, and the labor market. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. Expressions of agency within complex policy structures: science teachers' experiences of education policy reforms in Sweden

    NASA Astrophysics Data System (ADS)

    Ryder, Jim; Lidar, Malena; Lundqvist, Eva; Östman, Leif

    2018-03-01

    We explore the experiences of school science teachers as they enact three linked national curriculum and assessment policy reforms in Sweden. Our goal is to understand teachers' differing responses to these reforms. A sample of 13 teachers engaged in 2 interviews over a 6-9-month period. Interviews included exploration of professional background and school context, perceptions of the aims of the policy reforms and experiences of working with these reforms in the classroom. Analysis was guided by an individual-oriented sociocultural perspective on professional agency. Here teaching is conceptualised as an ongoing interplay between teachers' knowledge, skills and personal goals, and the characteristics of the social, institutional and policy settings in which they work. Our analysis shows that navigating the ensuing continuities and contradictions results in many different expressions of teacher agency, e.g. loss of autonomy and trust, pushing back, subversion, transfer of authority, and creative tensions. Typically, an individual teacher's enactment of these reforms involved several of these expressions of agency. We demonstrate that the sociocultural perspective provides insights into teachers' responses to education policy reform likely to be missed by studies that focus largely on individual teacher knowledge/beliefs about reform or skills in 'implementing' reform practices.

  12. Call it a monster for lack of anything else: narrative insight in psychosis.

    PubMed

    Roe, David; Hasson-Ohayon, Ilanit; Kravetz, Shlomo; Yanos, Phil T; Lysaker, Paul H

    2008-12-01

    Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or actively reject their diagnostic label. It is unclear, however, how this lack of awareness relates to important outcomes. Broadening the definition of awareness to include "narrative insight" may clarify this issue. The objective of this study was to identify profiles of narrative insight and test how these relate to standardized measure of insight. Sixty-five individuals with schizophrenia spectrum disorders participated in an assessment that included the Scale of Unawareness of Mental Disorder (SUMD) and an in-depth semi-structured interview. Qualitative analysis revealed 5 central themes related to insight on the basis of which each interview was then rated. Cluster analysis of these ratings resulted in 4 profiles of narrative insight: (1) accepts illness/rejects label, (2) rejects illness/searches for a name (3) passive insight of illness and label, and (4) integrative insight. The SUMD differentiated between individuals assigned to profile 2 who showed low insight to their illness and those assigned to the other profiles of narrative insight, but could not differentiate between them. Results support the claim that illness narratives are multifaceted and that traditional measures of insight may not be sensitive to different ways in which people understand their illness.

  13. Call It a Monster for Lack of Anything Else

    PubMed Central

    Roe, David; Hasson-Ohayon, Ilanit; Kravetz, Shlomo; Yanos, Phil T.; Lysaker, Paul H.

    2011-01-01

    Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or actively reject their diagnostic label. It is unclear, however, how this lack of awareness relates to important outcomes. Broadening the definition of awareness to include “narrative insight” may clarify this issue. The objective of this study was to identify profiles of narrative insight and test how these relate to standardized measure of insight. Sixty-five individuals with schizophrenia spectrum disorders participated in an assessment that included the Scale of Unawareness of Mental Disorder (SUMD) and an in-depth semi-structured interview. Qualitative analysis revealed 5 central themes related to insight on the basis of which each interview was then rated. Cluster analysis of these ratings resulted in 4 profiles of narrative insight: (1) accepts illness/rejects label, (2) rejects illness/searches for a name (3) passive insight of illness and label, and (4) integrative insight. The SUMD differentiated between individuals assigned to profile 2 who showed low insight to their illness and those assigned to the other profiles of narrative insight, but could not differentiae between them. Results support the claim that illness narratives are multifaceted and that traditional measures of insight may not be sensitive to different ways in which people understand their illness. PMID:19077852

  14. Implementing and sustaining dietary change in the context of social relationships.

    PubMed

    Rydén, Petra J; Sydner, Ylva Mattsson

    2011-09-01

    Changing to healthier dietary habits is quite difficult to implement and even more difficult to sustain. As the majority of people have some or all their meals with others, it is likely that their social relationships influence the dietary change process and its sustainability. Thus, the aim of this research was to explore and describe experiences of dietary change and its sustainability in the context of an individual's social relationships. Semi-structured interviews were conducted individually with fourteen individuals who had previously been participants in a 3-month dietary intervention study using a Mediterranean diet. Thematic analysis was used on verbatim transcripts of the interviews. Social relationships were the main barrier to sustainability - in particular social relationships within the household where various coping strategies were needed on an everyday basis. Social relationships outside the household were also difficult to manage as dietary change challenged existing traditions and norms of what to eat. The changer was thereby forced to risk social disapproval or to deviate from the diet. Social relationships within and outside the household complicated the accomplishment of healthy dietary changes. Hence, it is important to acknowledge the social context of the changer when dietary change is to be implemented. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  15. Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills

    PubMed Central

    Keifenheim, Katharina Eva; Petzold, Ernst Richard; Junne, Florian; Erschens, Rebecca Sarah; Speiser, Natalie; Herrmann-Werner, Anne; Zipfel, Stephan; Teufel, Martin

    2017-01-01

    Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups. Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students’ self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students’ most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients’ emotional demands appropriately. By the end of the course, students’ self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student–patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients. PMID:28890926

  16. Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills.

    PubMed

    Keifenheim, Katharina Eva; Petzold, Ernst Richard; Junne, Florian; Erschens, Rebecca Sarah; Speiser, Natalie; Herrmann-Werner, Anne; Zipfel, Stephan; Teufel, Martin

    2017-01-01

    Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups. Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students' self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students' most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients' emotional demands appropriately. By the end of the course, students' self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student-patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.

  17. Stakeholders' views on the ethical challenges of pragmatic trials investigating pharmaceutical drugs.

    PubMed

    Kalkman, Shona; van Thiel, Ghislaine J M W; Grobbee, Diederick E; Meinecke, Anna-Katharina; Zuidgeest, Mira G P; van Delden, Johannes J M

    2016-08-22

    We explored the views of key stakeholders to identify the ethical challenges of pragmatic trials investigating pharmaceutical drugs. A secondary aim was to capture stakeholders' attitudes towards the implementation of pragmatic trials in the drug development process. We conducted semistructured, in-depth interviews among individuals from different key stakeholder groups (academia and independent research institutions, the pharmaceutical industry, regulators, Health Technology Assessment (HTA) agencies and patients' organizations) through telephone or face-to-face sessions. Interviews were structured around the question "what challenges were experienced or perceived during the design, conduct and/or review of pragmatic trials." Respondents were additionally asked about their views on implementation of pragmatic trials in the drug development process. Thematic analysis was used to identify the ethically relevant features across data sets. We interviewed 34 stakeholders in 25 individual sessions and four group sessions. The four perceived challenges of ethical relevance were: (1) less controlled conditions creating safety concerns, (2) comparison with usual care potentially compromising clinical equipoise, (3) tailored or waivers of informed consent affecting patient autonomy, and (4) minimal interference with "real-world" practice reducing the knowledge value of trial results. We identified stakeholder concerns regarding risk assessment, use of suboptimal usual care as a comparator, tailoring of informed consent procedures and ensuring the social value of pragmatic trials. These concerns increased when respondents were asked about pragmatic trials conducted before market authorization.

  18. Qualitative Evaluation of Pediatric Pain-Behavior, -Quality and -Intensity Item Candidates and the PROMIS Pain Domain Framework in Children with Chronic Pain

    PubMed Central

    Jacobson, C. Jeffrey; Kashikar-Zuck, Susmita; Farrell, Jennifer; Barnett, Kimberly; Goldschneider, Ken; Dampier, Carlton; Cunningham, Natoshia; Crosby, Lori; DeWitt, Esi Morgan

    2015-01-01

    As initial steps in a broader effort to develop and test pediatric Pain Behavior and Pain Quality item banks for the Patient Reported Outcomes Measurement Information System (PROMIS®), we employed qualitative interview and item review methods to 1) evaluate the overall conceptual scope and content validity of the PROMIS pain domain framework among children with chronic /recurrent pain conditions, and 2) develop item candidates for further psychometric testing. To elicit the experiential and conceptual scope of pain outcomes across a variety of pediatric recurrent/chronic pain conditions, we conducted semi-structured individual (32) and focus-group interviews (2) with children and adolescents (8–17 years), and parents of children with pain (individual (32) and focus group (2)). Interviews with pain experts (10) explored the operational limits of pain measurement in children. For item bank development, we identified existing items from measures in the literature, grouped them by concept, removed redundancies, and modified remaining items to match PROMIS formatting. New items were written as needed and cognitive debriefing was completed with children and their parents, resulting in 98 Pain Behavior (47 self, 51 proxy), 54 Quality and 4 Intensity items for further testing. Qualitative content analyses suggest that reportable pain outcomes that matter to children with pain are captured within and consistent with the pain domain framework in PROMIS. PMID:26335990

  19. Individuals with excessive alcohol intake recruited by advertisement: demographic and clinical characteristics.

    PubMed

    Berglund, Kristina; Fahlke, Claudia; Berggren, Ulf; Eriksson, Matts; Balldin, Jan

    2006-01-01

    Studies have shown that most individuals with alcohol problems have never received any treatment for their alcoholism. The purpose of the present study was to describe demographic and clinical characteristics in male individuals with excessive alcohol intake who were recruited by advertisements. These characteristics were compared between individuals with or without prior treatment histories. Subjects (n = 367) responded to the advertisements in a regional daily newspaper and called the investigators. A structured interview was performed and a complete dataset of demographic and clinical information was collected in 342 individuals. Individuals with no prior treatment history (n = 238) were found to be more often cohabitant, employed, and they reported fewer on-going psychiatric symptoms than individuals with treatment histories (n = 104). Since individuals with no prior treatment history seldom experience psychiatric symptoms, they are less likely to seek treatment in the health care system. It is therefore of importance to find ways to reach this 'hidden' group early with excessive alcohol consumption. One way to do so might be via alcohol treatment programs at working places since the majority of them are employed.

  20. The lived experience of pediatric burn nurses following patient death.

    PubMed

    Kellogg, Marni B; Barker, Marianne; McCune, Nancy

    2014-01-01

    The purpose of this study is to describe the lived experience of pediatric burn unit nurses who have experienced the death of a patient. A qualitative phenomenological design was used for the interview and analysis. Methods were incorporated into the design to ensure reliability, consistency, and rigor. Using a semi-structured interview guide and phenomenological concepts, the investigators interviewed seven registered nurses who were employed in a pediatric burn unit. Data obtained were analyzed for common themes that emerged during examination of transcribed interviews. Four common themes of feelings were identified: 1) grief and sadness, 2) helplessness, 2) compartmentalization of feelings, and 4) lack of preparedness for dealing with situations involving the death of a pediatric patient. While nurses are emotionally supportive to patients and families, the emotional support available to nurses who are dealing with these situations is lacking. By developing individual coping strategies and seeking peer support, nurses attempt to deal with emotional situations faced in the workplace. Nurses, nurse educators, and administrators must understand the impact of nurses' grief following patient death. By understanding and validating their emotions, it is hoped that nurses will be supported in a way that will enhance a healthy professional environment and personal well-being.

  1. Building from within: pastoral insights into community resources and assets.

    PubMed

    Ford, Cassandra D

    2013-01-01

    To explore perceptions of community pastors regarding the extent of community resources and assets in a rural, Southern, African American community. Utilizing a qualitative, descriptive design, interviews were conducted with six African American pastors. Interviews were conducted using a semi-structured interview guide based on an assets-oriented approach. Pastors discussed various resources and assets, probable within the community that may be considered as support for program development. Key themes included: (1) community strengths, (2) community support, and (3) resources for a healthy lifestyle. The church was identified, throughout the interviews, as a primary source of strength and support for community members. In this study of African American pastors, various perceptions of community resources were identified. Findings indicate that a sample, rural, Southern, African American community has a wealth of resources and assets, but additional resources related to health promotion are still necessary to produce optimal results. Specific programs to prevent chronic conditions such as cardiovascular disease can provide an effective means for addressing related health disparities. Programs implemented through churches can reach large numbers of individuals in the community and provide an important source of sustainable efforts to improve the health of African Americans. © 2013 Wiley Periodicals, Inc.

  2. 32 CFR 310.15 - General considerations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... individual's rights, privileges, or benefits under any Federal program. (b) Collecting social security... regardless of the medium used to collect the information (forms, personal interviews, telephonic interviews... mandatory (See paragraph (e) of this section); and (v) The effects on the individual if he or she chooses...

  3. 32 CFR 310.15 - General considerations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... individual's rights, privileges, or benefits under any Federal program. (b) Collecting social security... regardless of the medium used to collect the information (forms, personal interviews, telephonic interviews... mandatory (See paragraph (e) of this section); and (v) The effects on the individual if he or she chooses...

  4. 32 CFR 310.15 - General considerations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... individual's rights, privileges, or benefits under any Federal program. (b) Collecting social security... regardless of the medium used to collect the information (forms, personal interviews, telephonic interviews... mandatory (See paragraph (e) of this section); and (v) The effects on the individual if he or she chooses...

  5. Experiences of Siblings of Individuals with Autism Spectrum Disorders

    PubMed Central

    Angell, Maureen E.; Meadan, Hedda; Stoner, Julia B.

    2012-01-01

    The purpose of this study was to explore the experiences of siblings of individuals with autism spectrum disorders (ASDs) and identify their self-reported support needs. We conducted in-person semi-structured interviews with 12 siblings aged 7 to 15 of children aged 6 to 15 with ASDs. Employing a qualitative collective case study research method, we conducted cross-case analyses to address our research questions. Three major themes emerged: (a) descriptions of the sibling subsystem (b) cohesion between and among the siblings, and (c) adaptability of the participant siblings to having family members with ASDs. Discussion of these findings and recommendations for future research contributes to the existing literature on siblings of children with disabilities. PMID:22928104

  6. Pragmatism rules: the intervention and prevention strategies used by psychiatric nurses working with non-suicidal self-harming individuals.

    PubMed

    O'Donovan, A

    2007-02-01

    Self harm in the absence of expressed suicidal intent is an under explored area in psychiatric nursing research. This paper reports on findings of a study undertaken in two acute psychiatric inpatient units in Ireland. The purpose of the study was to gain an understanding of the practices of psychiatric nurses in relation to people who self harm, but who are not considered suicidal. Semi structured interviews were held with eight psychiatric nurses. Content analysis revealed several themes. For the purpose of this paper the prevention and intervention strategies psychiatric nurses engage in when working with non-suicidal self harming individuals are presented. Recommendations for further research are offered.

  7. Inter-organizational collaboration in the implementation of evidence-based practices among public agencies serving abused and neglected youth.

    PubMed

    Palinkas, Lawrence A; Fuentes, Dahlia; Finno, Megan; Garcia, Antonio R; Holloway, Ian W; Chamberlain, Patricia

    2014-01-01

    This study examined the role of inter-organizational collaboration in implementing new evidence-based practices for addressing problem behaviors in at-risk youth. Semi-structured interviews were conducted with 38 systems leaders of probation, mental health, and child welfare departments of 12 California counties participating in a large randomized controlled trial to scale-up the use of Multidimensional Treatment Foster Care. Three sets of collaboration characteristics were identified: (1) characteristics of collaboration process, (2) characteristics of the external environment, and (3) characteristics of participating organizations and individuals. Inter-organizational collaboration enables an exchange of information and advice and a pooling of resources individual agencies may require for successful implementation.

  8. A Spatial View of the Interpersonal Structure of Family Interviews: Similarities and Differences Across Counselors.

    ERIC Educational Resources Information Center

    Friedlander, Myrna L.; Highlen, Pamela S.

    1984-01-01

    Examined the interpersonal structures of interviews by Ackerman, Bowen, Jackson, and Whitaker with the same family to identify common features across counselors. Multidimensional scaling provided a spatial representation of the hidden structure in the communication patterns of these interviews. Correlations indicated counselors' interactions were…

  9. A Qualitative Evaluation of the Views of Community Workers on the Dental Health Education Material Available in New South Wales for Culturally and Linguistically Diverse Communities

    ERIC Educational Resources Information Center

    Blinkhorn, Anthony; Gittani, Jamily

    2009-01-01

    Objective: To record the views of individuals whose main professional role is community liaison on dental health education material for culturally and linguistically diverse communities. Methods: Tape-recorded interviews were undertaken, reviewed by two individuals and themes identified. Results: Twenty four individuals were interviewed out of a…

  10. Developing a customized multiple interview for dental school admissions.

    PubMed

    Gardner, Karen M

    2014-04-01

    From the early 1980s until recently, the University of British Columbia Faculty of Dentistry had employed the Canadian Dental Association (CDA) Structured Interview in its Phase 2 admissions process (with those applicants invited for interviews). While this structured interview had demonstrated reliability and validity, the Faculty of Dentistry came to believe that a multiple interview process using scenarios would help it better identify applicants who would match its mission. After a literature review that investigated such interview protocols as unstructured, semi-structured, computerized, and telephone formats, a multiple interview format was chosen. This format was seen as an emerging trend, with evidence that it has been deemed fairer by applicants, more reliable by interviewers, more difficult for applicants to provide set answers for the scenarios, and not to require as many interviewers as other formats. This article describes the process undertaken to implement a customized multiple interview format for admissions and reports these outcomes of the process: a smoothly running multiple interview; effective training protocols for staff, interviewers, and applicants; and reports from successful applicants and interviewers that they felt the multiple interview was a more reliable and fairer recruiting tool than other models.

  11. 76 FR 4700 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    .... Questions vary by respondent type. 5. Post-training semi-structured interview--The purpose of this interview.... Questions vary by respondent type. 6. Post-implementation semi-structured interview--The purpose of this... in this interview. Questions do not vary by respondent type. Estimated Annual Respondent Burden...

  12. Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands.

    PubMed

    Perdok, Hilde; Jans, Suze; Verhoeven, Corine; Henneman, Lidewij; Wiegers, Therese; Mol, Ben Willem; Schellevis, François; de Jonge, Ank

    2016-07-26

    This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Three main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy. An integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of professionals.

  13. Norms and attitudes related to alcohol usage and driving : a review of the relevant literature. Volume 3, Report of individual interviews

    DOT National Transportation Integrated Search

    1982-09-01

    This project provides information about norms and attitudes related to alcohol use and driving. This volume reports the methodology, findings, discussions, and conclusions of individual interviews conducted with early adolescents (ages 13-14), middle...

  14. Assessment of complex dissociative disorder patients and simulated dissociation in forensic contexts.

    PubMed

    Brand, Bethany L; Webermann, Aliya R; Frankel, A Steven

    Few assessors receive training in assessing dissociation and complex dissociative disorders (DDs). Potential differential diagnoses include anxiety, mood, psychotic, substance use, and personality disorders, as well as exaggeration and malingering. Individuals with DDs typically elevate on many clinical and validity scales on psychological tests, yet research indicates that they can be distinguished from DD simulators. Becoming informed about the testing profiles of DD individuals and DD simulators can improve the accuracy of differential diagnoses in forensic settings. In this paper, we first review the testing profiles of individuals with complex DDs and contrast them with DD simulators on assessment measures used in forensic contexts, including the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Personality Assessment Inventory (PAI), and the Structured Inventory of Reported Symptoms (SIRS), as well as dissociation-specific measures such as the Dissociative Experiences Scale (DES) and Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D-R). We then provide recommendations for assessing complex trauma and dissociation through the aforementioned assessments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Contextualising eating problems in individual diet counselling.

    PubMed

    Kristensen, Søren T; Køster, Allan

    2014-05-01

    Health professionals consider diet to be a vital component in managing weight, chronic diseases and the overall promotion of health. This article takes the position that the complexity and contextual nature of individual eating problems needs to be addressed in a more systematic and nuanced way than is usually the case in diet counselling, motivational interviewing and health coaching. We suggest the use of narrative practice as a critical and context-sensitive counselling approach to eating problems. Principles of externalisation and co-researching are combined within a counselling framework that employs logistic, social and discursive eating problems as analytic categories. Using cases from a health clinic situated at the Metropolitan University College in Copenhagen, we show that even if the structural conditions associated with eating problems may not be solvable through individual counselling sessions, exploration of the complex structures of food and eating with the client can provide agency by helping them navigate within the context of the problem. We also exemplify why a reflexive and critical approach to the way health is perceived by clients should be an integrated part of diet counselling.

  16. Wellbeing in the aftermath of floods.

    PubMed

    Walker-Springett, Kate; Butler, Catherine; Adger, W Neil

    2017-01-01

    The interactions between flood events, their aftermath, and recovery leading to health and wellbeing outcomes for individuals are complex, and the pathways and mechanisms through which wellbeing is affected are often hidden and remain under-researched. This study analyses the diverse processes that explain changes in wellbeing for those experiencing flooding. It identifies key pathways to wellbeing outcomes that concern perceptions of lack of agency, dislocation from home, and disrupted futures inducing negative impacts, with offsetting positive effects through community networks and interactions. The mixed method study is based on data from repeated qualitative semi-structured interviews (n=60) and a structured survey (n=1000) with individuals that experienced flooding directly during winter 2013/14 in two UK regions. The results show for the first time the diversity and intersection of pathways to wellbeing outcomes in the aftermath of floods. The findings suggest that enhanced public health planning and interventions could focus on the precise practices and mechanisms that intersect to produce anxiety, stress, and their amelioration at individual and community levels. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Exploratory Analysis of Survey Data for Understanding Adoption of Novel Aerospace Systems

    NASA Astrophysics Data System (ADS)

    Reddy, Lauren M.

    In order to meet the increasing demand for manned and unmanned flight, the air transportation system must constantly evolve. As new technologies or operational procedures are conceived, we must determine their effect on humans in the system. In this research, we introduce a strategy to assess how individuals or organizations would respond to a novel aerospace system. We employ the most appropriate and sophisticated exploratory analysis techniques on the survey data to generate insight and identify significant variables. We employ three different methods for eliciting views from individuals or organizations who are affected by a system: an opinion survey, a stated preference survey, and structured interviews. We conduct an opinion survey of both the general public and stakeholders in the unmanned aircraft industry to assess their knowledge, attitude, and practices regarding unmanned aircraft. We complete a statistical analysis of the multiple-choice questions using multinomial logit and multivariate probit models and conduct qualitative analysis on free-text questions. We next present a stated preference survey of the general public on the use of an unmanned aircraft package delivery service. We complete a statistical analysis of the questions using multinomial logit, ordered probit, linear regression, and negative binomial models. Finally, we discuss structured interviews conducted on stakeholders from ANSPs and airlines operating in the North Atlantic. We describe how these groups may choose to adopt a new technology (space-based ADS-B) or operational procedure (in-trail procedures). We discuss similarities and differences between the stakeholders groups, the benefits and costs of in-trail procedures and space-based ADS-B as reported by the stakeholders, and interdependencies between the groups interviewed. To demonstrate the value of the data we generated, we explore how the findings from the surveys can be used to better characterize uncertainty in the cost-benefit analysis of aerospace systems. We demonstrate how the findings from the opinion and stated preference surveys can be infused into the cost-benefit analysis of an unmanned aircraft delivery system. We also demonstrate how to apply the findings from the interviews to characterize uncertainty in the estimation of the benefits of space-based ADS-B.

  18. Interviewing with or without the partner present?--an underexposed dilemma between ethics and methodology in nursing research.

    PubMed

    Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth

    2016-04-01

    To discuss ethical and methodological challenges related to in-depth interviews with patients and partners when interviewed together or separately. Increased interest in exploring illness phenomena from both patients' and partners' perspectives has emerged. The decision about how to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner on data collection. Discussion paper that draws on data from three phenomenological studies. Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may be caught up in a dilemma between ethical concerns and methodological considerations. We argue that the presence of the partner during an interview session might influence the data and favour expressions of shared rather than individual experiences of the phenomenon studied. Furthermore, we argue that ethical concerns must be given higher priority than methodology when interviewing couples. An increased awareness of the tension between ethical and methodological challenges in joint or individual interviewing with patients and partners is necessary, as this issue is underexposed. © 2015 John Wiley & Sons Ltd.

  19. A community-based qualitative study on the experience and understandings of intimate partner violence and HIV vulnerability from the perspectives of female sex workers and male intimate partners in North Karnataka state, India.

    PubMed

    Blanchard, Andrea K; Nair, Sapna G; Bruce, Sharon G; Ramanaik, Satyanarayana; Thalinja, Raghavendra; Murthy, Srikanta; Javalkar, Prakash; Pillai, Priya; Collumbien, Martine; Heise, Lori; Isac, Shajy; Bhattacharjee, Parinita

    2018-05-11

    Research has increasingly documented the important role that violence by clients and the police play in exacerbating HIV vulnerability for women in sex work. However few studies have examined violence in the intimate relationships of women in sex work, or drawn on community partnerships to explore the social dynamics involved. A community-based participatory research study was undertaken by community and academic partners leading intimate partner violence (IPV) and HIV prevention programs in Bagalkot district, Karnataka state, India. The purpose was to explore the experience and understandings of intimate partner violence and HIV/AIDS among women in sex work and their intimate partners in Bagalkot that would inform both theory and practice. A community-based, interpretive qualitative methodology was used. Data was collected between July and October 2014 through in-depth interviews with 38 participants, including 10 couples, 13 individual female sex workers, and 5 individual male intimate partners. Purposive sampling was done to maximize variation on socio-demographic characteristics. Thematic content analysis was conducted through coding and categorization for each interview question in NVivo 10.0, followed by collaborative analysis to answer the research questions. The results showed that an array of interrelated, multi-level factors underlay the widespread acceptance and perpetuation of violence and lack of condom use in participants' intimate relationships. These included individual expectations that justified violence and reflected societal gender norms, compounded by stigma, legal and economic constraints relating to sex work. The results demonstrate that structural vulnerability to IPV and HIV must be addressed not only on the individual and relationship levels to resolve relevant triggers of violence and lack of condom use, but also the societal-level to address gender norms and socio-economic constraints among women in sex work and their partners. The study contributes to a better understanding on the interplay of individual agency and structural forces at a time when researchers and program planners are increasingly pondering how best to address complex and intersecting social and health issues. Ongoing research should assess the generalizability of the results and the effectiveness of structural interventions aiming to reduce IPV and HIV vulnerability in other contexts.

  20. Factors associated with false positives in MDQ screening for bipolar disorder: Insight into the construct validity of the scale.

    PubMed

    Paterniti, Sabrina; Bisserbe, Jean-Claude

    2018-05-29

    Identifying bipolar patients in the first phases of the illness is essential to establish adequate treatment. The goal of this study was to examine the discriminant ability of the Mood Disorders Questionnaire (MDQ) in recognizing bipolar patients referred to a tertiary care structure. Between 2006 and 2012, we assessed 843 individuals referred to the Mood Disorders Program by family physicians in the community. The Structured Clinical Interview for DSM-IV-TR (SCID) was used to assess diagnoses. A nurse collected the information about lifetime symptoms of (hypo)mania in 759 individuals using the MDQ. Univariate chi-square test and logistic regression were used for the statistical analysis. Overall, 86% of the sample had a current anxiety or depressive disorder. When compared to the diagnoses formulated through the SCID, the sensitivity of the MDQ was 75.0%, the specificity was 74%, the positive predictive value was 55%, and the negative predictive value was 88%. Among non-bipolar patients, current post-traumatic stress disorder, borderline personality disorder, current or early remission substance use disorder, and the history of childhood abuse were independently associated with false positive screening using the MDQ. Individuals with current substance use disorders were under-represented, whether or not the patients were aware of their diagnosis of bipolar disorder was not recorded, and the history of childhood abuse was collected based on an open interview. The self-rated measure of the symptoms listed by the MDQ seems to measure a dimension shared by both bipolar disorder and other conditions characterized by affective instability and impulsivity. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Urban elementary students' views of environmental scientists, environmental caretakers and environmentally responsible behaviors

    NASA Astrophysics Data System (ADS)

    Horne, Patricia Lynne

    The purpose of this research was to determine the nature of the relationship between urban elementary fifth graders, environmental workers, and the environment. The study examined 320 urban fifth grade elementary students' drawings of environmental scientists (DAEST) and environmental caretakers (DAECT). Additionally, semi-structured interviews were included to elucidate student illustrations. The study's sample represented one-third of all fifth graders in the mid-Atlantic school district selected for this research. Approximately 5% of participants were chosen for follow-up semi-structured interviews based on their illustrations. A general conclusion is some of the stereotypes, particularly related to gender, revealed in prior research (Barman, 1999, Chambers, 1983; Huber & Burton, 1995; Schibeci & Sorensen's, 1983; Sumrall, 1995) are evident among many elementary students. Male environmental scientists were drawn twice as often as female environmental scientists. Females were represented in more pictures of environmental caretakers than environmental scientists. Students overwhelmingly drew environmental scientists (98.1%) and environmental caretakers (76.5%) working alone. Wildlife was noticeably absent from most drawings (85%). Where wildlife was included, it was most often birds (6.9%) and fish (3.1%). More than one species was evident in only 2.5% of the pictures. Fifty percent of environmental caretakers were shown picking up trash from land. Actions such as reducing resource use occurred in only 13 out of 319 pictures (4.1%). Pictures of environmental caretakers sharing knowledge were even less common (2.5%). Almost 22% of females drew multiple individuals compared to 18.5% drawn by males. Females were more likely to show individuals collaborating (22.4% to 16.8%) while males were more likely to show individuals working in opposition (5.2% to 2.0%).

  2. ELICITED EXPERT PERCEPTIONS FOR CLIMATE CHANGE RISKS AND ADAPTATION IN AGRICULTURE AND FOOD PRODUCTION THROUGH MENTAL MODELS APPROACH

    NASA Astrophysics Data System (ADS)

    Suda, Eiko; Kubota, Hiromi; Baba, Kenshi; Hijioka, Yasuaki; Takahashi, Kiyoshi; Hanasaki, Naota

    Impacts of climate change have become obvious in agriculture and food production in Japan these days, and researches to adapt to their risks have been conducted as a key effort to cope with the climate change. Numerous scientific findings on climate change impacts have been presented so far; however, prospective risks to be adapted to and their management in the context of individual on-site situations have not been investigated in detail. The structure of climate change risks and their management vary depending on geographical and social features in the regions where the adaptation options should be applied; therefore, a practical adaptation strategy should consider actual on-site situations. This study intended to clarify climate change risks to be adapted to in the Japanese agricultural sector, and factors to be considered in adaptation options, for encouragement of decision-making on adaptation implementation in the field. Semi-structured individual interviews have been conducted with 9 multidisciplinary experts engaging in climate change impacts research in agricultural production, economics, engineering, policy, and so on. Based on the results of the interviews, and the latest literatures available for risk assessment and adaptation, an expert mental model including their perceptions which cover the process from climate change impacts assessment to adaptation has been developed. The prospective risks, adaptation options, and issues to be examined to progress the development of practical and effective adaptation options and to support individual or social decision-making, have been shown on the developed expert mental model. It is the basic information for developing social communication and stakeholders cooperations in climate change adaptation strategies in agriculture and food production in Japan.

  3. Popular or Unpopular? Therapists' Use of Structured Interviews and Their Estimation of Patient Acceptance

    ERIC Educational Resources Information Center

    Bruchmuller, Katrin; Margraf, Jurgen; Suppiger, Andrea; Schneider, Silvia

    2011-01-01

    An accurate diagnosis is an important precondition for effective psychotherapeutic treatment. The use of structured interviews provides the gold standard for reliable diagnosis. Suppiger et al. (2009) showed that structured interviews have a high acceptance among patients. On a scale from 0 ("not at all satisfied") to 100 ("totally…

  4. A hybrid health service accreditation program model incorporating mandated standards and continuous improvement: interview study of multiple stakeholders in Australian health care.

    PubMed

    Greenfield, David; Hinchcliff, Reece; Hogden, Anne; Mumford, Virginia; Debono, Deborah; Pawsey, Marjorie; Westbrook, Johanna; Braithwaite, Jeffrey

    2016-07-01

    The study aim was to investigate the understandings and concerns of stakeholders regarding the evolution of health service accreditation programs in Australia. Stakeholder representatives from programs in the primary, acute and aged care sectors participated in semi-structured interviews. Across 2011-12 there were 47 group and individual interviews involving 258 participants. Interviews lasted, on average, 1 h, and were digitally recorded and transcribed. Transcriptions were analysed using textual referencing software. Four significant issues were considered to have directed the evolution of accreditation programs: altering underlying program philosophies; shifting of program content focus and details; different surveying expectations and experiences and the influence of external contextual factors upon accreditation programs. Three accreditation program models were noted by participants: regulatory compliance; continuous quality improvement and a hybrid model, incorporating elements of these two. Respondents noted the compatibility or incommensurability of the first two models. Participation in a program was reportedly experienced as ranging on a survey continuum from "malicious compliance" to "performance audits" to "quality improvement journeys". Wider contextual factors, in particular, political and community expectations, and associated media reporting, were considered significant influences on the operation and evolution of programs. A hybrid accreditation model was noted to have evolved. The hybrid model promotes minimum standards and continuous quality improvement, through examining the structure and processes of organisations and the outcomes of care. The hybrid model appears to be directing organisational and professional attention to enhance their safety cultures. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Recruitment, Promotion and Retention of Women in Academic Medicine: How Institutions Are Addressing Gender Disparities

    PubMed Central

    Carr, Phyllis L.; Gunn, Christine; Raj, Anita; Kaplan, Samantha; Freund, Karen M.

    2017-01-01

    Objective Greater numbers of women in medicine have not resulted in more women achieving senior positions. Programs supporting recruitment, promotion and retention of women in academic medicine could help to achieve greater advancement of more women to leadership positions. Qualitative research was conducted to understand such programs at 23 institutions and, using the social ecological model, examine how they operate at the individual, interpersonal, institutional, academic community and policy levels. Methods Telephone interviews were conducted with faculty representatives (N=44) of the Group on Women in Medicine and Science (GWIMS), Diversity and Inclusion (GDI) or senior leaders with knowledge on gender climate in 24 medical schools. Four trained interviewers conducted semi-structured interviews that addressed faculty perceptions of gender equity and advancement, which were audio-taped and transcribed. The data were categorized into three content areas: recruitment, promotion and retention, and coded a priori for each area based on their social ecological level of operation. Findings Participants from nearly 40% of the institutions reported no special programs for recruiting, promoting or retaining women, largely describing such programming as unnecessary. Existing programs primarily targeted the individual and interpersonal levels simultaneously, via training, mentoring, and networking, or the institutional level, via search committee trainings, child and elder care, and spousal hiring programs. Lesser effort at the academic community and policy levels were described. Conclusions Our findings demonstrate that many US medical schools have no programs supporting gender equity among medical faculty. Existing programs primarily target the individual or interpersonal level of the social ecological interaction. The academic community and broader policy environment require greater focus as levels with little attention to advancing women’s careers. Universal multi-level efforts are needed to more effectively advance the careers of medical women faculty and support gender equity. PMID:28063849

  6. What helps children to be more active and less sedentary? Perceptions of mothers living in disadvantaged neighbourhoods.

    PubMed

    Veitch, J; Hume, C; Salmon, J; Crawford, D; Ball, K

    2013-01-01

      Increasing children's participation in physical activity and decreasing time spent in sedentary behaviours is of great importance to public health. Despite living in disadvantaged neighbourhoods, some children manage to engage in health-promoting physical activity and avoid high levels of screen-based activities (i.e. watching TV, computer use and playing electronic games). Understanding how these children manage to do well and whether there are unique features of their home or neighbourhood that explain their success is important for informing strategies targeting less active and more sedentary children. The aim of this qualitative study was to gain in-depth insights from mothers regarding their child's resilience to low physical activity and high screen-time.   Semi-structured face-to-face interviews were conducted with 38 mothers of children who lived in disadvantaged neighbourhoods in urban and rural areas of Victoria, Australia. The interviews were designed to gain in-depth insights about perceived individual, social and physical environmental factors influencing resilience to low physical activity and high screen-time.   Themes relating to physical activity that emerged from the interviews included: parental encouragement, support and modelling; sports culture in a rural town; the physical home and neighbourhood environment; child's individual personality; and dog ownership. Themes relating to screen-time behaviours encompassed: parental control; and child's individual preferences.   The results offer important insights into potential avenues for developing 'resilience' and increasing physical activity and reducing screen-time among children living in disadvantaged neighbourhoods. In light of the negative effects of low physical activity and high levels of screen-time on children's health, this evidence is urgently needed. © 2011 Blackwell Publishing Ltd.

  7. Seasonal severity of depressive symptoms as a predictor of health service use in a community-based sample.

    PubMed

    Vigod, Simone N; Levitt, Anthony J

    2011-05-01

    To determine whether severity of seasonal depressive symptoms is an independent predictor of depression-specific health service use. Cross-sectional telephone survey evaluating mood-related symptom changes across seasons using a structured interview based on the World Mental Health Composite International Diagnostic Interview, in a community sample representative of the province of Ontario, Canada (N = 1605). This study focuses on the 625 individuals (out of a total of 1605 interviewed) who screened positive for lifetime depressive symptoms. Severity of seasonal symptoms of depression (or "seasonality") was measured using the Seasonal Depression Severity (SDS) score (range 0-36). The primary outcome was lifetime depression-specific use of health services from a physician (family physician or psychiatrist). Lifetime psychotropic medication use, use of health services from a non-physician therapist, and psychiatric hospitalization were secondary outcomes. Other important variables that are known to predict depression-specific health service use were considered in multivariable analysis. In our sample of individuals with depressive symptoms, those who had used physician health services had higher SDS scores than non-users (11.5 (SD 7.2) vs. 9.7 (SD 6.4), t(616) = 3.182, P = 0.001). In multivariable analysis, SDS score was independently associated with depression-specific health service use by a physician (OR = 1.04, 95% CI 1.01-1.07, p = 0.004). The relationship between seasonality and use of psychotropic medication use was similar (OR = 1.04, 95% CI 1.01-1.07, p = 0.007). Seasonality was independently associated with depression-specific health service use for individuals with depressive symptoms. The results imply that greater seasonality may independently reflect increased severity and need for treatment of depression. Copyright © 2010 Elsevier Ltd. All rights reserved.

  8. Mental models of adherence: parallels in perceptions, values, and expectations in adherence to prescribed home exercise programs and other personal regimens.

    PubMed

    Rizzo, Jon; Bell, Alexandra

    2018-05-09

    A mental model is the collection of an individual's perceptions, values, and expectations about a particular aspect of their life, which strongly influences behaviors. This study explored orthopedic outpatients mental models of adherence to prescribed home exercise programs and how they related to mental models of adherence to other types of personal regimens. The study followed an interpretive description qualitative design. Data were collected via two semi-structured interviews. Interview One focused on participants prior experiences adhering to personal regimens. Interview Two focused on experiences adhering to their current prescribed home exercise program. Data analysis followed a constant comparative method. Findings revealed similarity in perceptions, values, and expectations that informed individuals mental models of adherence to personal regimens and prescribed home exercise programs. Perceived realized results, expected results, perceived social supports, and value of convenience characterized mental models of adherence. Parallels between mental models of adherence for prescribed home exercise and other personal regimens suggest that patients adherence behavior to prescribed routines may be influenced by adherence experiences in other aspects of their lives. By gaining insight into patients adherence experiences, values, and expectations across life domains, clinicians may tailor supports that enhance home exercise adherence. Implications for Rehabilitation A mental model is the collection of an individual's perceptions, values, and expectations about a particular aspect of their life, which is based on prior experiences and strongly influences behaviors. This study demonstrated similarity in orthopedic outpatients mental models of adherence to prescribed home exercise programs and adherence to personal regimens in other aspects of their lives. Physical therapists should inquire about patients non-medical adherence experiences, as strategies patients customarily use to adhere to other activities may inform strategies to promote prescribed home exercise adherence.

  9. Learning at Work: Organisational Affordances and Individual Engagement

    ERIC Educational Resources Information Center

    Bryson, Jane; Pajo, Karl; Ward, Robyn; Mallon, Mary

    2006-01-01

    Purpose: The purpose of this research is to explore the interaction between organisational affordances for the development of individuals' capability, and the engagement of workers at various levels with those opportunities. Design/methodology/approach: A case study of a large New Zealand wine company, using in-depth interviews. Interviews were…

  10. What Are We Educating Towards? Socialization, Acculturization, and Individualization as Reflected in Home Education

    ERIC Educational Resources Information Center

    Neuman, Ari; Guterman, Oz

    2017-01-01

    This article examines the educational objectives of parents who homeschool (or practice home education) in terms of the widely accepted division of primary educational objectives, namely, socialisation, acculturation, and individualization. Using qualitative methodology and in-depth interviews, 30 homeschooling mothers were interviewed about their…

  11. Self-verification in clinical depression: the desire for negative evaluation.

    PubMed

    Giesler, R B; Josephs, R A; Swann, W B

    1996-08-01

    Do clinically depressed individuals seek favorable or unfavorable information about the self? Self-verification theory makes the counterintuitive prediction that depressed individuals solicit feedback that confirms their negative self-views. To test this prediction, participants were classified on the basis of a structured clinical interview and self-report measures into high-esteem, low self-esteem, and depressed groups. All participants were offered a choice between receiving favorable or unfavorable feedback; 82% of the depressed participants chose the unfavorable feedback, compared to 64% of the low self-esteem participants and 25% of the high self-esteem participants. Additional evidence indicated that depressed individuals also failed to exploit fully an opportunity to acquire favorable evaluations that were self-verifying. The authors discuss how seeking negative evaluations and failing to seek favorable evaluations may help maintain depression.

  12. Managing and Creating an Image in the Interview: The Role of Interviewee Initial Impressions

    ERIC Educational Resources Information Center

    Swider, Brian W.; Barrick, Murray R.; Harris, T. Brad; Stoverink, Adam C.

    2011-01-01

    In employment interviews, individuals use impression management tactics to present themselves as suitable candidates to interviewers. However, not all impression management tactics, or the interviewees who employ them, are effective at positively influencing interview scores. Results of this study indicate that the relationship between impression…

  13. Characteristic Interviews, Different Strategies: Methodological Challenges in Qualitative Interviewing among Respondents with Mild Intellectual Disabilities

    ERIC Educational Resources Information Center

    Sigstad, Hanne Marie Høybråten

    2014-01-01

    Conducting qualitative research interviews among individuals with intellectual disabilities, including cognitive limitations and difficulties in communication, presents particular research challenges. One question is whether the difficulties that informants encounter affect interviews to such an extent that the validity of the results is weakened.…

  14. 10 CFR 10.12 - Interview and other investigation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Interview and other investigation. 10.12 Section 10.12... Interview and other investigation. (a) The Director, Division of Facilities and Security, Office of... the information in the possession of the NRC or may authorize an interview with the individual, if the...

  15. 10 CFR 10.12 - Interview and other investigation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Interview and other investigation. 10.12 Section 10.12... Interview and other investigation. (a) The Director, Division of Facilities and Security, Office of... the information in the possession of the NRC or may authorize an interview with the individual, if the...

  16. 'Being a conduit' between hospital and home: stakeholders' views and perceptions of a nurse-led Palliative Care Discharge Facilitator Service in an acute hospital setting.

    PubMed

    Venkatasalu, Munikumar Ramasamy; Clarke, Amanda; Atkinson, Joanne

    2015-06-01

    To explore and critically examine stakeholders' views and perceptions concerning the nurse-led Palliative Care Discharge Service in an acute hospital setting and to inform sustainability, service development and future service configuration. The drive in policy and practice is to enable individuals to achieve their preferred place of care during their last days of life. However, most people in UK die in acute hospital settings against their wishes. To facilitate individuals' preferred place of care, a large acute hospital in northeast England implemented a pilot project to establish a nurse-led Macmillan Palliative Care Discharge Facilitator Service. A pluralistic evaluation design using qualitative methods was used to seek stakeholders' views and perceptions of this service. In total, 12 participants (five bereaved carers and seven health professionals) participated in the evaluation. Semi-structured interviews were conducted with bereaved carers who used this service for their relatives. A focus group and an individual interview were undertaken with health professionals who had used the service since its inception. Individual interviews were also conducted with the Discharge Facilitator and service manager. Analysis of all data was guided by Framework Analysis. Four key themes emerged relating to the role of the Discharge Facilitator Service: achieving preferred place of care; the Discharge Facilitator as the 'conduit' between hospital and community settings; delays in hospital discharge and stakeholders' perceptions of the way forward for the service. The Discharge Facilitator Service acted as a reliable resource and support for facilitating the fast-tracking of end-of-life patients to their preferred place of care. Future planning for hospital-based palliative care discharge facilitating services need to consider incorporating strategies that include: increased profile of the service, expansion of service provision and the Discharge Facilitator's earlier involvement in the discharge process. © 2015 John Wiley & Sons Ltd.

  17. Did you seek assistance for writing your advance directive? A qualitative study.

    PubMed

    Becker, Matthias; Jaspers, Birgit; King, Claudius; Radbruch, Lukas; Voltz, Raymond; Nauck, Friedemann

    2010-11-01

    the completion of an advanced directive is paired with a high degree of self-responsibility of the signatory. It requires anticipation of probably complex medical situations. In the literature, the family physician is often seen as the most important person for advice when writing an advance directive. But little is known about whether or not patients want to involve medical advisors and to what extent physicians are willing to give advice. The aim of this study was to analyse whether or not individuals approached advisors for the completion of their advance directive, whom they chose and which reasons were given for seeking or foregoing assistance. semi-structured interviews with healthy individuals, chronically ill individuals and patients in palliative care including questions associated with advice for completing an advance directive (8/2008-7/2009). age 55-70 years and advance directive ≥ 3 months old. The interviews were fully transcribed according to standard transcription rules and analysed applying an inductive category development. interviews were conducted with 53 probands (healthy n = 20, chronically ill n = 17, palliative care patients n = 16); 18 probands were male. Mean age was 63.2 ± 4.4 years (range 55-70 years). Professional advice was sought by 12 probands (physician = 2, nurse = 1, lawyer/notary = 8, self-employed advisor = 1), another 8 probands included family members. In 17 cases, the physician knew the proband's advance directive, 36 probands never told their doctor about its existence. Categories of reasons for seeking or foregoing advice were trust/lack of trust, autonomy, rejection and financial considerations. information about the medical implications concerning patient preferences for end-of-life care seems not to be the main focus of interest when individuals write an advance directive. Autonomy and trust into notarially certified documents seem to be more important matters. If family physicians want to have a role in their patients' completing of an advance directive, they should proactively get in touch with them.

  18. Cultural adaptation of patient and observational outcome measures: a methodological example using the COMFORT behavioral rating scale.

    PubMed

    Andersen, Randi Dovland; Jylli, Leena; Ambuel, Bruce

    2014-06-01

    There is little empirical evidence regarding the translation and cultural adaptation of self-report and observational outcome measures. Studies that evaluate and further develop existing practices are needed. This study explores the use of cognitive interviews in the translation and cultural adaptation of observational measures, using the COMFORT behavioral scale as an example, and demonstrates a structured approach to the analysis of data from cognitive interviews. The COMFORT behavioral scale is developed for assessment of distress and pain in a pediatric intensive care setting. Qualitative, descriptive methodological study. One general public hospital trust in southern Norway. N=12. Eight nurses, three physicians and one nurse assistant, from different wards and with experience caring for children. We translated the COMFORT behavior scale into Norwegian before conducting individual cognitive interviews. Participants first read and then used the translated version of the COMFORT behavioral scale to assess pain based on a 3-min film vignette depicting an infant in pain/distress. Two cognitive interview techniques were applied: Thinking Aloud (TA) during the assessment and Verbal Probing (VP) afterwards. In TA the participant verbalized his/her thought process while completing the COMFORT behavioral scale. During VP the participant responded to specific questions related to understanding of the measure, information recall and the decision process. We audio recorded, transcribed and analyzed interviews using a structured qualitative method (cross-case analysis based on predefined categories and development of a results matrix). Our analysis revealed two categories of problems: (1) Scale problems, warranting a change in the wording of the scale, including (a) translation errors, (b) content not understood as intended, and (c) differences between the original COMFORT scale and the revised COMFORT behavioral scale; and (2) Rater-context problems caused by (a) unfamiliarity with the scale, (b) lack of knowledge and experience, and (c) assessments based on a film vignette. Cognitive interviews revealed problems with both the translated and the original versions of the scale and suggested solutions that enhanced the validity of both versions. Cognitive interviews might be seen as a complement to current published best practices for translation and cultural adaptation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Development and reliability of a structured interview guide for the Montgomery Asberg Depression Rating Scale (SIGMA).

    PubMed

    Williams, Janet B W; Kobak, Kenneth A

    2008-01-01

    The Montgomery-Asberg Depression Rating Scale (MADRS) is often used in clinical trials to select patients and to assess treatment efficacy. The scale was originally published without suggested questions for clinicians to use in gathering the information necessary to rate the items. Structured and semi-structured interview guides have been found to improve reliability with other scales. To describe the development and test-retest reliability of a structured interview guide for the MADRS (SIGMA). A total of 162 test-retest interviews were conducted by 81 rater pairs. Each patient was interviewed twice, once by each rater conducting an independent interview. The intraclass correlation for total score between raters using the SIGMA was r=0.93, P<0.0001. All ten items had good to excellent interrater reliability. Use of the SIGMA can result in high reliability of MADRS scores in evaluating patients with depression.

  20. The MMPI-2 Restructured Clinical Scales in the Assessment of Posttraumatic Stress Disorder and Comorbid Disorders

    PubMed Central

    Wolf, Erika J.; Miller, Mark W.; Orazem, Robert J.; Weierich, Mariann R.; Castillo, Diane T.; Milford, Jaime; Kaloupek, Danny G.; Keane, Terence M.

    2008-01-01

    This study examined the psychometric properties of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Restructured Clinical Scales (RCSs) in individuals with posttraumatic stress disorder (PTSD) receiving clinical services at Veterans Affairs medical centers. Study 1 included 1,098 men who completed the MMPI-2 and were assessed for a range of psychological disorders via structured clinical interview. Study 2 included 136 women who completed the MMPI-2 and were interviewed with the Clinician Administered Scale for PTSD. The utility of the RCSs was compared to that of the Clinical Scales (CSs) and the Keane PTSD (PK) scale. The RCSs demonstrated good psychometric properties along with patterns of associations with other measures of psychopathology that corresponded to current theory regarding the structure of comorbidity. A notable advantage of the RCSs compared to the MMPI-2 CSs was their enhanced construct validity and clinical utility in the assessment of comorbid internalizing and externalizing psychopathology. The PK scale demonstrated incremental validity in the prediction of PTSD beyond that of the RCSs or CSs. PMID:19086756

  1. Comparison of personality traits in pedophiles, abstinent opiate addicts, and healthy controls: considering pedophilia as an addictive behavior.

    PubMed

    Cohen, Lisa J; Grebchenko, Yuli F; Steinfeld, Matthew; Frenda, Steven J; Galynker, Igor I

    2008-11-01

    To investigate the model of pedophilia as a disorder of addictive behavior, pedophiles and chemically addicted individuals were compared on personality traits potentially associated with impaired behavioral inhibition. Twenty-nine pedophiles, 25 opiate addicts (OA's), and 27 healthy controls were administered the Barratt Impulsivity Scale, Hare Psychopathy Checklist-Revised (PCL-R), and Structured Clinical Interview for DSM-V for Axis-II. OA's scored higher than either pedophiles or controls on the Barratt. Pedophiles and OA's scored higher than controls on all 3 Psychopathy Checklist-Revised scores but OA's scored marginally higher than pedophiles on factor 2 (behavioral) and total scores. On Structured Clinical Interview for DSM-V for Axis-II, pedophiles scored higher than controls on paranoid and schizoid scores whereas OA's did so on paranoid scores. Thus, both pedophiles and OA's may have elevated psychopathic traits and propensity toward cognitive distortions, as reflected in cluster A traits. Such similarities support the conceptualization of pedophilia as a behavioral addiction. Pedophiles may be less impulsive than OA's, however, and more prone toward cognitive distortions.

  2. Nursing professional identity: an infant or one with Alzheimer

    PubMed Central

    Yazdannik, Ahmadreza; Yekta, Zohreh Parsa; Soltani, Aliasghar

    2012-01-01

    Background: Each group or profession has its own discourse. Discourses create identity, support institutions and reproduce power relationships. Professional identity of Iranian nurses, which has recently had the opportunity to represent itself in social arena, needs investigation. This study aimed to make internal aspect of this identity clear. Materials and Methods: This study was conducted by discourse analysis, using data of 23 semi-structured individual interviews and 4 focus group interviews with nurses and senior nursing students of Tehran and Isfahan University of Medical Sciences, Iran, to evaluate their professional identity. Findings: In professional self-concept, elements like spirituality value and low financial benefits were identified as well as conflicting features of holiness and humility, identity emerging, identity escape, low professional self-confidence and justice seeking, lost professional authority and pride. Conclusions: Nursing professional identity has been formed based on cultural social structure, values and beliefs governing health system. This is a spectrum of a growing and emerging identity to a developed but forgotten identity. Although nursing discourse is subordinate in health system discourse, signs of moving toward professional maturity have emerged. PMID:23833602

  3. Nursing professional identity: an infant or one with Alzheimer.

    PubMed

    Yazdannik, Ahmadreza; Yekta, Zohreh Parsa; Soltani, Aliasghar

    2012-02-01

    Each group or profession has its own discourse. Discourses create identity, support institutions and reproduce power relationships. Professional identity of Iranian nurses, which has recently had the opportunity to represent itself in social arena, needs investigation. This study aimed to make internal aspect of this identity clear. This study was conducted by discourse analysis, using data of 23 semi-structured individual interviews and 4 focus group interviews with nurses and senior nursing students of Tehran and Isfahan University of Medical Sciences, Iran, to evaluate their professional identity. In professional self-concept, elements like spirituality value and low financial benefits were identified as well as conflicting features of holiness and humility, identity emerging, identity escape, low professional self-confidence and justice seeking, lost professional authority and pride. Nursing professional identity has been formed based on cultural social structure, values and beliefs governing health system. This is a spectrum of a growing and emerging identity to a developed but forgotten identity. Although nursing discourse is subordinate in health system discourse, signs of moving toward professional maturity have emerged.

  4. Influences on GP coping and resilience: a qualitative study in primary care.

    PubMed

    Cheshire, Anna; Ridge, Damien; Hughes, John; Peters, David; Panagioti, Maria; Simon, Chantal; Lewith, George

    2017-06-01

    'Neoliberal' work policies, austerity, NHS restructuring, and increased GP consultation rates provide the backdrop against increasing reports of GP burnout and an impending shortage of GPs. To explore GPs' experiences of workplace challenges and stresses, and their coping strategies, particularly focusing on understanding the impact of recent NHS workplace change. Study design was qualitative, with data collected from two focus groups and seven one-to-one telephone interviews. Focus groups and one-to-one telephone interviews explored the experiences of GPs currently practising in England, recruited through convenience sampling. Data were collected using a semi-structured interview approach and analysed using thematic analysis. There were 22 GP participants recruited: focus groups ( n = 15) and interviews ( n = 7). Interviewees understood GPs to be under intense and historically unprecedented pressures, which were tied to the contexts in which they work, with important moral implications for 'good' doctoring. Many reported that being a full-time GP was too stressful: work-related stress led to mood changes, sleep disruption, increases in anxiety, and tensions with loved ones. Some had subsequently sought ways to downsize their clinical workload. Workplace change resulted in little time for the things that helped GP resilience: a good work-life balance and better contact with colleagues. Although some GPs were coping better than others, GPs acknowledged that there was only so much an individual GP could do to manage their stress, given the external work issues they faced. GPs experience their emotional lives and stresses as being meaningfully shaped by NHS factors. To support GPs to provide effective care, resilience building should move beyond the individual to include systemic work issues. © British Journal of General Practice 2017.

  5. Physicians' perceptions on the impact of telemedicine on recruitment and retention in underserved areas: a descriptive study in Senegal.

    PubMed

    Ly, Birama Apho; Bourgeault, Ivy Lynn; Labonté, Ronald; Niang, Mbayang Ndiaye

    2017-09-18

    Similar to many places, physicians in Senegal are unevenly distributed. Telemedicine is considered a potential solution to this problem. This study investigated the perceptions of Senegal's physicians of the impact of telemedicine on their recruitment to and retention in underserved areas. We conducted individual interviews with a random sample of 60 physicians in Senegal, including 30 physicians working in public hospitals and 30 physicians working in district health centres between January and June 2014, as part of a mixed methods study. Data were collected using a semi-structured interview guide comprising both open- and close-ended questions. Interviews were recorded, transcribed and coded thematically using NVivo 10 software using a priori and emergent codes. Participants' characteristics were analyzed descriptively using SPSS 23. The impact of telemedicine on physicians' recruitment and retention in underserved areas was perceived with some variability. Among the physicians who were interviewed, most (36) thought that telemedicine could have a positive impact on their recruitment and retention but many (24) believed the opposite. The advantages noted by the first included telemedicine's ability to break their professional isolation and reduce the stress related to this, facilitate their distance learning and improve their working conditions. They did acknowledge that it is not sufficient in itself, an opinion also shared by physicians who did not believe that telemedicine could affect their recruitment and retention. Both identified contextual, economic, educational, family, individual, organizational and professional factors as influential. Based on these opinions of physicians, telemedicine promotion is one intervention that, alongside others, could be promoted to assist in addressing the multiple factors that influence physicians' recruitment and retention in underserved areas.

  6. Experiences of fear of falling in persons with Parkinson's disease - a qualitative study.

    PubMed

    Jonasson, Stina B; Nilsson, Maria H; Lexell, Jan; Carlsson, Gunilla

    2018-02-06

    Fear of falling is common among persons with Parkinson's disease and is negatively associated with quality of life. However a lack of in-depth understanding of fear of falling as a phenomenon persists. This qualitative study aimed to explore the experiences of fear of falling in persons with Parkinson's disease. Individual interviews were performed with twelve persons with Parkinson's disease (median age 70 years, median Parkinson duration 9 years, 50% women). The interviews were semi-structured and followed a study-specific interview guide. The transcribed interviews were analyzed using qualitative content analysis. Fear of falling was experienced as a disturbing factor in everyday life. It generated a feeling of vulnerability and made daily activities and everyday environments seem potentially hazardous. Persons also missed performing previous activities. The fear of falling was a varying experience, fueled by an awareness of falls and near falls, Parkinson-related symptoms and disabilities, and by others in their environment. The persons adopted different strategies to handle their fear of falling. Activities were adapted, avoided, performed with help, or carried out despite their fear of falling. The experiences of fear of falling were complex, multifaceted and varied over time and in relation to different activities and environments. This indicates that interventions targeting fear of falling need to be individually tailored for persons with Parkinson's disease and should focus on several aspects, such as Parkinson-related symptoms and disabilities, activities and environmental factors. This study provides new information that increases the understanding of fear of falling, which has implications for researchers as well as clinicians working with persons with Parkinson's disease and fear of falling.

  7. Quality care provision for older people: an interview study with patients and primary healthcare professionals

    PubMed Central

    van de Pol, Marjolein Helena Johanna; Fluit, Cornelia Rita Maria Gertruda; Lagro, Joep; Niessen, Danielle; Rikkert, Marcellinus Gerardus Maria Olde; Lagro-Janssen, Antoinette Leonarda Maria

    2015-01-01

    Background In recent years, primary health care for the ageing population has become increasingly complex. Aim This study sought to explore the views and needs of healthcare professionals and older patients relating to primary care in order to identify focal areas for improving primary health care for older people. Design and setting This research was structured as a mixed interview study with focus groups and individual interviews. Participants were made up of primary healthcare professionals and older patients. Patients were recruited from five elderly care homes in a small city in the southern part of the Netherlands. Method All interviews were transcribed verbatim and analysed by two individual researchers applying constant comparative analysis. Data collection proceeded until saturation was reached. Results Participants in the study agreed about the need for primary care for older patients, and showed sympathy with one another’s perspectives. They did note, however, a number of obstacles hindering good healthcare provision. The major themes that arose were: ‘autonomy and independence’, ‘organisational barriers’, and ‘professional expertise’. Participants generally noted that it is important to clarify differences in perspectives about good care between patients and healthcare professionals. Conclusion Effective primary care intervention for older patients requires mutual understanding of the expectations and goals of all parties involved. There are a number of important requirements, especially accessible patient information in the form of care plans; specialist training for nurses and GPs on complex care and multimorbidity; and training on discussing autonomy, goal setting, and shared care. Further improvement in health care for older people and its evaluation research should focus on these requirements. PMID:26212845

  8. Influences on GP coping and resilience: a qualitative study in primary care

    PubMed Central

    Cheshire, Anna; Ridge, Damien; Hughes, John; Peters, David; Panagioti, Maria; Simon, Chantal; Lewith, George

    2017-01-01

    Background ‘Neoliberal’ work policies, austerity, NHS restructuring, and increased GP consultation rates provide the backdrop against increasing reports of GP burnout and an impending shortage of GPs. Aim To explore GPs’ experiences of workplace challenges and stresses, and their coping strategies, particularly focusing on understanding the impact of recent NHS workplace change. Design and setting Study design was qualitative, with data collected from two focus groups and seven one-to-one telephone interviews. Method Focus groups and one-to-one telephone interviews explored the experiences of GPs currently practising in England, recruited through convenience sampling. Data were collected using a semi-structured interview approach and analysed using thematic analysis. Results There were 22 GP participants recruited: focus groups (n = 15) and interviews (n = 7). Interviewees understood GPs to be under intense and historically unprecedented pressures, which were tied to the contexts in which they work, with important moral implications for ‘good’ doctoring. Many reported that being a full-time GP was too stressful: work-related stress led to mood changes, sleep disruption, increases in anxiety, and tensions with loved ones. Some had subsequently sought ways to downsize their clinical workload. Workplace change resulted in little time for the things that helped GP resilience: a good work–life balance and better contact with colleagues. Although some GPs were coping better than others, GPs acknowledged that there was only so much an individual GP could do to manage their stress, given the external work issues they faced. Conclusion GPs experience their emotional lives and stresses as being meaningfully shaped by NHS factors. To support GPs to provide effective care, resilience building should move beyond the individual to include systemic work issues. PMID:28483822

  9. Peanut allergy as a family project: social relations and transitions in adolescence.

    PubMed

    Stensgaard, Anette; Bindslev-Jensen, Carsten; Nielsen, Dorthe

    2017-11-01

    To explore and better understand the impact that peanut allergy can have on family experiences in everyday life through interviews with individual family members. Peanut allergy affects adolescents' quality of life through the need to avoid eating peanut-containing food and the risk of anaphylaxis. Adolescence is a period of increasing separation from parents and has the highest risk of food fatalities. A qualitative interview study taking a phenomenological-hermeneutical approach. Data were generated through semi-structured individual interviews with the adolescent with peanut allergy, and both parents and a sibling. Five families were interviewed, with 20 participants in total. The theoretical foundation was the family as an interactive system, and data were analysed with Ricoeur's theory of interpretation. The consequences of peanut allergy appeared to affect all family members and required knowledge and understanding, especially in the social network. Siblings took responsibility and had concerns for the well-being of the adolescent with allergy, while parents expressed difficulties with their child's transition to independence and their subsequent loss of control. Social relations with new family members or friends were challenged by lack of knowledge about the potential seriousness of peanut allergy. Risk and uncertainty were permanent companions for the adolescents with peanut allergy and their families. It takes time to acquire the necessary understanding about peanut allergy and the risk of anaphylaxis. The adolescent's social network also needs this knowledge during the transition to independent living. In the management of peanut allergy in adolescence, it is important to consider not only the smaller biological family unit (mothers, fathers and siblings) but to also take a wider perspective to include others such as stepfamily and friends. © 2016 John Wiley & Sons Ltd.

  10. The participant's perspective: learning from an aggression management training course for nurses. Insights from a qualitative interview study.

    PubMed

    Heckemann, Birgit; Breimaier, Helga Elisabeth; Halfens, Ruud J G; Schols, Jos M G A; Hahn, Sabine

    2016-09-01

    Aggression management training for nurses is an important part of a comprehensive strategy to reduce patient and visitor aggression in healthcare. Although training is commonplace, few scientific studies examine its benefits. To explore and describe, from a nurse's perspective, the learning gained from attending aggression management training. This was a descriptive qualitative interview study. We conducted semi-structured individual interviews with seven nurses before (September/October 2012) and after they attended aggression management training (January/February 2013). Interview transcripts were content-analysed qualitatively. The study plan was reviewed by the responsible ethics committees. Participants gave written informed consent. Aggression management training did not change nurses' attitude. Coping emotionally with the management of patient and visitor aggression remained a challenge. Nurses' theoretical knowledge increased, but they did not necessarily acquire new strategies for managing patient/visitor aggression. Instead, the course refreshed or activated existing knowledge of prevention, intervention and de-escalation strategies. The training increased nurses' environmental and situational awareness for early signs of patient and visitor. They also acquired some strategies for emotional self-management. Nurses became more confident in dealing with (potentially) aggressive situations. While the training influenced nurses' individual clinical practice, learning was rarely shared within teams. Aggression management training increases skills, knowledge and confidence in dealing with patient or visitor aggression, but the emotional management remains a challenge. Future research should investigate how aggression management training courses can strengthen nurses' ability to emotionally cope with patient and visitor aggression. More knowledge is needed on how the theoretical and practical knowledge gained from the training may be disseminated more effectively within teams and thus contributed to the creation of low-conflict ward cultures. © 2016 Nordic College of Caring Science.

  11. Communicating with Clinicians: The Experiences of Surrogate Decision Makers for Hospitalized Older Adults

    PubMed Central

    Torke, Alexia M.; Petronio, Sandra; Purnell, Christianna E.; Sachs, Greg A.; Helft, Paul R.; Callahan, Christopher M.

    2012-01-01

    Background/Objectives When hospitalized older adults have impaired cognition, family members or other surrogates must communicate with clinicians to provide information and make medical decisions for the patient. The present study describes communication experiences of surrogates who recently made a major medical decision for a hospitalized older adult. Design Semi-structured interviews about a recent hospitalization. Setting Two hospitals both affiliated with 1 large medical school: an urban, public hospital; and a university-affiliated tertiary referral hospital. Participants Surrogates were eligible if they had recently made a major medical decision for a hospitalized patient aged 65 or older and were available for an interview within 1 month (2-5 months if the patient died). Measurements Interviews were audio-recorded, transcribed, and analyzed using methods of grounded theory. Results We interviewed 35 surrogates. They were 80% female, 44% white and 56% African American. Three primary themes emerged. We found the Nature of Surrogate/Clinician Relationships was best characterized as a relationship with a “team” of clinicians rather than individual clinicians due to frequent staff changes and multiple clinicians. Surrogates reported their Communication Needs, including frequent communication, information, and emotional support. Surrogates valued communication from any member of the clinical team, including nurses, social workers, and physicians. Third, surrogates described Trust and Mistrust, which were formed largely through surrogates’ communication experiences. Conclusion In the hospital, surrogates form relationships with a “team” of clinicians rather than with individuals. Yet effective communication and expressions of emotional support frequently occur and are highly valued by surrogates. Future interventions should focus on meeting surrogates’ needs for frequent communication, high levels of information and emotional support. PMID:22881864

  12. Qualitative Evaluation of Pediatric Pain Behavior, Quality, and Intensity Item Candidates and the PROMIS Pain Domain Framework in Children With Chronic Pain.

    PubMed

    Jacobson, C Jeffrey; Kashikar-Zuck, Susmita; Farrell, Jennifer; Barnett, Kimberly; Goldschneider, Ken; Dampier, Carlton; Cunningham, Natoshia; Crosby, Lori; DeWitt, Esi Morgan

    2015-12-01

    As initial steps in a broader effort to develop and test pediatric pain behavior and pain quality item banks for the Patient-Reported Outcomes Measurement Information System (PROMIS), we used qualitative interview and item review methods to 1) evaluate the overall conceptual scope and content validity of the PROMIS pain domain framework among children with chronic/recurrent pain conditions, and 2) develop item candidates for further psychometric testing. To elicit the experiential and conceptual scope of pain outcomes across a variety of pediatric recurrent/chronic pain conditions, we conducted 32 semi-structured individual and 2 focus-group interviews with children and adolescents (8-17 years), and 32 individual and 2 focus-group interviews with parents of children with pain. Interviews with pain experts (10) explored the operational limits of pain measurement in children. For item bank development, we identified existing items from measures in the literature, grouped them by concept, removed redundancies, and modified the remaining items to match PROMIS formatting. New items were written as needed and cognitive debriefing was completed with the children and their parents, resulting in 98 pain behavior (47 self, 51 proxy), 54 quality, and 4 intensity items for further testing. Qualitative content analyses suggest that reportable pain outcomes that matter to children with pain are captured within and consistent with the pain domain framework in PROMIS. PROMIS pediatric pain behavior, quality, and intensity items were developed based on a theoretical framework of pain that was evaluated by multiple stakeholders in the measurement of pediatric pain, including researchers, clinicians, and children with pain and their parents, and the appropriateness of the framework was verified. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  13. Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

    PubMed

    Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

    2016-03-22

    Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of optimal care, implementation of effective systemic approaches should be considered.

  14. Measuring Professional Behaviour in Canadian Physical Therapy Students' Objective Structured Clinical Examinations: An Environmental Scan

    PubMed Central

    Ellerton, Cindy; Evans, Cathy

    2015-01-01

    ABSTRACT Purpose: To identify professional behaviours measured in objective structured clinical examinations (OSCEs) by Canadian university physical therapy (PT) programs. Method: A cross-sectional telephone survey was conducted to review current practice and determine which OSCE items Canadian PT programs are using to measure PT students' professional behaviours. Telephone interviews using semi-structured questions were conducted with individual instructors responsible for courses that included an OSCE as part of the assessment component. Results: Nine PT programmes agreed to take part in the study, and all reported conducting at least one OSCE. The number and characteristics of OSCEs varied both within and across programs. Participants identified 31 professional behaviour items for use in an OSCE; these items clustered into four categories: communication (n=14), respect (n=10), patient safety (n=4), and physical therapists' characteristics (n=3). Conclusions: All Canadian entry-level PT programmes surveyed assess professional behaviours in OSCE-type examinations; however, the content and style of assessment is variable. The local environment should be considered when determining what professional behaviours are appropriate to assess in the OSCE context in individual programmes. PMID:25931656

  15. Enhancing stakeholder participation in land-based adaptation to environmental change with photo elicitation and photovoice

    NASA Astrophysics Data System (ADS)

    Orr, Barron; Kong, Taryn; Kellner, Klaus

    2015-04-01

    Land degradation is one of the main environmental changes confronting South Africa. Active participation from local land users to adopt land-based adaptation to land degradation is necessary for at least two obvious reasons. Firstly, most of the lands in South Africa are privately owned. Secondly, the costs for adapting to land degradation are substantial and are not feasible for an individual entity to afford. Land-based adaptation includes management practices that can reduce the vulnerability of land users to the threats posed by land degradation. To engage land users to participate in land-based adaptation, approaches to allow diverse stakeholders to effectively communicate their observations, knowledge and perspectives are needed. In addition to semi-structured interviews, photo elicitation and photovoice were implemented to engage 25 local livestock farmers from two rural areas in the South African Kalahari - Mier and Molopo - in a participatory research project. The results showed that photo elicitation enhanced stakeholder interaction relative to semi-structured interviews in a number of ways. Firstly, photo elicitation provided more details and new information beyond those in semi-structured interviews. Secondly, photo elicitation also allowed stakeholders to more easily communicate personal or concrete examples, comparisons, contrasts, explanatory information, attitudes and values. The results also showed that photovoice created opportunities for mutual learning among the participants. These enhancements have the potential to improve co-production of knowledge and quality of stakeholder engagement. Improvement in stakeholder engagement can in turn contribute toward land-based adaptation that is more locally relevant and a greater degree of translation of scientific advancement into actual adaptation practices.

  16. Perceptions of intersectional stigma among diverse women living with HIV in the United States.

    PubMed

    Rice, Whitney S; Logie, Carmen H; Napoles, Tessa M; Walcott, Melonie; Batchelder, Abigail W; Kempf, Mirjam-Colette; Wingood, Gina M; Konkle-Parker, Deborah J; Turan, Bulent; Wilson, Tracey E; Johnson, Mallory O; Weiser, Sheri D; Turan, Janet M

    2018-05-04

    Attitudes and behavior that devalue individuals based upon their HIV status (HIV-related stigma) are barriers to HIV prevention, treatment, and wellbeing among women living with HIV. Other coexisting forms of stigma (e.g., racism, sexism) may worsen the effects of HIV-related stigma, and may contribute to persistent racial and gendered disparities in HIV prevention and treatment. Few studies examine perceptions of intersectional stigma among women living with HIV. From June to December 2015, we conducted 76 qualitative interviews with diverse women living with HIV from varied socioeconomic backgrounds enrolled in the Women's Interagency HIV Study (WIHS) in Birmingham, Alabama; Jackson, Mississippi; Atlanta, Georgia; and San Francisco, California. Interview guides facilitated discussions around stigma and discrimination involving multiple interrelated identities. Interviews were audio-recorded, transcribed verbatim, and coded using thematic analysis. Interviewees shared perceptions of various forms of stigma and discrimination, most commonly related to their gender, race, and income level, but also incarceration histories and weight. Women perceived these interrelated forms of social marginalization as coming from multiple sources: their communities, interpersonal interactions, and within systems and structures. Our findings highlight the complexity of social processes of marginalization, which profoundly shape life experiences, opportunities, and healthcare access and uptake among women living with HIV. This study highlights the need for public health strategies to consider community, interpersonal, and structural dimensions across intersecting, interdependent identities to promote the wellbeing among women living with HIV and to reduce social structural and health disparities. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. A Study of the Structure and Content of Principal Selection Interviews in Pennsylvania

    ERIC Educational Resources Information Center

    Weber, Elizabeth A.

    2012-01-01

    The principal plays a key role in student success. The employment interview is a critical element in the principal selection process. This study examined the interview structure and the content of the interview questions that districts used in their principal search for the 2011-2012 school year. The research-based practices for interview…

  18. 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.

  19. Case Study: Students’ Symbolic Manipulation in Calculus Among UTHM Students

    NASA Astrophysics Data System (ADS)

    Ali, Maselan; Sufahani, Suliadi; Ahmad, Wan N. A. W.; Ghazali Kamardan, M.; Saifullah Rusiman, Mohd; Che-Him, Norziha

    2018-04-01

    Words are symbols representing certain aspects of mathematics. The main purpose of this study is to gain insight into students’ symbolic manipulation in calculus among UTHM students. This study make use the various methods in collecting data which are documentation, pilot study, written test and follow up individual interviews. Hence, the results analyzed and interpreted based on action-process-object-schema framework which is based on Piaget’s ideas of reflective abstraction, the concept of relational and instrumental understanding and the zone of proximal development idea. The students’ reply in the interview session is analyzed and then the overall performance is discussed briefly to relate with the students flexibility in symbolic manipulation in linking to the graphical idea, the students interpretation towards different symbolic structure in calculus and the problem that related to overgeneralization in their calculus problems solving.

  20. What characteristics do service users with intellectual disability value in direct support staff within residential forensic services?

    PubMed

    Clarkson, Rachael; Murphy, Glynis H; Coldwell, Jon B; Dawson, David L

    2009-12-01

    This study explores the perceptions of a group of adults with intellectual disability regarding direct support staff. Semi-structured interviews relating to experiences of direct support staff were developed from two focus groups. These interviews were conducted with 11 adults with intellectual disability residing within a forensic inpatient service. Interpretative Phenomenological Analysis (IPA) revealed two superordinate themes; namely, staff relationship factors and positive and negative attributes of staff. The participants valued relationships with staff based on qualities such as honesty, trust, and a caring, nurturing manner that enabled individuals to feel safe. Staff characteristics such as immaturity, inexperience, and a short temper appeared to lead to feelings of discontentment amongst the participants. The implications of the findings are discussed in relation to clinical practice, staff recruitment, and training.

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